51
|
Wiggs KK, Rickert ME, Sujan AC, Quinn PD, Larsson H, Lichtenstein P, Oberg AS, D'Onofrio BM. Antiseizure medication use during pregnancy and risk of ASD and ADHD in children. Neurology 2020; 95:e3232-e3240. [PMID: 33115775 PMCID: PMC7836668 DOI: 10.1212/wnl.0000000000010993] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 08/24/2020] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To determine whether children born to women who use antiseizure medications (ASMs) during pregnancy have higher risk of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) independent of confounding factors. METHODS We used Swedish register data (n = 14,614 children born 1996-2011 and followed up through 2013) to examine associations in children of women with epilepsy, using the largest sample to date and adjusting for a range of measured confounders. We examined maternal-reported first-trimester use of any ASM (22.7%) and the 3 most commonly reported individual drugs (valproic acid 4.8%, lamotrigine 6.8%, and carbamazepine 9.7%). We identified ASD with ICD-10 diagnoses and ADHD with ICD-10 diagnoses or filled prescriptions of ADHD medication. RESULTS Examination of individual drugs revealed that after adjustment for confounding, use of valproic acid was associated with ASD (hazard ratio [HR] 2.30, 95% confidence interval [CI] 1.53-3.47) and ADHD (HR 1.74, 95% CI 1.28-2.38). Whereas a small, nonstatistically significant association with ASD (HR 1.25, 95% CI = 0.88-1.79) and ADHD (HR 1.18, 95% CI 0.91-1.52) remained for reported use of carbamazepine, confounding explained all of the associations with lamotrigine (HRASD 0.86, 95% CI 0.67-1.53; HRADHD 1.01, 95% CI 0.67-1.53). CONCLUSIONS We found no evidence of risk related to exposure to lamotrigine, whereas we observed elevated risk of ASD and ADHD related to maternal use of valproic acid. Associations with carbamazepine were weak and not statistically significant. Our findings add to a growing body of evidence that suggests that certain ASMs may be safer than others in pregnancy.
Collapse
Affiliation(s)
- Kelsey K Wiggs
- From the Department of Psychological & Brain Sciences (K.K.W., M.E.R., A.C.S., B.M.D.) and Department of Applied Health Science (P.D.Q.), School of Public Health, Indiana University-Bloomington; Department of Medical Epidemiology and Biostatistics (H.L., P.L., A.S.O., B.M.D.), Karolinska Institutet, Stockholm; School of Medical Sciences (H.L.), Örebro University, Sweden; and Department of Epidemiology (A.S.O.), T.H. Chan School of Public Health, Harvard, Boston, MA.
| | - Martin E Rickert
- From the Department of Psychological & Brain Sciences (K.K.W., M.E.R., A.C.S., B.M.D.) and Department of Applied Health Science (P.D.Q.), School of Public Health, Indiana University-Bloomington; Department of Medical Epidemiology and Biostatistics (H.L., P.L., A.S.O., B.M.D.), Karolinska Institutet, Stockholm; School of Medical Sciences (H.L.), Örebro University, Sweden; and Department of Epidemiology (A.S.O.), T.H. Chan School of Public Health, Harvard, Boston, MA
| | - Ayesha C Sujan
- From the Department of Psychological & Brain Sciences (K.K.W., M.E.R., A.C.S., B.M.D.) and Department of Applied Health Science (P.D.Q.), School of Public Health, Indiana University-Bloomington; Department of Medical Epidemiology and Biostatistics (H.L., P.L., A.S.O., B.M.D.), Karolinska Institutet, Stockholm; School of Medical Sciences (H.L.), Örebro University, Sweden; and Department of Epidemiology (A.S.O.), T.H. Chan School of Public Health, Harvard, Boston, MA
| | - Patrick D Quinn
- From the Department of Psychological & Brain Sciences (K.K.W., M.E.R., A.C.S., B.M.D.) and Department of Applied Health Science (P.D.Q.), School of Public Health, Indiana University-Bloomington; Department of Medical Epidemiology and Biostatistics (H.L., P.L., A.S.O., B.M.D.), Karolinska Institutet, Stockholm; School of Medical Sciences (H.L.), Örebro University, Sweden; and Department of Epidemiology (A.S.O.), T.H. Chan School of Public Health, Harvard, Boston, MA
| | - Henrik Larsson
- From the Department of Psychological & Brain Sciences (K.K.W., M.E.R., A.C.S., B.M.D.) and Department of Applied Health Science (P.D.Q.), School of Public Health, Indiana University-Bloomington; Department of Medical Epidemiology and Biostatistics (H.L., P.L., A.S.O., B.M.D.), Karolinska Institutet, Stockholm; School of Medical Sciences (H.L.), Örebro University, Sweden; and Department of Epidemiology (A.S.O.), T.H. Chan School of Public Health, Harvard, Boston, MA
| | - Paul Lichtenstein
- From the Department of Psychological & Brain Sciences (K.K.W., M.E.R., A.C.S., B.M.D.) and Department of Applied Health Science (P.D.Q.), School of Public Health, Indiana University-Bloomington; Department of Medical Epidemiology and Biostatistics (H.L., P.L., A.S.O., B.M.D.), Karolinska Institutet, Stockholm; School of Medical Sciences (H.L.), Örebro University, Sweden; and Department of Epidemiology (A.S.O.), T.H. Chan School of Public Health, Harvard, Boston, MA
| | - A Sara Oberg
- From the Department of Psychological & Brain Sciences (K.K.W., M.E.R., A.C.S., B.M.D.) and Department of Applied Health Science (P.D.Q.), School of Public Health, Indiana University-Bloomington; Department of Medical Epidemiology and Biostatistics (H.L., P.L., A.S.O., B.M.D.), Karolinska Institutet, Stockholm; School of Medical Sciences (H.L.), Örebro University, Sweden; and Department of Epidemiology (A.S.O.), T.H. Chan School of Public Health, Harvard, Boston, MA
| | - Brian M D'Onofrio
- From the Department of Psychological & Brain Sciences (K.K.W., M.E.R., A.C.S., B.M.D.) and Department of Applied Health Science (P.D.Q.), School of Public Health, Indiana University-Bloomington; Department of Medical Epidemiology and Biostatistics (H.L., P.L., A.S.O., B.M.D.), Karolinska Institutet, Stockholm; School of Medical Sciences (H.L.), Örebro University, Sweden; and Department of Epidemiology (A.S.O.), T.H. Chan School of Public Health, Harvard, Boston, MA
| |
Collapse
|
52
|
Gräfe C, Müller EK, Gresing L, Weidner A, Radon P, Friedrich RP, Alexiou C, Wiekhorst F, Dutz S, Clement JH. Magnetic hybrid materials interact with biological matrices. PHYSICAL SCIENCES REVIEWS 2020. [DOI: 10.1515/psr-2019-0114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Abstract
Magnetic hybrid materials are a promising group of substances. Their interaction with matrices is challenging with regard to the underlying physical and chemical mechanisms. But thinking matrices as biological membranes or even structured cell layers they become interesting with regard to potential biomedical applications. Therefore, we established in vitro blood-organ barrier models to study the interaction and processing of superparamagnetic iron oxide nanoparticles (SPIONs) with these cellular structures in the presence of a magnetic field gradient. A one-cell-type–based blood-brain barrier model was used to investigate the attachment and uptake mechanisms of differentially charged magnetic hybrid materials. Inhibition of clathrin-dependent endocytosis and F-actin depolymerization led to a dramatic reduction of cellular uptake. Furthermore, the subsequent transportation of SPIONs through the barrier and the ability to detect these particles was of interest. Negatively charged SPIONs could be detected behind the barrier as well as in a reporter cell line. These observations could be confirmed with a two-cell-type–based blood-placenta barrier model. While positively charged SPIONs heavily interact with the apical cell layer, neutrally charged SPIONs showed a retarded interaction behavior. Behind the blood-placenta barrier, negatively charged SPIONs could be clearly detected. Finally, the transfer of the in vitro blood-placenta model in a microfluidic biochip allows the integration of shear stress into the system. Even without particle accumulation in a magnetic field gradient, the negatively charged SPIONs were detectable behind the barrier. In conclusion, in vitro blood-organ barrier models allow the broad investigation of magnetic hybrid materials with regard to biocompatibility, cell interaction, and transfer through cell layers on their way to biomedical application.
Collapse
Affiliation(s)
- Christine Gräfe
- Department of Internal Medicine II, Hematology and Medical Oncology , Jena University Hospital , Jena , Germany
| | - Elena K. Müller
- Department of Internal Medicine II, Hematology and Medical Oncology , Jena University Hospital , Jena , Germany
| | - Lennart Gresing
- Department of Internal Medicine II, Hematology and Medical Oncology , Jena University Hospital , Jena , Germany
| | - Andreas Weidner
- Institute of Biomedical Engineering and Informatics (BMTI), Technische Universität Ilmenau , Ilmenau , Germany
| | - Patricia Radon
- Physikalisch-Technische Bundesanstalt , Berlin , Germany
| | - Ralf P. Friedrich
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Experimental Oncology and Nanomedicine (SEON) , Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen , Erlangen , Germany
| | - Christoph Alexiou
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Experimental Oncology and Nanomedicine (SEON) , Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen , Erlangen , Germany
| | | | - Silvio Dutz
- Institute of Biomedical Engineering and Informatics (BMTI), Technische Universität Ilmenau , Ilmenau , Germany
| | - Joachim H. Clement
- Department of Internal Medicine II, Hematology and Medical Oncology , Jena University Hospital , Jena , Germany
| |
Collapse
|
53
|
Zabel RR, Bär C, Ji J, Schultz R, Hammer M, Groten T, Schleussner E, Morales-Prieto DM, Markert UR, Favaro RR. Enrichment and characterization of extracellular vesicles from ex vivo one-sided human placenta perfusion. Am J Reprod Immunol 2020; 86:e13377. [PMID: 33175429 DOI: 10.1111/aji.13377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 11/04/2020] [Indexed: 12/15/2022] Open
Abstract
PROBLEM Extracellular vesicles (EVs) released by the placenta are packed with biological information and play a major role in fetomaternal communication. Here, we describe a comprehensive set-up for the enrichment and characterization of EVs from human placenta perfusion and their application in further assays. METHOD OF STUDY Human term placentas were used for 3 h ex vivo one-sided perfusions to simulate the intervillous circulation. Thereafter, populations of small (sEVs) and large EV (lEVs) were enriched from placental perfusate via serial ultracentrifugation. Following, EV populations were characterized regarding their size, protein concentration, RNA levels, expression of surface markers as well as their uptake and miRNA transfer to recipient cells. RESULTS The sEV and lEV fractions from an entire perfusate yielded, respectively, 294 ± 32 µg and 525 ± 96 µg of protein equivalents and 2.6 ± 0.5 µg and 3.6 ± 0.9 µg of RNA. The sEV fraction had a mean diameter of 117 ± 47 nm, and the lEV fraction presented 236 ± 54 nm. CD63 was strongly detected by dot blot in sEVs, whereas only traces of this marker were found in lEVs. Both EV fractions were positive for the trophoblast marker PLAP (placental alkaline phosphatase) and annexin A1. EV internalization in immune cells was visualized by confocal microscopy, and the transfer of placental miRNAs was detected by quantitative real-time PCR (qPCR). CONCLUSIONS Enriched EV populations showed characteristic features of sEVs and lEVs. EV uptake and transfer of miRNAs to recipient cells demonstrated their functional integrity. Therefore, we advocate the ex vivo one-sided placenta perfusion as a robust approach for the collection of placental EVs.
Collapse
Affiliation(s)
- Rachel R Zabel
- Placenta-Lab, Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - Christin Bär
- Placenta-Lab, Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - Jinlu Ji
- Placenta-Lab, Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - Rowena Schultz
- Department of Ophthalmology, Jena University Hospital, Jena, Germany
| | - Martin Hammer
- Department of Ophthalmology, Jena University Hospital, Jena, Germany
| | - Tanja Groten
- Placenta-Lab, Department of Obstetrics, Jena University Hospital, Jena, Germany
| | | | | | - Udo R Markert
- Placenta-Lab, Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - Rodolfo R Favaro
- Placenta-Lab, Department of Obstetrics, Jena University Hospital, Jena, Germany
| |
Collapse
|
54
|
Pencolé L, Lê MP, Bouchet-Crivat F, Duro D, Peytavin G, Mandelbrot L. Placental transfer of the integrase strand inhibitors cabotegravir and bictegravir in the ex-vivo human cotyledon perfusion model. AIDS 2020; 34:2145-2149. [PMID: 32796211 DOI: 10.1097/qad.0000000000002637] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
: Data on placental transfer is lacking for the recent HIV integrase inhibitors, bictegravir and cabotegravir, although their future use in pregnancy is to be expected. The objective of this study was to determine their transplacental pharmacokinetics. Maternal-to-fetal transfer was investigated using the open-circuit ex-vivo dually perfused human cotyledon model. Cabotegravir or bictegravir was added to a maternal perfusate containing 2 g/l of human albumin and antipyrine, a marker to validate the cotyledon's viability, and cotyledons were dually perfused for up to 90 min. For cabotegravir, in five experiments, the median (IQR 25-75) concentrations in the maternal and in the fetal compartments were, respectively, 550 ng/ml (344-788) and 48 ng/ml (37-54), with a maternal-to-fetal ratio of 10% (5-16) and a clearance index (in comparison with antipyrine transfer) of 22% (19-28). The median cotyledon accumulation index was 10% (2-21). For bictegravir, in six experiments, the median (IQR 25-75) concentrations in the maternal and in the fetal compartments were, respectively, 1650 ng/ml (1455-1960) and 126 ng/ml (112-142), with a maternal-to-fetal ratio of 7% (6-9.5) and a clearance index (in comparison with antipyrine transfer) of 21% (17-29). The median cotyledon accumulation index was 4% (3-5). Placental transfer of cabotegravir and bictegravir were low. This may not only limit the potential for fetal toxicities but also be a limit to their usefulness at the time of labor and delivery to reduce the risk of vertical HIV transmission. The safety and efficacy of these new integrase inhibitors in pregnancy require more investigation.
