Zsolt Bara, Horea Gozar, Nándor Nagy, Simona Gurzu, Zoltán Derzsi, Timea Forró, Evelyn Kovács, Ioan Jung
George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures. County Emergency Clinical Hospital. Semmelweis University. Romanian Academy of Medical Sciences.
Romania and Hungary
International Journal of Molecular Sciences
Int J Mol Sci 2025; 26:
DOI: 10.3390/ijms26041639
Abstract
Congenital diaphragmatic hernia (CDH) is a relatively rare and severe developmental disease. Even with the most recent multidisciplinary therapies, the risk for neonatal mortality and morbidity remains high. Recent advancements in prenatal treatments, alongside experimental and clinical data, suggest that fetoscopic endoluminal tracheal occlusion (FETO) promotes lung development and offers a promising strategy against lung hypoplasia and pulmonary hypertension. It is the only existing direct mechanical therapy that intervenes in the regulation of pulmonary pressure. Its influence on lung development also interferes with tissue homeostasis and cell differentiation; it also enhances inflammation and apoptosis. Its physiopathology on cellular and molecular levels is still poorly understood. Unfortunately, the procedure also carries significant pregnancy-, maternal-, and fetus-related risks. Assessing a multifaceted intervention requires a collective view of all aspects. This scoping review uncovers potential materno-fetal procedure-related risks and highlights innovative solutions. Future research on lung development therapies in CDH may focus on the “dual hit” mechanism, combining molecular-targeting drugs and regenerative medicine with the mechanical nature of FETO for synergistic effects.
Category
Class III. Pulmonary Hypertension Associated with Lung Hypoplasia
Surgical and Catheter-mediated Interventions for Pulmonary Vascular Disease
Review Articles Concerning Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes