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Passaponti S, Ermini L, Acconci G, Severi FM, Romagnoli R, Cutrupi S, Clerico M, Guerrera G, Ietta F. Rank-Rankl-Opg Axis in Multiple Sclerosis: The Contribution of Placenta. Cells 2022; 11:cells11081357. [PMID: 35456036 PMCID: PMC9031903 DOI: 10.3390/cells11081357] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 02/01/2023] Open
Abstract
Women with multiple sclerosis (MS) can safely become pregnant and give birth, with no side effects or impediments. Pregnancy is generally accepted as a period of well-being in which relapses have a softer evolution, particularly in the third trimester. Herein, we hypothesized that the placenta, via its “secretome”, could contribute to the recognized beneficial effects of pregnancy on MS activity. We focused on a well-known receptor/ligand/decoy receptor system, such as the one composed by the receptor activator of nuclear factor-kB (RANK), its ligand (RANKL), and the decoy receptor osteoprotegerin (OPG), which have never been investigated in an integrated way in MS, pregnancy, and placenta. We reported that pregnancy at the term of gestation influences the balance between circulating RANKL and its endogenous inhibitor OPG in MS women. We demonstrated that the placenta at term is an invaluable source of homodimeric OPG. By functional studies on astrocytes, we showed that placental OPG suppresses the mRNA expression of the CCL20, a chemokine responsible for Th17 cell recruitment. We propose placental OPG as a crucial molecule for the recognized beneficial effect of late pregnancy on MS and its potential utility for the development of new and more effective therapeutic approaches.
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Affiliation(s)
- Sofia Passaponti
- Department of Life Sciences, University of Siena, 53100 Siena, Italy; (S.P.); (L.E.); (R.R.)
| | - Leonardo Ermini
- Department of Life Sciences, University of Siena, 53100 Siena, Italy; (S.P.); (L.E.); (R.R.)
| | - Giulia Acconci
- Department of Molecular and Developmental Medicine, Division of Prenatal Diagnosis and Obstetrics, University of Siena, 53100 Siena, Italy; (G.A.); (F.M.S.)
| | - Filiberto Maria Severi
- Department of Molecular and Developmental Medicine, Division of Prenatal Diagnosis and Obstetrics, University of Siena, 53100 Siena, Italy; (G.A.); (F.M.S.)
| | - Roberta Romagnoli
- Department of Life Sciences, University of Siena, 53100 Siena, Italy; (S.P.); (L.E.); (R.R.)
| | - Santina Cutrupi
- Department of Clinical and Biological Sciences, University of Turin, 10124 Turin, Italy; (S.C.); (M.C.)
| | - Marinella Clerico
- Department of Clinical and Biological Sciences, University of Turin, 10124 Turin, Italy; (S.C.); (M.C.)
| | - Gisella Guerrera
- Neuroimmunology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy;
| | - Francesca Ietta
- Department of Life Sciences, University of Siena, 53100 Siena, Italy; (S.P.); (L.E.); (R.R.)
- Correspondence: ; Tel.: +39-05-7723-2370
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Jiang Y, Li J, Li G, Liu S, Lin X, He Y, Lu J, Zhang Y, Wu J, Yang Z, Jiang Y, Wang H, Kong S, Shi G. Osteoprotegerin interacts with syndecan-1 to promote human endometrial stromal decidualization by decreasing Akt phosphorylation. Hum Reprod 2021; 35:2439-2453. [PMID: 33047116 DOI: 10.1093/humrep/deaa233] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/25/2020] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Does osteoprotegerin (OPG) promote human endometrial stromal decidualization? SUMMARY ANSWER OPG is essential for human endometrial stromal decidualization through its interaction with syndecan-1 to decrease Akt phosphorylation. WHAT IS KNOWN ALREADY OPG (a cytokine receptor) levels are significantly increased in the circulation of pregnant women. However, the role and mechanism of OPG in human endometrial stromal cell (ESC) decidualization remain elusive. STUDY DESIGN, SIZE, DURATION We analyzed the endometrial expression of OPG in endometrial tissue samples collected from women with regular menstrual cycles (ranging from 25 to 35 days), and decidual tissue samples collected from woman with normal early pregnancy or recurrent pregnancy loss (RPL) who visited the Department of Gynecology and Obstetrics at a tertiary care center from January to October 2018. None of the subjects had hormonal treatment for at least 3 months prior to the procedure. In total, 16 women with normal early pregnancy and 15 with RPL were selected as subjects for this study. The function of OPG in decidualization was explored in a human endometrial stromal cell (HESC) line and primary cultures of HESCs. PARTICIPANTS/MATERIALS, SETTING, METHODS We collected endometrial tissues (by biopsy) from the subjects during their menstrual cycle and decidual tissues from subjects with a normal early pregnancy and those with RPL at the time of dilation and curettage. The control group comprised randomly selected women who underwent termination of an apparently normal early pregnancy. The endometrial OPG expression was analyzed using immunohistochemical staining and quantitative RT-PCR (qRT-PCR). Immunofluorescence staining and western blot, and qRT-PCR were used to explore the mRNA and protein expression, respectively, of OPG in an immortalized HESC line and in primary cultures of HESC during proliferation and decidualization. siRNA-mediated knockdown experiments were performed to examine the function of OPG in HESC proliferation and decidualization. Flow cytometry and the cell proliferation MTS assay were performed to further examine the role of OPG in HESC proliferation. We also analyzed decidual marker gene expression by qRT-PCR to assess the consequences of OPG loss for HESC decidualization. A co-immunoprecipitation (IP) assay was used to determine the potential interaction between the OPG and Syndecan-1. Western blot analysis of the rescue experiments performed using the phosphatidylinositol 3-kinase (PI3K) signaling-specific inhibitor LY294002 was used to investigate the downstream signaling pathways through which OPG could mediate HESC decidualization. MAIN RESULTS AND THE ROLE OF CHANCE OPG was expressed in both the human endometrium and in vitro decidualized ESCs. Knockdown experiments revealed that OPG loss impaired the expression of IGF-binding protein-1 (IGFBP-1) (P < 0.05) and prolactin (PRL) (P < 0.05), two specific markers of decidualization, in HESC undergoing decidualization. We also uncovered that OPG knockdown induced the aberrant activation of Akt (protein kinase B) during HESC decidualization (P < 0.05). The inhibition of Akt activation could rescue the impaired expression of the decidual markers PRL (P < 0.05) and IGFBP-1 (P < 0.05) in response to OPG knockdown. Syndecan-1 was considered a potential receptor candidate, as it was expressed in both the endometrium and in vitro cultured stromal cells. Subsequent co-IP experiments demonstrated the interaction between OPG and Syndecan-1 during decidualization. In addition, Syndecan-1 knockdown not only clearly attenuated the decidualization markers PRL (P < 0.05) and IGFBP-1 (P < 0.05) but also induced the aberrant enhancement of Akt phosphorylation in decidualized cells, consistent with the phenotype of OPG knockdown cells. Finally, we revealed that the transcript and protein expression of both OPG and Syndecan-1 was significantly lower in the decidual samples of women with RPL than in those of women with normal pregnancy (P < 0.05). LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION In this study, based on a number of approaches, it was demonstrated that OPG mediated the repression of Akt that occurs during human stromal cell decidualization, however, the molecular link between OPG and Akt signaling was not determined, and still requires further exploration. WIDER IMPLICATIONS OF THE FINDINGS OPG is required for decidualization, and a decrease in OPG levels is associated with RPL. These findings provide a new candidate molecule for the diagnosis and potential treatment of RPL. STUDY FUNDING/COMPETING INTEREST(S) This work was supported in part by the National Natural Science Foundation of China U1605223 (to G.S.), 81701457 (to Y.J.) and 81601349 (to Y.J.). The authors have no conflicts of interest to disclose.
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Affiliation(s)
- Yufei Jiang
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China.,Fujian Provincial Key Laboratory of Reproductive Health Research, School of Medicine, Xiamen University, Xiamen, Fujian, China.,Xiamen Key Laboratory of Reproduction and Genetics, Reproductive Medical Center, Maternal and Child Health Hospital of Xiamen, Xiamen, Fujian, China
| | - Jianing Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
| | - Gaizhen Li
- Fujian Provincial Key Laboratory of Reproductive Health Research, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Songting Liu
- Fujian Provincial Key Laboratory of Reproductive Health Research, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Xinjie Lin
- Fujian Provincial Key Laboratory of Reproductive Health Research, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yan He
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
| | - Jinhua Lu
- Fujian Provincial Key Laboratory of Reproductive Health Research, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Ying Zhang
- Fujian Provincial Key Laboratory of Reproductive Health Research, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jinxiang Wu
- Fujian Provincial Key Laboratory of Reproductive Health Research, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Zhiping Yang
- Fujian Provincial Key Laboratory of Reproductive Health Research, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yaling Jiang
- Department of Obstetrics and Gynecology, Reproductive Medical Center, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Haibin Wang
- Fujian Provincial Key Laboratory of Reproductive Health Research, School of Medicine, Xiamen University, Xiamen, Fujian, China.,Department of Obstetrics and Gynecology, Reproductive Medical Center, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
| | - Shuangbo Kong
- Fujian Provincial Key Laboratory of Reproductive Health Research, School of Medicine, Xiamen University, Xiamen, Fujian, China.,Department of Obstetrics and Gynecology, Reproductive Medical Center, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
| | - Guixiu Shi
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
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Huang B, Zhu W, Zhao H, Zeng F, Wang E, Wang H, Chen J, Li M, Huang C, Ren L, Niu J, Zhang JV. Placenta-Derived Osteoprotegerin Is Required for Glucose Homeostasis in Gestational Diabetes Mellitus. Front Cell Dev Biol 2020; 8:563509. [PMID: 32984349 PMCID: PMC7493629 DOI: 10.3389/fcell.2020.563509] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/13/2020] [Indexed: 12/15/2022] Open
Abstract
Osteoprotegerin (OPG) is involved in various biological processes, including bone remodeling, vascular calcification and pancreatic β-cell function. Although some clinical studies have shown an increase in serum OPG level during pregnancy, the role of OPG in gestational diabetes mellitus (GDM) is largely unknown. Therefore, we explored the effect of OPG in metabolic homeostasis during pregnancy. We initially evaluated serum OPG levels using ELISA and western blotting techniques on samples from GDM patients. We also assessed OPG expression levels in maternal mice. We then used blastocysts transduced with lentiviruses capable of trophoblast-specific transgene expression to establish placenta-specific OPG knockdown or overexpression mouse models for functional and mechanistic investigation after embryo transplantation. We found that OPG expression was positively associated with GDM in clinical samples, and OPG levels were significantly increased in GDM patient sera and term placenta. Serum OPG was significantly increased in maternal compared to non-pregnant mice, and expression levels of OPG were the highest in placenta compared with other organs, including bone, liver and pancreas. OPG was also significantly increased in pregnant mice fed a high-fat diet (HFD). Placenta-specific OPG knockdown induced glucose intolerance, decreased β-cell proliferation and decreased serum insulin levels, whereas placenta-specific OPG overexpression promoted glucose tolerance and enhanced β-cell proliferation, which increased serum insulin production and decreased fetal weight in HFD-feeding pregnant mice. Placenta-derived OPG (pl-OPG) regulated glucose homeostasis during pregnancy via enhancement of β-cell proliferation, which suggests a potential therapeutic application of OPG for GDM.
