Molecular Diagnostics and In Utero Therapeutics for Orofacial Clefts.

Details

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State: Public
Version: Author's accepted manuscript
License: Not specified
Serval ID
serval:BIB_41FCE1137086
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Molecular Diagnostics and In Utero Therapeutics for Orofacial Clefts.
Journal
Journal of dental research
Author(s)
Oliver J.D., Turner E.C., Halpern L.R., Jia S., Schneider P., D'Souza R.N.
ISSN
1544-0591 (Electronic)
ISSN-L
0022-0345
Publication state
Published
Issued date
10/2020
Peer-reviewed
Oui
Volume
99
Number
11
Pages
1221-1227
Language
english
Notes
Publication types: Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Abstract
Orofacial clefts and their management impose a substantial burden on patients, on their families, and on the health system. Under the current standard of care, affected patients are subjected to a lifelong journey of corrective surgeries and multidisciplinary management to replace bone and soft tissues, as well as restore esthetics and physiologic functions while restoring self-esteem and psychological health. Hence, a better understanding of the dynamic interplay of molecular signaling pathways at critical phases of palate development is necessary to pioneer novel prenatal interventions. Such pathways include transforming growth factor-β (Tgfβ), sonic hedgehog (Shh), wingless-integrated site (Wnt)/β-catenin, bone morphogenetic protein (Bmp), and fibroblast growth factor (Fgf) and its associated receptors, among others. Here, we summarize commonly used surgical methods used to correct cleft defects postnatally. We also review the advances made in prenatal diagnostics of clefts through imaging and genomics and the various in utero surgical corrections that have been attempted thus far. An overview of how key mediators of signaling that drive palatogenesis are emphasized in the context of the framework and rationale for the development and testing of therapeutics in animal model systems and in humans is provided. The pros and cons of in utero therapies that can potentially restore molecular homeostasis needed for the proper growth and fusion of palatal shelves are presented. The theme advanced throughout this review is the need to develop preclinical molecular therapies that could ultimately be translated into human trials that can correct orofacial clefts at earlier stages of development.
Keywords
Animals, Cleft Lip/genetics, Cleft Lip/surgery, Cleft Palate/genetics, Cleft Palate/surgery, Esthetics, Dental, Female, Hedgehog Proteins, Humans, Palate, Pathology, Molecular, Pregnancy, cleft palate, craniofacial, prenatal drug delivery, replacement therapies, signaling molecules, translational medicine
Pubmed
Web of science
Create date
03/07/2020 15:48
Last modification date
23/02/2021 6:26
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