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Research Topic : PRETERM LABOUR
Scheme : NHMRC Project Grants
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  • Funded Activity

    Molecular Mechanisms Regulating Spontaneous Onset Of Human Labour

    Funder
    National Health and Medical Research Council
    Funding Amount
    $481,156.00
    Summary
    The single most important complication contributing to poor pregnancy and neonatal outcome is premature birth. If we are to provide the best possible start to life, improve perinatal health and reduce the risk of developing adult disease . A better understanding of labour is requisite to improving health care delivery during pregnancy and outcomes for both mother and baby. This reserach project will investigate the how labour-associated events are reguluated by nuclear proteins.
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    Funded Activity

    Estrogen Receptors And The Onset Of Labour

    Funder
    National Health and Medical Research Council
    Funding Amount
    $336,922.00
    Summary
    This project will test if the ratio of the two different estrogens found in the blood of pregnant women is the critical factor in determining the onset of contractions in the uterus at labour. The studies will also determine the role of a newly discovered receptor for estrogens in allowing powerful contractions at labour. Results will allow development of new treatments to prevent premature birth that block the actions of estrogen at this new receptor or change the ratio of the two estrogens.
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    Funded Activity

    Regulation Of Progesterone Action In Human Parturition.

    Funder
    National Health and Medical Research Council
    Funding Amount
    $314,983.00
    Summary
    Premature birth is the leading cause of neonatal death and sickness, and numbers are increasing due to our ignorance of the biology of labour. Progesterone maintains pregnancy and its withdrawal results in birth, but how this is achieved in humans is unknown. This project will determine the molecular mechanisms by which progesterone action is regulated during the transition from pregnancy to birth. This data will guide new strategies to prevent premature birth.
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    Funded Activity

    The Mechanisms That Regulate The Onset Of Human Labour And Delivery

    Funder
    National Health and Medical Research Council
    Funding Amount
    $528,170.00
    Summary
    Reproductive biologists still cannot explain the molecular mechanisms that govern human birth. This lack of knowledge prevents the development of better moitoring and treament of complications of labour and delivery. If we are to provide the best possible start to life and improve newborn health care delivery then we must: (1) better understand what triggers labour; (2) determine whether there are biomarkers that we can use to identify women at risk of early birth; and (3) identify new ways to d .... Reproductive biologists still cannot explain the molecular mechanisms that govern human birth. This lack of knowledge prevents the development of better moitoring and treament of complications of labour and delivery. If we are to provide the best possible start to life and improve newborn health care delivery then we must: (1) better understand what triggers labour; (2) determine whether there are biomarkers that we can use to identify women at risk of early birth; and (3) identify new ways to delay birth. This is the overall objective of this research project. In particular, this project focuses on how the multiple events needed to achieve a successful outcome to pregnancy are coordinated at the time of birth.
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    Funded Activity

    A Randomised Trial Of Reduced Antenatal Exercise To Inc Rease Birthweight

    Funder
    National Health and Medical Research Council
    Funding Amount
    $83,818.00
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    Funded Activity

    Heat Shock Proteins In Myometrium

    Funder
    National Health and Medical Research Council
    Funding Amount
    $454,691.00
    Summary
    Premature birth is a major cause of neonatal death and intellectual and other handicaps among the survivors. While neonatal intensive care has improved the survival of premature babies, there has been no reduction in the number of premature babies born, in fact the numbers are increasing. Our inability to reduce premature birth is partly related to our lack of knowledge of the physiological processes that lead to normal labour. As a result many of our drugs for women in premature labour are not .... Premature birth is a major cause of neonatal death and intellectual and other handicaps among the survivors. While neonatal intensive care has improved the survival of premature babies, there has been no reduction in the number of premature babies born, in fact the numbers are increasing. Our inability to reduce premature birth is partly related to our lack of knowledge of the physiological processes that lead to normal labour. As a result many of our drugs for women in premature labour are not very effective. We have recently identified a novel pathway that regulates the activity of the muscle cells that form the uterus. This project seeks to understand the biochemical processes that change a muscle cell so that it begins to contract actively at the end of pregnancy. Specifically the project will examine two proteins called HSP20 and HSP27. These proteins have recently been reported to play a critical role in the contraction and relaxation of smooth muscle cells in the heart and blood vessels. We have identified for the first time that these proteins are also present in the muscle of the human uterus. It is likely that they play a critical role in regulating the contractions of the uterus. By understanding this process better we may be able to design better treatments to prevent premature birth.
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    Funded Activity

