Sudden infant death syndrome: near-weightlessness and delayed neural transformation

Sudden infant death syndrome (SIDS): Microgravity and inadequate sensory stimulation

In early gestation, the human foetus develops in a buoyant environment, which is similar to the near-weightlessness of space flight. After the 26th week of gestation, the foetus gradually becomes exposed to gravitational forces. The influence of fluid immersion declines as the weight of the foetus increases. In this way, the foetus adapts and trains for the gravity environment after birth. Failure of gravitational loading in the last trimester of pregnancy delays development and maintains the pathophysiological environment of microgravity as experienced by the astronaut in space flight. The deconditioning effects of microgravity during space flight are the reverse processes of intrauterine development after the 26th week when the foetus begins training body processes for adaptation to an earthly environment. Growth requires space and movement, which suggests that a growth-retarded foetus may have been deprived of the mechanical dimension of uterine wall pressure, and, in twins, the smaller sibling may have been deprived of space. The behaviour of a study group of sudden infant death syndrome infants suggested a continuation of the effects of the foetal akinesia syndrome during the third trimester period of gestation. NASA research into the pathophysiology of microgravity was based on a simple insight: that the physiological effects of human space travel were virtually identical to the adjustments the body makes when lying down. This is the same environment as that of the human foetus in the first 22 weeks of gestation after which the uterine environment becomes a prelude to adaptations to the force of gravity.

Plasticity of Human Stem Cells in the Fetal Sheep Model of Human Stem Cell Transplantation

Experimental models that allow the evaluation of the full potential of stem cells under normal physiological conditions and in the absence of genetic or injury-induced dysfunction would serve as valuable tools for the study of the mechanisms underlying stem cell differentiation. Ideally, such a model would also permit the robust formation of donor-derived tissue-specific cells. Because studies have shown that the differentiation of stem cells into cells of a different germinal layer is highly inefficient in the absence of selective pressure, it is very unlikely that a healthy adult animal can fulfill these requirements. In this review, we describe the advantages of the permissive aspects of the developing preimmune fetus in the early gestational age that led us to develop the sheep as a large-animal model of human stem cell plasticity.

Adult stem cell plasticity and methods of detection

The ability to selectively produce one or more differentiated cell types at will from totipotent stem cells would be of profound clinical importance, as it would enable the specific replacement of damaged/dysfunctional cell types within the body, potentially curing numerous diseases. Until recently, it was thought that the only cells that possessed sufficient immaturity to be capable of giving rise to more than one tissue type in vitro and in vivo were the embryonic stem cells. However, recent studies have now provided compelling evidence that the adult bone marrow, brain and skeletal muscle contain stem cells that possess the remarkable ability to trans-differentiate and give rise to progeny of alternate embryologic derivations. These recent findings have shattered the existing dogma that the stages of embryologic development are irreversible. In this review, we present a brief summary of the most significant findings in the field of stem cell plasticity, emphasizing studies involving the hematopoietic system, discussing the models used thus far, and finishing with our findings on human stem cell plasticity using the fetal sheep model.

Sudden infant death syndrome: hypothalamic failure to sense elevated blood pyrogens

Sudden infant death syndrome (SIDS) is frequently associated with a mild infection, the incidence peaking during the third month of life. We hypothesize that the neonatal immaturity of both the acute febrile response and hypothalamus promote neonatal protection from SIDS. Vagal afferents modify the febrile response. Vagotomized rodents displayed a loss of febrile responsiveness in a 'non-sensing' brain. The failure of a 'non- sensing' brain to react to elevated blood pyrogens leads to failure of the febrile response and to a shock-like state. SIDS infants may appear well yet, within hours of this observation, may be found dead. There is a mismatch between the acute febrile response and hypothalamic hypoactivation. The discrepancy increase wtih development. There is an elevated cytokine response in endothelial cells which induces nitric oxide (NO) production and retarded development of the hypothalamus. Cigarette smoke also induces NO production and retards hypothalamic development by augmented apoptosis. Zinc inhibits this effect in mouse thymocytes. Fetal haemoglobin (HbF) induces hypoxia which is a stimulator of the immune response, while vasodilator gases (carbon monoxide (CO), NO) reduce hypothalamic function. The hypothalamic failure to sense elevated blood pyrogens induces toxic shock--a feature of SIDS.

Sudden infant death syndrome: hypothalamic failure to sense elevated blood pyrogens

Sudden infant death syndrome (SIDS) is frequently associated with a mild infection, the incidence peaking during the third month of life. We hypothesize that the neonatal immaturity of both the acute febrile response and hypothalamus promote neonatal protection from SIDS. Vagal afferents modify the febrile response. Vagotomized rodents displayed a loss of febrile responsiveness in a 'non-sensing' brain. The failure of a 'non-sensing' brain to react to elevated blood pyrogens leads to failure of the febrile response and to a shock-like state. SIDS infants may appear well yet, within hours of this observation, may be found dead. There is a mismatch between the acute febrile response and hypothalamic hypoactivation. The discrepancy increases with development. There is an elevated cytokine response in endothelial cells which induces nitric oxide (NO) production and retarded development of the hypothalamus. Cigarette smoke also induces NO production and retards hypothalamic development by augmented apoptosis. Zinc inhibits this effect in mouse thymocytes. Fetal haemoglobin (HbF) induces hypoxia, which is a stimulator of the immune response while vasodilator gases (carbon monoxide (CO), NO) reduce hypothalamic function. The hypothalamic failure to sense elevated blood pyrogens induces toxic shock - a feature of SIDS.

Sudden infant death syndrome and placental disorders: the thyroid-selenium link

Placental insufficiency, inducing hypoxia-ischaemia, is considered a major cause of neuronal injury and impaired post natal development. Placental insufficiency alters the metabolism of arachidonic acid and its oxidation products. Premature labour and low-birth-weight infants are associated with reduced intrauterine blood-flow and infections of the reproductive tract. Thyroidal activity is depressed in undernutrition (placental insufficiency). Premature infants require extra vitamin C for normal tyrosine metabolism (tyrosine is the thyroxine precursor). Among the symptoms indicating infantile cretinism, which appear during 3-5 months of age are: delayed union of skull bones, torpid behaviour, slow feeding, cyanosis during feeding, excessive sleepiness, enlarged tongue, umbilical herniation, flabby musculature, short stature and delayed development. These symptoms have all been described in low-birth-weight infants and sudden infant death syndrome victims by various authors. Bacteria utilize selenium (at the expense of host tissue). Escherichia coli is among the bacteria invading the reproductive tract. E. coli produce thiouracil and are goitrogenic. Some strains of E. coli produce phospholipase A2 which releases arachidonic acid from phospholipids for prostaglandin synthesis. Phospholipase A2 is more active against peroxidized than non-peroxidized lipids. Bacterial competition for intrauterine selenium and goitrogenic bacterial infections of the reproductive tract during pregnancy, depress thyroid function in the fetus but not in the mother.