Richard K. Miller, Ph.D.

See information for Patients. Viewing information for Researchers.

Perinatal Toxicology is the focus of this laboratory. How viruses, metals, anti-HIV therapy, and vitamins (A, B12, C and E), nanoparticles, and hyperthermia affect normal development of the embryo/ fetus are being investigated. In particular, the role of the placenta as the anchor, controller, and conduit during pregnancy as well as a site for toxic action is examined.

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.

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. 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.

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 on human placental function to understand the relationship between plasticizer exposures and miscarriages.

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 and biotech products concerning maternal/ fetal exposures.

Current Appointments

• Professor - Department of Obstetrics and Gynecology (SMD)
• Professor - Department of Pathology and Laboratory Medicine (SMD)
• Professor - Department of Environmental Medicine (SMD)

Education
PhD Pharmacology and Toxicology	Dartmouth Medical School	1973
AB Biology	Dartmouth College	1968

Fellowship Awards
Fullbright Distinguished Professor Fellowship	1988
NIH/Fogarty Senior International Fellowship	1983
Fellowship in Developmental Biology/Teratology, 1972-1974, Jefferson Medical College, Philadelphia, PA	1972 - 1974
NIH Postdoctoral Traineeships	1972 - 1974
Smith, Kline and French Postdoctoral Fellowship	1972 - 1974
NIH Predoctoral Traineeships	1968 - 1972

Board Certifications
Fellow, Academy of Toxicological Sciences	1999 - Present
Diplomate, Board Certified Forensic Examiner, American Board of Forensic Examiners	1996 - Present
Diplomate, Board Certified in Forensic Medicine, American Board of Forensic Medicine	1996 - Present
Clinical Laboratory Director, Certified State of NY	1995 - 2011

Recent Journal Articles
Showing the 5 most recent journal articles. (143 available)
Lash GE; Ansari T; Bischof P; Burton GJ; Chamley L; Crocker I; Dantzer V; Desoye G; Drewlo S; Fazleabas A; Jansson T; Keating S; Kliman HJ; Lang I; Mayhew T; Meiri H; Miller RK; Nelson DM; Pfarrer C; Roberts C; Sammar M; Sharma S; Shiverick K; Strunk D; Turner MA; Huppertz B. "IFPA meeting 2008 workshops report." Placenta. 2009; 30 Suppl A():S4-14. Epub 2008 Dec 11.
Miller RK. "Henning Schneider, M.D." Placenta. 2009; 30 Suppl A():S66-70. Epub 2009 Jan 20.
Salafia CM; Misra DP; Yampolsky M; Charles AK; Miller RK. "Allometric metabolic scaling and fetal and placental weight." Placenta. 2009; 30(4):355-60. Epub 2009 Mar 04.
Krtolica A; Ilic D; Genbacev O; Miller RK. "Human embryonic stem cells as a model for embryotoxicity screening." Regenerative medicine. 2009; 4(3):449-59.
Misra DP; Salafia CM; Miller RK; Charles AK. "Non-Linear and Gender-Specific Relationships Among Placental Growth Measures and The Fetoplacental Weight Ratio." Placenta. 2009; Epub 2009 Oct 28.