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de Carvalho LIA, Tuda LTS, de Morais Almeida SL, Estevam TL, Novelleto ALMT, Araujo Júnior E, Zielinsky P, da Rocha Amorim LA. Fetal ductus arteriosus constriction associated with citronella maternal use. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024. [PMID: 38760954 DOI: 10.1002/jcu.23729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 04/13/2024] [Indexed: 05/20/2024]
Abstract
Constriction of the fetal ductus arteriosus is a condition that narrows the ductus arteriosus and can lead to death, so the importance of prior diagnosis. Citronella, due to its anti-inflammatory properties, should be avoided during pregnancy as it may cause constriction of the fetal duct.
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Affiliation(s)
| | | | | | - Thayla Lais Estevam
- Postgraduate Program in Health Sciences, Medical School, Federal University of Amazonas (UFAM), Manaus, 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
| | - Paulo Zielinsky
- Fetal Cardiology Unit, Institute of Cardiology of Rio Grande do Sul, Porto Alegre, Brazil
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Zielinsky P, Sulis NM, Martins CM, Zucatti KP, Bonamigo ER, Vian I. Fetal ductal constriction in the third trimester of pregnancy: a prevalence study. J Perinatol 2024; 44:444-445. [PMID: 38042943 DOI: 10.1038/s41372-023-01844-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 11/06/2023] [Accepted: 11/24/2023] [Indexed: 12/04/2023]
Affiliation(s)
- Paulo Zielinsky
- Fetal Cardiology Unit, Institute of Cardiology/University Foundation of Cardiology, Avenida Princesa Isabel, 370-Santana/CEP 90620-000, Porto Alegre, Brazil.
- Department of Pediatrics, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2400-Santa Cecília/CEP 90035-003, Porto Alegre, Brazil.
| | - Natássia Miranda Sulis
- Fetal Cardiology Unit, Institute of Cardiology/University Foundation of Cardiology, Avenida Princesa Isabel, 370-Santana/CEP 90620-000, Porto Alegre, Brazil
| | - Cláudia Monster Martins
- Fetal Cardiology Unit, Institute of Cardiology/University Foundation of Cardiology, Avenida Princesa Isabel, 370-Santana/CEP 90620-000, Porto Alegre, Brazil
| | - Kelly Pozzer Zucatti
- Fetal Cardiology Unit, Institute of Cardiology/University Foundation of Cardiology, Avenida Princesa Isabel, 370-Santana/CEP 90620-000, Porto Alegre, Brazil
| | - Eduarda Rodrigues Bonamigo
- Fetal Cardiology Unit, Institute of Cardiology/University Foundation of Cardiology, Avenida Princesa Isabel, 370-Santana/CEP 90620-000, Porto Alegre, Brazil
| | - Izabele Vian
- Fetal Cardiology Unit, Institute of Cardiology/University Foundation of Cardiology, Avenida Princesa Isabel, 370-Santana/CEP 90620-000, Porto Alegre, Brazil
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Darby JRT, Williams GK, Cho SKS, Meakin AS, Holman SL, Quinn M, Wiese MD, Macgowan CK, Seed M, Morrison JL. Acute resveratrol exposure does not impact hemodynamics of the fetal sheep. Physiol Rep 2023; 11:e15749. [PMID: 37332034 PMCID: PMC10277215 DOI: 10.14814/phy2.15749] [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: 04/29/2023] [Revised: 05/29/2023] [Accepted: 05/29/2023] [Indexed: 06/20/2023] Open
Abstract
Babies born growth restricted are at an increased risk of both poor short-and long-term outcomes. Current interventions to improve fetal growth are ineffective and do not lower the lifetime risk of poor health status. Maternal resveratrol (RSV) treatment increases uterine artery blood flow, fetal oxygenation, and fetal weight. However, studies suggest that diets high in polyphenols such as RSV may impair fetal hemodynamics. We aimed to characterize the effect of RSV on fetal hemodynamics to further assess its safety as an intervention strategy. Pregnant ewes underwent magnetic resonance imaging (MRI) scans to measure blood flow and oxygenation within the fetal circulation using phase contrast-MRI and T2 oximetry. Blood flow and oxygenation measures were performed in a basal state and then repeated while the fetus was exposed to RSV. Fetal blood pressure and heart rate were not different between states. RSV did not impact fetal oxygen delivery (DO2 ) or consumption (VO2 ). Blood flow and oxygen delivery throughout the major vessels of the fetal circulation were not different between basal and RSV states. As such, acute exposure of the fetus to RSV does not directly impact fetal hemodynamics. This strengthens the rationale for the use of RSV as an intervention strategy against fetal growth restriction.
