Ashima Madan

Laboratory Based Research
Approximately 12 of every 100 babies that are born each year in the U.S. are preterm i.e. delivered at less than 37 weeks gestation. Premature birth is the most common cause of neonatal morbidity and mortality in the U.S. Despite efforts the incidence has continued to rise. One of the problems facing perinatologists is our lack of understanding of the various pathways that culminate in preterm birth. Yet another problem is the absence of a biomarker early in gestation that is predictive of development of preterm labor.
The focus of the Madan laboratory is to elucidate the molecular pathways underlying development of preterm labor and to identify an early biomarker predictive of preterm labor. With this goal in mind her lab has developed a mouse model of preterm labor. Several studies are being conducted using the mouse model. In addition, translational research studies to take this work from the bench to the bedside are underway (see Proteomic studies).

A) Effects of Prematurity on Visual Development
Preterm infants are at high risk for vision loss. Some of this is secondary to abnormal growth of blood vessels in the retina- a condition known as retinopathy of prematurity (ROP). Although ROP continues to be a problem particularly in developing countries, cortical vision impairment (ie bilateral vision loss in the presence of a normal retina) is now the most common cause of childhood blindness in the U.S. CVI is difficult to diagnose in preverbal children and measuring visual acuity using current methods is difficult. In the current study the sweep visual evoked potential (sVEP), a quantitative electrophysiological tool to measure visual function is being used in 6 month old former preterm infants of < 32 weeks gestation at birth. The goal is to determine: a) the utility of the sVEP for early identification of babies at risk for CVI and b) its predictive ability to identify babies at risk for school age visuospatial or visuomotor problems.

B) Clinical Applications of Proteomics in Neonatal/Perinatal Medicine
The emergence of new technologies such as SELDI-TOF allows for determining the low mol wt protein profile (proteomics) in serum and other body fluids. These low MW proteins have the potential to be biomarkers that can be predictive of disease. One of Dr Madan's areas of interest is in adapting this technology to help answer questions in the field of neonatal/perinatal biology. Some ongoing studies are:

i) Identification of a biomarker in preterm infants with Necrotizing Enterocolitis (NEC). NEC is a life threatening condition that affects preterm infants. The goal of this study is to identify biomarkers that can be diagnostic of early NEC and predictive of severity of disease.

ii) Detection of a biomarker predictive of development of retinopathy of prematurity (ROP).
Dr Madan's group recently reported the presence of a biomarker in the cord blood of preterm infants that is predictive of development of ROP.

iii) Identification of a biomarker predictive of development of preterm labor in women early in gestation.