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Nonsurgical Correction of Congenital Ear Deformities: The Relationship Between Age of Presentation and Regression. J Craniofac Surg 2022; 33:e822-e828. [PMID: 36102908 DOI: 10.1097/scs.0000000000008758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 04/02/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE After 3 weeks of age, studies show ear molding to be unsuccessful due to increased regression rates. Studies have not differentiated success rates based on regression severity; partial regressions may be deemed successful and satisfactory by parents. We examined successful ear molding at different ages of presentation by measuring regression severity and parental satisfaction. METHODS Patients who presented to [blinded for review] for ear molding from January 2017 to October 2018 were eligible for inclusion. Molds were applied on the initial visit and monitored biweekly. Treatment length was based on age, deformity type, and severity. One month after treatment completion, parents completed a satisfaction survey where they assessed regression on a 3-point severity scale. RESULTS A total of 165 patients were included in this study. Sixty-seven were younger than 3 weeks of age and had an overall correction rate of 95%. The complete correction rate was 80% and only 5% saw complete regression. In the remaining 98, the overall correction rate was 94%, with a 63% complete correction rate. Only 6% saw complete regression. There was no statistical significance in parental satisfaction, perceived improvement, or likelihood to recommend ear molding between age groups. CONCLUSIONS Regression rates are higher in children older than 3 weeks although not statistically significant. Most regressions were partial and ear molding still significantly corrected most deformities. We suggest that ear molding be offered past 3 weeks of age, with maximum age being dependent on deformity type, as it still leads to high parental satisfaction.
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Pepe G, Calafiore M, Velletri MR, Corica D, Valenzise M, Mondello I, Alibrandi A, Wasniewska M, Aversa T. Minipuberty in born small for gestational age infants: A case control prospective pilot study. Endocrine 2022; 76:465-473. [PMID: 35142975 DOI: 10.1007/s12020-022-03003-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/30/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To evaluate minipuberty (MP) in small for gestational age (SGA) infants, both preterm and full-term, during the first year of life. METHODS 33 SGA healthy newborns (group A), 21 of which full-term (subgroup A1) and 12 preterm (A2) were enrolled. Control group (B) consisted of 27 AGA, 17 full-term (subgroup B1) and 10 preterm (B2) infants. Growth parameters, FSH, LH, and Estradiol (E2) or Testosterone (T) serum levels were monitored at 3, 6, and 12 months. RESULTS The gonadotropin surge reached greater increase of LH in males at 3 months and FSH in females at 3, 6 and 12 months (p < 0.001). In male infants: T at 3 months was higher in subgroup A2 vs A1(p = 0.001), and correlated negatively with gestational age (GA, p < 0.005), length and weight at birth (p < 0.05); LH was higher in subgroup B2 vs B1 at 6 months (p = 0.003), and in group A vs B at 12 months (p = 0.03). Females displayed higher E2 at 6 months in B2 vs B1 (p < 0.05), negatively correlated with GA and weight gain (p < 0.05); LH at 6 months was increased in A2 vs A1 (p = 0.03). Overall, preterm males displayed higher T at 3 months (p = 0.001), LH at 3, 6 and 12 months (p < 0.05), and LH/FSH ratio at 6 months (p = 0.001). Preterm females exhibited increased LH/FSH ratio at 3 and 6 months (p < 0.05). CONCLUSIONS Irrespectively of GA, MP occurred with a typical sexual dimorphism and exhibited sex-specific correlations between hormones and perinatal parameters. SGA condition and prematurity seemed to enhance and protract MP over time in both sexes.
