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Sengul M, Karadas B, Acar-Sahan S, Simsek F, Horoz E, Özok IC, Temiz T. Functional and Histological Changes in Umbilical Artery and Myometrium Isolated from IUGR Complicated Pregnancies. Fetal Pediatr Pathol 2023; 42:845-859. [PMID: 37578058 DOI: 10.1080/15513815.2023.2245892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/15/2023]
Abstract
Objective: To investigate the relaxation responses mediated by L-type Ca2+ channels and big-conductance Ca2+-activated K+ (BKCa) channels and histological changes in the human umbilical artery (HUA) and myometrium smooth muscle isolated from pregnancies complicated with intrauterine growth restriction (IUGR).Methods: The muscle reactivity and the histology of the smooth muscle of the HUA and myometrium retrieved from 14 women with IUGR and 14 controls were investigated by the isolated tissue bath and immunohistochemical method.Results: In HUA, the maximum relaxation responses and pD2 values of nifedipine and NS11021 (BKCa channel opener) were significantly increased and significant histopathological changes are observed in the IUGR group.Conclusions: The pathogenesis of IUGR might be associated with the impairment in the functional responses of L-type Ca2+ channels and BKCa channels in HUA smooth muscle. The increased staining of myometrium and UC with HIF-1α in IUGR may indicate apoptosis, histological damage, and impaired fetal growth.
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Affiliation(s)
- Mustafa Sengul
- Department of Obstetrics and Gynecology Izmir, Izmir Katip Celebi University Faculty of Medicine, Turkey
| | - Baris Karadas
- Department of Pharmacology Izmir, Izmir Katip Celebi University Faculty of Medicine, Turkey
| | - Selin Acar-Sahan
- Department of Pharmacology Izmir, Izmir Katip Celebi University Faculty of Medicine, Turkey
| | - Fatma Simsek
- Department of Histology and Embryology Izmir, Izmir Katip Celebi University Faculty of Medicine, Turkey
| | - Ersan Horoz
- Department of Pharmacology Izmir, Izmir Katip Celebi University Faculty of Medicine, Turkey
| | - Işık Cem Özok
- Department of Pharmacology Izmir, Izmir Katip Celebi University Faculty of Medicine, Turkey
| | - Tijen Temiz
- Department of Pharmacology Izmir, Izmir Katip Celebi University Faculty of Medicine, Turkey
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2
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Sutherland MR, Black MJ. The impact of intrauterine growth restriction and prematurity on nephron endowment. Nat Rev Nephrol 2023; 19:218-228. [PMID: 36646887 DOI: 10.1038/s41581-022-00668-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2022] [Indexed: 01/18/2023]
Abstract
In humans born at term, maximal nephron number is reached by the time nephrogenesis is completed - at approximately 36 weeks' gestation. The number of nephrons does not increase further and subsequently remains stable until loss occurs through ageing or disease. Nephron endowment is key to the functional capacity of the kidney and its resilience to disease; hence, any processes that impair kidney development in the developing fetus can have lifelong adverse consequences for renal health and, consequently, for quality and length of life. The timing of nephrogenesis underlies the vulnerability of developing human kidneys to adverse early life exposures. Indeed, exposure of the developing fetus to a suboptimal intrauterine environment during gestation - resulting in intrauterine growth restriction (IUGR) - and/or preterm birth can impede kidney development and lead to reduced nephron endowment. Furthermore, emerging research suggests that IUGR and/or preterm birth is associated with an elevated risk of chronic kidney disease in later life. The available data highlight the important role of early life development in the aetiology of kidney disease and emphasize the need to develop strategies to optimize nephron endowment in IUGR and preterm infants.
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Affiliation(s)
- Megan R Sutherland
- Department of Anatomy and Developmental Biology and Monash Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia
| | - Mary Jane Black
- Department of Anatomy and Developmental Biology and Monash Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia.
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3
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Pehrson M, Edsfeldt A, Sarno G, Fraser A, Rich-Edwards JW, Goncalves I, Pihlsgård M, Timpka S. Coronary artery restenosis and target lesion revascularisation in women by pregnancy history. Open Heart 2023; 10:openhrt-2022-002130. [PMID: 36931658 PMCID: PMC10030621 DOI: 10.1136/openhrt-2022-002130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/27/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Women's pregnancy history is associated with incident risk of coronary artery disease with some evidence also suggesting a relevance for prognosis following treatment. OBJECTIVES To study the associations between maternal history of preterm delivery, a history of small for gestational age infant, parity and age at first delivery with clinical restenosis after percutaneous coronary intervention (PCI). METHODS In this prospective cohort study, we included 6027 women <65 years undergoing their first PCI 2006-2017, merging clinical register data on PCI procedures in Sweden with comprehensive registry data on deliveries since 1973. We used proportional hazards regression to study the association between aspects of pregnancy history and clinical restenosis in per-segment analyses, and with target lesion revascularisation (TLR) in per-patient analyses. We adjusted models for procedural-related and patient-related predictors of restenosis. RESULTS During 15 981 segment-years of follow-up, 343 (3.7%) events of clinical restenosis occurred. We found no strong evidence of associations between the studied aspects of pregnancy history and clinical restenosis following PCI. For example, the restenosis HR for a history of preterm delivery in the fully adjusted model was 1.09 (95% CI 0.77 to 1.55) and the TLR HR was 1.18 (95% CI 0.91 to 1.52). CONCLUSION Risk of restenosis following treatment with PCI did not differ by the studied aspects of pregnancy history, including preterm delivery, in young and middle-aged women. Larger studies are needed to obtain more precise estimates.
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Affiliation(s)
- Moa Pehrson
- Perinatal and Cardiovascular Epidemiology, Lund University Diabetes Centre, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Andreas Edsfeldt
- Cardiovascular Research- Translational Studies, Lund University, Malmö, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
- Department of Cardiology, Skåne University Hospital, Lund/Malmö, Sweden
| | - Giovanna Sarno
- Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Abigail Fraser
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Janet W Rich-Edwards
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Isabel Goncalves
- Cardiovascular Research- Translational Studies, Lund University, Malmö, Sweden
- Department of Cardiology, Skåne University Hospital, Lund/Malmö, Sweden
| | - Mats Pihlsgård
- Perinatal and Cardiovascular Epidemiology, Lund University Diabetes Centre, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Simon Timpka
- Perinatal and Cardiovascular Epidemiology, Lund University Diabetes Centre, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Department of Obstetrics and Gynaecology, Skåne University Hospital, Malmö, Sweden
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4
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Lovato I, Simonelli A, Visentin S, Priante E, Baraldi E, Sacchi C. Prenatal environment and developmental trajectories: the intrauterine growth restriction. Minerva Pediatr (Torino) 2023; 75:62-74. [PMID: 35708036 DOI: 10.23736/s2724-5276.22.06949-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The prenatal environment is of fundamental importance for the fetus, as the fetus is particularly susceptible to environmental influences while in utero, and several prenatal adversities may constitute a risk factor for fetal growth and child development. Intrauterine growth restriction (IUGR) refers to a pregnancy complication involving the inadequate growth of the fetus in utero, with potential programming consequences on the children's brain-behavior development. In this narrative review we will discuss the most recent literature about IUGR children, including their development and their relationship with the prenatal and postnatal environment. In particular, as an attempt to an adaptive response to intrauterine changes, the brain development of IUGR fetuses follows abnormal developmental pathways, which likely has cascade effects on the future neurodevelopmental outcomes of the children. Cognitive and motor functions are in fact impaired, as well as IUGR children present, across studies, poor socio-emotional abilities and a greater risk for internalizing and externalizing behavior problems. The current work also highlights how the postnatal environment, and in particular parental care, has an important role in IUGR development, acting as a protective factor, or otherwise increasing their constitutional vulnerabilities. Overall, this narrative review has important implications for clinical practice, suggesting the need for long-term follow-up care with IUGR children and strategies supporting parent-child interactions as well.
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Affiliation(s)
- Irene Lovato
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Alessandra Simonelli
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Silvia Visentin
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Elena Priante
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Eugenio Baraldi
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Chiara Sacchi
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy -
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Takeshita S, Kakita H, Asai S, Asai T, Mori M, Ueda H, Aoki H, Aoyama M, Yamada Y. Thrombocytopenia and insufficient thrombopoietin production in human small-for-gestational-age infants. Pediatr Res 2023; 93:619-624. [PMID: 35568734 PMCID: PMC9988681 DOI: 10.1038/s41390-022-02107-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 04/26/2022] [Accepted: 05/02/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Small-for-gestational-age (SGA) infants are at increased risk for transient thrombocytopenia. The aim of this study was to determine whether thrombocytopenia in human SGA infants is due to insufficient thrombopoietin (TPO) production. METHODS A prospective study of 202 infants with gestational age less than 37 weeks was conducted; 30 of them were SGA infants, and 172 were non-SGA infants. Thrombocytopenia was seen in 17 of 30 SGA infants and 40 of 172 non-SGA infants. RESULTS Platelet counts were significantly lower in the SGA group than in the non-SGA group at the time of the lowest platelet count within 72 h of birth. The platelet count and immature platelet fraction (IPF) were negatively correlated in non-SGA infants, but not in SGA infants. In addition, the platelet count and TPO were negatively correlated in non-SGA infants. IPF and TPO were significantly lower in SGA than in non-SGA infants with thrombocytopenia. CONCLUSION IPF increased with thrombocytopenia to promote platelet production in non-SGA infants due to increasing TPO, but not in SGA infants. This study found an association between insufficient TPO production and thrombocytopenia in SGA infants. In addition, this study is important for understanding the etiology of thrombocytopenia in SGA infants. IMPACT The immature platelet fraction was low, and serum thrombopoietin was not increased in small-for-gestational-age (SGA) infants with thrombocytopenia. Thrombocytopenia in SGA infants is due to insufficient thrombopoietin production. This study is important for understanding the etiology of thrombocytopenia in SGA infants.
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Affiliation(s)
- Satoru Takeshita
- Department of Perinatal and Neonatal Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.,Department of Pathobiology, Nagoya City University Graduate School of Pharmaceutical Sciences, 3-1 Tanabedori, Mizuho-ku, Nagoya, Aichi, 467-8603, Japan
| | - Hiroki Kakita
- Department of Perinatal and Neonatal Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan. .,Department of Pathobiology, Nagoya City University Graduate School of Pharmaceutical Sciences, 3-1 Tanabedori, Mizuho-ku, Nagoya, Aichi, 467-8603, Japan.
| | - Shimpei Asai
- Department of Perinatal and Neonatal Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Takafumi Asai
- Department of Perinatal and Neonatal Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Mari Mori
- Department of Perinatal and Neonatal Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Hiroko Ueda
- Department of Perinatal and Neonatal Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Hiromasa Aoki
- Department of Pathobiology, Nagoya City University Graduate School of Pharmaceutical Sciences, 3-1 Tanabedori, Mizuho-ku, Nagoya, Aichi, 467-8603, Japan
| | - Mineyoshi Aoyama
- Department of Pathobiology, Nagoya City University Graduate School of Pharmaceutical Sciences, 3-1 Tanabedori, Mizuho-ku, Nagoya, Aichi, 467-8603, Japan
| | - Yasumasa Yamada
- Department of Perinatal and Neonatal Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
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Zhang Y, Zeng HH. Placental morphological features of small for gestational age preterm neonates born to mothers with pregnancy-induced hypertension. Front Pediatr 2023; 11:1093622. [PMID: 37025291 PMCID: PMC10070738 DOI: 10.3389/fped.2023.1093622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/20/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction Small for gestational age (SGA) neonates are often born to mothers with pregnancy-induced hypertension (PIH). Here, we aimed to explore the morphometric characteristics of the placenta during the perinatal period associated with SGA risk in mothers with PIH and identify the risk factors related to SGA. Methods The medical records of 134 neonates born between 28- and 32-weeks' gestation to PIH mothers were retrospectively analyzed. Placental morphology and umbilical cord (UC) length were compared between the SGA and appropriate for gestational age (AGA) groups. Results The placenta of the SGA group had a shorter major (15.00 vs. 18.00 cm; z = -6.04, p < 0.01) and minor placenta axes (13.00 vs. 15.00 cm; z = -4.59, p < 0.01), lower weight (300.00 vs. 420.00 g; z = -7.21, p < 0.01), smaller volume (282.00 vs. 396.00 cm3; z = -5.00, p < 0.01), and smaller area (141.00 vs. 212.00 cm2; z = -5.96, p < 0.01) than the AGA group. The UC was significantly shorter (39.00 vs. 44.00 cm; z = -3.68, p < 0.01). Short placental major axis [p = 0.03; odds ratio (OR): 2.16; 95% confidence interval (CI): 1.84 - 2.63] and low placental weight (p < 0.01; OR: 2.68; 95% CI: 2.66 - 2.70) were independent risk factors for SGA in premature newborns of PIH mothers. Discussion A major axis shorter than 15.5 cm or placental weight lower than 347.50 g at birth was related to a greater risk of SGA infants born to PIH mothers. As a predictor in prenatal ultrasound, the major axis is more helpful for precise prenatal pre-evaluation of vulnerable SGA preterm neonates with PIH mothers.
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Dangudubiyyam SV, Mishra JS, Song R, Kumar S. Maternal PFOS exposure during rat pregnancy causes hypersensitivity to angiotensin II and attenuation of endothelium-dependent vasodilation in the uterine arteries. Biol Reprod 2022; 107:1072-1083. [PMID: 35835584 DOI: 10.1093/biolre/ioac141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/21/2022] [Accepted: 07/06/2022] [Indexed: 01/09/2023] Open
Abstract
Epidemiological studies show a strong association between environmental exposure to perfluorooctane sulfonic acid (PFOS) and preeclampsia and fetal growth restriction; however, the underlying mechanisms are unclear. We tested the hypothesis that gestational PFOS exposure leads to pregnancy complications via alterations in uterine vascular endothelium-independent angiotensin II-related mechanisms and endothelium-derived factors such as nitric oxide. Pregnant Sprague Dawley rats were exposed to PFOS 0.005, 0.05, 0.5, 5, 10, and 50 μg/mL through drinking water from gestational day 4 to 20, and dams with PFOS 50 μg/mL were used to assess mechanisms. PFOS exposure dose-dependently increased maternal blood pressure but decreased fetal weights. Uterine artery blood flow was lower and resistance index was higher in the PFOS dams. In PFOS dams, uterine artery contractile responses to angiotensin II were significantly greater, whereas contractile responses to K+ depolarization and phenylephrine were unaffected. Plasma angiotensin II levels were not significantly different between control and PFOS dams; however, PFOS exposure significantly increased AGTR1 and decreased AGTR2 protein levels in uterine arteries. Endothelium-dependent relaxation response to acetylcholine was significantly reduced with decreased endothelial nitric oxide synthase expression in the uterine arteries of PFOS dams. Left ventricular hypertrophy and fibrosis were observed, along with increased ejection fraction and fractional shortening in PFOS dams. These results suggest that elevated maternal PFOS levels decrease uterine blood flow and increase vascular resistance via heightened angiotensin II-mediated vasoconstriction and impaired endothelium-dependent vasodilation, which provides a molecular mechanism linking elevated maternal PFOS levels with gestational hypertension and fetal growth restriction.