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Affiliation(s)
- Jack R. T. Darby
- Early Origins of Adult Health Research GroupUniSA: Clinical and Health SciencesUniversity of South AustraliaSouth AustraliaAdelaideAustralia
| | - Georgia K. Williams
- Preclinical, Imaging and Research LaboratoriesSouth Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
| | - Steven K. S. Cho
- Early Origins of Adult Health Research GroupUniSA: Clinical and Health SciencesUniversity of South AustraliaSouth AustraliaAdelaideAustralia
- Univeristy of Toronto and The Hospital for Sick ChildrenTorontoOntarioCanada
| | - Ashley S. Meakin
- Early Origins of Adult Health Research GroupUniSA: Clinical and Health SciencesUniversity of South AustraliaSouth AustraliaAdelaideAustralia
| | - Stacey L. Holman
- Early Origins of Adult Health Research GroupUniSA: Clinical and Health SciencesUniversity of South AustraliaSouth AustraliaAdelaideAustralia
| | - Megan Quinn
- Early Origins of Adult Health Research GroupUniSA: Clinical and Health SciencesUniversity of South AustraliaSouth AustraliaAdelaideAustralia
| | - Michael D. Wiese
- Centre for Pharmaceutical Innovation, UniSA: Clinical and Health SciencesUniversity of South AustraliaSouth AustraliaAdelaideAustralia
| | | | - Mike Seed
- Univeristy of Toronto and The Hospital for Sick ChildrenTorontoOntarioCanada
| | - Janna L. Morrison
- Early Origins of Adult Health Research GroupUniSA: Clinical and Health SciencesUniversity of South AustraliaSouth AustraliaAdelaideAustralia
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Nacka-Aleksić M, Pirković A, Vilotić A, Bojić-Trbojević Ž, Jovanović Krivokuća M, Giampieri F, Battino M, Dekanski D. The Role of Dietary Polyphenols in Pregnancy and Pregnancy-Related Disorders. Nutrients 2022; 14:nu14245246. [PMID: 36558404 PMCID: PMC9782043 DOI: 10.3390/nu14245246] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Polyphenols are a group of phytochemicals with extensive biological functions and health-promoting potential. These compounds are present in most foods of plant origin and their increased widespread availability through the intake of nutritional supplements, fortified foods, and beverages, has also led to increased exposure throughout gestation. In this narrative review, we focus on the role of polyphenols in both healthy and pathological pregnancy. General information related to their classification and function is followed by an overview of their known effects in early-pregnancy events, including the current insights into molecular mechanisms involved. Further, we provide an overview of their involvement in some of the most common pregnancy-associated pathological conditions, such as preeclampsia and gestational diabetes mellitus. Additionally, we also discuss the estimated possible risk of polyphenol consumption on pregnancy outcomes. The consumption of dietary polyphenols during pregnancy needs particular attention considering the possible effects of polyphenols on the mechanisms involved in maternal adaptation and fetal development. Further studies are strongly needed to unravel the in vivo effects of polyphenol metabolites during pregnancy, as well as their role on advanced maternal age, prenatal nutrition, and metabolic risk of the offspring.
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Affiliation(s)
- Mirjana Nacka-Aleksić
- Institute for the Application of Nuclear Energy, Department for Biology of Reproduction, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia
| | - Andrea Pirković
- Institute for the Application of Nuclear Energy, Department for Biology of Reproduction, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia
| | - Aleksandra Vilotić
- Institute for the Application of Nuclear Energy, Department for Biology of Reproduction, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia
| | - Žanka Bojić-Trbojević
- Institute for the Application of Nuclear Energy, Department for Biology of Reproduction, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia
| | - Milica Jovanović Krivokuća
- Institute for the Application of Nuclear Energy, Department for Biology of Reproduction, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia
| | - Francesca Giampieri
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain
- Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Maurizio Battino
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain
- International Joint Research Laboratory of Intelligent Agriculture and Agri-Products Processing, Jiangsu University, Zhenjiang 212013, China
- Dipartimento di Scienze Cliniche Specialistiche, Facoltà di Medicina, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Dragana Dekanski
- Institute for the Application of Nuclear Energy, Department for Biology of Reproduction, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia
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Salinas-Roca B, Rubió-Piqué L, Montull-López A. Polyphenol Intake in Pregnant Women on Gestational Diabetes Risk and Neurodevelopmental Disorders in Offspring: A Systematic Review. Nutrients 2022; 14:nu14183753. [PMID: 36145129 PMCID: PMC9502213 DOI: 10.3390/nu14183753] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/03/2022] [Accepted: 09/08/2022] [Indexed: 11/18/2022] Open
Abstract
The intake of foods containing polyphenols can have a protective role to avoid comorbidities during pregnancy and, at the same time, promote transgenerational health. This review aims to describe the effect of polyphenol intake through supplements or polyphenol-rich foods during pregnancy on the incidence and evolution of gestational diabetes mellitus (GDM), as well as the link with the neurodevelopment of the fetus. Using PRISMA procedures, a systematic review was conducted by searching in biomedical databases (PubMed, Cinahl and Scopus) from January to June 2022. Full articles were screened (n = 419) and critically appraised. Fourteen studies were selected and were divided into two different thematic blocks considering (i) the effect of polyphenols in GDM and (ii) the effect of GDM to mental disorders in the offspring. A positive relationship was observed between the intake of polyphenols and the prevention and control of cardiometabolic complications during pregnancy, such as GDM, which could be related to thwarted inflammatory and oxidative processes, as well as neuronal factors. GDM is related to a greater risk of suffering from diseases related to neurodevelopment, such as attention deficit hyperactivity disorder, autism spectrum disorder and learning disorder. Further clinical research on the molecule protective mechanism of polyphenols on pregnant women is required to understand the transgenerational impact on fetal neurodevelopment.
