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Gad HF, Salman MM, Koleib MH, Nada AI, Daoud MA. Correlation between Diameter of Yolk Sac on Transvaginal Ultrasonography at 6-12 Weeks of Gestation and Adverse Pregnancy Outcomes. JBRA Assist Reprod 2024; 28:47-53. [PMID: 37962967 PMCID: PMC10936919 DOI: 10.5935/1518-0557.20230052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 09/21/2023] [Indexed: 11/16/2023] Open
Abstract
OBJECTIVE To evaluate the correlation between yolk sac diameter at 6 to 12 weeks of gestation measured via transvaginal ultrasound and adverse pregnancy outcomes. METHODS This prospective cohort study was conducted at the Ain Shams University Maternity Hospital from July 1, 2019 to January 30, 2020. It included 120 pregnant women attending the outpatient clinic at 6 to 12 weeks of gestation. Transvaginal ultrasound was performed to measure inner yolk sac diameter. Normal diameter was considered to be 2-5 mm. Cases were followed up in routine antenatal care until the 16th week of gestation. RESULTS Significant associations were found between maternal age and yolk sac diameter; yolk sac diameter and early miscarriage; a high percentage of cases of positive fetal life occurred when a normal yolk sac diameter (2-5 mm) was present (p<0.001); in yolk sac diameters <2mm positive fetal life was 0.0% and negative fetal life was 42.9%; in yolk sac diameters of 2-5mm positive fetal life was 81.1% and the negative fetal life was 7.1%; and in yolk sac diameters >5mm positive fetal life was 18.9% and negative fetal life was 50.0% (p<0.001), x2 60.094; and the best cutoff value for yolk sac diameter was >0.56, with a sensitivity of 78.6%, a specificity of 84.3%. CONCLUSIONS We found a highly significant correlation between yolk sac diameter and early pregnancy loss.
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Affiliation(s)
- Haitham Fathy Gad
- Lecturer of Obstetrics and Gynecology, Ain Shams University, Cairo,
Egypt
| | | | | | - Aya Ibrahim Nada
- Resident of Obstetrics and Gynecology, Elgalaa Military Hospital,
Cairo, Egypt
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2
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Cismaru CA, Tomuleasa C, Jurj A, Chira S, Isachekcu E, Cismaru G, Gherman LM, Gulei D, Munteanu R, Berindan Neagoe I. Synergistic Effect of Human Chorionic Gonadotropin and Granulocyte Colony Stimulating Factor in the Mobilization of HSPCs Improves Overall Survival After PBSCT in a Preclinical Murine Model. Are We Far Enough for Therapy? Stem Cell Rev Rep 2024; 20:206-217. [PMID: 37922107 DOI: 10.1007/s12015-023-10648-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 11/05/2023]
Abstract
Strategies to improve hematopoietic stem and progenitor cell (HSPC) mobilization from the bone marrow can have a pivotal role in addressing iatrogenic bone-marrow insufficiency from chemo(radio)therapy and overcoming peripheral blood stem cell transplantation (PBSCT) limitations such as insufficient mobilization. Granulocyte-colony stimulating factor (G-CSF) represents the standard mobilization strategy for HSPC and has done so for more than three decades since its FDA approval. Its association with non-G-CSF agents is often employed for difficult HSPC mobilization. However, obtaining a synergistic effect between the two classes is limited by different timing and mechanisms of action. Based on our previous in vitro results, we tested the mobilization potential of human chorionic gonadotropin (HCG), alone and in combination with G-CSF in vivo in a murine study. Our results show an improved mobilization capability of the combination, which seems to act synergistically in stimulating hematopoiesis. With the current understanding of the dynamics of HSPCs and their origins in more primitive cells related to the germline, new strategies to employ the mobilization of hematopoietic progenitors using chorionic gonadotropins could soon become clinical practice.
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Affiliation(s)
- Cosmin Andrei Cismaru
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, 23 Gheorghe Marinescu Street, P.O. 400393, Cluj-Napoca, Romania.
| | - Ciprian Tomuleasa
- MEDFUTURE - The Research Center for Advanced Medicine "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ancuta Jurj
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, 23 Gheorghe Marinescu Street, P.O. 400393, Cluj-Napoca, Romania
| | - Sergiu Chira
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, 23 Gheorghe Marinescu Street, P.O. 400393, Cluj-Napoca, Romania
| | - Ekaterina Isachekcu
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, 23 Gheorghe Marinescu Street, P.O. 400393, Cluj-Napoca, Romania
| | - Gabriel Cismaru
- Department of Internal Medicine, Cardiology-Rehabilitation, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Luciana Madalina Gherman
- Laboratory Animal Facility - Centre for Experimental Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Diana Gulei
- MEDFUTURE - The Research Center for Advanced Medicine "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Raluca Munteanu
- MEDFUTURE - The Research Center for Advanced Medicine "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioana Berindan Neagoe
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, 23 Gheorghe Marinescu Street, P.O. 400393, Cluj-Napoca, Romania
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Translational Comparison of the Human and Mouse Yolk Sac Development and Function. Reprod Sci 2023; 30:41-53. [PMID: 35137348 DOI: 10.1007/s43032-022-00872-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/29/2022] [Indexed: 01/06/2023]
Abstract
The yolk sac (YS) is the oldest of the extraembryonic membranes in vertebrates. Considered a transitory structure in the human species, the importance of the YS for a successful pregnancy is often overlooked. Due to the general inaccessibility of healthy human YS tissue for research, the use of experimental animal models is of great value. In order to better understand whether the mouse could be used as a translational model for the study of the human YS under normal and pathological conditions, this review comprehensively describes key developmental aspects of the human and mouse YS, detailing their development and function. YS major similarities in both species comprise the following: (1) histological composition (both being composed of endoderm, mesoderm, and mesothelium layers); (2) endoderm endocytosis, synthesis, secretion, and transport capabilities; and (3) mesoderm onset of haematopoiesis and angiogenesis. Examples of main dissimilarities include (1) persistence across pregnancy (i.e. early pregnancy in humans vs term pregnancy in mice); (2) the existence of a secondary YS in humans; (3) the presence of proliferative primordial germ cells (PGCs) in the human versus their absence in mice; and (4) eversion of histological layers in the mouse. Although these differences should be considered when interpreting data from mouse-based studies, the overall morphofunctional similarities in the YS between these species indicate that the mouse can be potentially used as a translational model for the study of the human YS.
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Stem Cells in the Tumor Immune Microenvironment -Part of the Cure or Part of the Disease? Ontogeny and Dichotomy of Stem and Immune Cells has Led to better Understanding. Stem Cell Rev Rep 2022; 18:2549-2565. [PMID: 35841518 DOI: 10.1007/s12015-022-10428-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
Stem cells are at the basis of tissue homeostasis, hematopoiesis and various regenerative processes. Epigenetic changes in their somatically imprinted genes, prolonged exposure to mutagens/carcinogens or alteration of their niche can lead to the development of an enabling environment for tumor growth and progression. The involvement of stem cells in both health and disease becomes even more compelling with ontogeny as embryonic and extraembryonic stem cells which persist into adulthood in well established and specific niche may have distinct implications in tumorigenesis. Immune surveillance plays an important role in this interplay since the response of immune cells toward the oncogenic process can range from reactivity to placidity and even complicity, being orchestrated by intercellular molecular dialogues with the other key players of the tumor microenvironment. With the current understanding that every developing and adult tissue contains inherent stem and progenitor cells, in this manuscript we review the most relevant interactions carried out between the stem cells, tumor cells and immune cells in a bottom-up incursion through the tumor microenvironment beginning from the perivascular niche and going through the tumoral parenchyma and the related stroma. With the exploitation of various factors that influence the behavior of immune effectors toward stem cells and other resting cells in their niche, new therapeutic strategies to tackle the polarization of immune effectors toward a more immunogenic phenotype may arise.
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5
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Burton GJ, Jauniaux E. Placentation in the Human and Higher Primates. ADVANCES IN ANATOMY, EMBRYOLOGY, AND CELL BIOLOGY 2021; 234:223-254. [PMID: 34694484 DOI: 10.1007/978-3-030-77360-1_11] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Placentation in humans is precocious and highly invasive compared to other mammals. Implantation is interstitial, with the conceptus becoming completely embedded within the endometrium towards the end of the second week post-fertilization. Villi initially form over the entire surface of the chorionic sac, stimulated by histotrophic secretions from the endometrial glands. The secondary yolk sac never makes contact with the chorion, and a choriovitelline placenta is never established. However, recent morphological and transcriptomic analyses suggest that the yolk sac plays an important role in the uptake of nutrients from the coelomic fluid. Measurements performed in vivo demonstrate that early development takes place in a physiological, low-oxygen environment that protects against teratogenic free radicals and maintains stem cells in a multipotent state. The maternal arterial circulation to the placenta is only fully established around 10-12 weeks of gestation. By then, villi have regressed over the superficial, abembryonic pole, leaving the definitive discoid placenta, which is of the villous, hemochorial type. Remodeling of the maternal spiral arteries is essential to ensure a high-volume but low-velocity inflow into the mature placenta. Extravillous trophoblast cells migrate from anchoring villi and surround the arteries. Their interactions with maternal immune cells release cytokines and proteases that are key to remodeling, and a successful pregnancy.
