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Tiensuu H, Haapalainen AM, Tissarinen P, Pasanen A, Hallman M, Rämet M. MicroRNA expression profile in the basal plate of human placenta associates with spontaneous preterm birth. Placenta 2024; 155:60-69. [PMID: 39137705 DOI: 10.1016/j.placenta.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 07/24/2024] [Accepted: 08/05/2024] [Indexed: 08/15/2024]
Abstract
INTRODUCTION MicroRNAs regulate post-transcriptional gene expression. Their expression has been linked to many pregnancy complications, including preterm birth. Placental microRNA levels differ between preterm and term pregnancies. Not much is known about the targets that are affected by these differences in microRNA expression. We investigated associations between microRNA expression levels in the basal plate of the placenta and their targets and the onset of preterm birth. METHODS MiRNAomes of spontaneous preterm (n = 6) and term (n = 6) placentas were characterized using RNA sequencing. MicroRNA target and enrichment analyses were performed to explore potential gene targets and pathways. Selected findings were validated using qPCR (n = 41). MicroRNA mimic transfection and luciferase reporter assays were performed to test if certain microRNAs regulate their predicted target, SLIT2, the expression of which has been shown to associate with preterm birth. RESULTS We identified 39 differentially expressed microRNAs from the preterm placentas compared to term. Many downregulated microRNAs were from the placenta-specific C14MC microRNA cluster. Target gene and pathway analyses showed that microRNAs that associate with preterm birth target transcription related factors and genes linked with protein binding and invasive pathways. Eight of the identified microRNAs putatively target SLIT2, including miR-766-3p and miR-489-3p. Luciferase reporter assay suggested that these microRNAs regulate SLIT2 expression. DISCUSSION MicroRNA expression changes are associated with spontaneous preterm birth. A group of microRNAs targeting the same gene or genes belonging to the same pathway can have a significant effect on the critical processes maintaining pregnancy and placental functions.
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Affiliation(s)
- Heli Tiensuu
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Aapistie 5A, 90220, Oulu, Finland.
| | - Antti M Haapalainen
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Aapistie 5A, 90220, Oulu, Finland
| | - Pinja Tissarinen
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Aapistie 5A, 90220, Oulu, Finland
| | - Anu Pasanen
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Aapistie 5A, 90220, Oulu, Finland
| | - Mikko Hallman
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Aapistie 5A, 90220, Oulu, Finland
| | - Mika Rämet
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Aapistie 5A, 90220, Oulu, Finland; Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520, Tampere, Finland
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Del Pozzo J, Kouba I, Alvarez A, O'Sullivan-Bakshi T, Krishnamoorthy K, Blitz MJ. Environmental Justice Index and adverse pregnancy outcomes. AJOG GLOBAL REPORTS 2024; 4:100330. [PMID: 38586614 PMCID: PMC10994970 DOI: 10.1016/j.xagr.2024.100330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND The Environmental Justice Index is a tool released by the Centers for Disease Control and Prevention that quantifies and ranks the environmental burden and social vulnerability of each census tract. Racial and ethnic disparities in adverse pregnancy outcomes are well established. The relative contributions of individual (person-level) and environmental (neighborhood-level) risk factors to disease prevalence remain poorly understood. OBJECTIVE This study aimed to determine whether the Environmental Justice Index is associated with adverse pregnancy outcomes after adjustment for individual clinical and sociodemographic risk factors. STUDY DESIGN This was a retrospective cross-sectional study of all patients who delivered a singleton newborn at ≥23 weeks of gestation between January 2019 and February 2022 at 7 hospitals within a large academic health system in New York. Patients were excluded if their home address was not available, if the address could not be geocoded to a census tract, or if the census tract did not have corresponding Environmental Justice Index data. Patients were also excluded if they had preexisting diabetes or hypertension. For patients who had multiple pregnancies during the study period, only