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Affiliation(s)
- Binbin Huang
- Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
| | - Wen Zhu
- Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
| | - Huashan Zhao
- Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Department of Clinical Pharmacy and Translational Medicine, School of Pharmacy and Biomedicine, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Fa Zeng
- Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Esther Wang
- Biological Sciences Collegiate Division, The University of Chicago, Chicago, IL, United States
| | - Hefei Wang
- Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Department of Clinical Pharmacy and Translational Medicine, School of Pharmacy and Biomedicine, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Jie Chen
- Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Department of Clinical Pharmacy and Translational Medicine, School of Pharmacy and Biomedicine, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Mengxia Li
- Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Department of Clinical Pharmacy and Translational Medicine, School of Pharmacy and Biomedicine, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Chen Huang
- Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Department of Clinical Pharmacy and Translational Medicine, School of Pharmacy and Biomedicine, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Lirong Ren
- Shenzhen Bao'an Traditional Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Jianmin Niu
- Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Jian V Zhang
- Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Department of Clinical Pharmacy and Translational Medicine, School of Pharmacy and Biomedicine, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Guangdong Key Laboratory of Nanomedicine, Shenzhen, China
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4
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Henriksson HE, White RA, Iliadis SI, Fransson E, Papadopoulos FC, Sundström-Poromaa I, Skalkidou A. Spring peaks and autumn troughs identified in peripheral inflammatory markers during the peripartum period. Sci Rep 2019; 9:15328. [PMID: 31653981 PMCID: PMC6814733 DOI: 10.1038/s41598-019-51527-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 10/01/2019] [Indexed: 11/08/2022] Open
Abstract
Seasonal variations have recently been described in biomarkers, cell types, and gene expression associated with the immune system, but so far no studies have been conducted among women in the peripartum period. It is of note that pregnancy complications and outcomes, as well as autoimmune diseases, have also been reported to exhibit seasonal fluctuations. We report here a clear-cut seasonal pattern of 23 inflammatory markers, analysed using proximity-extension assay technology, in pregnant women. The inflammatory markers generally peaked in the spring and had a trough in the autumn. During the postpartum period we found seasonality in one inflammatory marker, namely monocyte chemotactic protein 4 (MCP-4). Our findings suggest that seasonal variations in peripheral inflammatory markers are only observed during pregnancy. The results of this study could be valuable to professionals working within the field of immunology-related areas, and provide insight for the understanding of obstetric complications.
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Affiliation(s)
- Hanna E Henriksson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | | | - Stavros I Iliadis
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Emma Fransson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Martín-Del-Campo M, Sampedro JG, Flores-Cedillo ML, Rosales-Ibañez R, Rojo L. Bone Regeneration Induced by Strontium Folate Loaded Biohybrid Scaffolds. Molecules 2019; 24:E1660. [PMID: 31035627 PMCID: PMC6539601 DOI: 10.3390/molecules24091660] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 01/01/2023] Open
Abstract
Nowadays, regenerative medicine has paid special attention to research (in vitro and in vivo) related to bone regeneration, specifically in the treatment of bone fractures or skeletal defects, which is rising worldwide and is continually demanding new developments in the use of stem cells, growth factors, membranes and scaffolds based on novel nanomaterials, and their applications in patients by using advanced tools from molecular biology and tissue engineering. Strontium (Sr) is an element that has been investigated in recent years for its participation in the process of remodeling and bone formation. Based on these antecedents, this is a review about the Strontium Folate (SrFO), a recently developed non-protein based bone-promoting agent with interest in medical and pharmaceutical fields due to its improved features in comparison to current therapies for bone diseases.
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Affiliation(s)
- Marcela Martín-Del-Campo
- Departamento de Biomateriales, Instituto de Ciencia y Tecnología de Polímeros, CSIC, 28006 Madrid, Spain.
| | - José G Sampedro
- Instituto de Física, Universidad Autónoma de San Luis Potosí, Manuel Nava 6, Zona Universitaria, San Luis Potosí C.P. 78290, S.L.P., Mexico.
| | - María Lisseth Flores-Cedillo
- División de Ingeniería Industrial, Instituto Tecnológico Superior de San Luis Potosí, Capital, Carretera 57 Tramo Qro-SLP Km 189+100 No. 6501, Deleg, Villa de Pozos, San Luis Potosí C.P. 78421, S.L.P., Mexico.
| | - Raul Rosales-Ibañez
- Escuela de Etudios Superiores, Iztacala, Universidad Nacional Autónoma de Mexico, UNAM, Tlalnepantla 54090, Mexico.
| | - Luis Rojo
- Departamento de Biomateriales, Instituto de Ciencia y Tecnología de Polímeros, CSIC, 28006 Madrid, Spain.
- Consorcio Centro de Investigación Biomedica en red, CIBER-BBN, 28029 Madrid, Spain.
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FATHI MAROUFI N, GHORBANIHAGHJO A, SAYYAH MELLI M, VAEZI M, HEKMATI AZAR MEHRABANI Z, BANNAZADEH AMIRKHIZ M, RASHTCHIZADEH N. Effects of High and Low Doses of Folic Acid on the Soluble Receptor Activator of Nuclear Factor-kappa B Ligand/Osteoprotegerin Ratio during Pregnancy. IRANIAN JOURNAL OF PUBLIC HEALTH 2017; 46:517-524. [PMID: 28540268 PMCID: PMC5439041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pregnancy Associated Osteoporosis (PAO) can lead to serious difficulties such as fragility fractures, elongated back pain and height loss in affected women. Soluble Receptor Activator of Nuclear Factor-Kappa B ligand (sRANKL) to Osteoprotegerin (OPG) ratio is chosen as a bone metabolism equation in many bone diseases characterized by bone resorption, such as post-menopausal osteoporosis and would be modified with folic acid supplementation. This study was done to compare the effects of high dose (5mg/day) and low dose (0.5 mg/day) folic acid in the RANKL/OPG ratio and Tumor Necrosis Factorα (TNFα) concentration during pregnancy. METHODS Forty-five pregnant women who visited the AL-Zahra Hospital, Tabriz Iran, from September 2013 to November 2014 were assigned into two groups in this randomized, double-blind, clinical trial, included women who took 5 mg/day (group1) and who took 0.5 mg/day (Group 2) folic acid supplementation before pregnancy until 36th pregnancy. The biochemical variables in serum of pregnant women were measured before and at the end of the study. The study was registered in the Iranian Registry of Clinical Trials (IRCT) as ID, IRCT2013122315903N1. RESULTS OPG levels were significantly higher compared with the baseline value (P=0.008), although sRANKL (P<0.001), TNFα (P=0.005) and sRANKL/OPG ratio (P<0.001) reduced significantly with high dose of folic acid supplementation. A significant positive correlation was observed between the decreased RANKL and TNFα levels (r=0.451, P=0.031) at the end of study in high dose group. CONCLUSION High dose of folic acid supplementation could decrease bone resorptive biomarkers and may prevent PAO in pregnant women by increasing OPG and decreasing sRANKL and TNFα.
