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Bartin R, Melbourne A, Bobet L, Gauchard G, Menneglier A, Grevent D, Bussieres L, Siauve N, Salomon LJ. Static and dynamic responses to hyperoxia of normal placenta across gestation with T2*-weighted MRI sequences. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2024; 64:236-244. [PMID: 38348601 DOI: 10.1002/uog.27609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 08/03/2024]
Abstract
OBJECTIVES T2*-weighted magnetic resonance imaging (MRI) sequences have been identified as non-invasive tools with which to study placental oxygenation in vivo. This study aimed to use these to investigate both static and dynamic responses to hyperoxia of the normal placenta across gestation. METHODS We conducted a single-center prospective study including 52 uncomplicated pregnancies. Two T2*-weighted sequences (T2* relaxometry) were performed, one before and one after maternal hyperoxia. The distribution of placental T2* values was modeled by fitting a gamma probability density function (T2* ~ Γ α β ), describing the structure of the histogram using the mean T2* value, the shape parameter (α) and the rate (β). A dynamic acquisition (blood-oxygen-level-dependent (BOLD) MRI) was also performed before and during maternal oxygen supply, until placental oxygen saturation had been achieved. The signal change over time was modeled using a sigmoid function, to determine the intensity of enhancement (ΔBOLD (% with respect to baseline)), a temporal variation coefficient (λ (min-1), controlling the slope of the curve) and the maximum steepness (Vmax (% of placental enhancement/min)). RESULTS The histogram analysis of the T2* values in normoxia showed a whole-placenta variation, with a decreasing linear trend in the mean T2* value (Pearson's correlation coefficient (R) = -0.83 (95% CI, -0.9 to -0.71), P < 0.001), along with an increasingly peaked and narrower distribution of T2* values with advancing gestation. After maternal hyperoxia, the mean T2* ratios (mean T2*hyperoxia/mean T2*baseline) were positively correlated with gestational age, while the other histogram parameters remained stable, suggesting a translation of the histogram towards higher values with a similar appearance after maternal hyperoxia. ΔBOLD showed a non-linear increase across gestation. Conversely, λ showed an inverted trend across gestation, with a weaker correlation (R = -0.33 (95% CI, -0.58 to -0.02), P = 0.04, R2 = 0.1). As a combination of ΔBOLD and λ, the changes in Vmax throughout gestation were influenced mainly by the changes in ΔBOLD and showed a positive non-linear correlation with gestational age. CONCLUSIONS Our results suggest that the decrease in the T2* placental signal as gestation progresses does not reflect placental dysfunction. The BOLD dynamic signal change is representative of a free-diffusion model of oxygenation and highlights the increasing differences in oxygen saturation between mother and fetus as gestation progresses (ΔBOLD) and in the placental permeability to oxygen (λ). © 2024 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- R Bartin
- Department of Fetal Medicine, Surgery and Imaging, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
- Plateforme LUMIERE, Hôpital Universitaire Necker-Enfants Malades, URP 7328 and PACT, affiliated to Imagine Institut, Université de Paris, Faculté de Médecine, Paris, France
| | - A Melbourne
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
- School of Biomedical Engineering & Imaging Sciences, Kings College London, London, UK
| | - L Bobet
- Plateforme LUMIERE, Hôpital Universitaire Necker-Enfants Malades, URP 7328 and PACT, affiliated to Imagine Institut, Université de Paris, Faculté de Médecine, Paris, France
| | - G Gauchard
- Plateforme LUMIERE, Hôpital Universitaire Necker-Enfants Malades, URP 7328 and PACT, affiliated to Imagine Institut, Université de Paris, Faculté de Médecine, Paris, France
| | - A Menneglier
- Plateforme LUMIERE, Hôpital Universitaire Necker-Enfants Malades, URP 7328 and PACT, affiliated to Imagine Institut, Université de Paris, Faculté de Médecine, Paris, France
| | - D Grevent
- Plateforme LUMIERE, Hôpital Universitaire Necker-Enfants Malades, URP 7328 and PACT, affiliated to Imagine Institut, Université de Paris, Faculté de Médecine, Paris, France
- Department of Pediatric Radiology, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - L Bussieres
- Department of Fetal Medicine, Surgery and Imaging, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
- Plateforme LUMIERE, Hôpital Universitaire Necker-Enfants Malades, URP 7328 and PACT, affiliated to Imagine Institut, Université de Paris, Faculté de Médecine, Paris, France
| | - N Siauve
- Department of Radiology, Hôpital Louis Mourier, AP-HP, Colombes, France
| | - L J Salomon
- Department of Fetal Medicine, Surgery and Imaging, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
- Plateforme LUMIERE, Hôpital Universitaire Necker-Enfants Malades, URP 7328 and PACT, affiliated to Imagine Institut, Université de Paris, Faculté de Médecine, Paris, France
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Steele JW, Krishnan V, Finnell RH. Mechanisms of neurodevelopmental toxicity of topiramate. Crit Rev Toxicol 2024; 54:465-475. [PMID: 38995641 PMCID: PMC11296906 DOI: 10.1080/10408444.2024.2368552] [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: 02/27/2024] [Revised: 05/03/2024] [Accepted: 06/11/2024] [Indexed: 07/13/2024]
Abstract
Prescriptions for antiseizure medications (ASMs) have been rapidly growing over the last several decades due, in part, to an expanding list of clinical indications for which they are now prescribed. This trend has raised concern for potential adverse neurodevelopmental outcomes in ASM-exposed pregnancies. Recent large scale population studies have suggested that the use of topiramate (TOPAMAX, Janssen-Cilag), when prescribed for seizure control, migraines, and/or weight management, is associated with an increased risk for autism spectrum disorder (ASD), intellectual disability, and attention-deficit/hyperactivity disorder (ADHD) in exposed offspring. Here, we critically review epidemiologic evidence demonstrating the neurobehavioral teratogenicity of topiramate and speculate on the neuromolecular mechanisms by which prenatal exposure may perturb neurocognitive development. Specifically, we explore the potential role of topiramate's pharmacological interactions with ligand- and voltage-gated ion channels, especially GABAergic signaling, its effects on DNA methylation and histone acetylation, whether topiramate induces oxidative stress, and its association with fetal growth restriction as possible mechanisms contributing to neurodevelopmental toxicity. Resolving this biology will be necessary to reduce the risk of adverse pregnancy outcomes caused by topiramate or other ASMs.
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Affiliation(s)
- John W. Steele
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Vaishnav Krishnan
- Departments of Neurology, Neuroscience and Psychiatry, and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Richard H. Finnell
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Departments of Molecular and Cellular Biology and Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
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3
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Lu H, Jiang H, Li C, Derisoud E, Zhao A, Eriksson G, Lindgren E, Pui HP, Risal S, Pei Y, Maxian T, Ohlsson C, Benrick A, Haider S, Stener-Victorin E, Deng Q. Dissecting the Impact of Maternal Androgen Exposure on Developmental Programming through Targeting the Androgen Receptor. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024:e2309429. [PMID: 39075722 DOI: 10.1002/advs.202309429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 05/15/2024] [Indexed: 07/31/2024]
Abstract
Women with polycystic ovary syndrome (PCOS) exhibit sustained elevation in circulating androgens during pregnancy, an independent risk factor linked to pregnancy complications and adverse outcomes in offspring. Yet, further studies are required to understand the effects of elevated androgens on cell type-specific placental dysfunction and fetal development. Therefore, a PCOS-like mouse model induced by continuous androgen exposure is examined. The PCOS-mice exhibited impaired placental and embryonic development, resulting in mid-gestation lethality. Co-treatment with the androgen receptor blocker, flutamide, prevents these phenotypes including germ cell specification . Comprehensive profiling of the placenta by whole-genome bisulfite and RNA sequencing shows a reduced proportion of trophoblast precursors, possibly due to the downregulation of Cdx2 expression. Reduced expression of Gcm1, Synb, and Prl3b1 is associated with reduced syncytiotrophoblasts and sinusoidal trophoblast giant cells, impairs placental labyrinth formation. Importantly, human trophoblast organoids exposed to androgens exhibit analogous changes, showing impaired trophoblast differentiation as a key feature in PCOS-related pregnancy complications. These findings provide new insights into the potential cellular targets for future treatments.
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Affiliation(s)
- Haojiang Lu
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Hong Jiang
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Congru Li
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Emilie Derisoud
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Allan Zhao
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Gustaw Eriksson
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Eva Lindgren
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Han-Pin Pui
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Sanjiv Risal
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Yu Pei
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Theresa Maxian
- Department of Obstetrics and Gynaecology, Reproductive Biology Unit, Placental Development Group, Medical University of Vienna, Vienna, 1090, Austria
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 40530, Sweden
| | - Anna Benrick
- Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 40530, Sweden
- School of Health Sciences, University of Skövde, Skövde, 54128, Sweden
| | - Sandra Haider
- Department of Obstetrics and Gynaecology, Reproductive Biology Unit, Placental Development Group, Medical University of Vienna, Vienna, 1090, Austria
| | | | - Qiaolin Deng
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, 17177, Sweden
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Motomura K, Morita H, Yamamoto H, Wada S, Sago H, Takahashi H, Saito H, Matsumoto K. Isolation of pure primary term human cytotrophoblasts and their differentiation into syncytiotrophoblast-like cells as an ex vivo model of the human placenta. Placenta 2024:S0143-4004(24)00603-9. [PMID: 39089887 DOI: 10.1016/j.placenta.2024.07.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/10/2024] [Accepted: 07/23/2024] [Indexed: 08/04/2024]
Abstract
The placenta plays a fundamental role in fetal growth and maintenance of pregnancy. Its cellular components include a large multinucleated syncytiotrophoblast (STB) and its progenitor, cytotrophoblasts (CTBs), both of which perform vital functions in the human placenta. Primary cytotrophoblasts isolated from term human placentas that spontaneously fuse and differentiate into syncytiotrophoblast-like cells in vitro have been utilized to investigate the functions of the syncytiotrophoblast and placenta with multiple modifications. Although recent advances have enabled the use of trophoblast stem cell-derived organoids as a model for villous trophoblasts, primary CTBs offer several advantages, including spontaneous differentiation, easy access to materials (from term-delivered human placentas), and simple methodology. Here, we present a precise step-by-step process for isolating pure CTBs from term human placenta based on previously reported placenta digestion, density centrifugation, and CTB purification using anti-HLA-A, B, C antibody. Subsequently, we provide a method to improve CTB viability and differentiation into STB-like cells using epidermal growth factor (EGF) and a ROCK inhibitor (Y-27632) that ensures long-term and stable cultures without altering their proliferation. Because these cells can grow on standard tissue culture plates, this model can be easily utilized for various placental investigations, including innate immune responses, drug resistance, and STB metabolism. Employing this approach considerably enhances our understanding of placental functions, which are key to maternal and offspring health.
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Affiliation(s)
- Kenichiro Motomura
- Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Tokyo, Japan; Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
| | - Hideaki Morita
- Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Tokyo, Japan; Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Hiromichi Yamamoto
- Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Tokyo, Japan; Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan
| | - Seiji Wada
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Haruhiko Sago
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan; Center for Medical Genetics, National Center for Child Health and Development, Tokyo, Japan
| | - Hironori Takahashi
- Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan
| | - Hirohisa Saito
- Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Kenji Matsumoto
- Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Tokyo, Japan.
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Wong GP, Hartmann S, Simmons DG, Ellis S, Nonn O, Cannon P, Nguyen TV, Nguyen A, Bartho LA, Tong S, Hannan NJ, Kaitu'u-Lino TJ. Trophoblast Side-Population Markers are Dysregulated in Preeclampsia and Fetal Growth Restriction. Stem Cell Rev Rep 2024:10.1007/s12015-024-10764-w. [PMID: 39028417 DOI: 10.1007/s12015-024-10764-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2024] [Indexed: 07/20/2024]
Abstract
Dysregulated progenitor cell populations may contribute to poor placental development and placental insufficiency pathogenesis. Side-population cells possess progenitor properties. Recent human trophoblast side-population isolation identified enrichment of 8 specific genes (CXCL8, ELL2, GATA6, HK2, HLA-DPB1, INTS6, SERPINE3 and UPP1) (Gamage et al. 2020, Stem Cell Rev Rep). We characterised these trophoblast side-population markers in human placenta and in placental insufficiency disorders: preeclampsia and fetal growth restriction (FGR). Trophoblast side-population markers localised to mononuclear trophoblasts lining the placental villous basement membrane in preterm control, preeclamptic and FGR placental sections (n = 3, panel of 3 markers/serial section). Analysis of single-cell transcriptomics of an organoid human trophoblast stem cell (hTSC) to extravillous trophoblast (EVT) differentiation model (Shannon et al. 2022, Development) identified that all side-population genes were enriched in mononuclear trophoblast and trophoblasts committed to differentiation under hTSC culture conditions. In vitro validation via 96 h time course hTSC differentiation to EVTs or syncytiotrophoblasts (n = 5) demonstrated ELL2 and HK2 increased with differentiation (p < 0.0024, p < 0.0039 respectively). CXCL8 and HLA-DPB1 were downregulated (p < 0.030, p < 0.011 respectively). GATA6 and INTS6 increased with EVT differentiation only, and UPP1 reduced with syncytialisation. SERPINE3 was undetectable. Trophoblast side-population marker mRNA was measured in human placentas (< 34-weeks' gestation; n = 78 preeclampsia, n = 30 FGR, and n = 18 gestation-matched controls). ELL2, HK2 and CXCL8 were elevated in preeclamptic (p = 0.0006, p < 0.0001, p = 0.0335 respectively) and FGR placentas (p = 0.0065, p < 0.0001, p = 0.0001 respectively) versus controls. Placental GATA6 was reduced in pregnancies with preeclampsia and FGR (p = 0.0014, p = 0.0146 respectively). Placental INTS6 was reduced with FGR only (p < 0.0001). This study identified the localisation of a unique trophoblast subset enriched for side-population markers. Aberrant expression of some side-population markers may indicate disruptions to unique trophoblast subtypes in placental insufficiency.
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Affiliation(s)
- Georgia P Wong
- The Department of Obstetrics, Gynaecology and Newborn Health, Mercy Hospital for Women, University of Melbourne, 163 Studley Road, Heidelberg, Victoria, 3084, Australia.
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia.
| | - Sunhild Hartmann
- The Department of Obstetrics, Gynaecology and Newborn Health, Mercy Hospital for Women, University of Melbourne, 163 Studley Road, Heidelberg, Victoria, 3084, Australia
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany
- Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité - Universitätsmedizin Berlin, Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - David G Simmons
- School of Biomedical Sciences, University of Queensland, Brisbane, Australia
| | - Sarah Ellis
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia
- School of Cancer Medicine, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Olivia Nonn
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany
- Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité - Universitätsmedizin Berlin, Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Ping Cannon
- The Department of Obstetrics, Gynaecology and Newborn Health, Mercy Hospital for Women, University of Melbourne, 163 Studley Road, Heidelberg, Victoria, 3084, Australia
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Tuong-Vi Nguyen
- The Department of Obstetrics, Gynaecology and Newborn Health, Mercy Hospital for Women, University of Melbourne, 163 Studley Road, Heidelberg, Victoria, 3084, Australia
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Anna Nguyen
- The Department of Obstetrics, Gynaecology and Newborn Health, Mercy Hospital for Women, University of Melbourne, 163 Studley Road, Heidelberg, Victoria, 3084, Australia
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Lucy A Bartho
- The Department of Obstetrics, Gynaecology and Newborn Health, Mercy Hospital for Women, University of Melbourne, 163 Studley Road, Heidelberg, Victoria, 3084, Australia
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Stephen Tong
- The Department of Obstetrics, Gynaecology and Newborn Health, Mercy Hospital for Women, University of Melbourne, 163 Studley Road, Heidelberg, Victoria, 3084, Australia
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Natalie J Hannan
- The Department of Obstetrics, Gynaecology and Newborn Health, Mercy Hospital for Women, University of Melbourne, 163 Studley Road, Heidelberg, Victoria, 3084, Australia
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Tu'uhevaha J Kaitu'u-Lino
- The Department of Obstetrics, Gynaecology and Newborn Health, Mercy Hospital for Women, University of Melbourne, 163 Studley Road, Heidelberg, Victoria, 3084, Australia
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia
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Umapathy A, Clark A, Sehgal A, Karanam V, Rajaraman G, Kalionis B, Jones H, James J, Murthi P. Molecular regulators of defective placental and cardiovascular development in fetal growth restriction. Clin Sci (Lond) 2024; 138:761-775. [PMID: 38904187 PMCID: PMC11193155 DOI: 10.1042/cs20220428] [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: 12/29/2023] [Revised: 05/12/2024] [Accepted: 05/22/2024] [Indexed: 06/22/2024]
Abstract
Placental insufficiency is one of the major causes of fetal growth restriction (FGR), a significant pregnancy disorder in which the fetus fails to achieve its full growth potential in utero. As well as the acute consequences of being born too small, affected offspring are at increased risk of cardiovascular disease, diabetes and other chronic diseases in later life. The placenta and heart develop concurrently, therefore placental maldevelopment and function in FGR may have profound effect on the growth and differentiation of many organ systems, including the heart. Hence, understanding the key molecular players that are synergistically linked in the development of the placenta and heart is critical. This review highlights the key growth factors, angiogenic molecules and transcription factors that are common causes of defective placental and cardiovascular development.