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Affiliation(s)
- Giorgia Pepe
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Messina, Italy.
| | - Mariarosa Calafiore
- Neonatology Unit, Bianchi-Melacrinò-Morelli Hospital, Reggio Calabria, Italy
| | - Maria Rosa Velletri
- Neonatology Unit, Bianchi-Melacrinò-Morelli Hospital, Reggio Calabria, Italy
| | - Domenico Corica
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - Mariella Valenzise
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - Isabella Mondello
- Neonatology Unit, Bianchi-Melacrinò-Morelli Hospital, Reggio Calabria, Italy
| | | | - Malgorzata Wasniewska
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - Tommaso Aversa
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
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Shirakawa A, Yasui T, Machida C, Imaizumi J, Yoshida A, Iwasa T, Kaji T. Ultrasonographic assessment of testicular volume in Japanese newborn infants. THE JOURNAL OF MEDICAL INVESTIGATION 2022; 69:256-260. [DOI: 10.2152/jmi.69.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Aya Shirakawa
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Toshiyuki Yasui
- Department of Reproductive and Menopausal Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Chiharu Machida
- School of Health Sciences, Faculty of Medicine, Tokushima University, Tokushima, Japan
| | - Junki Imaizumi
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Atsuko Yoshida
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Takeshi Iwasa
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Takashi Kaji
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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Chin HB, Baird DD, Kaplan SL, Darge K, Adgent MA, Ford EG, Rogan WJ, Stallings VA, Umbach DM. Characterization of ovarian development in girls from birth to 9 months. Paediatr Perinat Epidemiol 2021; 35:75-82. [PMID: 32285479 PMCID: PMC7554126 DOI: 10.1111/ppe.12673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/28/2020] [Accepted: 03/01/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND The minipuberty of infancy is a period of increased reproductive axis activity. Changes in reproductive hormone concentrations and organ size occur during this period, but longitudinal changes have not been well described. OBJECTIVES The objective of this study was to characterize ovarian growth trajectories and ovarian follicle development during the first 9 months of life in a large longitudinal cohort of healthy girls. METHODS Data from the Infant Feeding and Early Development Study, a longitudinal cohort study of oestrogen-responsive outcomes in healthy infants, were used to estimate ovarian growth trajectories and describe the presence of ovarian antral follicles in girls 0-9 months old. Ovarian ultrasound evaluations were performed on the infants within 72 hours of birth (newborn visit) and at 4, 8, 16, 24, and 32 weeks of age. Mixed-effects regression splines were used to characterize changes in ovarian volume during infancy and assess the association between the presence of ovarian follicles at the newborn visit and ovarian growth. RESULTS This analysis included 163 girls with two or more ovarian ultrasounds in the study. Results from the estimated overall ovarian growth trajectory show that ovarian volume increases more than sixfold during the first 16 weeks after birth and then remains relatively stable in the later weeks of infancy. Among girls with observable ovaries at the newborn visit (n = 133), girls with at least one visible ovarian follicle showed more rapid initial ovarian growth compared with girls without visible follicles. CONCLUSIONS Infant ovarian volume increased to a peak at 16 weeks, which was influenced by the number and size of developing follicles. This research contributes to future development of reference ranges for postnatal ovarian growth in healthy, term infants.
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Affiliation(s)
- Helen B Chin
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC
| | - Donna D Baird
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC
| | - Summer L Kaplan
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA;,Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Kassa Darge
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA;,Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Margaret A Adgent
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
| | - Eileen G Ford
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Walter J Rogan
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC
| | - Virginia A Stallings
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA;,Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - David M Umbach
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC
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Cory H, Passarelli S, Szeto J, Tamez M, Mattei J. The Role of Polyphenols in Human Health and Food Systems: A Mini-Review. Front Nutr 2018; 5:87. [PMID: 30298133 PMCID: PMC6160559 DOI: 10.3389/fnut.2018.00087] [Citation(s) in RCA: 631] [Impact Index Per Article: 105.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 08/30/2018] [Indexed: 12/12/2022] Open
Abstract
This narrative mini- review summarizes current knowledge of the role of polyphenols in health outcomes-and non-communicable diseases specifically-and discusses the implications of this evidence for public health, and for future directions for public health practice, policy, and research. The publications cited originate mainly from animal models and feeding experiments, as well as human cohort and case-control studies. Hypothesized protective effects of polyphenols in acute and chronic diseases, including obesity, neurodegenerative diseases, type 2 diabetes, and cardiovascular diseases, are evaluated. Potential harmful effects of some polyphenols are also considered, counterbalanced with the limited evidence of harm in the research literature. Recent international governmental regulations are discussed, as the safety and health claims of only a few specific polyphenolic compounds have been officially sanctioned. The implications of food processing on the bioavailability of polyphenols are also assessed, in addition to the health claims and marketing of polyphenols as a functional food. Finally, this mini-review asserts the need for increased regulation and guidelines for polyphenol consumption and supplementation in order to ensure consumers remain safe and informed about polyphenols.
