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Ming X, Yang Y, Li Y, He Z, Tian X, Cheng J, Zhou W. Association between risk of preterm birth and long-term and short-term exposure to ambient carbon monoxide during pregnancy in chongqing, China: a study from 2016-2020. BMC Public Health 2024; 24:1411. [PMID: 38802825 PMCID: PMC11129390 DOI: 10.1186/s12889-024-18913-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/21/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Preterm birth (PTB) is an important predictor of perinatal morbidity and mortality. Previous researches have reported a correlation between air pollution and an increased risk of preterm birth. However, the specific relationship between short-term and long-term exposure to carbon monoxide (CO) and preterm birth remains less explored. METHODS A population-based study was conducted among 515,498 pregnant women in Chongqing, China, to assess short-term and long-term effects of CO on preterm and very preterm births. Generalized additive models (GAM) were applied to evaluate short-term effects, and exposure-response correlation curves were plotted after adjusting for confounding factors. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using COX proportional hazard models to estimate the long-term effect. RESULTS The daily incidence of preterm and very preterm birth was 5.99% and 0.41%, respectively. A positive association between a 100 µg/m³ increase in CO and PTB was observed at lag 0-3 days and 12-21 days, with a maximum relative risk (RR) of 1.021(95%CI: 1.001-1.043). The exposure-response curves (lag 0 day) revealed a rapid increase in PTB due to CO. Regarding long-term exposure, positive associations were found between a 100 µg/m3 CO increase for each trimester(Model 2 for trimester 1: HR = 1.054, 95%CI: 1.048-1.060; Model 2 for trimester 2: HR = 1.066, 95%CI: 1.060-1.073; Model 2 for trimester 3: HR = 1.007, 95%CI: 1.001-1.013; Model 2 for entire pregnancy: HR = 1.080, 95%CI: 1.073-1.088) and higher HRs of very preterm birth. Multiplicative interactions between air pollution and CO on the risk of preterm and very preterm birth were detected (P- interaction<0.05). CONCLUSIONS Our findings suggest that short-term exposure to low levels of CO may have protective effects against preterm birth, while long-term exposure to low concentrations of CO may reduce the risk of both preterm and very preterm birth. Moreover, our study indicated that very preterm birth is more susceptible to the influence of long-term exposure to CO during pregnancy, with acute CO exposure exhibiting a greater impact on preterm birth. It is imperative for pregnant women to minimize exposure to ambient air pollutants.
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Affiliation(s)
- Xin Ming
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, 401147, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, 401147, China
- Chongqing Research Center for Prevention & Control of Maternal and Child Disease and Public Health, Chongqing, China
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Yunping Yang
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, 401147, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, 401147, China
- Chongqing Research Center for Prevention & Control of Maternal and Child Disease and Public Health, Chongqing, China
| | - Yannan Li
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, 401147, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, 401147, China
- Chongqing Research Center for Prevention & Control of Maternal and Child Disease and Public Health, Chongqing, China
| | - Ziyi He
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, 401147, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, 401147, China
- Chongqing Research Center for Prevention & Control of Maternal and Child Disease and Public Health, Chongqing, China
| | - Xiaoqin Tian
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Jin Cheng
- Department of Public Health and Emergency Management, Chongqing Medical and Pharmaceutical College, Chongqing, China.
| | - Wenzheng Zhou
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, 401147, China.
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, 401147, China.
- Chongqing Research Center for Prevention & Control of Maternal and Child Disease and Public Health, Chongqing, China.
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Menon R, Peltier MR. Novel Insights into the Regulatory Role of Nuclear Factor (Erythroid-Derived 2)-Like 2 in Oxidative Stress and Inflammation of Human Fetal Membranes. Int J Mol Sci 2020; 21:E6139. [PMID: 32858866 PMCID: PMC7503839 DOI: 10.3390/ijms21176139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 12/16/2022] Open
Abstract
Fetal membrane dysfunction in response to oxidative stress (OS) is associated with adverse pregnancy outcomes. Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is one of the regulators of innate OS response. This study evaluated changes in Nrf2 expression and its downstream targets heme oxygenase (HO-1) and peroxisome proliferator-activated receptor gamma (PPARγ) in fetal membranes during OS and infection in vitro. Furthermore, we tested the roles of sulforaphane (SFN; an extract from cruciferous vegetables) and trigonelline (TRN; an aromatic compound in coffee) in regulating Nrf2 and its targets. Fetal membranes (n = 6) collected at term were placed in an organ explant system were treated with water-soluble cigarette smoke extract (CSE), an OS inducer (1:10), and lipopolysaccharide (LPS; 100 ng/mL). Nrf2 expression, expression, its enhancement by sulforaphane (SFN, 10 µM/mL) and down regulation by TRN (10uM/mL) was determined by western blots. Expression of Nrf2 response elements PPARγ (western) heme oxygenase (HO-1), and IL-6 were quantified by ELISA. CSE and LPS treatment of fetal membranes increased nrf2, but reduced HO-1 and PPARγ and increased IL-6. Co-treatment of SFN, but not with TRN, with CSE and LPS increased Nrf2 substantially, as well as increased HO-1 and PPARγ and reduced IL-6 expression. Risk factor-induced Nrf2 increase is insufficient to generate an antioxidant response in fetal membranes. Sulforaphane may enhance innate antioxidant and anti-inflammatory capacity by increasing NRF-2 expression.