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Affiliation(s)
- Graham J Burton
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK.
| | - Eric Jauniaux
- Faculty of Population Health Sciences, EGA Institute for Women's Health, University College London, London, UK
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6
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Cellular Basis of Embryonic Hematopoiesis and Its Implications in Prenatal Erythropoiesis. Int J Mol Sci 2020; 21:ijms21249346. [PMID: 33302450 PMCID: PMC7763178 DOI: 10.3390/ijms21249346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/04/2020] [Accepted: 12/05/2020] [Indexed: 01/02/2023] Open
Abstract
Primitive erythrocytes are the first hematopoietic cells observed during ontogeny and are produced specifically in the yolk sac. Primitive erythrocytes express distinct hemoglobins compared with adult erythrocytes and circulate in the blood in the nucleated form. Hematopoietic stem cells produce adult-type (so-called definitive) erythrocytes. However, hematopoietic stem cells do not appear until the late embryonic/early fetal stage. Recent studies have shown that diverse types of hematopoietic progenitors are present in the yolk sac as well as primitive erythroblasts. Multipotent hematopoietic progenitors that arose in the yolk sac before hematopoietic stem cells emerged likely fill the gap between primitive erythropoiesis and hematopoietic stem-cell-originated definitive erythropoiesis and hematopoiesis. In this review, we discuss the cellular origin of primitive erythropoiesis in the yolk sac and definitive hematopoiesis in the fetal liver. We also describe mechanisms for developmental switches that occur during embryonic and fetal erythropoiesis and hematopoiesis, particularly focusing on recent studies performed in mice.
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7
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Alonso L, Carugno J. The Yolk Sac: An Interesting Small Structure of the Human Embryonic Stage. J Minim Invasive Gynecol 2020; 28:166-167. [PMID: 32504822 DOI: 10.1016/j.jmig.2020.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/16/2020] [Accepted: 05/24/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Luis Alonso
- Endoscopy Unit, Centro Gutenberg, Malaga, Spain (Dr. Luis)
| | - Jose Carugno
- Minimally Invasive Gynecology Unit, Department of Obstetrics, Gynecology, and Reproductive Science, Miller School of Medicine, University of Miami, Miami, Florida (Dr. Carugno)..
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8
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Detti L, Roman RA, Goedecke PJ, Christiansen ME, Peregrin-Alvarez I, Ikwuezunma G, Francillon L. Pilot study establishing a nomogram of yolk sac growth during the first trimester of pregnancy. J Obstet Gynaecol Res 2019; 46:223-228. [PMID: 31814235 DOI: 10.1111/jog.14173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 11/15/2019] [Indexed: 11/29/2022]
Abstract
AIM The yolk sac (YS) has been reported as a reliable predictor of adverse pregnancy outcomes, however, it has always been evaluated cross-sectionally with a single ultrasound per patient. We sought to validate the use of YS dimensions in serial ultrasounds throughout the first 10 weeks of singleton and multiple gestations. METHODS This was a prospective cohort study where YS diameters were serially obtained with 2D ultrasound in singleton and multiple gestations from 5 to 11 weeks. Nonparametric test were used for comparisons with P < 0.05 indicating significance. RESULTS One hundred ninety-three patients were included, 42 twins (3 monochorionic and 39 dichorionic), 2 triplets (monochorionic twins plus a singleton) and 148 singleton pregnancies (238 total fetuses). There was no difference in YS dimensions in singleton versus multiple pregnancies. Starting at 5 weeks' gestation, the YS increased 0.4 mm (95% CI 0.3-0.5 mm) per week until 10 weeks' gestation. Forty-five fetuses were lost in the first trimester. The risk of pregnancy loss was higher with a large YS until 8 weeks (P ≤ 0.001), while after 8 weeks it was higher with a small YS (P < 0.005). CONCLUSION We established a nomogram of YS development during the first 10 weeks of pregnancy. The YS reliably detected pregnancies that ended in loss as early as 6 weeks' gestation. The YS was either smaller or larger than in ongoing pregnancies. While all pregnancies with large YS were lost within 10 weeks, those with smaller YS were lost beyond the first 10 weeks.