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Affiliation(s)
- Hannah Cory
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Simone Passarelli
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - John Szeto
- Massachusetts General Hospital, Charlestown, MA, United States
| | - Martha Tamez
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Josiemer Mattei
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
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Adgent MA, Umbach DM, Zemel BS, Kelly A, Schall JI, Ford EG, James K, Darge K, Botelho JC, Vesper HW, Chandler DW, Nakamoto JM, Rogan WJ, Stallings VA. A Longitudinal Study of Estrogen-Responsive Tissues and Hormone Concentrations in Infants Fed Soy Formula. J Clin Endocrinol Metab 2018; 103:1899-1909. [PMID: 29506126 PMCID: PMC6456922 DOI: 10.1210/jc.2017-02249] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 02/26/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE Chemicals with hormonelike activity, such as estrogenic isoflavones, may perturb human development. Infants exclusively fed soy-based formula are highly exposed to isoflavones, but their physiologic responses remain uncharacterized. Estrogen-responsive postnatal development was compared in infants exclusively fed soy formula, cow-milk formula, and breast milk. METHODS We enrolled 410 infants born in Philadelphia-area hospitals between 2010 and 2014; 283 were exclusively fed soy formula (n = 102), cow-milk formula (n = 111), or breast milk (n = 70) throughout the study (birth to 28 or 36 weeks for boys and girls, respectively). We repeatedly measured maturation index (MI) in vaginal and urethral epithelial cells using standard cytological methods, uterine volume and breast-bud diameter using ultrasound, and serum estradiol and follicle-stimulating hormone levels. We estimated MI, organ-growth, and hormone trajectories by diet using mixed-effects regression splines. RESULTS Maternal demographics did not differ between cow-milk-fed and soy-fed infants but did differ between formula-fed and breastfed infants. Vaginal-cell MI trended higher (P = 0.01) and uterine volume decreased more slowly (P = 0.01) in soy-fed girls compared with cow-milk-fed girls; however, their trajectories of breast-bud diameter and hormone concentrations did not differ. We observed no significant differences between boys fed cow-milk vs soy formula; estradiol was not detectable. Breastfed infants differed from soy-formula-fed infants in vaginal-cell MI, uterine volume, and girls' estradiol and boys' breast-bud diameter trajectories. CONCLUSIONS Relative to girls fed cow-milk formula, those fed soy formula demonstrated tissue- and organ-level developmental trajectories consistent with response to exogenous estrogen exposure. Studies are needed to further evaluate the effects of soy on child development.
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Affiliation(s)
- Margaret A Adgent
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
- Correspondence and Reprint Requests: Margaret A. Adgent, PhD, 1313 21st Avenue S, Suite 313, Nashville, Tennessee 37232. E-mail:
| | - David M Umbach
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Babette S Zemel
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Andrea Kelly
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Department of Pediatrics, Division of Endocrinology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Joan I Schall
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Eileen G Ford
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kerry James
- Social & Scientific Systems, Inc., Durham, North Carolina
| | - Kassa Darge
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Julianne C Botelho
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hubert W Vesper
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Jon M Nakamoto
- Quest Diagnostics Nichols Institute, San Juan Capistrano, California
| | - Walter J Rogan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Virginia A Stallings
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Gilsanz V, Wren TAL, Ponrartana S, Mora S, Rosen CJ. Sexual Dimorphism and the Origins of Human Spinal Health. Endocr Rev 2018; 39:221-239. [PMID: 29385433 PMCID: PMC5888211 DOI: 10.1210/er.2017-00147] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 01/24/2018] [Indexed: 12/26/2022]
Abstract
Recent observations indicate that the cross-sectional area (CSA) of vertebral bodies is on average 10% smaller in healthy newborn girls than in newborn boys, a striking difference that increases during infancy and puberty and is greatest by the time of sexual and skeletal maturity. The smaller CSA of female vertebrae is associated with greater spinal flexibility and could represent the human adaptation to fetal load in bipedal posture. Unfortunately, it also imparts a mechanical disadvantage that increases stress within the vertebrae for all physical activities. This review summarizes the potential endocrine, genetic, and environmental determinants of vertebral cross-sectional growth and current knowledge of the association between the small female vertebrae and greater risk for a broad array of spinal conditions across the lifespan.