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Affiliation(s)
- Sri Vidya Dangudubiyyam
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA.,Endocrinology-Reproductive Physiology Program, University of Wisconsin, Madison, WI 53715, USA
| | - Jay S Mishra
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA
| | - Ruolin Song
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA
| | - Sathish Kumar
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA.,Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53792, USA.,Endocrinology-Reproductive Physiology Program, University of Wisconsin, Madison, WI 53715, USA
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8
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Alfian I, Chakraborty A, Yong HEJ, Saini S, Lau RWK, Kalionis B, Dimitriadis E, Alfaidy N, Ricardo SD, Samuel CS, Murthi P. The Placental NLRP3 Inflammasome and Its Downstream Targets, Caspase-1 and Interleukin-6, Are Increased in Human Fetal Growth Restriction: Implications for Aberrant Inflammation-Induced Trophoblast Dysfunction. Cells 2022; 11:1413. [PMID: 35563719 PMCID: PMC9102093 DOI: 10.3390/cells11091413] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/30/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023] Open
Abstract
Fetal growth restriction (FGR) is commonly associated with placental insufficiency and inflammation. Nonetheless, the role played by inflammasomes in the pathogenesis of FGR is poorly understood. We hypothesised that placental inflammasomes are differentially expressed and contribute to the aberrant trophoblast function. Inflammasome gene expression profiles were characterised by real-time PCR on human placental tissues collected from third trimester FGR and gestation-matched control pregnancies (n = 25/group). The functional significance of a candidate inflammasome was then investigated using lipopolysaccharide (LPS)-induced models of inflammation in human trophoblast organoids, BeWo cells in vitro, and a murine model of FGR in vivo. Placental mRNA expression of NLRP3, caspases 1, 3, and 8, and interleukin 6 increased (>2-fold), while that of the anti-inflammatory cytokine, IL-10, decreased (<2-fold) in FGR compared with control pregnancies. LPS treatment increased NLRP3 and caspase-1 expression (>2-fold) in trophoblast organoids and BeWo cell cultures in vitro, and in the spongiotrophoblast and labyrinth in the murine model of FGR. However, the LPS-induced rise in NLRP3 was attenuated by its siRNA-induced down-regulation in BeWo cell cultures, which correlated with reduced activity of the apoptotic markers, caspase-3 and 8, compared to the control siRNA-treated cells. Our findings support the role of the NLRP3 inflammasome in the inflammation-induced aberrant trophoblast function, which may contribute to FGR.
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Affiliation(s)
- Irvan Alfian
- Department of Pharmacology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia; (I.A.); (A.C.); (S.S.); (R.W.K.L.); (S.D.R.)
- Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya 6, Jakarta Pusat 10160, Indonesia
| | - Amlan Chakraborty
- Department of Pharmacology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia; (I.A.); (A.C.); (S.S.); (R.W.K.L.); (S.D.R.)
| | - Hannah E. J. Yong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore;
| | - Sheetal Saini
- Department of Pharmacology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia; (I.A.); (A.C.); (S.S.); (R.W.K.L.); (S.D.R.)
| | - Ricky W. K. Lau
- Department of Pharmacology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia; (I.A.); (A.C.); (S.S.); (R.W.K.L.); (S.D.R.)
| | - Bill Kalionis
- Department of Maternal-Fetal Medicine Pregnancy Research Centre, The Royal Women’s Hospital, Melbourne, VIC 3052, Australia;
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC 3052, Australia;
| | - Evdokia Dimitriadis
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC 3052, Australia;
- Gynaecology Research Centre, The Royal Women’s Hospital, Melbourne, VIC 3052, Australia
| | - Nadia Alfaidy
- Institut National de la Santé et de la Recherche Médicale U1292, Biologie et Biotechnologie pour la Santé, 38043 Grenoble, France;
- Commissariat à l’Energie Atomique et aux Energies Alternatives (CEA), Biosciences and Biotechnology Institute of Grenoble, 38054 Grenoble, France
- Service Obstétrique & Gynécologie, Centre Hospitalo-Universitaire Grenoble Alpes, University Grenoble-Alpes, CEDEX 9, 38043 Grenoble, France
| | - Sharon D. Ricardo
- Department of Pharmacology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia; (I.A.); (A.C.); (S.S.); (R.W.K.L.); (S.D.R.)
| | - Chrishan S. Samuel
- Department of Pharmacology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia; (I.A.); (A.C.); (S.S.); (R.W.K.L.); (S.D.R.)
| | - Padma Murthi
- Department of Pharmacology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia; (I.A.); (A.C.); (S.S.); (R.W.K.L.); (S.D.R.)
- Department of Maternal-Fetal Medicine Pregnancy Research Centre, The Royal Women’s Hospital, Melbourne, VIC 3052, Australia;
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC 3052, Australia;
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Namoju R, Chilaka NK. Maternal supplementation of α-lipoic acid attenuates prenatal cytarabine exposure-induced oxidative stress, steroidogenesis suppression and testicular damage in F1 male rat fetus. BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2022. [DOI: 10.1186/s43088-022-00240-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cytarabine (Ara-C) is an anticancer drug, which is considered as the mainstay in the treatment of hematological malignancies, known to cause various teratogenic effects. Alpha-lipoic acid (ALA) is a natural antioxidant and its supplementation proved to improve pregnancy outcomes in several pathological conditions. We aimed at exploring the benefits of maternal supplementation of ALA against in-utero Ara-C exposure-induced testicular toxicity in rat fetuses.
Methods
Pregnant rats (dams) received normal saline (control group), ALA 200 mg/kg (ALA group), Ara-C 12.5 mg/kg (Ara-C 12.5 group), Ara-C 25 mg/kg (Ara-C 25 group), and Ara-C 25 mg/kg + ALA 200 mg/kg (protection group) from gestational day (GD)8 to GD21. Ara-C and ALA were administered via the intraperitoneal and oral routes, respectively. The day of parturition was considered as postnatal day (PND)1. On PND1, all the live male pups were collected. The maternal parameters evaluated include (a) food intake, (b) bodyweight, and (c) oxidative stress (OS) markers. The fetal parameters evaluated include (a) bodyweight, (b) anogenital distances (AGD), (c) testicular weight (d) testicular testosterone levels (e) testicular histopathology, and (f) morphometrical parameters.
Results
A significant and dose-dependent decrease in maternal food intake, weight gain, and an increase in oxidative stress (OS) were observed in the pregnant rats of the Ara-C groups as compared to pregnant rats of the control group. Further, a significant and dose-dependent (a) reduction in bodyweight, AGD, testicular weight, and testosterone levels, (b) increase in OS, and (c) structural and morphometrical anomalies in fetal testes were observed in fetuses of Ara-C groups as compared to fetuses of the control rats. These deleterious effects observed in the Ara-C groups were found to be diminished in the pregnant rats and fetuses of the Protection group as compared to the pregnant rats and fetuses of the Ara-C 25 group.
Conclusions
From the results of this study, we conclude that the maternal supplementation of ALA may ameliorate the Ara-C exposure-induced impairment in prenatal development and function of the testes in the rat fetuses. However, future experimental and clinical studies are warranted to explore the possible mechanisms involved in the protection offered by maternal supplementation of ALA against Ara-C induced testicular toxicity.
Graphical Abstract
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10
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Rocha AS, Andrade ARA, Moleiro ML, Guedes-Martins L. Doppler Ultrasound of the Umbilical Artery: Clinical Application. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:519-531. [PMID: 35405757 PMCID: PMC9948152 DOI: 10.1055/s-0042-1743097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To provide a survey of relevant literature on umbilical artery Doppler ultrasound use in clinical practice, technical considerations and limitations, and future perspectives. METHODS Literature searches were conducted in PubMed and Medline, restricted to articles written in English. Additionally, the references of all analyzed studies were searched to obtain necessary information. RESULTS The use of this technique as a routine surveillance method is only recommended for high-risk pregnancies with impaired placentation. Meta-analyses of randomized trials have established that obstetric management guided by umbilical artery Doppler findings can improve perinatal mortality and morbidity. The values of the indices of Umbilical artery Doppler decrease with advancing gestational age; however, a lack of consensus on reference ranges prevails. CONCLUSION Important clinical decisions are based on the information obtained with umbilical artery Doppler ultrasound. Future efforts in research are imperative to overcome the current limitations of the technique.
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Affiliation(s)
- Ana Sá Rocha
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Ana Rosa Araújo Andrade
- Departamento da Mulher e da Medicina Reprodutiva, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto EPE, Porto, Portugal
| | - Maria Lúcia Moleiro
- Departamento da Mulher e da Medicina Reprodutiva, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto EPE, Porto, Portugal
| | - Luís Guedes-Martins
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,Departamento da Mulher e da Medicina Reprodutiva, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto EPE, Porto, Portugal.,Departamento da Mulher e da Medicina Reprodutiva, Centro Materno Infantil do Norte, Unidade de Investigação e Formação, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
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11
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Chand K, Nano R, Wixey J, Patel J. OUP accepted manuscript. Stem Cells Transl Med 2022; 11:372-382. [PMID: 35485440 PMCID: PMC9052430 DOI: 10.1093/stcltm/szac005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/12/2021] [Indexed: 11/25/2022] Open
Abstract
Fetal growth restriction (FGR) occurs when a fetus is unable to grow normally due to inadequate nutrient and oxygen supply from the placenta. Children born with FGR are at high risk of lifelong adverse neurodevelopmental outcomes, such as cerebral palsy, behavioral issues, and learning and attention difficulties. Unfortunately, there is no treatment to protect the FGR newborn from these adverse neurological outcomes. Chronic inflammation and vascular disruption are prevalent in the brains of FGR neonates and therefore targeted treatments may be key to neuroprotection. Tissue repair and regeneration via stem cell therapies have emerged as a potential clinical intervention for FGR babies at risk for neurological impairment and long-term disability. This review discusses the advancement of research into stem cell therapy for treating neurological diseases and how this may be extended for use in the FGR newborn. Leading preclinical studies using stem cell therapies in FGR animal models will be highlighted and the near-term steps that need to be taken for the development of future clinical trials.
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Affiliation(s)
- Kirat Chand
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
| | - Rachel Nano
- Cancer and Ageing Research Program, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Julie Wixey
- Julie Wixey, Faculty of Medicine, Royal Brisbane and Women’s Hospital, The University of Queensland Centre for Clinical Research, Herston 4029 QLD, Australia.
| | - Jatin Patel
- Corresponding authors: Jatin Patel, Translational Research Institute, Queensland University of Technology, 37 Kent Street, Woolloongabba 4102 QLD, Australia.
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12
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Shen Z, Zhu W, Du L. Analysis of Gene Expression Profiles in the Liver of Rats With Intrauterine Growth Retardation. Front Pediatr 2022; 10:801544. [PMID: 35321016 PMCID: PMC8934861 DOI: 10.3389/fped.2022.801544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Intrauterine growth restriction (IUGR) is highly associated with fetal as well as neonatal morbidity, mortality, and an increased risk metabolic disease development later in life. The mechanism involved in the increased risk has not been established. We compared differentially expressed genes between the liver of appropriate for gestational age (AGA) and IUGR rat models and identified their effects on molecular pathways involved in the metabolic syndrome. METHODS We extracted RNA from the liver of IUGR and AGA rats and profiled gene expression by microarray analysis. GO function and KEGG pathway enrichment analyses were conducted using the Search Tool for the Retrieval of Interacting Genes database. Then, the Cytoscape software was used to visualize regulatory interaction networks of IUGR-related genes. The results were further verified via quantitative reverse transcriptase PCR analysis. RESULTS In this study, 815 genes were found to be markedly differentially expressed (fold-change >1.5, p < 0.05) between IUGR and AGA, with 347 genes elevated and 468 suppressed in IUGR, relative to AGA. Enrichment and protein-protein interaction network analyses of target genes revealed that core genes including Ppargc1a, Prkaa2, Slc2a1, Rxrg, and Gcgr, and pathways, including the PPAR signaling pathway and FoxO signaling pathway, had a potential association with metabolic syndrome development in IUGR. We also confirmed that at the mRNA level, five genes involved in glycometabolism were differentially expressed between IUGR and AGA. CONCLUSION Our findings elucidate on differential gene expression profiles in IUGR and AGA. Moreover, they elucidate on the pathogenesis of IUGR-associated metabolic syndromes. The suggested candidates are potential biomarkers and eventually intended to treat them appropriately.
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Affiliation(s)
- Zheng Shen
- Department of Clinical Laboratory, Zhejiang University School of Medicine Children's Hospital, Hangzhou, China.,National Clinical Research Center for Child Health, Hangzhou, China
| | - Weifen Zhu
- Department of Endocrinology, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Lizhong Du
- National Clinical Research Center for Child Health, Hangzhou, China.,Department of Neonatology, Zhejiang University School of Medicine Children's Hospital, Hangzhou, China
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13
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Moradi B, Ghorbani Z, Shirazi M, Gity M, Kazemi MA, Sharifian H, Rahimi Sharbaf F. Comparison of fetal lung maturation in fetuses with intrauterine growth restriction with control group, using lung volume, lung/liver and lung/muscle signal intensity and apparent diffusion coefficient ratios on different magnetic resonance imaging sequences. J Matern Fetal Neonatal Med 2021; 35:8936-8944. [PMID: 34847801 DOI: 10.1080/14767058.2021.2008349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To compare lung volume, lung apparent diffusion coefficient (ADC) and signal intensity ratio (SIR) on different magnetic resonance imaging (MRI) sequences between intrauterine growth restriction (IUGR) fetuses and the control group. MATERIALS AND METHODS 49 IUGR and 58 non-IUGR fetuses were imaged using 3 Tesla MRI units. Total lung volume (TLV), lung/liver SIR (LLSIR) and lung/muscle SIR (LMSIR) in T1 and T2-weighted sequences and lung/liver ADC ratio (LLADCR) and lung/muscle ADC ratio (LMADCR) were assessed. RESULTS LLSIR and LMSIR were significantly higher in the T1-weighted sequence (p-value: .03) and LLADCR and LMADCR were significantly lower on diffusion-weighted imaging (DWI) in IUGR fetuses compared to the control group (p-value: .01). There was no significant difference in SIRs in the T2-weighted sequence between the two groups. Although TLV was increased with gestational age in both groups, it was significantly lower in the IUGR group (mean: 82 ± 22.7 ml vs. 110.8 ± 18 ml, p-value: <.001). CONCLUSION The T1-weighted sequence and DWI seem to be better than the T2-weighted sequence for assessing the faint difference of lung maturity between groups. However, SIR differences were not as meaningful as TLV differences and this could be related to the complex maturation process in IUGR fetuses as the effect of higher endogenous corticosteroids.
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Affiliation(s)
- Behnaz Moradi
- Department of Radiology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohre Ghorbani
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboobeh Shirazi
- Maternal, Fetal and Neonatal Research Center, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Gity
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Kazemi
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.,Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hashem Sharifian
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Rahimi Sharbaf
- Maternal, Fetal and Neonatal Research Center, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
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14
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Kaneko K, Ozawa N, Murashima A. Obstetric anti-phospholipid syndrome: from pathogenesis to treatment. Immunol Med 2021; 45:79-93. [PMID: 34470570 DOI: 10.1080/25785826.2021.1969116] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by clinical manifestations such as thrombosis and obstetric complications with documented persistence of antiphospholipid antibodies (aPLs). Recent studies have revealed that the cause of aPL-related obstetric complications is dysfunction of placental trophoblasts and inflammation of the maternal-fetal interface induced by aPLs, not thrombosis. Although aPLs are associated with recurrence of serious complications during pregnancy, appropriate combination therapy with heparin and low-dose aspirin can improve the course of 70-80% of subsequent pregnancies. Preconception counseling and patient-tailored treatment are fundamental to improving maternal and fetal outcomes. Non-anticoagulant treatments such as hydroxychloroquine and statins are being developed for cases refractory to conventional treatment. Risk factors for thrombosis after pregnancy complications were identified based on the analysis of large databases of obstetric APS.