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Affiliation(s)
- Laura Detti
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Robert A Roman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Patricia J Goedecke
- Division of Biostatistics, Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Mary E Christiansen
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Irene Peregrin-Alvarez
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Gini Ikwuezunma
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Ludwig Francillon
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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9
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Huang ZW, Fong CY, Gauthaman K, Sukumar P, Mahyuddin AP, Barrett AN, Bongso A, Choolani M. Biology of human primitive erythroblasts for application in noninvasive prenatal diagnosis. Prenat Diagn 2018; 38:673-684. [PMID: 29876942 DOI: 10.1002/pd.5295] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 05/23/2018] [Accepted: 05/30/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Human primitive erythroblasts produced during early embryogenesis have been found in maternal circulation at early gestation and are considered good target cells for noninvasive prenatal diagnosis. We aimed to gain a better understanding of the biology of primitive erythroblasts and maximize their potential utility for noninvasive prenatal diagnosis. METHODS Cells were obtained from first trimester human placental tissues. Biological properties including surface antigen composition, differentiation, proliferation, enucleation, and degeneration were studied as gestation progressed. A microdroplet culture system was developed to observe the behavior of these cells in vitro. RESULTS Histology showed that primitive erythroblasts undergo maturation from polychromatic to orthochromatic erythroblasts and can differentiate spontaneously in vitro. Cell surface markers and nuclear gene expression suggest that the cells do not possess stemness properties, despite being primitive in nature. They have limited proliferative activity and highly deacetylated chromatin, but a microdroplet culture system can prolong their viability under normoxic conditions. No apoptosis was seen by 11 weeks' gestation, and there was no enucleation in vitro. CONCLUSION These properties confirm that viable cells with intact nuclei can be obtained at very early gestation for genetic analysis.
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Affiliation(s)
- Zhou-Wei Huang
- National University of Singapore, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University Health System, 119228, Singapore
| | - Chui-Yee Fong
- National University of Singapore, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University Health System, 119228, Singapore
| | - Kalamegam Gauthaman
- King Abdulaziz University, King Fahd Medical Research Centre, Jeddah, 21589, Saudi Arabia
| | - Ponnusamy Sukumar
- National University of Singapore, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University Health System, 119228, Singapore.,Management Development Institute of Singapore, 501 Stirling Road, 148951, Singapore
| | - Aniza P Mahyuddin
- National University of Singapore, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University Health System, 119228, Singapore
| | - Angela N Barrett
- National University of Singapore, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University Health System, 119228, Singapore
| | - Ariff Bongso
- National University of Singapore, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University Health System, 119228, Singapore
| | - Mahesh Choolani
- National University of Singapore, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University Health System, 119228, Singapore
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10
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Burton GJ, Jauniaux E. Development of the Human Placenta and Fetal Heart: Synergic or Independent? Front Physiol 2018; 9:373. [PMID: 29706899 PMCID: PMC5906582 DOI: 10.3389/fphys.2018.00373] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 03/27/2018] [Indexed: 12/03/2022] Open
Abstract
The placenta is the largest fetal organ, and toward the end of pregnancy the umbilical circulation receives at least 40% of the biventricular cardiac output. It is not surprising, therefore, that there are likely to be close haemodynamic links between the development of the placenta and the fetal heart. Development of the placenta is precocious, and in advance of that of the fetus. The placenta undergoes considerable remodeling at the end of the first trimester of pregnancy, and its vasculature is capable of adapting to environmental conditions and to variations in the blood supply received from the mother. There are two components to the placental membranes to consider, the secondary yolk sac and the chorioallantoic placenta. The yolk sac is the first of the extraembryonic membranes to be vascularized, and condensations in the mesenchyme at ~17 days post-conception (p.c.) give rise to endothelial and erythroid precursors. A network of blood vessels is established ~24 days p.c., with the vitelline vein draining through the region of the developing liver into the sinus venosus. Gestational sacs of early pregnancy failures often display aberrant development of the yolk sac, which is likely to be secondary to abnormal fetal development. Vasculogenesis occurs in the villous mesenchyme of the chorioallantoic placenta at a similarly early stage. Nucleated erythrocytes occupy the lumens of the placental capillaries and end-diastolic flow is absent in the umbilical arterial circulation throughout most of the first trimester, indicating a high resistance to blood flow. Resistance begins to fall in the umbilico-placental circulation around 12–14 weeks. During normal early pregnancy the placental capillary network is plastic, and considerable remodeling occurs in response to the local oxygen concentration, and in particular to oxidative stress. In pregnancies complicated by preeclampsia and/or fetal growth restriction, utero-placental malperfusion induces smooth muscle cells surrounding the placental arteries to dedifferentiate and adopt a proliferative phenotype. This change is associated with increased umbilical resistance measured by Doppler ultrasound, and is likely to exert a major effect on the developing heart through the afterload. Thus, both the umbilical and maternal placental circulations may impact on development of the heart.