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Affiliation(s)
- Blanca Salinas-Roca
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Science, Ramon Llull University, Padilla, 326-332, 08025 Barcelona, Spain
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig 2, 25198 Lleida, Spain
- Correspondence:
| | - Laura Rubió-Piqué
- Antioxidants Research Group, Food Technology Department, AGROTECNIO-CERCA Center, University of Lleida, Av/Alcalde Rovira Roure 191, 25198 Lleida, Spain
| | - Anna Montull-López
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig 2, 25198 Lleida, Spain
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Dathe K, Frank J, Padberg S, Hultzsch S, Beck E, Schaefer C. Fetal adverse effects following NSAID or metamizole exposure in the 2nd and 3rd trimester: an evaluation of the German Embryotox cohort. BMC Pregnancy Childbirth 2022; 22:666. [PMID: 36028798 PMCID: PMC9413886 DOI: 10.1186/s12884-022-04986-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-steroidal anti-inflammatory drugs (NSAID) are frequently used to treat pain, fever and inflammatory conditions. Due to evidenced fetotoxicity, treatment with NSAID and metamizole should be avoided in the 3rd trimester of pregnancy. There is an ongoing debate on fetotoxic risk of 2nd trimester use which is why we have conducted this study. METHODS In this observational cohort study outcome of pregnancies with NSAID and/or metamizole exposure in the 2nd and/or 3rd trimester (study cohort n = 1092) was compared with pregnancies exposed to NSAID and/or metamizole in the 1st trimester only (comparison cohort, n = 1154). The WHO-UMC system was used to assess causality between study medication and study endpoints. Prenatal study endpoints were constriction of ductus arteriosus Botalli, oligohydramnios, late spontaneous abortion (SAB) or stillbirth. Postnatal study endpoints were patent ductus arteriosus (PDA), anomalies of the right heart ventricle, primary pulmonary hypertension (PPHT), and neonatal impairment of kidney function. RESULTS Ductus arteriosus constriction was diagnosed in 5/1092 (0.5%) in the study cohort versus 0/1154 pregnancies in the comparison cohort. In one fetus, ductus arteriosus constriction and oligohydramnios occurred already in the late 2nd trimester after long-term NSAID exposure. Oligohydramnios was diagnosed in 41/1092 (3.8%) in the study cohort versus 29/1154 (2.5%) cases in the comparison cohort [RR, 1.5 (95% CI 0.9-2.4)]. Limited to 2nd trimester, oligohydramnios occurred in 8/904 (0.9%) versus 2/1154 (0.2%) pregnancies [RR, 5.1 (95% CI 1.1-24.0)]. At least in four of the 2nd trimester exposed pregnancies NSAID exposure lasted several weeks. Late SAB or stillbirth occurred in 14/1092 (1.3%) versus 17/1154 (1.5%). Postnatal cardiovascular or renal pathology did not differ between the cohorts. CONCLUSIONS NSAID use in the 2nd trimester limited to a few days does not appear to pose a relevant risk. Use for longer periods in the advanced 2nd trimester, however, may cause oligohydramnios and ductus arteriosus constriction similar to effects observed after 3rd trimester use.
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Affiliation(s)
- Katarina Dathe
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Klinische Pharmakologie und Toxikologie, Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie (Embryotox), Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Johanna Frank
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Klinische Pharmakologie und Toxikologie, Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie (Embryotox), Augustenburger Platz 1, 13353, Berlin, Germany
| | - Stephanie Padberg
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Klinische Pharmakologie und Toxikologie, Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie (Embryotox), Augustenburger Platz 1, 13353, Berlin, Germany
| | - Stefanie Hultzsch
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Klinische Pharmakologie und Toxikologie, Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie (Embryotox), Augustenburger Platz 1, 13353, Berlin, Germany
| | - Evelin Beck
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Klinische Pharmakologie und Toxikologie, Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie (Embryotox), Augustenburger Platz 1, 13353, Berlin, Germany
| | - Christof Schaefer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Klinische Pharmakologie und Toxikologie, Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie (Embryotox), Augustenburger Platz 1, 13353, Berlin, Germany
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Ma J, Cao H, Hong L, Liu J, Song X, Shi J, Zhang Y, Cui L, Zhang L, Xie M. Cardiac Function Assessment in Fetuses With Ductus Arteriosus Constriction: A Two-Dimensional Echocardiography and FetalHQ Study. Front Cardiovasc Med 2022; 9:868675. [PMID: 35958395 PMCID: PMC9360592 DOI: 10.3389/fcvm.2022.868675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/17/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundFetal ductal constriction (DC) is associated with excessive polyphenol-rich food (PRF) consumption during pregnancy. However, the effect of this hemodynamic change on fetal cardiac function still needs to be elucidated. Therefore, this study aimed to evaluate the cardiac function of fetuses with PRF-related DC and to describe serial observations of cardiac function changes.MethodsWe compared the traditional echocardiographic indices, including morphological, hemodynamic, and functional parameters, between study fetuses and controls. For global and segmental deformation analysis of the left and right ventricles, fetalHQ with the speckle-tracking technique was used to calculate sphericity index (SI), global longitudinal strain (GLS), fractional shortening (FS), fractional area change (FAC), etc. In addition, follow-up data were compared with the generalized linear model.ResultsA total of 60 DC fetuses and 60 gestational-matched controls were enrolled in our study, with 20 DC fetuses undertaking a follow-up echocardiogram after 2–3 weeks. Compared with controls, there was a distinct decrease in right ventricular GLS (RVGLS) (−13.39 ± 3.77 vs. −21.59 ± 2.51, p < 0.001), RVFAC (22.20 ± 9.56 vs. 36.01 ± 4.84, p < 0.001), left ventricular GLS (LVGLS) (−19.52 ± 3.24 vs. −23.81 ± 2.01 p < 0.001), and LVFAC (39.64 ± 7.32 vs. 44.89 ± 4.91, p = 0.004). For 24-segment FS analysis, DC fetuses showed lower FS in left ventricular (LV) segments 18–24, with no difference in LV segments 1–17. Right ventricular (RV) FS in segments 4–23 was also reduced in the DC group. The 24-segment SI analysis indicated significantly lower SI in DC than those in controls for LV segments 1–14 and RV segments 19–24. We found that the pulsatility index (PI) of ductus arteriosus (DA) was an independent variable for RVGLS (β = −0.29, p = 0.04). In 20 DC fetuses with follow-up echocardiograms, no obvious difference in myocardial deformation was found between the initial examination and follow-up data.ConclusionLeft and right ventricular performances were both impaired in DC fetuses, along with a series of morphological and hemodynamic changes. Although the state of DA constriction improved on second examinations, cardiac function was not completely restored.
