A Precision Medicine approach to study pre-term birth

In the United States, roughly 12% of babies are born prior to 37 weeks of gestation. This preterm birth is a major health concern, as infants born prematurely have elevated risks of neonatal mortality and a wide array of health problems. Healthy pregnancy involves multiple tolerance mechanisms that prevent the maternal and fetal immune systems from recognizing and rejecting each other. Immunity and inflammation has been shown to play an important role in adverse pregnancy outcomes, including preterm birth.

UCSF Faculty members Tippi MacKenzie, MD (Pediatric Surgery) and Marina Sirota, PhD (Pediatrics, ICHS) are teaming up to further examine the role of the immune system in pregnancy and preterm birth. Their goal is to understand whether preterm labor represents a breakdown in maternal-fetal tolerance, possibly triggered by infection. The Burroughs Wellcome Fund recently announced the awarding of their proposed project entitled “A precision medicine approach to detect dysbiosis and immune activation in preterm birth,” which plans to utilize novel ‘omics technologies and integrative computational methods to achieve this goal.

This multidisciplinary team of investigators will leverage a unique sample set, including materials from both matched maternal-fetal pairs as well as longitudinal samples across pregnancy, to uncover novel insights about microbial, T-cell, and transcriptomic signatures related to preterm labor.

“The development and availability of genomic and other “omics” profiling technologies coupled with powerful bioinformatics tools provide an unprecedented opportunity to apply precision medicine strategies to preterm birth research. I’m very excited about the partnership with Dr. MacKenzie and the opportunity to develop integrative computational techniques to elucidate the role of the immune system in pregnancy,” says Dr. Sirota.

The team hopes to discover novel biomarkers that may ultimately lead to the development of effective interventional strategies in the management and prevention of preterm labor, and also contribute insights into immune tolerance mechanisms that may be at work in other contexts.