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Affiliation(s)
- Graham J Burton
- Department of Physiology, Development and Neuroscience, Centre for Trophoblast Research, University of Cambridge, Cambridge, United Kingdom
| | - Eric Jauniaux
- Faculty of Population Health Sciences, EGA Institute for Women's Health, University College London, London, United Kingdom
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11
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Peixoto AB, Caldas TMRDC, Petrini CG, Romero ACP, Júnior LEB, Martins WP, Araujo Júnior E. The impact of first-trimester intrauterine hematoma on adverse perinatal outcomes. Ultrasonography 2018; 37:330-336. [PMID: 29807403 PMCID: PMC6177692 DOI: 10.14366/usg.18006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 03/17/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose The aim of this study was to evaluate whether the presence of an intrauterine hematoma (IUH) on an early pregnancy ultrasound scan showing a live fetus was related to adverse perinatal outcomes. Methods We performed a retrospective cohort study to evaluate pregnant women who underwent an ultrasound examination in early pregnancy, between 6 weeks 0 days and 10 weeks 6 days. We compared the perinatal outcomes between women with and without firsttrimester IUH using the Mann-Whitney and Fisher exact tests. Furthermore, we performed a stepwise regression analysis to identify possible predictors of miscarriage among maternal characteristics, ultrasound parameters, and IUH. Results During the study period, data from 783 pregnancies were included, and the incidence of IUH was 4.5% (35 of 783). We observed a higher proportion of miscarriage following the scan (28.6% vs. 10%, P=0.003) and a larger yolk sac diameter during the scan (4.8 mm vs. 3.8 mm, P<0.001) in the pregnant women with first-trimester IUH. There was no significant difference regard the prevalence of low birth weight (LBW; P=0.091), very LBW (P=0.370), or extremely LBW (P=0.600) between cases with IUH and without IUH, the cesarean section rate (68% vs. 81%, P=0.130), preterm delivery (16% vs. 16%, P>0.999), or the incidence of first-trimester vaginal bleeding (31% vs. 20%, P=0.130). Moreover, heart rate (HR) was the only variable that predicted miscarriage with statistical significance (P=0.017). Conclusion Women with first-trimester IUH had a higher risk of miscarriage after the ultrasound scan. HR was the only variable that predicted miscarriage with statistical significance.
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Affiliation(s)
- Alberto Borges Peixoto
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil.,Mário Palmério University Hospital, University of Uberaba (UNIUBE), Uberaba, Brazil.,Radiologic Clinic of Uberaba (CRU), Uberaba, Brazil
| | | | | | | | | | - Wellington P Martins
- Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, University of São Paulo (FMRPUSP), Ribeiráo Preto, Brazil
| | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
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12
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Ashoush S, Abuelghar W, Tamara T, Aljobboury D. Relation between types of yolk sac abnormalities and early embryonic morphology in first-trimester missed miscarriage. J Obstet Gynaecol Res 2015; 42:21-8. [DOI: 10.1111/jog.12837] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 07/14/2015] [Accepted: 07/18/2015] [Indexed: 12/21/2022]
Affiliation(s)
- Sherif Ashoush
- Department of Obstetrics and Gynecology, Faculty of Medicine; Ain Shams University; Cairo Egypt
| | - Wessam Abuelghar
- Department of Obstetrics and Gynecology, Faculty of Medicine; Ain Shams University; Cairo Egypt
| | - Tarek Tamara
- Department of Obstetrics and Gynecology, Faculty of Medicine; Ain Shams University; Cairo Egypt
| | - Dalia Aljobboury
- Department of Obstetrics and Gynecology; Fallujah Hospital; Fallujah Iraq
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13
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Pereda J, Sulz L, Monge JI. The role of the gastrointestinal epithelium as a possible pathway for the transfer of nutrients to the embryo's circulation. Microsc Res Tech 2015; 78:500-7. [PMID: 25808242 DOI: 10.1002/jemt.22501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 03/07/2015] [Indexed: 11/09/2022]
Abstract
The endodermal cells of the human yolk sac (YS) produce non-nucleated erythrocytes (NNEs) and numerous serum proteins that are transiently storage within the YS cavity. After their transfer via the vitelline duct to the embryo gastrointestinal lumen, the nutrients' final fate is unknown. With the aim of investigate how erythroid cells and nutrients are conveyed to embryo circulation, we studied, using a morphological and immunohistochemical approach, the embryo anatomy and the serum protein α-fetoprotein (AFP) presence, in 15 human embryos and their YS, collected from tubal pregnancies from 4 to 8 wpf. We observed at 5 wpf, a strong AFP staining in the endodermal cells of the YS, thereafter AFP was only present in the YS cavity and the gastrointestinal lumen. During 7 wpf, AFP expression declined and disappeared, concomitant with YS regression. Between 5 and 7 wpf, NNEs were observed in the gastrointestinal cavity, where they accumulate in the stomach. Here, the cells were attached to the endodermal epithelial cells or were free in the lumen. By scanning electron microscopy, we identified signs of NNEs phagocytized by endodermal cells. Those NNEs free in the lumen, after hemolysis, were probably removed by endocytosis (cell debris). Taking all together, we postulate that after reaching the endodermal epithelial cells of the stomach, nutrients are transferred to the embryo by a phagocytic/endocytic mechanism that is operative until the end of 6 wpf. After absorption, NNEs are probably degraded within phagosomes, nutrients delivered to the cell cytoplasm and then transported towards the embryonic circulation.
