Role of redox in fetal development and neonatal diseases

Redox modulation of Ca2+ signaling in human endothelial and smooth muscle cells in pre-eclampsia

Pre-eclampsia (PE) is a leading cause of maternal hypertension in pregnancy and is associated with fetal growth restriction, premature birth, and fetal and maternal mortality. Activation and dysfunction of the maternal and fetal endothelium in PE appears to be a consequence of increased oxidative stress, resulting from elevated levels of circulating lipid peroxides. Accumulating evidence implicates reactive oxygen species (ROS) in the pathogenesis of vascular dysfunction in PE, perhaps involving a disturbance in intracellular Ca(2+) signaling. Several ion-transport pathways are highly sensitive to oxidative stress, and the resulting modulation of ion transport by ROS will affect intracellular Ca(2+) homeostasis. We review the evidence that changes in ion transport induced by ROS may be linked with abnormalities in Ca(2+)-mediated signal transduction, leading to endothelial and smooth muscle dysfunction in maternal and fetal circulations in PE. As dysregulation of Ca(2+) signaling in fetal umbilical endothelial cells is maintained in culture and embryonic, fetal, and postnatal development is affected by the cellular redox state, we hypothesize that impaired redox signaling in PE may influence "programming" of the fetal cardiovascular system and endothelial function in adulthood.

Redox considerations in female reproductive function and assisted reproduction: from molecular mechanisms to health implications

Physiological levels of reactive oxygen species (ROS) play an important regulatory role through various signaling transduction pathways in folliculogenesis, oocyte maturation, endometrial cycle, luteolysis, implantation, embryogenesis, and pregnancy. Persistent and elevated generation of ROS leads to a disturbance of redox potential that in turn causes oxidative stress (OS). Our literature review captures the role of ROS in modulating a range of physiological functions and pathological processes affecting the female reproductive life span and even thereafter (i.e., menopause). The role of OS in female reproduction is becoming increasingly important, as recent evidence suggest that it plays a part in conditions such as polycystic ovarian disease, endometriosis, spontaneous abortions, preeclampsia, hydatidiform mole, embryopathies, preterm labor, and intrauterine growth retardation. OS has been implicated in different reproductive scenarios and is detrimental to both natural and assisted fertility. Many extrinsic and intrinsic conditions exist in assisted reproduction settings that can be tailored to reduce the toxic effects of ROS. Laboratory personnel should avoid procedures that are known to be deleterious, especially when safer procedures that can prevent OS are available. Although antioxidants such as folate, zinc, and thiols may help enhance fertility, the available data are contentious and must be evaluated in controlled studies with larger populations.

Fluidity and oxidative stress in erythrocytes from very low birth weight infants during their first 7 days of life

OBJECTIVE

To study the evolution of lipid peroxidation, enzymatic antioxidants response, lipid profile and membrane fluidity in erythrocytes from very low birth weight (VLBW) infants during their first 7 days of extra-uterine life.

STUDY DESIGN

One hundred and twenty infants were selected and divided in two groups according to their weight and gestational age. Hydroperoxides, fatty-acid profile, fluidity (DPH and TMA-DPH) and catalase, SOD and GPx activities were measured in erythrocytes.

RESULTS

VLBW group showed higher concentration of hydroperoxides and lower membrane fluidity during the first 72 h, lower SOD activity during the first 3 h and higher GPx activity during the first 7 days of life. Also, this group showed lower n-3 polyunsaturated fatty-acids percentage with respect to the term group.

CONCLUSION

Erythrocytes from VLBW infants showed higher oxidative damage and lower fluidity in their membranes, at least during the first 3 days of extra-uterine life, which may cause alterations in their functions and flexibility.

Antioxidant metabolism of Xenopus laevis embryos during the first days of development

Reactive oxygen species (ROS) are formed and degraded in all aerobic organisms, but their role during embryonic development has not yet been well established. In this paper, we report the activities of various enzymes involved in antioxidant metabolism during the first 7 days of embryonic development of Xenopus laevis embryos. During the first two days of development, embryo antioxidant metabolism is based on catalase and superoxide dismutase activities. Later, the glutathione system is activated, and the activity of all the enzymes involved increases. The results presented in this study, together with previously reported data, support the hypothesis that antioxidant defences may include enzymes that are genetically regulated, while the other systems that appear to be environmentally modulated become relevant later in development, probably to protect embryos from environmental and toxic factors.