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Affiliation(s)
- Anandita Umapathy
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Alys Clark
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
- Auckland Bioengineering Institute, Bioengineering Institute, New Zealand
| | - Arvind Sehgal
- Department of Paediatrics, Monash University, Melbourne, VIC, Australia and Monash Newborn, Monash Children’s Hospital, Melbourne, VIC, Australia
| | - Vijaya Karanam
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Royal Women’s Hospital, Victoria, Australia
| | - Gayathri Rajaraman
- First year college, Victoria University, St Albans, Victoria 3021, Australia
| | - Bill Kalionis
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Royal Women’s Hospital, Victoria, Australia
- Department of Maternal Fetal Medicine, Pregnancy Research Centre, Royal Women’s Hospital, Victoria, Australia
| | - Helen N. Jones
- Department of Physiology and Aging, University of Florida College of Medicine, Gainesville, FL, U.S.A
- Center for Research in Perinatal Outcomes, University of Florida College of Medicine, Gainesville, FL, U.S.A
| | - Jo James
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
- Auckland Bioengineering Institute, Bioengineering Institute, New Zealand
| | - Padma Murthi
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Royal Women’s Hospital, Victoria, Australia
- Department of Maternal Fetal Medicine, Pregnancy Research Centre, Royal Women’s Hospital, Victoria, Australia
- Department of Pharmacology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
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Santos LG, de Sá RAM, Baião AER, Portari EA, de Avila Frayha A, Gomes Junior SC, Araujo Júnior E. Fetal hemodynamics and placental histopathology in Down syndrome. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:680-686. [PMID: 38587238 DOI: 10.1002/jcu.23686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/26/2024] [Accepted: 04/01/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To evaluate the association between Doppler patterns in fetuses with Down syndrome (DS) and their placental histopathologic findings. METHODS A retrospective cross-sectional study was performed by collecting data from medical records of singleton pregnancies between January 2014 and January 2022, whose fetuses had a confirmed diagnosis of DS either prenatally or postnatally. Placental histopathology, maternal characteristics, and prenatal ultrasound (biometric parameters and umbilical artery [UA] Doppler) were evaluated. RESULTS Of 69 eligible pregnant women, 61 met the inclusion and exclusion criteria. In the sample, 15 fetuses had an estimated fetal weight < 10th percentile for gestational age (GA) and were considered small for gestational age (SGA). Thirty-eight fetuses had increased resistance on the UA Doppler. Histologic changes were detected in 100% of the placentas, the most common being delayed villous maturation, alterations associated with poor fetal vascular perfusion, and villous dysmorphism. More than 50% of the placentas showed alterations related to placental insufficiency. We did not observe a statistically significant association between UA Doppler examination and placental alterations. All placentas analyzed in the SGA subgroup showed findings compatible with placental insufficiency. CONCLUSION We found no statistically significant association between placental histopathologic findings and UA Doppler abnormalities in fetuses with DS. The placental alterations identified were delayed villous maturation, alterations associated with poor fetal vascular perfusion, and villous dysmorphism.
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Affiliation(s)
- Luisa Guimarães Santos
- Fetal Medicine Service, National Institute of Women, Children and Adolescents Health Fernandes Figueira/Oswaldo Cruz Foundation (IFF/FIOCRUZ), Rio de Janeiro, Brazil
| | - Renato Augusto Moreira de Sá
- Fetal Medicine Service, National Institute of Women, Children and Adolescents Health Fernandes Figueira/Oswaldo Cruz Foundation (IFF/FIOCRUZ), Rio de Janeiro, Brazil
- Department of Obstetrics, Fluminense Federal University (UFF), Niteroi, Brazil
| | - Ana Elisa Rodrigues Baião
- Fetal Medicine Service, National Institute of Women, Children and Adolescents Health Fernandes Figueira/Oswaldo Cruz Foundation (IFF/FIOCRUZ), Rio de Janeiro, Brazil
| | - Elyzabeth Avvad Portari
- Pathology Service, National Institute of Women, Children and Adolescents Health Fernandes Figueira/Oswaldo Cruz Foundation (IFF/FIOCRUZ), Rio de Janeiro, Brazil
| | - Alexia de Avila Frayha
- Fetal Medicine Service, National Institute of Women, Children and Adolescents Health Fernandes Figueira/Oswaldo Cruz Foundation (IFF/FIOCRUZ), Rio de Janeiro, Brazil
| | - Saint Clair Gomes Junior
- Biostatistics Sector, National Institute of Women, Children and Adolescents Health Fernandes Figueira/Oswaldo Cruz Foundation (IFF/FIOCRUZ), Rio de Janeiro, Brazil
| | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
- Discipline of Woman Health, Municipal University of São Caetano do Sul (USCS), São Caetano do Sul, Brazil
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Peng J, Zhang Y, Liu Q, Tang Y, Zhang W, Zheng S, Huang W, Yang M, He Y, Li Z, Xie L, Li J, Wang J, Zhou Y. Allicin in pregnancy diets modulates steroid metabolism in pregnant sows and placental sulphate metabolism promoting placental angiogenesis and foetal development. Animal 2024; 18:101224. [PMID: 39024999 DOI: 10.1016/j.animal.2024.101224] [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: 02/24/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 07/20/2024] Open
Abstract
The low-birth-weight of piglets is an important factor affecting pig enterprises. The placenta, as a key organ for material exchange between mother and foetus, directly influences the growth and development of the foetus. Allicin exhibits various biological activities, including anti-inflammatory and antioxidant properties. It may also play a crucial role in enhancing sow reproductive performance and placental angiogenesis. In this study, we used 70 lactating Landrace × Yorkshire binary heterozygous sows to explore the effect of allicin on the reproductive performance of sows and placental development. The sows were randomly assigned into the Allicin group (Allicin), which was fed with a diet containing 0.25% allicin, and the negative control group, which was fed with basal feed. The experimental period lasted for 114 d from the date of mating to the end of farrowing. The results showed that the addition of allicin to the gestation diets increased the number of total born piglets, born alive piglets, and high-birth-weight piglets, reduced peripartum oxidative stress, alleviated dysregulation of glucose-lipid metabolism in sows, and increased the levels of antioxidant markers in the placenta. Differential analysis of metabolites in maternal plasma and placenta samples by non-targeted metabolomics revealed that allicin improved cholesterol metabolism, steroid biosynthesis, and increased plasma progesterone levels in sows. Allicin promoted sulphur metabolism, cysteine and methionine metabolism in placental samples and increased the hydrogen sulphide (H2S) content in the placenta. In addition, Quantitative Real-time PCR, Western blot and immunofluorescence results showed that allicin upregulated the expression of angiogenesis-related genes, VEGF-A, FLK 1 and Ang 1, in the placenta, implying that it promoted placental angiogenesis. These results indicate that supplementing the diet of pregnant sows with allicin reduces oxidative stress, alleviates dysregulation of glucose-lipid metabolism during the periparturient period, and promotes placental angiogenesis and foetal development by increasing plasma progesterone level and placental H2S content.
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Affiliation(s)
- J Peng
- Innovative Institute of Animal Healthy Breeding, College of Animal Science and Technology, College of Light Industry and Food Sciences, Academy of Contemporary Agricultural Engineering Innovations, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Y Zhang
- Innovative Institute of Animal Healthy Breeding, College of Animal Science and Technology, College of Light Industry and Food Sciences, Academy of Contemporary Agricultural Engineering Innovations, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Q Liu
- Innovative Institute of Animal Healthy Breeding, College of Animal Science and Technology, College of Light Industry and Food Sciences, Academy of Contemporary Agricultural Engineering Innovations, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Y Tang
- Innovative Institute of Animal Healthy Breeding, College of Animal Science and Technology, College of Light Industry and Food Sciences, Academy of Contemporary Agricultural Engineering Innovations, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - W Zhang
- Innovative Institute of Animal Healthy Breeding, College of Animal Science and Technology, College of Light Industry and Food Sciences, Academy of Contemporary Agricultural Engineering Innovations, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - S Zheng
- Innovative Institute of Animal Healthy Breeding, College of Animal Science and Technology, College of Light Industry and Food Sciences, Academy of Contemporary Agricultural Engineering Innovations, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - W Huang
- Innovative Institute of Animal Healthy Breeding, College of Animal Science and Technology, College of Light Industry and Food Sciences, Academy of Contemporary Agricultural Engineering Innovations, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China; College of Animal Science and Technology and Animal Medicine, Huazhong Agricultural University, Frontiers Science Center for Animal Breeding and Sustainable Production, Wuchang, Wuhan 430000, China
| | - M Yang
- Innovative Institute of Animal Healthy Breeding, College of Animal Science and Technology, College of Light Industry and Food Sciences, Academy of Contemporary Agricultural Engineering Innovations, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Y He
- Innovative Institute of Animal Healthy Breeding, College of Animal Science and Technology, College of Light Industry and Food Sciences, Academy of Contemporary Agricultural Engineering Innovations, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Z Li
- Innovative Institute of Animal Healthy Breeding, College of Animal Science and Technology, College of Light Industry and Food Sciences, Academy of Contemporary Agricultural Engineering Innovations, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - L Xie
- Innovative Institute of Animal Healthy Breeding, College of Animal Science and Technology, College of Light Industry and Food Sciences, Academy of Contemporary Agricultural Engineering Innovations, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - J Li
- School of Life and Health Science, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - J Wang
- Division of AOS & CDC, Faculty of Dentistry, and State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong 999077, China
| | - Y Zhou
- College of Animal Science and Technology and Animal Medicine, Huazhong Agricultural University, Frontiers Science Center for Animal Breeding and Sustainable Production, Wuchang, Wuhan 430000, China.
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Dap M, Albert T, Ramdhani I, Couturier-Tarrade A, Morel O, Chavatte-Palmer P, Beaumont M, Bertholdt C. Is the rabbit a natural model of fetal growth restriction? Morphological and functional characterization study using diffusion-weighted MRI and stereology. Placenta 2024; 154:74-79. [PMID: 38909564 DOI: 10.1016/j.placenta.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/03/2024] [Accepted: 06/18/2024] [Indexed: 06/25/2024]
Abstract
INTRODUCTION Rabbits are routinely used as a natural model of fetal growth restriction (FGR); however, no studies have confirmed that rabbits have FGR. This study aimed to characterize the fetoplacental unit (FPU) in healthy pregnant rabbits using diffusion-weighted MRI and stereology. A secondary objective of the study was to describe the associations among findings from diffusion-weighted MRI (DW-MRI), fetal weight measurement and histological analysis of the placenta. METHODS Pregnant rabbits underwent DW-MRI under general anesthesia on embryonic day 28 of pregnancy. MR imaging was performed at 3.0 T. The apparent diffusion coefficient (ADC) values were calculated for the fetal brain, liver, and placenta. The placenta was analyzed by stereology (volume density of trophoblasts, the maternal blood space and fetal vessels). Each fetus and placenta were weighed. Two groups of fetuses were defined according to the position in the uterine horn (Cervix group versus Ovary group). RESULTS We analyzed 20 FPUs from 5 pregnant rabbits. Fetuses and placentas were significantly lighter in the Cervix group than in the Ovary group (34.7 ± 3.7 g vs. 40.2 ± 5.4 g; p = 0.02). Volume density analysis revealed that the percentage of fetal vessels, the maternal blood space and trophoblasts was not significantly affected by the position of the fetus in the uterine horn. There was no difference in ADC values according to the position of the fetus in the uterine horn, and there was no correlation between ADC values and fetal weight. DISCUSSION The findings of a multimodal evaluation of the placenta in a rabbit model of FGR suggested is not a natural model of fetal growth restriction.
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Affiliation(s)
- Matthieu Dap
- Université de Lorraine, CHRU-NANCY, Pôle de la Femme, F-54000, Nancy, France; Université de Lorraine, Inserm, IADI, F-54000, Nancy, France; Université de Lorraine, Pôle Laboratoire, F-54000, Nancy, France.
| | - Théo Albert
- Université de Lorraine, Inserm, IADI, F-54000, Nancy, France
| | - Ikrame Ramdhani
- Université de Lorraine, Inserm, IADI, F-54000, Nancy, France
| | - Anne Couturier-Tarrade
- Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France; Ecole Nationale Vétérinaire d'Alfort, BREED, 94700, Maisons-Alfort, France
| | - Olivier Morel
- Université de Lorraine, CHRU-NANCY, Pôle de la Femme, F-54000, Nancy, France; Université de Lorraine, Inserm, IADI, F-54000, Nancy, France
| | - Pascale Chavatte-Palmer
- Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France; Ecole Nationale Vétérinaire d'Alfort, BREED, 94700, Maisons-Alfort, France
| | - Marine Beaumont
- Université de Lorraine, Inserm, IADI, F-54000, Nancy, France; CHRU-NANCY, Inserm, Université de Lorraine, CIC, Innovation Technologique, F-54000, Nancy, France
| | - Charline Bertholdt
- Université de Lorraine, CHRU-NANCY, Pôle de la Femme, F-54000, Nancy, France; Université de Lorraine, Inserm, IADI, F-54000, Nancy, France
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10
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Kozai A, Murakami R, Chiba Y, Miyai Y, Matsumoto K, Kanenishi K, Ueno M. Immunohistochemical localization of HCA1 receptor in placenta in presence of fetal growth restriction. Placenta 2024; 154:80-87. [PMID: 38909565 DOI: 10.1016/j.placenta.2024.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 06/06/2024] [Accepted: 06/18/2024] [Indexed: 06/25/2024]
Abstract
INTRODUCTION Glucose metabolism produces lactate and hydrogen ions in an anaerobic environment. Fetuses with intrauterine growth restriction are considered to become progressively lactacidemic as well as hypoxic. Roles of lactate in the placenta in the presence of fetal growth restriction (FGR) remain to be clarified. METHODS Immunohistochemical localization of lactate-related substances, such as a receptor for lactate (hydroxy-carboxylic acid 1 receptor (HCA1 receptor/GPR81)), monocarboxylate transporters (MCTs) for lactate, lactate dehydrogenases (LDHs), and proteins expressed in syncytiotrophoblasts or cytotrophoblasts was examined in placentas of appropriate weight for gestational age (AGA) fetus and those showing FGR. RESULTS Immunoreactivity for the HCA1 receptor was present in the cytoplasm of some trophoblasts, predominantly localized to their basal (fetus-facing) side, and was frequently colocalized with that for E-cadherin or serine peptidase inhibitor, Kunitz type 1 (SPINT1), a marker protein of cytotrophoblasts. Immunoreactivity for MCT1 and MCT4 was present on the basal and the microvillous (maternal-facing) membranes of trophoblasts in both groups, respectively. Clear immunoreactivity for LDHA and LDHB was also observed in the cytoplasm of trophoblasts, mainly localized to their basal side. However, there were no significant differences in immunohistochemically stained areas of lactate-related substances between AGA and late-onset FGR groups. On the other hand, there were correlations between coefficients of the presence of chorioamnionitis and the values of LDHB and E-cadherin. DISCUSSION Immunohistochemical localization of the HCA1 receptor was predominantly observed in the cytoplasm located on the basal side of trophoblasts, suggesting a role of lactate in human placental development, including syncytialization.
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Affiliation(s)
- Ayumi Kozai
- Department of Pathology and Host Defense, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan; Department of Perinatology and Gynecology, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan
| | - Ryuta Murakami
- Department of Pathology and Host Defense, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan
| | - Yoichi Chiba
- Department of Pathology and Host Defense, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan
| | - Yumi Miyai
- Department of Pathology and Host Defense, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan
| | - Koichi Matsumoto
- Department of Pathology and Host Defense, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan
| | - Kenji Kanenishi
- Department of Perinatology and Gynecology, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan
| | - Masaki Ueno
- Department of Pathology and Host Defense, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan.