the first pregnancy was included for analysis. Clinical and demographic data were obtained from the electronic medical record. Environmental Justice Index score, the primary independent variable, ranges from 0 to 1. Higher Environmental Justice Index scores indicate communities with increased cumulative environmental burden and increased social vulnerability. The primary outcome was adverse pregnancy outcome, defined as the presence of ≥1 of any of the following conditions: hypertensive disorders of pregnancy, gestational diabetes, preterm birth, fetal growth restriction, low birthweight, small for gestational age newborn, placental abruption, and stillbirth. Multivariable logistic regression was performed to investigate the relationship between Environmental Justice Index score and adverse pregnancy outcome, adjusting for potential confounding variables, including body mass index group, race and ethnicity group, advanced maternal age, nulliparity, public health insurance, and English as the preferred language. RESULTS A total of 65,273 pregnancies were included for analysis. Overall, adverse pregnancy outcomes occurred in 37.6% of pregnancies (n=24,545); hypertensive disorders of pregnancy (13.4%) and gestational diabetes (12.2%) were the most common adverse pregnancy outcome conditions. On unadjusted analysis, the strongest associations between Environmental Justice Index score and individual adverse pregnancy outcome conditions were observed for stillbirth (odds ratio, 1.079; 95% confidence interval, 1.025-1.135) and hypertensive disorders of pregnancy (odds ratio, 1.052; 95% confidence interval, 1.042-1.061). On multivariable logistic regression, every 0.1 increase in Environmental Justice Index score was associated with 1.4% higher odds of adverse pregnancy outcome (adjusted odds ratio, 1.014; 95% confidence interval, 1.007-1.021). The strongest associations with adverse pregnancy outcomes were observed with well-established clinical and social risk factors, including class 3 obesity (adjusted odds ratio, 1.710; 95% confidence interval, 1.580-1.849; reference: body mass index <25 kg/m2) and certain race and ethnicity groups (reference: non-Hispanic White), particularly Asian and Pacific Islander (adjusted odds ratio, 1.817; 95% confidence interval, 1.729-1.910), and non-Hispanic Black (adjusted odds ratio, 1.668; 95% confidence interval, 1.581-1.760) people. CONCLUSION Environmental Justice Index score is positively associated with adverse pregnancy outcomes, and most strongly associated with stillbirth and hypertensive disorders of pregnancy. Geospatial analysis with Environmental Justice Index may help to improve our understanding of health inequities by identifying neighborhood characteristics that increase the risk of pregnancy complications.
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Affiliation(s)
- Jaclyn Del Pozzo
- Northwell Health, New Hyde Park (Drs Del Pozzo and Kouba, Mr Alvarez, and Dr Blitz), NY
- Department of Obstetrics and Gynecology, South Shore University Hospital (Drs Del Pozzo, Kouba, and Blitz), Bay Shore, NY
- Zucker School of Medicine (Drs Del Pozzo, Kouba, and Blitz), Hempstead, NY
| | - Insaf Kouba
- Northwell Health, New Hyde Park (Drs Del Pozzo and Kouba, Mr Alvarez, and Dr Blitz), NY
- Department of Obstetrics and Gynecology, South Shore University Hospital (Drs Del Pozzo, Kouba, and Blitz), Bay Shore, NY
- Zucker School of Medicine (Drs Del Pozzo, Kouba, and Blitz), Hempstead, NY
| | - Alejandro Alvarez
- Northwell Health, New Hyde Park (Drs Del Pozzo and Kouba, Mr Alvarez, and Dr Blitz), NY
- Department of Biostatistics, Office of Academic Affairs, Northwell Health (Mr Alvarez), New Hyde Park, NY
| | - Tadhg O'Sullivan-Bakshi
- Feinstein Institutes for Medical Research, Northwell Health (Mr. O'Sullivan-Bakshi and Ms. Krishnamoorthy), Manhasset, NY
| | - Kaveri Krishnamoorthy
- Feinstein Institutes for Medical Research, Northwell Health (Mr. O'Sullivan-Bakshi and Ms. Krishnamoorthy), Manhasset, NY
| | - Matthew J. Blitz
- Northwell Health, New Hyde Park (Drs Del Pozzo and Kouba, Mr Alvarez, and Dr Blitz), NY
- Department of Obstetrics and Gynecology, South Shore University Hospital (Drs Del Pozzo, Kouba, and Blitz), Bay Shore, NY
- Zucker School of Medicine (Drs Del Pozzo, Kouba, and Blitz), Hempstead, NY
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health (Dr Blitz), Manhasset, NY
