Conway Review Lecture 1985
16/09/1985 in Queen
Palate Development: Mechanisms and Malformations
M. W. J. Ferguson, Head of Department of Cell and Structural Biology, School of Biological Sciences, University of Manchester, Coupland III Building, Manchester M13 9PL, England.
Congenital craniofacial malformations are amongst the most prevalent birth defects in man: 1 in 500 infants are born with a cleft lip and palate and the incidence has doubled in the past 25 years. In Britain approximately 1,800 babies with cleft lip and palate are born each year and approximately 50,000 people are currently affected by these malformations : the corresponding figures for USA are 15,000 and 330,000. These statistics translate into enormous human suffering and significant health care costs. Facial clefting is of multifactorial aetiology, therefore primary prevention is possible but depends upon a thorough understanding of the developmental mechanisms involved in normal palate development and how these may be disturbed in cleft palate. Moreover, the forming palate is a useful system in which to study fundamental developmental mechanisms common to many structures, as it appears relatively late in embryogenesis, can be easily excised and cultured under chemically defined, serum-free conditions, and exhibits: morphogenetic movements, extracellular matrix synthesis, cell adhesion, epithelial-mesenchymal interactions and programmed cell death. Some of these developmental events are regulated by cyclic AMP , neurotransmitters, prostaglandins PGE I and Fα, EGF and glucocorticoids and occur in cell culture. Moreover, we. have shown that subtle differences between palate development in mice, alligators and chicks can be utilised to investigate fundamental developmental controls in epithelial differentiation. Several recent reviews summarise much of the data on normal and abnormal palatal development.