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Affiliation(s)
- Kayoko Kaneko
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Nobuaki Ozawa
- Division of Reproductive Medicine and Maternal Care/Immunology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Atsuko Murashima
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
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15
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Wolters VERA, Lok CAR, Gordijn SJ, Wilthagen EA, Sebire NJ, Khong TY, van der Voorn JP, Amant F. Placental pathology in cancer during pregnancy and after cancer treatment exposure. Placenta 2021; 111:33-46. [PMID: 34153795 DOI: 10.1016/j.placenta.2021.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 06/03/2021] [Indexed: 01/07/2023]
Abstract
Cancer during pregnancy has been associated with (pathologically) small for gestational age offspring, especially after exposure to chemotherapy in utero. These infants are most likely growth restricted, but sonographic results are often lacking. In view of the paucity of data on underlying pathophysiological mechanisms, the objective was to summarize all studies investigating placental pathology related to cancer(treatment). A systematic search in PubMed/Medline, Embase (OVID) and SCOPUS was conducted to retrieve all studies about placental pathology in cancer during pregnancy or after cancer treatment, published until August 2020. The literature search yielded 5784 unique publications, of which 111 were eligible for inclusion. Among them, three groups of placental pathology were distinguished. First, various histopathologic changes including maternal vascular malperfusion have been reported in pregnancies complicated by cancer and after cancer treatment exposure, which were not specific to type of cancer(treatment). Second, cancer(treatment) has been associated with placental cellular pathology including increased oxidative damage and apoptosis, impaired angiogenesis and genotoxicity. Finally, involvement of the placenta by cancer cells has been described, involving both the intervillous space and rarely villous invasion, with such fetuses are at risk of having metastases. In conclusion, growth restriction is often observed in pregnancies complicated by cancer and its cause can be multifactorial. Placental histopathologic changes, cellular pathology and genotoxicity caused by the cancer(treatment) may each play a role.
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Affiliation(s)
- Vera E R A Wolters
- Department of Gynecologic Oncology and Center for Gynecologic Oncology Amsterdam (CGOA), Netherlands Cancer Institute - Antoni van Leeuwenhoek and University Medical Centers Amsterdam, Plesmanlaan 121, 1066, CX Amsterdam, the Netherlands.
| | - Christine A R Lok
- Department of Gynecologic Oncology and Center for Gynecologic Oncology Amsterdam (CGOA), Netherlands Cancer Institute - Antoni van Leeuwenhoek and University Medical Centers Amsterdam, Plesmanlaan 121, 1066, CX Amsterdam, the Netherlands.
| | - Sanne J Gordijn
- Department of Gynaecology and Obstetrics, University of Groningen, University Medical Center Groningen, CB 20 Hanzeplein 1, 9713, GZ Groningen, the Netherlands.
| | - Erica A Wilthagen
- Scientific Information Service, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066, CX Amsterdam, the Netherlands.
| | - Neil J Sebire
- Department of Paediatric Pathology, NIHR Great Ormond Street Hospital BRC, London, WC1N 3JH, United Kingdom.
| | - T Yee Khong
- SA Pathology, Women's and Children's Hospital, 72 King William Road, North Adelaide, SA5006, Australia.
| | - J Patrick van der Voorn
- Department of Pathology, University Medical Centers Amsterdam, Location VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
| | - Frédéric Amant
- Department of Gynecologic Oncology and Center for Gynecologic Oncology Amsterdam (CGOA), Netherlands Cancer Institute - Antoni van Leeuwenhoek and University Medical Centers Amsterdam, Plesmanlaan 121, 1066, CX Amsterdam, the Netherlands; Department of Oncology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
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16
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Looney P, Yin Y, Collins SL, Nicolaides KH, Plasencia W, Molloholli M, Natsis S, Stevenson GN. Fully Automated 3-D Ultrasound Segmentation of the Placenta, Amniotic Fluid, and Fetus for Early Pregnancy Assessment. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:2038-2047. [PMID: 33460372 PMCID: PMC8154733 DOI: 10.1109/tuffc.2021.3052143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Volumetric placental measurement using 3-D ultrasound has proven clinical utility in predicting adverse pregnancy outcomes. However, this metric cannot currently be employed as part of a screening test due to a lack of robust and real-time segmentation tools. We present a multiclass (MC) convolutional neural network (CNN) developed to segment the placenta, amniotic fluid, and fetus. The ground-truth data set consisted of 2093 labeled placental volumes augmented by 300 volumes with placenta, amniotic fluid, and fetus annotated. A two-pathway, hybrid (HB) model using transfer learning, a modified loss function, and exponential average weighting was developed and demonstrated the best performance for placental segmentation (PS), achieving a Dice similarity coefficient (DSC) of 0.84- and 0.38-mm average Hausdorff distances (HDAV). The use of a dual-pathway architecture improved the PS by 0.03 DSC and reduced HDAV by 0.27 mm compared with a naïve MC model. The incorporation of exponential weighting produced a further small improvement in DSC by 0.01 and a reduction of HDAV by 0.44 mm. Per volume inference using the FCNN took 7-8 s. This method should enable clinically relevant morphometric measurements (such as volume and total surface area) to be automatically generated for the placenta, amniotic fluid, and fetus. The ready availability of such metrics makes a population-based screening test for adverse pregnancy outcomes possible.
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17
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Organ-on-a-chip technology for the study of the female reproductive system. Adv Drug Deliv Rev 2021; 173:461-478. [PMID: 33831478 DOI: 10.1016/j.addr.2021.03.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/11/2021] [Accepted: 03/16/2021] [Indexed: 12/12/2022]
Abstract
Over the past decade, organs-on-a-chip and microphysiological systems have emerged as a disruptive in vitro technology for biopharmaceutical applications. By enabling new capabilities to engineer physiological living tissues and organ units in the precisely controlled environment of microfabricated devices, these systems offer great promise to advance the frontiers of basic and translational research in biomedical sciences. Here, we review an emerging body of interdisciplinary work directed towards harnessing the power of organ-on-a-chip technology for reproductive biology and medicine. The focus of this topical review is to provide an overview of recent progress in the development of microengineered female reproductive organ models with relevance to drug delivery and discovery. We introduce the engineering design of these advanced in vitro systems and examine their applications in the study of pregnancy, infertility, and reproductive diseases. We also present two case studies that use organ-on-a-chip design principles to model placental drug transport and hormonally regulated crosstalk between multiple female reproductive organs. Finally, we discuss challenges and opportunities for the advancement of reproductive organ-on-a-chip technology.
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18
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Intrauterine growth restriction: Clinical consequences on health and disease at adulthood. Reprod Toxicol 2021; 99:168-176. [DOI: 10.1016/j.reprotox.2020.10.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/01/2020] [Accepted: 10/04/2020] [Indexed: 02/06/2023]
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19
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Namoju R, Chilaka NK. Alpha-lipoic acid ameliorates cytarabine-induced developmental anomalies in rat fetus. Hum Exp Toxicol 2020; 40:851-868. [PMID: 33225757 DOI: 10.1177/0960327120975114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Cytarabine (Ara-C) is a nucleoside analogue used in the treatment of cancers and viral infections. It has teratogenic potential and causes a variety of birth defects in fetuses. Alpha-lipoic acid (ALA) is a natural antioxidant offers protection against the developmental toxicity induced by drug- or toxicant-exposure or pathological conditions. This study was aimed at evaluating the protective effect of ALA against Ara-C induced developmental toxicity in rat fetus. Pregnant rats divided into five groups and received normal saline, ALA200 mg/kg, Ara-C12.5 mg/kg, Ara-C25 mg/kg and, Ara-C25 mg/kg plus ALA200 mg/kg respectively from gestational day (GD) 8 to GD14 and sacrificed on GD21. Ara-C treatment led to a significant and dose-dependent decrease in food intake, weight gain, placental weight, and an increase in oxidative stress in pregnant rats. Further, the in-utero exposure to Ara-C led to an increase in fetal mortality, resorptions, oxidative stress, external morphological anomalies and limb abnormalities, and impaired ossification. Co-administration of ALA resulted in amelioration of the footprints of Ara-C induced toxicity in pregnant rats as well as the fetus. These findings indicate that the ALA supplementation offers protection against developmental toxicity caused by Ara-C prenatal exposure in rats.
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Affiliation(s)
- Ramanachary Namoju
- Department of Pharmacology, 78997GITAM Institute of Pharmacy, GITAM Deemed to be University, Vishakhapatnam, Andhra Pradesh, India.,Department of Pharmacology, Bhaskar Pharmacy College, Jawaharlal Nehru Technical University, Hyderabad, Telangana, India
| | - Naga Kavitha Chilaka
- Department of Pharmacology, 78997GITAM Institute of Pharmacy, GITAM Deemed to be University, Vishakhapatnam, Andhra Pradesh, India
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20
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Management Challenges of Metastatic Spinal Cord Compression in Pregnancy. Case Rep Surg 2020; 2020:8891021. [PMID: 33204568 PMCID: PMC7652620 DOI: 10.1155/2020/8891021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/13/2020] [Accepted: 10/24/2020] [Indexed: 11/17/2022] Open
Abstract
Primary and secondary spinal tumours with cord compression often represent a challenging condition for the patient and clinicians alike, even more so during pregnancy. The balance between safe delivery of a healthy baby and management of the mother's disease bears many clinical, psychological, and ethical dilemmas. Pregnancy sets a conflict between the optimal surgical and oncological managements of the mother's tumour and the well-being of her foetus. We followed the CARE guidelines from the EQUATOR Network to report an exemplificative case of a 39-year-old woman with a 10-year history of breast cancer, presenting in the second trimester of her first pregnancy with acute onset severe thoracic spinal instability, causing mechanical pain and weakness in lower limbs. Neuroradiological investigations revealed multilevel spinal deposits with a pathological T10 fracture responsible for spinal cord compression. The patient was adamant that she wanted a continuation of the pregnancy and her baby delivered. After discussion with her oncologist and obstetrician, we agreed to perform emergency spinal surgery—decompression and instrumented fixation. The literature search did not reveal a similar case of spinal metastatic breast cancer undergoing spinal instrumentation and delivery of a healthy baby a few months later. Following the delivery, the patient had further oncological treatment, including chemotherapy and radiotherapy. The paucity of such reports prompted us to present this case and highlight the relevance of a multidisciplinary approach involving obstetrician, oncologist, spinal surgeon, and radiologist to guide the optimal decision-making process.
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21
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Silva JNDA, Monteiro NR, Antunes PA, Favareto APA. Maternal and developmental toxicity after exposure to formulation of chlorothalonil and thiophanate-methyl during organogenesis in rats. AN ACAD BRAS CIENC 2020; 92:e20191026. [PMID: 33206784 DOI: 10.1590/0001-3765202020191026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 01/14/2020] [Indexed: 02/02/2023] Open
Abstract
Chlorothalonil and thiophanate-methyl are fungicides widely used in agriculture. The aim of this study was to assess maternal toxicity and embryotoxic potential of exposure to chlorothalonil and thiophanate-methyl during organogenesis period in rats. Pregnant rats were divided into four groups: control and exposed to 400 (CT400), 800 (CT800) and 1200 mg-1kg bw-1 day (CT1200) of commercial formulation constituted of 200 g of thiophanate-methyl kg-1 and 500 g of chlorothalonil kg-1 by gavage, from 6th to 15th gestational day. Maternal toxicity, liver, kidney and placenta histology, reproductive performance, and external, skeletal and visceral malformations of fetuses were evaluated. Maternal liver weight was decreased in CT1200 group and focal necrosis and microvesicular steatosis, inflammatory infiltrate and hepatocytes with pyknotic nucleus were observed in CT800 and CT1200 groups. Reproductive performance was similar among groups. The percentage of fetuses small for pregnancy age was increase in CT400 and CT800 groups. Moreover, incidence of skeletal anomalies was increased in the three groups exposed to fungicides. Chlorothalonil and thiophanate-methyl exposure showed affect the prenatal development and induce maternal toxicity.
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Affiliation(s)
- Jaqueline N DA Silva
- Universidade do Oeste Paulista/ UNOESTE, Faculdade de Artes, Ciências e Letras de Presidente Prudente/FACLEPP, Rodovia Raposo Tavares, Km 572, Limoeiro, 19067-175 Presidente Prudente, SP, Brazil.,Programa de Pós-Graduação em Meio Ambiente e Desenvolvimento Regional, Universidade do Oeste Paulista/UNOESTE, Rodovia Raposo Tavares, Km 572, Limoeiro, 19067-175 Presidente Prudente, SP, Brazil
| | - Nayara R Monteiro
- Universidade do Oeste Paulista/ UNOESTE, Faculdade de Artes, Ciências e Letras de Presidente Prudente/FACLEPP, Rodovia Raposo Tavares, Km 572, Limoeiro, 19067-175 Presidente Prudente, SP, Brazil
| | - Patricia A Antunes
- Universidade do Oeste Paulista/ UNOESTE, Faculdade de Artes, Ciências e Letras de Presidente Prudente/FACLEPP, Rodovia Raposo Tavares, Km 572, Limoeiro, 19067-175 Presidente Prudente, SP, Brazil
| | - Ana Paula A Favareto
- Programa de Pós-Graduação em Meio Ambiente e Desenvolvimento Regional, Universidade do Oeste Paulista/UNOESTE, Rodovia Raposo Tavares, Km 572, Limoeiro, 19067-175 Presidente Prudente, SP, Brazil
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22
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The Effects of Maternal Metformin Treatment on Late Prenatal and Early Postnatal Development of the Offspring Are Modulated by Sex. Pharmaceuticals (Basel) 2020; 13:ph13110363. [PMID: 33158193 PMCID: PMC7694275 DOI: 10.3390/ph13110363] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 10/31/2020] [Accepted: 11/03/2020] [Indexed: 11/17/2022] Open
Abstract
Metformin is currently used to improve pregnancy outcome in women affected by polycystic ovary syndrome (PCOS) or diabetes. However, metformin may also be useful in pregnancies at risk of intrauterine growth restriction (IUGR) since it improves placental efficiency and the fetuses' developmental competence. There is no data on the duration of the effect of this treatment from the prenatal up to the postnatal stages. Therefore, the present trial aimed at determining the impact of metformin treatment on the offspring neonatal traits and early postnatal development (i.e., during lactation) using an in vivo swine model. The results support that maternal metformin treatment during pregnancy induces protective changes in body shape and composition of the progeny (i.e., larger head size and body length at birth and higher total viscera weight at weaning). However, there were also major effects of the offspring sex (smaller corpulence in females and lower relative weight of main viscerae in males), which should be considered for further preclinical studies and when even the current clinical application in women affected by PCOS or diabetes is implemented.