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Affiliation(s)
- Vicente Gilsanz
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027.,Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027.,Department of Orthopaedic Surgery, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027
| | - Tishya A L Wren
- Department of Orthopaedic Surgery, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027
| | - Skorn Ponrartana
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027
| | - Stefano Mora
- Laboratory of Pediatric Endocrinology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Clifford J Rosen
- Center for Clinical and Translational Research, Maine Medical Center Research Institute, Scarborough, Maine 04074
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Kaplan SL, Edgar JC, Ford EG, Adgent MA, Schall JI, Kelly A, Umbach DM, Rogan WJ, Stallings VA, Darge K. Size of testes, ovaries, uterus and breast buds by ultrasound in healthy full-term neonates ages 0-3 days. Pediatr Radiol 2016; 46:1837-1847. [PMID: 27580909 PMCID: PMC5744487 DOI: 10.1007/s00247-016-3681-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 06/14/2016] [Accepted: 07/26/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Hormonally sensitive organs in the neonate can change size within days of birth as circulating maternal estrogen wanes. Although several reports document the size of these organs through infancy, few focus attention on the near-birth period. Clinical and research evaluation of hormonal and genitourinary disorders would benefit from reference size standards. OBJECTIVE We describe the size of the uterus, ovaries, testes and breast buds in healthy term neonates. MATERIALS AND METHODS As part of the Infant Feeding and Early Development (IFED) study, we sonographically measured the largest diameter of these organs in sagittal, transverse and anterior-posterior planes for 194 female and 204 male newborns up to 3 days old. We calculated mean, median and percentiles for longest axis length and for volume calculated from measured diameters. We evaluated size differences by laterality, gender and race and compared our observations against published values. RESULTS Mean length and mean volume were as follows: uterus, 4.2 cm and 10.0 cm3; ovary, 1.0 cm and 0.2 cm3; testis, 1.1 cm and 0.3 cm3 (0.4 cm3 Lambert volume); female breast bud, 1.2 cm and 0.7 cm3; male breast bud, 1.1 cm and 0.6 cm3. Breast buds were larger in females than males. Laterality differences were typically below the precision of clinical measurement. No significant race differences were detected. CONCLUSION Using data from our large cohort together with published values, we provide guidelines for evaluating the size of reproductive organs within the first 3 days of age. Discrepancies between our results and published values are likely attributable to technique.
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Affiliation(s)
- SL Kaplan
- Department of Radiology, The Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA, 19104, USA.
