Richard Kermit Miller, Ph.D.

During this time, he has been involved with the leadership of the NIEHS Environmental Health Sciences Center, as well as Associate Chair for Research in Obs/Gyn. In 1987, Dr. Miller began the Perinatal Environmental and Drug Consultation Service (PEDECS) (New York Teratogen Information Service) in Obs/Gyn and is its Director. This service provides expertise concerning exposures during pregnancy or before pregnancy to environmental, occupational and therapeutic exposures to the women and/or family.

He is also co-Director of the New York State Center of Excellence in Children's Environmental Health at the University of Rochester.

Dr. Miller is Past President of the Teratology Society and has been active with National and International Concerns involving Vitamins and Herbal Products as well as environmental exposures.

He is actively involved with OTIS, the Organization of Teratology Information Specialists, with their Committees on Occupational Exposures and on Research. He is currently Chair of the International Committee on Research for OTIS and ENTIS.

Dr. Miller has recently co-edited a volume on these subjects entitled, "Drugs During Pregnancy and Lactation - Treatment Options and Risk Assessment" besides his other 10 volumes.

Also he was Scientific Director of the NIH sponsored Women's Reproductive Health Research Scholars Program for training Obstetrician/Gynecologists as Clinical Scientists from 1999 - 2010.

Dr. Miller is a member of the Scientific Board of TERIS as well as Dysmorphologist and Scientific Board Member for the US Ribavirin Pregnancy Registry.

He has been involved with a number of research programs with the National Toxicology Program (Scientific Board), the FDA, NIH, Merck, Roche, Centecor, Eastman Kodak, Johnson and Johnson and other partners.

He has trained more than 25 fellows and graduate students, who are providing leadership in Academia, Government and Industry throughout the world.

His funding does and has come from NICHHD, NIAID, NIAAA, NCI, NIEHS, FDA, NCS, US Israel Binational Fdn, Goode Fdn and industry partners.

He was also the recipient of the Bock Prize for Developmental Biology and Child Health in 2011.

For 2011, he has organized, spoken or will be
• Faculty, NIH CICHR Summer Institute on Obstetrical Pharmacology (Montreal, Canada)
• International ENTIS and OTIS Meeting (Jerusalem, Israel) Organized and Speaking in the Symposium on the Placenta in Clinical Teratology;
• Symposium Society of Toxicology (Washington, DC) on Toxicological Considerations of Pharmacotherapy During Pregnancy
• Reproductive and Developmental Toxicology for Industrial and Regulatory Scientists Course sponsored by the Teratology Society (Virginia): Placental and Maternal Influences on Development;
• Bock Prize Lecturer - Impact of Prenatal, Neonatal and Early Childhood Nutritional and Environmental Factors on a Child's Growth and Development – a Pediatric Problem. A.I DuPont Children's Hospital, Jefferson Medical College (Wilmington, Del)
• Toxicology Distinguished Lecturer, University of Michigan, School of Public Health, Ann Arbor (MI)

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Placental Toxicology and Pathology.

Cadmium can be a placental toxin in rodents by producing fetal death and placental necrosis. Using an in vitro dually perfused human placenta model, cadmium also produced necrosis. Pharmacokinetic studies in both rodent and human studies demonstrated the role of the placenta as a site for control of passage and intoxication. The response of the cell to cadmium toxicity may be regulated by metallothionein and calmodulin. Different isoforms of metallothionein are being identified via cDNA isolation and in situ hybridization for determination of metallothionein distribution and inducibility in placentae from women exposed during pregnancy to environmental metals (cadmium, arsenic, lead and mercury). Currently gene environment interactions during development are being pursued in an animal model of diabetes mellitus.

Placental Pathology and the relationship to in utero development and adult disease is being evaluated. Focus is on specific evaluations of shape, size and vascular structure of the placenta and an understanding of the underlying pathology. These investigations are being pursued as part of an NIH National Children's Study Formative Research Study

Implantation Biology.

Pregnancy loss due to implantation failures is being examined using an in vitro model consisting of both human trophoblast and endometrium to study the biology of attachment and invasion as well as the influence of hormones, xenobiotics and disease (antiphospholipid syndrome, pre-eclampsia). Additional investigations are examining the effects of plasticizers - phthalates and bisphenol A on human placental function to understand the relationship between plasticizer exposures and miscarriages.

Vertical transmission of HIV.

Why do only 25-40% of the babies of HIV positive mothers become infected? Why not all the babies? What controls infectivity of the fetus in utero? These are questions being explored in patients who are pregnant and HIV positive. In vitro models of human placenta are used to study how the placenta may modulate HIV infection in utero. Certain strains of HIV-1 can selectively infect the human placenta, while others do not. Molecular techniques are being used - Real Time - PCR, ISPCR - to determine which cells are being infected. With these models we can test how anti-HIV therapies may best prevent the vertical transmission of HIV as well as produce toxicity in the human placenta.

Clinical Investigations:

Preeclampsia is a major contributor to adverse pregnancy outcomes for both mother and baby. A major difficulty is diagnosing the illness before the conditions are too severe. Previous studies have demonstrated that placental growth factor and vascular endothelial growth factor levels are reduced in women who will develop severe preeclampsia. Current investigations are underway examining the clinical possibilities of early diagnosis of preeclampsia in hopes that treatment modalities will then be possible to prevent the disease.

Other investigations examine the pharmacokinetics of antiseizure, anti-HIV, ACE inhibitors, anticoagulants, nanomedicines and biotech products concerning maternal/ fetal exposures.

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