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De Vos ES, Mulders AGMGJ, Koning AHJ, Willemsen SP, Rousian M, Van Rijn BB, Steegers EAP, Steegers-Theunissen RPM. Morphologic development of the first-trimester utero-placental vasculature is positively associated with embryonic and fetal growth: the Rotterdam Periconception Cohort. Hum Reprod 2024; 39:923-935. [PMID: 38503486 PMCID: PMC11063559 DOI: 10.1093/humrep/deae056] [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: 06/26/2023] [Revised: 01/31/2024] [Indexed: 03/21/2024] Open
Abstract
STUDY QUESTION Is morphologic development of the first-trimester utero-placental vasculature associated with embryonic growth and development, fetal growth, and birth weight percentiles? SUMMARY ANSWER Using the utero-placental vascular skeleton (uPVS) as a new imaging marker, this study reveals morphologic development of the first-trimester utero-placental vasculature is positively associated with embryonic growth and development, fetal growth, and birth weight percentiles. WHAT IS KNOWN ALREADY First-trimester development of the utero-placental vasculature is associated with placental function, which subsequently impacts embryonic and fetal ability to reach their full growth potential. The attribution of morphologic variations in the utero-placental vascular development, including the vascular structure and branching density, on prenatal growth remains unknown. STUDY DESIGN, SIZE, DURATION This study was conducted in the VIRTUAL Placental study, a subcohort of 214 ongoing pregnancies, embedded in the prospective observational Rotterdam Periconception Cohort (Predict study). Women were included before 10 weeks gestational age (GA) at a tertiary referral hospital in The Netherlands between January 2017 and March 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS We obtained three-dimensional power Doppler volumes of the gestational sac including the embryo and the placenta at 7, 9, and 11 weeks of gestation. Virtual Reality-based segmentation and a recently developed skeletonization algorithm were applied to the power Doppler volumes to generate the uPVS and to measure utero-placental vascular volume (uPVV). Absolute vascular morphology was quantified by assigning a morphologic characteristic to each voxel in the uPVS (i.e. end-, bifurcation-crossing-, or vessel point). Additionally, total vascular length (mm) was calculated. The ratios of the uPVS characteristics to the uPVV were calculated to determine the density of vascular branching. Embryonic growth was estimated by crown-rump length and embryonic volume. Embryonic development was estimated by Carnegie stages. Fetal growth was measured by estimated fetal weight in the second and third trimester and birth weight percentiles. Linear mixed models were used to estimate trajectories of longitudinal measurements. Linear regression analysis with adjustments for confounders was used to evaluate associations between trajectories of the uPVS and prenatal growth. Groups were stratified for conception method (natural/IVF-ICSI conceptions), fetal sex (male/female), and the occurrence of placenta-related complications (yes/no). MAIN RESULTS AND THE ROLE OF CHANCE Increased absolute vascular morphologic development, estimated by positive random intercepts of the uPVS characteristics, is associated with increased embryonic growth, reflected by crown-rump length (endpoints β = 0.017, 95% CI [0.009; 0.025], bifurcation points β = 0.012, 95% CI [0.006; 0.018], crossing points β = 0.017, 95% CI [0.008; 0.025], vessel points β = 0.01, 95% CI [0.002; 0.008], and total vascular length β = 0.007, 95% CI [0.003; 0.010], and similarly with embryonic volume and Carnegie stage, all P-values ≤ 0.01. Density of vascular branching was negatively associated with estimated fetal weight in the third trimester (endpoints: uPVV β = -94.972, 95% CI [-185.245; -3.698], bifurcation points: uPVV β = -192.601 95% CI [-360.532; -24.670]) and birth weight percentiles (endpoints: uPVV β = -20.727, 95% CI [-32.771; -8.683], bifurcation points: uPVV β -51.097 95% CI [-72.257; -29.937], and crossing points: uPVV β = -48.604 95% CI [-74.246; -22.961])), all P-values < 0.05. After stratification, the associations were observed in natural conceptions specifically. LIMITATION, REASONS FOR CAUTION Although the results of this prospective observational study clearly demonstrate associations between first-trimester utero-placental vascular morphologic development and prenatal growth, further research is required before we can draw firm conclusions about a causal relationship. WIDER IMPLICATIONS OF THE FINDINGS Our findings support the hypothesis that morphologic variations in utero-placental vascular development play a role in the vascular mechanisms involved in embryonic and fetal growth and development. Application of the uPVS could benefit our understanding of the pathophysiology underlying placenta-related complications. Future research should focus on the clinical applicability of the uPVS as an imaging marker for the early detection of fetal growth restriction. STUDY FUNDING/COMPETING INTEREST(S) This research was funded by the Department of Obstetrics and Gynecology of the Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. There are no conflicts of interest. TRIAL REGISTRATION NUMBER Registered at the Dutch Trial Register (NTR6854).
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Affiliation(s)
- E S De Vos
- Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - A G M G J Mulders
- Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - A H J Koning
- Department of Pathology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - S P Willemsen
- Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Biostatistics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M Rousian
- Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - B B Van Rijn
- Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - E A P Steegers
- Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - R P M Steegers-Theunissen
- Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Van Vliet MM, Schoenmakers S, Haug B, Willemsen S, Steegers-Theunissen RPM. Paternal age and first trimester placental size and growth: The Rotterdam Periconceptional Cohort. Placenta 2024; 150:1-7. [PMID: 38537411 DOI: 10.1016/j.placenta.2024.03.009] [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: 12/01/2023] [Revised: 03/06/2024] [Accepted: 03/15/2024] [Indexed: 05/04/2024]
Abstract
INTRODUCTION Despite a noticeable trend of delayed fatherhood, less is known about the impact of paternal age on the paternally programmed placenta. We hypothesize that paternal aging affects seminal quality and as such induces ageing-related epigenetic alterations that influence placental growth. Our main aim is to investigate associations between paternal age and first trimester (vascular) placental growth trajectories. METHODS Pregnant women were enrolled before 10 weeks of gestation in the Rotterdam Periconceptional Cohort (Predict study). Placental volumes (PV) and utero-placental vascular volumes (uPVV) were measured at 7, 9, and 11 weeks gestation. Associations between paternal age and PV and uPVV were investigated using linear mixed models and the maximum likelihood ratio test to test non-linear relationships. We adjusted for gestational age, fetal sex, parental smoking and maternal age, BMI, education and parity, and stratified for conception mode. RESULTS From 808 pregnancies we obtained 1313 PV and from 183 pregnancies 345 uPVV measurements. We show no associations between paternal age and PV (p = 0.934) and uPVV (p = 0.489) in our total population or in pregnancies conceived naturally (PV p = 0.166; uPVV p = 0.446) and after IVF/ICSI (PV p = 0.909; uPVV p = 0.749). For example, PV was 0.9% smaller (95% CI -5.7%-7.1%) in fathers aged 40 compared to 30 years old at 9 weeks gestation in the total study population. DISCUSSION We are not demonstrating a significant impact of paternal age on first trimester placental growth in a tertiary care population. Given the trend of increasing paternal age, our study should be repeated in the general population.
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Affiliation(s)
- M M Van Vliet
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Developmental Biology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - S Schoenmakers
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - B Haug
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - S Willemsen
- Department Biostatistics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - R P M Steegers-Theunissen
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
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Li R, Song F, Zhou Q, Wu W, Cao Y, Zhang G, Qian Z, Wang L. A Hybrid Model for Fetal Growth Restriction Assessment by Automatic Placental Radiomics on T2-Weighted MRI and Multifeature Fusion. J Magn Reson Imaging 2024. [PMID: 38655903 DOI: 10.1002/jmri.29399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND MRI-based placental analyses have been used to improve fetal growth restriction (FGR) assessment by complementing ultrasound-based measurements. However, these are still limited by time-consuming manual annotation in MRI data and the lack of mother-based information. PURPOSE To develop and validate a hybrid model for accurate FGR assessment by automatic placental radiomics on T2-weighted imaging (T2WI) and multifeature fusion. STUDY TYPE Retrospective. POPULATION 274 pregnant women (29.5 ± $$ \pm $$ 4.0 years) from two centers were included and randomly divided into training (N = 119), internal test (N = 40), time-independent validation (N = 43), and external validation (N = 72) sets. FIELD STRENGTH/SEQUENCE 1.5-T, T2WI half-Fourier acquisition single-shot turbo spin-echo pulse sequence. ASSESSMENT First, the placentas on T2WI were manually annotated, and a deep learning model was developed to automatically segment the placentas. Then, the radiomic features were extracted from the placentas and selected by three-step feature selection. In addition, fetus-based measurement features and mother-based clinical features were obtained from ultrasound examinations and medical records, respectively. Finally, a hybrid model based on random forest was constructed by fusing these features, and further compared with models based on other machine learning methods and different feature combinations. STATISTICAL TESTS The performances of placenta segmentation and FGR assessment were evaluated by Dice similarity coefficient (DSC) and the area under the receiver operating characteristic curve (AUROC), respectively. A P-value <0.05 was considered statistically significant. RESULTS The placentas were automatically segmented with an average DSC of 90.0%. The hybrid model achieved an AUROC of 0.923, 0.931, and 0.880 on the internal test, time-independent validation, and external validation sets, respectively. The mother-based clinical features resulted in significant performance improvements for FGR assessment. DATA CONCLUSION The proposed hybrid model may be able to assess FGR with high accuracy. Furthermore, information complementation based on placental, fetal, and maternal features could also lead to better FGR assessment performance. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY Stage 2.
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Affiliation(s)
- Ruikun Li
- Department of Automation, Shanghai Jiao Tong University, Shanghai, China
| | - Fuzhen Song
- The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Qing Zhou
- Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Weibin Wu
- The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Yunyun Cao
- The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Guofu Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Zhaoxia Qian
- The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Lisheng Wang
- Department of Automation, Shanghai Jiao Tong University, Shanghai, China
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Guo Y, Huang C, Qiu L, Fu J, Xu C, Yang F. CircTHBS1 promotes trophoblast cell migration and invasion and inhibits trophoblast apoptosis by regulating miR-136-3p/IGF2R axis. FASEB J 2024; 38:e23598. [PMID: 38581244 DOI: 10.1096/fj.202302113rr] [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: 10/17/2023] [Revised: 03/16/2024] [Accepted: 03/25/2024] [Indexed: 04/08/2024]
Abstract
The precise molecular mechanism behind fetal growth restriction (FGR) is still unclear, although there is a strong connection between placental dysfunction, inadequate trophoblast invasion, and its etiology and pathogenesis. As a new type of non-coding RNA, circRNA has been shown to play a crucial role in the development of FGR. This investigation identified the downregulation of hsa_circ_0034533 (circTHBS1) in FGR placentas through high-sequencing analysis and confirmed this finding in 25 clinical placenta samples using qRT-PCR. Subsequent in vitro functional assays demonstrated that silencing circTHBS1 inhibited trophoblast proliferation, migration, invasion, and epithelial mesenchymal transition (EMT) progression and promoted apoptosis. Furthermore, when circTHBS1 was overexpressed, cell function experiments showed the opposite result. Analysis using fluorescence in situ hybridization revealed that circTHBS1 was primarily found in the cytoplasmic region. Through bioinformatics analysis, we anticipated the involvement of miR-136-3p and IGF2R in downstream processes, which was subsequently validated through qRT-PCR and dual-luciferase assays. Moreover, the inhibition of miR-136-3p or the overexpression of IGF2R partially reinstated proliferation, migration, and invasion abilities following the silencing of circTHBS1. In summary, the circTHBS1/miR-136-3p/IGF2R axis plays a crucial role in the progression and development of FGR, offering potential avenues for the exploration of biological indicators and treatment targets.
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Affiliation(s)
- Yanyan Guo
- Department of Fetal Medicine and Prenatal Diagnosis, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Chuyi Huang
- Department of Fetal Medicine and Prenatal Diagnosis, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Liyan Qiu
- Department of Fetal Medicine and Prenatal Diagnosis, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiahui Fu
- Department of Fetal Medicine and Prenatal Diagnosis, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Cailing Xu
- Department of Fetal Medicine and Prenatal Diagnosis, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Fang Yang
- Department of Fetal Medicine and Prenatal Diagnosis, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Ewing A, O'Callaghan JL, McCracken S, Ellery S, Lappas M, Holland OJ, Perkins A, Saif Z, Clifton VL. Placentae of small appropriately-grown-for-gestational-age neonates exhibit sexually dimorphic transcriptomic changes representative of placental insufficiency. Placenta 2024; 149:37-43. [PMID: 38492471 DOI: 10.1016/j.placenta.2024.02.003] [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: 12/13/2023] [Revised: 01/23/2024] [Accepted: 02/09/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION Previous studies have reported that neonates less than the 25th BWC especially if they were male, were more likely to be associated with birth complications suggesting small neonates often identified as appropriately grown are at risk of adverse outcomes. We have questioned whether smaller neonates not typically categorized as "small for gestational age" may not reach their genetically determined growth due to placental insufficiency. METHODS RNA-Seq was performed on the Illumina NovaSeq 600 using term placentae from neonates that were less than the 10th birthweight centile (BWC) (n = 39), between the 10th and the 30th BWC (n = 15) or greater than the 30th BWC (n = 23). Bioinformatic analyses were conducted and statistical significance was assessed at a level of P < 0.05 for single comparisons or FDR <0.05 unless otherwise noted. RESULTS Gene set enrichment analysis revealed differences between BWC groups and in relation to the sex of the placenta. Genes associated with hypoxia, inflammatory responses, estrogen responsive genes, and androgen responsive genes were enriched (FDR <0.1) for in placentae of neonates <10th BWC regardless of sex and also in male placentae of neonates between the 10th-30th BWC. Female placenta of neonates between the 10th-30th BWC were comparable to placentae of neonates >30th BWC. DISCUSSION These findings provide evidence that small male neonates may be at a greater risk of an adverse outcome than females due to changes in gene expression that are associated with placental dysfunction. The current data raises questions of whether placental pathology for smaller appropriately grown neonates should be scientifically and clinically examined in more depth.
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Affiliation(s)
- Adam Ewing
- Mater Research Institute, Translational Research Institute, University of Queensland, Brisbane QLD, Australia
| | | | - Sharon McCracken
- Women and Babies Research, Perinatal Medicine, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia; Northern Sydney Local Health District Research (Kolling Institute), St Leonards, NSW, Australia
| | - Stacy Ellery
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
| | - Martha Lappas
- Department of Obstetrics, Gynaecology and Newborn Health, Mercy Hospital for Women, The University of Melbourne, Melbourne VIC, Australia
| | - Olivia J Holland
- School of Medical Science, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
| | - Anthony Perkins
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Zarqa Saif
- Mater Research Institute, Translational Research Institute, University of Queensland, Brisbane QLD, Australia
| | - Vicki L Clifton
- Mater Research Institute, Translational Research Institute, University of Queensland, Brisbane QLD, Australia.
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16
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Ji X, Shang Y, Zhang J, An P. The MR radiomics-based model may predict placental vascular dysplasia. Asian J Surg 2024; 47:1999-2001. [PMID: 38218645 DOI: 10.1016/j.asjsur.2023.12.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 12/29/2023] [Indexed: 01/15/2024] Open
Affiliation(s)
- Xianqun Ji
- Department of Radiology and Surgery, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei Province, 441000, China; Department of Stomatology and Orthopedics, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei Province, 441000, China
| | - Yu Shang
- Department of Radiology and Surgery, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei Province, 441000, China; Department of Stomatology and Orthopedics, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei Province, 441000, China
| | - Junyan Zhang
- Department of Clinical Pathology, Hubei Province Clinical Research Center of Parkinson's Disease, Xiangyang Key Laboratory of Movement Disorders, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Hubei, P.R.C, Xiangyang, Hubei Province, 441000, China.
| | - Peng An
- Department of Radiology and Surgery, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei Province, 441000, China; Department of Clinical Pathology, Hubei Province Clinical Research Center of Parkinson's Disease, Xiangyang Key Laboratory of Movement Disorders, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Hubei, P.R.C, Xiangyang, Hubei Province, 441000, China.
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17
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George M, Allerkamp HH, Koshenov Z, Oflaz FE, Tam-Amersdorfer C, Kolesnik T, Rittchen S, Lang M, Fröhlich E, Graier W, Strobl H, Wadsack C. Liver X receptor activation mitigates oxysterol-induced dysfunction in fetoplacental endothelial cells. Biochim Biophys Acta Mol Cell Biol Lipids 2024; 1869:159466. [PMID: 38369253 DOI: 10.1016/j.bbalip.2024.159466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/19/2024] [Accepted: 02/12/2024] [Indexed: 02/20/2024]
Abstract
Maintaining the homeostasis of the placental vasculature is of paramount importance for ensuring normal fetal growth and development. Any disruption in this balance can lead to perinatal morbidity. Several studies have uncovered an association between high levels of oxidized cholesterol (oxysterols), and complications during pregnancy, including gestational diabetes mellitus (GDM) and preeclampsia (PE). These complications often coincide with disturbances in placental vascular function. Here, we investigate the role of two oxysterols (7-ketocholesterol, 7β-hydroxycholesterol) in (dys)function of primary fetoplacental endothelial cells (fpEC). Our findings reveal that oxysterols exert a disruptive influence on fpEC function by elevating the production of reactive oxygen species (ROS) and interfering with mitochondrial transmembrane potential, leading to its depolarization. Moreover, oxysterol-treated fpEC exhibited alterations in intracellular calcium (Ca2+) levels, resulting in the reorganization of cell junctions and a corresponding increase in membrane stiffness and vascular permeability. Additionally, we observed an enhanced adhesion of THP-1 monocytes to fpEC following oxysterol treatment. We explored the influence of activating the Liver X Receptor (LXR) with the synthetic agonist T0901317 (TO) on oxysterol-induced endothelial dysfunction in fpEC. Our results demonstrate that LXR activation effectively reversed oxysterol-induced ROS generation, monocyte adhesion, and cell junction permeability in fpEC. Although the effects on mitochondrial depolarization and calcium mobilization did not reach statistical significance, a strong trend towards stabilization of calcium mobilization was evident in LXR-activated cells. Taken together, our results suggest that high levels of systemic oxysterols link to placental vascular dysfunction and LXR agonists may alleviate their impact on fetoplacental vasculature.
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Affiliation(s)
- Meekha George
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria.
| | | | - Zhanat Koshenov
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Division of Molecular Biology and Biochemistry, Medical University of Graz, 8010 Graz, Austria; Department of Biochemistry, Weill Cornell Medicine, New York, USA
| | - Furkan E Oflaz
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Division of Molecular Biology and Biochemistry, Medical University of Graz, 8010 Graz, Austria
| | - Carmen Tam-Amersdorfer
- Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Division of Immunology, Medical University of Graz, 8010 Graz, Austria
| | | | - Sonja Rittchen
- Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Division of Immunology, Medical University of Graz, 8010 Graz, Austria; Department of Pharmacology, Medical University of Graz, Austria
| | - Magdalena Lang
- Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Division of Immunology, Medical University of Graz, 8010 Graz, Austria
| | | | - Wolfgang Graier
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Division of Molecular Biology and Biochemistry, Medical University of Graz, 8010 Graz, Austria
| | - Herbert Strobl
- Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Division of Immunology, Medical University of Graz, 8010 Graz, Austria
| | - Christian Wadsack
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria; BioTech-Med, 8010 Graz, Austria.
