Imperial College London

MrRajRai

Faculty of MedicineDepartment of Metabolism, Digestion and Reproduction

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 3312 2475r.rai

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Publication Type
Year
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117 results found

Salker M, Teklenburg G, Molokhia M, Lavery S, Trew G, Aojanepong T, Mardon HJ, Lokugamage AU, Rai R, Landles C, Roelen BAJ, Quenby S, Kuijk EW, Kavelaars A, Heijnen CJ, Regan L, Macklon NS, Brosens JJet al., 2010, Natural Selection of Human Embryos: Impaired Decidualization of Endometrium Disables Embryo-Maternal Interactions and Causes Recurrent Pregnancy Loss, PLOS One, Vol: 5, ISSN: 1932-6203

Background: Recurrent pregnancy loss (RPL), defined as 3 or more consecutive miscarriages, is widely attributed either torepeated chromosomal instability in the conceptus or to uterine factors that are poorly defined. We tested the hypothesisthat abnormal cyclic differentiation of endometrial stromal cells (ESCs) into specialized decidual cells predisposes to RPL,based on the observation that this process may not only be indispensable for placenta formation in pregnancy but also forembryo recognition and selection at time of implantation.Methodology/Principal Findings: Analysis of mid-secretory endometrial biopsies demonstrated that RPL is associated withdecreased expression of the decidual marker prolactin (PRL) but increased levels of prokineticin-1 (PROK1), a cytokine thatpromotes implantation. These in vivo findings were entirely recapitulated when ESCs were purified from patients with andwithout a history of RPL and decidualized in culture. In addition to attenuated PRL production and prolonged and enhancedPROK1 expression, RPL was further associated with a complete dysregulation of both markers upon treatment of ESCcultures with human chorionic gonadotropin, a glycoprotein hormone abundantly expressed by the implanting embryo. Wepostulated that impaired embryo recognition and selection would clinically be associated with increased fecundity, definedby short time-to-pregnancy (TTP) intervals. Woman-based analysis of the mean and mode TTP in a cohort of 560 RPLpatients showed that 40% can be considered ‘‘superfertile’’, defined by a mean TTP of 3 months or less.Conclusions: Impaired cyclic decidualization of the endometrium facilitates implantation yet predisposes to subsequentpregnancy failure by disabling natural embryo selection and by disrupting the maternal responses to embryonic signals.These findings suggest a novel pathological pathway that unifies maternal and embryonic causes of RPL.

Journal article

Teklenburg G, Salker M, Molokhia M, Lavery S, Trew G, Aojanepong T, Mardon HJ, Lokugamage AU, Rai R, Landles C, Roelen BAJ, Quenby S, Kuijk EW, Kavelaars A, Heijnen CJ, Regan L, Brosens JJ, Macklon NSet al., 2010, Natural selection of human embryos: decidualizing endometrial stromal Cells serve as sensors of embryo quality upon implantation, PLoS One, Vol: 5, Pages: 1-6, ISSN: 1932-6203

BackgroundPregnancy is widely viewed as dependent upon an intimate dialogue, mediated by locally secreted factors between a developmentally competent embryo and a receptive endometrium. Reproductive success in humans is however limited, largely because of the high prevalence of chromosomally abnormal preimplantation embryos. Moreover, the transient period of endometrial receptivity in humans uniquely coincides with differentiation of endometrial stromal cells (ESCs) into highly specialized decidual cells, which in the absence of pregnancy invariably triggers menstruation. The role of cyclic decidualization of the endometrium in the implantation process and the nature of the decidual cytokines and growth factors that mediate the crosstalk with the embryo are unknown.Methodology/Principal FindingsWe employed a human co-culture model, consisting of decidualizing ESCs and single hatched blastocysts, to identify the soluble factors involved in implantation. Over the 3-day co-culture period, approximately 75% of embryos arrested whereas the remainder showed normal development. The levels of 14 implantation factors secreted by the stromal cells were determined by multiplex immunoassay. Surprisingly, the presence of a developing embryo had no significant effect on decidual secretions, apart from a modest reduction in IL-5 levels. In contrast, arresting embryos triggered a strong response, characterized by selective inhibition of IL-1β, -6, -10, -17, -18, eotaxin, and HB-EGF secretion. Co-cultures were repeated with undifferentiated ESCs but none of the secreted cytokines were affected by the presence of a developing or arresting embryo.ConclusionsHuman ESCs become biosensors of embryo quality upon differentiation into decidual cells. In view of the high incidence of gross chromosomal errors in human preimplantation embryos, cyclic decidualization followed by menstrual shedding may represent a mechanism of natural embryo selection that limits maternal investment in deve