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Affiliation(s)
- Jaime Pereda
- Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Avda, Bdo, O'Higgins 3363, Casilla 442-Carreo 2, Santiago, Chile
| | - Lorena Sulz
- Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Avda, Bdo, O'Higgins 3363, Casilla 442-Carreo 2, Santiago, Chile
| | - Juan I Monge
- Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Avda, Bdo, O'Higgins 3363, Casilla 442-Carreo 2, Santiago, Chile.,Carrera de Medicina, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Ricardo Morales 3369, San Miguel, Santiago, Chile
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Hua R, Barrett AN, Tan TZ, Huang Z, Mahyuddin AP, Ponnusamy S, Sandhu JS, Ho SSY, Chan JKY, Chong S, Quan S, Choolani M. Detection of aneuploidy from single fetal nucleated red blood cells using whole genome sequencing. Prenat Diagn 2014; 35:637-44. [PMID: 25178640 DOI: 10.1002/pd.4491] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 08/26/2014] [Accepted: 08/27/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of the study was to detect aneuploidy in single fetal nucleated red blood cells (FNRBCs) from placental villi using whole genome amplification (WGA) and next generation sequencing. METHODS Three single FNRBCs per sample were manually picked from villi collected from ten women undergoing elective first-trimester termination of pregnancy, and one or two cells were picked from each of four aneuploid chorionic villus samples. Following WGA and addition of adaptor and index sequences, samples were sequenced on the Illumina MiSeq. Leading and trailing 15 bases were trimmed, and reads were aligned to the human reference genome. Z-scores were calculated to determine deviation of the mean of the test from reference samples, with a score of 3 used as the threshold for classification of a particular chromosome as trisomic. RESULTS We successfully made correct diagnoses from ten single cells isolated from villi from two cases of trisomy 21 (one case from a single cell and one from two cells), two cases of trisomy 18 (two cells each), and a case of trisomy 15 (three cells). CONCLUSION With their faithful representation of fetal genome, diagnosis using single FNRBCs provides a definitive result compared with non-invasive prenatal testing using cell-free fetal DNA, and is a safer alternative to invasive amniocentesis.
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Affiliation(s)
- Rui Hua
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, S119228.,Department of Obstetrics and Gynaecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Angela N Barrett
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, S119228
| | - Tuan Zea Tan
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, S117599
| | - Zhouwei Huang
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, S119228
| | - Aniza Puteri Mahyuddin
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, S119228
| | - Sukumar Ponnusamy
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, S119228
| | - Jaspal Singh Sandhu
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, S119228
| | - Sherry S Y Ho
- Department of Laboratory Medicine, Molecular Diagnosis Centre, National University Hospital, Singapore, S119074
| | - Jerry K Y Chan
- Experimental Fetal Medicine Group, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, S119228.,Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, S229899
| | - Samuel Chong
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University Hospital, National University of Singapore, Singapore, S119074
| | - Song Quan
- Department of Obstetrics and Gynaecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Mahesh Choolani
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, S119228
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Fraser ST. The modern primitives: applying new technological approaches to explore the biology of the earliest red blood cells. ISRN HEMATOLOGY 2013; 2013:568928. [PMID: 24222861 PMCID: PMC3814094 DOI: 10.1155/2013/568928] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 08/25/2013] [Indexed: 01/01/2023]
Abstract
One of the most critical stages in mammalian embryogenesis is the independent production of the embryo's own circulating, functional red blood cells. Correspondingly, erythrocytes are the first cell type to become functionally mature during embryogenesis. Failure to achieve this invariably leads to in utero lethality. The recent application of technologies such as transcriptome analysis, flow cytometry, mutant embryo analysis, and transgenic fluorescent gene expression reporter systems has shed new light on the distinct erythroid lineages that arise early in development. Here, I will describe the similarities and differences between the distinct erythroid populations that must form for the embryo to survive. While much of the focus of this review will be the poorly understood primitive erythroid lineage, a discussion of other erythroid and hematopoietic lineages, as well as the cell types making up the different niches that give rise to these lineages, is essential for presenting an appropriate developmental context of these cells.