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Affiliation(s)
- Ramkumar Menon
- Division of Maternal-Fetal Medicine and Perinatal Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
| | - Morgan R Peltier
- Department of Foundations of Medicine, New York University-Long Island School of Medicine, Mineola, NY 11501, USA;
- Department of Obstetrics and Gynecology, New York University-Long Island School of Medicine, Mineola, NY 11501, USA
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Kim ML, Maloney C, Klimova N, Gurzenda E, Lin X, Arita Y, Walker T, Fazzari MJ, Hanna N. Repeated lipopolysaccharide exposure leads to placental endotoxin tolerance. Am J Reprod Immunol 2019; 81:e13080. [PMID: 30586203 DOI: 10.1111/aji.13080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/12/2018] [Accepted: 11/30/2018] [Indexed: 11/29/2022] Open
Abstract
PROBLEM Placental infection induces increased levels of pro-inflammatory cytokines, which have been implicated in the pathogenesis of pre-term labor. Endotoxin tolerance is a phenomenon in which exposure to a dose of endotoxin makes tissue less responsive to subsequent exposures. The objective of our study was to determine whether repeated exposure to endotoxin will induce a tolerant phenotype in normal human second-trimester placental tissue. METHODS OF STUDY Human second-trimester placental explants from elective termination of pregnancy were cultured and exposed to endotoxin (LPS). After 24 hours, the media was collected for analysis, and the explants were re-exposed to LPS after adding fresh media for another 24 hours. This process was repeated for a total of 4 LPS doses. The media was collected from each day and analyzed for cytokine levels. RESULTS The first LPS treatment stimulated the secretion of the pro-inflammatory cytokines IL-1β and TNF-α. However, their production was significantly diminished with repeated LPS doses. Production of the anti-inflammatory cytokines, IL-1ra and IL-10, was also stimulated by the first LPS treatment, but secretion was more gradually and moderately decreased with repeated LPS doses compared to the pro-inflammatory cytokines. The ratios of the anti-inflammatory/pro-inflammatory mediators (IL-1ra/IL-1β and IL-10/TNF-α) indicate a progressively more anti-inflammatory milieu with repeated LPS doses. CONCLUSION Repeated LPS exposure of human second-trimester placental tissues induced endotoxin tolerance. We speculate that endotoxin tolerance at the maternal-fetal interface will protect the fetus from exaggerated inflammatory responses after repeated infectious exposure.
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Affiliation(s)
- Maureen L Kim
- Women and Children's Research Laboratory, NYU Winthrop Hospital, Mineola, New York.,Department of Pediatrics, NYU Winthrop Hospital, Mineola, New York
| | - Caroline Maloney
- Women and Children's Research Laboratory, NYU Winthrop Hospital, Mineola, New York.,Donald and Barbara Zucker School of Medicine and Northwell/Hofstra, Hempstead, New York
| | - Natalia Klimova
- Women and Children's Research Laboratory, NYU Winthrop Hospital, Mineola, New York.,University of Kentucky College of Dentistry, Lexington, Kentucky
| | - Ellen Gurzenda
- Women and Children's Research Laboratory, NYU Winthrop Hospital, Mineola, New York
| | - Xinhua Lin
- Women and Children's Research Laboratory, NYU Winthrop Hospital, Mineola, New York
| | - Yuko Arita
- Women and Children's Research Laboratory, NYU Winthrop Hospital, Mineola, New York
| | | | - Melissa J Fazzari
- Department of Biostatistics, NYU Winthrop Hospital, Mineola, New York
| | - Nazeeh Hanna
- Women and Children's Research Laboratory, NYU Winthrop Hospital, Mineola, New York.,Department of Pediatrics, NYU Winthrop Hospital, Mineola, New York
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Olgun NS, Hanna N, Reznik SE. BQ-123 prevents LPS-induced preterm birth in mice via the induction of uterine and placental IL-10. Toxicol Appl Pharmacol 2015; 282:275-84. [DOI: 10.1016/j.taap.2014.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 09/05/2014] [Accepted: 09/08/2014] [Indexed: 01/04/2023]
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Liu Q, Qiao FY, Shi XW, Liu HY, Gong X, Wu YY. Promoter hypomethylation and increased maspin expression in preeclamptic placentas in a Chinese population. Placenta 2014; 35:876-82. [PMID: 25151033 DOI: 10.1016/j.placenta.2014.08.088] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 07/15/2014] [Accepted: 08/05/2014] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Preeclampsia is thought to begin with shallow trophoblast invasion and inadequate spiral artery remodeling. Maspin, a tumor-suppressor gene, plays a regulatory role in trophoblast invasion and motility. The tissue-specific methylation of the maspin promoter can regulate maspin gene expression in various cancers. We sought to detect maspin gene expression and assess the degrees of methylation of maspin promoter regions in preeclamptic placentas in the Han Chinese population and to investigate the potential role of maspin in the pathophysiology of preeclampsia. METHODS We conducted RT-PCR, immunohistochemistry and western blotting to characterize maspin gene expression and protein levels in the placentas from normal and preeclamptic pregnancies. Finally, using methylation-specific PCR and bisulfite sequencing PCR, we detected the degrees of methylation of the promoter regions of maspin in each of the two studied groups. RESULTS Maspin expression was increased at the mRNA and protein levels in the preeclamptic placentas compared to the control group. Maspin immunohistochemical staining revealed positive staining in the syncytio-cytotrophoblast layers and more diffuse staining in the preeclamptic group. The mean methylation level of the analyzed promoter region was significantly hypomethylated in the preeclamptic placentas compared to the control placentas, pointing to a negative relationship between maspin promoter methylation and gene expression. DISCUSSION Hypomethylation of the maspin promoter results in increased expression of maspin in preeclamptic placentas, which suggests a negative relationship between maspin methylation and maspin expression in this Han Chinese population. Thus, maspin is likely involved in the etiology of preeclampsia.
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Affiliation(s)
- Q Liu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - F Y Qiao
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - X W Shi
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - H Y Liu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - X Gong
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Y Y Wu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
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