
Aleksandar Ljubi
Belgrade, SerbiaTitle: Biologic Therapy in Reproductive and Perinatal Medicine
Abstract
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.
Biography
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.