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Schuster J, Tollefson GA, Zarate V, Agudelo A, Stabila J, Ragavendran A, Padbury J, Uzun A. Protein Network Analysis of Whole Exome Sequencing of Severe Preeclampsia. Front Genet 2022; 12:765985. [PMID: 35719905 PMCID: PMC9201216 DOI: 10.3389/fgene.2021.765985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 11/03/2021] [Indexed: 11/13/2022] Open
Abstract
Preeclampsia is a hypertensive disorder of pregnancy, which complicates up to 15% of US deliveries. It is an idiopathic disorder associated with several different phenotypes. We sought to determine if the genetic architecture of preeclampsia can be described by clusters of patients with variants in genes in shared protein interaction networks. We performed a case-control study using whole exome sequencing on early onset preeclamptic mothers with severe clinical features and control mothers with uncomplicated pregnancies between 2016 and 2020. A total of 143 patients were enrolled, 61 women with early onset preeclampsia with severe features based on ACOG criteria, and 82 control women at term, matched for race and ethnicity. A network analysis and visualization tool, Proteinarium, was used to confirm there are clusters of patients with shared gene networks associated with severe preeclampsia. The majority of the sequenced patients appear in two significant clusters. We identified one case dominant and one control dominant cluster. Thirteen genes were unique to the case dominated cluster. Among these genes, LAMB2, PTK2, RAC1, QSOX1, FN1, and VCAM1 have known associations with the pathogenic mechanisms of preeclampsia. Using bioinformatic analysis, we were able to identify subsets of patients with shared protein interaction networks, thus confirming our hypothesis about the genetic architecture of preeclampsia.
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Affiliation(s)
- Jessica Schuster
- Pediatrics, Women and Infants Hospital, Providence, RI, United States
- Pediatrics, Warren Alpert Medical School, Brown University, Providence, RI, United States
| | | | - Valeria Zarate
- Pediatrics, Women and Infants Hospital, Providence, RI, United States
| | - Anthony Agudelo
- Pediatrics, Women and Infants Hospital, Providence, RI, United States
| | - Joan Stabila
- Pediatrics, Women and Infants Hospital, Providence, RI, United States
| | - Ashok Ragavendran
- Center for Computation and Visualization, Brown University, Providence, RI, United States
- Computational Biology of Human Disease, Brown University, Providence, RI, United States
| | - James Padbury
- Pediatrics, Women and Infants Hospital, Providence, RI, United States
- Pediatrics, Warren Alpert Medical School, Brown University, Providence, RI, United States
- Center for Computational Molecular Biology, Brown University, Providence, RI, United States
| | - Alper Uzun
- Pediatrics, Women and Infants Hospital, Providence, RI, United States
- Pediatrics, Warren Alpert Medical School, Brown University, Providence, RI, United States
- Computational Biology of Human Disease, Brown University, Providence, RI, United States
- Center for Computational Molecular Biology, Brown University, Providence, RI, United States
- *Correspondence: Alper Uzun,
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Padmanabhan V, Song W, Puttabyatappa M. Praegnatio Perturbatio-Impact of Endocrine-Disrupting Chemicals. Endocr Rev 2021; 42:295-353. [PMID: 33388776 PMCID: PMC8152448 DOI: 10.1210/endrev/bnaa035] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Indexed: 02/07/2023]
Abstract
The burden of adverse pregnancy outcomes such as preterm birth and low birth weight is considerable across the world. Several risk factors for adverse pregnancy outcomes have been identified. One risk factor for adverse pregnancy outcomes receiving considerable attention in recent years is gestational exposure to endocrine-disrupting chemicals (EDCs). Humans are exposed to a multitude of environmental chemicals with known endocrine-disrupting properties, and evidence suggests exposure to these EDCs have the potential to disrupt the maternal-fetal environment culminating in adverse pregnancy and birth outcomes. This review addresses the impact of maternal and fetal exposure to environmental EDCs of natural and man-made chemicals in disrupting the maternal-fetal milieu in human leading to adverse pregnancy and birth outcomes-a risk factor for adult-onset noncommunicable diseases, the role lifestyle and environmental factors play in mitigating or amplifying the effects of EDCs, the underlying mechanisms and mediators involved, and the research directions on which to focus future investigations to help alleviate the adverse effects of EDC exposure.
