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44 Robert WoodJohnson
RH is found both in the brain and in the placenta.
It is released by the brain in response to stress. In
the placenta, it is increasingly produced through-
out gestation. When a pregnancy reaches full term, between
37 and 41 weeks, stress hormones known as glucocorti-
coids initiate a reconfiguration through the signaling path-
way, causing a surge of CRH in the placenta and triggering
As Dr. Rosen explains, stress induces change, and during
pregnancy there are three potential targets for stress: the
mother, the fetus, and the placenta. The body is designed to
keep the mother and fetus safe. When it recognizes that the
fetus is too big to support, it places stress on the placenta
and begins the process of birth.
The same process can also occur in preterm labor.
However, the question remains, why does the process
switch on before the fetus is full term?
Further research into the signaling pathway by the team
determined that blocking any step in the process prevents
the surge in CRH. Although there are no known chemical
inhibitors for the signaling pathway, the team screened
approximately 1,300 candidate drugs and determined that
eight have the potential to halt the process of labor if it
occurs too early.
"Using these potential drug inhibitors, we have experi-
ments planned to attack the pathways we have identified that
could lead to better cures for preterm labor," Dr. Wang says.
Motivated by his medical background, Dr. Wang is com-
mitted to finding the therapeutic treatment for this unique
disorder--unique in that only women who are pregnant are
at risk.
"We are actually no better at preventing preterm birth
now than we were 25 years ago, which is what makes this
research so important; it is a significant, national public
health issue," Dr. Wang explains.
Preterm labor's impact is more than evident, as reported
by the U.S. Centers for Disease Control and Prevention: it
affects more than 11 percent of women in the United States,
meaning that one in every nine newborns is affected. About
35 percent of infant deaths can be attributed to complica-
tions of preterm labor. One in 50 pregnancies experience
preterm labor before 32 weeks, one in 200 pregnancies
before 28 weeks of gestation. Women of African descent
are twice as likely to deliver early as women from other eth-
nic backgrounds.
Unlike heart disease or cancer, research into causes of
preterm labor is limited. So is available funding.
In addition to submitting grants for financial support,
the team has opened a Benefunder website, hoping to gain
private support for the work. Benefunder is a new tool that
connects investigators with philanthropists who care about
their cause, offering additional financial support that can-
not be garnered through traditional channels.
"With this breakthrough, we are prepared to move forward
with new research that we hope will lead to clinical trials of
drug therapies," says Dr. Rosen. "With funding from private
donors, we can broaden our study and look at other genes
within the placenta that we believe affect the process of labor.
"Preterm labor has a substantial impact on families
before and after the birth of a child born premature,"
explains Dr. Rosen. "One of my mentors told me that if I
was going into maternal-fetal medicine and conducting
research, then I had better do something important. To me,
there is nothing more important than ending the preterm
delivery epidemic in this country."
otivated by his medical background,
Dr.Wang is committed to finding the
therapeutic treatment for preterm labor.