PMID- 38177082
OWN - NLM
STAT- MEDLINE
DCOM- 20240123
LR  - 20240305
IS  - 1097-0223 (Electronic)
IS  - 0197-3851 (Linking)
VI  - 44
IP  - 1
DP  - 2024 Jan
TI  - Mammalian target of rapamycin inhibitors: A new-possible approach for in-utero 
      medication therapy.
PG  - 88-98
LID - 10.1002/pd.6492 [doi]
AB  - The mammalian/mechanistic target of rapamycin (mTOR) is a protein kinase that 
      plays a crucial role in regulating cellular growth, metabolism, and survival. 
      Although there is no absolute contraindication for the use of mTOR inhibitors 
      during pregnancy, the specific fetal effects remain unknown. Available data from 
      the past 2 decades have examined the use of mTOR inhibitors during pregnancy in 
      patients with solid organ transplantation, showing no clear link to fetal 
      complications or structural abnormalities. Recently, a handful of case reports 
      and series have described transplacental therapy of mTOR inhibitors to control 
      symptomatic and complicated pathologies in the fetus. The effect of these agents 
      includes a significant reduction in lesion size in the fetus and a reduced need 
      for mechanical ventilation in neonates. In this context, we delve into the 
      potential of mTOR inhibitors as in-utero therapy for fetal abnormalities, with a 
      primary focus on lymphatic malformation (LM) and cardiac rhabdomyoma (CR). While 
      preliminary reports underscore the efficacy of mTOR inhibitors for the treatment 
      of fetal CR and fetal brain lesions associated with tuberous sclerosis complex, 
      chylothorax, and LMs, additional investigation and clinical trials are essential 
      to comprehensively assess the safety and efficacy of these medications.
CI  - (c) 2024 John Wiley & Sons Ltd.
FAU - Qaderi, Shohra
AU  - Qaderi S
AD  - Maternal Fetal Care Center, Division of Fetal Medicine and Surgery, Boston 
      Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
FAU - Javinani, Ali
AU  - Javinani A
AD  - Maternal Fetal Care Center, Division of Fetal Medicine and Surgery, Boston 
      Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
FAU - Blumenfeld, Yair J
AU  - Blumenfeld YJ
AUID- ORCID: 0000-0002-9440-8175
AD  - Department of Obstetrics and Gynecology, Stanford University School of Medicine, 
      Stanford, California, USA.
FAU - Krispin, Eyal
AU  - Krispin E
AUID- ORCID: 0000-0001-5859-9528
AD  - Maternal Fetal Care Center, Division of Fetal Medicine and Surgery, Boston 
      Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
FAU - Papanna, Ramesha
AU  - Papanna R
AUID- ORCID: 0000-0002-3801-346X
AD  - Division of Fetal Intervention, Department of Obstetrics, Gynecology and 
      Reproductive Sciences, McGovern Medical School at UT Health Houston, Houston, 
      Texas, USA.
FAU - Chervenak, Frank A
AU  - Chervenak FA
AD  - Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of 
      Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, New York, USA.
FAU - Shamshirsaz, Alireza A
AU  - Shamshirsaz AA
AUID- ORCID: 0000-0001-6333-3177
AD  - Maternal Fetal Care Center, Division of Fetal Medicine and Surgery, Boston 
      Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20240104
PL  - England
TA  - Prenat Diagn
JT  - Prenatal diagnosis
JID - 8106540
RN  - W36ZG6FT64 (Sirolimus)
RN  - 0 (MTOR Inhibitors)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
SB  - IM
MH  - Pregnancy
MH  - Infant, Newborn
MH  - Female
MH  - Humans
MH  - Sirolimus/therapeutic use
MH  - MTOR Inhibitors
MH  - TOR Serine-Threonine Kinases
MH  - *Tuberous Sclerosis
MH  - Fetus/metabolism
MH  - *Rhabdomyoma/drug therapy
EDAT- 2024/01/05 00:42
MHDA- 2024/01/23 06:43
CRDT- 2024/01/04 22:42
PHST- 2023/12/04 00:00 [revised]
PHST- 2023/09/13 00:00 [received]
PHST- 2023/12/04 00:00 [accepted]
PHST- 2024/01/23 06:43 [medline]
PHST- 2024/01/05 00:42 [pubmed]
PHST- 2024/01/04 22:42 [entrez]
AID - 10.1002/pd.6492 [doi]
PST - ppublish
SO  - Prenat Diagn. 2024 Jan;44(1):88-98. doi: 10.1002/pd.6492. Epub 2024 Jan 4.