Collapse
Affiliation(s)
- Lucile Pencolé
- AP-HP, Hôpital Louis Mourier, Service de Gynécologie-Obstétrique, Colombes
| | - Minh P Lê
- AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Pharmacologie-Toxicologie
- INSERM, UMRS 1144, Université de Paris
- INSERM, IAME, UMR 1137 Université de Paris, Paris, France
| | | | - Dominique Duro
- AP-HP, Hôpital Louis Mourier, Service de Gynécologie-Obstétrique, Colombes
| | - Gilles Peytavin
- AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Pharmacologie-Toxicologie
- INSERM, IAME, UMR 1137 Université de Paris, Paris, France
| | - Laurent Mandelbrot
- AP-HP, Hôpital Louis Mourier, Service de Gynécologie-Obstétrique, Colombes
- INSERM, IAME, UMR 1137 Université de Paris, Paris, France
| |
Collapse
|
55
|
Zafeiri A, Mitchell RT, Hay DC, Fowler PA. Over-the-counter analgesics during pregnancy: a comprehensive review of global prevalence and offspring safety. Hum Reprod Update 2020; 27:67-95. [PMID: 33118024 DOI: 10.1093/humupd/dmaa042] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/16/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Analgesia during pregnancy is often necessary. Due to their widespread availability, many mothers opt to use over-the-counter (OTC) analgesics. Those analgesic compounds and their metabolites can readily cross the placenta and reach the developing foetus. Evidence for safety or associations with adverse health outcomes is conflicting, limiting definitive decision-making for healthcare professionals. OBJECTIVE AND RATIONALE This review provides a detailed and objective overview of research in this field. We consider the global prevalence of OTC analgesia during pregnancy, explain the current mechanistic understanding of how analgesic compounds cross the placenta and reach the foetus, and review current research on exposure associations with offspring health outcomes. SEARCH METHODS A comprehensive English language literature search was conducted using PubMed and Scopus databases. Different combinations of key search terms were used including 'over-the-counter/non-prescription analgesics', 'pregnancy', 'self-medication', 'paracetamol', 'acetaminophen', 'diclofenac', 'aspirin', 'ibuprofen', 'in utero exposure', 'placenta drug transport', 'placental transporters', 'placenta drug metabolism' and 'offspring outcomes'. OUTCOMES This article examines the evidence of foetal exposure to OTC analgesia, starting from different routes of exposure to evidence, or the lack thereof, linking maternal consumption to offspring ill health. There is a very high prevalence of maternal consumption of OTC analgesics globally, which is increasing sharply. The choice of analgesia selected by pregnant women differs across populations. Location was also observed to have an effect on prevalence of use, with more developed countries reporting the highest consumption rates. Some of the literature focuses on the association of in utero exposure at different pregnancy trimesters and the development of neurodevelopmental, cardiovascular, respiratory and reproductive defects. This is in contrast to other studies which report no associations. WIDER IMPLICATIONS The high prevalence and the challenges of reporting exact consumption rates make OTC analgesia during pregnancy a pressing reproductive health issue globally. Even though some healthcare policy-making authorities have declared the consumption of some OTC analgesics for most stages of pregnancy to be safe, such decisions are often based on partial review of literature. Our comprehensive review of current evidence highlights that important knowledge gaps still exist. Those areas require further research in order to provide pregnant mothers with clear guidance with regard to OTC analgesic use during pregnancy.
Collapse
Affiliation(s)
- Aikaterini Zafeiri
- Institute of Medical Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Rod T Mitchell
- MRC Centre for Reproductive Health, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, UK
| | - David C Hay
- MRC Centre for Regenerative Medicine, Institute of Regeneration and Repair, University of Edinburgh, Edinburgh, UK
| | - Paul A Fowler
- Institute of Medical Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| |
Collapse
|
56
|
Kurosawa K, Chiba K, Noguchi S, Nishimura T, Tomi M. Development of a Pharmacokinetic Model of Transplacental Transfer of Metformin to Predict In Vivo Fetal Exposure. Drug Metab Dispos 2020; 48:1293-1302. [PMID: 33051249 DOI: 10.1124/dmd.120.000127] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/14/2020] [Indexed: 11/22/2022] Open
Abstract
Two types of systems are used in ex vivo human placental perfusion studies to predict fetal drug exposures, that is, closed systems with recirculation of the maternal and fetal buffer and open systems using a single-pass mode without recirculation. The in vivo fetal/maternal (F:M) ratio of metformin, a cationic drug that crosses the placenta, is consistent with that reported in an open system ex vivo but not with that in a closed system. In the present study, we aimed to develop a pharmacokinetic (PK) model of transplacental transfer of metformin to predict in vivo fetal exposure to metformin and to resolve the apparent inconsistency between open and closed ex vivo systems. The developed model shows that the difference between open and closed systems is due to the difference in the time required to achieve the steady state. The model-predicted F:M ratio (approx. 0.88) is consistent with reported in vivo values [mean (95% confidence interval): 1.10 (0.69-1.51)]. The model incorporates bidirectional transport via organic cation transporter 3 (OCT3) at the basal plasma membrane, and simulations indicate that the use of trimethoprim (an OCT3 inhibitor) to prevent microbial growth in the placenta ex vivo has a negligible effect on the overall maternal-to-fetal and fetal-to-maternal clearances. The model could successfully predict in vivo fetal exposure using ex vivo human placental perfusion data from both closed and open systems. This transplacental PK modeling approach is expected to be useful for evaluating human fetal exposures to other poorly permeable compounds, besides metformin. SIGNIFICANCE STATEMENT: We developed a pharmacokinetic model of transplacental transfer of metformin, used to treat gestational diabetes mellitus, in order to predict in vivo fetal exposure and resolve the discrepancy between reported findings in open and closed ex vivo perfusion systems. The discrepancy is due to a difference in the time required to reach the steady state. The model can predict in vivo fetal exposure using data from both closed and open systems.
Collapse
Affiliation(s)
- Ken Kurosawa
- Department of Clinical Pharmacology, Janssen Pharmaceutical K.K., Tokyo, Japan (K.K.); Laboratory of Clinical Pharmacology, Yokohama University of Pharmacy, Kanagawa, Japan (K.C.); and Faculty of Pharmacy, Keio University of Pharmacy, Tokyo, Japan (K.K., S.N., T.N., M.T.)
| | - Koji Chiba
- Department of Clinical Pharmacology, Janssen Pharmaceutical K.K., Tokyo, Japan (K.K.); Laboratory of Clinical Pharmacology, Yokohama University of Pharmacy, Kanagawa, Japan (K.C.); and Faculty of Pharmacy, Keio University of Pharmacy, Tokyo, Japan (K.K., S.N., T.N., M.T.)
| | - Saki Noguchi
- Department of Clinical Pharmacology, Janssen Pharmaceutical K.K., Tokyo, Japan (K.K.); Laboratory of Clinical Pharmacology, Yokohama University of Pharmacy, Kanagawa, Japan (K.C.); and Faculty of Pharmacy, Keio University of Pharmacy, Tokyo, Japan (K.K., S.N., T.N., M.T.)
| | - Tomohiro Nishimura
- Department of Clinical Pharmacology, Janssen Pharmaceutical K.K., Tokyo, Japan (K.K.); Laboratory of Clinical Pharmacology, Yokohama University of Pharmacy, Kanagawa, Japan (K.C.); and Faculty of Pharmacy, Keio University of Pharmacy, Tokyo, Japan (K.K., S.N., T.N., M.T.)
| | - Masatoshi Tomi
- Department of Clinical Pharmacology, Janssen Pharmaceutical K.K., Tokyo, Japan (K.K.); Laboratory of Clinical Pharmacology, Yokohama University of Pharmacy, Kanagawa, Japan (K.C.); and Faculty of Pharmacy, Keio University of Pharmacy, Tokyo, Japan (K.K., S.N., T.N., M.T.)
| |
Collapse
|
57
|
Gruber MM, Hirschmugl B, Berger N, Holter M, Radulović S, Leitinger G, Liesinger L, Berghold A, Roblegg E, Birner-Gruenberger R, Bjelic-Radisic V, Wadsack C. Plasma proteins facilitates placental transfer of polystyrene particles. J Nanobiotechnology 2020; 18:128. [PMID: 32907583 PMCID: PMC7487953 DOI: 10.1186/s12951-020-00676-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/13/2020] [Indexed: 12/15/2022] Open
Abstract
Background Nanoparticles, which are exposed to biological fluids are rapidly interacting with proteins and other biomolecules forming a corona. In addition to dimension, charge and material the distinct protein corona influences the interplay of nanoparticles with tissue barriers. In this study we were focused on the impact of in situ formed human plasma protein corona on the transfer of 80 nm polystyrene nanoparticles (PS-particles) across the human placenta. To study materno-to fetal PS transfer we used the human ex vivo placental perfusion approach, which represents an intact and physiological tissue barrier. To analyze the protein corona of PS particles we performed shotgun proteomics of isolated nanoparticles before and after tissue exposure. Results Human plasma incubated with PS-particles of 80 nm and subsequent formed protein corona enhanced the transfer across the human placenta compared to PS-corona formed by bovine serum albumin and dextran which served as a control. Quantitative and qualitative changes of plasma proteins determined the changes in PS transfer across the barrier. Based on the analysis of the PS-proteome two candidate proteins, namely human albumin and immunoglobulin G were tested if these proteins may account for the enhanced PS-transfer across the placenta. Interestingly, the protein corona formed by human albumin significantly induced the transfer of PS-particles across the tissue compared to the formed IgG-corona. Conclusion In total we demonstrate the PS corona dynamically and significantly evolves upon crossing the human placenta. Thus, the initial composition of PS particles in the maternal circulation is not predictive for their transfer characteristics and performance once beyond the barrier of the placenta. The precise mechanism of these effects remains to be elucidated but highlights the importance of using well designed biological models when testing nanoparticles for biomedical applications.![]()
Collapse
Affiliation(s)
- Michael M Gruber
- Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria
| | - Birgit Hirschmugl
- Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria.,BioTechMed-Graz, Mozartgasse 12/II, 8010, Graz, Austria
| | - Natascha Berger
- Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria
| | - Magdalena Holter
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Auenbruggerplatz 2, 8036, Graz, Austria
| | - Snježana Radulović
- Division of Molecular Biology and Biochemistry, Gottfried Schatz Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/VI, 8010, Graz, Austria.,Research Unit Electron Microscopic Techniques, Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/II, 8010, Graz, Austria
| | - Gerd Leitinger
- Research Unit Electron Microscopic Techniques, Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/II, 8010, Graz, Austria
| | - Laura Liesinger
- Diagnostic and Research Institute of Pathology, Diagnostic and Research Center for Molecular BioMedicine, Medical University of Graz, Stiftingtalstrasse 6, 8010, Graz, Austria.,Omics Center Graz, BioTechMed-Graz, Stiftingtalstrasse 24, 8010, Graz, Austria
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Auenbruggerplatz 2, 8036, Graz, Austria
| | - Eva Roblegg
- Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology and Biopharmacy, University of Graz, Universitätsplatz 1/EG, 8010, Graz, Austria
| | - Ruth Birner-Gruenberger
- Diagnostic and Research Institute of Pathology, Diagnostic and Research Center for Molecular BioMedicine, Medical University of Graz, Stiftingtalstrasse 6, 8010, Graz, Austria.,Omics Center Graz, BioTechMed-Graz, Stiftingtalstrasse 24, 8010, Graz, Austria.,Institute of Chemical Technologies and Analytics, Faculty of Technical Chemistry, Vienna University of Technology-TU Wien, Getreidemarkt 9/164, 1060, Vienna, Austria
| | - Vesna Bjelic-Radisic
- Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria
| | - Christian Wadsack
- Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria. .,BioTechMed-Graz, Mozartgasse 12/II, 8010, Graz, Austria.
| |
Collapse
|
58
|
Gundacker C, Ellinger I. The unique applicability of the human placenta to the Adverse Outcome Pathway (AOP) concept: the placenta provides fundamental insights into human organ functions at multiple levels of biological organization. Reprod Toxicol 2020; 96:273-281. [PMID: 32768559 DOI: 10.1016/j.reprotox.2020.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 07/27/2020] [Accepted: 07/31/2020] [Indexed: 12/17/2022]
Abstract
Despite the short lifespan of the human placenta, the proper formation and function of the organ is of crucial importance for fetal development. Placental dysfunction increases the risk of complications for mother and child during pregnancy and childbirth and beyond as it predisposes to fetal programming. The placenta is an upstream organ of the fetus. It performs the functions of fetal lungs, liver, intestines, kidneys and glands as long as these organs are not fully functional. Furthermore, it is the only human organ that is non-invasively available either after elective abortion or after birth. This is a crucial point given that the conceptual framework of Adverse Outcome Pathway (AOP) requires data on organ function. In vitro and ex vivo placental studies, combined with epidemiological and clinical data on pregnant women, newborns, and infants can uniquely cover all levels of information needed to develop new AOPs and complement existing AOPs related to reproductive toxicity and beyond. To stimulate further research in this area and to support researchers in future studies dealing with the development of AOPs related to the placenta, this review first gives a brief description of placental structure, placental development and relevant pregnancy diseases. The state of knowledge about the available placental models, their particularities and limitations are briefly discussed. Finally, the use of placental research for the development of AOPs is presented with an illustrative example.