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Affiliation(s)
- Stuart T. Fraser
- Disciplines of Physiology, Anatomy and Histology, Bosch Institute, School of Medical Sciences, University of Sydney, Medical Foundation Building K25, 92-94 Parramatta Road, Camperdown, NSW 2050, Australia
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16
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Mançanares CA, Leiser R, Favaron PO, Carvalho AF, Oliveira VCD, Santos JMD, Ambrósio CE, Miglino MA. A morphological analysis of the transition between the embryonic primitive intestine and yolk sac in bovine embryos and fetuses. Microsc Res Tech 2013; 76:756-66. [DOI: 10.1002/jemt.22227] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 04/04/2013] [Accepted: 04/10/2013] [Indexed: 11/06/2022]
Affiliation(s)
| | - Rudolf Leiser
- Department of Veterinary Anatomy, Histology and Embryology; Justus-Liebig-University; Giessen; Germany
| | - Phelipe O. Favaron
- Department of Surgery, Faculty of Veterinary Medicine and Animal Science; University of Sao Paulo; Sao Paulo; Brazil
| | - Ana F. Carvalho
- Morphology Laboratory of Veterinary Medicine College; UNIFEOB; São João da Boa Vista; Brazil
| | - Vanessa C. De Oliveira
- Department of Surgery, Faculty of Veterinary Medicine and Animal Science; University of Sao Paulo; Sao Paulo; Brazil
| | - José M. Dos Santos
- Department of Morphological Sciences; Universidade Anhembi Morumbi; São Paulo; Brazil
| | - Carlos E. Ambrósio
- Department of Veterinary Medicine, FZEA; University of Sao Paulo; Pirassununga; São Paulo; Brazil
| | - Maria A. Miglino
- Department of Surgery, Faculty of Veterinary Medicine and Animal Science; University of Sao Paulo; Sao Paulo; Brazil
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17
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Yang H, Zhou B, Prinz M, Siegel D. Proteomic analysis of menstrual blood. Mol Cell Proteomics 2012; 11:1024-35. [PMID: 22822186 DOI: 10.1074/mcp.m112.018390] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Menstruation is the expulsion of the endometrial lining of the uterus following a nearly month long preparation for embryo implantation and pregnancy. Increasingly, the health of the endometrium is being recognized as a critical factor in female fertility, and proteomes and transcriptomes from endometrial biopsies at different stages of the menstrual cycle have been studied for both diagnostic and therapeutic purposes (1 Kao, L. C., et al. 2003 Endocrinology 144, 2870-2881; Strowitzki, Tet al. 2006 Hum. Reprod. Update 12, 617-630; DeSouza, L., et al. 2005 Proteomics 5, 270-281). Disorders of the uterus ranging from benign to malignant tumors, as well as endometriosis, can cause abnormal menstrual bleeding and are frequently diagnosed through endometrial biopsy (Strowitzki, Tet al. 2006 Hum. Reprod. Update 12, 617-630; Ferenczy, A. 2003 Maturitas 45, 1-14). Yet the proteome of menstrual blood, an easily available noninvasive source of endometrial tissue, has yet to be examined for possible causes or diagnoses of infertility or endometrial pathology. This study employed five different methods to define the menstrual blood proteome. A total of 1061 proteins were identified, 361 were found by at least two methods and 678 were identified by at least two peptides. When the menstrual blood proteome was compared with those of circulating blood (1774 proteins) and vaginal fluid (823 proteins), 385 proteins were found unique to menstrual blood. Gene ontology analysis and evaluation of these specific menstrual blood proteins identified pathways consistent with the processes of the normal endometrial cycle. Several of the proteins unique to menstrual blood suggest that extramedullary uterine hematopoiesis or parenchymal hemoglobin synthesis may be occurring in late endometrial tissue. The establishment of a normal menstrual blood proteome is necessary for the evaluation of its usefulness as a diagnostic tool for infertility and uterine pathologies. Identification of unique menstrual blood proteins should aid the forensic community in distinguishing menstrual blood from circulating blood.