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Affiliation(s)
- Jing Ma
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Haiyan Cao
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Liu Hong
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Juanjuan Liu
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Xiaoyan Song
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Jiawei Shi
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yi Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Li Cui
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Li Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
- *Correspondence: Li Zhang,
| | - Mingxing Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
- Mingxing Xie,
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Battistoni G, Montironi R, Di Giuseppe J, Giannella L, Delli Carpini G, Baldinelli A, Pozzi M, Ciavattini A. Foetal ductus arteriosus constriction unrelated to non-steroidal anti-Inflammatory drugs: a case report and literature review. Ann Med 2021; 53:860-873. [PMID: 34096417 PMCID: PMC8189142 DOI: 10.1080/07853890.2021.1921253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/18/2021] [Indexed: 11/25/2022] Open
Abstract
Foetal ductus arteriosus (DA) constriction can be found in complex foetal heart malformations, but rarely as an isolated defect. Although many cases of DA constriction are usually related to Non-steroidal Anti-Inflammatory Drugs (NSAIDs) maternal intake, other causes remain without an established aetiology and are referred to as idiopathic. Recently, a wide range of risks factors or substances (polyphenol-rich foods intake, naphazoline, fluoxetine, caffeine and pesticides) showed a definitive effect upon the pathway of inflammation, causing DA constriction. We report a case of a premature DA constriction in a woman whose possible risk factor was identified in her maternal occupational exposure to solvents and a comprehensive literature review of 176 cases of NSAID-unrelated DA constriction. A 30-year-old Asian woman was referred to our institution at 33 gestational weeks and 0 days because of suspicion of premature DA constriction. The woman had no history of medication intake, including NSAIDs, alcohol, tobacco or polyphenol-rich-food consumption during pregnancy. A detailed foetal echocardiography revealed a normal cardiac anatomy with hypertrophic, hypokinetic and a dilated right ventricle due to right pressure overload, holosystolic tricuspid regurgitation, and, at the level of the DA, high systolic and diastolic velocities, indicating premature ductal restriction. The right outflow showed dilatation of the pulmonary artery with narrow DA. An urgent caesarean section was performed at 33 gestational weeks and 4 days due to worsening of DA PI and signs of right pressure overload, despite the interruption of exposure to solvents. We assume a relationship exists between premature DA constriction and a maternal occupational exposure to solvents. This hypothesis is reinforced by the presence of associated foetal malformations in in two of the patient's children. Further research is needed to confirm the role of exposure to solvents and toxic chemicals in the pathogenesis of DA constriction, also with experimental animal models.KEY MESSAGESMany cases of DA constriction are usually related to Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) maternal intake.A wide range of risks factors or substances (polyphenol-rich foods intake, naphazoline, fluoxetine, caffeine and pesticides) can cause foetal DA constriction.Further investigation are needed to confirm the role of maternal exposure to solvents in the pathogenesis of DA constriction.
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Affiliation(s)
- Giovanna Battistoni
- Woman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy
| | - Ramona Montironi
- Woman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy
| | - Jacopo Di Giuseppe
- Woman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy
| | - Luca Giannella
- Woman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy
| | - Giovanni Delli Carpini
- Woman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy
| | - Alessandra Baldinelli
- Department of Paediatric and Congenital Cardiac Surgery and Cardiology, Ospedali Riuniti, Ancona, Italy
| | - Marco Pozzi
- Department of Paediatric and Congenital Cardiac Surgery and Cardiology, Ospedali Riuniti, Ancona, Italy
| | - Andrea Ciavattini
- Woman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy
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Zielinsky P, MagalhÃes GA, Zurita-Peralta J, Sosa-OlavarrÍa A, Marinho G, Van Der Sand L, Sulis NM, Nicoloso LH, Piccoli A, Vian I. Improvement in fetal pulmonary hypertension and maturity after reversal of ductal constriction: prospective cohort study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2021; 58:420-427. [PMID: 33502049 DOI: 10.1002/uog.23599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/20/2020] [Accepted: 01/20/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To test the hypotheses that estimated mean pulmonary arterial pressure (MPAP) decreases and pulmonary vascular maturation, assessed by the ratio of pulmonary arterial flow acceleration time to ejection time (AT/ET ratio), increases after reversal of fetal ductus arteriosus constriction by reducing maternal intake of the causal agent (prostaglandin inhibitors, such as polyphenol-rich foods or non-steroidal anti-inflammatory drugs), and that these effects are independent of gestational age, which are inferences not yet demonstrated in the clinical setting. METHODS This was a prospective cohort study comparing Doppler echocardiographic ductal flow dynamics, MPAP and pulmonary arterial flow AT/ET ratio in third-trimester fetuses (≥ 28 weeks' gestation) with ductus arteriosus constriction, at the time of diagnosis and after 2 weeks of reduced maternal intake of prostaglandin inhibitors either by suspending the use of pharmacological agents with potential for prostaglandin inhibition or by restricting the consumption of polyphenol-rich foods. MPAP was estimated using the Dabestani equation (MPAP = 90 - (0.62 × AT)), and pulmonary vascular maturity was assessed using the AT/ET ratio, according to reported validation studies. Student's t-test was used for comparison of variables at diagnosis with those after reversal of ductal constriction. Change in MPAP and pulmonary AT/ET ratio between the two assessments was compared with the expected change in the same gestational period in normal fetuses based on reference curves of MPAP and pulmonary AT/ET ratio constructed in normal fetuses from healthy pregnant women at 19-37 weeks' gestation, encompassing the same gestational age range as the study group (28-37 weeks). RESULTS Seventy pregnancies with fetal ductus arteriosus constriction were included in the study. After 2 weeks of reduced maternal intake of prostaglandin inhibitors, normalization of mean systolic (change from 1.86 ± 0.34 m/s at diagnosis to 1.38 ± 0.41 m/s; P < 0.001) and diastolic (change from 0.41 ± 0.11 m/s to 0.21 ± 0.065 m/s; P < 0.001) ductal velocities and of mean pulsatility index (change from 1.99 ± 0.20 to 2.55 ± 0.42; P < 0.001) was demonstrated. MPAP decreased between the assessments (change from 66.7 ± 6.90 mmHg at diagnosis to 54.5 ± 6.70 mmHg after 2 weeks; P < 0.001) and mean pulmonary AT/ET ratio increased (change from 0.20 ± 0.06 to 0.33 ± 0.07; P < 0.001). Change in MPAP between diagnosis and after 2 weeks of reduced maternal intake of prostaglandin inhibitors was -12.2 ± 0.30 mmHg, which was 5.3-times higher than that in 305 normal fetuses over 2 weeks during the same gestational period (-2.3 ± 0.19 mmHg) (P < 0.001), and change in pulmonary AT/ET ratio between the two assessments was 0.13 ± 0.08, which was 8.7-times higher than that in normal fetuses in the same gestational period (0.015 ± 0.08) (P < 0.001). CONCLUSIONS Resolution of fetal ductal constriction is followed by a fall in MPAP and by an increase in pulmonary vascular maturity, to a significantly greater degree than is observed in normal fetuses in the same gestational-age period. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- P Zielinsky