| | - JC Edgar
- Department of Radiology, The Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA, 19104, USA,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - EG Ford
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - MA Adgent
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Research Triangle Park, NC, USA
| | - JI Schall
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - A Kelly
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Department of Pediatrics, Division of Endocrinology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - DM Umbach
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Research Triangle Park, NC, USA
| | - WJ Rogan
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Research Triangle Park, NC, USA
| | - VA Stallings
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - K Darge
- Department of Radiology, The Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA, 19104, USA,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Hewlett M, Chow E, Aschengrau A, Mahalingaiah S. Prenatal Exposure to Endocrine Disruptors: A Developmental Etiology for Polycystic Ovary Syndrome. Reprod Sci 2016; 24:19-27. [PMID: 27342273 DOI: 10.1177/1933719116654992] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common and complex endocrinopathies among reproductive-age women. Polycystic ovary syndrome is characterized by symptomatology of oligomenorrhea and androgen excess, with or without presence of polycystic ovarian morphology. The etiology of PCOS is multifactorial, including genetic and environmental components. It has been previously established that prenatal androgen exposure results in a PCOS phenotype in experimental animal models and epidemiologic human studies. Investigators hypothesize that prenatal exposure to endocrine-disrupting chemicals (EDCs) may contribute to PCOS development. This review examines the emerging research investigating prenatal exposure to 3 major classes of EDCs-bisphenol A (BPA), phthalates, and androgenic EDCs-and the development of PCOS and/or PCOS-related abnormalities in humans and animal models. Highlights of this review are as follows: (1) In rodent studies, maternal BPA exposure alters postnatal development and sexual maturation;, (2) gestational exposure to dibutyl phthalate and di(2-ethylhexyl)phthalate results in polycystic ovaries and a hormonal profile similar to PCOS; and (3) androgenic EDCs, nicotine and 3,4,4'-trichlorocarbanilide, create a hyperandrogenic fetal environment and may pose a potential concern. In summary, prenatal exposure to EDCs may contribute to the altered fetal programming hypothesis and explain the significant variability in severity and presentation.
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Affiliation(s)
- Meghan Hewlett
- 1 Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA, USA
| | - Erika Chow
- 1 Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA, USA
| | - Ann Aschengrau
- 2 Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Shruthi Mahalingaiah
- 1 Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA, USA.,2 Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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Kuiri-Hänninen T, Sankilampi U, Dunkel L. Activation of the hypothalamic-pituitary-gonadal axis in infancy: minipuberty. Horm Res Paediatr 2015; 82:73-80. [PMID: 25012863 DOI: 10.1159/000362414] [Citation(s) in RCA: 247] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 03/21/2014] [Indexed: 11/19/2022] Open
Abstract
The hypothalamic-pituitary-gonadal (HPG) axis is active in the midgestational foetus but silenced towards term because of the negative feedback effects mediated by the placental hormones. This restraint is removed at birth, leading to reactivation of the axis and an increase in gonadotrophin levels. Gonadotrophin levels are high during the first 3 months of life but decrease towards the age of 6 months except for FSH levels in girls that remain elevated until 3-4 years of age. After this, the HPG axis remains quiescent until puberty. The postnatal gonadotrophin surge results in gonadal activation in both sexes. In boys, testosterone levels rise to a peak at 1-3 months of age and then decline following LH levels. Postnatal HPG axis activation is associated with penile and testicular growth and therefore considered important for the development of male genitalia. In girls, elevated gonadotrophin levels result in the maturation of ovarian follicles and in an increase in oestradiol levels. Biological significance and possible long-term consequences of this minipuberty remain elusive, as do the mechanisms that silence the HPG axis until puberty. However, the first months of life provide a 'window of opportunity' for functional studies of the HPG axis prior to pubertal development.
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Affiliation(s)
- Tanja Kuiri-Hänninen
- Department of Pediatrics, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
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11
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Barrett ES, Sobolewski M. Polycystic ovary syndrome: do endocrine-disrupting chemicals play a role? Semin Reprod Med 2014; 32:166-76. [PMID: 24715511 DOI: 10.1055/s-0034-1371088] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by multiple endocrine disturbances, and its underlying causes, although uncertain, are likely to be both genetic and environmental. Recently, there has been interest in whether endocrine-disrupting chemicals (EDCs) in the environment, particularly Bisphenol A (BPA), may contribute to the disorder. In animal models, exposure to BPA during the perinatal period dramatically disrupts ovarian and reproductive function in females, often at doses similar to typical levels of human exposure. BPA also appears to have obesogenic properties, disrupting normal metabolic activity and making the body prone to overweight. In humans, cross-sectional data suggest that BPA concentrations are higher in women with PCOS than in reproductively healthy women, but the direction of causality has not been established. As this research is in its infancy, additional work is needed to understand the mechanisms by which EDCs may contribute to PCOS as well as the critical periods of exposure, which may even be transgenerational. Future research should also focus on translating the promising work in animal models into longitudinal human studies and determining whether additional EDCs, beyond BPA, may be important to consider.