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Affiliation(s)
| | - Wenhui Song
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
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5
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Nelson DB, Rockwell LC, Prioleau MD, Goetzl L. The role of the bacterial microbiota on reproductive and pregnancy health. Anaerobe 2016; 42:67-73. [PMID: 27612939 DOI: 10.1016/j.anaerobe.2016.09.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/18/2016] [Accepted: 09/05/2016] [Indexed: 11/17/2022]
Abstract
Recent assessments have examined the composition of bacterial communities influencing reproductive, pregnancy and infant health. The Microbiome Project has made great strides in sequencing the microbiome and identifying the vast communities of microorganisms that inhabit our bodies and much work continues to examine the individual contribution of bacteria on health and disease to inform future therapies. This review explores the current literature outlining the contribution of important bacteria on reproductive health among sexually active men and women, outlines gaps in current research to determine causal and interventional relationships, and suggests future research initiatives. Novel treatments options to reduce adverse outcomes must recognize the heterogeneity of the bacteria within the microbiome and adequately assess long-term benefits in reducing disease burden and re-establishing a healthy Lactobacillus-dominant state. Recognizing other reservoirs outside of the lower genital track and within sexual partners as well as genetic and individual moderators may be most important for long-term cure and reduction of disease. It will be important to develop useful screening tools and comprehensively examine novel therapeutic options to promote the long-term reduction of high-risk bacteria and the re-establishment of healthy bacterial levels to considerably improve outcomes among pregnant women and sexually active men and women.
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Affiliation(s)
- Deborah B Nelson
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, USA; Department of Obstetrics, Gynecology and Reproductive Sciences, College of Medicine, Temple University, USA.
| | | | | | - Laura Goetzl
- Department of Obstetrics, Gynecology and Reproductive Sciences, College of Medicine, Temple University, USA
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Jefferson KK. The bacterial etiology of preterm birth. ADVANCES IN APPLIED MICROBIOLOGY 2016; 80:1-22. [PMID: 22794142 DOI: 10.1016/b978-0-12-394381-1.00001-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Preterm birth is the leading cause of infant morbidity and mortality. Very preterm births, those occurring before 32 completed weeks of gestation, are associated with the greatest risks. The leading cause of very preterm birth is intrauterine infection, which can lead to an inflammatory response that triggers labor or preterm premature rupture of membranes. How bacteria invade the uterine cavity, which is normally a sterile environment, and the reasons why different species vary in their capacity to induce inflammation and preterm birth are still incompletely understood. However, advanced techniques that circumvent the need for cultivating bacteria, deep sequence analysis that allows for the comprehensive characterization of the microbiome of a given body site and detection of low-prevalence species, and transcriptomics and metabolomics approaches that shed light on the host response to bacterial invasion are all providing a more complete picture of the progression from vaginal colonization to uterine invasion to preterm labor and preterm birth.
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Affiliation(s)
- Kimberly K Jefferson
- Department of Microbiology and Immunology, Virginia Commonwealth University, Richmond, Virginia, USA.
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Murphy K, Mitchell CM. The Interplay of Host Immunity, Environment and the Risk of Bacterial Vaginosis and Associated Reproductive Health Outcomes. J Infect Dis 2016; 214 Suppl 1:S29-35. [PMID: 27056955 DOI: 10.1093/infdis/jiw140] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Bacterial vaginosis (BV) is one of the most common causes of vaginal symptoms in US women, but its causal mechanism has not yet been defined. BV is more prevalent in women who are immunosuppressed, and several risk factors for the development of BV are associated with lower quantities of immune mediators in vaginal fluid. In contrast, the poor reproductive health outcomes associated with BV, such as preterm birth and human immunodeficiency virus type 1 acquisition, are associated with increased levels of proinflammatory immune mediators in the genital tract. In this article, we discuss how variations in the host immune profile and environmental effects on host immunity may influence the risk of BV, as well as the risk of complications associated with BV.