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Affiliation(s)
- Nazila FATHI MAROUFI
- Dept. of Clinical Biochemistry and Laboratory Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir GHORBANIHAGHJO
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Manizheh SAYYAH MELLI
- Dept. of Obstetrics and Gynecology, Alzahra Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam VAEZI
- Dept. of Obstetrics and Gynecology, Alzahra Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Nadereh RASHTCHIZADEH
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding Author:
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Gulson B, Taylor A, Eisman J. Bone remodeling during pregnancy and post-partum assessed by metal lead levels and isotopic concentrations. Bone 2016; 89:40-51. [PMID: 27233973 DOI: 10.1016/j.bone.2016.05.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 05/21/2016] [Accepted: 05/23/2016] [Indexed: 11/16/2022]
Abstract
Bone remodeling is normally evaluated using bone turnover markers/indices as indicators of bone resorption and formation. However, during pregnancy and post-partum, there have been inconsistent results between and within biomarkers for bone formation and resorption. These differences may relate to pregnancy-related changes in metabolism and/or hemodilution altering measured marker levels. An alternative approach to evaluating bone remodeling is to use the metal lead (Pb) concentrations and Pb isotopic compositions in blood. These measurements can also provide information on the amount of Pb that is mobilized from the maternal skeleton. Despite some similarities with accepted bone turnover markers, the Pb data demonstrate increased bone resorption throughout pregnancy that further continues post-partum independent of length of breast-feeding, dietary intake and resumption of menses. Furthermore the isotopic measurements are not affected by hemodilution. These data confirm calcium balance studies that indicate increased bone resorption throughout pregnancy and lactation. They also indicate potentially major public health implications of the transfer of maternal Pb burden to the fetus and new born.
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Affiliation(s)
- Brian Gulson
- Department of Environmental Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, NSW, Australia; Commonwealth Scientific and Industrial Research Organisation (CSIRO), Energy Flagship, Sydney, Australia.
| | - Alan Taylor
- Department of Psychology, Macquarie University, Australia.
| | - John Eisman
- Garvan Institute of Medical Research, St Vincent's Hospital, School of Medicine Sydney, University of Notre Dame Australia, Sydney, NSW, Australia; University of New South Wales, Garvan Institute of Medical Research, St Vincent's Hospital, School of Medicine Sydney, Sydney, NSW, Australia.
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8
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Schock H, Zeleniuch-Jacquotte A, Lundin E, Grankvist K, Lakso HÅ, Idahl A, Lehtinen M, Surcel HM, Fortner RT. Hormone concentrations throughout uncomplicated pregnancies: a longitudinal study. BMC Pregnancy Childbirth 2016; 16:146. [PMID: 27377060 PMCID: PMC4932669 DOI: 10.1186/s12884-016-0937-5] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 06/24/2016] [Indexed: 12/03/2022] Open
Abstract
Background Evidence suggests that the hormonal milieu of pregnancy is an important determinant of subsequent cancer and other chronic diseases in both the mother and the offspring. Many of the existing maternity and birth cohorts include specimens drawn only once during pregnancy. How well a single blood specimen collected during a pregnancy characterizes exposure to these hormones throughout gestation, and also in subsequent pregnancies, is not well understood. Methods We used serial serum samples from 71 pregnant women (25 primiparous, 25 multiparous, and 21 with two consecutive pregnancies) with natural, complication-free pregnancies and a healthy offspring at term who participated in a population-based screening trial for congenital infections in Finland between January 1st, 1988 and June 30, 1989 and provided a blood sample in each trimester. Results Hormone levels were more strongly correlated between consecutive trimesters of a pregnancy than between the 1st and 3rd trimester (e.g., estradiol, rT1 vs. T2 = 0.51 and rT2 vs. T3 = 0.60, p < 0.01; rT1 vs. T3 = 0.32, p < 0.05). Concentrations of sRANKL remained stable throughout gestation, whereas estradiol, estrone, progesterone, testosterone, prolactin, and osteoprotegerin increased throughout pregnancy. First trimester hormone concentrations explained less of the variation in the third trimester on their own than second trimester hormone levels (e.g. estradiol R2T1
= 16 % and R2T2 = 42 %). Addition of maternal (e.g., smoking) and/or child characteristics (e.g., sex) improved the accuracy of the 3rd trimester estimates for some of the hormones. Conclusions One hormone measurement in early pregnancy, in conjunction with maternal and fetal characteristics, permits estimation of 3rd trimester hormone concentrations. Therefore, single hormone measurements available from maternity cohorts are suitable to quantify hormone exposure during pregnancy. To our knowledge, we provide the first data on correlations between hormone concentrations both across trimesters of a single pregnancy, as well as between two subsequent pregnancies. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-0937-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Helena Schock
- Division of Cancer Epidemiology, German Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg, 69120, Germany. .,Department of Medical Biosciences, Umeå University, Umeå, Sweden.