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18
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Song W, Guo Q, Puttabyatappa M, Elangovan VR, Wang J, Li F, Liu F, Bi X, Li H, Fu G, Padmanabhan V, Wu X. FGR-associated placental insufficiency and capillary angiogenesis involves disruptions in human placental miRNAs and mRNAs. Heliyon 2024; 10:e28007. [PMID: 38509973 PMCID: PMC10951647 DOI: 10.1016/j.heliyon.2024.e28007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 02/28/2024] [Accepted: 03/11/2024] [Indexed: 03/22/2024] Open
Abstract
Fetal growth restriction (FGR) is one of the most common pregnancy complications culminating in adverse fetal outcome, including preterm birth, neonatal mortality and stillbirth. Compromised placental development and function, especially disruption in angiogenesis and inadequate nutrient supply are contributing factors. Fetal sex also influences placental function. Knowledge of gene expression changes and epigenetic factors contributing to placental dysfunction in FGR pregnancies will help identify biomarkers and help target interventions. This study tested the hypothesis that FGR pregnancies are associated with disruptions in miRNA - an epigenetic factor and mRNAs involving key mediators of angiogenesis and microvessel development. Changes in expression of key genes/proteins involved in placental dysfunction by RT-PCR and immunohistochemistry and miRNA changes by RNA sequencing were undertaken with term placenta from 12 control and 20 FGR pregnancies. Findings showed changes in expression of genes involved in steroidogenesis, steroid action, IGF family members, inflammatory cytokines and angiogenic factors in FGR pregnancies. In addition, upregulation of MIR451A and downregulation of MIR543 in placentas from FGR group with female newborns and upregulation of MIR520G in placentas from FGR group with male newborns were also noted. MIR451A and MIR543 have been implicated in angiogenesis. Consistent with gene changes, CD34, the microvessel angiogenesis marker, also showed reduced staining only in female FGR group. These findings provide evidence that epigentically regulated gene expression changes in angiogenesis and capillary development influence placental impairment in FGR pregnancies. Our preliminary observations also support for these changes to be driven in a sex-specific manner.
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Affiliation(s)
- Wenhui Song
- Department of Obstetrics and Gynecology, Hebei Medical University, Shijiazhuang, Hebei, PR China
- The Fourth Hospital of Shijiazhuang affiliated to Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Qing Guo
- Department of Obstetrics and Gynecology, Hebei Medical University, Shijiazhuang, Hebei, PR China
- The Fourth Hospital of Shijiazhuang affiliated to Hebei Medical University, Shijiazhuang, Hebei, PR China
- Department of Obstetrics and Gynecology, Hebei Key Laboratory of Maternal and Fetal Medicine, Shijiazhuang, Hebei, PR China
| | | | | | - Jianping Wang
- The Fourth Hospital of Shijiazhuang affiliated to Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Fang Li
- The Fourth Hospital of Shijiazhuang affiliated to Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Fangfang Liu
- The Fourth Hospital of Shijiazhuang affiliated to Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Xuejie Bi
- The Fourth Hospital of Shijiazhuang affiliated to Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Haiying Li
- The Fourth Hospital of Shijiazhuang affiliated to Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Guangping Fu
- Hebei Key Laboratory of Forensic Medicine, College for Forensic Medicine, Hebei Medical University, Shijiazhuang, Hebei, PR China
| | | | - XiaoHua Wu
- Department of Obstetrics and Gynecology, Hebei Medical University, Shijiazhuang, Hebei, PR China
- The Fourth Hospital of Shijiazhuang affiliated to Hebei Medical University, Shijiazhuang, Hebei, PR China
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19
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Virk MS, Virk MA, He Y, Tufail T, Gul M, Qayum A, Rehman A, Rashid A, Ekumah JN, Han X, Wang J, Ren X. The Anti-Inflammatory and Curative Exponent of Probiotics: A Comprehensive and Authentic Ingredient for the Sustained Functioning of Major Human Organs. Nutrients 2024; 16:546. [PMID: 38398870 PMCID: PMC10893534 DOI: 10.3390/nu16040546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 02/10/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
Several billion microorganisms reside in the gastrointestinal lumen, including viruses, bacteria, fungi, and yeast. Among them, probiotics were primarily used to cure digestive disorders such as intestinal infections and diarrhea; however, with a paradigm shift towards alleviating health through food, their importance is large. Moreover, recent studies have changed the perspective that probiotics prevent numerous ailments in the major organs. Probiotics primarily produce biologically active compounds targeting discommodious pathogens. This review demonstrates the implications of using probiotics from different genres to prevent and alleviate ailments in the primary human organs. The findings reveal that probiotics immediately activate anti-inflammatory mechanisms by producing anti-inflammatory cytokines such as interleukin (IL)-4, IL-10, IL-11, and IL-13, and hindering pro-inflammatory cytokines such as IL-1, IL-6, and TNF-α by involving regulatory T cells (Tregs) and T helper cells (Th cells). Several strains of Lactobacillus plantarum, Lactobacillus rhamnosus, Lactobacillus casei, Lactobacillus reuteri, Bifidobacterium longum, and Bifidobacterium breve have been listed among the probiotics that are excellent in alleviating various simple to complex ailments. Therefore, the importance of probiotics necessitates robust research to unveil the implications of probiotics, including the potency of strains, the optimal dosages, the combination of probiotics, their habitat in the host, the host response, and other pertinent factors.
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Affiliation(s)
- Muhammad Safiullah Virk
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China; (M.S.V.)
| | | | - Yufeng He
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China; (M.S.V.)
| | - Tabussam Tufail
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China; (M.S.V.)
- University Institute of Diet and Nutritional Sciences, The University of Lahore, Lahore 54000, Pakistan
| | - Mehak Gul
- Department of Internal Medicine, Sheikh Zayed Hospital, Lahore 54000, Pakistan
| | - Abdul Qayum
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China; (M.S.V.)
| | - Abdur Rehman
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China; (M.S.V.)
| | - Arif Rashid
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China; (M.S.V.)
| | - John-Nelson Ekumah
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China; (M.S.V.)
| | - Xu Han
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China; (M.S.V.)
| | - Junxia Wang
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China; (M.S.V.)
| | - Xiaofeng Ren
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China; (M.S.V.)
- Institute of Food Physical Processing, Jiangsu University, Zhenjiang 212013, China
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20
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Stroganov S, Harris T, Fellus-Alyagor L, Ben Moyal L, Plitman Mayo R, Golani O, Hirsch D, Ben-Dor S, Brandis A, Mehlman T, Kovo M, Biron-Shental T, Dekel N, Neeman M. The differential regulation of placenta trophoblast bisphosphoglycerate mutase in fetal growth restriction: preclinical study in mice and observational histological study of human placenta. eLife 2024; 13:e82631. [PMID: 38314803 PMCID: PMC10883672 DOI: 10.7554/elife.82631] [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: 08/11/2022] [Accepted: 01/25/2024] [Indexed: 02/07/2024] Open
Abstract
Background Fetal growth restriction (FGR) is a pregnancy complication in which a newborn fails to achieve its growth potential, increasing the risk of perinatal morbidity and mortality. Chronic maternal gestational hypoxia, as well as placental insufficiency are associated with increased FGR incidence; however, the molecular mechanisms underlying FGR remain unknown. Methods Pregnant mice were subjected to acute or chronic hypoxia (12.5% O2) resulting in reduced fetal weight. Placenta oxygen transport was assessed by blood oxygenation level dependent (BOLD) contrast magnetic resonance imaging (MRI). The placentae were analyzed via immunohistochemistry and in situ hybridization. Human placentae were selected from FGR and matched controls and analyzed by immunohistochemistry (IHC). Maternal and cord sera were analyzed by mass spectrometry. Results We show that murine acute and chronic gestational hypoxia recapitulates FGR phenotype and affects placental structure and morphology. Gestational hypoxia decreased labyrinth area, increased the incidence of red blood cells (RBCs) in the labyrinth while expanding the placental spiral arteries (SpA) diameter. Hypoxic placentae exhibited higher hemoglobin-oxygen affinity compared to the control. Placental abundance of Bisphosphoglycerate mutase (BPGM) was upregulated in the syncytiotrophoblast and spiral artery trophoblast cells (SpA TGCs) in the murine gestational hypoxia groups compared to the control. Hif1α levels were higher in the acute hypoxia group compared to the control. In contrast, human FGR placentae exhibited reduced BPGM levels in the syncytiotrophoblast layer compared to placentae from healthy uncomplicated pregnancies. Levels of 2,3 BPG, the product of BPGM, were lower in cord serum of human FGR placentae compared to control. Polar expression of BPGM was found in both human and mouse placentae syncytiotrophoblast, with higher expression facing the maternal circulation. Moreover, in the murine SpA TGCs expression of BPGM was concentrated exclusively in the apical cell side, in direct proximity to the maternal circulation. Conclusions This study suggests a possible involvement of placental BPGM in maternal-fetal oxygen transfer, and in the pathophysiology of FGR. Funding This work was supported by the Weizmann Krenter Foundation and the Weizmann - Ichilov (Tel Aviv Sourasky Medical Center) Collaborative Grant in Biomedical Research, by the Minerva Foundation, by the ISF KillCorona grant 3777/19.
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Affiliation(s)
- Sima Stroganov
- Immunology and Regenerative Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Talia Harris
- Chemical Research Support Weizmann Institute of Science, Rehovot, Israel
| | | | - Lital Ben Moyal
- Immunology and Regenerative Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Romina Plitman Mayo
- Immunology and Regenerative Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Ofra Golani
- Life Science Core Facilities, Weizmann Institute of Science, Rehovot, Israel
| | - Dana Hirsch
- Life Science Core Facilities, Weizmann Institute of Science, Rehovot, Israel
| | - Shifra Ben-Dor
- Life Science Core Facilities, Weizmann Institute of Science, Rehovot, Israel
| | - Alexander Brandis
- Life Science Core Facilities, Weizmann Institute of Science, Rehovot, Israel
| | - Tevie Mehlman
- Life Science Core Facilities, Weizmann Institute of Science, Rehovot, Israel
| | - Michal Kovo
- OBGYN, Meir Medical Center, Kfar Saba, Israel
- Tel Aviv University, School of Medicine, Tel Aviv, Israel
| | - Tal Biron-Shental
- OBGYN, Meir Medical Center, Kfar Saba, Israel
- Tel Aviv University, School of Medicine, Tel Aviv, Israel
| | - Nava Dekel
- Immunology and Regenerative Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Michal Neeman
- Immunology and Regenerative Biology, Weizmann Institute of Science, Rehovot, Israel
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21
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Pan L, Zhu F, Yu A, Jiang Y, Wang D, Zhou M, Jia C, Cui Y, Tang L, Tang H, Li J. The Prl3d1-Cre mouse line selectively induces the expression of Cre recombinase in parietal trophoblast giant cells. Genesis 2024; 62:e23585. [PMID: 38124435 DOI: 10.1002/dvg.23585] [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: 09/06/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
The placenta plays a pivotal role in the maintenance of normal pregnancy, but how it forms, matures, and performs its function remains poorly understood. Here, we describe a novel mouse line (Prl3d1-iCre) that expresses iCre recombinase under the control of the endogenous prl3d1 promoter. Prl3d1 has been proposed as a marker for distinguishing trophoblast giant cells (TGCs) from other trophoblast cells in the placenta. The in vivo efficiency and specificity of the Cre line were analyzed by interbreeding Prl3d1-iCre mice with B6-G/R reporter mice. Through anatomical studies of the placenta and other tissues of Prl3d1-iCre/+; B6-G/R mouse mice, we found that the tdTomato signal was expressed in parietal trophoblast giant cells (P-TGCs). Thus, we report a mouse line with ectopic Cre expression in P-TGCs, which provides a valuable tool for studying human pathological pregnancies caused by implantation failure or abnormal trophoblast secretion due to aberrant gene regulation.
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Affiliation(s)
- Linqing Pan
- Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Kangda College of Nanjing Medical University, Lianyungang, China
- College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, China
| | - Fuquan Zhu
- College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, China
| | - Aochen Yu
- College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, China
| | - Yuan Jiang
- College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, China
| | - Dayu Wang
- College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, China
| | - Minglian Zhou
- Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Kangda College of Nanjing Medical University, Lianyungang, China
| | - Chao Jia
- College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, China
| | - Yugui Cui
- State Key Laboratory of Reproductive Medicine Center of Clinical Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lisha Tang
- Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Kangda College of Nanjing Medical University, Lianyungang, China
| | - Huaiyun Tang
- Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Kangda College of Nanjing Medical University, Lianyungang, China
| | - Juan Li
- College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, China
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22
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Anvar Z, Chakchouk I, Sharif M, Mahadevan S, Su L, Anikar S, Naini FA, Utama AB, Van den Veyver IB. Comparison of Four Protocols for In Vitro Differentiation of Human Embryonic Stem Cells into Trophoblast Lineages by BMP4 and Dual Inhibition of Activin/Nodal and FGF2 Signaling. Reprod Sci 2024; 31:173-189. [PMID: 37658178 PMCID: PMC10784360 DOI: 10.1007/s43032-023-01334-5] [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: 12/20/2022] [Accepted: 08/16/2023] [Indexed: 09/03/2023]
Abstract
Human embryonic stem cells (hESCs) cultured in media containing bone morphogenic protein 4 (BMP4; B) differentiate into trophoblast-like cells. Supplementing media with inhibitors of activin/nodal signaling (A83-01) and of fibroblast growth factor 2 (PD173074) suppresses mesoderm and endoderm formation and improves specification of trophoblast-like lineages, but with variable effectiveness. We compared differentiation in four BMP4-containing media: mTeSR1-BMP4 only, mTeSR1-BAP, basal medium with BAP (basal-BAP), and a newly defined medium, E7-BAP. These media variably drive early differentiation towards trophoblast-like lineages with upregulation of early trophoblast markers CDX2 and KRT7 and downregulation of pluripotency markers (OCT4 and NANOG). As expected, based on differences between media in FGF2 and its inhibitors, downregulation of mesendoderm marker EOMES was variable between media. By day 7, only hESCs grown in E7-BAP or basal-BAP expressed HLA-G protein, indicating the presence of cells with extravillous trophoblast characteristics. Expression of HLA-G and other differentiation markers (hCG, KRT7, and GCM1) was highest in basal-BAP, suggesting a faster differentiation in this medium, but those cultures were more inhomogeneous and still expressed some endodermal and pluripotency markers. In E7-BAP, HLA-G expression increased later and was lower. There was also a low but maintained expression of some C19MC miRNAs, with more CpG hypomethylation of the ELF5 promoter, suggesting that E7-BAP cultures differentiate slower along the trophoblast lineage. We conclude that while all protocols drive differentiation into trophoblast lineages with varying efficiency, they have advantages and disadvantages that must be considered when selecting a protocol for specific experiments.
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Affiliation(s)
- Zahra Anvar
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
- Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund Street, Room 1025.14, Houston, TX, 77030, USA
| | - Imen Chakchouk
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
- Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund Street, Room 1025.14, Houston, TX, 77030, USA
| | - Momal Sharif
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
- Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund Street, Room 1025.14, Houston, TX, 77030, USA
| | - Sangeetha Mahadevan
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
- Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund Street, Room 1025.14, Houston, TX, 77030, USA
| | - Li Su
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
- Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund Street, Room 1025.14, Houston, TX, 77030, USA
| | - Swathi Anikar
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
- Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund Street, Room 1025.14, Houston, TX, 77030, USA
| | - Fatemeh Alavi Naini
- Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund Street, Room 1025.14, Houston, TX, 77030, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | | | - Ignatia B Van den Veyver
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.
- Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund Street, Room 1025.14, Houston, TX, 77030, USA.
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.
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23
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Sun C, James JL, Murthi P. Three-Dimensional In Vitro Human Placental Organoids from Mononuclear Villous Trophoblasts or Trophoblast Stem Cells to Understand Trophoblast Dysfunction in Fetal Growth Restriction. Methods Mol Biol 2024; 2728:235-245. [PMID: 38019405 DOI: 10.1007/978-1-0716-3495-0_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
The placenta plays a critical role in the efficient delivery of nutrients and oxygen from mother to fetus to maintain normal fetal growth. Human placental development and function is a highly orchestrated process, which is spatially and temporally controlled by hormones and growth factors. Specialized epithelial cells called trophoblasts play key roles in placental exchange capacity, and their abnormal function and development contribute to many pregnancy complications, including fetal growth restriction (FGR), a condition in which the fetus does not reach its full growth potential in utero. Great variation in the anatomy and development of the placenta in animal model systems (in vivo) and 2D culture model systems of trophoblasts (in vitro) limits our ability to understand pregnancy disorders. Generating in vitro models that recapitulate the unique features of the human placenta has been challenging. Here, we describe detailed methods to isolate mononuclear villous trophoblasts (containing cytotrophoblasts and trophoblast stem cells) from first trimester placentae, and use both these and trophoblast stem cell populations that can be grown long term in a three-dimensional (3D) placental organoid culture system.
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Affiliation(s)
- Cherry Sun
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Joanna L James
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Padma Murthi
- Department of Pharmacology, Monash Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia.
