India Cleft Study

Dundee, Utah and Chennai collaborate on orofacial cleft project
Monday, December 10, 2012
Professor Peter Mossey (RH) Dundee Dental School


A Dundee Dental School instigated project has received a UK-India Education and Research Initiative (UKIERI) award to support a three-nation study on the links between environmental pollution and  infants born in the sub-continent with orofacial clefts.

The principal investigator is Dundee’s Professor Peter Mossey – who heads several major national and international research programmes that focus on clefts. He is joined by Professor Ronald Munger of Utah State University, US, who is recognised globally for his studies of environmental, nutritional and maternal metabolic causes of cleft palate. In India, Professor Jyotsna Murthy of Sri Ramachandra Medical College, Chennai, and Dr Kalpana Balakrishnan bring special surgical expertise in orofacial clefts plus experience in monitoring domestic smoke from burning coal bricks, which is a plausible hypothesis in the cause of birth defects.

“Experts in India estimate the prevalence of orofacial clefts to be higher than in many western countries with between 27,000 and 35,000 infants born with clefts each year,” explains Professor Mossey. “There is an increasing research focus towards discovery of what the genetic and environmental causes are. This project aims to conduct research into the aetiology of orofacial clefts and simultaneously raise awareness and educate communities about primary prevention. “

Solid carbon fuel burning stoves are commonly used for cooking in some regions, but to date, no study has ever been conducted on a link between maternal exposure to the smoke and the risk of oral clefts. The Chennai researchers have developed a unique system for monitoring indoor smoke exposure that includes carbon monoxide levels.

The project would simultaneously address three components that all three participating countries – the UK, US and India – have recognised expertise: maternal metabolism assessment, particularly relating to diabetes and folic acid; nutritional assessment; and environmental exposure. Studies will include mothers of children born with clefts; a similar control group of mothers whose children do not have clefts; questionnaires, blood samples and laboratory assessments.

“This is an example of an initiative where the combined and synergistic expertise of these three teams in the UK, US and India is essential for the investigation of the complex interactions in the genetic and environmental aetiology of orofacial clefts with an educational component conferring research skills on the next generation of scientists in this field,” says Professor Mossey. “ It also fulfils the objectives of our combined aspiration to be able to carry out this research in a susceptible population where there is a high rate of clefts and diabetes, and where domestic environmental pollution can be monitored.”

The ultimate scientific and humanitarian objective is the prevention of birth defects and a key objective of this project is to contribute to the knowledge base regarding primary preventive interventions. The project budget is £80,000 of which almost 50% will be covered by the UKIERI award.