Chapter 1 of 4 · Fundamentals
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Video
CAPS - Administration of amniotic fluid stem cell extracellular vesicles regenerates the lung epithelium in fetal rats with CDH at translationally relevant developmental stages - Kasra Khalaj
7 min · Published May 2022
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EUPSA - MicroRNAs in amniotic fluid stem cellextracellular vesicles modulate lung development in experimental congenital diaphragmatic hernia - Kasra Khalaj
10 min · Published May 2022
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Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski
4 min · Published Jul 2026
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EUPSA - Circular RNA profiles isolated from amniotic fluidscan distinguish between CDH survivors and non-survivers - Richard Wagner
9 min · Published May 2022
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BOB Ped Surg 2023 - Shelby Sferra, AAP - Presentation
5 min · Published Feb 2023
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BOB in Ped Surg 2023 - AAP Winner - Shelby Sferra, MD
11 min · Published Feb 2023
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Pediatric Surgical Oncology Research Collaborative (PSORC): Studying Rare Pediatric Tumors
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Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real
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Pooling Patients to Study Rare Pediatric Tumors: An Introduction to PSORC
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The fetal frontier: A review of current and emerging fetal therapies for genetic diseases
44 s · Published May 2026
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Indocyanine green assists with sentinel lymph node mapping in pediatric and adolescent patients
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Tricuspid valve surgery in transposition of the great arteries with a systemic right ventricle
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What the experts said
Congenital diaphragmatic hernia is characterized by impaired fetal lung growth and maturation
CDH has unacceptably high mortality and morbidity rates
One of the biggest challenges for babies with CDH is that fetal hypoplastic lungs are immature with impairment of cell differentiation, especially in the epithelium
Extracellular vesicles (EVs) are the main mediators of stem cell paracrine signaling
Amniotic fluid stem cell derived EVs can rescue fetal lung growth and maturation in several models of CDH at the pseudoglandular stage
The pseudoglandular stage corresponds to 7 to 16 weeks of human gestation
CDH is diagnosed around 18 to 20 weeks gestation
The canalicular and saccular stages are translationally relevant developmental stages where intervention is possible for CDH
The nitrophin model is a well-established model for studying CDH, created by administering the herbicide nitrophin to pregnant rat dams at embryonic day 9.5
Hypoplastic lungs at canalicular and saccular stages show down-regulation of alveolar type 1 and 2 cells, as well as basal and club cells compared to control
Treatment of hypoplastic lungs with amniotic fluid stem cell derived extracellular vesicles restores primary markers of alveolar type 1 and 2 cells, basal cells, and club cells, indicating cell homeostasis can be achieved
In vivo experiments have been performed looking at different administration routes including intraamniotic and tracheal routes for extracellular vesicles
Results from in vivo administration of extracellular vesicles are quite promising
Collaboration with Dr. Jan De Prest is underway to look at safety and feasibility of AFSC-EV treatment in a lab model
The lack of ciliated cell rescue may be due to an imbalance of different cell types in the hypoplastic fetal lung, with the treatment achieving overall cell homeostatic balance rather than rescuing every specific cell type
Key markers expressed in branching morphogenesis are being rescued effectively with AFSC-EV treatment
No difference was found in ciliated cells with AFSC-EV treatment