- Department of Maternal Fetal Medicine, Pregnancy Research Centre, Royal Women's Hospital and Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, VIC, Australia.
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Wise RL, Brown BP, Haas DM, Sparks C, Sadhasivam S, Zhao Y, Radhakrishnan R. Placental volume in pregnant women with opioid use: prenatal MRI assessment. J Matern Fetal Neonatal Med 2023; 36:2157256. [PMID: 36599439 DOI: 10.1080/14767058.2022.2157256] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Opioid use in pregnant women is a growing public health concern and is shown to be associated with lower infant birth weights. Placental volume changes in prior studies correlated with various maternal and fetal conditions. We aimed to identify differences between placental volumes in pregnant women with opioid use, and control pregnant women without drug use. METHODS We prospectively recruited 27 healthy pregnant women and 17 pregnant women with opioid use disorder who were on medication-assisted treatment (MAT). All women underwent placenta/fetal MRI at 27-39 weeks gestation on a 3 Tesla MR scanner. Placental volumes were measured in a blinded fashion using a previously validated technique. Multiple linear regression was used to identify associations of placental volume with multiple maternal and fetal clinical factors. The significance threshold was set at p < .05. RESULTS Placental volume was significantly associated with gestational age at MRI (p < .0001), fetal sex (p = .027), MAT with smoking (p = .0008), MAT with polysubstance use (p = .01), and maternal BMI (p = .032). Placental volume was not associated with opioid MAT alone in our cohort. CONCLUSION For pregnant women on medication-assisted treatment for opioid use disorder, there was no significant difference in placental volume compared to healthy pregnant women. However, concomitant smoking and polysubstance use in the setting of medication-assisted treatment may be detrimental to placental health. To our knowledge, this is the first study assessing placental volume in opioid use on prenatal MRI. These results support the benefit of medication-assisted treatment during pregnancy; however additional studies are needed to further elucidate the impact of opioid use on placental and fetal development and postnatal outcomes.
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Affiliation(s)
- Rachel L Wise
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Brandon P Brown
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.,The Fetal Center at Riley Children's Health, Indianapolis, IN, USA
| | - David M Haas
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Christina Sparks
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Senthilkumar Sadhasivam
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, USA.,Department of Anesthesia, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Yi Zhao
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Rupa Radhakrishnan
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
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25
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Wu ZH, Li FF, Ruan LL, Feng Q, Zhang S, Li ZH, Otoo A, Tang J, Fu LJ, Liu TH, Ding YB. miR-181d-5p, which is upregulated in fetal growth restriction placentas, inhibits trophoblast fusion via CREBRF. J Assist Reprod Genet 2023; 40:2725-2737. [PMID: 37610607 PMCID: PMC10643557 DOI: 10.1007/s10815-023-02917-6] [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: 03/27/2023] [Accepted: 08/15/2023] [Indexed: 08/24/2023] Open
Abstract
PURPOSE Fetal growth restriction (FGR) is a common complication characterized by impaired placental function and unfavorable pregnancy outcomes. This study aims to elucidate the expression pattern of miR-181d-5p in FGR placentas and explore its effects on trophoblast fusion. METHODS The expression pattern of miR-181d-5p in human FGR placentas were evaluated using qRT-PCR. Western blot, qRT-PCR, and Immunofluorescence analysis were performed in a Forskolin (FSK)-induced BeWo cell fusion model following the transfection of miR-181d-5p mimic or inhibitor. Potential target genes for miR-181d-5p were identified by screening miRNA databases. The interaction between miR-181d-5p and Luman/CREB3 Recruitment Factor (CREBRF) was determined through a luciferase assay. Moreover, the effect of CREBRF on BeWo cell fusion was examined under hypoxic conditions. RESULTS Aberrant up-regulation of miR-181d-5p and altered expression of trophoblast fusion makers, including glial cell missing 1 (GCM1), Syncytin1 (Syn1), and E-cadherin (ECAD), were found in human FGR placentas. A down-regulation of miR-181d-5p expression was observed in the FSK-induced BeWo cell fusion model. Transfection of the miR-181d-5p mimic resulted in the inhibition of BeWo cell fusion, characterized by a down-regulation of GCM1 and Syn1, accompanied by an up-regulation of ECAD. Conversely, the miR-181d-5p inhibitor promoted BeWo cell fusion. Furthermore, miR-181d-5p exhibited negative regulation of CREBRF, which was significantly down-regulated in the hypoxia-induced BeWo cell model. The overexpression of CREBRF was effectively ameliorated the impaired BeWo cell fusion induced by hypoxia. CONCLUSIONS Our study demonstrated that miR-181d-5p, which is elevated in FGR placenta, inhibited the BeWo cell fusion through negatively regulating the expression of CREBRF.
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Affiliation(s)
- Zhi-Hong Wu
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, No.120 Longshan Road, Yubei District, Chongqing, 401147, China
- Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, Chongqing Medical University, Chongqing, China
| | - Fang-Fang Li
- Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, Chongqing Medical University, Chongqing, China
| | - Ling-Ling Ruan
- Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, Chongqing Medical University, Chongqing, China
| | - Qian Feng
- Chongqing Key Laboratory of Traditional Chinese Medicine for Prevention and Cure of Metabolic Diseases, Chongqing Medical University, Chongqing, China
| | - Shuang Zhang
- Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, Chongqing Medical University, Chongqing, China
| | - Zhuo-Hang Li
- Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, Chongqing Medical University, Chongqing, China
| | - Antonia Otoo
- Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, Chongqing Medical University, Chongqing, China
| | - Jing Tang
- Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, Chongqing Medical University, Chongqing, China
| | - Li-Juan Fu
- Department of Pharmacology, the School of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, China.
- Academician Workstation, Changsha Medical University, Changsha, China.
| | - Tai-Hang Liu
- Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, Chongqing Medical University, Chongqing, China.
| | - Yu-Bin Ding
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, No.120 Longshan Road, Yubei District, Chongqing, 401147, China.
- Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, Chongqing Medical University, Chongqing, China.
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Jost E, Kosian P, Jimenez Cruz J, Albarqouni S, Gembruch U, Strizek B, Recker F. Evolving the Era of 5D Ultrasound? A Systematic Literature Review on the Applications for Artificial Intelligence Ultrasound Imaging in Obstetrics and Gynecology. J Clin Med 2023; 12:6833. [PMID: 37959298 PMCID: PMC10649694 DOI: 10.3390/jcm12216833] [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: 09/21/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Artificial intelligence (AI) has gained prominence in medical imaging, particularly in obstetrics and gynecology (OB/GYN), where ultrasound (US) is the preferred method. It is considered cost effective and easily accessible but is time consuming and hindered by the need for specialized training. To overcome these limitations, AI models have been proposed for automated plane acquisition, anatomical measurements, and pathology detection. This study aims to overview recent literature on AI applications in OB/GYN US imaging, highlighting their benefits and limitations. For the methodology, a systematic literature search was performed in the PubMed and Cochrane Library databases. Matching abstracts were screened based on the PICOS (Participants, Intervention or Exposure, Comparison, Outcome, Study type) scheme. Articles with full text copies were distributed to the sections of OB/GYN and their research topics. As a result, this review includes 189 articles published from 1994 to 2023. Among these, 148 focus on obstetrics and 41 on gynecology. AI-assisted US applications span fetal biometry, echocardiography, or neurosonography, as well as the identification of adnexal and breast masses, and assessment of the endometrium and pelvic floor. To conclude, the applications for AI-assisted US in OB/GYN are abundant, especially in the subspecialty of obstetrics. However, while most studies focus on common application fields such as fetal biometry, this review outlines emerging and still experimental fields to promote further research.
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Affiliation(s)
- Elena Jost
- Department of Obstetrics and Gynecology, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Philipp Kosian
- Department of Obstetrics and Gynecology, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Jorge Jimenez Cruz
- Department of Obstetrics and Gynecology, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Shadi Albarqouni
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
- Helmholtz AI, Helmholtz Munich, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Ulrich Gembruch
- Department of Obstetrics and Gynecology, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Brigitte Strizek
- Department of Obstetrics and Gynecology, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Florian Recker
- Department of Obstetrics and Gynecology, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
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Shi D, Zhou X, Cai L, Wei X, Zhang L, Sun Q, Zhou F, Sun L. Placental DNA methylation analysis of selective fetal growth restriction in monochorionic twins reveals aberrant methylated CYP11A1 gene for fetal growth restriction. FASEB J 2023; 37:e23207. [PMID: 37732623 DOI: 10.1096/fj.202300742r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 08/04/2023] [Accepted: 09/07/2023] [Indexed: 09/22/2023]
Abstract
Fetal growth restriction (FGR) is associated with increased susceptibility to perinatal morbidity and mortality. Evidence suggests that epigenetic changes play critical roles in the regulation of fetal growth. We sought to present a comprehensive analysis of the associations between placental DNA methylation and selective fetal growth restriction (sFGR), which is a severe complication of monochorionic twin pregnancies, characterized by one fetus experiencing restricted growth. Genome-wide methylation analysis was performed on 24 placental samples obtained from 12 monochorionic twins with sFGR (Cohort 1) using Illumina Infinium MethylationEPIC BeadChip. Integrative analysis of our EPIC data and two previous placental methylation studies of sFGR (a total of 30 placental samples from 15 sFGR twins) was used to identify convincing differential promoter methylation. Validation analysis was performed on the placentas from 15 sFGR twins (30 placental samples), 15 FGR singletons, and 14 control singletons (Cohort 2) using pyrosequencing, quantitative real-time polymerase chain reaction, western blot, and immunohistochemistry (IHC). A globe shift toward hypomethylation was identified in the placentas of growth-restricted fetuses compared with the placentas of normal fetuses in monochorionic twins, including 5625 hypomethylated CpGs and 452 hypermethylated CpGs, especially in the regions of CpG islands, gene-body and promoters. The analysis of pathways revealed dysregulation primarily in steroid hormone biosynthesis, metabolism, cell adhesion, signaling transduction, and immune response. Integrative analysis revealed a differentially methylated promoter region in the CYP11A1 gene, encoding a rate-limiting enzyme of steroidogenesis converting cholesterol to pregnenolone. The CYP11A1 gene was validated to have hypomethylation and higher mRNA expression in sFGR twins and FGR singletons. In conclusion, our findings suggested that the changes in placental DNA methylation pattern in sFGR may have functional implications for differentially methylated genes and regulatory regions. The study provides reliable evidence for identifying abnormally methylated CYP11A1 gene in the placenta of sFGR.
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Affiliation(s)
- Dayuan Shi
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Fetal Medicine & Prenatal Diagnosis Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xinyao Zhou
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Fetal Medicine & Prenatal Diagnosis Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Luyao Cai
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Fetal Medicine & Prenatal Diagnosis Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xing Wei
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Fetal Medicine & Prenatal Diagnosis Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Luye Zhang
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Fetal Medicine & Prenatal Diagnosis Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qianqian Sun
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Fetal Medicine & Prenatal Diagnosis Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Fenhe Zhou
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Fetal Medicine & Prenatal Diagnosis Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Luming Sun
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Department of Fetal Medicine & Prenatal Diagnosis Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
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Allerkamp HH, Leighton S, Pole T, Clark AR, James JL. Synergistic regulation of uterine radial artery adaptation to pregnancy by paracrine and hemodynamic factors. Am J Physiol Heart Circ Physiol 2023; 325:H790-H805. [PMID: 37539447 PMCID: PMC10643003 DOI: 10.1152/ajpheart.00205.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/05/2023]
Abstract
Fetal growth throughout pregnancy relies on delivery of an increasing volume of maternal blood to the placenta. To facilitate this, the uterine vascular network adapts structurally and functionally, resulting in wider blood vessels with decreased flow-mediated reactivity. Impaired remodeling of the rate-limiting uterine radial arteries has been associated with fetal growth restriction. However, the mechanisms underlying normal or pathological radial artery remodeling are poorly understood. Here, we used pressure myography to determine the roles of hemodynamic (resistance, flow rate, shear stress) and paracrine [β-estradiol, progesterone, placental growth factor (PlGF), vascular endothelial growth factor] factors on rat radial artery reactivity. We show that β-estradiol, progesterone, and PlGF attenuate flow-mediated constriction of radial arteries from nonpregnant rats, allowing them to withstand higher flow rates in a similar manner to pregnant vessels. This effect was partly mediated by nitric oxide (NO) production. To better understand how the combination of paracrine factors and shear stress may impact human radial artery remodeling in the first half of gestation, computational models of uterine hemodynamics, incorporating physiological parameters for trophoblast plugging and spiral artery remodeling, were used to predict shear stress in the upstream radial arteries across the first half of pregnancy. Human microvascular endothelial cells subjected to these predicted shear stresses demonstrated higher NO production when paracrine factors were added. This suggests that synergistic effects of paracrine and hemodynamic factors induce uterine vascular remodeling and that alterations in this balance could impair radial artery adaptation, limiting blood flow to the placenta and negatively impacting fetal growth.NEW & NOTEWORTHY Placenta-specific paracrine factors β-estradiol, progesterone, and placental growth factor attenuate flow-mediated constriction of the rate-limiting uterine radial arteries, enabling higher flow rates in pregnancy. These paracrine factors induce their actions in part via nitric oxide mediated mechanisms. A synergistic combination of paracrine factors and shear stress is likely necessary to produce sufficient levels of nitric oxide during early human pregnancy to trigger adequate uterine vascular adaptation.
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Affiliation(s)
- H. H. Allerkamp
- Department of Obstetrics and Gynecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - S. Leighton
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - T. Pole
- Department of Obstetrics and Gynecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - A. R. Clark
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - J. L. James
- Department of Obstetrics and Gynecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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29
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Weingrill RB, Lee MJ, Benny P, Riel J, Saiki K, Garcia J, de Magalhaes Oliveira LFA, da Silva Fonseca EJ, de Souza ST, de Oliveira Silva D’Amato F, Silva UR, Dutra ML, Marques ALX, Borbely AU, Urschitz J. Temporal trends in microplastic accumulation in placentas from pregnancies in Hawai'i. ENVIRONMENT INTERNATIONAL 2023; 180:108220. [PMID: 37741006 PMCID: PMC10593309 DOI: 10.1016/j.envint.2023.108220] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/03/2023] [Accepted: 09/18/2023] [Indexed: 09/25/2023]
Abstract
Microplastics are created for commercial use, are shed from textiles, or result from the breakdown of larger plastic items. Recent reports have shown that microplastics accumulate in human tissues and may have adverse health consequences. Currently, there are no standardized environmental monitoring systems to track microplastic accumulation within human tissues. Using Raman spectroscopy, we investigated the temporal exposures to plastic pollution in Hawai'i and noted a significant increase in the accumulation of microplastics in discarded placentas over the past 15 years, with changes in the size and chemical composition of the polymers. These findings provide a rare insight into the vulnerability and sensitivity of Pacific Island residents to plastic pollution and illustrate how discarded human tissues can be used as an innovative environmental plastic pollution monitoring system.
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Affiliation(s)
- Rodrigo Barbano Weingrill
- Institute for Biogenesis Research, Department of Anatomy, Biochemistry, and Physiology, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, HI, USA
| | - Men-Jean Lee
- Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI, USA
| | - Paula Benny
- Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI, USA
| | - Jonathan Riel
- Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI, USA
| | - Kevin Saiki
- Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI, USA
| | - Jacob Garcia
- Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI, USA
| | | | | | | | | | - Ueslen Rocha Silva
- Physics Institute, Federal University of Alagoas, Maceio, Alagoas, Brazil
| | - Mariana Lima Dutra
- Institute of Biological and Health Sciences, Federal University of Alagoas, Campus A.C. Simões, Maceio, Alagoas, Brazil
| | - Aldilane Lays Xavier Marques
- Institute of Biological and Health Sciences, Federal University of Alagoas, Campus A.C. Simões, Maceio, Alagoas, Brazil
| | - Alexandre Urban Borbely
- Institute of Biological and Health Sciences, Federal University of Alagoas, Campus A.C. Simões, Maceio, Alagoas, Brazil
| | - Johann Urschitz
- Institute for Biogenesis Research, Department of Anatomy, Biochemistry, and Physiology, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, HI, USA
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Tang H, Li H, Li D, Peng J, Zhang X, Yang W. The Gut Microbiota of Pregnant Rats Alleviates Fetal Growth Restriction by Inhibiting the TLR9/MyD88 Pathway. J Microbiol Biotechnol 2023; 33:1213-1227. [PMID: 37416999 PMCID: PMC10580896 DOI: 10.4014/jmb.2304.04020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/02/2023] [Accepted: 06/14/2023] [Indexed: 07/08/2023]
Abstract
Fetal growth restriction (FGR) is a prevalent obstetric condition. This study aimed to investigate the role of Toll-like receptor 9 (TLR9) in regulating the inflammatory response and gut microbiota structure in FGR. An FGR animal model was established in rats, and ODN1668 and hydroxychloroquine (HCQ) were administered. Changes in gut microbiota structure were assessed using 16S rRNA sequencing, and fecal microbiota transplantation (FMT) was conducted. HTR-8/Svneo cells were treated with ODN1668 and HCQ to evaluate cell growth. Histopathological analysis was performed, and relative factor levels were measured. The results showed that FGR rats exhibited elevated levels of TLR9 and myeloid differentiating primary response gene 88 (MyD88). In vitro experiments demonstrated that TLR9 inhibited trophoblast cell proliferation and invasion. TLR9 upregulated lipopolysaccharide (LPS), LPS-binding protein (LBP), interleukin (IL)-1β and tumor necrosis factor (TNF)-α while downregulating IL-10. TLR9 activated the TARF3-TBK1-IRF3 signaling pathway. In vivo experiments showed HCQ reduced inflammation in FGR rats, and the relative cytokine expression followed a similar trend to that observed in vitro. TLR9 stimulated neutrophil activation. HCQ in FGR rats resulted in changes in the abundance of Eubacterium_coprostanoligenes_group at the family level and the abundance of Eubacterium_coprostanoligenes_group and Bacteroides at the genus level. TLR9 and associated inflammatory factors were correlated with Bacteroides, Prevotella, Streptococcus, and Prevotellaceae_Ga6A1_group. FMT from FGR rats interfered with the therapeutic effects of HCQ. In conclusion, our findings suggest that TLR9 regulates the inflammatory response and gut microbiota structure in FGR, providing new insights into the pathogenesis of FGR and suggesting potential therapeutic interventions.