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
- Department of Pediatrics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - G A MagalhÃes
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - J Zurita-Peralta
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | | | - G Marinho
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - L Van Der Sand
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - N M Sulis
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - L H Nicoloso
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - A Piccoli
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - I Vian
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
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10
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August PM, Klein CP, Grings M, Sagini JP, Rodrigues PIDL, Stocher DP, Stone V, Silva YD, Couto PRG, Salomon TB, Benfato MDS, Leipnitz G, Matté C. Maternal polyphenol intake impairs cerebellar redox homeostasis in newborn rats. Nutr Neurosci 2021; 25:2066-2076. [PMID: 34076555 DOI: 10.1080/1028415x.2021.1933330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Polyphenols are compounds found in plants that have been extensively studied due to the health benefits of its consumption in adulthood. Meanwhile, recent evidence suggests that polyphenol consumption during pregnancy may not be safe for the fetus. OBJECTIVE The goal of this study was to evaluate the effect of naringenin supplementation during pregnancy on brain redox homeostasis and mitochondrial activity of the newborn rat. METHODS Adult female Wistar rats were divided into two groups: (1) vehicle (1 mL/Kg p.o.) or (2) naringenin (50 mg/Kg p.o.). Naringenin was administered once a day during pregnancy. The offspring were euthanized on postnatal day 7, as well the dams, and brain regions were dissected. RESULTS The offspring cerebellum was the most affected region, presenting increased activity of the mitochondrial electron transport system, allied to increased reactive species levels, lipid peroxidation, and glutathione concentration. The nitric oxide levels suffered structure-dependent alteration, with decreased levels in the pups' cerebellum and increased in the hippocampus. The offspring parietal cortex was not affected, as well as the parameters evaluated in the dams' brains. CONCLUSION Maternal consumption of naringenin alters offspring cerebellar redox homeostasis, which could be related to adverse effects on the motor and cognitive development in the descendants.
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Affiliation(s)
- Pauline Maciel August
- Programa de Pós-graduação em Ciências Biológicas: Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Caroline Peres Klein
- Programa de Pós-graduação em Ciências Biológicas: Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mateus Grings
- Programa de Pós-graduação em Ciências Biológicas: Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - João Pedro Sagini
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Daniela Pereira Stocher
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vinicius Stone
- Programa de Pós-graduação em Ciências Biológicas: Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Yasmini Dandara Silva
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pablo Ribeiro Gonçalves Couto
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tiago Boeira Salomon
- Programa de Pós-graduação em Biologia Molecular e Celular, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mara da Silveira Benfato
- Programa de Pós-graduação em Biologia Molecular e Celular, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Departamento de Biofísica, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Guilhian Leipnitz
- Programa de Pós-graduação em Ciências Biológicas: Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Cristiane Matté
- Programa de Pós-graduação em Ciências Biológicas: Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Programa de Pós-graduação em Ciências Biológicas: Fisiologia, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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11
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Zielinsky P, Martignoni FV, Markoski M, Zucatti KP, Dos Santos Marinho G, Pozzobon G, Magno PR, de Bittencourt Antunes V, Sulis NM, Cardoso A, Mattos D, Naujorks AA, von Frankenberg AD, Vian I. Maternal ingestion of cocoa causes constriction of fetal ductus arteriosus in rats. Sci Rep 2021; 11:9929. [PMID: 33976258 PMCID: PMC8113492 DOI: 10.1038/s41598-021-89309-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 04/20/2021] [Indexed: 01/13/2023] Open
Abstract
Maternal consumption of polyphenol-rich foods has been associated with fetal ductus arteriosus constriction (DAC), but safety of chocolate exposure in fetal life has not been studied. This experimental study tested the hypothesis that maternal cocoa consumption in late pregnancy causes fetal DAC, with possible associated antioxidant effects. Pregnant Wistar rats, at the 21st gestational day, received by orogastric tube cocoa (720 mg/Kg) for 12 h, indomethacin (10 mg/Kg), for 8 h, or only water, before cesaren section. Immediately after withdrawal, every thorax was obtained and tissues were fixed and stained for histological analysis. The ratio of the narrowest part of the pulmonary artery to the fetal ductus inner diameter and increased ductal inner wall thickness characterized ductal constriction. Substances reactive to thiobarbituric acid were quantified. Statistical analysis used ANOVA and Tukey test. Cocoa (n = 33) and indomethacin (n = 7) reduced fetal internal ductus diameter when compared to control (water, n = 25) (p < 0.001) and cocoa alone increased ductus wall thickness (p < 0.001), but no change was noted in enzymes activity. This pharmacological study shows supporting evidences that there is a cause and effect relationship between maternal consumption of cocoa and fetal ductus arteriosus constriction. Habitual widespread use of chocolate during gestation could account for undetected ductus constriction and its potentially severe consequences, such as perinatal pulmonary hypertension, cardiac failure and even death. For this reason, dietary guidance in late pregnancy to avoid high chocolate intake, to prevent fetal ductal constriction, may represent the main translational aspect of this study.