| | - Anne Zeleniuch-Jacquotte
- Department of Population Health, New York University School of Medicine, New York, USA.,New York University Cancer Institute, New York University School of Medicine, New York, USA
| | - Eva Lundin
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Kjell Grankvist
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Hans-Åke Lakso
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Annika Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Matti Lehtinen
- School of Public Health, University of Tampere, Tampere, Finland
| | - Heljä-Marja Surcel
- Unit of Sexual and Reproductive Health, National Institute for Health and Welfare, Oulu, Finland
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg, 69120, Germany
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Kondegowda NG, Fenutria R, Pollack IR, Orthofer M, Garcia-Ocaña A, Penninger JM, Vasavada RC. Osteoprotegerin and Denosumab Stimulate Human Beta Cell Proliferation through Inhibition of the Receptor Activator of NF-κB Ligand Pathway. Cell Metab 2015; 22:77-85. [PMID: 26094891 PMCID: PMC4597781 DOI: 10.1016/j.cmet.2015.05.021] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 03/18/2015] [Accepted: 05/22/2015] [Indexed: 01/06/2023]
Abstract
Diabetes results from a reduction of pancreatic β-cells. Stimulating replication could normalize β-cell mass. However, adult human β-cells are recalcitrant to proliferation. We identified osteoprotegerin, a bone-related decoy receptor, as a β-cell mitogen. Osteoprotegerin was induced by and required for lactogen-mediated rodent β-cell replication. Osteoprotegerin enhanced β-cell proliferation in young, aged, and diabetic mice. This resulted in increased β-cell mass in young mice and significantly delayed hyperglycemia in diabetic mice. Osteoprotegerin stimulated replication of adult human β-cells, without causing dedifferentiation. Mechanistically, osteoprotegerin induced human and rodent β-cell replication by modulating CREB and GSK3 pathways, through binding Receptor Activator of NF-κB (RANK) Ligand (RANKL), a brake in β-cell proliferation. Denosumab, an FDA-approved osteoporosis drug, and RANKL-specific antibody induced human β-cell proliferation in vitro, and in vivo, in humanized mice. Thus, osteoprotegerin and Denosumab prevent RANKL/RANK interaction to stimulate β-cell replication, highlighting the potential for repurposing an osteoporosis drug to treat diabetes.
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Affiliation(s)
- Nagesha Guthalu Kondegowda
- Diabetes, Obesity and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Division of Endocrinology and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Rafael Fenutria
- Diabetes, Obesity and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Division of Endocrinology and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ilana R Pollack
- Diabetes, Obesity and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Division of Endocrinology and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Michael Orthofer
- IMBA, Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Dr. Bohrgasse 3,1030 Vienna, Austria
| | - Adolfo Garcia-Ocaña
- Diabetes, Obesity and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Division of Endocrinology and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Josef M Penninger
- IMBA, Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Dr. Bohrgasse 3,1030 Vienna, Austria
| | - Rupangi C Vasavada
- Diabetes, Obesity and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Division of Endocrinology and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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Sanz-Salvador L, García-Pérez MÁ, Tarín JJ, Cano A. Bone metabolic changes during pregnancy: a period of vulnerability to osteoporosis and fracture. Eur J Endocrinol 2015; 172:R53-65. [PMID: 25209679 DOI: 10.1530/eje-14-0424] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Changes in bone density and bone markers suggest that pregnancy is associated with deterioration of bone mass in the mother. The metabolism of calcium resets to allow for the needs imposed by the building of the fetal skeleton. The fetus contributes to the process through the output of regulators from the placenta. Understanding of the whole process is limited, but some changes are unambiguous. There is an increase in the circulating levels of vitamin D, but its functional impact is unclear. Fetal parathyroid hormone (PTH) and PTH-related peptide (PTHrp) play an indirect role through support of a calcium gradient that creates hypercalcemia in the fetus. Placental GH, which increases up to the end of pregnancy, may exert some anabolic effects, either directly or through the regulation of the IGF1 production. Other key regulators of bone metabolism, such as estrogens or prolactin, are elevated during pregnancy, but their role is uncertain. An increase in the ratio of receptor activator of nuclear factor kappa B ligand (RANKL) to osteoprotegerin (OPG) acts as an additional pro-resorbing factor in bone. The increase in bone resorption may lead to osteoporosis and fragility fracture, which have been diagnosed, although rarely. However, the condition is transitory as long-term studies do not link the number of pregnancies with osteoporosis. Prevention is limited by the lack of identifiable risk factors. When fractures are diagnosed, rest, analgesics, or, when indicated, orthopedic intervention have demonstrated efficacy. Systemic treatment with anti-osteoporotic drugs is effective, but the potential harm to the fetus imposes caution in their use.