Collapse
Affiliation(s)
- Claudia Gundacker
- Institute of Medical Genetics, Medical University Vienna, Vienna, Austria.
| | - Isabella Ellinger
- Institute for Pathophysiology and Allergy Research, Medical University Vienna, Vienna, Austria
| |
Collapse
|
59
|
Saso A, Kampmann B. Maternal Immunization: Nature Meets Nurture. Front Microbiol 2020; 11:1499. [PMID: 32849319 PMCID: PMC7396522 DOI: 10.3389/fmicb.2020.01499] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/09/2020] [Indexed: 12/17/2022] Open
Abstract
Vaccinating women in pregnancy (i.e., maternal immunization) has emerged as a promising tool to tackle infant morbidity and mortality worldwide. This approach nurtures a 'gift of nature,' whereby antibody is transferred from mother to fetus transplacentally during pregnancy, or postnatally in breast milk, thereby providing passive, antigen-specific protection against infections in the first few months of life, a period of increased immune vulnerability for the infant. In this review, we briefly summarize the rationale for maternal immunization programs and the landscape of vaccines currently in use or in the pipeline. We then direct the focus to the underlying biological phenomena, including the main mechanisms by which maternally derived antibody is transferred efficiently to the infant, at the placental interface or in breast milk; important research models and methodological approaches to interrogate these processes, particularly in the context of recent advances in systems vaccinology; the potential biological and clinical impact of high maternal antibody titres on neonatal ontogeny and subsequent infant vaccine responses; and key vaccine- and host-related factors influencing the maternal-infant dyad across different environments. Finally, we outline important gaps in knowledge and suggest future avenues of research on this topic, proposing potential strategies to ensure optimal testing, delivery and implementation of maternal vaccination programs worldwide.
Collapse
Affiliation(s)
- Anja Saso
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Vaccines and Immunity Theme, MRC Unit The Gambia at LSHTM, Banjul, Gambia
| | - Beate Kampmann
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Vaccines and Immunity Theme, MRC Unit The Gambia at LSHTM, Banjul, Gambia
| |
Collapse
|
60
|
Wang CC, Lin P, Chou CY, Wang SS, Tung CW. Prediction of human fetal-maternal blood concentration ratio of chemicals. PeerJ 2020; 8:e9562. [PMID: 32742813 PMCID: PMC7380269 DOI: 10.7717/peerj.9562] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/26/2020] [Indexed: 12/13/2022] Open
Abstract
Background The measurement of human fetal-maternal blood concentration ratio (logFM) of chemicals is critical for the risk assessment of chemical-induced developmental toxicity. While a few in vitro and ex vivo experimental methods were developed for predicting logFM of chemicals, the obtained experimental results are not able to directly predict in vivo outcomes. Methods A total of 55 chemicals with logFM values representing in vivo fetal-maternal blood ratio were divided into training and test datasets. An interpretable linear regression model was developed along with feature selection methods. Cross-validation on training dataset and prediction on independent test dataset were conducted to validate the prediction model. Results This study presents the first valid quantitative structure-activity relationship model following the Organisation for Economic Co-operation and Development (OECD) guidelines based on multiple linear regression for predicting in vivo logFM values. The autocorrelation descriptor AATSC1c and information content descriptor ZMIC1 were identified as informative features for predicting logFM. After the adjustment of the applicability domain, the developed model performs well with correlation coefficients of 0.875, 0.850 and 0.847 for model fitting, leave-one-out cross-validation and independent test, respectively. The model is expected to be useful for assessing human transplacental exposure.
Collapse
Affiliation(s)
- Chia-Chi Wang
- Department and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Pinpin Lin
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Che-Yu Chou
- Graduate Institute of Data Science, Taipei Medical University, Taipei, Taiwan
| | - Shan-Shan Wang
- Graduate Institute of Data Science, Taipei Medical University, Taipei, Taiwan
| | - Chun-Wei Tung
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan.,Graduate Institute of Data Science, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
61
|
Comprehensive Measurements of Intrauterine and Postnatal Exposure to Lamotrigine. Clin Pharmacokinet 2020; 58:535-543. [PMID: 30255309 DOI: 10.1007/s40262-018-0713-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of this study was to measure and investigate correlations of lamotrigine concentrations in maternal as well as umbilical cord blood, amniotic fluid, and breast milk to account for the distribution of the drug. METHODS Concentrations of lamotrigine were measured in 19 mother-infant pairs at the time of delivery. To account for the penetration ratio into amniotic fluid, cord blood and breast milk, the concentration of lamotrigine in the particular environment was divided by the concentration in maternal serum. A no-intercept model was applied for associations between maternal serum concentrations, amniotic fluid, umbilical cord blood, and breast milk concentrations. RESULTS The mean daily dosage of lamotrigine was 351.32 mg (range 50-650 mg). We detected associations between maternal serum and amniotic fluid (β = 0.088, p < 0.001), as well as umbilical cord (β = 0.939, p < 0.001) and breast milk (β = 0.964, p < 0.001). The median penetration ratio into amniotic fluid, cord blood, and breast milk was 0.68, 0.92, and 0.77, respectively. CONCLUSIONS Lamotrigine concentrations in amniotic fluid, cord blood, and breast milk give evidence that the fetus/newborn is constantly exposed to lamotrigine. Maternal serum concentrations predicted exposure via amniotic fluid, umbilical cord, and breast milk. Data suggest that therapeutic drug monitoring can be recommended as part of the clinical routine in psychopharmacotherapy for pregnant or breastfeeding women.
Collapse
|
62
|
Arnold C. Tracking Zearalenone: Placental Transfer of a Fungal Toxin. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:74001. [PMID: 32648767 PMCID: PMC7350757 DOI: 10.1289/ehp6540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 06/11/2023]
|
63
|
Eliesen GAM, van Drongelen J, van Hove H, Kooijman NI, van den Broek P, de Vries A, Roeleveld N, Russel FGM, Greupink R. Assessment of Placental Disposition of Infliximab and Etanercept in Women With Autoimmune Diseases and in the Ex Vivo Perfused Placenta. Clin Pharmacol Ther 2020; 108:99-106. [PMID: 32153014 PMCID: PMC7325311 DOI: 10.1002/cpt.1827] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 02/25/2020] [Indexed: 12/26/2022]
Abstract
Tumor necrosis factor (TNF) inhibitors are increasingly applied during pregnancy without clear knowledge of the impact on placenta and fetus. We assessed placental transfer and exposure to infliximab (n = 3) and etanercept (n = 3) in women with autoimmune diseases. Furthermore, we perfused healthy term placentas for 6 hours with 100 µg/mL infliximab (n = 4) or etanercept (n = 5). In pregnant women, infliximab transferred into cord blood but also entered the placenta (cord‐to‐maternal ratio of 1.6 ± 0.4, placenta‐to‐maternal ratio of 0.3 ± 0.1, n = 3). For etanercept, a cord‐to‐maternal ratio of 0.04 and placenta‐to‐maternal ratio of 0.03 was observed in one patient only. In ex vivo placenta perfusions, the extent of placental transfer did not differ between the drugs. Final concentrations in the fetal compartment for infliximab and etanercept were 0.3 ± 0.3 and 0.2 ± 0.2 µg/mL, respectively. However, in placental tissue, infliximab levels exceeded those of etanercept (19 ± 6 vs. 1 ± 3 µg/g, P < 0.001). In conclusion, tissue exposure to infliximab is higher than that of etanercept both in vivo as well as in ex vivo perfused placentas. However, initial placental transfer, as observed ex vivo, does not differ between infliximab and etanercept when administered in equal amounts. The difference in placental tissue exposure to infliximab and etanercept may be of clinical relevance and warrants further investigation. More specifically, we suggest that future studies should look into the occurrence of placental TNF inhibition and possible consequences thereof.
Collapse
Affiliation(s)
- Gaby A M Eliesen
- Department of Pharmacology & Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joris van Drongelen
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hedwig van Hove
- Department of Pharmacology & Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nina I Kooijman
- Department of Pharmacology & Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Petra van den Broek
- Department of Pharmacology & Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Nel Roeleveld
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frans G M Russel
- Department of Pharmacology & Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rick Greupink
- Department of Pharmacology & Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
64
|
Paulzen M, Schoretsanitis G, Gründer G, Franz C, Stingl JC, Augustin M. Pregnancy exposure to venlafaxine-Therapeutic drug monitoring in maternal blood, amniotic fluid and umbilical cord blood and obstetrical outcomes. J Affect Disord 2020; 266:578-584. [PMID: 32056930 DOI: 10.1016/j.jad.2020.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 01/19/2020] [Accepted: 02/01/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND For treatment with psychotropic drugs during pregnancy, extended therapeutic drug monitoring is recommended for individual therapy adjustment. We measured venlafaxine (VEN), O-desmethylvenlafaxine (ODV) and active moiety, AM (sum of VEN+ODV) concentrations in maternal serum, amniotic fluid and umbilical cord blood. METHODS Concentrations of VEN, ODVEN and AM were measured in nine mother-infant pairs at time of delivery; in five cases, amniotic fluid samples were available. Concentrations are reported as median values, first (Q1) and third (Q3) quartiles and ranges. Penetration ratio was calculated by dividing concentrations of VEN, ODVEN and AM in amniotic fluid and umbilical cord blood by maternal serum concentrations. RESULTS Median daily dosage of venlafaxine was 75 mg (range 37.5-225 mg). There were no significant correlations between daily dose, maternal serum, umbilical cord blood and amniotic fluid concentrations. Median penetration ratio into amniotic fluid was 2.5 (range 0.56-4.48). Median penetration ratio into fetal circulation was 1.05 (range 0.62-2.08). Median concentration of AM was 223.8 ng/mL, range 33.9-338.0 ng/mL (maternal serum), 789.0 ng/mL, range 309-1052.5 ng/mL (amniotic fluid) and 291.0 ng/mL, range 21.1-448.4 ng/mL (cord blood). DISCUSSION VEN, ODVEN and AM concentrations in maternal serum, amniotic fluid and umbilical cord blood indicate that the fetus might have been exposed to relatively high concentrations throughout pregnancy. High concentrations in amniotic fluid indicate an increased penetration into and/or accumulation within amniotic fluid and a decreased elimination out of amniotic fluid. Findings indicate that fetal in-utero exposition to venlafaxine is higher compared to other antidepressants.
Collapse
Affiliation(s)
- Michael Paulzen
- Alexianer Hospital Aachen, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany; JARA-Translational Brain Medicine, Aachen, Germany
| | - Georgios Schoretsanitis
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York, USA; Hofstra Northwell School of Medicine, Hempstead, New York, USA; The Feinstein Institute for Medical Research, Manhasset, New York, USA
| | - Gerhard Gründer
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Cordula Franz
- Department of Gynecology and Obstetrics, RWTH Aachen University, Aachen, Germany
| | - Julia C Stingl
- Institute of Clinical Pharmacology, University Hospital of RWTH Aachen, Aachen, Germany
| | - Marc Augustin
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany; JARA-Translational Brain Medicine, Aachen, Germany; Protestant University of Applied Sciences Bochum, Immanuel-Kant-Str. 18-20, 44803 Bochum, Germany.
| |
Collapse
|
65
|
Excretion of Antipsychotics Into the Amniotic Fluid, Umbilical Cord Blood, and Breast Milk: A Systematic Critical Review and Combined Analysis. Ther Drug Monit 2020; 42:245-254. [DOI: 10.1097/ftd.0000000000000692] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
66
|
Russo FM, De Bie F, Hodges R, Flake A, Deprest J. Sildenafil for Antenatal Treatment of Congenital Diaphragmatic Hernia: From Bench to Bedside. Curr Pharm Des 2020; 25:601-608. [PMID: 30894101 DOI: 10.2174/1381612825666190320151856] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/18/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Persistent pulmonary hypertension (PPH) is one of the main causes of mortality and morbidity in infants affected by congenital diaphragmatic hernia (CDH). Since the structural changes that lead to PPH take place already in utero, a treatment starting in the prenatal phase may prevent the occurrence of this complication. OBJECTIVE To summarize the development process of antenatal sildenafil for CDH. METHODS The pharmacokinetics and efficacy of sildenafil have been assessed in the rat and the rabbit model. The transfer of the drug through the human placenta has been measured with the ex-vivo placenta perfusion model. Results from this experiment are being incorporated in a pregnancy-physiologically based pharmacokinetic (p- PBPK) model. A phase I-IIb placental transfer and safety study is ongoing. RESULTS Sildenafil administration to pregnant rats and rabbits led to therapeutic foetal drug levels without maternal and foetal toxicity, although it was associated with impaired vascular development in foetuses with nonhypoplastic lungs. Peak concentrations and 24-hour exposure were higher in pregnant rabbits compared to nonpregnant ones. In rat and rabbit foetuses with CDH, sildenafil rescued the lung vascular anomalies and partially improved parenchymal development. Sildenafil crossed the human placenta at a high rate ex-vivo, independently from the initial maternal concentration. CONCLUSION There is preclinical evidence that maternally administered sildenafil prevents the vascular changes that lead to PPH in CDH newborns. The phase I/IIb clinical study together with the p-PBPK model will define the maternal dose needed for a therapeutic effect in the foetus. Foetal safety will be investigated both in the clinical study and in the sheep. The final step will be a multicentre, randomized, placebo-controlled trial.