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Affiliation(s)
- Paulo Zielinsky
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil. .,Departament of Pediatrics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. .,Fetal Cardiology Unit, Institute of Cardiology/University Foundation of Cardiology, Avenida Princesa Isabel, 395 - Santana, Porto Alegre, CEP 90620-000, Brazil.
| | - Felipe Villa Martignoni
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil.,Federal University of Santa Maria, Avenida Roraima, 1000, Santa Maria, CEP 97105-900, Brazil
| | - Melissa Markoski
- Basic Health Science, Federal University of Health Sciences of Porto Alegre, Avenida Sarmento Leite, 245, Porto Alegre, CEP 90050-170, Brazil
| | - Kelly Pozzer Zucatti
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil
| | - Gabriela Dos Santos Marinho
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil
| | - Gabriela Pozzobon
- Federal University of Santa Maria, Avenida Roraima, 1000, Santa Maria, CEP 97105-900, Brazil
| | - Pedro Rafael Magno
- Federal University of Santa Maria, Avenida Roraima, 1000, Santa Maria, CEP 97105-900, Brazil
| | | | - Natassia Miranda Sulis
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil
| | - Alexandra Cardoso
- Federal University of Santa Maria, Avenida Roraima, 1000, Santa Maria, CEP 97105-900, Brazil
| | - Daniel Mattos
- Federal University of Santa Maria, Avenida Roraima, 1000, Santa Maria, CEP 97105-900, Brazil
| | - Alexandre Antônio Naujorks
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil
| | - Anize Delfino von Frankenberg
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil
| | - Izabele Vian
- Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil
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12
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Hauben M, Bai S, Hung E, Lobello K, Tressler C, Zucal VP. Maternal paracetamol intake and fetal ductus arteriosus constriction/closure: comprehensive signal evaluation using the Austin Bradford Hill criteria. Eur J Clin Pharmacol 2021; 77:1019-1028. [PMID: 33410971 DOI: 10.1007/s00228-020-03039-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/09/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Acetaminophen (APAP) is available over-the-counter and widely regarded as safe for use in pregnancy. APAP has been used to close a persistently patent ductus arteriosus. Fetal constriction/closure of the ductus arteriosus (FCCDA), of public health interest given the drug's widespread use during pregnancy, is being monitored globally, including by the European Medicines Agency Pharmacovigilance Risk Assessment Committee. Our objective was to share a comprehensive signal evaluation of FCCDA with in utero APAP exposure to determine if the totality of evidence is sufficiently more consistent with one of the following two possibilities: (1) APAP never contributes to FCCDA (null hypothesis or HO) versus (2) APAP may in some cases be at least a contributory cause of in utero DA narrowing (alternative hypothesis or HA) to justify risk communication. METHODS To assess the relative support for HO versus HA, we synthesize and interpret within an Austin Bradford Hill criteria framework a comprehensive, cross-disciplinary set of published information and de novo analysis, including toxicology, epidemiology, clinical pharmacology, and clinical and quantitative pharmacovigilance analysis of spontaneous reports. RESULTS While residual uncertainty remains, the totality of information is more compatible with HA than H0, to the extent that it is reasonably possible that APAP may sometimes be at least a contributory cause of FCCDA. CONCLUSION It is reasonably possible that APAP may sometimes be at least a contributory cause of FCCDA, and this should therefore be communicated to stakeholders. TRIAL REGISTRATION CLINICALTRIALS. GOV REGISTRATION NOT APPLICABLE.
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Affiliation(s)
- Manfred Hauben
- Worldwide Safety and Regulatory, Pfizer Inc., 235 E 42nd St, New York, NY, 10017, USA. .,Department of Medicine, NYU Langone Health, 550 First Avenue, New York, NY, 10016, USA.
| | - Stephen Bai
- Clinical Pharmacology, Pfizer Inc., 235 E 42nd St, New York, NY, 10017, USA
| | - Eric Hung
- Worldwide Safety and Regulatory, Pfizer Inc., 235 E 42nd St, New York, NY, 10017, USA
| | - Kasia Lobello
- Safety Surveillance and Risk Management, Pfizer Inc., 235 E 42nd St, New York, NY, 10017, USA
| | - Charles Tressler
- Safety Surveillance and Risk Management, Pfizer Inc., 235 E 42nd St, New York, NY, 10017, USA
| | - Vincent P Zucal
- Safety Surveillance and Risk Management, Pfizer Inc., 235 E 42nd St, New York, NY, 10017, USA
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13
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Ganguly M, Hazarika J, Sarma S, Bhuyan P, Mahanta R. Estrogen receptor modulation of some polyphenols extracted from Daucus carota as a probable mechanism for antifertility effect: An in silico study. JOURNAL OF THEORETICAL & COMPUTATIONAL CHEMISTRY 2020. [DOI: 10.1142/s0219633620410047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The seeds of Daucus carota, traditionally used by women in many countries to prevent conception, were proved to have negative impact on reproductive hormone levels as well as on the estrous cycles in albino mice affecting the fertility status. This study is an attempt to investigate the possible role of polyphenols present in the seeds in hampering the reproductive processes. The Molecular Docking, Molecular Dynamics (MD) simulation and binding free energy calculation studies reveal that six polyphenols present in the seeds can bind with the active sites of human Estrogen Receptor (ER) and may interfere in the estrogen signaling in human. These polyphenols were found to bind to a conservative pocket of ER[Formula: see text], which is comprised of residues 343–388, 421–428 and 525–540. Docking studies indicated the presence of strong hydrogen bonding, pi–pi interactions and numerous hydrophobic interactions that stabilize the ER[Formula: see text]-polyphenol complexes. The docked complexes were further subjected to MM/GBSA analysis to calculate binding free energies. Molecular dynamic simulation studies carried out for a period of 20[Formula: see text]ns revealed low RMS deviation values suggesting high accuracy of the docking poses and stability of the complexes. Out of the six polyphenols, catechin and epicatechin have shown highest binding affinity towards the ER[Formula: see text] receptor. These findings will help in identifying ER modulators of plant origin targeting ER alpha and predicting their effects on the reproductive hormone homeostasis. Moreover, this study may form preliminary basis for further identification of potential herbal antifertility agents.