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Affiliation(s)
- Hui Tang
- Department of Maternal and Child Health, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, 416 Chengnan Dong Lu, Yuhua District, 410007, Changsha, Hunan, P.R. China
| | - Hanmei Li
- Department of Maternal and Child Health, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, 416 Chengnan Dong Lu, Yuhua District, 410007, Changsha, Hunan, P.R. China
| | - Dan Li
- Department of Maternal and Child Health, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, 416 Chengnan Dong Lu, Yuhua District, 410007, Changsha, Hunan, P.R. China
| | - Jing Peng
- Department of Maternal and Child Health, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, 416 Chengnan Dong Lu, Yuhua District, 410007, Changsha, Hunan, P.R. China
| | - Xian Zhang
- Department of Maternal and Child Health, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, 416 Chengnan Dong Lu, Yuhua District, 410007, Changsha, Hunan, P.R. China
| | - Weitao Yang
- Department of Maternal and Child Health, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, 416 Chengnan Dong Lu, Yuhua District, 410007, Changsha, Hunan, P.R. China
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Lackovic M, Nikolic D, Jankovic M, Rovcanin M, Mihajlovic S. Stroke vs. Preeclampsia: Dangerous Liaisons of Hypertension and Pregnancy. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1707. [PMID: 37893425 PMCID: PMC10608338 DOI: 10.3390/medicina59101707] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/08/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023]
Abstract
Stroke during pregnancy and preeclampsia are two distinct but interrelated medical conditions, sharing a common denominator-blood control failure. Along with cardiovascular diseases, diabetes, dyslipidemia, and hypercoagulability, hypertension is undoubtedly a major risk factor associated with stroke. Even though men have higher age-specific stroke rates, women are facing higher life-long stroke risk, primarily due to longer life expectancy. Sex hormones, especially estrogen and testosterone, seem to play a key link in the chain of blood pressure control differences between the genders. Women affected with stroke are more susceptible to experience some atypical stroke manifestations, which might eventually lead to delayed diagnosis establishment, and result in higher morbidity and mortality rates in the population of women. Preeclampsia is a part of hypertensive disorder of pregnancy spectrum, and it is common knowledge that women with a positive history of preeclampsia are at increased stroke risk during their lifetime. Preeclampsia and stroke display similar pathophysiological patterns, including hypertension, endothelial dysfunction, dyslipidemia, hypercoagulability, and cerebral vasomotor reactivity abnormalities. High-risk pregnancies carrying the burden of hypertensive disorder of pregnancy have up to a six-fold higher chance of suffering from stroke. Resemblance shared between placental and cerebral vascular changes, adaptations, and sophisticated auto-regulatory mechanisms are not merely coincidental, but they reflect distinctive and complex cardiovascular performances occurring in the maternal circulatory system during pregnancy. Placental and cerebral malperfusion appears to be in the midline of both of these conditions; placental malperfusion eventually leads to preeclampsia, and cerebral to stoke. Suboptimal performances of the cardiovascular system are proposed as a primary cause of uteroplacental malperfusion. Placental dysfunction is therefore designated as a secondary condition, initiated by the primary disturbances of the cardiovascular system, rather than an immunological disorder associated with abnormal trophoblast invasion. In most cases, with properly and timely applied measures of prevention, stroke is predictable, and preeclampsia is a controllable condition. Understanding the differences between preeclampsia and stroke in pregnancy is vital for healthcare providers to enhance their clinical decision-making strategies, improve patient care, and promote positive maternal and pregnancy outcomes. Management approaches for preeclampsia and stroke require a multidisciplinary approach involving obstetricians, neurologists, and other healthcare professionals.
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Affiliation(s)
- Milan Lackovic
- University Hospital “Dragisa Misovic”, Heroja Milana Tepica 1, 11000 Belgrade, Serbia; (M.L.); (S.M.)
| | - Dejan Nikolic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
- Department of Physical Medicine and Rehabilitation, University Children’s Hospital, 11000 Belgrade, Serbia
| | - Milena Jankovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
- Neurology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Marija Rovcanin
- Clinic for Gynecology and Obstetrics “Narodni Front”, 11000 Belgrade, Serbia;
| | - Sladjana Mihajlovic
- University Hospital “Dragisa Misovic”, Heroja Milana Tepica 1, 11000 Belgrade, Serbia; (M.L.); (S.M.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
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Deng J, Cao Y, Lu Y, Song J, Zhang A, Zhao M, Zhou X, Mu X, Qu F, Wu F, Chen T. Value of placental virtual magnetic resonance elastography and intravoxel incoherent motion-based diffusion and perfusion in predicting adverse outcomes of small-for-gestational-age infants. Insights Imaging 2023; 14:153. [PMID: 37741945 PMCID: PMC10517907 DOI: 10.1186/s13244-023-01503-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/12/2023] [Indexed: 09/25/2023] Open
Abstract
OBJECTIVE It is critical to early monitor and manage small-for-gestational age (SGA) infants with truly adverse outcomes not detected by conventional methods. We aimed to explore the value of diffusion-weighted imaging (DWI)-based virtual magnetic resonance elastography (vMRE) and intravoxel incoherent motion (IVIM)-based biexponential and stretched exponential parameters in predicting adverse outcomes of SGA infants. METHODS Twenty SGA infants with adverse outcomes and forty without adverse outcomes were included in this prospective study. One DWI-based vMRE parameter [the stiffness value (μdiff)], five IVIM-based parameters [true diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), diffusion distribution coefficient (DDC), and diffusion heterogeneity index (Alpha)] and apparent diffusion coefficient (ADC) were calculated and compared between groups. The predictive efficiency was compared by the logistic regression analysis and receiver operating characteristic curve analysis. The relationship between the μdiff value with gestational age was also evaluated. RESULTS The placental μdiff value was remarkably higher, and the f, DDC, and ADC values were considerably lower in the SGA infants with adverse outcomes compared with those without adverse outcomes. The μdiff and f value were predictive risk factors for SGA infants with adverse outcomes. A combined predictive model (μdiff and f) improved the predictive efficacy. Moreover, there was no statistically significant correlation between the placental stiffness value and gestational age. CONCLUSIONS Functional MRI parameters to quantify placenta elastography and microcirculation in SGA patients. This might be a useful tool to assess placental function and a vital non-invasive supplement for predicting adverse outcomes of SGA infants. CRITICAL RELEVANCE STATEMENT This prospective study shows DWI-based virtual magnetic resonance elastography and intravoxel incoherent motion-based functional parameters to quantify placenta elastography and microcirculation in small-for-gestational-age patients, which could complement existing non-invasive methods for monitoring and predicting neonatal perinatal adverse outcome. KEY POINTS • vMRE is an emerging non-invasive imaging technique for evaluating placenta stiffness. • SGA infants with adverse outcome have stiffer placental elasticity and lower microcirculation. • Risk factors combination displayed better efficacy in predicting adverse outcomes of SGA.
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Affiliation(s)
- Jing Deng
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yuwei Cao
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yao Lu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Jiacheng Song
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Aining Zhang
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Meng Zhao
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xin Zhou
- Department of Obstetrics & Gynecology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xihu Mu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Feifei Qu
- MR Collaboration, Siemens Healthineers Ltd, Shanghai, China
| | - Feiyun Wu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
| | - Ting Chen
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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Su EJ. Scaling the EVERREST of severe, early-onset fetal growth restriction. J Clin Invest 2023; 133:e173563. [PMID: 37712422 PMCID: PMC10503793 DOI: 10.1172/jci173563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
Severe, early-onset fetal growth restriction is a leading cause of medically indicated preterm birth and substantially increases the risk for perinatal death or disability. No treatments exist to improve fetal growth or safely prolong pregnancy. Furthermore, wide-ranging phenotypes limit the accurate prediction of pregnancy outcome. In this issue of the JCI, Spencer and colleagues combine a discovery-science approach with ultrasound parameters to identify the most discriminative models for predicting either the primary outcome of fetal or neonatal death, or a secondary outcome of death or delivery at 28 weeks of gestation or earlier. Their findings can better individualize patient counseling but, just as compellingly, provide the capacity to identify those pregnancies that are at such considerable risk as to justify enrollment in paradigm-shifting interventional trials that are in the pipeline.
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Spencer R, Maksym K, Hecher K, Maršál K, Figueras F, Ambler G, Whitwell H, Nené NR, Sebire NJ, Hansson SR, Diemert A, Brodszki J, Gratacós E, Ginsberg Y, Weissbach T, Peebles DM, Zachary I, Marlow N, Huertas-Ceballos A, David AL. Maternal PlGF and umbilical Dopplers predict pregnancy outcomes at diagnosis of early-onset fetal growth restriction. J Clin Invest 2023; 133:e169199. [PMID: 37712421 PMCID: PMC10503803 DOI: 10.1172/jci169199] [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: 02/01/2023] [Accepted: 06/27/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUNDSevere, early-onset fetal growth restriction (FGR) causes significant fetal and neonatal mortality and morbidity. Predicting the outcome of affected pregnancies at the time of diagnosis is difficult, thus preventing accurate patient counseling. We investigated the use of maternal serum protein and ultrasound measurements at diagnosis to predict fetal or neonatal death and 3 secondary outcomes: fetal death or delivery at or before 28+0 weeks, development of abnormal umbilical artery (UmA) Doppler velocimetry, and slow fetal growth.METHODSWomen with singleton pregnancies (n = 142, estimated fetal weights [EFWs] below the third centile, less than 600 g, 20+0 to 26+6 weeks of gestation, no known chromosomal, genetic, or major structural abnormalities) were recruited from 4 European centers. Maternal serum from the discovery set (n = 63) was analyzed for 7 proteins linked to angiogenesis, 90 additional proteins associated with cardiovascular disease, and 5 proteins identified through pooled liquid chromatography and tandem mass spectrometry. Patient and clinician stakeholder priorities were used to select models tested in the validation set (n = 60), with final models calculated from combined data.RESULTSThe most discriminative model for fetal or neonatal death included the EFW z score (Hadlock 3 formula/Marsal chart), gestational age, and UmA Doppler category (AUC, 0.91; 95% CI, 0.86-0.97) but was less well calibrated than the model containing only the EFW z score (Hadlock 3/Marsal). The most discriminative model for fetal death or delivery at or before 28+0 weeks included maternal serum placental growth factor (PlGF) concentration and UmA Doppler category (AUC, 0.89; 95% CI, 0.83-0.94).CONCLUSIONUltrasound measurements and maternal serum PlGF concentration at diagnosis of severe, early-onset FGR predicted pregnancy outcomes of importance to patients and clinicians.TRIAL REGISTRATIONClinicalTrials.gov NCT02097667.FUNDINGThe European Union, Rosetrees Trust, Mitchell Charitable Trust.
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Affiliation(s)
- Rebecca Spencer
- UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, United Kingdom
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Kasia Maksym
- UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, United Kingdom
| | - Kurt Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karel Maršál
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden
| | - Francesc Figueras
- Institut D’Investigacions Biomèdiques August Pi í Sunyer, University of Barcelona, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Barcelona, Spain
| | - Gareth Ambler
- Department of Statistical Science, University College London, London, United Kingdom
| | - Harry Whitwell
- UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, United Kingdom
- National Phenome Centre and Imperial Clinical Phenotyping Centre, Department of Metabolism, Digestion and Reproduction and
- Section of Bioanalytical Chemistry, Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
| | - Nuno Rocha Nené
- UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, United Kingdom
| | - Neil J. Sebire
- Population, Policy and Practice Department, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Stefan R. Hansson
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden
| | - Anke Diemert
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jana Brodszki
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden
| | - Eduard Gratacós
- Institut D’Investigacions Biomèdiques August Pi í Sunyer, University of Barcelona, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Barcelona, Spain
| | - Yuval Ginsberg
- UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, United Kingdom
- Department of Obstetrics and Gynecology, Rambam Medical Centre, Haifa, Israel
| | - Tal Weissbach
- UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, United Kingdom
- Department of Obstetrics and Gynecology, Sheba Medical Center Tel Hashomer, Tel Aviv, Israel
| | - Donald M. Peebles
- UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, United Kingdom
| | - Ian Zachary
- Division of Medicine, Faculty of Medical Sciences, University College London, United Kingdom
| | - Neil Marlow
- UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, United Kingdom
| | - Angela Huertas-Ceballos
- Neonatal Department, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Anna L. David
- UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, United Kingdom
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Wang KW, Ling ZJ, Yuan Z, Zhang J, Yi SJ, Xiong YW, Chang W, Lin ZJ, Zhu HL, Yang L, Wang H. The Long-Term Effect of Maternal Iron Levels in the Second Trimester on Mild Thinness among Preschoolers: The Modifying Effect of Small for Gestational Age. Nutrients 2023; 15:3939. [PMID: 37764723 PMCID: PMC10535896 DOI: 10.3390/nu15183939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/23/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
The supplementation of multiple micronutrients throughout pregnancy can reduce the risk of adverse birth outcomes and various diseases in children. However, the long-term effect of maternal multiple micronutrient levels in the second trimester on the overall development of preschoolers remains unknown. Therefore, 1017 singleton mother-infant pairs and 6-year-old preschoolers were recruited based on the China-Wuxi Birth Cohort Study. Meanwhile, information on the demographic characteristics of pregnant women and preschoolers, maternal copper, calcium, iron, magnesium, and zinc levels in whole blood during the second trimester, and neonatal outcomes, were collected. We aimed to investigate the long-term impact of maternal copper, calcium, iron, magnesium, and zinc levels in the second trimester on mild thinness among 6-year-old preschoolers, and the modifying effect of small for gestational age (SGA), within the Chinese population. Multiple logistic regression models revealed that high-level maternal iron in the second trimester reduced the risk of mild thinness [adjusted OR: 0.46 (95% CI: 0.26, 0.80)] among 6-year-old preschoolers. However, no significant association was found for the remaining four maternal essential metal elements. Additionally, the restricted cubic spline function showed that the risk of mild thinness decreased when maternal iron concentration exceeded 7.47 mmol/L in whole blood during the second trimester. Furthermore, subgroup analysis indicated that the long-term protective effect of high-level maternal iron on mild thinness was only observed in SGA infants. Summarily, high-level maternal iron in the second trimester distinctly lowers the risk of mild thinness among 6-year-old preschoolers, especially in preschoolers with birth outcomes of SGA. Our findings offer evidence for the implementation of iron supplementation in the second trimester as a preventive measure against mild thinness in children.
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Affiliation(s)
- Kai-Wen Wang
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China
| | - Zheng-Jia Ling
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China
- Department of Medical Genetics and Prenatal Diagnosis, Wuxi Maternity and Child Health Care Hospital, Wuxi 214002, China
| | - Zhi Yuan
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China
| | - Jin Zhang
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China
| | - Song-Jia Yi
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China
| | - Yong-Wei Xiong
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China
| | - Wei Chang
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China
| | - Zhi-Jing Lin
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China
| | - Hua-Long Zhu
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China
| | - Lan Yang
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
- Department of Medical Genetics and Prenatal Diagnosis, Wuxi Maternity and Child Health Care Hospital, Wuxi 214002, China
| | - Hua Wang
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, China
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Zhu S, Liu N, Gong H, Liu F, Yan G. Identification of biomarkers and sex differences in the placenta of fetal growth restriction. J Obstet Gynaecol Res 2023; 49:2324-2336. [PMID: 37553225 DOI: 10.1111/jog.15735] [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: 12/05/2022] [Accepted: 06/20/2023] [Indexed: 08/10/2023]
Abstract
AIM Fetal growth restriction (FGR) can lead to short-term and long-term impairments in the fetus. The placenta functions as an exchanger for substance transport, playing a critical role in fetal growth. However, the mechanism from the placental standpoint is still not fully understood. In this study, we aimed to investigate the pathophysiological mechanisms in the placenta that mediated the development of FGR and sex differences. METHODS We analyzed the gene expression profiles of GSE100415 containing specific normotensive FGR placental samples and GSE114691 with canonical samples using three different methods, differentially expressed gene analysis, weighted gene co-expression network analysis, and gene set enrichment analysis. Gene enrichment was performed, including the gene ontology and pathway from the Kyoto Encyclopedia of Genes and Genomes. The important process was then validated in pregnant Wistar rats subcutaneously administered dexamethasone (0.2 mg/kg/d) or saline from gestation Day 9 to 21. RESULTS Our results revealed little difference between the comparison of normal and normotensive FGR placental samples but confirmed the sex difference. Further analyses of the canonical samples identified the occurrence of vascular dysfunction, which was validated by the calculation of the vascular lumen area, showing that the vascular lumen in the FGR group was more than in the control. We also discovered 17 significantly expressed genes from the involved eigengenes. CONCLUSION Our study provides an important theoretical and experimental basis to reevaluate the development of FGR from the placental standpoint and suggests a series of biomarkers for future clinical use.