Collapse
Affiliation(s)
- Francesca M Russo
- Cluster Woman and Child, Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - Felix De Bie
- Cluster Woman and Child, Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - Ryan Hodges
- The Ritchie Centre, Hudson Institute for Medical Research, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Alan Flake
- Center for Fetal Research, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Jan Deprest
- Cluster Woman and Child, Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynecology, Institute of Women's Health, University College London, London, United Kingdom
| |
Collapse
|
67
|
Bouazza N, Foissac F, Hirt D, Urien S, Benaboud S, Lui G, Treluyer JM. Methodological Approaches to Evaluate Fetal Drug Exposure. Curr Pharm Des 2020; 25:496-504. [PMID: 30892158 DOI: 10.2174/1381612825666190319102812] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/16/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Drug prescriptions are usual during pregnancy, however, women and their fetuses still remain an orphan population with regard to drugs efficacy and safety. Most xenobiotics diffuse through the placenta and some of them can alter fetus development resulting in structural abnormalities, growth or functional deficiencies. METHODS To summarize the different methodologies developed towards the prediction of fetal drug exposure. RESULTS Neonatal cord blood concentration is the most specific measurement of the transplacental drug transfer at the end of pregnancy. Using the cord blood and mother drug concentrations altogether, drug exchanges between the mother and fetus can be modeled and quantified via a population pharmacokinetic analysis. Thereafter, it is possible to estimate the fetus exposure and the fetus-to-mother exposure ratio. However, the prediction of placental transfer before any administration to pregnant women is desirable. Animal studies remain difficult to interpret due to structural and functional inter-species placenta differences. The ex-vivo perfusion of the human placental cotyledon is the method of reference to study the human placental transfer of drugs because it is thought to mimic the functional placental tissue. However, extrapolation of data to in vivo situation remains difficult. Some research groups have extensively worked on physiologically based models (PBPK) to predict fetal drug exposure and showed very encouraging results. CONCLUSION PBPK models appeared to be a very promising tool in order to predict fetal drug exposure in-silico. However, these models mainly picture the end of pregnancy and knowledge regarding both, development of the placental permeability and transporters is strongly needed.
Collapse
Affiliation(s)
- Naïm Bouazza
- Universite Paris Descartes, EA7323, Sorbonne Paris Cite, France.,Unite de Recherche Clinique Paris Descartes Necker Cochin, AP-HP, France.,CIC-1419 Inserm, Cochin-Necker, Paris, France
| | - Frantz Foissac
- Universite Paris Descartes, EA7323, Sorbonne Paris Cite, France.,Unite de Recherche Clinique Paris Descartes Necker Cochin, AP-HP, France.,CIC-1419 Inserm, Cochin-Necker, Paris, France
| | - Déborah Hirt
- Universite Paris Descartes, EA7323, Sorbonne Paris Cite, France.,Unite de Recherche Clinique Paris Descartes Necker Cochin, AP-HP, France.,CIC-1419 Inserm, Cochin-Necker, Paris, France.,Service de Pharmacologie Clinique, Hôpital Cochin, AP-HP, Groupe Hospitalier Paris Centre, Paris, France
| | - Saïk Urien
- Universite Paris Descartes, EA7323, Sorbonne Paris Cite, France.,Unite de Recherche Clinique Paris Descartes Necker Cochin, AP-HP, France.,CIC-1419 Inserm, Cochin-Necker, Paris, France
| | - Sihem Benaboud
- Universite Paris Descartes, EA7323, Sorbonne Paris Cite, France.,Unite de Recherche Clinique Paris Descartes Necker Cochin, AP-HP, France.,CIC-1419 Inserm, Cochin-Necker, Paris, France.,Service de Pharmacologie Clinique, Hôpital Cochin, AP-HP, Groupe Hospitalier Paris Centre, Paris, France
| | - Gabrielle Lui
- Universite Paris Descartes, EA7323, Sorbonne Paris Cite, France.,Service de Pharmacologie Clinique, Hôpital Cochin, AP-HP, Groupe Hospitalier Paris Centre, Paris, France
| | - Jean-Marc Treluyer
- Universite Paris Descartes, EA7323, Sorbonne Paris Cite, France.,Unite de Recherche Clinique Paris Descartes Necker Cochin, AP-HP, France.,CIC-1419 Inserm, Cochin-Necker, Paris, France.,Service de Pharmacologie Clinique, Hôpital Cochin, AP-HP, Groupe Hospitalier Paris Centre, Paris, France
| |
Collapse
|
68
|
Freriksen JJM, Schalkwijk S, Colbers AP, Abduljalil K, Russel FGM, Burger DM, Greupink R. Assessment of Maternal and Fetal Dolutegravir Exposure by Integrating Ex Vivo Placental Perfusion Data and Physiologically-Based Pharmacokinetic Modeling. Clin Pharmacol Ther 2020; 107:1352-1361. [PMID: 31868223 PMCID: PMC7325314 DOI: 10.1002/cpt.1748] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 11/22/2019] [Indexed: 12/13/2022]
Abstract
Antiretroviral therapy during pregnancy reduces the risk of vertical HIV‐1 transmission. However, drug dosing is challenging as pharmacokinetics (PK) may be altered during pregnancy. We combined a pregnancy physiologically‐based pharmacokinetic (PBPK) modeling approach with data on placental drug transfer to simulate maternal and fetal exposure to dolutegravir (DTG). First, a PBPK model for DTG exposure in healthy volunteers was established based on physiological and DTG PK data. Next, the model was extended with a fetoplacental unit using transplacental kinetics obtained by performing ex vivo dual‐side human cotyledon perfusion experiments. Simulations of fetal exposure after maternal dosing in the third trimester were in accordance with clinically observed DTG cord blood data. Furthermore, the predicted fetal trough plasma concentration (Ctrough) following 50 mg q.d. dosing remained above the concentration that results in 90% of viral inhibition. Our integrated approach enables simulation of maternal and fetal DTG exposure, illustrating this to be a promising way to assess DTG PK during pregnancy.
Collapse
Affiliation(s)
- Jolien J M Freriksen
- Department of Pharmacology and Toxicology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Stein Schalkwijk
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Angela P Colbers
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Frans G M Russel
- Department of Pharmacology and Toxicology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - David M Burger
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rick Greupink
- Department of Pharmacology and Toxicology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
69
|
Hitzerd E, Neuman RI, Broekhuizen M, Simons SHP, Schoenmakers S, Reiss IKM, Koch BCP, van den Meiracker AH, Versmissen J, Visser W, Danser AHJ. Transfer and Vascular Effect of Endothelin Receptor Antagonists in the Human Placenta. Hypertension 2019; 75:877-884. [PMID: 31884859 DOI: 10.1161/hypertensionaha.119.14183] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Increasing evidence suggests a role for the ET (endothelin) system in preeclampsia. Hence, blocking this system with endothelin receptor antagonists (ERAs) could be a therapeutic strategy. Yet, clinical studies are lacking due to possible teratogenic effects of ERAs. In this study, we investigated the placental transfer of ERAs and their effect on ET-1-mediated vasoconstriction. Term placentas were dually perfused with the selective ETAR (ET type A receptor) antagonists sitaxentan and ambrisentan or the nonselective ETAR/ETBR antagonist macitentan and subsequently exposed to ET-1 in the fetal circulation. ET-1 concentration-response curves after incubation with sitaxentan, ambrisentan, macitentan, or the selective ETBR antagonist BQ-788 were also constructed in isolated chorionic plate arteries using wire-myography, and gene expression of the ET-system was quantified in healthy and early onset preeclamptic placentas. At steady state, the mean fetal-to-maternal transfer ratios were 0.32±0.05 for sitaxentan, 0.21±0.02 for ambrisentan, and 0.05±0.01 for macitentan. Except for BQ-788, all ERAs lowered the response to ET-1, both in the perfused cotyledon and isolated chorionic plate arteries. Placental gene expression of ECE-1, ETAR, and ETBR were comparable in healthy and preeclamptic placentas, while ET-1 expression was higher in preeclampsia. Our study is the first to show direct transfer of ERAs across the term human placenta. Furthermore, ETAR exclusively mediates ET-1-induced constriction in the fetoplacental vasculature. Given its limited transfer, macitentan could be considered as potential preeclampsia therapy. Extending knowledge on placental transfer to placentas of preeclamptic pregnancies is required to determine whether ERAs might be applied safely in preeclampsia.
Collapse
Affiliation(s)
- Emilie Hitzerd
- From the Department of Internal Medicine, Division of Pharmacology and Vascular Medicine (E.H., R.I.N., M.B., A.H.v.d.M., J.V., A.H.J.D.), Erasmus MC University Medical Center, Rotterdam, the Netherlands.,Department of Pediatrics, division of Neonatology (E.H., M.B., S.H.P.S., I.K.M.R.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Rugina I Neuman
- From the Department of Internal Medicine, Division of Pharmacology and Vascular Medicine (E.H., R.I.N., M.B., A.H.v.d.M., J.V., A.H.J.D.), Erasmus MC University Medical Center, Rotterdam, the Netherlands.,Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine (R.I.N., S.S., W.V.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Michelle Broekhuizen
- From the Department of Internal Medicine, Division of Pharmacology and Vascular Medicine (E.H., R.I.N., M.B., A.H.v.d.M., J.V., A.H.J.D.), Erasmus MC University Medical Center, Rotterdam, the Netherlands.,Department of Pediatrics, division of Neonatology (E.H., M.B., S.H.P.S., I.K.M.R.), Erasmus MC University Medical Center, Rotterdam, the Netherlands.,Department of Cardiology, Division of Experimental Cardiology (M.B.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Sinno H P Simons
- Department of Pediatrics, division of Neonatology (E.H., M.B., S.H.P.S., I.K.M.R.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Sam Schoenmakers
- Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine (R.I.N., S.S., W.V.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Irwin K M Reiss
- Department of Pediatrics, division of Neonatology (E.H., M.B., S.H.P.S., I.K.M.R.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Birgit C P Koch
- Department of Pharmacy (B.C.P.K.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Anton H van den Meiracker
- From the Department of Internal Medicine, Division of Pharmacology and Vascular Medicine (E.H., R.I.N., M.B., A.H.v.d.M., J.V., A.H.J.D.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jorie Versmissen
- From the Department of Internal Medicine, Division of Pharmacology and Vascular Medicine (E.H., R.I.N., M.B., A.H.v.d.M., J.V., A.H.J.D.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Willy Visser
- Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine (R.I.N., S.S., W.V.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - A H Jan Danser
- From the Department of Internal Medicine, Division of Pharmacology and Vascular Medicine (E.H., R.I.N., M.B., A.H.v.d.M., J.V., A.H.J.D.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
70
|
Codaccioni M, Bois F, Brochot C. Placental transfer of xenobiotics in pregnancy physiologically-based pharmacokinetic models: Structure and data. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.comtox.2019.100111] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
71
|
Freriksen JJM, van Seyen M, Judd A, Gibb DM, Collins IJ, Greupink R, Russel FGM, Drenth JPH, Colbers A, Burger DM. Review article: direct-acting antivirals for the treatment of HCV during pregnancy and lactation - implications for maternal dosing, foetal exposure, and safety for mother and child. Aliment Pharmacol Ther 2019; 50:738-750. [PMID: 31448450 PMCID: PMC6773363 DOI: 10.1111/apt.15476] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 07/25/2019] [Accepted: 08/02/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND With the global efforts to eradicate hepatitis C virus (HCV), treatment during pregnancy is becoming a priority for research as this, and maternal cure should reduce vertical transmission. However, as information on the efficacy and safety of direct-acting antivirals (DAAs) in pregnancy is generally lacking, treatment of HCV infection during pregnancy is not currently recommended. AIM To provide an overview of current knowledge regarding maternal exposure, placental handling and safety of DAAs during pregnancy and lactation METHODS: A literature search was performed focusing on the effect of pregnancy on maternal exposure to DAAs, the placental handling of DAAs, the safety of DAAs for mother and child during pregnancy and the safety of DAAs during lactation. RESULTS Exposure to all DAAs studied is likely to be altered during pregnancy, mostly related to pregnancy-induced effects on drug absorption and metabolism. Although animal studies show that most DAAs are reported to cross the placenta and transfer into breast milk, most DAA combinations show a favourable safety profile. Because of the rapid viral decline after treatment initiation, and to avoid the critical period of organogenesis, treatment may be started at the end of the second trimester or early third trimester. CONCLUSIONS Treatment of HCV infection during pregnancy is realistic, as DAAs are highly effective and treatment duration is relatively short. There is an urgent need to study DAAs during pregnancy and lactation to contribute to the goal of HCV elimination.
Collapse
Affiliation(s)
- Jolien J M Freriksen
- Department of Pharmacy, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Pharmacology and Toxicology, Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Minou van Seyen
- Department of Pharmacy, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ali Judd
- MRC Clinical Trials Unit at University College London, London, UK
| | - Diana M Gibb
- MRC Clinical Trials Unit at University College London, London, UK
| | - Intira J Collins
- MRC Clinical Trials Unit at University College London, London, UK
| | - Rick Greupink
- Department of Pharmacology and Toxicology, Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frans G M Russel
- Department of Pharmacology and Toxicology, Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joost P H Drenth
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Angela Colbers
- Department of Pharmacy, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - David M Burger
- Department of Pharmacy, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
72
|
Warth B, Preindl K, Manser P, Wick P, Marko D, Buerki-Thurnherr T. Transfer and Metabolism of the Xenoestrogen Zearalenone in Human Perfused Placenta. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:107004. [PMID: 31596610 PMCID: PMC6867367 DOI: 10.1289/ehp4860] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Pregnancy is a sensitive condition during which adverse environmental exposures should be monitored thoroughly and minimized whenever possible. In particular, the hormone balance during gestation is delicate, and disturbance may cause acute or chronic long-term health effects. A potential endocrine disruption may be provoked by in utero exposure to xenoestrogens mimicking endogenous estrogens. The mycoestrogen zearalenone (ZEN), a toxic fungal secondary metabolite and mycotoxin found frequently in food and feed, constitutes a prominent example. OBJECTIVES We performed a comprehensive assessment of the transfer as well as phase I and phase II metabolism of ZEN at the human placental barrier. METHODS Human placentas were perfused with 1μM (318μg/L) ZEN for 6 h. Samples from the maternal and fetal compartment, placental tissue, and fetal plasma were analyzed by a highly sensitive UHPLC-MS/MS assay to detect ZEN as well as nine key metabolites (α-zearalenol, β-zearalenol, zearalanone, α-zearalanol, β-zearalanol, ZEN-14-glucuronide, α-zearalenol-14-glucuronide, β-zearalenol-14-glucuronide, ZEN-14-sulfate). RESULTS The model revealed a fast maternofetal transfer of ZEN across the human placental barrier. We also unraveled phase I and phase II metabolism of the parent toxin ZEN into the approximately 70-times more estrogenic α-zearalenol and the less active ZEN-14-sulfate conjugate, which are effectively released into the maternal and fetal circulation in considerable amounts. CONCLUSIONS Our findings suggest that exposure to ZEN (such as through consumption of ZEN-contaminated cereal-based products) during pregnancy may result in in utero exposure of the fetus, not only to ZEN but also some of its highly estrogenically active metabolites. In the light of the known affinity of ZEN and potentially co-occurring xenoestrogens to the estrogen receptor, and our results demonstrating placental transfer of ZEN and its metabolites in an ex vivo model, we recommend further research and more comprehensive assessment of gestational exposures in women. https://doi.org/10.1289/EHP4860.