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Affiliation(s)
- Mausumi Ganguly
- Department of Chemistry, Cotton University, Guwahati 781001, Assam, India
| | - Jnyandeep Hazarika
- Department of Chemistry, Cotton University, Guwahati 781001, Assam, India
| | - Shruti Sarma
- Department of Chemistry, Cotton University, Guwahati 781001, Assam, India
| | - Pranjal Bhuyan
- Department of Chemistry, Cotton University, Guwahati 781001, Assam, India
| | - Rita Mahanta
- Department of Zoology, Cotton University, Guwahati 781001, Assam, India
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14
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Pedra SRFF, Zielinsky P, Binotto CN, Martins CN, Fonseca ESVBD, Guimarães ICB, Corrêa IVDS, Pedrosa KLM, Lopes LM, Nicoloso LHS, Barberato MFA, Zamith MM. Brazilian Fetal Cardiology Guidelines - 2019. Arq Bras Cardiol 2019; 112:600-648. [PMID: 31188968 PMCID: PMC6555576 DOI: 10.5935/abc.20190075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Simone R F Fontes Pedra
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil.,Hospital do Coração (HCor), São Paulo, SP - Brazil
| | - Paulo Zielinsky
- Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre, RS - Brazil
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15
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Vian I, Zielinsky P, Zílio AM, Schaun MI, Brum C, Lampert KV, De Ávila N, Baldissera G, Klanovicz TM, Zenki K, Zurita-Peralta J, Olszewski A, Piccoli A, Nicoloso LH, Sulis N, Van Der Sand L, Markoski M. Increase of prostaglandin E2 in the reversal of fetal ductal constriction after polyphenol restriction. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 52:617-622. [PMID: 29205592 DOI: 10.1002/uog.18974] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 11/18/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Anti-inflammatory substances that inhibit the synthesis of prostaglandins, such as non-steroidal anti-inflammatory drugs (NSAIDs) and polyphenol-rich foods, can cause constriction of the fetal ductus arteriosus. This study aimed to test the hypothesis that reversal of fetal ductal constriction after maternal restriction of polyphenol-rich foods, in the third trimester of pregnancy, is accompanied by increased plasma levels of prostaglandin E2 (PGE2). METHODS This was a controlled clinical trial of women with singleton pregnancy ≥ 28 weeks undergoing fetal echocardiography. The intervention group included pregnancies with diagnosis of fetal ductal constriction and not exposed to NSAIDs. The control group consisted of third-trimester normal pregnancies. Both groups answered a food frequency questionnaire to assess the amount of total polyphenols in their diet, underwent Doppler echocardiographic examination and had blood samples collected for analysis of plasma levels of PGE2. Intervention group participants received dietary guidance to restrict the intake of polyphenol-rich foods. The assessments were repeated after 2 weeks in both groups. RESULTS Forty normal pregnancies were assessed in the control group and 35 with fetal ductal constriction in the intervention group. Mean maternal age (26.6 years) and mean body mass index (30.12 kg/m2 ) were similar between the two groups. Intragroup analysis showed that dietary guidance reduced the median consumption of polyphenols (from 1234.82 to 21.03 mg/day, P < 0.001), increasing significantly the plasma concentration of PGE2 (from 1091.80 to 1136.98 pg/mL, P < 0.05) in the intervention group after 2 weeks. In addition, Doppler echocardiography showed reversal of fetal ductal constriction in the intervention group. No significant changes were observed in the control group. CONCLUSIONS Dietary intervention for maternal restriction of polyphenol-rich foods in the third trimester of pregnancy is accompanied by increase in plasma levels of PGE2 and reversal of fetal ductal constriction. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- I Vian
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - P Zielinsky
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
- Department of Pediatrics, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - A M Zílio
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - M I Schaun
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - C Brum
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - K V Lampert
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - N De Ávila
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - G Baldissera
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - T M Klanovicz
- Federal University of Health Sciences, Porto Alegre, Brazil
| | - K Zenki
- Federal University of Health Sciences, Porto Alegre, Brazil
| | - J Zurita-Peralta
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - A Olszewski
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - A Piccoli
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - L H Nicoloso
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - N Sulis
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - L Van Der Sand
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
| | - M Markoski
- Federal University of Health Sciences, Porto Alegre, Brazil
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16
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Zilio AM, Zielinsky P, Vian I, Lampert K, Raupp D, Weschenfelder C, Brum C, Arnt A, Piccoli A, Nicoloso LH, Schaun MI, Markoski M. Polyphenol supplementation inhibits physiological increase of prostaglandin E2 during reproductive period - A randomized clinical trial. Prostaglandins Leukot Essent Fatty Acids 2018; 136:77-83. [PMID: 28408067 DOI: 10.1016/j.plefa.2017.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/30/2017] [Accepted: 04/03/2017] [Indexed: 01/08/2023]
Abstract
Anti-inflammatory property of polyphenols and their effect on the metabolism of prostaglandins is not established in healthy humans. This study aimed to evaluate the effect of polyphenol supplementation in plasma levels of prostaglandin E2 and other markers of inflammation and oxidative stress in women using contraceptives. In this randomized double-blind clinical trial, women aged 25-35 years were selected. Participants received capsules containing polyphenols or placebo, to be consumed for fifteen days. From 40 women randomized, 28 completed the study. Control group showed a significant increase in the levels of PGE2 (p=0.01) while the polyphenols group showed no change in these levels (p=0.79). There was an increase in hs-CRP (p<0.01) and F2-isoprostane (p=0.04) in the control group. The GSSG to GSH ratio significantly reduced in the polyphenols group (p=0.02). Supplementation with polyphenol capsules inhibited the increase in markers of inflammation and oxidative stress in women of childbearing age using combined hormonal contraceptives.