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Affiliation(s)
- Lucía Sanz-Salvador
- Fundación para la Investigación Sanitaria y Biomédica (FISABIO)Juan de Garay 21, 46017 Valencia, SpainDepartment of GeneticsUniversity of Valencia and Research Foundation, INCLIVA, Avenida Blasco Ibáñez 15, 46010 Valencia, SpainDepartment of Functional Biology and Physical AnthropologySchool of Biological Sciences, University of Valencia, Burjasot Campus, Valencia, SpainDepartment of PediatricsObstetrics and Gynecology, Facultad de Medicina, University Hospital Dr Peset, University of Valencia, Avenida Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Miguel Ángel García-Pérez
- Fundación para la Investigación Sanitaria y Biomédica (FISABIO)Juan de Garay 21, 46017 Valencia, SpainDepartment of GeneticsUniversity of Valencia and Research Foundation, INCLIVA, Avenida Blasco Ibáñez 15, 46010 Valencia, SpainDepartment of Functional Biology and Physical AnthropologySchool of Biological Sciences, University of Valencia, Burjasot Campus, Valencia, SpainDepartment of PediatricsObstetrics and Gynecology, Facultad de Medicina, University Hospital Dr Peset, University of Valencia, Avenida Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Juan J Tarín
- Fundación para la Investigación Sanitaria y Biomédica (FISABIO)Juan de Garay 21, 46017 Valencia, SpainDepartment of GeneticsUniversity of Valencia and Research Foundation, INCLIVA, Avenida Blasco Ibáñez 15, 46010 Valencia, SpainDepartment of Functional Biology and Physical AnthropologySchool of Biological Sciences, University of Valencia, Burjasot Campus, Valencia, SpainDepartment of PediatricsObstetrics and Gynecology, Facultad de Medicina, University Hospital Dr Peset, University of Valencia, Avenida Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Antonio Cano
- Fundación para la Investigación Sanitaria y Biomédica (FISABIO)Juan de Garay 21, 46017 Valencia, SpainDepartment of GeneticsUniversity of Valencia and Research Foundation, INCLIVA, Avenida Blasco Ibáñez 15, 46010 Valencia, SpainDepartment of Functional Biology and Physical AnthropologySchool of Biological Sciences, University of Valencia, Burjasot Campus, Valencia, SpainDepartment of PediatricsObstetrics and Gynecology, Facultad de Medicina, University Hospital Dr Peset, University of Valencia, Avenida Blasco Ibáñez 15, 46010 Valencia, Spain
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11
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Osteoprotegerin in pregnant adolescents differs by race and is related to infant birth weight z-score. J Dev Orig Health Dis 2014; 2:272-9. [PMID: 25141264 DOI: 10.1017/s2040174411000511] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Osteoprotegerin (OPG) is involved in the regulation of bone turnover, but little is known about this protein during pregnancy or among neonates. We undertook a prospective longitudinal study to identify relationships between OPG, markers of bone turnover and birth outcomes in 155 pregnant adolescents (13-18 years) and their newborns. Maternal blood samples were collected at mid-gestation and at delivery. Cord blood was obtained at delivery. Serum OPG, estradiol and markers of bone formation (osteocalcin) and resorption (N-telopeptide) were assessed in all samples. Placental OPG expression was assessed in placental tissue obtained at delivery. Bone markers and OPG increased significantly from mid-gestation (26.0 ± 3.4 weeks) to delivery (39.3 ± 2.6 weeks). Neonatal OPG was significantly lower, but bone turnover markers were significantly higher than maternal values at mid-gestation and at parturition (P < 0.001). African-American adolescents had higher concentrations of OPG than Caucasian adolescents at mid-gestation (P = 0.01) and delivery (P = 0.04). Gestational age and estradiol were also predictors of maternal OPG at mid-gestation and delivery. OPG concentrations in cord blood were correlated with maternal OPG concentrations and were negatively associated with infant birth weight z-score (P = 0.02) and ponderal index (P = 0.02). In conclusion, maternal OPG concentrations increased across gestation and were significantly higher than neonatal OPG concentrations. Maternal and neonatal OPG concentrations were not associated with markers of bone turnover or placental OPG expression, but neonatal OPG was inversely associated with neonatal anthropometric measures. Additional research is needed to identify roles of OPG during pregnancy.
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12
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Association of parity with osteoprotegerin levels and atherosclerosis. Arch Gynecol Obstet 2013; 287:1081-6. [DOI: 10.1007/s00404-012-2703-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 12/21/2012] [Indexed: 11/28/2022]
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Shen P, Gong Y, Wang T, Chen Y, Jia J, Ni S, Zhou B, Song Y, Zhang L, Zhou R. Expression of osteoprotegerin in placenta and its association with preeclampsia. PLoS One 2012; 7:e44340. [PMID: 22952959 PMCID: PMC3431377 DOI: 10.1371/journal.pone.0044340] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Accepted: 08/02/2012] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Osteoprotegerin (OPG), a key regulatory factor in bone metabolism, was documented also a potential pro-angiogenic factor, which acts an important role in protecting vascular endothelial cells. Since preeclampsia has gradually been employed to be vascular diseases, we speculated that OPG might be associated with preeclampsia. The study was to evaluate the level of OPG protein and mRNA in placenta, and investigate the relationship between OPG and the pathogenesis of preeclampsia. METHODOLOGY/PRINCIPAL FINDINGS Placental specimens from 30 term normal pregnancy, 30 severe preeclampsia and 30 mild cases were studied. The expression and levels of OPGs' protein and mRNA were detected by immunohistochemistry, western blot analysis and real-time quantitative PCR analysis respectively. The expression of OPG protein was found in cytoplasm of placenta cytotrophoblasts and syncytiotrophoblasts in three groups. There were no significant differences of OPG protein between the maternal and fetal side in each group. The OPG protein and mRNA levels in severe preeclampsia were significantly higher than those in mild cases and normal pregnancy. However, there were no markedly differences of the OPG protein and mRNA levels between term delivery and preterm delivery in severe cases. In preeclampsia, the OPG protein and mRNA level was positively correlated with systolic blood pressure and 24 h urinary protein respectively. CONCLUSIONS/SIGNIFICANCE OPG protein and mRNA level in placentas of preeclampsia were found abnormal compared with normal pregnancy. In preeclampsia, the OPG protein and mRNA levels were closely related with its important clinical parameters. Taken together, OPG might be closely correlated with the pathogenesis of preeclampsia.