Collapse
Affiliation(s)
- Benedikt Warth
- Department of Food Chemistry and Toxicology, Faculty of Chemistry, University of Vienna, Vienna, Austria
- Research Network Chemistry, Microbiology and Environmental Systems Science, University of Vienna, Vienna, Austria
| | - Karin Preindl
- Department of Food Chemistry and Toxicology, Faculty of Chemistry, University of Vienna, Vienna, Austria
| | - Pius Manser
- Laboratory for Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, Switzerland
| | - Peter Wick
- Laboratory for Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, Switzerland
| | - Doris Marko
- Department of Food Chemistry and Toxicology, Faculty of Chemistry, University of Vienna, Vienna, Austria
| | - Tina Buerki-Thurnherr
- Laboratory for Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, Switzerland
| |
Collapse
|
73
|
Jain A, Coffey C, Mehrotra V, Flammer J. Endothelin-1 traps as a potential therapeutic tool: from diabetes to beyond? Drug Discov Today 2019; 24:1937-1942. [PMID: 31394173 DOI: 10.1016/j.drudis.2019.07.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 06/27/2019] [Accepted: 07/26/2019] [Indexed: 12/16/2022]
Abstract
There is substantial research on the vasoactive peptide endothelin (ET)-1 in physiology, as well as in pathology. In fact, pathologically elevated levels of ET-1 have been found in several disease states, such as various cardiovascular diseases, different cancers, some neurodegenerative disorders, as well as in diabetes. Here, we describe and discuss ET-1, its importance in different diseases, and the potential therapeutic effects of ET-traps in the treatment of these diseases. Previous in vitro and in vivo research (in the diabetes disease space) demonstrated that ET-traps potently and significantly prevent the induction of different markers of diabetes-related pathology. This included induction of extracellular matrix (ECM) proteins (collagen 4α1 and fibronectin), which are pathologically elevated in diabetes. The ET-traps prevented induction of these and brought a significant return to non-diabetic levels. We also discuss the merits of using ET-traps over the currently used endothelin receptor antagonists (ERAs) and previously used therapeutic antibodies.
Collapse
Affiliation(s)
- Arjun Jain
- Accelerate Cambridge, Judge Business School, University of Cambridge, Cambridge, UK.
| | | | - Vidhi Mehrotra
- Accelerate Cambridge, Judge Business School, University of Cambridge, Cambridge, UK
| | | |
Collapse
|
74
|
Dallmann A, Liu XI, Burckart GJ, van den Anker J. Drug Transporters Expressed in the Human Placenta and Models for Studying Maternal-Fetal Drug Transfer. J Clin Pharmacol 2019; 59 Suppl 1:S70-S81. [PMID: 31502693 PMCID: PMC7304533 DOI: 10.1002/jcph.1491] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 06/25/2019] [Indexed: 12/30/2022]
Abstract
Tremendous efforts have been directed to investigate the ontogeny of drug transporters in fetuses, neonates, infants, and children based on their importance for understanding drug pharmacokinetics. During development (ie, in the fetus and newborn infant), there is special interest in transporters expressed in the placenta that modulate placental drug transfer. Many of these transporters can decrease or increase drug concentrations in the fetus and at birth, stressing the relevance of elucidating expression in the placenta and potential gestational age-dependent changes therein. Hence, the main objective of this review was to summarize the current knowledge about expression and ontogeny of transporters in the human placenta in healthy pregnant women. In addition, various in vitro, ex vivo, and in silico models that can be used to investigate placental drug transfer, namely, placental cancer cell lines, ex vivo cotyledon perfusion experiments, and physiologically based pharmacokinetic (PBPK) models, are discussed together with their advantages and shortcomings. A particular focus was placed on PBPK models because these models can integrate different types of information, such as expression data, ontogeny information, and observations obtained from the ex vivo cotyledon perfusion experiment. Such a mechanistic modeling framework may leverage the available information and ultimately help to improve knowledge about the adequacy and safety of pharmacotherapy in pregnant women and their fetuses.
Collapse
Affiliation(s)
- André Dallmann
- Pediatric Pharmacology and Pharmacometrics Research Center, University Children’s Hospital Basel (UKBB), Switzerland
| | - Xiaomei I. Liu
- Division of Clinical Pharmacology, Children’s National Medical Center, Washington, DC, USA
| | - Gilbert J. Burckart
- US Food and Drug Administration, Office of Clinical Pharmacology, Silver Spring, MD, USA
| | - John van den Anker
- Pediatric Pharmacology and Pharmacometrics Research Center, University Children’s Hospital Basel (UKBB), Switzerland
- Division of Clinical Pharmacology, Children’s National Medical Center, Washington, DC, USA
| |
Collapse
|
75
|
Prediction of Fetal Darunavir Exposure by Integrating Human Ex-Vivo Placental Transfer and Physiologically Based Pharmacokinetic Modeling. Clin Pharmacokinet 2019; 57:705-716. [PMID: 28744795 PMCID: PMC5974000 DOI: 10.1007/s40262-017-0583-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Fetal antiretroviral exposure is usually derived from the cord-to-maternal concentration ratio. This static parameter does not provide information on the pharmacokinetics in utero, limiting the assessment of a fetal exposure–effect relationship. Objective The aim of this study was to incorporate placental transfer into a pregnancy physiologically based pharmacokinetic model to simulate and evaluate fetal darunavir exposure at term. Methods An existing and validated pregnancy physiologically based pharmacokinetic model of maternal darunavir/ritonavir exposure was extended with a feto-placental unit. To parameterize the model, we determined maternal-to-fetal and fetal-to-maternal darunavir/ritonavir placental clearance with an ex-vivo human cotyledon perfusion model. Simulated maternal and fetal pharmacokinetic profiles were compared with observed clinical data to qualify the model for simulation. Next, population fetal pharmacokinetic profiles were simulated for different maternal darunavir/ritonavir dosing regimens. Results An average (±standard deviation) maternal-to-fetal cotyledon clearance of 0.91 ± 0.11 mL/min and fetal-to-maternal clearance of 1.6 ± 0.3 mL/min was determined (n = 6 perfusions). Scaled placental transfer was integrated into the pregnancy physiologically based pharmacokinetic model. For darunavir 600/100 mg twice a day, the predicted fetal maximum plasma concentration, trough concentration, time to maximum plasma concentration, and half-life were 1.1, 0.57 mg/L, 3, and 21 h, respectively. This indicates that the fetal population trough concentration is higher or around the half-maximal effective darunavir concentration for a resistant virus (0.55 mg/L). Conclusions The results indicate that the population fetal exposure after oral maternal darunavir dosing is therapeutic and this may provide benefits to the prevention of mother-to-child transmission of human immunodeficiency virus. Moreover, this integrated approach provides a tool to prevent fetal toxicity or enhance the development of more selectively targeted fetal drug treatments. Electronic supplementary material The online version of this article (doi:10.1007/s40262-017-0583-8) contains supplementary material, which is available to authorized users.
Collapse
|
76
|
Endothelin receptor antagonism during preeclampsia: a matter of timing? Clin Sci (Lond) 2019; 133:1341-1352. [PMID: 31221823 DOI: 10.1042/cs20190464] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/06/2019] [Accepted: 06/12/2019] [Indexed: 02/07/2023]
Abstract
Preeclampsia (PE) is a pregnancy complication, featuring elevated blood pressure and proteinuria, with no appropriate treatment. Activation of the endothelin system has emerged as an important pathway in PE pathophysiology based on experimental PE models where endothelin receptor antagonists (ERAs) prevented or attenuated hypertension and proteinuria. Hence, ERAs have been suggested as potential therapy for PE. However, developmental toxicity studies in animals have shown severe teratogenic effects of ERAs, particularly craniofacial malformations. Nonetheless, sporadic cases of pregnancy in women using ERAs to treat pulmonary hypertension have been described. In this review we give an overview of cases describing ERA use in pregnancy and critically address their possible teratogenic effects. A systematic search in literature yielded 18 articles describing 39 cases with ERA exposure during human pregnancy. In most cases there was only exposure in the first trimester, but exposure later or throughout pregnancy was reported in five cases. Elective termination of pregnancy was performed in 12 pregnancies (31%), two ended in a spontaneous miscarriage (5%) and no fetal congenital abnormalities have been described in the remaining cases. These preliminary findings support the idea that ERA treatment for severe, early onset PE might be an option if applied later in pregnancy, when organogenesis is completed to avoid teratogenic risks. However, third trimester toxicology studies are warranted to evaluate drug safety. Subsequently, it remains to be established whether ERA treatment is effective for alleviating maternal symptoms, as demonstrated in preclinical PE models, allowing pregnancy prolongation without leading to adverse neonatal outcomes.
Collapse
|
77
|
Abstract
Medicine use in pregnancy is extremely common, but there are significant knowledge gaps surrounding the safety, dosage and long-term effects of drugs used. Pregnant women have been purposively excluded from clinical trials of the majority of treatments for conditions that may occur concurrently with pregnancy. There is minimal information on the pharmacokinetics of many existing treatments and no systematic capture of long-term outcome data to help inform choices. Treatments commonly used in pregnancy are thus often old and untested, not optimised in dose, and prescribed off-label without adequate safety information. In addition, there has been a staggering lack of investment in drug development for obstetric conditions for decades. This is a major public health concern, and pregnancy complications are the leading cause of mortality in children under five years old globally, and health in pregnancy is a major determinant of women's long-term health and wellbeing. There is an acute need for adequate investment and legislation to boost inclusion of pregnant women in clinical studies, capture high-quality information on medication use in pregnancy in general, and encourage new medicinal product development for obstetric conditions.
Collapse
Affiliation(s)
- Sarah JE Stock
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Nine Edinburgh BioQuarter, 9 Little France Road, Edinburgh, EH16 4UX, UK
| | - Jane E Norman
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh BioQuarter, Edinburgh, EH16 4SA, UK
- Faculty of Health Sciences, University of Bristol, 5 Tyndall Avenue, Bristol, UK
| |
Collapse
|
78
|
Placental effects and transfer of sildenafil in healthy and preeclamptic conditions. EBioMedicine 2019; 45:447-455. [PMID: 31204276 PMCID: PMC6642075 DOI: 10.1016/j.ebiom.2019.06.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/28/2019] [Accepted: 06/06/2019] [Indexed: 12/17/2022] Open
Abstract
Background The phosphodiesterase-5 inhibitor (PDE5) sildenafil has emerged as a promising treatment for preeclampsia (PE). However, a sildenafil trial was recently halted due to lack of effect and increased neonatal morbidity. Methods Ex vivo dual-sided perfusion of an isolated cotyledon and wire-myography on chorionic plate arteries were performed to study the effects of sildenafil and the non-selective PDE inhibitor vinpocetine on the response to the NO donor sodium nitroprusside (SNP) under healthy and PE conditions. Ex vivo perfusion was also used to study placental transfer of sildenafil in 6 healthy and 2 PE placentas. Furthermore, placental mRNA and protein levels of eNOS, iNOS, PDE5 and PDE1 were quantified. Findings Sildenafil and vinpocetine significantly enhanced SNP responses in chorionic plate arteries of healthy, but not PE placentas. Only sildenafil acutely decreased baseline tension in arteries of both healthy and PE placentas. At steady state, the foetal-to-maternal transfer ratio of sildenafil was 0·37 ± 0·03 in healthy placentas versus 0·66 and 0·47 in the 2 PE placentas. mRNA and protein levels of PDE5, eNOS and iNOS were comparable in both groups, while PDE1 levels were lower in PE. Interpretation The absence of sildenafil-induced NO potentiation in arteries of PE placentas, combined with the non-PDE-mediated effects of sildenafil and the lack of PDE5 upregulation in PE, argue against sildenafil as the preferred drug of use in PE. Moreover, increased placental transfer of sildenafil in PE might underlie the neonatal morbidity in the STRIDER trial. Fund This study was funded by an mRACE Erasmus MC grant.