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Affiliation(s)
- Kerry Murphy
- Division of Infectious Diseases, Albert Einstein College of Medicine, Bronx, New York
| | - Caroline M Mitchell
- Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston
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Huang B, Fettweis JM, Brooks JP, Jefferson KK, Buck GA. The changing landscape of the vaginal microbiome. Clin Lab Med 2014; 34:747-61. [PMID: 25439274 DOI: 10.1016/j.cll.2014.08.006] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Deep sequence analysis of the vaginal microbiome is revealing an unexpected complexity that was not anticipated as recently as several years ago. The lack of clarity in the definition of a healthy vaginal microbiome, much less an unhealthy vaginal microbiome, underscores the need for more investigation of these phenomena. Some clarity may be gained by the careful analysis of the genomes of the specific bacteria in these women. Ongoing studies will clarify this process and offer relief for women with recurring vaginal maladies and hope for pregnant women to avoid the experience of preterm birth.
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Affiliation(s)
- Bernice Huang
- Department of Microbiology and Immunology, Center for the Study of Biological Complexity, 1101 East Marshall Street, PO Box 980678, Richmond, VA 23298, USA
| | - Jennifer M Fettweis
- Department of Microbiology and Immunology, Center for the Study of Biological Complexity, 1101 East Marshall Street, PO Box 980678, Richmond, VA 23298, USA
| | - J Paul Brooks
- Department of Statistical Sciences and Operations Research, Virginia Commonwealth University, PO Box 843083, Richmond, VA 23284, USA
| | - Kimberly K Jefferson
- Department of Microbiology and Immunology, Center for the Study of Biological Complexity, 1101 East Marshall Street, PO Box 980678, Richmond, VA 23298, USA
| | - Gregory A Buck
- Department of Microbiology and Immunology, Center for the Study of Biological Complexity, 1101 East Marshall Street, PO Box 980678, Richmond, VA 23298, USA.
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Nibali L, Henderson B, Sadiq ST, Donos N. Genetic dysbiosis: the role of microbial insults in chronic inflammatory diseases. J Oral Microbiol 2014; 6:22962. [PMID: 24578801 PMCID: PMC3936111 DOI: 10.3402/jom.v6.22962] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 12/22/2013] [Accepted: 01/04/2014] [Indexed: 01/06/2023] Open
Abstract
Thousands of bacterial phylotypes colonise the human body and the host response to this bacterial challenge greatly influences our state of health or disease. The concept of infectogenomics highlights the importance of host genetic factors in determining the composition of human microbial biofilms and the response to this microbial challenge. We hereby introduce the term ‘genetic dysbiosis’ to highlight the role of human genetic variants affecting microbial recognition and host response in creating an environment conducive to changes in the normal microbiota. Such changes can, in turn, predispose to, and influence, diseases such as: cancer, inflammatory bowel disease, rheumatoid arthritis, psoriasis, bacterial vaginosis and periodontitis. This review presents the state of the evidence on host genetic factors affecting dysbiosis and microbial misrecognition (i.e. an aberrant response to the normal microbiota) and highlights the need for further research in this area.