Journal article

Unadkat SN, Leff DR, Teoh T-G, Rai R, Darzi AW, Ziprin Pet al., 2010, Anorectal symptoms during pregnancy: how important is trimester?, INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, Vol: 25, Pages: 375-379, ISSN: 0179-1958

Journal article

Abu-Amero S, Moore G, Regan L, Rai R, White S, Miller A, Lo W, Johnson M, Nicolaides K, Williamson C, Peebles D, Whittaker Jet al., 2009, The Baby Bio Bank of London, British Human Genetics Conference, Publisher: B M J PUBLISHING GROUP, Pages: S113-S113, ISSN: 0022-2593

Conference paper

Hameed A, Rai R, Lo W, Al-Ghamdi A, Marikinti K, Regan Let al., 2009, Reproductive Outcome in Women Age 40 Years or Older with a History of Recurrent Miscarriage-2 Year Follow up., 56th Annual Meeting of the Society-for-Gynecologic-Investigation, Publisher: SAGE PUBLICATIONS INC, Pages: 356A-356A, ISSN: 1933-7191

Conference paper

Lo W, Rai R, Aisha H, Al-Ghamdi A, Brailsford S, Marikinti K, Regan Let al., 2009, The Effect of Body Mass Index on Pregnancy Outcome in Women with Recurrent Miscarriage., 56th Annual Meeting of the Society-for-Gynecologic-Investigation, Publisher: SAGE PUBLICATIONS INC, Pages: 357A-358A, ISSN: 1933-7191

Conference paper

Disu SA, Zaher S, Hameed A, Rai R, Hamady MN, Gedroyc WM, Regan Let al., 2009, Management of Fibroids in an Inner London Teaching Hospital - A Review of 2 Treatment Modalities: MRgFUS (Magnetic Resonance Guided Focused Ultrasound) Versus UAE (Uterine Artery Embolisation), 56th Annual Meeting of the Society-for-Gynecologic-Investigation, Publisher: SAGE PUBLICATIONS INC, Pages: 123A-123A, ISSN: 1933-7191

Conference paper

Hameed A, Lo W, Disu S, Horner E, Rai R, Regan Let al., 2009, Pregnancy Outcome in Women with History of Higher Order (≥6) Recurrent Miscarriages., 56th Annual Meeting of the Society-for-Gynecologic-Investigation, Publisher: SAGE PUBLICATIONS INC, Pages: 355A-356A, ISSN: 1933-7191

Conference paper

Al-Ghamdi A, Rai R, Hameed A, Lo W, Regan Let al., 2009, Peripheral Blood Karyotyping amongst Couples with Recurrent Miscarriage-Universal or Selective Screening?, 56th Annual Meeting of the Society-for-Gynecologic-Investigation, Publisher: SAGE PUBLICATIONS INC, Pages: 185A-185A, ISSN: 1933-7191

Conference paper

Rai R, Campbell MI, 2008, Q2S2: Merging qualitative information in sequential DOE, ASME International Design Engineering Technical Conferences/Computers and Information in Engineering Conference, Publisher: AMER SOC MECHANICAL ENGINEERS, Pages: 649-662

Conference paper

Cornish JA, Tan E, Teare J, Teoh TG, Rai R, Darzi AW, Paraskevas P, Clark SK, Tekkis PPet al., 2007, The effect of restorative proctocolectomy on sexual function, urinary function, fertility, pregnancy and delivery: A systematic review, DISEASES OF THE COLON & RECTUM, Vol: 50, Pages: 1128-1138, ISSN: 0012-3706