Collapse
|
79
|
Russo FM, Conings S, Allegaert K, Van Mieghem T, Toelen J, Van Calsteren K, Annaert P, Deprest J. Sildenafil crosses the placenta at therapeutic levels in a dually perfused human cotyledon model. Am J Obstet Gynecol 2018; 219:619.e1-619.e10. [PMID: 30194048 DOI: 10.1016/j.ajog.2018.08.041] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 08/19/2018] [Accepted: 08/30/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sildenafil already is administered during gestation in patients with pulmonary hypertension and is under evaluation as a treatment for several pregnancy complications, such as preeclampsia and intrauterine growth restriction. Animal studies have shown a potential therapeutic effect of the drug in fetuses with congenital diaphragmatic hernia, rescuing peripheral pulmonary vasculature, and airway phenotype. When considering this drug for evaluation in a clinical trial, data on effective human placental drug passage are required. OBJECTIVE We quantified transplacental passage of sildenafil in the ex vivo dually perfused cotyledon model. STUDY DESIGN Six placentas that were collected after term delivery from healthy volunteers were cannulated and perfused dually. Sildenafil citrate was added to the maternal circulation at 2 different concentrations: 500 ng/mL, which represented the maximum tolerated concentration (n=3), and 50 ng/mL, which represented the therapeutic concentration (n=3). Samples were collected from both the fetal and the maternal reservoir at 0, 6, 30, 60, 90, 120, 150, and 180 minutes; the concentrations of sildenafil and its metabolite desmethyl-sildenafil were determined with the use of high performance liquid chromatography. The fetal/maternal concentration ratio was calculated for each timepoint. Transfer clearance was calculated as the rate of maternal to fetal passage/maternal concentration. RESULTS Sildenafil crossed the placenta at both maximal and therapeutic concentrations. Maternal and fetal levels reached a plateau at 90-120 minutes. Transfer clearance was the highest during the first hour of perfusion: 3.15 mL/min (range, 2.14-3.19 mL/min) for the maximum tolerated concentration and 3.07mL/min (range, 2.75-3.42 mL/min) for the therapeutic concentration (not significant). The fetomaternal concentration ratio significantly increased over time, up to 0.91±0.16 for the maximal concentration and 0.95±0.22 for the therapeutic concentration at the end of the perfusion (not significant). Desmethyl-sildenafil was not detected in any sample. CONCLUSION Sildenafil crosses the term placenta at a relatively high rate ex vivo, which suggests that there is sufficient placental transfer to reach clinically active fetal drug levels at the currently used maternal doses.
Collapse
Affiliation(s)
- Francesca M Russo
- Cluster Woman and Child, the Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium; Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - Sigrid Conings
- Cluster Woman and Child, the Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - Karel Allegaert
- Cluster Woman and Child, the Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium; Department of Pediatrics, Division of Neonatology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Tim Van Mieghem
- Cluster Woman and Child, the Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium; Fetal Medicine Unit, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Jaan Toelen
- Cluster Woman and Child, the Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - Kristel Van Calsteren
- Cluster Woman and Child, the Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium; Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - Pieter Annaert
- Drug Delivery and Disposition, the Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Jan Deprest
- Cluster Woman and Child, the Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium; Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium; Institute of Women's Health, Institute of Child Health, University College London, London, UK.
| |
Collapse
|
80
|
Aengenheister L, Dietrich D, Sadeghpour A, Manser P, Diener L, Wichser A, Karst U, Wick P, Buerki-Thurnherr T. Gold nanoparticle distribution in advanced in vitro and ex vivo human placental barrier models. J Nanobiotechnology 2018; 16:79. [PMID: 30309365 PMCID: PMC6180500 DOI: 10.1186/s12951-018-0406-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/29/2018] [Indexed: 12/29/2022] Open
Abstract
Background Gold nanoparticles (AuNPs) are promising candidates to design the next generation NP-based drug formulations specifically treating maternal, fetal or placental complications with reduced side effects. Profound knowledge on AuNP distribution and effects at the human placental barrier in dependence on the particle properties and surface modifications, however, is currently lacking. Moreover, the predictive value of human placental transfer models for NP translocation studies is not yet clearly understood, in particular with regards to differences between static and dynamic exposures. To understand if small (3–4 nm) AuNPs with different surface modifications (PEGylated versus carboxylated) are taken up and cross the human placental barrier, we performed translocation studies in a static human in vitro co-culture placenta model and the dynamic human ex vivo placental perfusion model. The samples were analysed using ICP-MS, laser ablation-ICP-MS and TEM analysis for sensitive, label-free detection of AuNPs. Results After 24 h of exposure, both AuNP types crossed the human placental barrier in vitro, although in low amounts. Even though cellular uptake was higher for carboxylated AuNPs, translocation was slightly increased for PEGylated AuNPs. After 6 h of perfusion, only PEGylated AuNPs were observed in the fetal circulation and tissue accumulation was similar for both AuNP types. While PEGylated AuNPs were highly stable in the biological media and provided consistent results among the two placenta models, carboxylated AuNPs agglomerated and adhered to the perfusion device, resulting in different cellular doses under static and dynamic exposure conditions. Conclusions Gold nanoparticles cross the human placental barrier in limited amounts and accumulate in placental tissue, depending on their size- and/or surface modification. However, it is challenging to identify the contribution of individual characteristics since they often affect colloidal particle stability, resulting in different biological interaction in particular under static versus dynamic conditions. This study highlights that human ex vivo and in vitro placenta models can provide valuable mechanistic insights on NP uptake and translocation if accounting for NP stability and non-specific interactions with the test system. Electronic supplementary material The online version of this article (10.1186/s12951-018-0406-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Leonie Aengenheister
- Empa, Particles-Biology Interactions, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014, St. Gallen, Switzerland
| | - Dörthe Dietrich
- Institute of Inorganic & Analytical Chemistry, Westfälische Wilhelms-Universität Münster, Corrensstraße 28/30, 48149, Münster, Germany
| | - Amin Sadeghpour
- Empa, Center for X-ray Analytics, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014, St. Gallen, Switzerland
| | - Pius Manser
- Empa, Particles-Biology Interactions, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014, St. Gallen, Switzerland
| | - Liliane Diener
- Empa, Particles-Biology Interactions, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014, St. Gallen, Switzerland
| | - Adrian Wichser
- Empa, Laboratory for Advanced Analytical Technologies, Swiss Federal Laboratories for Materials Science and Technology, Ueberlandstrasse 129, 8600, Duebendorf, Switzerland
| | - Uwe Karst
- Institute of Inorganic & Analytical Chemistry, Westfälische Wilhelms-Universität Münster, Corrensstraße 28/30, 48149, Münster, Germany
| | - Peter Wick
- Empa, Particles-Biology Interactions, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014, St. Gallen, Switzerland
| | - Tina Buerki-Thurnherr
- Empa, Particles-Biology Interactions, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014, St. Gallen, Switzerland.
| |
Collapse
|
81
|
Seno K, Munakata Y, Sano M, Kawahara-Miki R, Takahashi H, Ohkuchi A, Iwata H, Kuwayama T, Shirasuna K. Aggregation of Human Trophoblast Cells into Three-Dimensional Culture System Enhances Anti-Inflammatory Characteristics through Cytoskeleton Regulation. Int J Mol Sci 2018; 19:ijms19082322. [PMID: 30096769 PMCID: PMC6121648 DOI: 10.3390/ijms19082322] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 08/03/2018] [Accepted: 08/06/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Three-dimensional (3D) culture changes cell characteristics and function, suggesting that 3D culture provides a more physiologically relevant environment for cells compared with 2D culture. We investigated the differences in cell functions depending on the culture model in human trophoblast cells (Sw.71). METHODS Sw.71 cells were incubated in 2D monolayers or simple 3D spheroids. After incubation, cells were corrected to assess RNA-seq transcriptome or protein expression, and culture medium were corrected to detect cytokines. To clarify the role of actin cytoskeleton, spheroid Sw.71 cells were treated mycalolide B (inhibitor of actin polymerization) in a 3D culture. RESULTS RNA-seq transcriptome analysis, results revealed that 3D-cultured cells had a different transcriptional profile compared with 2D-cultured cells, especially regarding inflammation-related molecules. Although interleukin-6 (IL-6) mRNA level was higher in 3D-culured cells, its secretion levels were higher in 2D-cultured cells. In addition, the levels of mRNA and protein expression of regnase-1, regulatory RNase of inflammatory cytokine, significantly increased in 3D culture, suggesting post-translational modification of IL-6 mRNA via regnase-1. Treatment with mycalolide B reduced cell-to-cell contact to build 3D formation and increased expression of actin cytoskeleton, resulting in increased IL-6 secretin. CONCLUSION Cell dimensionality plays an essential role in governing the spatiotemporal cellular outcomes, including inflammatory cytokine production and its negative regulation associated with regnase-1.
Collapse
Affiliation(s)
- Kotomi Seno
- Laboratory of Animal Reproduction, Department of Animal Science, Tokyo University of Agriculture, Atsugi, Kanagawa 243-0034, Japan.
| | - Yasuhisa Munakata
- Laboratory of Animal Reproduction, Department of Animal Science, Tokyo University of Agriculture, Atsugi, Kanagawa 243-0034, Japan.
| | - Michiya Sano
- Laboratory of Animal Reproduction, Department of Animal Science, Tokyo University of Agriculture, Atsugi, Kanagawa 243-0034, Japan.
| | - Ryouka Kawahara-Miki
- NODAI Genome Research Center, Tokyo University of Agriculture, Setagaya, Tokyo 154-0017, Japan.
| | - Hironori Takahashi
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
| | - Akihide Ohkuchi
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
| | - Hisataka Iwata
- Laboratory of Animal Reproduction, Department of Animal Science, Tokyo University of Agriculture, Atsugi, Kanagawa 243-0034, Japan.
| | - Takehito Kuwayama
- Laboratory of Animal Reproduction, Department of Animal Science, Tokyo University of Agriculture, Atsugi, Kanagawa 243-0034, Japan.
| | - Koumei Shirasuna
- Laboratory of Animal Reproduction, Department of Animal Science, Tokyo University of Agriculture, Atsugi, Kanagawa 243-0034, Japan.
| |
Collapse
|
82
|
Paulzen M, Goecke TW, Kuzin M, Augustin M, Gründer G, Schoretsanitis G. Pregnancy exposure to quetiapine - Therapeutic drug monitoring in maternal blood, amniotic fluid and cord blood and obstetrical outcomes. Schizophr Res 2018; 195:252-257. [PMID: 28965779 DOI: 10.1016/j.schres.2017.09.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/24/2017] [Accepted: 09/24/2017] [Indexed: 10/18/2022]
Abstract
RATIONALE This prospective study is the first to measure and correlate quetiapine concentrations in maternal blood, amniotic fluid and umbilical cord blood to account for the distribution of quetiapine. METHODS Concentrations of quetiapine are quantified in seven mother infant pairs at the time of delivery. Data are provided as median values, first (Q1) and third (Q3) quartiles and ranges. To account for the penetration ratio, the concentration of quetiapine in amniotic fluid and cord blood was divided by maternal concentrations. Correlations between daily dosage, maternal serum and umbilical cord blood concentrations were computed for seven patients while calculations for amniotic fluid were only available for six mother-infant pairs. RESULTS The median daily dosage of quetiapine was 300mg (Q1: 300mg, Q3: 600mg, range 200-800mg). There was a strong and significant correlation between maternal serum and cord blood concentrations (r=0.893, p=0.007). The median penetration ratio into fetal circulation was 0.18 (Q1: 0.16, Q3: 0.32; range 0.13-0.42), suggesting a low penetration. The median penetration ratio into amniotic fluid was 0.44 (Q1: 0.15, Q3: 0.96; range 0.09-1.70). CONCLUSIONS Quetiapine concentrations in amniotic fluid and cord blood give evidence that quetiapine is constantly accessible to the fetus with a relatively low penetration ratio. A high correlation between maternal serum and umbilical cord blood concentrations highlights a predictive role of quantifying drug concentrations in maternal serum for assessing drug concentrations in fetal circulation. Findings support the important role of therapeutic drug monitoring in supporting the efficacy and safety of psychopharmacological treatment strategies in highly vulnerable populations.
Collapse
Affiliation(s)
- Michael Paulzen
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany; Alexianer Hospital Aachen, Germany; JARA - Translational Brain Medicine, Aachen, Germany.
| | - Tamme W Goecke
- Department of Gynecology and Obstetrics, RWTH Aachen University, Germany
| | - Maxim Kuzin
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Marc Augustin
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Gerhard Gründer
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Georgios Schoretsanitis
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany; University Hospital of Psychiatry, Bern, Switzerland
| |
Collapse
|
83
|
Valero L, Alhareth K, Gil S, Lecarpentier E, Tsatsaris V, Mignet N, Fournier T, Andrieux K. Nanomedicine as a potential approach to empower the new strategies for the treatment of preeclampsia. Drug Discov Today 2018; 23:1099-1107. [DOI: 10.1016/j.drudis.2018.01.048] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/28/2017] [Accepted: 01/24/2018] [Indexed: 01/27/2023]
|
84
|
Aengenheister L, Keevend K, Muoth C, Schönenberger R, Diener L, Wick P, Buerki-Thurnherr T. An advanced human in vitro co-culture model for translocation studies across the placental barrier. Sci Rep 2018; 8:5388. [PMID: 29599470 PMCID: PMC5876397 DOI: 10.1038/s41598-018-23410-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/12/2018] [Indexed: 01/10/2023] Open
Abstract
Although various drugs, environmental pollutants and nanoparticles (NP) can cross the human placental barrier and may harm the developing fetus, knowledge on predictive placental transfer rates and the underlying transport pathways is mostly lacking. Current available in vitro placental transfer models are often inappropriate for translocation studies of macromolecules or NPs and do not consider barrier function of placental endothelial cells (EC). Therefore, we developed a human placental in vitro co-culture transfer model with tight layers of trophoblasts (BeWo b30) and placental microvascular ECs (HPEC-A2) on a low-absorbing, 3 µm porous membrane. Translocation studies with four model substances and two polystyrene (PS) NPs across the individual and co-culture layers revealed that for most of these compounds, the trophoblast and the EC layer both demonstrate similar, but not additive, retention capacity. Only the paracellular marker Na-F was substantially more retained by the BeWo layer. Furthermore, simple shaking, which is often applied to mimic placental perfusion, did not alter translocation kinetics compared to static exposure. In conclusion, we developed a novel placental co-culture model, which provides predictive values for translocation of a broad variety of molecules and NPs and enables valuable mechanistic investigations on cell type-specific placental barrier function.