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Affiliation(s)
- Emily S Barrett
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry
| | - Marissa Sobolewski
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
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Abstract
Soya-based infant formulas (SIF) containing soya flour were introduced almost 100 years ago. Modern soya formulas are used in allergy/intolerance to cows' milk-based formulas (CMF), post-infectious diarrhoea, lactose intolerance and galactosaemia, as a vegan human milk (HM) substitute, etc. The safety of SIF is still debated. In the present study, we reviewed the safety of SIF in relation to anthropometric growth, bone health (bone mineral content), immunity, cognition, and reproductive and endocrine functions. The present review includes cross-sectional, case-control, cohort studies or clinical trials that were carried out in children fed SIF compared with those fed other types of infant formulas and that measured safety. The databases that were searched included PubMed (1909 to July 2013), Embase (1988 to May 2013), LILACS (1990 to May 2011), ARTEMISA (13th edition, December 2012), Cochrane controlled trials register, Bandolier and DARE using the Cochrane methodology. Wherever possible, a meta-analysis was carried out. We found that the anthropometric patterns of children fed SIF were similar to those of children fed CMF or HM. Despite the high levels of phytates and aluminium in SIF, Hb, serum protein, Zn and Ca concentrations and bone mineral content were found to be similar to those of children fed CMF or HM. We also found the levels of genistein and daidzein to be higher in children fed SIF; however, we did not find strong evidence of a negative effect on reproductive and endocrine functions. Immune measurements and neurocognitive parameters were similar in all the feeding groups. In conclusion, modern SIF are evidence-based safety options to feed children requiring them. The patterns of growth, bone health and metabolic, reproductive, endocrine, immune and neurological functions are similar to those observed in children fed CMF or HM.
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Urogenital epithelial cells as simple markers of estrogen response in infants: methods and applications. PLoS One 2013; 8:e77061. [PMID: 24146956 PMCID: PMC3797772 DOI: 10.1371/journal.pone.0077061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 07/19/2013] [Indexed: 12/26/2022] Open
Abstract
Exposure to estrogen-mimicking chemicals during critical periods of development, such as infancy, may have adverse effects. However, these effects can be difficult to characterize in most epidemiologic studies. For example, growth of reproductive organs may be susceptible to estrogenic chemicals, but measuring it requires skilled ultrasound examination; timing of pubertal onset may be altered, but observing it requires long-term follow up. To address the need for a simple marker of response to estrogenic exposures in infants, we propose a novel application of a classic marker of estrogen response in adult women: cytological evaluation of urogenital epithelial cells. In this cross-sectional study of 34 female and 41 male infants, we demonstrate that epithelial cells can be obtained from swabs of the vaginal introitus (females) and urethral meatus (males), as well as from spun urine, and that these cells respond to differential estrogenic conditions, as indicated by the relative abundance of the superficial epithelial cell type. To model varying estrogen exposure, we sampled from infants who were either newborn (highly exposed to maternal estrogens), or 12 weeks old (12W) (negligibly exposed to estrogen). Newborns had a higher percentage of superficial cells (%S), as compared to 12W (mean ± standard error: 8.3 ± 1.8 vs. 0.9 ± 0.2) (p < 0.01), consistent with an estrogen response. This difference in %S from newborn to 12W was observed similarly for swab (-7.6 ± 1.7) and urine (-7.3 ± 2.6) specimens and for males (-9.6 ± 2.9) and females (-5.2 ± 2.1). Examination of urogenital epithelial cells can successfully demonstrate estrogen response in both sexes, using cell specimens collected from either swab or urine sampling. In future studies, this simple, non-invasive method may be applied to assess whether estrogen-mimicking chemicals produce an estrogenic response in infants.
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