Lye - clinical applications

So we’ve been able to use this information to look for new predictive or diagnostic tests. So in one situation, there’s a condition called threatened preterm labour. What that is, is when a woman experiences uterine contractions early in the pregnancy, before term, and there’s a concern that that is going to lead to the birth of a preterm baby so she will be admitted to hospital. In many cases, she will begin drugs to try and stop those contractions or given hormones such as glucocorticoid hormones that pass across the placenta into the fetus to try and mature the baby’s lungs. The biggest problem preterm babies have is oxygenating their lungs when they’re born and these steroids try to help with that. So given these treatments are good if that women is actually going to deliver preterm. But it turns out of women coming into hospital with threatened preterm labour, only about 10% or so actually deliver within the next 48 hours and a large number of them settle down, and many continue to term. They were in what we call false labour. So, obviously if they have treatments, like drugs to try and stop the labour or hormones to advance the maturation of the baby’s systems, that’s not optimal for that group.

And so we’ve been able to look at the activation status of these white blood cells, and devise a gene expression signature in them that is able to predict which women will deliver within the next 48 hours and which women will settle down. We hope over the next few years that this will be validated and we can introduce it into hospitals to try and help make decisions about which women receive therapies. The other opportunity is to try and use the same sort of analyses to predict women early in their pregnancy if they’re going to have a preterm birth. So these women would be not having any contractions, they’d be just normal, but asks the question, ‘Can you identify changes in those white blood cells early enough before they even go into labour?’ And we think we have some evidence that we’ll be able to do that. And the final one becomes, okay so, ‘If you can predict which women are going to deliver, can you treat them before that process occurs to stop the preterm birth?’ And there we have some animal data that, if you can block the activation of those white blood cells, you may be able to prevent the initiation of preterm labour in those animals.