Collapse
Affiliation(s)
- Leonie Aengenheister
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014, St. Gallen, Switzerland
| | - Kerda Keevend
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014, St. Gallen, Switzerland
| | - Carina Muoth
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014, St. Gallen, Switzerland
| | - René Schönenberger
- UTOX, EAWAG, Swiss Federal Institute of Aquatic Science and Technology, Ueberlandstrasse 133, 8600, Dübendorf, Switzerland
| | - Liliane Diener
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014, St. Gallen, Switzerland
| | - Peter Wick
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014, St. Gallen, Switzerland
| | - Tina Buerki-Thurnherr
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014, St. Gallen, Switzerland.
| |
Collapse
|
85
|
The Placental Barrier: the Gate and the Fate in Drug Distribution. Pharm Res 2018; 35:71. [DOI: 10.1007/s11095-017-2286-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/17/2017] [Indexed: 12/23/2022]
|
86
|
Koren G, Ornoy A. The role of the placenta in drug transport and fetal drug exposure. Expert Rev Clin Pharmacol 2018; 11:373-385. [DOI: 10.1080/17512433.2018.1425615] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Gideon Koren
- Institute of Research and Innovation, Maccabi Health Services, Israel
| | - Asher Ornoy
- Department of Pediatrics, Hebrew University, Israel
| |
Collapse
|
87
|
Current and future antenatal management of isolated congenital diaphragmatic hernia. Semin Fetal Neonatal Med 2017; 22:383-390. [PMID: 29169875 DOI: 10.1016/j.siny.2017.11.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Congenital diaphragmatic hernia is surgically correctable, yet the poor lung development determines mortality and morbidity. In isolated cases the outcome may be predicted prenatally by medical imaging. Cases with a poor prognosis could be treated before birth. However, prenatal modulation of lung development remains experimental. Fetoscopic endoluminal tracheal occlusion triggers lung growth and is currently being evaluated in a global clinical trial. Prenatal transplacental sildenafil administration may in due course be a therapeutic approach, reducing the occurrence of persistent pulmonary hypertension, either alone or in combination with fetal surgery.
Collapse
|
88
|
Zheng Q, Zhou Q, Li J, Tian Y, Huang H, Yao Q, Wang J, Zhang J. Placental transfer of bromocriptine in an ex vivo human placental perfusion model. J Matern Fetal Neonatal Med 2017; 32:1155-1159. [PMID: 29103345 DOI: 10.1080/14767058.2017.1402000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Purpose: To determine the rate and extent of the maternal-fetal transplacental passage of bromocriptine (BCT) in the dually perfused human placental model. Methods: Twenty term placentas were included in an ex vivo human placental perfusion experiment with a closed-circuit model. At the start of the perfusion, BCT at the concentration of 10 or 100 ng/ml along with 100 µg/ml antipyrine which used as a positive marker were added to the maternal reservoir. Samples were collected for the measurements of BCT and markers of placental viability both from the maternal reservoir and fetal reservoir throughout the perfusion which lasted for 3 h. Determination of BCT was carried out with liquid chromatography-tandem mass spectrometry. Results: At the end of the study, the concentration in the fetal compartment was 0.82 ± 0.32 ng/ml in the low concentration group and 5.02 ± 0.97 ng/ml in the high concentration group with a fetal transfer rate of 6.13 ± 1.94% and 5.46 ± 0.87%, respectively. Conclusion: These data showed that only trace amount of BCT could transport across the human placenta in vitro which suggested that fetal exposure to maternally administered BCT may be insignificant. More additional studies are required to explore the safety of BCT administrated in pregnancy.
Collapse
Affiliation(s)
- Qiaoling Zheng
- a Department of Clinical Pharmacy , First Affiliated Hospital of Kunming Medical University , Kunming , China
| | - Qiong Zhou
- a Department of Clinical Pharmacy , First Affiliated Hospital of Kunming Medical University , Kunming , China
| | - Juan Li
- a Department of Clinical Pharmacy , First Affiliated Hospital of Kunming Medical University , Kunming , China
| | - Yuqin Tian
- b Department of Obstetrics and Gynecology , First Affiliated Hospital of Kunming Medical University , Kunming , China
| | - Hua Huang
- a Department of Clinical Pharmacy , First Affiliated Hospital of Kunming Medical University , Kunming , China
| | - Qin Yao
- a Department of Clinical Pharmacy , First Affiliated Hospital of Kunming Medical University , Kunming , China
| | - Jingjing Wang
- a Department of Clinical Pharmacy , First Affiliated Hospital of Kunming Medical University , Kunming , China
| | - Jun Zhang
- a Department of Clinical Pharmacy , First Affiliated Hospital of Kunming Medical University , Kunming , China
| |
Collapse
|
89
|
Valero L, Alhareth K, Gil S, Simasotchi C, Roques C, Scherman D, Mignet N, Fournier T, Andrieux K. Assessment of dually labelled PEGylated liposomes transplacental passage and placental penetration using a combination of two ex-vivo human models: the dually perfused placenta and the suspended villous explants. Int J Pharm 2017; 532:729-737. [DOI: 10.1016/j.ijpharm.2017.07.076] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/25/2017] [Accepted: 07/26/2017] [Indexed: 12/18/2022]
|
90
|
Gahir SS, Piquette-Miller M. The Role of PXR Genotype and Transporter Expression in the Placental Transport of Lopinavir in Mice. Pharmaceutics 2017; 9:pharmaceutics9040049. [PMID: 29064386 PMCID: PMC5750655 DOI: 10.3390/pharmaceutics9040049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 10/19/2017] [Accepted: 10/20/2017] [Indexed: 12/23/2022] Open
Abstract
Lopinavir (LPV), an antiretroviral protease inhibitor frequently prescribed in HIV-positive pregnancies, is a substrate of Abcb1 and Abcc2. As differences in placental expression of these transporters were seen in Pregnane X Receptor (PXR) −/− mice, we examined the impact of placental transporter expression and fetal PXR genotype on the fetal accumulation of LPV. PXR +/− dams bearing PXR +/+, PXR +/−, and PXR −/− fetuses were generated by mating PXR +/− female mice with PXR +/− males. On gestational day 17, dams were administered 10 mg/kg LPV (i.v.) and sacrificed 30 min post injection. Concentrations of LPV in maternal plasma and fetal tissue were measured by LC-MS/MS, and transporter expression was determined by quantitative RT-PCR. As compared to the PXR +/+ fetal units, placental expression of Abcb1a, Abcc2, and Abcg2 mRNA were two- to three-fold higher in PXR −/− fetuses (p < 0.05). Two-fold higher fetal:maternal LPV concentration ratios were also seen in the PXR +/+ as compared to the PXR −/− fetuses (p < 0.05), and this significantly correlated to the placental expression of Abcb1a (r = 0.495; p < 0.005). Individual differences in the expression of placental transporters due to genetic or environmental factors can impact fetal exposure to their substrates.
Collapse
Affiliation(s)
- Sarabjit S Gahir
- Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, ON M5S 3M2, Canada.
- Reata Pharmaceuticals, Irving, TX 75063, USA.
| | - Micheline Piquette-Miller
- Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, ON M5S 3M2, Canada.
| |
Collapse
|
91
|
Pregnancy exposure to citalopram - Therapeutic drug monitoring in maternal blood, amniotic fluid and cord blood. Prog Neuropsychopharmacol Biol Psychiatry 2017; 79:213-219. [PMID: 28663113 DOI: 10.1016/j.pnpbp.2017.06.030] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 06/20/2017] [Accepted: 06/26/2017] [Indexed: 01/20/2023]
Abstract
RATIONALE Aim of the study was to measure and correlate citalopram concentrations in maternal blood, amniotic fluid and umbilical cord blood to account for the distribution of the drug between these three compartments. METHODS Concentrations of citalopram were measured in twelve mother infant pairs at the time of delivery. Data are provided as median values, first (Q1) and third (Q3) quartiles as well as ranges. To account for the penetration ratio into amniotic fluid and cord blood, the concentration of citalopram in was divided by the concentration in maternal serum. Correlations between daily dosage, maternal serum concentrations and umbilical cord blood concentrations were computed for twelve patients. As amniotic fluid was only available for nine mother infant pairs, appropriate calculations are provided for these mother-infant pairs. RESULTS The median daily dosage of citalopram was 20mg (Q1: 10mg, Q3: 20mg; range 10-40mg). The relation between the daily dosage of citalopram and its concentrations in maternal serum was highly significant (r=0.667, p=0.018). Maternal serum concentrations and cord blood concentrations were positively correlated (r=0.790, p=0.002) with a median penetration ratio into the fetal circulation of 0.78 (Q1: 0.52, Q3: 1.16, range 0.46-1.66). The median penetration ratio into amniotic fluid was 1.8 (Q1: 1.07, Q3: 2.64; range 0.52-6.97). CONCLUSIONS Citalopram concentrations in amniotic fluid and cord blood give evidence that maternally administered citalopram is constantly accessible to the fetus via amniotic fluid. A high correlation between maternal serum concentrations of citalopram and umbilical cord blood concentrations highlights a predictive role of quantifying drug concentrations in maternal serum for assessing drug concentrations in the fetal circulation. Findings support the important role of therapeutic drug monitoring in maintaining the safety of pregnant women and exposed infants.
Collapse
|
92
|
Hou CC, Zhu JQ. Nanoparticles and female reproductive system: how do nanoparticles affect oogenesis and embryonic development. Oncotarget 2017; 8:109799-109817. [PMID: 29312650 PMCID: PMC5752563 DOI: 10.18632/oncotarget.19087] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 06/15/2017] [Indexed: 12/20/2022] Open
Abstract
Along with the increasing application of nanoparticles (NPs) in many walks of life, environmental exposure to NPs has raised considerable health concerns. When NPs enter a pregnant woman’s body through inhalation, venous injection, ingestion or skin permeation, maternal toxic stress reactions such as reactive oxygen species (ROS), inflammation, apoptosis and endocrine dyscrasia are induced in different organs, particularly in the reproductive organs. Recent studies have shown that NPs disturb the developing oocyte by invading the protective barrier of theca cells, granulosa cell layers and zona pellucida. NPs disrupt sex hormone levels through the hypothalamic–pituitary-gonadal axis or by direct stimulation of secretory cells, such as granule cells, follicle cells, thecal cells and the corpus luteum. Some NPs can cross the placenta into the fetus by passive diffusion or endocytosis, which can trigger fetal inflammation, apoptosis, genotoxicity, cytotoxicity, low weight, reproductive deficiency, nervous damage, and immunodeficiency, among others. The toxicity of these NPs depend on their size, dosage, shape, charge, material and surface-coating. We summarize new findings on the toxic effect of various NPs on the ovary and on oogenesis and embryonic development. Meanwhile, we highlight the problems that need to be studied in the future. This manuscript will also provide valuable guidelines for protecting the female reproductive system from the toxicity of NPs and provide a certain reference value for NP application in the area of ovarian diseases.
Collapse
Affiliation(s)
- Cong-Cong Hou
- College of Marine Sciences, Ningbo University, Ningbo, Zhejiang, China
| | - Jun-Quan Zhu
- College of Marine Sciences, Ningbo University, Ningbo, Zhejiang, China
| |
Collapse
|
93
|
Abstract
Epidemiological evidence links an individual's susceptibility to chronic disease in adult life to events during their intrauterine phase of development. Biologically this should not be unexpected, for organ systems are at their most plastic when progenitor cells are proliferating and differentiating. Influences operating at this time can permanently affect their structure and functional capacity, and the activity of enzyme systems and endocrine axes. It is now appreciated that such effects lay the foundations for a diverse array of diseases that become manifest many years later, often in response to secondary environmental stressors. Fetal development is underpinned by the placenta, the organ that forms the interface between the fetus and its mother. All nutrients and oxygen reaching the fetus must pass through this organ. The placenta also has major endocrine functions, orchestrating maternal adaptations to pregnancy and mobilizing resources for fetal use. In addition, it acts as a selective barrier, creating a protective milieu by minimizing exposure of the fetus to maternal hormones, such as glucocorticoids, xenobiotics, pathogens, and parasites. The placenta shows a remarkable capacity to adapt to adverse environmental cues and lessen their impact on the fetus. However, if placental function is impaired, or its capacity to adapt is exceeded, then fetal development may be compromised. Here, we explore the complex relationships between the placental phenotype and developmental programming of chronic disease in the offspring. Ensuring optimal placentation offers a new approach to the prevention of disorders such as cardiovascular disease, diabetes, and obesity, which are reaching epidemic proportions.
Collapse
Affiliation(s)
- Graham J Burton
- Centre for Trophoblast Research and Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom; and Department of Medicine, Knight Cardiovascular Institute, and Moore Institute for Nutrition and Wellness, Oregon Health and Science University, Portland, Oregon
| | - Abigail L Fowden
- Centre for Trophoblast Research and Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom; and Department of Medicine, Knight Cardiovascular Institute, and Moore Institute for Nutrition and Wellness, Oregon Health and Science University, Portland, Oregon
| | - Kent L Thornburg
- Centre for Trophoblast Research and Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom; and Department of Medicine, Knight Cardiovascular Institute, and Moore Institute for Nutrition and Wellness, Oregon Health and Science University, Portland, Oregon
| |
Collapse
|
94
|
Muoth C, Großgarten M, Karst U, Ruiz J, Astruc D, Moya S, Diener L, Grieder K, Wichser A, Jochum W, Wick P, Buerki-Thurnherr T. Impact of particle size and surface modification on gold nanoparticle penetration into human placental microtissues. Nanomedicine (Lond) 2017; 12:1119-1133. [DOI: 10.2217/nnm-2017-0428] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Aim: Nanoparticle-based drug carriers hold great promise for the development of targeted therapies in pregnancy with reduced off-target effects. Here, we performed a mechanistic in vitro study on placental localization and penetration of gold nanoparticles (AuNPs) in dependence of particle size and surface modification. Materials & methods: AuNP uptake and penetration in human placental coculture microtissues was assessed by inductively coupled plasma-mass spectrometry, transmission electron microscopy and laser ablation-inductively coupled plasma-mass spectrometry. Results: Higher uptake and deeper penetration was observed for smaller (3–4 nm) or sodium carboxylate-modified AuNPs than for larger (13–14 nm) or PEGylate AuNPs, which barely passed the trophoblast barrier layer. Conclusion: It is possible to steer placental uptake and penetration of AuNPs by tailoring their properties, which is a prerequisite for the development of targeted therapies in pregnancy.
