Aleksandar LjubiBelgrade, Serbia
Title: Biologic Therapy in Reproductive and Perinatal Medicine
Despite the significant progress in assisted reproductive technologies that has been made, challenging infertility conditions with poor in vitro fertilization (IVF) outcomes still remain. Various preimplantation changes may lead to inadequate placentation, which in turn may result in the development of pregnancy-related disorders. Hence, there should be an increased emphasis on preconception and peri-implantation care. The main therapeutic approaches of modern regenerative medicine are cell-based therapy, which utilizes stem cells and platelet-rich plasma (PRP), to restore damaged tissue, and gene therapy with the potential to prevent or treat certain genetically caused diseases. It has been demonstrated that paracrine factors released from the stem cells are responsible for immunomodulation, stimulation of proliferation and differentiation, inhibition of apoptosis, and other healing effects in injured tissues. These cellular and subcellular components represent a new therapeutic tool in the treatment of reproductive disorders and infertility, as well as in perinatal medicine.
PRP and mesenchymal stem cells (MSCs) have the potential to revive folliculogenesis and spermatogenesis by improving the microenvironment of the gonads with growth factors and other bioactive molecules they release. In the ovary, they could salvage antral follicles undergoing early atresia or activate inactive primordial follicles. In the testes, the improved niche can help Sertoli cells support spermatogenesis. Also, growth factors can activate tissue-resident stem cells to multiply and differentiate. Amniotic fluid stem cells could be used for direct fetal treatment in several fetal diseases (e.g., neurological disorders, intrauterine growth restriction). Biological autologous fibrin tissue adhesives successfully treat maternal problems such as amniotic sac rupture and placental adhesion. Peripartum local application of growth factors and/or stem cells may help prevent postpartum problems associated with pelvic floor alteration.
However, future trials are required to assess the effectiveness and safety of these novel approaches in order to be implemented in routine clinical practice.
Professor Aleksandar Ljubi?, MD, PhD, is a gynecologist recognized for his expertise in reproductive medicine and high-risk pregnancies. He was educated at the Faculty of Medicine, University of Belgrade, with postgraduate education in the USA, Japan, UK and Greece. He was the lead investigator in 12 national and international and national scientific projects, published more than 500 publications – in peer-reviewed magazines – 73 with overall citation number - 1190, Hi index 18. He is the pioneer in invasive ultrasound-guided fetal procedures, direct maturation of fetal lungs, inventor of the method of perinatal hearing screening, non-surgical fibroids treatment and advanced NOTES laparoscopic procedures. Professor's recent research areas include reproductive and perinatal biotechnology, regenerative medicine, assisted reproduction, minimally invasive reproductive surgery, and tumor biology. He is experimenting with novel biological therapies for sterility as well as new discoveries for life longevity. He created the SEGOVA and SEMPRE RB programs for ovarian rejuvenation and longevity, respectively.