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Affiliation(s)
- Luigi Nibali
- Periodontology Unit and Department of Clinical Research, UCL Eastman Dental Institute, University College London, London, United Kingdom
| | - Brian Henderson
- Division of Microbial Diseases, UCL Eastman Dental Institute, London, United Kingdom
| | - Syed Tariq Sadiq
- Institute of Infection and Immunity, St George's, University of London, London, United Kingdom
| | - Nikos Donos
- Periodontology Unit and Department of Clinical Research, UCL Eastman Dental Institute, University College London, London, United Kingdom
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Wu CS, Pedersen LH, Miller JE, Sun Y, Streja E, Uldall P, Olsen J. Risk of cerebral palsy and childhood epilepsy related to infections before or during pregnancy. PLoS One 2013; 8:e57552. [PMID: 23460873 PMCID: PMC3583873 DOI: 10.1371/journal.pone.0057552] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 01/22/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIM Maternal infections during pregnancy have been associated with several neurological disorders in the offspring. However, given the lack of specificity for both the exposures and the outcomes, other factors related to infection such as impaired maternal immune function may be involved in the causal pathway. If impaired maternal immune function plays a role, we would expect infection before pregnancy to be associated with these neurological outcomes. METHODS/PRINCIPAL FINDINGS The study population included all first-born singletons in Denmark between January 1 1982 and December 31 2004. We identified women who had hospital-recorded infections within the 5 year period before pregnancy, and women who had hospital-recorded infections during pregnancy. We grouped infections into either infections of the genitourinary system, or any other infections. Cox models were used to estimate adjusted hazard ratios (aHRs) with 95% confidence interval (CI). Maternal infection of the genitourinary system during pregnancy was associated with an increased risk of cerebral palsy (aHR = 1.63, 95% CI: 1.34-1.98) and epilepsy (aHR = 1.27, 95% CI: 1.13-1.42) in the children, compared to children of women without infections during pregnancy. Among women without hospital-recorded infections during pregnancy, maternal infection before pregnancy was associated with an increased risk of epilepsy (aHR = 1.35, 95% CI: 1.21-1.50 for infections of the genitourinary system, and HR = 1.12, 95% CI: 1.03-1.22 for any other infections) and a slightly higher risk of cerebral palsy (aHR = 1.20, 95% CI: 0.96-1.49 for infections of the genitourinary system, and HR = 1.23, 95% CI: 1.06-1.43 for any other infections) in the children, compared to children of women without infections before (and during) pregnancy. CONCLUSIONS These findings indicate that the maternal immune system, maternal infections, or factors related to maternal immune function play a role in the observed associations between maternal infections before pregnancy and cerebral diseases in the offspring.
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Affiliation(s)
- Chun S Wu
- Department of Public Health, Aarhus University, Aarhus, Denmark.
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Abstract
Bacterial vaginosis (BV) is the most common vaginal infection among women of childbearing age. This condition is notorious for causing severe complications related to the reproductive health of women. Five decades of intense research established many risk factors for acquisition of BV; however, because of the complexity of BV and lack of a reliable animal model for this condition, its exact aetiology remains elusive. In this manuscript, we use a historical perspective to critically review the development of major theories on the aetiology of BV, ultimately implicating BV-related pathogens, healthy vaginal microbiota, bacteriophages and the immune response of the host. None of these theories on their own can reliably explain the epidemiological data. Instead, BV is caused by a complex interaction of multiple factors, which include the numerous components of the vaginal microbial ecosystem and their human host. Many of these factors are yet to be characterized because a clear understanding of their relative contribution to the aetiology of BV is pivotal to the formulation of an effective treatment for and prophylaxis of this condition.
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Affiliation(s)
- Y Turovskiy
- Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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Mayor-Lynn K, Toloubeydokhti T, Cruz AC, Chegini N. Expression profile of microRNAs and mRNAs in human placentas from pregnancies complicated by preeclampsia and preterm labor. Reprod Sci 2010; 18:46-56. [PMID: 21079238 DOI: 10.1177/1933719110374115] [Citation(s) in RCA: 213] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
MicroRNAs (miRNAs) have emerged as key regulators of gene expression stability implicated in cell proliferation, apoptosis, and development, whereas their altered expression has been associated with various pathological disorders. The objective of this study was to assess the expression profile of miRNAs and their predicted target genes in placentas from patients with preeclampsia (PC) and preterm (PT) labor as compared to normal term (NT) pregnancies. Using microarray profiling of 820 miRNAs and 18,630 mRNA transcripts, the analysis indicated that 283 of these miRNAs and 9119 mRNAs were expressed in all placentas, of which the relative expression of 20 miRNAs (P < .05 and ≥ 1.5-fold) and 120 mRNAs (P < .05, and 2-fold cutoff) was differentially expressed in PT and PC as compared to NT. The expression of miR-15b, miR-181a, miR-200C, miR-210, miR-296-3p, miR-377, miR-483-5p, and miR-493 and a few of their predicted target genes: matrix metalloproteinases (MMP-1, MMP-9), a disintegrin and metalloproteinase domains (ADAM-17, ADAM-30), tissue inhibitor of metalloproteinase 3 (TIMP-3); suppressor of cytokine signaling 1 (SOCS1); Stanniocalcin (STC2); corticotropin-releasing hormone (CRH), CRH-binding protein (CRHBP); and endothelin-2 (EDN2) were validated in these cohorts using real-time polymerase chain reaction (PCR), some displaying an inverse correlation with the expression of their predicted target genes. Functional analysis indicated that the products of these genes regulate cellular activities considered critical in normal placental functions and those affected by PC and PT labor. In conclusion, the results provide further evidence that placentas affected by PC and PT labor display an altered expression of a number of miRNAs with potential regulatory functions on the expression of specific target genes whose altered expression and function have been associated with these pregnancy complications.