Journal article

Cornish J, Tan E, Teare J, Teoh TG, Rai R, Clark SK, Tekkis PPet al., 2007, A meta-analysis on the influence of inflammatory bowel disease on pregnancy, GUT, Vol: 56, Pages: 830-837, ISSN: 0017-5749

Journal article

Jindal P, Regan L, Fourkala EO, Rai R, Moore G, Goldin RD, Sebire NJet al., 2007, Placental pathology of recurrent spontaneous abortion: the role of histopathological examination of products of conception in routine clinical practice: a mini review, HUMAN REPRODUCTION, Vol: 22, Pages: 313-316, ISSN: 0268-1161

Journal article

Rai R, Regan L, 2006, Recurrent miscarriage, LANCET, Vol: 368, Pages: 601-611, ISSN: 0140-6736

Journal article

Francis J, Rai R, Sebire NJ, El-Gaddal S, Fernandes MS, Jindal P, Lokugamage A, Regan L, Brosens JJet al., 2006, Impaired expression of endometrial differentiation markers and complement regulatory proteins in patients with recurrent pregnancy loss associated with antiphospholipid syndrome, MOLECULAR HUMAN REPRODUCTION, Vol: 12, Pages: 435-442

Journal article

Rai R, Backos M, Francis J, Brosens J, Regan Let al., 2006, Peripheral blood natural killer cells and recurrent miscarriage - a prospective study, 22nd Annual Meeting of the European-Society-of-Human-Reproduction-and-Embryology, Publisher: OXFORD UNIV PRESS, Pages: I11-I11, ISSN: 0268-1161

Conference paper

Jivraj S, Rai R, Underwood J, Regan Let al., 2006, Genetic thrombophilic mutations among couples with recurrent miscarriage, HUMAN REPRODUCTION, Vol: 21, Pages: 1161-1165, ISSN: 0268-1161

Journal article

Hills FA, Abrahams VM, Gonzalez-Timon B, Francis J, Cloke B, Hinkson L, Rai R, Mor G, Regan L, Sullivan M, Lam EW-F, Brosens JJet al., 2006, Heparin prevents programmed cell death in human trophoblast, MOLECULAR HUMAN REPRODUCTION, Vol: 12, Pages: 237-243

Journal article

Heeps A, Crouch N, Backos M, Brosens J, Higham J, Rai R, Regan Let al., 2006, Successful prevention of second trimester pregnancy loss using high cervical cerclage., 53rd Annual Scientific Meeting of the Society-for-Gynecologic-Investigation, Publisher: ELSEVIER SCIENCE INC, Pages: 333A-333A, ISSN: 1071-5576

Conference paper

Rai R, Backos M, Francis J, Brosens J, Regan Let al., 2006, Peripheral blood NK cell levels are not predictive of future pregnancy outcome amongst women with recurrent miscarriage - A prospective study., 53rd Annual Scientific Meeting of the Society-for-Gynecologic-Investigation, Publisher: ELSEVIER SCIENCE INC, Pages: 354A-354A, ISSN: 1071-5576

Conference paper

Regan L, Hills F, Abrahams V, Gonzalez-Timon B, Francis J, Hinkson L, Rai R, Mor G, Lam E, Brosens Jet al., 2006, Heparin prevents programmed cell death in human trophoblast., 53rd Annual Scientific Meeting of the Society-for-Gynecologic-Investigation, Publisher: ELSEVIER SCIENCE INC, Pages: 353A-353A, ISSN: 1071-5576

Conference paper

Rai R, Brosens J, Sebire N, Francis J, Goldin R, Regan Let al., 2006, Expression of endometrial complement regulatory proteins in antiphospholipid syndrome., 53rd Annual Scientific Meeting of the Society-for-Gynecologic-Investigation, Publisher: ELSEVIER SCIENCE INC, Pages: 355A-355A, ISSN: 1071-5576