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Affiliation(s)
- Pei Shen
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yunhui Gong
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Tao Wang
- Laboratory of Molecular and Translational Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yueyue Chen
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Jin Jia
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Shanshan Ni
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Bin Zhou
- Laboratory of Molecular and Translational Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yapin Song
- Laboratory of Molecular and Translational Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Lin Zhang
- Laboratory of Molecular and Translational Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Rong Zhou
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
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Hossein-nezhad A, Mirzaei K, Maghbooli Z, Najmafshar A, Larijani B. The influence of folic acid supplementation on maternal and fetal bone turnover. J Bone Miner Metab 2011; 29:186-92. [PMID: 20602129 DOI: 10.1007/s00774-010-0205-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Accepted: 06/07/2010] [Indexed: 10/19/2022]
Abstract
The aim of our study was to investigate the relationship between maternal and fetal bone turnover markers and folic acid supplementation during pregnancy. In an observational study performed in Tehran University of Medical Sciences related hospitals, 113 healthy pregnant women with gestational age between 8 and 12 weeks and aged between 15 and 42 years were recruited and followed until delivery time. The participants were divided into two groups; women who took 1 mg of folic acid daily supplement from the beginning of the pregnancy until the end of the second trimester entered into group I and women who choose to continue their daily intake of folic acid until the delivery time entered into group II. The two groups were matched based on the maternal anthropometric data, energy, calcium and vitamin D intake. Following the delivery, venous blood samples were collected from mothers and umbilical cords of the neonates. Maternal and fetal serum concentrations of 25-hydroxy vitamin D3, PTH, osteocalcin (OC), crosslaps and maternal serum level of homocysteine, folate, soluble receptor activator of NF-kappaB ligand (sRANKL), osteoprotegerin (OPG), calcium, and phosphate were measured. Measured birth outcome parameters included weight, length, head circumference, appearance, and respiration. With regard to maternal assessment, the serum levels of OC and OPG and folate were significantly higher in group II compared to group I, while the serum levels of RANKL and homocysteine were significantly higher in group I. We did not find significant differences in serum levels of 25-OH vitamin D, PTH, crosslaps, calcium, or phosphate between the two groups. The neonates from mothers recruited in group II had higher (but not significantly) serum level of OC. We observed that the neonates born from mothers in group II had overall better birth outcome parameters and apgar scores compare to the neonates born from mothers in group I. Our results show that daily supplementation of folic acid during pregnancy could have a positive impact on the bone turnover markers in mothers and their newborns. This may suggest that both pregnant mothers and their fetuses could benefit from positive effects of folic acid taken during the whole period of pregnancy.
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Affiliation(s)
- Arash Hossein-nezhad
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, 5th Floor, Shariati Hospital, North Kargar Ave., 14114, Tehran, Iran.
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Vitoratos N, Lambrinoudaki I, Rizos D, Armeni E, Alexandrou A, Creatsas G. Maternal circulating osteoprotegerin and soluble RANKL in pre-eclamptic women. Eur J Obstet Gynecol Reprod Biol 2010; 154:141-5. [PMID: 21074311 DOI: 10.1016/j.ejogrb.2010.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 08/31/2010] [Accepted: 10/12/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate alterations in the concentrations of osteoprotegerin (OPG), RANKL and the OPG/RANKL ratio in pre-eclamptic women during the puerperium. STUDY DESIGN This cross-sectional study was performed in the maternity ward of Aretaieio Hospital in Athens, Greece. Fifteen pregnant women with severe pre-eclampsia and 15 matched controls with premature rupture of the membranes were recruited. Fasting blood samples were obtained antepartum, immediately after diagnosing pre-eclampsia (median: 32nd gestational week), and during the 3rd-6th day postpartum, to estimate levels of circulating OPG and RANKL as well as the OPG/RANKL ratio. The anthropometric parameters evaluated included body mass index and blood pressure. RESULTS Mean circulating OPG levels decreased significantly in both groups in the postpartum period (controls: 43.7 ± 19.1 ng/ml vs 22.9 ± 9.1 ng/ml, p = 0.008; pre-eclamptic group: 72.3 ± 49.9 vs 49.7 ± 40.9 ng/ml, p = 0.002). The antepartum OPG/RANKL ratio was elevated in hypertensive pregnancies (2.41 ± 1.72) compared to normotensive pregnancies (1.45 ± 0.63), but the difference did not reach statistical significance (p = 0.1). The OPG/RANKL ratio decreased in the control group (0.76 ± 0.30, NS) following delivery, while it remained unchanged in the pre-eclamptic women (1.63 ± 1.40, p = 0.13). Consequently, the postpartum OPG/RANKL ratio was significantly higher in the pre-eclamptic women compared to control women (1.63 ± 1.40 vs 0.76 ± 0.30, p = 0.01). Levels of RANKL demonstrated no significant alterations during puerperium in both cases. CONCLUSION Pregnancies complicated with pre-eclampsia exhibit higher OPG levels and OPG/RANKL ratios, compared to control pregnancies, which might be compatible with lower bone turnover. The significance of this finding with respect to bone metabolism remains to be elucidated in larger studies.
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Affiliation(s)
- Nikolaos Vitoratos
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
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Possible chondroregulatory role of prolactin on the tibial growth plate of lactating rats. Histochem Cell Biol 2010; 134:483-91. [DOI: 10.1007/s00418-010-0745-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2010] [Indexed: 10/19/2022]
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Dorota DK, Bogdan KG, Mieczyslaw G, Bozena LG, Jan O. The concentrations of markers of bone turnover in normal pregnancy and preeclampsia. Hypertens Pregnancy 2010; 31:166-76. [PMID: 20822429 DOI: 10.3109/10641955.2010.484084] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of our study was to investigate the concentrations of markers of bone turnover in normal pregnancy and preeclampsia. MATERIAL AND METHODS Forty-five pregnant patients with preeclampsia, 78 healthy pregnant women (26 in first, 26 in the second, and 26 in third trimester of pregnancy), and 20 nonpregnant women were included in the study. Serum concentrations of osteoprotegrin (OPG), receptor activator of nuclear factor kappa B ligand (sRANKL), and the markers of bone turnover, osteocalcin and CrossLaps-degradation products of type I collagen, were determined using the ELISA method. Statistical analysis was performed using Mann-Whitney U-test. RESULTS The concentrations of sRANKL and OPG were significantly higher in the second trimester of normal pregnancy when compared to the first and the third trimesters and to nonpregnant controls. The concentrations of osteocalcin were significantly higher in the first trimester of physiological pregnancy in comparison with nonpregnant women and with second and third trimesters of pregnancy. The concentrations of CrossLaps were significantly higher in the second trimester of normal pregnancy when compared to the first and third trimester. In preeclampsia, the sera concentrations of osteocalcin and CrossLaps were significantly higher when compared to the third trimester of normal pregnancy. CONCLUSION The results suggest that the bone formation is increased in the first trimester, whereas the bone resorption is increased in the second trimester of normal pregnancy. Furthermore, the results suggest that the bone turnover is increased in patients with preeclampsia when compared to healthy normotensive pregnant women.