    CRH Receptors In Myometrium

    Funder
    National Health and Medical Research Council
    Funding Amount
    $459,791.00
    Summary
    Premature birth is a major cause of neonatal death and intellectual and other handicaps among the survivors. While neonatal intensive care has improved the survival of premature babies, there has been no reduction in the number of premature babies born, in fact the numbers are increasing. Our inability to reduce premature birth is partly related to our lack of knowledge of the physiological processes that lead to normal labour. As a result many of our drugs for women in premature labour are not .... Premature birth is a major cause of neonatal death and intellectual and other handicaps among the survivors. While neonatal intensive care has improved the survival of premature babies, there has been no reduction in the number of premature babies born, in fact the numbers are increasing. Our inability to reduce premature birth is partly related to our lack of knowledge of the physiological processes that lead to normal labour. As a result many of our drugs for women in premature labour are not very effective. Our work has shown that a hormone called corticotrophin releasing hormone (CRH) made in the placenta plays a critical role in determining the length of a pregnancy. We have measured the levels of this hormone in the blood of pregnant women and shown that it increases more rapidly than normal in women who deliver prematurely and more slowly than normal in women who deliver late. It acts as a kind of clock to determine the length of pregnancy. What is not known is how this hormone acts to bring on labour. What is particularly puzzling is that some of the actions of the CRH seem likely to cause the uterus to relax rather than to contract. We wish to test the idea that the rapidly rising levels of this hormone in late pregnancy cause changes in the uterus that stop the pathways to relaxation and lead to contraction. To perform these studies we will use small pieces of uterus donated with informed consent from women undergoing caesarean section. The results of these studies may allow us to design better ways of preventing premature birth and prevent many cases of cerebral palsy and intellectual handicap.
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    Funded Activity

    Clinical Effectiveness Of Transdermal Nitrates For The Treatment Of Preterm Labour.

    Funder
    National Health and Medical Research Council
    Funding Amount
    $202,711.00
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    Funded Activity

    Rhythmicity And Synchronicity In Uterine Smooth Muscle

    Funder
    National Health and Medical Research Council
    Funding Amount
    $291,823.00
    Summary
    Natural birth occurs through rhythmic contractions of the smooth muscle of the uterus. There is surprisingly little understanding of the mechanism of the pacemaker clock that both initiates and times each contraction in a coordinated manner to expel the fetus. This project is to challenge this knowledge gap using our findings on cellular rhythms that herald Ca2+ stores as a major pacemaker mechanism. First, we will use electrophysiology and calcium imaging techniques to test the hypothesis that .... Natural birth occurs through rhythmic contractions of the smooth muscle of the uterus. There is surprisingly little understanding of the mechanism of the pacemaker clock that both initiates and times each contraction in a coordinated manner to expel the fetus. This project is to challenge this knowledge gap using our findings on cellular rhythms that herald Ca2+ stores as a major pacemaker mechanism. First, we will use electrophysiology and calcium imaging techniques to test the hypothesis that rhythmicity and synchronicity of uterine contractions are underpinned by store pacemaking. Second, we will probe the role of current spread between cells via gap junctions as a mechanism of recruitment and will examine whether accessory cells termed interstitial cells subserve a role in pacemaking. These cells are present within the uterine wall but their function is unknown. We will probe their ion channel properties in relation to pacemaking using patch clamp techniques. Third, we will examine the role of labour hormones, such as oxytocin, in augmenting uterine contractions via interaction with the Ca2+ store mechanism and cell recruitment. These studies will provide new and fundamental insights into uterine pacemaking, an outcome that should be of great significance to understanding and better controlling birth-associated complications such as preterm delivery and failure to progress.
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    Funded Activity

    The Role And Regulation Of Phospholipase Isozymes In The Initiation Of Human Labour

    Funder
    National Health and Medical Research Council
    Funding Amount
    $462,589.00
    Summary
    Being born too early is the most significant problem facing contemporary clinical obstetrics in the developed world. Preterm birth is the major cause of ill-health and death in newborns, accounting for 85% of all early infant deaths, not secondary to genetic abnormality. In Australia in 1998, more than 17,000 babies were born too early, of these over 10,000 suffered respiratory complications and 1300 died during the first 21 days of life. Even though the likelihood of a premature baby surviving .... Being born too early is the most significant problem facing contemporary clinical obstetrics in the developed world. Preterm birth is the major cause of ill-health and death in newborns, accounting for 85% of all early infant deaths, not secondary to genetic abnormality. In Australia in 1998, more than 17,000 babies were born too early, of these over 10,000 suffered respiratory complications and 1300 died during the first 21 days of life. Even though the likelihood of a premature baby surviving doubles for every two weeks that birth is delayed (between 23 and 28 weeks of gestation), currently there is no treatment available that reliably delays or prevents premature birth. In order to develop clinically useful treatments and improve pregnancy outcome and the well-being of our newborn, it is essential to understand the mechanisms that start the process of labour and delivery. Thus, the overall aim of this project is to increase our understanding of how human labour is initiated and to identify processes that may be manipulated to delay premature birth. In particular, this project focuses on the role and regulation, of what we believe is, a central and common pathway involved in triggering the birth process. This pathway is a known regulator of inflammatory process in the body. Intriguingly, the process of birth displays many of the hallmarks of an inflammatory reaction. Our pilot studies suggest that this pathway is involved in activation many of the events that occur at the time of birth and that further investigation of its role will provide valuable insights in to what triggers human birth. The specific aims of this project are (i) to develop a better understanding of the mechanisms that initiate human labour and (ii) to identify more effectively ways of prevent preterm birth.
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