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Affiliation(s)
- Heyi Yang
- New York City Office of Chief Medical Examiner, New York, New York 10016, USA
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18
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Santolaya-Forgas J, Mittal P, De Leon-Luis J, Than NG, Hong JS, Wolf R, Wildman D. A prospective and controlledin vivostudy to determine if acute episodes of high glucose concentrations in the extra-embryonic celomic cavity could be related to spontaneous abortion. J Matern Fetal Neonatal Med 2012; 25:1848-51. [DOI: 10.3109/14767058.2012.667178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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19
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Tan S, Pektaş MK, Arslan H. Sonographic evaluation of the yolk sac. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012; 31:87-95. [PMID: 22215774 DOI: 10.7863/jum.2012.31.1.87] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This pictorial essay aims to inform related clinicians by summarizing the normal and abnormal sonographic findings of the yolk sac in the first trimester of pregnancy. An abnormality in the sonographic appearance of a yolk sac can predict subsequent embryonic death or abnormalities. Therefore, the accurate recognition of normal and abnormal sonographic findings concerning the yolk sac can be used to anticipate the course of pregnancy.
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Affiliation(s)
- Sinan Tan
- Department of Radiology, Ankara Atatürk Education and Research Hospital, Ankara, Turkey.
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20
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Huang Z, Fong CY, Gauthaman K, Sukumar P, Choolani M, Bongso A. Novel approaches to manipulating foetal cells in the maternal circulation for non-invasive prenatal diagnosis of the unborn child. J Cell Biochem 2011; 112:1475-85. [DOI: 10.1002/jcb.23084] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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21
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Pereda J, Monge JI, Niimi G. Two different pathways for the transport of primitive and definitive blood cells from the yolk sac to the embryo in humans. Microsc Res Tech 2010; 73:803-9. [PMID: 20169616 DOI: 10.1002/jemt.20823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
During the early human embryonic period nutrients and blood cells are temporarily provided by the extraembryonic yolk sac (YS). The YS before week six is involved not only in primitive but also in definitive erythropoiesis. While the destiny of primitive erythroid cells that fill the blood vessels of the YS is well known, the final destination of erythrocytes present in the endodermal vesicular system is unknown. In the present study we have investigated, step by step, the destiny of the erythrocytes present in the endodermal vesicles during the embryonic period. Twelve human YSs and their corresponding yolk stalks were analyzed between weeks 4 and 7 of embryonic age by light and scanning electron microscopy. It is shown that erythrocytes (according to their size and morphological features) located within the endodermal vesicles of the YS wall are pulled out through endodermal pits into the YS cavity, from where they reach the lumen of the primitive gut of the embryo through the vitelline duct, a temporary pathway communicating both compartments. During the study period no erythrocytes were seen within the embryo's vascular network where only primitive erythroblasts were identified. Our results indicate that the vitelline duct plays an important transient role as a pathway for the transport of nutrients and blood cells between the YS and the embryo before week five of embryonic development that ends just at the time when YS-embryo circulation becomes established.
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Affiliation(s)
- Jaime Pereda
- Department of Human Embryology, School of Medicine, University of Santiago de Chile, Santiago, Chile.
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22
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Niimi G, Ohashi K, Ide T, Pereda J. Budding and direct division of adult human erythrocytes in serum-free cultures. Okajimas Folia Anat Jpn 2010; 86:73-7. [PMID: 20166547 DOI: 10.2535/ofaj.86.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This paper documents the budding and division process of human erythrocytes in vitro using time-lapse light microscopy of hanging-drop preparations. The erythrocytes were prepared from normal adult human peripheral blood. Red blood cells showed cytoplasmic budding, segmentation, and direct division with delayed addition of erythropoietin in serum-free Dulbecco's modified Eagle's medium/nutrient mixture F-12 Ham. These observations are thought to be useful for developing model of definitive erythropoiesis and simple expansion of human erythrocytes.
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Affiliation(s)
- Gen Niimi
- Laboratory of Electron Microscopy, School of Medicine, Fujita Health University, Toyoake, Aichi 470-1192, Japan.
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