Collapse
Affiliation(s)
- Carina Muoth
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science & Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Mandy Großgarten
- Institute of Inorganic & Analytical Chemistry, Westfälische Wilhelms-Universität Münster, Corrensstraße 28/30, 48149 Münster, Germany
| | - Uwe Karst
- Institute of Inorganic & Analytical Chemistry, Westfälische Wilhelms-Universität Münster, Corrensstraße 28/30, 48149 Münster, Germany
| | - Jaime Ruiz
- ISM, Université de Bordeaux, 351 Cours de la Libération, 33405 Talence Cedex, France
| | - Didier Astruc
- ISM, Université de Bordeaux, 351 Cours de la Libération, 33405 Talence Cedex, France
| | - Sergio Moya
- bCIC biomaGUNE, Unidad Biosuperficies, Paseo Miramon No. 182, Edif ‘C’ 20009 Donostia-San Sebastian, Spain
| | - Liliane Diener
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science & Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Kathrin Grieder
- Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science & Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Adrian Wichser
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science & Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
- Analytical Chemistry, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Wolfram Jochum
- Institute of Pathology, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland
| | - Peter Wick
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science & Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Tina Buerki-Thurnherr
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science & Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| |
Collapse
|
95
|
Paulzen M, Goecke TW, Stickeler E, Gründer G, Schoretsanitis G. Sertraline in pregnancy - Therapeutic drug monitoring in maternal blood, amniotic fluid and cord blood. J Affect Disord 2017; 212:1-6. [PMID: 28129551 DOI: 10.1016/j.jad.2017.01.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 01/16/2017] [Accepted: 01/19/2017] [Indexed: 12/11/2022]
Abstract
RATIONALE This study is the first to measure and correlate sertraline concentrations in maternal blood, amniotic fluid and umbilical cord blood and account for distribution of the drug between these three compartments. METHODS Concentrations of sertraline were measured in six mother infant pairs at the time of delivery. Data are provided as median values, first and third quartiles as well as ranges. To account for the penetration ratio into amniotic fluid and cord blood, the concentration of sertraline in both environments was divided by the concentration in maternal serum. Daily doses were correlated with maternal serum- and umbilical cord blood-concentrations, and serum levels were correlated with levels in amniotic fluid. RESULTS The median daily dose of sertraline was 75mg (Q1: 43.75mg, Q3: 100mg; range 25-100mg). Amniotic fluid concentrations of sertraline strongly correlated with the daily dose (r=0.833, p=0.039) while neither maternal serum concentrations nor cord blood concentrations correlated with the daily dose (p>0.05). The median penetration ratio for sertraline into amniotic fluid was 0.57 (Q1: 0.28, Q3: 0.75; range: 0.22-0.88). The median penetration ratio into the fetal circulation, calculated on the basis of umbilical cord blood-concentrations, was found to be 0.36 (Q1: 0.28, Q3: 0.49; range: 0.17-0.65). CONCLUSIONS Sertraline concentrations in amniotic fluid gave evidence that maternally administered sertraline is constantly accessible to the fetus via amniotic fluid in a manner not previously appreciated. A relatively low penetration into fetal circulation may contribute to a sufficient safety profile of sertraline during pregnancy although in our study APGAR Scores were relatively low in three infants. Our data support the important role of therapeutic drug monitoring in maintaining the safety of pregnant women and exposed infants.
Collapse
Affiliation(s)
- Michael Paulzen
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, JARA - Translational Brain Medicine, Aachen, Germany.
| | - Tamme W Goecke
- Department of Gynecology and Obstetrics, RWTH Aachen University, Germany
| | - Elmar Stickeler
- Department of Gynecology and Obstetrics, RWTH Aachen University, Germany
| | - Gerhard Gründer
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, JARA - Translational Brain Medicine, Aachen, Germany
| | - Georgios Schoretsanitis
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, JARA - Translational Brain Medicine, Aachen, Germany; University Hospital of Psychiatry, Bern, Switzerland
| |
Collapse
|
96
|
Muoth C, Wichser A, Monopoli M, Correia M, Ehrlich N, Loeschner K, Gallud A, Kucki M, Diener L, Manser P, Jochum W, Wick P, Buerki-Thurnherr T. A 3D co-culture microtissue model of the human placenta for nanotoxicity assessment. NANOSCALE 2016; 8:17322-17332. [PMID: 27714104 DOI: 10.1039/c6nr06749b] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
There is increasing evidence that certain nanoparticles (NPs) can overcome the placental barrier, raising concerns on potential adverse effects on the growing fetus. But even in the absence of placental transfer, NPs may pose a risk to proper fetal development if they interfere with the viability and functionality of the placental tissue. The effects of NPs on the human placenta are not well studied or understood, and predictive in vitro placenta models to achieve mechanistic insights on NP-placenta interactions are essentially lacking. Using the scaffold-free hanging drop technology, we developed a well-organized and highly reproducible 3D co-culture microtissue (MT) model consisting of a core of placental fibroblasts surrounded by a trophoblast cell layer, which resembles the structure of the in vivo placental tissue. We could show that secretion levels of human chorionic gonadotropin (hCG) were significantly higher in 3D than in 2D cell cultures, which indicates an enhanced differentiation of trophoblasts grown on 3D MTs. NP toxicity assessment revealed that cadmium telluride (CdTe) and copper oxide (CuO) NPs but not titanium dioxide (TiO2) NPs decreased MT viability and reduced the release of hCG. NP acute toxicity was significantly reduced in 3D co-culture MTs compared to 2D monocultures. Taken together, 3D placental MTs provide a new and promising model for the fast generation of tissue-relevant acute NP toxicity data, which are indispensable for the safe development of NPs for industrial, commercial and medical applications.
Collapse
Affiliation(s)
- Carina Muoth
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland.
| | - Adrian Wichser
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland.
| | - Marco Monopoli
- Centre for BioNano Interactions, School of Chemistry and Chemical Biology, University College Dublin, Dublin 4, Ireland
| | - Manuel Correia
- Research Group for Nano-Bio Science, Division for Food Technology, National Food Institute, Technical University of Denmark, Mørkhøj Bygade 19, DK-2860 Søborg, Denmark
| | - Nicky Ehrlich
- Research Group for Nano-Bio Science, Division for Food Technology, National Food Institute, Technical University of Denmark, Mørkhøj Bygade 19, DK-2860 Søborg, Denmark
| | - Katrin Loeschner
- Research Group for Nano-Bio Science, Division for Food Technology, National Food Institute, Technical University of Denmark, Mørkhøj Bygade 19, DK-2860 Søborg, Denmark
| | - Audrey Gallud
- Division of Molecular Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 171 77 Stockholm, Sweden
| | - Melanie Kucki
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland.
| | - Liliane Diener
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland.
| | - Pius Manser
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland.
| | - Wolfram Jochum
- Institute of Pathology, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland
| | - Peter Wick
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland.
| | - Tina Buerki-Thurnherr
- Particles-Biology Interactions, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland.
| |
Collapse
|
97
|
Joshi AA, Vaidya SS, St-Pierre MV, Mikheev AM, Desino KE, Nyandege AN, Audus KL, Unadkat JD, Gerk PM. Placental ABC Transporters: Biological Impact and Pharmaceutical Significance. Pharm Res 2016; 33:2847-2878. [PMID: 27644937 DOI: 10.1007/s11095-016-2028-8] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 08/23/2016] [Indexed: 01/02/2023]
Abstract
The human placenta fulfills a variety of essential functions during prenatal life. Several ABC transporters are expressed in the human placenta, where they play a role in the transport of endogenous compounds and may protect the fetus from exogenous compounds such as therapeutic agents, drugs of abuse, and other xenobiotics. To date, considerable progress has been made toward understanding ABC transporters in the placenta. Recent studies on the expression and functional activities are discussed. This review discusses the placental expression and functional roles of several members of ABC transporter subfamilies B, C, and G including MDR1/P-glycoprotein, the MRPs, and BCRP, respectively. Since placental ABC transporters modulate fetal exposure to various compounds, an understanding of their functional and regulatory mechanisms will lead to more optimal medication use when necessary in pregnancy.
Collapse
Affiliation(s)
- Anand A Joshi
- Department of Pharmaceutics, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, 23298-0533, USA
| | - Soniya S Vaidya
- Department of Pharmaceutics, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, 23298-0533, USA
- Novartis Institutes of Biomedical Research, Cambridge, Massachusetts, USA
| | - Marie V St-Pierre
- Department of Clinical Pharmacology and Toxicology, University of Zurich Hospital, Zurich, Switzerland
| | - Andrei M Mikheev
- Department of Pharmaceutics, University of Washington School of Pharmacy, Seattle, Washington, USA
- Department of Neurosurgery, Institute of Stem Cell and Regenerative Medicine, University of Washington School of Medicine, Seattle, Washington, 98109, USA
| | - Kelly E Desino
- Department of Pharmaceutical Chemistry, University of Kansas School of Pharmacy, Lawrence, Kansas, USA
- Abbvie Inc, North Chicago, Illinois, USA
| | - Abner N Nyandege
- Department of Pharmaceutics, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, 23298-0533, USA
| | - Kenneth L Audus
- Department of Pharmaceutical Chemistry, University of Kansas School of Pharmacy, Lawrence, Kansas, USA
| | - Jashvant D Unadkat
- Department of Pharmaceutics, University of Washington School of Pharmacy, Seattle, Washington, USA
| | - Phillip M Gerk
- Department of Pharmaceutics, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, 23298-0533, USA.
| |
Collapse
|
98
|
Daud ANA, Bergman JEH, Kerstjens-Frederikse WS, Groen H, Wilffert B. The Risk of Congenital Heart Anomalies Following Prenatal Exposure to Serotonin Reuptake Inhibitors-Is Pharmacogenetics the Key? Int J Mol Sci 2016; 17:ijms17081333. [PMID: 27529241 PMCID: PMC5000730 DOI: 10.3390/ijms17081333] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 07/27/2016] [Accepted: 07/27/2016] [Indexed: 12/12/2022] Open
Abstract
Serotonin reuptake inhibitors (SRIs) are often prescribed during pregnancy. Previous studies that found an increased risk of congenital anomalies, particularly congenital heart anomalies (CHA), with SRI use during pregnancy have created concern among pregnant women and healthcare professionals about the safety of these drugs. However, subsequent studies have reported conflicting results on the association between CHA and SRI use during pregnancy. These discrepancies in the risk estimates can potentially be explained by genetic differences among exposed individuals. In this review, we explore the potential pharmacogenetic predictors involved in the pharmacokinetics and mechanism of action of SRIs, and their relation to the risk of CHA. In general, the risk is dependent on the maternal concentration of SRIs and the foetal serotonin level/effect, which can be modulated by the alteration in the expression and/or function of the metabolic enzymes, transporter proteins and serotonin receptors involved in the serotonin signalling of the foetal heart development. Pharmacogenetics might be the key to understanding why some children exposed to SRIs develop a congenital heart anomaly and others do not.
Collapse
Affiliation(s)
- Aizati N A Daud
- Department of Pharmacy, Unit of PharmacoTherapy, -Epidemiology and -Economics, University of Groningen, 9713AV Groningen, The Netherlands.
- School of Pharmaceutical Sciences, Discipline of Clinical Pharmacy, Universiti Sains Malaysia, 11800 Penang, Malaysia.
| | - Jorieke E H Bergman
- Department of Genetics, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands.
| | | | - Henk Groen
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, 9713AV Groningen, The Netherlands.
| | - Bob Wilffert
- Department of Pharmacy, Unit of PharmacoTherapy, -Epidemiology and -Economics, University of Groningen, 9713AV Groningen, The Netherlands.
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands.
| |
Collapse
|
99
|
Huang H, Wang J, Li Q, Duan J, Yao Q, Zheng Q, Wang J, Wu D, Zhou Q, Tian Y, Zhang J. Transplacental transfer of oseltamivir phosphate and its metabolite oseltamivir carboxylate using the ex vivo human placenta perfusion model in Chinese Hans population. J Matern Fetal Neonatal Med 2016; 30:1288-1292. [DOI: 10.1080/14767058.2016.1211634] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
100
|
Affiliation(s)
- Paul Berveiller
- a Department of Gynecology and Obstetrics , Centre Hospitalier Intercommunal de Poissy Saint Germain , Poissy , France.,b GIG-EA 7404, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint Quentin en Yvelines , Montigny-le-Bretonneux , France
| | - Sophie Gil
- c INSERM UMR-S 1139, Université Paris Descartes, Sorbonne Paris Cité , Paris , France.,d PremUp Foundation , Paris , France , and
| | - François Vialard
- b GIG-EA 7404, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint Quentin en Yvelines , Montigny-le-Bretonneux , France.,e Department of Cytogenetic , Centre Hospitalier Intercommunal de Poissy Saint Germain , Poissy , France
| |
Collapse
|