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Affiliation(s)
- Sha Zhu
- Department of Obstetrics and Gynecology, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, Hubei, China
| | - Niying Liu
- Department of Obstetrics and Gynecology, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, Hubei, China
| | - Hongjun Gong
- Department of Obstetrics and Gynecology, Hubei Province Dongxihu District Maternal and Child Health Care Hospital, Wuhan, Hubei, China
| | - Fulin Liu
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Center for Medical Genetics, Department of Laboratory Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology, Chengdu, Sichuan, China
- Research Unit for Blindness Prevention, Chinese Academy of Medical Sciences (2019RU026), Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
- Université Paris Cité, Paris, France
| | - Ge Yan
- Department of Obstetrics and Gynecology, Hubei Province Dongxihu District Maternal and Child Health Care Hospital, Wuhan, Hubei, China
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Qi W, Gundogan F, Gilligan J, Monte SDL. Dietary soy prevents fetal demise, intrauterine growth restriction, craniofacial dysmorphic features, and impairments in placentation linked to gestational alcohol exposure: Pivotal role of insulin and insulin-like growth factor signaling networks. Alcohol 2023; 110:65-81. [PMID: 36898643 PMCID: PMC10272094 DOI: 10.1016/j.alcohol.2023.01.006] [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: 08/18/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 03/11/2023]
Abstract
INTRODUCTION Prenatal alcohol exposure can impair placentation and cause intrauterine growth restriction (IUGR), fetal demise, and fetal alcohol spectrum disorder (FASD). Previous studies showed that ethanol's inhibition of placental insulin and insulin-like growth factor, type 1 (IGF-1) signaling compromises trophoblastic cell motility and maternal vascular transformation at the implantation site. Since soy isolate supports insulin responsiveness, we hypothesized that dietary soy could be used to normalize placentation and fetal growth in an experimental model of FASD. METHODS Pregnant Long-Evans rat dams were fed with isocaloric liquid diets containing 0% or 8.2% ethanol (v/v) from gestation day (GD) 6. Dietary protein sources were either 100% soy isolate or 100% casein (standard). Gestational sacs were harvested on GD19 to evaluate fetal resorption, fetal growth parameters, and placental morphology. Placental insulin/IGF-1 signaling through Akt pathways was assessed using commercial bead-based multiplex enzyme-linked immunosorbent assays. RESULTS Dietary soy markedly reduced or prevented the ethanol-associated fetal loss, IUGR, FASD dysmorphic features, and impairments in placentation/maturation. Furthermore, ethanol's inhibitory effects on the placental glycogen cell population at the junctional zone, invasive trophoblast populations at the implantation site, maternal vascular transformation, and signaling through the insulin and IGF1 receptors, Akt and PRAS40 were largely abrogated by co-administration of soy. CONCLUSION Dietary soy may provide an economically feasible and accessible means of reducing adverse pregnancy outcomes linked to gestational ethanol exposure.
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Affiliation(s)
- Wei Qi
- Liver Research Center of the Department of Medicine at Rhode Island Hospital, Providence, RI, 02905, US
| | - Fusun Gundogan
- Alpert Medical School at Brown University, Providence, RI, 02905, US; Women & Infants Hospital, Providence, RI, 02905, US
| | - Jeffrey Gilligan
- Liver Research Center of the Department of Medicine at Rhode Island Hospital, Providence, RI, 02905, US
| | - Suzanne de la Monte
- Liver Research Center of the Department of Medicine at Rhode Island Hospital, Providence, RI, 02905, US; Department of Pathology and Laboratory Medicine at Rhode Island Hospital, Providence, RI, 02905, USA; Alpert Medical School at Brown University, Providence, RI, 02905, US; Women & Infants Hospital, Providence, RI, 02905, US.
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Amylidi-Mohr S, Wyss M, Surbek D, Raio L, Mosimann B. Diverse mechanisms underlying the fetal growth course in gastroschisis and omphalocele. AJOG GLOBAL REPORTS 2023; 3:100238. [PMID: 37424955 PMCID: PMC10329168 DOI: 10.1016/j.xagr.2023.100238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Gastroschisis and omphalocele are the 2 most common congenital fetal abdominal wall defects. Both malformations are commonly associated with small-for-gestational-age neonates. However, the extent and causes of growth restriction remain controversial in both gastroschisis and omphalocele without associated malformations or aneuploidy. OBJECTIVE This study aimed to examine the role of the placenta and the birthweight-to-placental weight ratio in fetuses with abdominal wall defects. STUDY DESIGN This study included all cases of abdominal wall defects examined at our hospital between January 2001 and December 2020, retrieving the data from the hospital's software. Fetuses with any other combined congenital anomalies, known chromosomal abnormalities, or lost to follow-up were excluded. Overall, 28 singleton pregnancies with gastroschisis and 24 singleton pregnancies with omphalocele met the inclusion criteria. Patient characteristics and pregnancy outcomes were reviewed. The primary outcome was to investigate the association between birthweight and placental weight in pregnancies with abdominal wall defects as measured after delivery. To correct for gestational age and to compare total placental weights, ratios between the observed and expected birthweights for the given gestational age in singletons were calculated. The scaling exponent β was compared with the reference value of 0.75. Statistical analysis was performed using GraphPad Prism (version 8.2.1; GraphPad Software, San Diego, CA) and IBM SPSS Statistics. A P value of <.05 indicated statistical significance. RESULTS Women pregnant with a fetus with gastroschisis were significantly younger and more often nulliparous. In addition, in this group, the gestational age of delivery was significantly earlier and almost exclusively for cesarean delivery. Of 28 children, 13 (46.7%) were born small for gestational age, only 3 of them (10.7%) had a placental weight <10th percentile. There is no correlation between birthweight percentiles and placental weight percentiles (P=not significant). However, in the omphalocele group, 4 of 24 children (16.7%) were born small for gestational age (<10th percentile), and all children also had a placental weight <10th percentile. There is a significant correlation between birthweight percentiles and placental weight percentiles (P<.0001). The birthweight-to-placental weight ratio differs significantly between pregnancies diagnosed with gastroschisis and pregnancies diagnosed with omphalocele (4.48 [3.79-4.91] vs 6.05 [5.38-6.47], respectively; P<.0001). Allometric metabolic scaling revealed that placentas complicated by gastroschisis and placentas complicated by omphalocele do not scale with birthweight. CONCLUSION Fetuses with gastroschisis displayed impaired intrauterine growth, which seemed to differ from the classical placental insufficiency growth restriction.
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Affiliation(s)
- Sofia Amylidi-Mohr
- Department of Obstetrics, University Hospital of Bern, University of Bern, Bern, Switzerland (Dr Amylidi-Mohr, Ms Wyss, Messrs Surbek and Raio, and Ms Mosimann)
- University Hospital of Basel, University of Basel, Basel, Switzerland (Dr Amylidi-Mohr and Ms Mosimann)
| | - Melanie Wyss
- Department of Obstetrics, University Hospital of Bern, University of Bern, Bern, Switzerland (Dr Amylidi-Mohr, Ms Wyss, Messrs Surbek and Raio, and Ms Mosimann)
| | - Daniel Surbek
- Department of Obstetrics, University Hospital of Bern, University of Bern, Bern, Switzerland (Dr Amylidi-Mohr, Ms Wyss, Messrs Surbek and Raio, and Ms Mosimann)
| | - Luigi Raio
- Department of Obstetrics, University Hospital of Bern, University of Bern, Bern, Switzerland (Dr Amylidi-Mohr, Ms Wyss, Messrs Surbek and Raio, and Ms Mosimann)
| | - Beatrice Mosimann
- Department of Obstetrics, University Hospital of Bern, University of Bern, Bern, Switzerland (Dr Amylidi-Mohr, Ms Wyss, Messrs Surbek and Raio, and Ms Mosimann)
- University Hospital of Basel, University of Basel, Basel, Switzerland (Dr Amylidi-Mohr and Ms Mosimann)
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Clark A, Flouri D, Mufti N, James J, Clements E, Aughwane R, Aertsen M, David A, Melbourne A. Developments in functional imaging of the placenta. Br J Radiol 2023; 96:20211010. [PMID: 35234516 PMCID: PMC10321248 DOI: 10.1259/bjr.20211010] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/26/2022] [Accepted: 02/22/2022] [Indexed: 12/21/2022] Open
Abstract
The placenta is both the literal and metaphorical black box of pregnancy. Measurement of the function of the placenta has the potential to enhance our understanding of this enigmatic organ and serve to support obstetric decision making. Advanced imaging techniques are key to support these measurements. This review summarises emerging imaging technology being used to measure the function of the placenta and new developments in the computational analysis of these data. We address three important examples where functional imaging is supporting our understanding of these conditions: fetal growth restriction, placenta accreta, and twin-twin transfusion syndrome.
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Affiliation(s)
- Alys Clark
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | | | | | - Joanna James
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Eleanor Clements
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Rosalind Aughwane
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, UK
| | - Michael Aertsen
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Anna David
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, UK
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Marzullo A, Vitelli E, Cazzato G, Fanelli M, Ingravallo G, Vimercati A, Rossi R, Resta L. Placental Angiodysplasia: A New Sign for Prediction of Fetal Outcome? J Clin Med 2023; 12:jcm12113835. [PMID: 37298030 DOI: 10.3390/jcm12113835] [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: 03/31/2023] [Revised: 05/26/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
The study of the placenta is of great importance, not only in the attempt to understand the etiopathogenesis of various maternal-fetal pathologies, but also in the attempt to understand whether it is possible to find the cause of pathological neonatal outcomes. On the other hand, abnormalities of blood vessel formation, such as angiodysplasias, have been poorly characterised in the literature, and there is a need for more studies investigating the potential impact on the fetus. In this paper, we retrospectively analysed 2063 placentas received at the Department of Pathology of the University of Bari 'Aldo Moro', among which we identified 70 placentas affected by angiodysplasia. On these placentas, we carried out histochemical staining with Masson's Trichrome, orcein-alcian blue, and, subsequently, immunostaining with anti-CD31, CD34, and desmin and actin muscle smoothness antibodies. Finally, we performed a morphometric analysis on the allantochorionic and truncal vessels and correlated the results with neonatal outcomes. We studied the characteristics of the angiodysplasias in detail, dividing the patients into two classes (A and B) according to the morphology and histochemical characteristics of the affected vessels; statistical analysis reported a statistically significant association (p < 0.05) between the ratio of maximum thickness to maximum diameter (Tmax/Dmax) and neonatal outcome, with only 30% physiological outcome in the cohort of the placentas affected by angiodysplasia. These results shed light on a rather neglected aspect in the 2015 Amsterdam Classification, as well as in the literature, and provided strong evidence that placental angiodysplasia is predictive of an increased likelihood of the pathological fetal outcome, while other factors remain in the field. Studies with larger case series and guidelines with more attention to these aspects are mandated to further investigate the predictive potential of this pathology.
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Affiliation(s)
- Andrea Marzullo
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Emmanuela Vitelli
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Gerardo Cazzato
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Margherita Fanelli
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giuseppe Ingravallo
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Antonella Vimercati
- Section of Gynaecology and Obstetrics, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Roberta Rossi
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Leonardo Resta
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", 70124 Bari, Italy
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Rakhanova Y, Almawi WY, Aimagambetova G, Riethmacher D. The effects of sildenafil citrate on intrauterine growth restriction: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2023; 23:409. [PMID: 37268873 DOI: 10.1186/s12884-023-05747-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/30/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND An increase in vascular resistance of uterine vessels is associated with intrauterine growth restriction (IUGR). Sildenafil citrate, a phosphodiesterase-5 inhibitor that stabilizes cyclic guanosine monophosphate (cGMP) and increases nitric oxide levels, improves placental perfusion by dilation of spiral arteries and is beneficial in managing IUGR. This study aims to determine the effectiveness of sildenafil citrate in improving perinatal outcomes in IUGR pregnancies. METHODS Meta-analysis was performed on data extracted from all studies specific to sildenafil citrate in IUGR management, searching relevant articles on PubMed, Medline, Google Scholar, Embase, and Cochrane databases. Publications identified by the manual search, based on references in reviews, were also included. Dichotomous results were presented as risk ratio (95% confidence interval), while continuous results were expressed as mean difference (MD); samples represented by the random effects model. RESULTS Nine trials were included where the sildenafil citrate effect was compared with a placebo or no intervention. A significant increase in birth weight [SMD (95% CI), 0.69 (0.31, 1.07)] was seen in IUGR pregnancies managed with sildenafil. However, gestational age (SMD (95% CI), 0.44 (-0.05, 0.94], fetal death rate [RR (95% CI), 0.56 (0.17, 1.79)] in IUGR pregnancies was not changed by sildenafil. Neonatal death [RR (95% CI), 0.93 (0.47, 1.86)] and neonatal intensive care unit (NICU) admissions [RR (95% CI), 0.76 (0.50, 1.17)] were not significantly different between sildenafil and control groups. CONCLUSION Sildenafil citrate increases birth weight and prolonged pregnancies but did not affect stillbirth rate, neonatal death, and NICU admission. TRIAL REGISTRATION The study was registered in PROSPERO on September 18, 2021 (CRD42021271992).
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Affiliation(s)
- Yenlik Rakhanova
- School of Medicine, Nazarbayev University, 010000, Astana, Kazakhstan
| | - Wassim Y Almawi
- Faculté Des Sciences de Tunis, Université de Tunis - El Manar, Tunis, Tunisia
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, 010000, Astana, Kazakhstan
| | - Gulzhanat Aimagambetova
- Department of Surgery, School of Medicine, Nazarbayev University, 010000, Astana, Kazakhstan.
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Geisler HC, Safford HC, Mitchell MJ. Rational Design of Nanomedicine for Placental Disorders: Birthing a New Era in Women's Reproductive Health. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023:e2300852. [PMID: 37191231 PMCID: PMC10651803 DOI: 10.1002/smll.202300852] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/16/2023] [Indexed: 05/17/2023]
Abstract
The placenta is a transient organ that forms during pregnancy and acts as a biological barrier, mediating exchange between maternal and fetal circulation. Placental disorders, such as preeclampsia, fetal growth restriction, placenta accreta spectrum, and gestational trophoblastic disease, originate in dysfunctional placental development during pregnancy and can lead to severe complications for both the mother and fetus. Unfortunately, treatment options for these disorders are severely lacking. Challenges in designing therapeutics for use during pregnancy involve selectively delivering payloads to the placenta while protecting the fetus from potential toxic side effects. Nanomedicine holds great promise in overcoming these barriers; the versatile and modular nature of nanocarriers, including prolonged circulation times, intracellular delivery, and organ-specific targeting, can control how therapeutics interact with the placenta. In this review, nanomedicine strategies are discussed to treat and diagnose placental disorders with an emphasis on understanding the unique pathophysiology behind each of these diseases. Finally, prior study of the pathophysiologic mechanisms underlying these placental disorders has revealed novel disease targets. These targets are highlighted here to motivate the rational design of precision nanocarriers to improve therapeutic options for placental disorders.
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Affiliation(s)
- Hannah C. Geisler
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Hannah C. Safford
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Michael J. Mitchell
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
- Penn Institute for RNA Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
- Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19014, USA
- Institute for Regenerative Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
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Tung S, Delavogia E, Fernandez-Gonzalez A, Mitsialis SA, Kourembanas S. Harnessing the therapeutic potential of the stem cell secretome in neonatal diseases. Semin Perinatol 2023; 47:151730. [PMID: 36990921 PMCID: PMC10133192 DOI: 10.1016/j.semperi.2023.151730] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Preterm birth and intrapartum related complications account for a substantial amount of mortality and morbidity in the neonatal period despite significant advancements in neonatal-perinatal care. Currently, there is a noticeable lack of curative or preventative therapies available for any of the most common complications of prematurity including bronchopulmonary dysplasia, necrotizing enterocolitis, intraventricular hemorrhage, periventricular leukomalacia and retinopathy of prematurity or hypoxic-ischemic encephalopathy, the main cause of perinatal brain injury in term infants. Mesenchymal stem/stromal cell-derived therapy has been an active area of investigation for the past decade and has demonstrated encouraging results in multiple experimental models of neonatal disease. It is now widely acknowledged that mesenchymal stem/stromal cells exert their therapeutic effects via their secretome, with the principal vector identified as extracellular vesicles. This review will focus on summarizing the current literature and investigations on mesenchymal stem/stromal cell-derived extracellular vesicles as a treatment for neonatal diseases and examine the considerations to their application in the clinical setting.
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Affiliation(s)
- Stephanie Tung
- Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States; Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Eleni Delavogia
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States; Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Angeles Fernandez-Gonzalez
- Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States; Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - S Alex Mitsialis
- Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States; Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Stella Kourembanas
- Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States; Department of Pediatrics, Harvard Medical School, Boston, MA, United States.
