Abstract

Fetal growth restriction (FGR) significantly contributes to neonatal and perinatal morbidity and mortality. Currently, there are no effective treatment options for FGR during pregnancy. We have developed a nanoparticle gene therapy targeting the placenta to increase expression of human insulin-like growth factor 1 (hIGF-1) to correct fetal growth trajectories. Using the maternal nutrient restriction (MNR) guinea pig model of FGR, an ultrasound-guided, intra-placental injection of non-viral, polymer-based nanoparticle gene therapy containing plasmid with the hIGF-1 gene and placenta-specific Cyp19a1 promotor was administered at mid-pregnancy. Sustained hIGF-1 expression was confirmed in the placenta five days after treatment. Whilst gene therapy treatment did not change fetal weight, circulating fetal glucose concentration were 33-67% higher. This was associated with increased expression of glucose and amino acid transporters in the placenta. Additionally, nanoparticle gene therapy treatment increased the fetal capillary volume density in the placenta, and reduced interhaemal distance between maternal and fetal circulation. Overall, our findings, that gene therapy treatment results in changes to glucose transporter expression and increases fetal glucose concentrations within a short time period, highlights the translational potential this treatment could have in correcting impaired placental nutrient transport in human pregnancies complicated by FGR.