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23
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Mugnier A, Chastant-Maillard S, Mila H, Lyazrhi F, Guiraud F, Adib-Lesaux A, Gaillard V, Saegerman C, Grellet A. Low and very low birth weight in puppies: definitions, risk factors and survival in a large-scale population. BMC Vet Res 2020; 16:354. [PMID: 32972422 PMCID: PMC7517789 DOI: 10.1186/s12917-020-02577-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 09/17/2020] [Indexed: 11/10/2022] Open
Abstract
Background Neonatal mortality (over the first three weeks of life) is a major concern in canine breeding facilities as an economic and welfare issue. Since low birth weight (LBW) dramatically increases the risk of neonatal death, the risk factors of occurrence need to be identified together with the chances and determinants of survival of newborns at-risk. Results Data from 4971 puppies from 10 breeds were analysed. Two birth weight thresholds regarding the risk of neonatal mortality were identified by breed, using respectively Receiver Operating Characteristics and Classification and Regression Tree method. Puppies were qualified as LBW and very low birth weight (VLBW) when their birth weight value was respectively between the two thresholds and lower than the two thresholds. Mortality rates were 4.2, 8.8 and 55.3%, in the normal, LBW and VLBW groups, accounting for 48.7, 47.9 and 3.4% of the included puppies, respectively. A separate binary logistic regression approach allowed to identify breed, gender and litter size as determinants of LBW. The increase in litter size and being a female were associated with a higher risk for LBW. Survival for LBW puppies was reduced in litters with at least one stillborn, compared to litters with no stillborn, and was also reduced when the dam was more than 6 years old. Concerning VLBW puppies, occurrence and survival were influenced by litter size. Surprisingly, the decrease in litter size was a risk factor for VLBW and also reduced their survival. The results of this study suggest that VLBW and LBW puppies are two distinct populations. Moreover, it indicates that events and factors affecting intrauterine growth (leading to birth weight reduction) also affect their ability to adapt to extrauterine life. Conclusion These findings could help veterinarians and breeders to improve the management of their facility and more specifically of LBW puppies. Possible recommendations would be to only select for reproduction dams of optimal age and to pay particular attention to LBW puppies born in small litters. Further studies are required to understand the origin of LBW in dogs.
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Affiliation(s)
- Amélie Mugnier
- NeoCare, Université de Toulouse, ENVT, 23 Chemin des Capelles, Toulouse, France
| | | | - Hanna Mila
- NeoCare, Université de Toulouse, ENVT, 23 Chemin des Capelles, Toulouse, France
| | - Faouzi Lyazrhi
- Biostatistiques, Université de Toulouse, ENVT, 23 Chemin des Capelles, Toulouse, France
| | - Florine Guiraud
- NeoCare, Université de Toulouse, ENVT, 23 Chemin des Capelles, Toulouse, France
| | | | - Virginie Gaillard
- Royal Canin, 650 Avenue de la Petite Camargue, 30470, Aimargues, France
| | - Claude Saegerman
- UREAR-ULiège, FARAH Center, Faculté de Médecine Vétérinaire, Université de Liège, B42, Quartier Vallée 2, Avenue de Cureghem 7A, 4000, Liège, Belgium
| | - Aurélien Grellet
- NeoCare, Université de Toulouse, ENVT, 23 Chemin des Capelles, Toulouse, France.
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Ma L, Tian MX, Sun QY, Liu NN, Dong JF, Feng K, Wu YK, Wang YX, Wang GY, Chen W, Xi JJ, Kang JH. Fetal growth restriction mice are more likely to exhibit depression-like behaviors due to stress-induced loss of dopaminergic neurons in the VTA. FASEB J 2020; 34:13257-13271. [PMID: 32860269 DOI: 10.1096/fj.202000534r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/05/2020] [Accepted: 07/16/2020] [Indexed: 11/11/2022]
Abstract
Fetal growth restriction (FGR) is a severe perinatal complication that can increase risk for mental illness. To investigate the mechanism by which FGR mice develop mental illness in adulthood, we established the FGR mouse model and the FGR mice did not display obvious depression-like behaviors, but after environmental stress exposure, FGR mice were more likely to exhibit depression-like behaviors than control mice. Moreover, FGR mice had significantly fewer dopaminergic neurons in the ventral tegmental area but no difference in serotoninergic neurons in the dorsal raphe. RNA-seq analysis showed that the downregulated genes in the midbrain of FGR mice were associated with many mental diseases and were especially involved in the regulation of NMDA-selective glutamate receptor (NMDAR) activity. Furthermore, the NMDAR antagonist memantine can relieve the stress-induced depression-like behaviors of FGR mice. In summary, our findings provide a theoretical basis for future research and treatment of FGR-related depression.
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Affiliation(s)
- Li Ma
- Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Collaborative Innovation Center for Brain Science, School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Meng-Xue Tian
- Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Collaborative Innovation Center for Brain Science, School of Life Sciences and Technology, Tongji University, Shanghai, China.,Institute of Translational Research, Tongji Hospital, School of Life Sciences and Technology, Shanghai Key Laboratory of Signaling and Disease Research, Collaborative Innovation Center for Brain Science, Tongji University, Shanghai, China
| | - Qiao-Yi Sun
- Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Collaborative Innovation Center for Brain Science, School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Na-Na Liu
- Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Collaborative Innovation Center for Brain Science, School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Jian-Feng Dong
- Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Collaborative Innovation Center for Brain Science, School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Ke Feng
- Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Collaborative Innovation Center for Brain Science, School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Yu-Kang Wu
- Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Collaborative Innovation Center for Brain Science, School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Yu-Xi Wang
- Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Collaborative Innovation Center for Brain Science, School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Gui-Ying Wang
- Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Collaborative Innovation Center for Brain Science, School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Wen Chen
- Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Collaborative Innovation Center for Brain Science, School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Jia-Jie Xi
- Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Collaborative Innovation Center for Brain Science, School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Jiu-Hong Kang
- Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Collaborative Innovation Center for Brain Science, School of Life Sciences and Technology, Tongji University, Shanghai, China
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Bæk O, Ren S, Brunse A, Sangild PT, Nguyen DN. Impaired Neonatal Immunity and Infection Resistance Following Fetal Growth Restriction in Preterm Pigs. Front Immunol 2020; 11:1808. [PMID: 32903565 PMCID: PMC7438575 DOI: 10.3389/fimmu.2020.01808] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/07/2020] [Indexed: 02/01/2023] Open
Abstract
Background: Infants born preterm or small for gestational age (SGA, due to fetal growth restriction) both show an increased risk of neonatal infection. However, it remains unclear how the co-occurrence of preterm birth and SGA may affect neonatal immunity and infection risk. We hypothesized that fetal growth restricted (FGR) preterm newborns possess impaired immune competence and increased susceptibility to systemic infection and sepsis, relative to corresponding normal birth weight (NBW) newborns. Methods: Using preterm pigs as a model for preterm infants, gene expression in lipopolysaccharide (LPS) stimulated cord blood was compared between NBW and FGR (lowest 25% birth weight percentile) preterm pigs. Next, clinical responses to a systemic Staphylococcus epidermidis (SE) challenge were investigated in newborn FGR and NBW preterm pigs. Finally, occurrence of spontaneous infections were investigated in 9 d-old FGR and NBW preterm pigs, with or without neonatal antibiotics treatment. Results: At birth, preterm FGR piglets showed diminished ex vivo cord blood responses to LPS for genes related to both innate and adaptive immunity, and also more severe septic responses following SE infection (e.g., higher blood lactate, decreased blood pH, neutrophil and platelet counts, relative to NBW pigs). After 9 d, FGR pigs had higher incidence and severity of spontaneous infections (e.g., higher bacterial densities in the bone marrow), increased regulatory T cell numbers, reduced neutrophil phagocytosis capacity, and impaired ex vivo blood gene responses to LPS, especially when receiving neonatal antibiotics. Conclusion: FGR at preterm birth is associated with poor immune competence, impaired infection resistance, and greater sepsis susceptibility in the immediate postnatal period. Our results may explain the increased morbidity and mortality of SGA preterm infants and highlight the need for clinical vigilance for this highly sensitive subgroup of preterm neonates.
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Affiliation(s)
- Ole Bæk
- Section for Comparative Pediatrics and Nutrition, University of Copenhagen, Copenhagen, Denmark
| | - Shuqiang Ren
- Section for Comparative Pediatrics and Nutrition, University of Copenhagen, Copenhagen, Denmark
| | - Anders Brunse
- Section for Comparative Pediatrics and Nutrition, University of Copenhagen, Copenhagen, Denmark
| | - Per Torp Sangild
- Section for Comparative Pediatrics and Nutrition, University of Copenhagen, Copenhagen, Denmark
| | - Duc Ninh Nguyen
- Section for Comparative Pediatrics and Nutrition, University of Copenhagen, Copenhagen, Denmark
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The impact of intrauterine growth restriction on cytochrome P450 enzyme expression and activity. Placenta 2020; 99:50-62. [PMID: 32755725 DOI: 10.1016/j.placenta.2020.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/14/2020] [Indexed: 01/16/2023]
Abstract
With the increased prevalence of non-communicable disease and availability of medications to treat these and other conditions, a pregnancy free from prescribed medication exposure is rare. Up to 99% of women take at least one medication during pregnancy. These medications can be divided into those used to improve maternal health and wellbeing (e.g., analgesics, antidepressants, antidiabetics, antiasthmatics), and those used to promote the baby's wellbeing in either fetal (e.g., anti-arrhythmics) or postnatal life (e.g., antenatal glucocorticoids). These medications are needed for pre-existing or coincidental illnesses in the mother, maternal conditions induced by the pregnancy itself through to conditions that arise in the fetus or that will be encountered by the newborn. Thus, medications administered to the mother may be used to treat the mother, the fetus or both. Metabolism of medications is regulated by a range of physiological processes that change during pregnancy. Other pathological processes such as placental insufficiency can in turn have both immediate and lifelong adverse health consequences for babies. Individuals born growth restricted are more likely to require medications but may also have an altered ability to metabolise these medications in fetal and postnatal life. This review aims to determine the effect of suboptimal fetal growth on the fetal expression of the drug metabolising enzymes (DMEs) that convert medications into active or inactive metabolites, and the transporters that remove both these medications and their metabolites from the fetal compartment.
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Aski SK, Akbari R, Hantoushzadeh S, Ghotbizadeh F. A bibliometric analysis of Intrauterine Growth Restriction research. Placenta 2020; 95:106-120. [PMID: 32452397 DOI: 10.1016/j.placenta.2020.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/24/2020] [Indexed: 12/15/2022]
Abstract
Intrauterine growth restriction (IUGR) is not a new subject in pregnancy. Nevertheless, this concept has newly begun to be integrated into pregnancy studies. We recognized articles that were published in English from 1977 to 2019 through electronic searches of the Web of Science™ database. The WoS database was searched for all published articles that compared preeclampsia from 1977 to January 2020. About 1469 documents in obstetrics and gynecology areas were analyzed in WoS database. VOSviewer software was employed to visualize the networks. The survey resulted in a 1469 published documents from 1977 to 2020. 'Gratacos' from Spain and 'Cetin' from Italy contributed the most publications. The greatest contribution came from the 'USA' (n = 498), 'Italy' (n = 155), and 'England' (n = 147). Furthermore, our results found that among these journals, the 'AJOG' (n = 318) and the 'Reproductive Sciences' (n = 209) published the largest number of papers. The top 100 most cited papers showed that 30% were reported in the 'AJOG'. About half the articles were published in the last decade and the most common studies were research paper (77%). The co-occurrence and co-citation analysis showed that the study formed four clusters. Finally, the strategic map was designed. We found that there existed an increasing trend in the large amount of publication on IUGR from 1977 to 2020. The number of studies in IUGR has substantially improved in the last decade. Authors from the 'USA' appeared the most proactive in addressing the IUGR area. By studying these articles, we propose important to support not only for grinding the IUGR challenges field but also for designing a new trend in this area.
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Affiliation(s)
- Soudabeh Kazemi Aski
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Rasht, Iran.
| | - Razieh Akbari
- Department of Obstetrics and Gynecology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sedigheh Hantoushzadeh
- Department of Obstetrics and Gynecology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fahimeh Ghotbizadeh
- Department of Obstetrics and Gynecology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Zhang L, Zhang J, Yan E, He J, Zhong X, Zhang L, Wang C, Wang T. Dietary Supplemented Curcumin Improves Meat Quality and Antioxidant Status of Intrauterine Growth Retardation Growing Pigs via Nrf2 Signal Pathway. Animals (Basel) 2020; 10:ani10030539. [PMID: 32213933 PMCID: PMC7143559 DOI: 10.3390/ani10030539] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/06/2020] [Accepted: 03/20/2020] [Indexed: 02/07/2023] Open
Abstract
Simple Summary More than 15% of piglets and about 10% of newborn humans suffer from intrauterine growth retardation (IUGR), which refers to growth lag, developmental restriction and impaired organs in the fetus. IUGR exhibits programming consequences and exerts permanent negative effects on postnatal growth and health. Dietary supplemented curcumin, as the main natural polyphenol isolated from the natural antioxidant (turmeric), might show possible effects on antioxidant capacity, and the meat quality of IUGR pigs. Therefore, in our present study, 12 normal birth weight (NBW) and 24 IUGR neonatal female piglets were selected and fed control diets supplemented 0 (NBW), 0 (IUGR) and 200 (IUGR + Cur) mg/kg curcumin from 26 to 115 days of age (n = 12). The growth performance, meat quality, redox status and its related Nrf2 pathway were determined to test the hypothesis that curcumin may play beneficial roles against IUGR-induced oxidative stress. This study suggested that curcumin could serve as a potential natural antioxidant in nutrition interventions of IUGR offspring to enhance the redox status and improve the meat quality of leg muscles. These results attained from IUGR pig models can also provide some useful theoretical references for IUGR offspring in humans. Abstract Intrauterine growth retardation (IUGR) exhibits programming consequences and may induce oxidative stress in growing animals and humans. This study was conducted to investigate the hypothesis that dietary curcumin may protect growing pigs from IUGR-induced oxidative stress via the Nrf2 pathway. Twelve normal birth weight (NBW) and 24 IUGR female piglets were selected and fed control diets supplemented 0 (NBW), 0 (IUGR) and 200 (IUGR + Cur) mg/kg curcumin from 26 to 115 days of age (n = 12). Growth performance, meat quality, redox status and its related Nrf2 pathway were determined. Results showed that IUGR pigs exhibited decreased body weight on 0 d, 26 d and 56 d (p < 0.01) but had no difference on 115 d among NBW, IUGR and IUGR + Cur groups (p > 0.05). Compared with NBW and IUGR groups, a significant decrease in drip loss (24 h and 48 h) was observed in the IUGR + Cur group (p < 0.01). IUGR pigs had higher concentrations of malondialdehyde (MDA) (p < 0.01) and protein carbonyl (PC) (p = 0.03) and lower activities of glutathione peroxidase (p = 0.02), catalase (p < 0.01) and peroxidase (p = 0.02) in leg muscles than NBW pigs. Dietary-added 200 mg/kg curcumin decreased concentrations of MDA and PC and improved the activities of catalase, superoxide dismutase (SOD) and peroxidase as compared to the IUGR group (p < 0.05). Additionally, dietary curcumin enhanced protein (NQO1) and mRNA expression of genes (Nrf2, NQO1, gamma-glutamyltransferase 1 (GGT1), heme oxygenase-1 (HO-1), glutathione S-transferase (GST) and catalase (CAT)) as compared to the IUGR group (p < 0.05). These results suggest that dietary curcumin could serve as a potential additive to enhance redox status and improve meat quality of IUGR growing pigs via the Nrf2 signal pathway.
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Affiliation(s)
| | | | | | | | | | | | - Chao Wang
- Correspondence: (C.W.); (T.W.); Tel.: +86-0258-439-6483 (C.W.); +86-0258-439-6195 (T.W.)
| | - Tian Wang
- Correspondence: (C.W.); (T.W.); Tel.: +86-0258-439-6483 (C.W.); +86-0258-439-6195 (T.W.)