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Srinivasan U, Misra D, Marazita ML, Foxman B. Vaginal and oral microbes, host genotype and preterm birth. Med Hypotheses 2009; 73:963-75. [PMID: 19942083 PMCID: PMC4026093 DOI: 10.1016/j.mehy.2009.06.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Revised: 06/03/2009] [Accepted: 06/06/2009] [Indexed: 01/08/2023]
Abstract
Preterm birth (PTB) is a leading cause of infant mortality and morbidity in the US and across the globe. Infection and associated inflammation are important initiators for PTB pathways; an estimated 40% of PTBs are attributed to amniochorionic-decidual or systemic inflammation. Historically, intrauterine infections have been implicated in PTB; recent evidence suggests that infections remote from the fetal site may also be causative. There is strong epidemiological evidence that bacterial vaginosis and periodontitis--two syndromes characterized by perturbations in the normal vaginal and oral bacterial microflora, respectively--are linked to infection-associated PTB. Oral and vaginal environments are similar in their bacterial microbiology; identical bacterial species have been independently isolated in periodontitis and bacterial vaginosis. Periodontitis and bacterial vaginosis also share many behavioral and sociodemographic risk factors suggesting a possible common pathophysiology. Genetic polymorphisms in host inflammatory responses to infection are shared between bacterial vaginosis, periodontitis and PTB, suggesting common mechanisms through which host genotype modify the effect of abnormal bacterial colonization on preterm birth. We review the state of knowledge regarding the risk of PTB attributable to perturbations in bacterial flora in oral and vaginal sites and the role of host genetics in modifying the risk of infection-related PTB. We posit that bacterial species that are common in perturbed vaginal and oral sites are associated with PTB through their interaction with the host immune system.
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Affiliation(s)
- Usha Srinivasan
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
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Bánhidy F, Ács N, Puho EH, Czeizel AE. Rate of preterm births in pregnant women with common lower genital tract infection: a population-based study based on the clinical practice. J Matern Fetal Neonatal Med 2009; 22:410-8. [DOI: 10.1080/14767050902801645] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Affiliation(s)
- Jean-Christophe Gris
- Department of Haematology, University Hospital, Nîmes; Faculty of Pharmacy and research team EA 2992, University of Montpellier, France.
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Himes KP, Simhan HN. Genetic susceptibility to infection-mediated preterm birth. Infect Dis Clin North Am 2009; 22:741-753. [PMID: 18954761 DOI: 10.1016/j.idc.2008.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Preterm birth is a heterogeneous disorder that is responsible for significant neonatal morbidity and mortality. Intrauterine infection is implicated in a significant proportion of preterm birth-particularly in early gestation. Epidemiologic evidence supports a genetic component to infection overall and preterm birth in particular. Furthermore, a number of studies examining genes involved in pathogen recognition and our response to pathogens suggest a genetic susceptibility to infection-mediated preterm birth. On the whole, however, these studies have been difficult to replicate and explain only a small portion of the phenotypic variation in preterm birth. Given this, methodological considerations are emphasized to improve our understanding of the genetic susceptibility to infection-mediated preterm birth.
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Affiliation(s)
- Katherine P Himes
- Division of Maternal Fetal Medicine, University of Pittsburgh Medical Center, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA
| | - Hyagriv N Simhan
- Division of Maternal Fetal Medicine, University of Pittsburgh Medical Center, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA.
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