Polarization-sensitive OCT as an early predictor of spontaneous pre-term birth.

偏振敏感 OCT 作为自发性早产的早期预测因子。

基本信息

批准号：
EP/V010581/1
负责人：
Stephen Matcher
金额：
$ 107.18万
依托单位：
University of Sheffield
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2021
资助国家：
英国
起止时间：
2021 至无数据
项目状态：
未结题

来源：
https://gtr.ukri.org/projects?ref=EP%2FV010581%2F1
关键词：
Polarization sensitive OCT early predictor

项目摘要

Spontaneous pre-term birth costs the UK NHS over £1billion annually and is a major cause of disability in the young. Babies that are born before the normal 38 weeks of gestation must spend the first weeks or months of their lives being kept alive artificially in incubators. Modern incubators represent a huge advance in medical care for premature babies and means that babies born as early as 28 weeks gestation now have an 80-90% chance of surviving to adulthood. Nonetheless, premature babies have an increased risk of growing up with disabilities such as cerebral palsy, retarded mental development, visual and hearing defects, breathing difficulties etc. Obstetricians and gynaecologists around the world are thus urgently trying to develop tools that can predict when a particular woman might be at risk of delivering her baby prematurely, so that preventative measures can be taken to try to delay the delivery and/or to try to speed up the development of the baby's lungs before he or she is born. A great deal of research is being undertaken currently to develop such a predictive tool, especially at Sheffield where we are pioneering methods that physically examine the cervical tissues themselves, as well as analyzing samples of the mother's blood or vaginal fluid. Despite these efforts however, the search is still ongoing to find a test that is sufficiently reliable to be useful to doctors, The human foetus develops in the womb and is contained within the protective, fluid-filled sack called the placenta. The placenta is held in position by the cervix, which is the narrow opening that separates the womb from the vagina. The mechanical strength of the cervix is what holds the developing baby inside the mothers body until it is ready to be delivered. Normal birth requires a softening (technically called "ripening") of the cervix, so that the baby can squeeze its way out. The strength of most body tissues, including the cervix, comes from a protein called collagen. As we age, the collagen content of our skin falls and so our skin becomes looser and more stretchy. Collagen can be degraded by a hormone called relaxin; this hormone is produced by the female body during pregnancy and is believed to contribute to a reduction in collagen content within the cervix. Might the risk of spontaneous preterm birth increase if the rate of collagen degradation is too high? Might it be possible to measure an "index" of collagen content of the cervix non-invasively, at various stages of a pregnancy? If so, might this index be able to identify women with an elevated risk of delivering prematurely sufficiently early that treatments can be applied in time to avoid the premature delivery? We will answer these questions by building a novel new type of camera that can measure the collagen content of the cervix, via a small imaging probe (similar to those used in keyhole surgery) that is inserted into the vagina and placed a few millimeters from the surface of the cervix. The procedure will be similar to an examination called "colposcopy" (which aims to detect cervical cancer) but will focus on the abundance of the collagen protein, not the health of the cells. Our technique is called "polarization sensitive optical coherence tomography" and we have already shown that it can measure the collagen content of cervical tissue samples that have been generously donated by women undergoing hysterectomies. The next stage is to use this measurement technique in the clinic, to image the cervix in its natural state. to this we will build a novel imaging probe and associated data collection system and then make trial measurements in volunteers. We will this learn what is the potential benefits of this technology for predicting pre-term birth.

自然早产每年给英国国民医疗服务体系 (NHS) 造成超过 10 亿英镑的损失，也是导致婴儿残疾的一个主要原因。在正常妊娠 38 周之前出生的婴儿必须在生命的最初几周或几个月内通过人工手段维持生命。现代保温箱代表了早产儿医疗保健的巨大进步，意味着怀孕 28 周出生的婴儿现在有 80-90% 的机会存活到成年。成长过程中罹患脑瘫、智力发育迟缓、视力和听力缺陷、呼吸困难等残疾的风险增加。因此，世界各地的妇产科医生都在紧急尝试开发工具，以预测特定女性何时可能面临患上残疾的风险。过早分娩，以便可以在婴儿出生前采取预防措施来推迟分娩和/或加速婴儿肺部的发育，目前正在进行大量研究来开发。这样一个预测工具，特别是在谢菲尔德，我们正在开创性地检查宫颈组织本身，以及分析母亲的血液或阴道液体样本。尽管如此，我们仍在继续寻找足够可靠的测试。为了对医生有用，人类胎儿在子宫中发育，并包含在称为胎盘的充满液体的保护袋中。胎盘由子宫颈固定到位，子宫颈是将子宫与子宫分开的狭窄开口。子宫颈的机械强度将发育中的婴儿固定在母亲体内，直到准备好分娩。正常分娩需要子宫颈软化（技术上称为“成熟”），以便婴儿可以挤压。大多数身体组织（包括子宫颈）的力量都来自于一种叫做胶原蛋白的蛋白质，随着年龄的增长，我们皮肤的胶原蛋白含量会下降，因此我们的皮肤会变得松弛且更有弹性。称为松弛素的激素；这种激素是由女性身体在怀孕期间产生的，据信会导致子宫颈内胶原蛋白含量的减少，如果胶原蛋白降解率过高，自发性早产的风险可能会增加吗？是否可以在怀孕的各个阶段以非侵入性方式测量子宫颈的胶原蛋白含量“指数”？如果是这样，该指数是否能够足够早地识别出早产风险较高的女性，以便可以进行治疗。避免过早的时机我们将通过构建一种新颖的相机来回答这些问题，该相机可以通过插入阴道并放置几毫米的小型成像探针（类似于锁孔手术中使用的探针）来测量子宫颈的胶原蛋白含量。该过程类似于称为“阴道镜检查”（旨在检测宫颈癌）的检查，但重点关注胶原蛋白的丰度，而不是细胞的健康状况。偏振敏感光学相干断层扫描”，我们已经证明它可以测量接受子宫切除术的妇女慷慨捐赠的宫颈组织样本中的胶原蛋白含量。下一阶段是在临床中使用这种测量技术，对自然状态下的宫颈进行成像为此，我们将构建一种新型成像探针和相关数据收集系统，然后对志愿者进行试验测量，我们将了解该技术在预测早产方面的潜在好处。