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Briana DD, Fotakis C, Kontogeorgou A, Gavrili S, Georgatzi S, Zoumpoulakis P, Malamitsi-Puchner A. Early Human-Milk Metabolome in Cases of Intrauterine Growth-Restricted and Macrosomic Infants. JPEN J Parenter Enteral Nutr 2020; 44:1510-1518. [PMID: 32026505 DOI: 10.1002/jpen.1783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/07/2019] [Accepted: 12/17/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Abnormal fetal growth is associated with short-term and long-term metabolic dysregulation and susceptibility to obesity-related disorders. Maternal milk, the ideal source of infantile nutrition, protects from metabolic diseases in adulthood. By applying nuclear magnetic resonance (NMR) metabolomics, this study investigated the metabolic profile of early human milk/colostrum (EHM/C) at the extremes of fetal-growth conditions, which could affect its nutritional value. METHODS From 98 mothers delivering 60 appropriate-for-gestational-age (AGA), 19 large-for-gestational-age (LGA), and 19 intrauterine growth-restricted (IUGR) full-term neonates, milk samples collected on the third to fourth day post partum were examined by NMR spectroscopy. Multivariate data analysis elicited information from NMR spectra and probed to metabolic signatures of EHM/C. RESULTS LGA and IUGR EHM/C samples depicted increased content in lactose, citric acid, choline, phosphocholine, and N-acetylglutamine. AGA samples exhibited increased isoleucine and valine. Metabolic pathways involved were valine, leucine/isoleucine biosynthesis and degradation, glycerophospholipid metabolism, aminoacyl-transfer RNA biosynthesis, and citrate cycle. Orthogonal projections to latent structures discriminant analysis models were validated. CONCLUSION This holistic metabolomics study framed an increased content of certain essential nutrients in EHM/C samples following the birth of LGA and IUGR infants prone to short- and long-term metabolic disorders, thus stressing additional benefits of early breastfeeding. Assessing the metabolic profile of EHΜ/C enables evaluation of its nutrition value, adjusted to fetal growth, and introduction of appropriate dietary interventions.
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Affiliation(s)
- Despina D Briana
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalambos Fotakis
- Institute of Biology, Medicinal Chemistry and Biotechnology, National Hellenic Research Foundation, Athens, Greece
| | - Anna Kontogeorgou
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavroula Gavrili
- Neonatal Intensive Care Unit, "Alexandra" University and State Maternity Hospital, Athens, Greece
| | - Sophia Georgatzi
- Neonatal Intensive Care Unit, "Alexandra" University and State Maternity Hospital, Athens, Greece
| | - Panagiotis Zoumpoulakis
- Institute of Biology, Medicinal Chemistry and Biotechnology, National Hellenic Research Foundation, Athens, Greece
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Zhang J, Xu W, Han H, Zhang L, Wang T. Dietary Leucine Supplementation Restores Serum Glucose Levels, and Modifying Hepatic Gene Expression Related to the Insulin Signal Pathway in IUGR Piglets. Animals (Basel) 2019; 9:ani9121138. [PMID: 31847151 PMCID: PMC6941017 DOI: 10.3390/ani9121138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Intrauterine malnutrition may compromise the size and structure of fetal organs and tissues, which leads to lower birth weight and a slower rate of growth after weaning. Intrauterine growth restriction/retardation (IUGR) impairs pancreas function, resulting in the decreased glucose levels in serum. Leucine, one of branched chain amino acids, is an essential amino acid and the substrate of protein synthesis. Leucine also acts as a major regulator of hormone signal transduction, like insulin. Dietary branched chain amino acids or leucine have beneficial effects on the glucose metabolism and glycogen synthesis of muscle. Leucine supplementation improves the insulin sensitivity in liver and muscle and then influences the systemic glucose homeostasis. However, it is still unclear whether leucine supplementation would alter insulin sensitivity in IUGR neonatal piglets. Our results showed that dietary leucine supplementation restored serum glucose concentrations, increased insulin and creatinine concentrations, and enhanced protein kinase adenosine monophosphate-activated γ 3-subunit and glucose transporter type 2 expression. These findings suggest that leucine might play a positive role in hepatic lipid metabolism and glucose metabolism in IUGR. Abstract This study aimed to investigate the effects of leucine with different levels on the insulin resistance in intrauterine growth restriction/retardation (IUGR) piglets. Thirty-two weaned piglets were arranged in a 2 × 2 factorial design and four treatments (n = 8) were as follow: (1) normal weaned piglets fed a basal diet (CONT), (2) IUGR weaned piglets fed a basal diet (IUGR), (3) normal weaned piglets fed a basal diet with the addition of 0.35% l-leucine (C-LEU), and (4) IUGR fed a basal diet with the addition of 0.35% l-leucine (I-LEU) for a 21-days trial. The results showed that compared to the IUGR group, the I-LEU group had higher final body weight and body weight gain, higher serum glucose concentrations, and higher serum insulin concentrations (p < 0.05). The gene expression of phosphatidylinositol 3-kinase p110 gamma, protein kinase adenosine monophosphate-activated γ 3-subunit, glycogen synthase kinase-3 alpha, and glucose transporter type 2 were increased in the I-LEU group as compared to the IUGR group (p < 0.05). It was concluded that dietary leucine supplementation restored serum glucose concentrations, increased insulin and creatinine concentrations, and enhanced protein kinase adenosine monophosphate-activated γ 3-subunit and glucose transporter type 2 expression, suggesting that leucine might play a positive role in hepatic lipid metabolism and glucose metabolism in IUGR.
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Affiliation(s)
| | | | | | | | - Tian Wang
- Correspondence: ; Tel./Fax: +86-25-84395156
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Igboanugo S, Chen A, Mielke JG. Maternal risk factors for birth asphyxia in low-resource communities. A systematic review of the literature. J OBSTET GYNAECOL 2019; 40:1039-1055. [PMID: 31825270 DOI: 10.1080/01443615.2019.1679737] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Birth asphyxia (BA) affects millions of newborns annually, especially in low-resource communities. Given that much of the attention to this point has focussed upon secondary prevention, we sought to inform the development of primary prevention strategies for BA in resource-limited settings by identifying maternal risk factors. To this end, we systematically reviewed the MEDLINE, PsychInfo, and EMBASE databases, and identified 38 relevant studies. Upon analysis, we found 12 maternal variables associated with BA, and thematically arranged them into 3 categories: sociodemographic factors (age, literacy, gravidity, parity), health care factors (antenatal care, delivery location), and health status (hypertension, pre-eclampsia, eclampsia, anaemia, antepartum haemorrhage, pyrexia). The factors with the greatest, and/or most consistent influence upon likelihood for BA were: young maternal age (<20 years), limited maternal literacy, insufficient antenatal care, non-hospital delivery, maternal hypertension, and anaemia. We hope our review will assist stakeholders guiding the development of BA-related policies and programmes.
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Affiliation(s)
- Somkene Igboanugo
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Alice Chen
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - John G Mielke
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
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Hines EA, Romoser MR, Kiefer ZE, Keating AF, Baumgard LH, Niemi J, Haberl B, Williams NH, Kerr BJ, Touchette KJ, Ross JW. The impact of dietary supplementation of arginine during gestation in a commercial swine herd: II. Offspring performance. J Anim Sci 2019; 97:3626-3635. [PMID: 31505650 DOI: 10.1093/jas/skz214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Indexed: 12/27/2022] Open
Abstract
Arginine (Arg) is an important amino acid of pig fetal development; however, whether Arg improves postnatal performance is ill-defined. Therefore, the influence of Arg supplementation at different gestational stages on offspring performance was evaluated in a commercial swine herd. Sows (n = 548) were allocated into 4, diet by stage of gestation treatments: Control (n = 143; 0% suppl. Arg), or dietary treatments supplemented with 1% L-Arg (free-base; Ajinomoto Animal Nutrition North America, Inc., Chicago, IL): from 15 to 45 d of gestation (n = 138; Early-Arg); 15 d of gestation to farrowing (n = 139; Full-Arg); and from day 85 of gestation to farrowing (n = 128; Late-Arg). All offspring were individually identified and weighed at birth; at weaning, a subset was selected for evaluation of carcass performance at market. All data were analyzed using birth weight (BiWt) and age as covariates. Wean weights (WW) and prewean (PW) ADG tended to increase (P = 0.06) in progeny from sows supplemented with Arg, as compared to progeny from Control sows. Preplanned contrast comparisons revealed an increased (P = 0.03) BiWt for pigs from sows receiving 1% L-Arg prior to day 45 of gestation (Early-Arg and Full-Arg; 1.38 kg/pig), as compared to pigs from sows not supplemented prior to day 45 of gestation (Control and Late-Arg; 1.34 kg/pig). No difference in BiWt was observed (1.36 kg/pig; P = 0.68) for Arg supplementation after day 85 of gestation (Full-Arg and Late-Arg), as compared to those not receiving Arg supplementation after day 85 (Control and Early-Arg); although WW and PW ADG were greater (P = 0.02), respectively. A 3.6% decrease (P = 0.05) in peak lean accretion ADG occurred when dams received 1% L-Arg prior to day 45 of gestation (Early-Arg and Full-Arg), however, no other significant differences were detected in finishing growth parameters or carcass characteristics (P ≥ 0.1). Pig mortality rates tended (P = 0.07) to decrease in progeny of dams supplemented Arg after day 85 (3.6%) compared to dams not provided additional Arg during late gestation (4.9%). Collectively, these data suggest that Arg provided during late gestation may improve WW and PW ADG, however, finishing performance was not affected. While Arg supplementation provided some moderate production benefits, further investigation is warranted to comprehensively understand the gestational timing and biological role of Arg supplementation during fetal and postnatal development in commercial production systems.
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Affiliation(s)
| | | | - Zoë E Kiefer
- Department of Animal Science, Iowa State University, Ames, IA
| | | | | | - Jarad Niemi
- Department of Statistics, Iowa State University, Ames, IA
| | | | | | - Brian J Kerr
- USDA-ARS-National Laboratory for Agriculture and the Environment, Ames, IA
| | | | - Jason W Ross
- Department of Animal Science, Iowa State University, Ames, IA
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Magnetic Resonance Imaging in Pregnancy with Intrauterine Growth Restriction: A Pilot Study. DISEASE MARKERS 2019; 2019:4373490. [PMID: 31827633 PMCID: PMC6881754 DOI: 10.1155/2019/4373490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 10/22/2019] [Indexed: 11/30/2022]
Abstract
Objective Intrauterine growth restriction (IUGR) is a major cause of late stillbirth, though not all compromised babies remain small or are considered growth restricted as pregnancy progresses. Fetal Magnetic Resonance Imaging (f-MRI) represents a second-line tool to study pregnancies with IUGR fetuses. The aim of our study was to evaluate the usefulness of f-MRI on predicting fetal growth and the offspring's perinatal respiratory outcome. Design All f-MRI performed between 2014 and 2016 in Siena were analysed. Pregnancies with IUGR (Study group (SG)) were recruited together with a control population (Control group (CG)), coupled for gestational age (GA) at the time of f-MRI (mean GA 31 wks). Neonatal information was collected. The f-MRI protocol consisted of T2w images. Six regions of interest (ROI) were placed as follows: 2 on the lung, 2 on the liver, and 2 on the amniotic fluid. The signal intensities (SI) of each ROI were measured. The SI lung to liver ratio (SI lung/liver) and SI lung to amniotic fluid ratio (SI lung/amniotic fluid) were obtained for each fetus. Each ratio was compared between SG and CG. Therefore, SG was divided into two subgroups: adequate and small for gestational age (AGA and SGA) newborns. All measurements were related to offspring's perinatal respiratory outcome. Results SI lung/liver was linearly related with GA at the time of f-MRI and with EFW. SI lung/amniotic fluid was significantly higher in SG than in CG (p = 0,014). In contrast, among SG, lower values of SI lung/amniotic fluid were found in the SGA compared to AGA (p = 0,036). The days of oxygen supply were higher in the SGA subgroup than in the AGA subgroup (p = 0,028). Conclusions SI lung/liver increases with fetal lung maturation and appears to be useful to estimate intrauterine fetal growth. SI lung/amniotic fluid seems to be a reliable predictive index to distinguish the IUGR fetuses that can recover their growth from those that were born SGA. f-MRI represents a promising frontier to predict IUGR fetus outcome, thus contributing to ameliorate the perinatal management.
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Lopez-Tello J, Arias-Alvarez M, Gonzalez-Bulnes A, Sferuzzi-Perri AN. Models of Intrauterine growth restriction and fetal programming in rabbits. Mol Reprod Dev 2019; 86:1781-1809. [PMID: 31538701 DOI: 10.1002/mrd.23271] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 09/02/2019] [Indexed: 12/23/2022]
Abstract
Intrauterine growth restriction (IUGR) affects approximately 10% of human pregnancies globally and has immediate and life-long consequences for offspring health. However, the mechanisms underlying the pathogenesis of IUGR and its association with later health and disease outcomes are poorly understood. To address these knowledge gaps, the use of experimental animals is critically important. Since the 50's different environmental, pharmacological, and surgical manipulations have been performed in the rabbit to improve our knowledge of the control of fetal growth, fetal responses to IUGR, and mechanisms by which offspring may be programmed by an adverse gestational environment. The purpose of this review is therefore to summarize the utility of the rabbit as a model for IUGR research. It first summarizes the knowledge of prenatal and postnatal development in the rabbit and how these events relate to developmental milestones in humans. It then describes the methods used to induce IUGR in rabbits and the knowledge gained about the mechanisms determining prenatal and postnatal outcomes of the offspring. Finally, it discusses the application of state of the art approaches in the rabbit, including high-resolution ultrasound, magnetic resonance imaging, and gene targeting, to gain a deeper integrative understanding of the physiological and molecular events governing the development of IUGR. Overall, we hope to engage and inspire investigators to employ the rabbit as a model organism when studying pregnancy physiology so that we may advance our understanding of mechanisms underlying IUGR and its consequences in humans and other mammalian species.
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Affiliation(s)
- Jorge Lopez-Tello
- Department of Physiology, Development, and Neuroscience, Centre for Trophoblast Research, University of Cambridge, Cambridge, UK
| | - Maria Arias-Alvarez
- Department of Animal Production. Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, Madrid, Spain
| | | | - Amanda N Sferuzzi-Perri
- Department of Physiology, Development, and Neuroscience, Centre for Trophoblast Research, University of Cambridge, Cambridge, UK
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Karlı P, Özdemir AZ, Ayan D. Maternal Serum and Fetal Cord Blood C-Reactive Protein Levels but not Procalcitonin Levels Are Increased in Idiopathic Intrauterine Growth Restriction. Med Sci Monit 2019; 25:6512-6517. [PMID: 31469126 PMCID: PMC6738000 DOI: 10.12659/msm.917397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of the present study was to compare procalcitonin and CRP levels in maternal serum and fetal cord blood samples of patients with idiopathic intrauterine growth restriction (IUGR) vs. a control group of appropriate for gestational age (AGA) infants. MATERIAL AND METHODS The present prospective study included 43 patients: 27 patients with idiopathic IUGR (IUGR group) and 26 AGA infants at similar gestational ages (control group). Maternal serum and fetal cord blood samples were collected from the control group and IUGR group at time of delivery. Procalcitonin and CRP levels were analyzed in maternal blood. Procalcitonin and CRP levels were analyzed in fetal cord blood. RESULTS The median value of CRP levels in maternal blood was 47.5 mg/dl in the IUGR group and 15.255 mg/dl in the AGA group (p=0.001). The mdian CRP level in cord blood was 36.4 mg/dl (range, 17.3-47.2) in the IUGR group and 10.1 mg/dl (range, 4.07-16.5) in the control group, and the difference was statistically significant (p=0.001). The median maternal serum procalcitonin level was 0.05 µg/l in the IUGR group and 0.04 µg/l in the AGA group, and the difference was not statistically significant (p=0.435). The median procalcitonin value in fetal cord blood was 0.06 µg/l in the IUGR group and 0.04 µg/l in the AGA group, and the difference was not statistically significant (p=0.741). CONCLUSIONS Maternal serum and fetal cord CRP levels were higher in the IUGR group; however, there was no difference in procalcitonin, which is another inflammatory indicator, between the groups.
