We’re used to the idea that we can find out about developing foetuses by sampling the amniotic fluid in which they grow. Several medical conditions – most notably Downs syndrome and sickle-cell anaemia – can be detected by testing amniotic fluid: the tests look at dead cells shed by the baby. Researchers at several institutions have now shown that even more information can be gleaned from the smaller number of living cells in the fluid, by growing them into structures which have some of the properties of the developing organs from where they originated, known as organoids.

The researchers, from University College London and Great Ormond Street Institute of Child Health, obtained their cell samples from amniocentsis, a now-routine procedure which extracts amniotic fluid using a hollow needle; 30,000 of these tests are carried out in the UK every year. The first stage of their new technique is determining what kind of cells are present in the sample. The team’s paper, in Nature Medicine (https://www.nature.com/articles/s41591-024-02807-z), explains that 95% of the cells are dead. The researchers used RNA sequencing to identify the cells in the living fraction, determining that the sample contained progenitor cells with the potential to develop into lungs, kidneys and parts of the gastrointestinal system including the small intestine.

The next step was to culture these cells, which was a matter of dropping them into a nutrient gel which would allow them to grow in three dimensions. Low-tech, but it worked: almost 90 per cent of the cells grew into organoids. The lung organoids developed cilia: tiny, hair-like structures which beat backwards and forwards, moving mucus from the lungs, where it traps potentially harmful microorganisms, into the throat, where it can be expelled from the body in coughs or sneezes. The small intestine organoids developed crypts: tiny glands containing digestive enzymes and lined with cells that can develop into replacement for intestinal lining worn away by food. The kidney cells developed tubules, the structures which filter out waste salts and excess water to make urine.

The first named author of the paper, Mattia Gerli of UCL, notes how this represents new knowledge in an area where this is badly needed. "The organoids we created from amniotic fluid cells exhibit many of the functions of the tissues they represent, including gene and protein expression. They will allow us to study what is happening during development in both health and disease, which is something that hadn’t been possible before." she said. "We know so little about late human pregnancy, so it’s incredibly exciting to open up new areas of prenatal medicine."

This was particularly interesting to one of the paper’s authors, Great Ormond Street paediatric surgeon Paolo de Coppi, who has an interest in a rare birth defect called congenital diaphragmatic hernia (CDH). This causes the diaphragm to develop incompletely, allowing the intestines to push up into the chest cavity, compressing the lungs and preventing them from developing properly. CDH can be diagnosed by amniocentesis, and De Coppi wanted to see whether lung cells in CDH foetuses had the potential to develop into healthy cells. The team found that CDH lung cells were not as efficient at producing and moving mucus.

Surgeons can treat CDH by operating on the foetus, inserting a balloon into the windpipe and inflating it to force the developing lungs back against the intestines pushing through the diaphragm. De Coppi and the research team tested lung cells taken after this surgery and found that they were developing more like the cells in foetuses unaffected by the condition. The team believes the technique might be useful to identify the foetuses which would benefit most from the balloon inserting surgery.

De Coppi said: “This is the first time that we’ve been able to make a functional assessment of a child’s congenital condition before birth, which is a huge step forward for prenatal medicine. When we meet families with a prenatal diagnosis, we’re often unable to tell them much about the outcome because each case is different. We’re not claiming that we can do that just yet, but the ability to study functional prenatal organoids is the first step towards being able to offer a more detailed prognosis and, hopefully, provide more effective treatments in future.”

Evidence of collaboration between Jewish and Islamic societies is something I always find welcome. Such is the level of animosity between the two at the moment that any sign that the two shared knowledge and understanding strikes me as hopeful. Such evidence has recently come to light in the form of an 11th century astrolabe in a museum in Verona.

Astrolabes are devices used to map the stars. In the past, they were particularly useful for religions whose festivals and rituals are determined by the phases and position of the moon. This astrolabe, made of brass, was in the collection of the Fondazione Museo Miniscalchi Erizzo, and examined by chance by historian Federica Gigante under glancing light from a window. This revealed that, as well as inscriptions in Arabic, the device had scratches on it surface which although she initially thought had just been acquired through use, she realised were actually Hebrew script, translating the names of some astrological signs. In a paper in the journal Nuncius (https://brill.com/view/journals/nun/39/1/article-p163_9.xml) she explains that astrolabe appears to have been made in Muslim Spain, and the Hebrew inscriptions were made by Jewish scholars in North Africa. This conclusion comes from a further inscriptions saying that the astrolabe was “For Ishaaq, the work of Yunus” – these are the Hebrew names Isaac and Jonah, but this inscription was in Arabic, the language used by Jews, Muslims and Christians in North Africa.

Gigante believes that the device was made and first used by Muslims, and then passed to Jews, who worked side by side in Spain, particularly in Toledo and Cordoba. It then travelled to Jewish communities in Morocco, before ending up in Verona, which in the 12th century was home to a large Jewish community and where a Spanish Jewish scholar called Abraham Ibn Ezra wrote the earliest surviving Hebrew work on using astrolabes. Later inscriptions on the device are in a European language, showing contact between Jewish and Christian scholars. None of this is new knowledge, she points out, but it is physical evidence of contacts and collaborations between three societies more commonly associated with animosity.

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