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Charoenphandhu N, Wongdee K, Krishnamra N. Is prolactin the cardinal calciotropic maternal hormone? Trends Endocrinol Metab 2010; 21:395-401. [PMID: 20304671 DOI: 10.1016/j.tem.2010.02.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2010] [Revised: 02/03/2010] [Accepted: 02/04/2010] [Indexed: 12/14/2022]
Abstract
To produce offspring, mothers require a large amount of calcium for fetal growth and milk production. Increased calcium demand leads to enhanced intestinal calcium absorption and stockpiling of bone calcium in pregnancy prior to demineralization in lactation. These coordinated events must be carefully organized by calciotropic hormone(s), but the classical hormones, namely 1,25-dihydroxyvitamin D(3), parathyroid hormone and calcitonin, do not appear to be responsible. Plasma prolactin (PRL) levels are elevated during pregnancy and, in view of the presence of PRL receptors in gut, bone and mammary glands, as well as recent evidence of the stimulatory effects of PRL on intestinal calcium transport, bone resorption and mammary calcium secretion, we postulate that PRL is the cardinal calciotropic hormone during pregnancy and lactation.
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Mulligan ML, Felton SK, Riek AE, Bernal-Mizrachi C. Implications of vitamin D deficiency in pregnancy and lactation. Am J Obstet Gynecol 2010; 202:429.e1-9. [PMID: 19846050 DOI: 10.1016/j.ajog.2009.09.002] [Citation(s) in RCA: 220] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Revised: 06/26/2009] [Accepted: 09/01/2009] [Indexed: 10/20/2022]
Abstract
Vitamin D is an essential fat soluble vitamin and a key modulator of calcium metabolism in children and adults. Because calcium demands increase in the third trimester of pregnancy, vitamin D status becomes crucial for maternal health, fetal skeletal growth, and optimal maternal and fetal outcomes. Vitamin D deficiency is common in pregnant women (5-50%) and in breastfed infants (10-56%), despite the widespread use of prenatal vitamins, because these are inadequate to maintain normal vitamin D levels (>or=32 ng/mL). Adverse health outcomes such as preeclampsia, low birthweight, neonatal hypocalcemia, poor postnatal growth, bone fragility, and increased incidence of autoimmune diseases have been linked to low vitamin D levels during pregnancy and infancy. Studies are underway to establish the recommended daily doses of vitamin D in pregnant women. This review discusses vitamin D metabolism and the implications of vitamin D deficiency in pregnancy and lactation.
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Styczynska H, Lis K, Sobanska I, Pater A, Pollak J, Mankowska A. Bone Turnover Markers and Osteoprotegerin in Uncomplicated Pregnancy. EJIFCC 2009; 19:193-202. [PMID: 27683317 PMCID: PMC4975284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although calcium metabolism during pregnancy is well described the mechanisms involved in bone metabolism are not quite clear. Increase of osteoprotegerin (OPG) with elevated bone turnover is supposed to be a homeostatic mechanism limiting bone loss. The aim of the study was to assess bone turnover in pregnancy in relation to serum osteoprotegerin level. Osteocalcin (OC), beta-crosslaps (CTx), OPG, vitamin 25 OH D3, parathormone (PTH), and calcium (Ca) were determined in 30 healthy women at 1(st) and at 3(rd) trimester of pregnancy and 27 healthy age-matched non pregnant women. In pregnant women average OPG, CTx and serum calcium concentrations were found to be highly elevated. During pregnancy OPG and bone resorption significantly rised whereas only slight increase in OC level was found with concomitant decrease in serum calcium. OPG correlated positively with OC and Ca only at 1(st) trimester. Serum CTx and OPG at 1(st) trimester seemed to be the only parameters to differentiate between elevated and normal bone turnover among pregnant women. In pregnancy bone turnover increases mainly due to enhanced bone resorption. The determination of osteocalcin at the beginning of pregnancy seems to be of limited clinical use, whereas measuring bone resorption markers such as CTx and/or osteoprotegerin may have a good predictive value for later pregnancy-associated bone loss.
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Affiliation(s)
- Hanna Styczynska
- Outpatient Rehabilitation Department, Biziel Hospital, Bydgoszcz
| | - Kinga Lis
- Department of Laboratory Medicine, Nicolaus Copernicus University, Collegium Medicum, Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland,
| | | | - Agnieszka Pater
- Department of Laboratory Medicine, Nicolaus Copernicus University, Collegium Medicum, Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
| | - Joanna Pollak
- Department of Laboratory Medicine, Nicolaus Copernicus University, Collegium Medicum, Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
| | - Aneta Mankowska
- Department of Laboratory Medicine, Nicolaus Copernicus University, Collegium Medicum, Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
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Abstract
Vitamin D is a secosteroid with an endocrine mechanism of action which is sequentially synthesized in humans in the skin, liver and kidneys. The active hormone, 1alpha,25-dihydrocholecalciferol [1,25(OH)2D3], is often considered only in terms of its role in controlling calcium and phosphorus homeostasis. However, cumulative evidence points to the presence of vitamin D receptors in many tissues. The present article summarizes key points regarding the participation of vitamin D in pregnancy and breastfeeding. During pregnancy, sufficient vitamin D concentrations are needed not only to address the growing demand for calcium on the part of the fetus, but also to participate in fetal growth, development of the nervous system, lung maturation and fetal immune system function. Hypovitaminosis D has been related to the development of diabetes, pre-eclampsia and fetal neurological disorders. During pregnancy and lactation, calcium from the maternal skeleton is mobilized, with a rise in bone turnover and a reduction in bone mass. It is advisable for pregnant and nursing women to maintain adequate levels of vitamin D, through small doses of solar exposure to facilitate natural formation of the hormone or by ingesting appropriate vitamin supplements. Further studies are needed to clarify the many gaps in knowledge and elucidate the role of vitamin D in the context of reproduction. Confirmation of experimental observations relating to the risks of hypovitaminosis D would have important public health implications.
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Affiliation(s)
- Faustino R Pérez-López
- Department of Obstetrics and Gynecology, Zaragoza Gynecological Institute, Zaragoza, Spain.
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