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Affiliation(s)
- Pervin Karlı
- Department of Obstetrics and Gynecology, Amasya University, Amasya, Turkey
| | - Ayşe Z Özdemir
- Department of Obstetrics and Gynecology, Ondokuz Mayis University IVF Center, Ondokuz Mayis University Hospital, Samsun, Turkey
| | - Durmuş Ayan
- Department of Biochemistry, Amasya Central Public Health Laboratory, Amasya, Turkey
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Paz AA, Arenas GA, Castillo-Galán S, Peñaloza E, Cáceres-Rojas G, Suazo J, Herrera EA, Krause BJ. Premature Vascular Aging in Guinea Pigs Affected by Fetal Growth Restriction. Int J Mol Sci 2019; 20:ijms20143474. [PMID: 31311132 PMCID: PMC6678381 DOI: 10.3390/ijms20143474] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/05/2019] [Accepted: 07/13/2019] [Indexed: 12/16/2022] Open
Abstract
Cardiovascular risk associated with fetal growth restriction (FGR) could result from an early impaired vascular function. However, whether this effect results in premature vascular aging has not been addressed. We studied the ex vivo reactivity of carotid and femoral arteries in fetal (near term), adults (eight months-old) and aged (16 months-old) guinea pigs in normal (control) and FGR offspring. Additionally, an epigenetic marker of vascular aging (i.e., LINE-1 DNA methylation) was evaluated in human umbilical artery endothelial cells (HUAEC) from control and FGR subjects. Control guinea pig arteries showed an increased contractile response (KCl-induced) and a progressive impairment of NO-mediated relaxing responses as animals get older. FGR was associated with an initial preserved carotid artery reactivity as well as a later significant impairment in NO-mediated responses. Femoral arteries from FGR fetuses showed an increased contractility but a decreased relaxing response compared with control fetuses, and both responses were impaired in FGR-adults. Finally, FGR-HUAEC showed decreased LINE-1 DNA methylation compared with control-HUAEC. These data suggest that the aging of vascular function occurs by changes in NO-mediated responses, with limited alterations in contractile capacity. Further, these effects are accelerated and imposed at early stages of development in subjects exposed to a suboptimal intrauterine environment.
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Affiliation(s)
- Adolfo A Paz
- Department of Neonatology, Division of Paediatrics, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 391, Santiago 8330024, Santiago, Chile
| | - German A Arenas
- Department of Neonatology, Division of Paediatrics, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 391, Santiago 8330024, Santiago, Chile
- Programa de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Alameda 340, Santiago 8330024, Santiago, Chile
| | - Sebastián Castillo-Galán
- Department of Neonatology, Division of Paediatrics, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 391, Santiago 8330024, Santiago, Chile
- Programa de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Alameda 340, Santiago 8330024, Santiago, Chile
| | - Estefanía Peñaloza
- Department of Neonatology, Division of Paediatrics, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 391, Santiago 8330024, Santiago, Chile
| | - Gabriela Cáceres-Rojas
- Instituto de Investigación en Ciencias Odontológicas, Facultad de Odontología, Universidad de Chile, Sergio Livingstone 943, Independencia 8380492, Santiago, Chile
| | - José Suazo
- Instituto de Investigación en Ciencias Odontológicas, Facultad de Odontología, Universidad de Chile, Sergio Livingstone 943, Independencia 8380492, Santiago, Chile
| | - Emilio A Herrera
- Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Av. Salvador 486, Providencia 7500922, Santiago, Chile
- International Center for Andean Studies (INCAS), Universidad de Chile, Baquedano s/n, Putre, Chile
| | - Bernardo J Krause
- Department of Neonatology, Division of Paediatrics, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 391, Santiago 8330024, Santiago, Chile.
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Mathewlynn S, Collins SL. Volume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta. Placenta 2019; 84:32-36. [PMID: 31279487 DOI: 10.1016/j.placenta.2019.06.379] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 06/19/2019] [Accepted: 06/22/2019] [Indexed: 11/19/2022]
Abstract
Fetal growth restriction (FGR) is a major cause of perinatal morbidity and mortality. Identifying which pregnancies are at risk of FGR facilitates enhanced surveillance and early delivery before fetal demise can ensue. However, existing risk stratification strategies yield an unacceptably low detection rate. A robust and reliable first trimester screening test for FGR would not only enable high-risk women to be appropriately monitored but would facilitate future trials for possible interventions to enhance fetal growth. Both the volume and vascularity of the first trimester placenta has been demonstrated to be linked to adverse pregnancy outcomes including FGR and pre-eclampsia. The investigation of novel ultrasound markers for FGR are discussed along with the development of methods for fully automatic placental volume estimation which has the potential for use as part of a multi-variable population-based screening test.
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Affiliation(s)
- S Mathewlynn
- Department of Obstetrics and Gynaecology, Milton Keynes University Hospital, Milton Keynes, UK
| | - S L Collins
- Nuffield Department of Women's and Reproductive Health, University of Oxford, UK; Fetal Medicine Unit, The Women's Centre, John Radcliffe Hospital, Oxford, UK.
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Neuroprotective effect of astaxanthin on newborn rats exposed to prenatal maternal seizures. Brain Res Bull 2019; 148:63-69. [PMID: 30910691 DOI: 10.1016/j.brainresbull.2019.03.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 03/12/2019] [Accepted: 03/17/2019] [Indexed: 11/21/2022]
Abstract
Maternal epilepsy during pregnancy is associated with an increased incidence of brain damage and cognitive deficits in offspring. Oxidative stress is believed to play a critical role in this process. Astaxanthin, a natural carotenoid and dietary supplement, possesses potent antioxidant properties. This study was designed to investigate whether astaxanthin ameliorates the hippocampal damage in newborn rats induced by maternal epileptic seizures in utero and to explore the underlying mechanisms. Female Sprague-Dawley rats underwent chronic amygdalar kindling. After being fully kindled, all rats were allowed to mate, and electrical stimulation in the amygdala was performed every other day throughout the pregnancy. Astaxanthin was intraperitoneally injected at a dose of 30 mg/kg/d throughout pregnancy. Prenatal astaxanthin administration ameliorated neuronal lesions, decreased oxidative stress and induced the expression of cAMP response element-binding protein (CREB) and brain-derived neurotrophic factor (BDNF) in the hippocampus of pups. Astaxanthin also ameliorated placental ischemic damage in epileptic mothers. Based on the results of the present study, we concluded that astaxanthin might serve as a therapeutic agent for preventing brain damage in offspring exposed to prenatal maternal seizures.
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Momen NC, Ernst A, Arendt LH, Olsen J, Li J, Gissler M, Ramlau-Hansen CH. Mental and behavioural disorders in the children of mothers diagnosed with cancer: A Danish population-based register study. Psychooncology 2018; 28:408-414. [PMID: 30511799 DOI: 10.1002/pon.4958] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 10/29/2018] [Accepted: 11/28/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Maternal cancer may be associated with offspring mental and behavioural disorders through various biological pathways. When postnatally diagnosed, it may cause stress and changes in care, potentially influencing mental health. Prenatally diagnosed cancer could lead to maternal stress and treatment, or influence foetal neural development. This study investigates associations between prenatally or postnatally diagnosed maternal cancers and mental and behavioural disorders in children. METHODS The study composed of 2 158 430 children born in Denmark (1978-2012). Children were exposed if their mother received a cancer diagnosis prenatally (2 years prepartum, until birth) or postnatally (birth, until 18 years postpartum). Further analyses considered cancer types and diagnostic delays. Children were followed until 18 years of age or the first of the following: diagnosis of a mental or behavioural disorder, emigration, death, end of follow-up. RESULTS During follow-up 79 682 (3.7%) children were diagnosed with mental or behavioural disorders. There was an increased risk among offspring exposed to postnatally diagnosed cancers (HR 1.05; 95% CI, 1.00-1.11); for prenatally diagnosed cancers HR was 1.07 (0.87-1.31). The strongest associations for disorder types were for prenatal diagnoses with mood/affective disorders (HR 2.45; 1.02-5.89) and postnatal diagnoses with mood/affective disorders (HR 1.43; 1.14-1.79). CONCLUSIONS The results indicate a link between maternal cancer occurrence during pregnancy or early postnatal life, and mental and behavioural disorders in offspring. This association could be driven by common factors in the two periods, such as psychological stress or genetic factors. No specific foetal programming was identified.
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Affiliation(s)
- Natalie C Momen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.,NCRR-The National Center for Register-based Research, Department of Economics and Business Economics, Business and Social Science, Aarhus University, Aarhus, Denmark
| | - Andreas Ernst
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.,Department of Epidemiology, University of California, Los Angeles, California
| | - Linn H Arendt
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Epidemiology, University of California, Los Angeles, California
| | - Jiong Li
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Mika Gissler
- Information Services Department, THL National Institute for Health and Welfare, Helsinki, Finland.,Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden.,Research Centre for Child Psychiatry, University of Turku, Turku, Finland
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Momen NC, Arendt LH, Ernst A, Olsen J, Li J, Gissler M, Ramlau-Hansen CH. Pregnancy-associated cancers and birth outcomes in children: a Danish and Swedish population-based register study. BMJ Open 2018; 8:e022946. [PMID: 30518582 PMCID: PMC6286483 DOI: 10.1136/bmjopen-2018-022946] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/20/2018] [Accepted: 10/05/2018] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study aims to estimate the association between pregnancy-associated maternal cancers, diagnosed both prenatally and postnatally, and birth outcomes. DESIGN Population-based register study. SETTING National registers of Denmark and Sweden. PARTICIPANTS A total of 5 523 365 children born in Denmark (1977-2008) and Sweden (1973-2006).Primary and secondary outcome measures: gestational age, birth weight, size for gestational age, Apgar score, caesarean section and sex were the outcomes of interest. ORs and relative risk ratios (RRR) with 95% CIs were estimated using logistic regression and multinomial logistic regression, respectively. RESULTS In this study, 2% of children were born to mothers with a diagnosis of cancer. Children whose mothers received a prenatal cancer diagnosis had higher risk of being born preterm (RRR: 1.77, 95% CI 1.64 to 1.90); low birth weight (RRR 1.84, 95% CI 1.69 to 2.01); low Apgar score (OR 1.36, 95% CI 1.20 to 1.56); and by caesarean section (OR: 1.69, 95% CI 1.59 to 1.80). Associations moved towards the null for analyses using postnatal diagnoses, but preterm birth (RRR: 1.13, 95% CI 1.09 to 1.17) and low birth weight (RRR: 1.14, 95% CI 1.09 to 1.18) remained statistically significant, while risk of caesarean section became so (OR: 0.95, 95% CI 0.91 to 0.98). Additionally, statistical significance was reached for large for gestational age (RRR: 1.06, 95% CI 1.01 to 1.11), high birth weight (RRR: 1.04, 95% CI 1.01 to 1.06) and caesarean section (OR: 0.95, 95% CI 0.91 to 0.98). CONCLUSIONS Results suggest an association between pregnancy-associated cancers and adverse birth outcomes in the offspring. While this is strongest for prenatally diagnosed cancers, some smaller associations exist for postnatally diagnosed cancers, indicating that cancer itself could affect fetal development, or that cancer and adverse birth outcomes share risk factors. Future studies on maternal cancer during pregnancy should consider including some postnatal years in their exposure window.
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Affiliation(s)
- Natalie C Momen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
| | | | - Andreas Ernst
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles (UCLA), Los Angeles, California, USA
| | - Jiong Li
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
| | - Mika Gissler
- National Institute for Health and Welfare (THL), Helsinki, Finland
- Department of Neurobiology, Karolinska Institute, Stockholm, Sweden
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Brun S, Pennamen P, Mattuizzi A, Coatleven F, Vuillaume ML, Lacombe D, Arveiler B, Toutain J, Rooryck C. Interest of chromosomal microarray analysis in the prenatal diagnosis of fetal intrauterine growth restriction. Prenat Diagn 2018; 38:1111-1119. [PMID: 30328630 DOI: 10.1002/pd.5372] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 10/04/2018] [Accepted: 10/05/2018] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate the diagnostic utility of prenatal diagnosis using the chromosomal microarray analysis (CMA) for fetuses presenting with isolated or associated intrauterine growth restriction (IUGR). METHOD We retrospectively included all fetuses with IUGR referred for prenatal testing and studied by rapid fluorescence in situ hybridization (FISH), karyotype, and CMA. RESULTS Among the 162 IUGR fetuses (78 associated and 84 isolated IUGR) included, 15 had an abnormal FISH result: 10 associated and five isolated fetal IUGRs. Among the 143 fetuses studied by CMA, 10 (7%) presented pathogenic copy number variations (CNVs). All 10 were in the associated fetal IUGR group (10/65 or 15.4%; 95% confidence interval [CI]: 8.4%-26.2%) versus 0/78 in the isolated fetal IUGR group (95% CI: 0%-5.6%). Six fetuses (4.2%) carried variants of unknown significance (VOUS) (three associated and three isolated fetal IUGRs). CONCLUSION Our study highlights the added value of CMA in the case of associated fetal IUGR with an incremental yield of 6.1% (4/65) over karyotyping. No pathogenic CNVs were reported in the isolated fetal IUGR group. More studies must be conducted to determine when and whether CMA would be wisely indicated in this population.
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Affiliation(s)
- Stephanie Brun
- Centre Aliénor d'Aquitaine Maternity, CHU Bordeaux, Bordeaux, France
| | | | | | | | | | - Didier Lacombe
- Service de Génétique Médicale, CHU Bordeaux, Bordeaux, France.,Maladies Rares: Génétique et Métabolisme (MRGM), INSERM, University of Bordeaux, Bordeaux, France
| | - Benoit Arveiler
- Service de Génétique Médicale, CHU Bordeaux, Bordeaux, France.,Maladies Rares: Génétique et Métabolisme (MRGM), INSERM, University of Bordeaux, Bordeaux, France
| | - Jerome Toutain
- Service de Génétique Médicale, CHU Bordeaux, Bordeaux, France
| | - Caroline Rooryck
- Service de Génétique Médicale, CHU Bordeaux, Bordeaux, France.,Maladies Rares: Génétique et Métabolisme (MRGM), INSERM, University of Bordeaux, Bordeaux, France
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Furukawa S, Tsuji N, Sugiyama A. Morphology and physiology of rat placenta for toxicological evaluation. J Toxicol Pathol 2018; 32:1-17. [PMID: 30739991 PMCID: PMC6361663 DOI: 10.1293/tox.2018-0042] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/04/2018] [Indexed: 12/18/2022] Open
Abstract
The placenta plays a pivotal role in fetal growth, and placental dysfunction and injury are associated with embryo/fetal toxicity. Histological examination of the rat placenta for safety evaluation provides valuable clues to the mechanisms of this toxicity. However, the placenta has specific and complex biological features unlike those of other organs, and placental structure dramatically changes depending on the time during the gestation period. Thus, time-dependent histopathological examination of the rat placenta should be performed based on the understanding of normal developmental changes in morphology and function. The placentas of rats and humans are both anatomically classified as discoid and hemochorial types. However, there are differences between rats and humans in terms of placental histological structure, the fetal-maternal interface, and the function of the yolk sac. Therefore, extrapolation of placental toxicity from rats to humans should be done cautiously in the evaluation of risk factors. This review describes the development, morphology, physiology, and toxicological features of the rat placenta and the differences between the rat and human placenta to enable accurate evaluation of reproductive and developmental toxicity in studies.