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Andescavage N, Bullen T, Liggett M, Barnett SD, Kapse A, Kapse K, Ahmadzia H, Vezina G, Quistorff J, Lopez C, duPlessis A, Limperopoulos C. Impaired in vivo feto-placental development is associated with neonatal neurobehavioral outcomes. Pediatr Res 2023; 93:1276-1284. [PMID: 36335267 PMCID: PMC10147575 DOI: 10.1038/s41390-022-02340-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Fetal growth restriction (FGR) is a risk factor for neurodevelopmental problems, yet remains poorly understood. We sought to examine the relationship between intrauterine development and neonatal neurobehavior in pregnancies diagnosed with antenatal FGR. METHODS We recruited women with singleton pregnancies diagnosed with FGR and measured placental and fetal brain volumes using MRI. NICU Network Neurobehavioral Scale (NNNS) assessments were performed at term equivalent age. Associations between intrauterine volumes and neurobehavioral outcomes were assessed using generalized estimating equation models. RESULTS We enrolled 44 women diagnosed with FGR who underwent fetal MRI and 28 infants underwent NNNS assessments. Placental volumes were associated with increased self-regulation and decreased excitability; total brain, brainstem, cortical and subcortical gray matter (SCGM) volumes were positively associated with higher self-regulation; SCGM also was positively associated with higher quality of movement; increasing cerebellar volumes were positively associated with attention, decreased lethargy, non-optimal reflexes and need for special handling; brainstem volumes also were associated with decreased lethargy and non-optimal reflexes; cerebral and cortical white matter volumes were positively associated with hypotonicity. CONCLUSION Disrupted intrauterine growth in pregnancies complicated by antenatally diagnosed FGR is associated with altered neonatal neurobehavior. Further work to determine long-term neurodevelopmental impacts is warranted. IMPACT Fetal growth restriction is a risk factor for adverse neurodevelopment, but remains difficult to accurately identify. Intrauterine brain volumes are associated with infant neurobehavior. The antenatal diagnosis of fetal growth restriction is a risk factor for abnormal infant neurobehavior.
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Affiliation(s)
- Nickie Andescavage
- Division of Neonatology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
- Developing Brain Institute, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
- Prenatal Pediatric Institute, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Theresa Bullen
- School of Medicine, George Washington University, Washington, DC, USA
| | - Melissa Liggett
- Division of Psychology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Scott D Barnett
- Developing Brain Institute, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Anushree Kapse
- Developing Brain Institute, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Kushal Kapse
- Developing Brain Institute, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Homa Ahmadzia
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, George Washington University, 2300 Eye St. NW, Washington, DC, 20037, USA
| | - Gilbert Vezina
- Division of Radiology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
- Department of Radiology, George Washington University, 2300 Eye St. NW, Washington, DC, 20037, USA
| | - Jessica Quistorff
- Developing Brain Institute, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Catherine Lopez
- Developing Brain Institute, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | - Adre duPlessis
- Developing Brain Institute, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
- Prenatal Pediatric Institute, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
- Department of Pediatrics, George Washington University, 2300 Eye St. NW, Washington, DC, 20037, USA
| | - Catherine Limperopoulos
- Developing Brain Institute, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA.
- Department of Radiology, George Washington University, 2300 Eye St. NW, Washington, DC, 20037, USA.
- Department of Pediatrics, George Washington University, 2300 Eye St. NW, Washington, DC, 20037, USA.
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Ferraz T, Benton SJ, Zareef I, Aribaloye O, Bloise E, Connor KL. Impact of Co-Occurrence of Obesity and SARS-CoV-2 Infection during Pregnancy on Placental Pathologies and Adverse Birth Outcomes: A Systematic Review and Narrative Synthesis. Pathogens 2023; 12:pathogens12040524. [PMID: 37111410 PMCID: PMC10140965 DOI: 10.3390/pathogens12040524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Obesity is a risk factor for severe COVID-19 disease during pregnancy. We hypothesized that the co-occurrence of high maternal body mass index (BMI) and gestational SARS-CoV-2 infection are detrimental to fetoplacental development. We conducted a systematic review following PRISMA/SWiM guidelines and 13 studies were eligible. In the case series studies (n = 7), the most frequent placental lesions reported in SARS-CoV-2(+) pregnancies with high maternal BMI were chronic inflammation (71.4%, 5/7 studies), fetal vascular malperfusion (FVM) (71.4%, 5/7 studies), maternal vascular malperfusion (MVM) (85.7%, 6/7 studies) and fibrinoids (100%, 7/7 studies). In the cohort studies (n = 4), three studies reported higher rates of chronic inflammation, MVM, FVM and fibrinoids in SARS-CoV-2(+) pregnancies with high maternal BMI (72%, n = 107/149; mean BMI of 30 kg/m2) compared to SARS-CoV-2(−) pregnancies with high BMI (7.4%, n = 10/135). In the fourth cohort study, common lesions observed in placentae from SARS-CoV-2(+) pregnancies with high BMI (n = 187 pregnancies; mean BMI of 30 kg/m2) were chronic inflammation (99%, 186/187), MVM (40%, n = 74/187) and FVM (26%, n = 48/187). BMI and SARS-CoV-2 infection had no effect on birth anthropometry. SARS-CoV-2 infection during pregnancy associates with increased prevalence of placental pathologies, and high BMI in these pregnancies could further affect fetoplacental trajectories.
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Affiliation(s)
- Thaina Ferraz
- Health Sciences, Carleton University, Ottawa, ON K1S 5B6, Canada
| | | | - Israa Zareef
- Health Sciences, Carleton University, Ottawa, ON K1S 5B6, Canada
| | | | - Enrrico Bloise
- Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Kristin L. Connor
- Health Sciences, Carleton University, Ottawa, ON K1S 5B6, Canada
- Correspondence: ; Tel.: +1-613-520-2600 (ext. 4202)
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Ma R, Jin N, Lei H, Dong J, Xiong Y, Qian C, Chen S, Wang X. Ovarian Stimulation in Mice Resulted in Abnormal Placentation through Its Effects on Proliferation and Cytokine Production of Uterine NK Cells. Int J Mol Sci 2023; 24:ijms24065907. [PMID: 36982985 PMCID: PMC10054838 DOI: 10.3390/ijms24065907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Ovarian stimulation is associated with an increased incidence of abnormal placentation. Uterine natural killer (uNK) cells are the major subpopulation of decidual immune cells, which are crucial for placentation. In a previous study, we found that ovarian stimulation impairs uNK cell density on gestation day (GD) 8.5 in mice. However, it was not clear how ovarian stimulation led to a reduction in the density of uNK cells. In this study, we constructed two mouse models, an in vitro mouse embryo transfer model and an estrogen-stimulated mouse model. We used HE and PAS glycogen staining, immunohistochemical techniques, q-PCR, Western blot, and flow cytometry to analyze the mouse decidua and placenta, and the results showed that SO resulted in a fetal weight reduction, abnormal placental morphology, decreased placental vascular density, and abnormal density and function of uNK cells. Our results suggest that ovarian stimulation resulted in aberrant estrogen signaling and may contribute to the disorder of uNK cells caused by ovarian stimulation. Together, these results provide new insights into the mechanisms of aberrant maternal endocrine environments and abnormal placentation.
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Affiliation(s)
- Rong Ma
- Department of Obstetrics and Gynecology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, China
| | - Ni Jin
- Department of Obstetrics and Gynecology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, China
| | - Hui Lei
- Department of Obstetrics and Gynecology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, China
| | - Jie Dong
- Department of Obstetrics and Gynecology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, China
| | - Yujing Xiong
- Department of Obstetrics and Gynecology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, China
| | - Chenxi Qian
- Department of Obstetrics and Gynecology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, China
| | - Shuqiang Chen
- Department of Obstetrics and Gynecology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, China
| | - Xiaohong Wang
- Department of Obstetrics and Gynecology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, China
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Melatonin Supplementation during the Late Gestational Stage Enhances Reproductive Performance of Sows by Regulating Fluid Shear Stress and Improving Placental Antioxidant Capacity. Antioxidants (Basel) 2023; 12:antiox12030688. [PMID: 36978937 PMCID: PMC10045541 DOI: 10.3390/antiox12030688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023] Open
Abstract
In this study, the effects of daily melatonin supplementation (2 mg/kg) at the late gestational stage on the reproductive performance of the sows have been investigated. This treatment potentially increased the litter size and birth survival rate and significantly increased the birth weight as well as the weaning weight and survival rate of piglets compared to the controls. The mechanistic studies have found that these beneficial effects of melatonin are not mediated by the alterations of reproductive hormones of estrogen and progesterone, nor did the glucose and lipid metabolisms, but they were the results of the reduced oxidative stress in placenta associated with melatonin supplementation. Indeed, the melatonergic system, including mRNAs and proteins of AANAT, MTNR1A and MTNR1B, has been identified in the placenta of the sows. The RNA sequencing of placental tissue and KEGG analysis showed that melatonin activated the placental tissue fluid shear stress pathway to stimulate the Nrf2 signaling pathway, which upregulated its several downstream antioxidant genes, including MGST1, GSTM3 and GSTA4, therefore, suppressing the placental oxidative stress. All these actions may be mediated by the melatonin receptor of MTNR1B.
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Sun H, Jiao J, Ren Y, Guo Y, Wang Y. Multimodal fusion model for classifying placenta ultrasound imaging in pregnancies with hypertension disorders. Pregnancy Hypertens 2023; 31:46-53. [PMID: 36577178 DOI: 10.1016/j.preghy.2022.12.003] [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: 02/10/2022] [Revised: 11/24/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND A multimodal fusion model was proposed to assist the traditional visual diagnosis in evaluating the placental features of hypertension disorders of pregnancy (HDP). OBJECTIVE The aim of this study was to analyse and compare the placental features between normal and HDP pregnancies and propose a multimodal fusion deep learning model for differentiating and characterizing the placental features from HDP to normal pregnancy. METHODS This observational prospective study included 654 pregnant women, including 75 with HDPs. Grayscale ultrasound images (GSIs) and Microflow images (MFIs) of the placentas were collected from all patients during routine obstetric examinations. On the basis of intelligent extraction and features fusion, after quantities of training and optimization, the classification model named GMNet (the intelligent network based on GSIs and MFIs) was introduced for differentiating the placental features of normal and HDP pregnancies. The distributions of placental features extracted by the deep convolutional neural networks (DCNNs) were visualized by Uniform Manifold Approximation and Projection for Dimension Reduction (UMAP). Metrics including sensitivity, specificity, accuracy, and the area under the curve (AUC) were used to score the model. Finally, placental tissue samples were randomly selected for microscopic analyses to prove the interpretability and effectiveness of the GMNet model. RESULTS Compared with the Normal group in ultrasonic images, the light spots were rougher and the parts with focal cystic or hypoechogenic lesions were increased in the HDP groups. The overall diagnostic performance of the GMNet model depending on the region of interest (ROI) was excellent (AUC: 97%), with a sensitivity of 90.0%, a specificity of 93.5%, and an accuracy of 93.1%. The fusion features of GSIs and MFIs in the placenta showed a higher discriminative power than single-mode features (fusion features vs GSI features vs MFI features, 97.0% vs 91.2% vs 94.8%). Furthermore, according to the microscopic analysis, unevenly distributed villi, increased syncyte nodules and aggregated intervillous cellulose deposition were particularly frequent in the HDP cases. CONCLUSIONS The GMNet model could sensitively identify abnormal changes in the placental microstructure in pregnancies with HDP.
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Affiliation(s)
- Hongshuang Sun
- Obstetrics and Gynecology Hospital of Fudan University, No.128, Shenyang Road, Shanghai 200090, China
| | - Jing Jiao
- Department of Electronic Engineering, Fudan University, No. 220, Handan Road, Yangpu District, Shanghai 200433, China; Key Laboratory of Medical Imaging, Computing and Computer-Assisted Intervention, Shanghai, China
| | - Yunyun Ren
- Obstetrics and Gynecology Hospital of Fudan University, No.128, Shenyang Road, Shanghai 200090, China.
| | - Yi Guo
- Department of Electronic Engineering, Fudan University, No. 220, Handan Road, Yangpu District, Shanghai 200433, China; Key Laboratory of Medical Imaging, Computing and Computer-Assisted Intervention, Shanghai, China.
| | - Yuanyuan Wang
- Department of Electronic Engineering, Fudan University, No. 220, Handan Road, Yangpu District, Shanghai 200433, China; Key Laboratory of Medical Imaging, Computing and Computer-Assisted Intervention, Shanghai, China.
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Lin S, Ye MY, Fu QY, Pan CL, Liu YJ, Zheng LM, Hong Q, Chen YH. Cholic acid exposure during late pregnancy causes placental dysfunction and fetal growth restriction by reactive oxygen species-mediated activation of placental GCN2/eIF2α pathway. FASEB J 2023; 37:e22820. [PMID: 36801982 DOI: 10.1096/fj.202202126r] [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: 12/22/2022] [Revised: 01/19/2023] [Accepted: 01/30/2023] [Indexed: 02/23/2023]
Abstract
Epidemiological studies suggest that fetal growth restriction (FGR) caused by gestational cholestasis is associated with elevated serum cholic acid (CA). Here, we explore the mechanism by which CA induces FGR. Pregnant mice except controls were orally administered with CA daily from gestational day 13 (GD13) to GD17. Results found that CA exposure decreased fetal weight and crown-rump length, and increased the incidence of FGR in a dose-dependent manner. Furthermore, CA caused placental glucocorticoid (GC) barrier dysfunction via down-regulating the protein but not the mRNA level of placental 11β-Hydroxysteroid dehydrogenase-2 (11β-HSD2). Additionally, CA activated placental GCN2/eIF2α pathway. GCN2iB, an inhibitor of GCN2, significantly inhibited CA-induced down-regulation of 11β-HSD2 protein. We further found that CA caused excessive reactive oxygen species (ROS) production and oxidative stress in mouse placentas and human trophoblasts. NAC significantly rescued CA-induced placental barrier dysfunction by inhibiting activation of GCN2/eIF2α pathway and subsequent down-regulation of 11β-HSD2 protein in placental trophoblasts. Importantly, NAC rescued CA-induced FGR in mice. Overall, our results suggest that CA exposure during late pregnancy induces placental GC barrier dysfunction and subsequent FGR may be via ROS-mediated placental GCN2/eIF2α activation. This study provides valuable insight for understanding the mechanism of cholestasis-induced placental dysfunction and subsequent FGR.
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Affiliation(s)
- Shuai Lin
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Meng-Ying Ye
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Qian-Yun Fu
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Chao-Lin Pan
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Ya-Jie Liu
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Li-Ming Zheng
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Qiang Hong
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Yuan-Hua Chen
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China.,Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, China
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Liu M, Lu S, Yang C, Zhang D, Zhu J, Yin J, Zhao H, Yang B, Kuang H. Maternal exposure to a glyphosate-based herbicide impairs placental development through endoplasmic reticulum stress in mice. Food Chem Toxicol 2023; 173:113640. [PMID: 36724846 DOI: 10.1016/j.fct.2023.113640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/14/2023] [Accepted: 01/25/2023] [Indexed: 01/30/2023]
Abstract
Glyphosate-based herbicides (GBHs) are the most widely used agrochemicals worldwide, increasing the risk of their occurrence in the environment. This study aimed to explore effects and mechanisms of GBH exposure on placental development in vivo during pregnancy in mice. Pregnant mice received GBH by gavage at 0, 5, and 50 mg⋅kg-1⋅day-1 doses from gestational day (GD) 1 to GD 13 and were sacrificed on GD 13 or GD19. Our data indicated that GBH administration significantly increased the number of resorbed fetuses, reduced the weight of fetuses and placentas, and inhibited placental growth, as evident from decreased placental total area and spongiotrophoblast area on GD 19. GBH treatment also inhibited proliferation and induced apoptosis of placenta via upregulation of Bax, cleaved caspase-3 and -12 expression, and downregulation of B cell lymphoma (Bcl)-2 expression. Further study showed that GBH exposure significantly increased expression levels of glucose-regulated protein 78 (GRP78), protein kinase RNA-like endoplasmic reticulum kinase (PERK), and C/EBP homologous protein (CHOP) mRNAs and proteins and triggered oxidative stress in placenta on GD 13 and GD 19. In conclusion, our findings suggest that maternal exposure to GBH can impair placental development through the endoplasmic reticulum stress-mediated activation of GRP78/PERK/CHOP signaling pathway in mice.
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Affiliation(s)
- Mengling Liu
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang, Jiangxi, 330006, PR China; Nursing School of Jiujiang University, Jiujiang, Jiangxi, 332000, PR China.
| | - Siying Lu
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang, Jiangxi, 330006, PR China.
| | - Chuanzhen Yang
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang, Jiangxi, 330006, PR China.
| | - Dalei Zhang
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang, Jiangxi, 330006, PR China; Jiangxi Provincial Key Laboratory of Reproductive Physiology and Pathology, Nanchang University, Nanchang, Jiangxi, 330006, PR China.
| | - Jun Zhu
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang, Jiangxi, 330006, PR China.
| | - Jiting Yin
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang, Jiangxi, 330006, PR China.
| | - Hongru Zhao
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang, Jiangxi, 330006, PR China.
| | - Bei Yang
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang, Jiangxi, 330006, PR China.
| | - Haibin Kuang
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang, Jiangxi, 330006, PR China; Jiangxi Provincial Key Laboratory of Reproductive Physiology and Pathology, Nanchang University, Nanchang, Jiangxi, 330006, PR China.
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