Ischemia-reperfusion and cardioprotection: a delicate balance between reactive oxygen species generation and redox homeostasis

Ischemia-reperfusion injury of the myocardium has long been a subject of intense research. Cardiac preconditioning, an associated phenomenon, has also been critically investigated over the past two decades. Although the biochemistry of ischemia-reperfusion and its association with oxidative metabolism has long been established, recent studies have further revealed a more intricate role of a number of reactive oxygen-nitrogen species in those processes. Emerging evidence suggests that an elaborate network of enzymes (and other biomolecules) dedicated to the generation, utilization, and diminution of reactive oxygen-nitrogen species maintains the redox homeostasis in the myocardium, and any perturbation of its status has distinctive effects. It thus appears that while excessive generation of reactive species leads to cellular injury, their regulated generation may cause transient and reversible modifications of cellular proteins leading the transmission of intracellular signals with specific effects. Taken together, generation of reactive oxygen-nitrogen species in the myocardium plays a nodal role in mediating both ischemic injury and cardioprotection.

Early oxidative stress in amniotic fluid of pregnancies with Down syndrome

OBJECTIVE

Some evidence suggests that oxidative stress, due to an imbalance between oxidants and antioxidants, occurs in babies with Down syndrome (DS). This study tests the hypothesis that oxidative stress occurs early in DS pregnancies.

DESIGN AND METHODS

Isoprostanes (IPs), a new marker of free radical-catalyzed lipid peroxidation, were measured in amniotic fluid from pregnancies with normal, growth restricted and DS fetuses, diagnosed by karyotype analysis of amniotic cells cultured.

RESULTS

A nine-fold increase in IP concentrations was found in amniotic fluid of pregnancies with DS fetuses. This increase (595.15; 542.96-631.64 pg/ml, median; 95% CI), was greater than in pregnancies with fetal growth-restricted fetuses (155; 130.57-172.23 pg/ml, median; 95% CI) and normal fetuses (67; 49.82-98.38 pg/ml, median; 95% CI; p<0.0001).

CONCLUSIONS

The study reveals that oxidative stress occurs early in pregnancy and supports the idea of testing whether prenatal antioxidant therapy may prevent or delay the onset of oxidative stress diseases in the DS population.

High levels of active quiescin Q6 sulfhydryl oxidase (QSOX) are selectively present in fetal serum

The participation of thiol-oxidoreductases such as thioredoxin during implantation, embryogenesis and fetal development has been extensively studied. Here, we analyzed the expression of the thioredoxin superfamily enzyme quiescin Q6/sulfhydryl oxidase (QSOX) during development. Results show that QSOX is present in fetal bovine serum (4 months' gestation), but its levels decrease with time after birth (from P1 to P60). We also demonstrate that a sulfhydryl oxidase activity correlates with QSOX expression in such sera, suggesting a putative role in the redox modulation of developmental programs.

Thioredoxin and its role in premature newborn biology

Thioredoxin (Trx) is a redox-active protein that has been shown to regulate various cellular processes due to its thiol-disulfide exchange reaction. It has antioxidant properties and also induces the expression of critical antioxidant enzymes such as manganese superoxide dismutase. Trx along with thioredoxin reductase and peroxiredoxins forms a complete system similar to the glutathione system, but with different and divergent functions. This review is a mini-update on key advances in the role of Trx in signal transduction and premature newborn biology. In addition, this mini-update also reviews recently reported prooxidant properties of Trx that relate to anthracycline redox cycling.

Endogenous production of lipoic acid is essential for mouse development

alpha-Lipoic acid (LA) is a cofactor for mitochondrial alpha-ketoacid dehydrogenase complexes and is one of the most potent, natural antioxidants. Reduction of oxidative stress by LA supplementation has been demonstrated in patients with diabetic neuropathy and in animal models. To determine how normal development or pathological conditions are affected by genetic alterations in the ability of mammalian cells to synthesize LA and whether dietary LA can circumvent its endogenous absence, we have generated mice deficient in lipoic acid synthase (Lias). Mice heterozygous for disruption of the Lias gene develop normally, and their plasma levels of thiobarbituric acid-reactive substances do not differ from those of wild-type mice. However, the heterozygotes have significantly reduced erythrocyte glutathione levels, indicating that their endogenous antioxidant capacity is lower than those of wild-type mice. Homozygous embryos lacking Lias appear healthy at the blastocyst stage, but their development is retarded globally by 7.5 days postcoitum (dpc), and all the null embryos die before 9.5 dpc. Supplementing the diet of heterozygous mothers with LA (1.65 g/kg of body weight) during pregnancy fails to prevent the prenatal deaths of homozygous embryos. Thus, endogenous LA synthesis is essential for developmental survival and cannot be replaced by LA in maternal tissues and blood.