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Affiliation(s)
- Satoshi Furukawa
- Biological Research Laboratories, Nissan Chemical Corporation, 1470 Shiraoka, Shiraoka-shi, Saitama 349-0294, Japan
| | - Naho Tsuji
- Biological Research Laboratories, Nissan Chemical Corporation, 1470 Shiraoka, Shiraoka-shi, Saitama 349-0294, Japan
| | - Akihiko Sugiyama
- Veterinary Clinical Pathology, Faculty of Veterinary Medicine Okayama University of Science, 1-3 Ikoinooka, Imabari, Ehime794-8555, Japan
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Gallardo Gaona J, Martínez Macías O, Acevedo Gallegos S, Velázquez Torres B, Ramírez Calvo J, Camarena Cabrera D. Propuesta clínica para el diagnóstico, la clasificación, el seguimiento y el manejo de la restricción del crecimiento intrauterino de origen placentario. PERINATOLOGÍA Y REPRODUCCIÓN HUMANA 2018. [DOI: 10.1016/j.rprh.2018.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Canti V, Del Rosso S, Tonello M, Lucianò R, Hoxha A, Coletto LA, Vaglio Tessitore I, Rosa S, Manfredi AA, Castiglioni MT, Ruffatti A, Rovere-Querini P. Antiphosphatidylserine/prothrombin Antibodies in Antiphospholipid Syndrome with Intrauterine Growth Restriction and Preeclampsia. J Rheumatol 2018; 45:1263-1272. [PMID: 30008452 DOI: 10.3899/jrheum.170751] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Antibodies that recognize the phosphatidylserine/prothrombin complex (antiphosphatidylserine/prothrombin antibodies; aPS/PT) might reveal enhanced thrombotic risk in patients with systemic lupus erythematosus. Little is known about their association with pregnancy complications in the antiphospholipid syndrome (APS). METHODS We enrolled 55 patients with APS who were seeking pregnancy in 2 Italian hospitals. Antiphospholipid antibodies (aPL), including anticardiolipin antibodies, anti-β2-glycoprotein I antibodies, lupus-like anticoagulant, and aPS/PT antibodies were assessed, and the patients were prospectively followed for 24 months. RESULTS There were 65% (36/55) of the APS patients who had aPS/PT antibodies. Forty-seven pregnancies were followed, including 33 of aPS/PT+ patients. Forty-one of the 47 patients (87%) who initiated a pregnancy eventually gave birth to a child. The pregnancy duration and the mean newborn weight at delivery were significantly lower in aPS/PT+ than in aPS/PT- patients (33.1 ± 4.7 vs 36.2 ± 3.4 wks of gestation, respectively, and 2058 ± 964 g vs 2784 ± 746 g, respectively, p < 0.05). Late pregnancy complications, including intrauterine fetal death, preterm delivery, preeclampsia, and intrauterine growth restriction (IUGR), were more frequent in aPS/PT+ patients, independent of the therapy. Titers of aPS/PT IgG were significantly inversely correlated with the neonatal weight at delivery. Vascular injury, as reflected by thrombosis, fibrinoid necrosis, ischemic and hemorrhagic areas, and presence of chorangiomas characterized the IUGR placentas in the presence of aPS/PT. CONCLUSION The aPS/PT antibodies might represent markers of aPL-related pregnancy complications, IUGR/preeclampsia in particular, and could help identify beforehand patients who may require additional treatment.
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Affiliation(s)
- Valentina Canti
- From the Istituto Scientifico Ospedale San Raffaele; Vita-Salute San Raffaele University, Milan; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua, Padua, Italy.,V. Canti, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Del Rosso, MD, Istituto Scientifico Ospedale San Raffaele; M. Tonello, BSc, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; R. Lucianò, MD, Istituto Scientifico Ospedale San Raffaele; A. Hoxha, MD, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; L.A. Coletto, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; I. Vaglio Tessitore, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Rosa, MD, Istituto Scientifico Ospedale San Raffaele; A.A. Manfredi, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; M.T. Castiglioni, MD, Istituto Scientifico Ospedale San Raffaele; A. Ruffatti, MD, PhD Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; P. Rovere-Querini, MD, PhD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University
| | - Stefania Del Rosso
- From the Istituto Scientifico Ospedale San Raffaele; Vita-Salute San Raffaele University, Milan; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua, Padua, Italy.,V. Canti, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Del Rosso, MD, Istituto Scientifico Ospedale San Raffaele; M. Tonello, BSc, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; R. Lucianò, MD, Istituto Scientifico Ospedale San Raffaele; A. Hoxha, MD, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; L.A. Coletto, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; I. Vaglio Tessitore, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Rosa, MD, Istituto Scientifico Ospedale San Raffaele; A.A. Manfredi, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; M.T. Castiglioni, MD, Istituto Scientifico Ospedale San Raffaele; A. Ruffatti, MD, PhD Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; P. Rovere-Querini, MD, PhD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University
| | - Marta Tonello
- From the Istituto Scientifico Ospedale San Raffaele; Vita-Salute San Raffaele University, Milan; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua, Padua, Italy.,V. Canti, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Del Rosso, MD, Istituto Scientifico Ospedale San Raffaele; M. Tonello, BSc, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; R. Lucianò, MD, Istituto Scientifico Ospedale San Raffaele; A. Hoxha, MD, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; L.A. Coletto, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; I. Vaglio Tessitore, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Rosa, MD, Istituto Scientifico Ospedale San Raffaele; A.A. Manfredi, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; M.T. Castiglioni, MD, Istituto Scientifico Ospedale San Raffaele; A. Ruffatti, MD, PhD Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; P. Rovere-Querini, MD, PhD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University
| | - Roberta Lucianò
- From the Istituto Scientifico Ospedale San Raffaele; Vita-Salute San Raffaele University, Milan; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua, Padua, Italy.,V. Canti, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Del Rosso, MD, Istituto Scientifico Ospedale San Raffaele; M. Tonello, BSc, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; R. Lucianò, MD, Istituto Scientifico Ospedale San Raffaele; A. Hoxha, MD, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; L.A. Coletto, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; I. Vaglio Tessitore, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Rosa, MD, Istituto Scientifico Ospedale San Raffaele; A.A. Manfredi, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; M.T. Castiglioni, MD, Istituto Scientifico Ospedale San Raffaele; A. Ruffatti, MD, PhD Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; P. Rovere-Querini, MD, PhD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University
| | - Ariela Hoxha
- From the Istituto Scientifico Ospedale San Raffaele; Vita-Salute San Raffaele University, Milan; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua, Padua, Italy.,V. Canti, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Del Rosso, MD, Istituto Scientifico Ospedale San Raffaele; M. Tonello, BSc, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; R. Lucianò, MD, Istituto Scientifico Ospedale San Raffaele; A. Hoxha, MD, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; L.A. Coletto, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; I. Vaglio Tessitore, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Rosa, MD, Istituto Scientifico Ospedale San Raffaele; A.A. Manfredi, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; M.T. Castiglioni, MD, Istituto Scientifico Ospedale San Raffaele; A. Ruffatti, MD, PhD Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; P. Rovere-Querini, MD, PhD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University
| | - Lavinia A Coletto
- From the Istituto Scientifico Ospedale San Raffaele; Vita-Salute San Raffaele University, Milan; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua, Padua, Italy.,V. Canti, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Del Rosso, MD, Istituto Scientifico Ospedale San Raffaele; M. Tonello, BSc, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; R. Lucianò, MD, Istituto Scientifico Ospedale San Raffaele; A. Hoxha, MD, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; L.A. Coletto, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; I. Vaglio Tessitore, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Rosa, MD, Istituto Scientifico Ospedale San Raffaele; A.A. Manfredi, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; M.T. Castiglioni, MD, Istituto Scientifico Ospedale San Raffaele; A. Ruffatti, MD, PhD Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; P. Rovere-Querini, MD, PhD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University
| | - Isadora Vaglio Tessitore
- From the Istituto Scientifico Ospedale San Raffaele; Vita-Salute San Raffaele University, Milan; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua, Padua, Italy.,V. Canti, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Del Rosso, MD, Istituto Scientifico Ospedale San Raffaele; M. Tonello, BSc, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; R. Lucianò, MD, Istituto Scientifico Ospedale San Raffaele; A. Hoxha, MD, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; L.A. Coletto, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; I. Vaglio Tessitore, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Rosa, MD, Istituto Scientifico Ospedale San Raffaele; A.A. Manfredi, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; M.T. Castiglioni, MD, Istituto Scientifico Ospedale San Raffaele; A. Ruffatti, MD, PhD Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; P. Rovere-Querini, MD, PhD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University
| | - Susanna Rosa
- From the Istituto Scientifico Ospedale San Raffaele; Vita-Salute San Raffaele University, Milan; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua, Padua, Italy.,V. Canti, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Del Rosso, MD, Istituto Scientifico Ospedale San Raffaele; M. Tonello, BSc, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; R. Lucianò, MD, Istituto Scientifico Ospedale San Raffaele; A. Hoxha, MD, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; L.A. Coletto, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; I. Vaglio Tessitore, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Rosa, MD, Istituto Scientifico Ospedale San Raffaele; A.A. Manfredi, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; M.T. Castiglioni, MD, Istituto Scientifico Ospedale San Raffaele; A. Ruffatti, MD, PhD Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; P. Rovere-Querini, MD, PhD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University
| | - Angelo A Manfredi
- From the Istituto Scientifico Ospedale San Raffaele; Vita-Salute San Raffaele University, Milan; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua, Padua, Italy.,V. Canti, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Del Rosso, MD, Istituto Scientifico Ospedale San Raffaele; M. Tonello, BSc, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; R. Lucianò, MD, Istituto Scientifico Ospedale San Raffaele; A. Hoxha, MD, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; L.A. Coletto, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; I. Vaglio Tessitore, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Rosa, MD, Istituto Scientifico Ospedale San Raffaele; A.A. Manfredi, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; M.T. Castiglioni, MD, Istituto Scientifico Ospedale San Raffaele; A. Ruffatti, MD, PhD Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; P. Rovere-Querini, MD, PhD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University
| | - Maria Teresa Castiglioni
- From the Istituto Scientifico Ospedale San Raffaele; Vita-Salute San Raffaele University, Milan; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua, Padua, Italy.,V. Canti, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Del Rosso, MD, Istituto Scientifico Ospedale San Raffaele; M. Tonello, BSc, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; R. Lucianò, MD, Istituto Scientifico Ospedale San Raffaele; A. Hoxha, MD, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; L.A. Coletto, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; I. Vaglio Tessitore, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Rosa, MD, Istituto Scientifico Ospedale San Raffaele; A.A. Manfredi, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; M.T. Castiglioni, MD, Istituto Scientifico Ospedale San Raffaele; A. Ruffatti, MD, PhD Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; P. Rovere-Querini, MD, PhD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University
| | - Amelia Ruffatti
- From the Istituto Scientifico Ospedale San Raffaele; Vita-Salute San Raffaele University, Milan; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua, Padua, Italy.,V. Canti, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Del Rosso, MD, Istituto Scientifico Ospedale San Raffaele; M. Tonello, BSc, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; R. Lucianò, MD, Istituto Scientifico Ospedale San Raffaele; A. Hoxha, MD, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; L.A. Coletto, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; I. Vaglio Tessitore, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Rosa, MD, Istituto Scientifico Ospedale San Raffaele; A.A. Manfredi, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; M.T. Castiglioni, MD, Istituto Scientifico Ospedale San Raffaele; A. Ruffatti, MD, PhD Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; P. Rovere-Querini, MD, PhD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University
| | - Patrizia Rovere-Querini
- From the Istituto Scientifico Ospedale San Raffaele; Vita-Salute San Raffaele University, Milan; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua, Padua, Italy. .,V. Canti, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Del Rosso, MD, Istituto Scientifico Ospedale San Raffaele; M. Tonello, BSc, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; R. Lucianò, MD, Istituto Scientifico Ospedale San Raffaele; A. Hoxha, MD, PhD, Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; L.A. Coletto, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; I. Vaglio Tessitore, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; S. Rosa, MD, Istituto Scientifico Ospedale San Raffaele; A.A. Manfredi, MD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University; M.T. Castiglioni, MD, Istituto Scientifico Ospedale San Raffaele; A. Ruffatti, MD, PhD Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Padua; P. Rovere-Querini, MD, PhD, Istituto Scientifico Ospedale San Raffaele, and Vita-Salute San Raffaele University.
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López-Tello J, Arias-Álvarez M, Jiménez-Martínez MÁ, Barbero-Fernández A, García-García RM, Rodríguez M, Lorenzo PL, Torres-Rovira L, Astiz S, González-Bulnes A, Rebollar PG. The effects of sildenafil citrate on feto-placental development and haemodynamics in a rabbit model of intrauterine growth restriction. Reprod Fertil Dev 2018; 29:1239-1248. [PMID: 27209378 DOI: 10.1071/rd15330] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 03/28/2016] [Indexed: 12/20/2022] Open
Abstract
The present study evaluated the effectiveness of sildenafil citrate (SC) to improve placental and fetal growth in a diet-induced rabbit model of intrauterine growth restriction (IUGR). Pregnant rabbits were fed either ad libitum (Group C) or restricted to 50% of dietary requirements (Group R) or restricted and treated with SC (Group SC). The treatment with SC improved placental development by increasing vascularity and vessel hypertrophy in the decidua. The assessment of feto-placental haemodynamics showed higher resistance and pulsatility indices at the middle cerebral artery (MCA) in fetuses treated with SC when compared with Group R, which had increased systolic peak and time-averaged mean velocities at the MCA. Furthermore, fetuses in the SC group had significantly higher biparietal and thoracic diameters and longer crown-rump lengths than fetuses in Group R. Hence, the SC group had a reduced IUGR rate and a higher kit size at birth compared with Group R. In conclusion, SC may provide potential benefits in pregnancies with placental insufficiency and IUGR, partially counteracting the negative effects of food restriction on placental development and fetal growth. However, the present study also found evidence of a possible blood overflow in the brain that warrants further investigation.