Conference paper

Mathew L, Sadd M, Kalpat S, Zavala M, Stephens T, Mora R, Rai R, Parker C, Vasek J, Sing D, Shimer R, Prabhu L, Workman GO, Ablen G, Shi Z, Saenz J, Min B, Burnett D, Nguyen B-Y, Mogab J, Chowdhury MM, Zhang W, Fossum JGet al., 2006, ITFET: Inverted T Channel FET, A Novel Device architecture and circuits based on the ITFET., IEEE International Conference on Integrated Circuit Design and Technology, Publisher: IEEE, Pages: 130-+

Conference paper

Ostensen M, Khamashta M, Lockshin M, Parke A, Brucato A, Carp H, Doria A, Rai R, Meroni P, Cetin I, Derksen R, Branch W, Motta M, Gordon C, Ruiz-Irastorza G, Spinillo A, Friedman D, Cimaz R, Czeizel A, Piette JC, Cervera R, Levy RA, Clementi M, De Carolis S, Petri M, Shoenfeld Y, Faden D, Valesini G, Tincani Aet al., 2006, Anti-inflammatory and immunosuppressive drugs and reproduction, ARTHRITIS RESEARCH & THERAPY, Vol: 8, ISSN: 1478-6354

Journal article

Thean AV-Y, Shi Z-H, Mathew L, Stephens T, Desjardin H, Parker C, White T, Stoker M, Prabhu L, Garcia R, Nguyen B-Y, Murphy S, Rai R, Conner J, White BE, Venkatesan Set al., 2006, Performance and variability comparisons between multi-gate FETs and planar SOI transistors, IEEE International Electron Devices Meeting, Publisher: IEEE, Pages: 630-+, ISSN: 2380-9248

Conference paper

Ng S-L, Vaidya A, Venkataraman V, Murcko B, Srihari K, Rai Ret al., 2006, Environmental conservation through lead-free electronics manufacturing, 14th IEEE International Symposium on Electronics and the Environment (ISEE)/7th Electronics Recycling Summit, Publisher: IEEE, Pages: 189-+, ISSN: 1095-2020

Conference paper

Rai R, Sacks G, Trew G, 2005, Natural Killer cells and reproductive failure - theory, practice and prejudice., Human Reproduction, Vol: 20, Pages: 1123-1126

Journal article

Regan L, Carrington B, Rasul S, Lawn A, Rai Ret al., 2005, Polycystic ovaries, insulin resistance, hypofibrinolysis and recurrent miscarriage., 52nd Annual Meeting of the Society-for-Gynecologic-Investigation, Publisher: ELSEVIER SCIENCE INC, Pages: 91A-92A, ISSN: 1071-5576

Conference paper

Mathew L, Du Y, Kalpat S, Sadd M, Zavala M, Stephens T, Mora R, Rai R, Becker S, Parker C, Sing D, Shimer R, Sanez J, Thean AVY, Prabhu L, Moosa M, Nguyen BY, Mogab J, Workman GO, Vandooren A, Shi Z, Chowdhury MM, Zhang W, Fossum JGet al., 2005, Multiple independent gate field effect transistor (MIGFET) - Multi-fin RF mixer architecture, three independent gates (MIGFET-T) operation and temperature characteristics, 25th Symposium on VLSI Technology, Publisher: JAPAN SOCIETY APPLIED PHYSICS, Pages: 200-201

Conference paper

Zhang D, Nguyen BY, White T, Goolsby B, Nguyen T, Dhandapani V, Hildreth J, Foisy M, Adams V, Shiho Y, Thean A, Theodore D, Canonico M, Zollner S, Bagchi S, Murphy S, Rai R, Jiang J, Jahanbani M, Noble R, Zavala M, Cotton R, Eades D, Parsons S, Montgomery P, Martinez A, Winstead B, Mendicino M, Cheek J, Liu J, Grudowski P, Ranami N, Tomasini P, Arena C, Werkhoven C, Kirby H, Chang CH, Lin CT, Tuan HC, See YC, Venkatesan S, Kolagunta V, Cave N, Mogab Jet al., 2005, Embedded SiGeS/D PMOS on thin body SOI substrate with drive current enhancement, 25th Symposium on VLSI Technology, Publisher: JAPAN SOCIETY APPLIED PHYSICS, Pages: 26-27

Conference paper

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