Role of oxidative stress in female reproduction

In a healthy body, ROS (reactive oxygen species) and antioxidants remain in balance. When the balance is disrupted towards an overabundance of ROS, oxidative stress (OS) occurs. OS influences the entire reproductive lifespan of a woman and even thereafter (i.e. menopause). OS results from an imbalance between prooxidants (free radical species) and the body's scavenging ability (antioxidants). ROS are a double-edged sword - they serve as key signal molecules in physiological processes but also have a role in pathological processes involving the female reproductive tract. ROS affect multiple physiological processes from oocyte maturation to fertilization, embryo development and pregnancy. It has been suggested that OS modulates the age-related decline in fertility. It plays a role during pregnancy and normal parturition and in initiation of preterm labor. Most ovarian cancers appear in the surface epithelium, and repetitive ovulation has been thought to be a causative factor. Ovulation-induced oxidative base damage and damage to DNA of the ovarian epithelium can be prevented by antioxidants. There is growing literature on the effects of OS in female reproduction with involvement in the pathophysiology of preeclampsia, hydatidiform mole, free radical-induced birth defects and other situations such as abortions. Numerous studies have shown that OS plays a role in the pathophysiology of infertility and assisted fertility. There is some evidence of its role in endometriosis, tubal and peritoneal factor infertility and unexplained infertility. This article reviews the role OS plays in normal cycling ovaries, follicular development and cyclical endometrial changes. It also discusses OS-related female infertility and how it influences the outcomes of assisted reproductive techniques. The review comprehensively explores the literature for evidence of the role of oxidative stress in conditions such as abortions, preeclampsia, hydatidiform mole, fetal embryopathies, preterm labour and preeclampsia and gestational diabetes. The review also addresses the growing literature on the role of nitric oxide species in female reproduction. The involvement of nitric oxide species in regulation of endometrial and ovarian function, etiopathogenesis of endometriosis, and maintenance of uterine quiescence, initiation of labour and ripening of cervix at parturition is discussed. Complex interplay between cytokines and oxidative stress in the etiology of female reproductive disorders is discussed. Oxidant status of the cell modulates angiogenesis, which is critical for follicular growth, corpus luteum formation endometrial differentiation and embryonic growth is also highlighted in the review. Strategies to overcome oxidative stress and enhance fertility, both natural and assisted are delineated. Early interventions being investigated for prevention of preeclampsia are enumerated. Trials investigating combination intervention strategy of vitamin E and vitamin C supplementation in preventing preeclampsia are highlighted. Antioxidants are powerful and there are few trials investigating antioxidant supplementation in female reproduction. However, before clinicians recommend antioxidants, randomized controlled trials with sufficient power are necessary to prove the efficacy of antioxidant supplementation in disorders of female reproduction. Serial measurement of oxidative stress biomarkers in longitudinal studies may help delineate the etiology of some of the diosorders in female reproduction such as preeclampsia.

Oxidative stress and its implications in female infertility – a clinician's perspective

Reactive oxygen species (ROS) have a role in the modulation of gamete quality and gamete interaction. Generation of ROS is inherent in spermatozoa and contaminating leukocytes. ROS influence spermatozoa, oocytes, embryos and their environment. Oxidative stress (OS) mediates peroxidative damage to the sperm membrane and induces nuclear DNA damage. ROS can modulate the fertilizing capabilities of the spermatozoa. There is extensive literature on OS and its role in male infertility and sperm DNA damage and its effects on assisted reproductive techniques. Evidence is accumulating on the role of ROS in female reproduction. Many animal and human studies have elucidated a role for ROS in oocyte development, maturation, follicular atresia, corpus luteum function and luteolysis. OS-mediated precipitation of pathologies in the female reproductive tract is similar to those involved in male infertility. OS influences the oocyte and embryo quality and thus the fertilization rates. ROS appears to play a significant role in the modulation of gamete interaction and also for successful fertilization to take place. ROS in culture media may impact post-fertilization development, i.e. cleavage rate, blastocyst yield and quality (indicators of assisted reproduction outcomes). OS is reported to affect both natural and assisted fertility. Antioxidant strategies should be able to intercept both extracellular and intracellular ROS. This review discusses the sources of ROS in media used in IVF-embryo transfer and strategies to overcome OS in oocyte in-vitro maturation, in-vitro culture and sperm preparation techniques.