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Affiliation(s)
- Jorge López-Tello
- Department of Animal Production, Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, s/n, 28040, Madrid, Spain
| | - María Arias-Álvarez
- Department of Animal Production, Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, s/n, 28040, Madrid, Spain
| | - Maria-Ángeles Jiménez-Martínez
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, s/n, 28040, Madrid, Spain
| | - Alicia Barbero-Fernández
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, s/n, 28040, Madrid, Spain
| | - Rosa María García-García
- Department of Physiology (Animal Physiology), Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, s/n, 28040, Madrid, Spain
| | - María Rodríguez
- Department of Animal Production, Polytechnic University of Madrid, Ciudad Universitaria, s/n, 28040, Madrid, Spain
| | - Pedro L Lorenzo
- Department of Physiology (Animal Physiology), Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, s/n, 28040, Madrid, Spain
| | - Laura Torres-Rovira
- Department of Animal Production, Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, s/n, 28040, Madrid, Spain
| | - Susana Astiz
- Comparative Physiology Lab, SGIT-INIA, Avda, Puerta de Hierro, s/n, 28040, Madrid, Spain
| | | | - Pilar G Rebollar
- Department of Animal Production, Polytechnic University of Madrid, Ciudad Universitaria, s/n, 28040, Madrid, Spain
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Cakar E, Ayvacı H, Karcaaltincaba D, Aydın G, Cilli A, Bicer C, Erel Ö, Kayatas Eser S. Thiol-disulfide homoestasis in pregnancies with fetal growth restriction. J Matern Fetal Neonatal Med 2018; 32:3974-3979. [PMID: 29890869 DOI: 10.1080/14767058.2018.1480603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Aim: To investigate the role of dynamic thiol-disulfide homeostasis in preeclamptic and idiopathic fetal growth restricted (FGR) pregnancies. Material and method: In this prospective case-control study, a total of 110 singleton pregnancies with FGR (study group) (51 preeclamptic and 59 idiopathic FGR's cases) were compared with 68 healthy pregnant controls at the same gestational weeks (control group). For serum disulfide-thiol homeostasis, a newly used method described by Erel and Neselioglu was used. Results: Serum native thiol and total thiol levels were lower in FGR pregnancies (285.63 ± 55.92 µmol/L, 324.41 ± 44.18 µmol/L, respectively) than control group (324.41 ± 44.18 µmol/L, 362.98 ± 51.43 µmol/L, p < .001, p = .004, respectively). In subgroup analysis, only preeclamptic FGR's have lower native and total thiol levels (254.41 ± 59.55, 324.41 ± 44.18 µmol/L, respectively) compare to both idiopathic FGR's and control's. There was no difference in native and total thiol levels with idiopathic FGR's with controls. Idiopathic FGR's have higher levels of disulfide than preeclamptic FGR's (21.72 ± 17.72 versus 16.80 ± 11.20 µmol/L). The serum albumin and total protein levels were positively and spot urine protein/creatinine ratio, 24-h urine protein levels were negatively correlated with native thiol and total thiol levels. Conclusion: The balance of thiol-disulfide homeostasis was shifted and native and total thiol levels were decreased only in preeclamptic FGR pregnancies. The serum disulfide level was increased in idiopathic FGR pregnancies compare to preeclamptic FGR pregnancies which may be a sign of oxidative stress in idiopathic FGR pregnancies with normal thiol pool.
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Affiliation(s)
- Erbil Cakar
- Department of Obsterics and Gynecology, Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey
| | - Habibe Ayvacı
- Department of Obsterics and Gynecology, Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey
| | - Deniz Karcaaltincaba
- Department of Obstetrics and Gynecology, Gazi University Faculty of Medicine , Ankara , Turkey
| | - Gultekin Aydın
- Department of Obstetrics and Gynecology, Cekirge Hospital Bursa , Bursa , Turkey
| | - Asli Cilli
- Department of Obsterics and Gynecology, Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey
| | - Cemile Bicer
- Department of Biochemistry, Yildirim Beyazit University, Faculty of Medicine , Ankara , Turkey
| | - Özcan Erel
- Department of Biochemistry, Yildirim Beyazit University, Faculty of Medicine , Ankara , Turkey
| | - Semra Kayatas Eser
- Department of Obsterics and Gynecology, Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey
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Campbell J, Armstrong K, Palaniappan N, Maher E, Glancy M, Porteous M, Mckenzie KJ, Evans MJ. In a Genomic Era, Placental Pathology Still Holds the Key in the Nondysmorphic Stillbirth. Pediatr Dev Pathol 2018; 21:308-318. [PMID: 28990860 DOI: 10.1177/1093526617733373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Objective To explore the relative utility of genetic testing in contrast to placental pathology in explaining causation of death in the structurally normal stillborn population. Methods A retrospective review of a structurally normal stillborn infant cohort in South East Scotland between 2011 and 2015, defined by death at or after 24 weeks of gestation. We reviewed pathology reports and collected demographic data on cases. This information was collated with genetic test results (quantitative fluorescent polymerase chain reaction and microarray analysis) and placental pathology to create a database for analysis. Primary Results Within the structurally normal population (n = 131), there were 125 genetic tests performed and 11 abnormal results. Sixty-six microarray analyses were performed, and 2 (3%) of the results were thought likely to reflect cause of stillbirth (1 case of incomplete trisomy 4 and 1 case of deletion of chromosome Xp in a female). Analysis was significantly limited in 2 cases as parental samples were not available. The placental pathology was available in a total of 129 cases; significant findings were identified in 100 cases; 79 (61%) showed changes that were considered to have caused death (including cord "accidents"), and a further 21 (16%) showed findings likely to influence the management of subsequent pregnancies. Conclusions We reaffirm the utility of placental examination in the investigation of stillbirth. In cases of nondysmorphic stillbirth where placental pathology does not explain the cause of stillbirth, microarray analysis of fetal DNA can add further diagnostic information in 3% of cases but can add further diagnostic confusion, and it is important that parental bloods are taken to minimize this risk.
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Affiliation(s)
- Jamie Campbell
- 1 Department of Clinical Genetics, Western General Hospital, Edinburgh, UK
| | - Kristy Armstrong
- 2 Department of Pathology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Nithiya Palaniappan
- 3 Department of Obstetrics and Gynaecology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Eddy Maher
- 4 Cytogenetic Laboratories Services, Center for Genomic and Experimental Medicine, Western General Hospital, Edinburgh, UK
| | - Mary Glancy
- 4 Cytogenetic Laboratories Services, Center for Genomic and Experimental Medicine, Western General Hospital, Edinburgh, UK
| | - Mary Porteous
- 1 Department of Clinical Genetics, Western General Hospital, Edinburgh, UK
| | | | - Margaret J Evans
- 2 Department of Pathology, Royal Infirmary of Edinburgh, Edinburgh, UK
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Hyperelastic Mechanical Properties of Ex Vivo Normal and Intrauterine Growth Restricted Placenta. Ann Biomed Eng 2018; 46:1066-1077. [DOI: 10.1007/s10439-018-2019-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/28/2018] [Indexed: 12/16/2022]
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Verheecke M, Cortès Calabuig A, Finalet Ferreiro J, Brys V, Van Bree R, Verbist G, Everaert T, Leemans L, Gziri MM, Boere I, Halaska MJ, Vanhoudt J, Amant F, Van Calsteren K. Genetic and microscopic assessment of the human chemotherapy-exposed placenta reveals possible pathways contributive to fetal growth restriction. Placenta 2018; 64:61-70. [PMID: 29626982 DOI: 10.1016/j.placenta.2018.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 03/06/2018] [Accepted: 03/07/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Fetal growth restriction (FGR) carries an increased risk of perinatal mortality and morbidity. A major cause of FGR is placental insufficiency. After in utero chemotherapy-exposure, an increased incidence of FGR has been reported. In a prospective cohort study we aimed to explore which pathways may contribute to chemotherapy-associated FGR. METHODS Placental biopsies were collected from 25 cancer patients treated with chemotherapy during pregnancy, and from 66 control patients. Differentially expressed pathways between chemotherapy-exposed patients and controls were examined by whole transcriptome shotgun sequencing (WTSS) and Ingenuity Pathway Analysis (IPA). Immunohistochemical studies for 8-OHdG and eNOS (oxidative DNA damage), proliferation (PCNA) and apoptosis (Cleaved Caspase 3) were performed. The expression level of eNOS, PCNA and IGFBP6 was verified by real-time quantitative Reverse Transcription Polymerase Chain Reaction (RT-qPCR). RESULTS Most differential expressed genes between chemotherapy-exposed patients and controls were related to growth, developmental processes, and radical scavenging networks. The duration of chemotherapy exposure had an additional impact on the expression of genes related to the superoxide radicals degeneration network. Immunohistochemical analyses showed a significantly increased expression of 8-OHdG (P = 0.003) and a decreased expression of eNOS (P=0.015) in the syncytiotrophoblast of the placenta of cancer patients. A decreased expression of PCNA was detected by immunohistochemistry as RT-qPCR (NS). CONCLUSION Chemotherapy exposure during pregnancy results in an increase of oxidative DNA damage and might impact the placental cellular growth and development, resulting in an increased incidence of FGR in this specific population. Further large prospective cohort studies and longitudinal statistical analyses are needed.
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Affiliation(s)
- M Verheecke
- Department of Oncology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Department of Obstetrics and Gynecology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | | | | | - V Brys
- Genomics Core, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - R Van Bree
- Department of Reproduction and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - G Verbist
- Genomics Core, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - T Everaert
- Department of Oncology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - L Leemans
- Department of Oncology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - M M Gziri
- Department of Obstetrics and Gynecology, Cliniques Universitaires St. Luc, Hippokrateslaan 10, 1200 Brussels, Belgium
| | - I Boere
- Department of Medical Oncology, Erasmus MC Cancer Institute, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - M J Halaska
- Department of Obstetrics and Gynaecology, 3rd Medical Faculty, Charles University, Prague 5, Faculty Hospital Kralovske Vinohrady, Srobarova 1150/50, 100 34, Prague 10, Czech Republic
| | - J Vanhoudt
- Genomics Core, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - F Amant
- Department of Oncology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Department of Gynaecologic Oncology, Center for Gynaecologic Oncology, Amsterdam, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
| | - K Van Calsteren
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium; Department of Reproduction and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
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de Haan J, Verheecke M, Van Calsteren K, Van Calster B, Shmakov RG, Mhallem Gziri M, Halaska MJ, Fruscio R, Lok CAR, Boere IA, Zola P, Ottevanger PB, de Groot CJM, Peccatori FA, Dahl Steffensen K, Cardonick EH, Polushkina E, Rob L, Ceppi L, Sukhikh GT, Han SN, Amant F. Oncological management and obstetric and neonatal outcomes for women diagnosed with cancer during pregnancy: a 20-year international cohort study of 1170 patients. Lancet Oncol 2018; 19:337-346. [PMID: 29395867 DOI: 10.1016/s1470-2045(18)30059-7] [Citation(s) in RCA: 127] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/13/2017] [Accepted: 11/21/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Awareness is growing that cancer can be treated during pregnancy, but the effect of this change on maternal and neonatal outcomes is unknown. The International Network on Cancer, Infertility and Pregnancy (INCIP) registers the incidence and maternal, obstetric, oncological, and neonatal outcomes of cancer occurring during pregnancy. We aimed to describe the oncological management and obstetric and neonatal outcomes of patients registered in INCIP and treated in the past 20 years, and assess associations between cancer type or treatment modality and obstetric and neonatal outcomes. METHODS This descriptive cohort study included pregnant patients with cancer registered from all 37 centres (from 16 countries) participating in the INCIP registry. Oncological, obstetric, and neonatal outcome data of consecutive patients diagnosed with primary invasive cancer during pregnancy between Jan 1, 1996, and Nov 1, 2016, were retrospectively and prospectively collected. We analysed changes over time in categorical patient characteristics, outcomes, and treatment methods with log-binomial regression. We used multiple logistic regression to analyse preterm, prelabour rupture of membranes (PPROM) or preterm contractions, small for gestational age, and admission to the neonatal intensive care unit (NICU). The INCIP registry study is registered with ClinicalTrials.gov, number NCT00330447, and is ongoing. FINDINGS 1170 patients were included in the analysis and 779 (67%) received treatment during pregnancy. Breast cancer was the most common malignant disease (462 [39%]). Every 5 years, the likelihood of receiving treatment during pregnancy increased (relative risk [RR] 1·10, 95% CI 1·05-1·15), mainly related to an increase of chemotherapeutic treatment (1·31, 1·20-1·43). Overall, 955 (88%) of 1089 singleton pregnancies ended in a livebirth, of which 430 (48%) of 887 pregnancies ended preterm. Each 5 years, we observed more livebirths (RR 1·04, 95% CI 1·01-1·06) and fewer iatrogenic preterm deliveries (0·91, 0·84-0·98). Our data suggest a relationship between platinum-based chemotherapy and small for gestational age (odds ratio [OR] 3·12, 95% CI 1·45-6·70), and between taxane chemotherapy and NICU admission (OR 2·37, 95% CI 1·31-4·28). NICU admission seemed to depend on cancer type, with gastrointestinal cancers having highest risk (OR 7·13, 95% CI 2·86-17·7) and thyroid cancers having lowest risk (0·14, 0·02-0·90) when compared with breast cancer. Unexpectedly, the data suggested that abdominal or cervical surgery was associated with a reduced likelihood of NICU admission (OR 0·30, 95% CI 0·17-0·55). Other associations between treatment or cancer type and outcomes were less clear. INTERPRETATION Over the years, the proportion of patients with cancer during pregnancy who received antenatal treatment increased, especially treatment with chemotherapy. Our data indicate that babies exposed to antenatal chemotherapy might be more likely to develop complications, specifically small for gestational age and NICU admission, than babies not exposed. We therefore recommend involving hospitals with obstetric high-care units in the management of these patients. FUNDING Research Foundation-Flanders, European Research Council, Charles University, Ministry of Health of the Czech Republic.
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Affiliation(s)
- Jorine de Haan
- Department of Oncology, KU Leuven, Leuven, Belgium; Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, Netherlands
| | - Magali Verheecke
- Department of Oncology, KU Leuven, Leuven, Belgium; Division of Gynaecologic Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Kristel Van Calsteren
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - Ben Van Calster
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Roman G Shmakov
- Federal State Budget Institution "Research Center for Obstetrics, Gynecology and Perinatology", Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Mina Mhallem Gziri
- Department of Obstetrics, Cliniques Universitaires St Luc, UCL, Sint-Lambrechts-Woluwe, Belgium
| | - Michael J Halaska
- Faculty Hospital Kralovske Vinohrady and 3rd Medical Faculty, Charles University, Prague, Czech Republic
| | - Robert Fruscio
- Clinic of Obstetrics and Gynecology, University of Milan Bicocca, San Gerardo Hospital, Monza, Italy
| | - Christianne A R Lok
- Center for Gynaecologic Oncology Amsterdam, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Ingrid A Boere
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Paolo Zola
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Petronella B Ottevanger
- Department of Medical Oncology, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
| | | | - Fedro A Peccatori
- Division of Gynaecologic Oncology, European Institute of Oncology, Milan, Italy
| | - Karina Dahl Steffensen
- Department of Oncology, Vejle Hospital, Vejle, Denmark; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Elyce H Cardonick
- Department of Obstetrics and Gynaecology, Cooper University Health Care, Camden, NJ, USA
| | - Evgeniya Polushkina
- Federal State Budget Institution "Research Center for Obstetrics, Gynecology and Perinatology", Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Lukas Rob
- Faculty Hospital Kralovske Vinohrady and 3rd Medical Faculty, Charles University, Prague, Czech Republic
| | - Lorenzo Ceppi
- Clinic of Obstetrics and Gynecology, University of Milan Bicocca, San Gerardo Hospital, Monza, Italy
| | - Gennady T Sukhikh
- Federal State Budget Institution "Research Center for Obstetrics, Gynecology and Perinatology", Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Sileny N Han
- Department of Oncology, KU Leuven, Leuven, Belgium; Division of Gynaecologic Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Frédéric Amant
- Department of Oncology, KU Leuven, Leuven, Belgium; Division of Gynaecologic Oncology, University Hospitals Leuven, Leuven, Belgium; Center for Gynaecologic Oncology Amsterdam, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, Netherlands; Centre for Gynaecologic Oncology Amsterdam, Academical Medical Center, Amsterdam, Netherlands.
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