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Affiliation(s)
- A M Zilio
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Rio Grande do Sul - Brazil.
| | - P Zielinsky
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Rio Grande do Sul - Brazil; Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Rio Grande do Sul - Brazil
| | - I Vian
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Rio Grande do Sul - Brazil
| | - K Lampert
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Rio Grande do Sul - Brazil
| | - D Raupp
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Rio Grande do Sul - Brazil
| | - C Weschenfelder
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Rio Grande do Sul - Brazil
| | - C Brum
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Rio Grande do Sul - Brazil
| | - A Arnt
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Rio Grande do Sul - Brazil
| | - A Piccoli
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Rio Grande do Sul - Brazil
| | - L H Nicoloso
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Rio Grande do Sul - Brazil
| | - M I Schaun
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Rio Grande do Sul - Brazil
| | - M Markoski
- Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Rio Grande do Sul - Brazil
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17
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Lewis TR, Shelton EL, Van Driest SL, Kannankeril PJ, Reese J. Genetics of the patent ductus arteriosus (PDA) and pharmacogenetics of PDA treatment. Semin Fetal Neonatal Med 2018; 23:232-238. [PMID: 29510900 PMCID: PMC6098727 DOI: 10.1016/j.siny.2018.02.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Patent ductus arteriosus (PDA) is a frequent, complex, and difficult to treat clinical syndrome among preterm infants in the neonatal intensive care unit. In addition to known clinical risk factors, there are emerging data about genetic predisposition to PDA in both animal and human models. Clinical response and toxicity from drugs used to treat PDA are highly variable. Developmental and genetic aspects of pharmacokinetics and pharmacodynamics influence exposure and response to pharmacologic therapies. Given the variable efficacy and toxicity of known drug therapies, novel therapeutic targets for PDA treatment offer the promise of precision medicine. This review addresses the known genetic contributions to prolonged ductal patency, variability in response to drug therapy for PDA, and potential novel drug targets for future PDA treatment discovery.
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Affiliation(s)
- Tamorah R Lewis
- Department of Pediatrics, Children's Mercy Hospitals & Clinics, University of Missouri, Kansas City School of Medicine, Kansas City, MO, USA
| | - Elaine L Shelton
- Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, TN, USA; Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sara L Van Driest
- Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, TN, USA; Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Prince J Kannankeril
- Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jeff Reese
- Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, TN, USA; Department of Cell and Developmental Biology, Vanderbilt University, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.
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Maternal pomegranate juice attenuates maternal inflammation-induced fetal brain injury by inhibition of apoptosis, neuronal nitric oxide synthase, and NF-κB in a rat model. Am J Obstet Gynecol 2018; 219:113.e1-113.e9. [PMID: 29709511 DOI: 10.1016/j.ajog.2018.04.040] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/15/2018] [Accepted: 04/19/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Maternal inflammation is a risk factor for neonatal brain injury and future neurological deficits. Pomegranates have been shown to exhibit anti-inflammatory, anti-apoptotic and anti-oxidant activities. OBJECTIVE We hypothesized that pomegranate juice (POM) may attenuate fetal brain injury in a rat model of maternal inflammation. STUDY DESIGN Pregnant rats (24 total) were randomized for intraperitoneal lipopolysaccharide (100 μg/kg) or saline at time 0 at 18 days of gestation. From day 11 of gestation, 12 dams were provided ad libitum access to drinking water, and 12 dams were provided ad libitum access to drinking water with pomegranate juice (5 mL per day), resulting in 4 groups of 6 dams (saline/saline, pomegranate juice/saline, saline/lipopolysaccharide, pomegranate juice/lipopolysaccharide). All dams were sacrificed 4 hours following the injection and maternal blood and fetal brains were collected from the 4 treatment groups. Maternal interleukin-6 serum levels and fetal brain caspase 3 active form, nuclear factor-κB p65, neuronal nitric oxide synthase (phosphoneuronal nitric oxide synthase), and proinflammatory cytokine levels were determined by enzyme-linked immunosorbent assay and Western blot. RESULTS Maternal lipopolysaccharide significantly increased maternal serum interleukin-6 levels (6039 ± 1039 vs 66 ± 46 pg/mL; P < .05) and fetal brain caspase 3 active form, nuclear factor-κB p65, phosphoneuronal nitric oxide synthase, and the proinflammatory cytokines compared to the control group (caspase 3 active form 0.26 ± 0.01 vs 0.20 ± 0.01 U; nuclear factor-κB p65 0.24 ± 0.01 vs 0.1 ± 0.01 U; phosphoneuronal nitric oxide synthase 0.23 ± 0.01 vs 0.11 ± 0.01 U; interleukin-6 0.25 ± 0.01 vs 0.09 ± 0.01 U; tumor necrosis factor-α 0.26 ± 0.01 vs 0.12 ± 0.01 U; chemokine (C-C motif) ligand 2 0.23 ± 0.01 vs 0.1 ± 0.01 U). Maternal supplementation of pomegranate juice to lipopolysaccharide-exposed dams (pomegranate juice/lipopolysaccharide) significantly reduced maternal serum interleukin-6 levels (3059 ± 1121 pg/mL, fetal brain: caspase 3 active form (0.2 ± 0.01 U), nuclear factor-κB p65 (0.22 ± 0.01 U), phosphoneuronal nitric oxide synthase (0.19 ± 0.01 U) as well as the brain proinflammatory cytokines (interleukin-6, tumor necrosis factor-α and chemokine [C-C motif] ligand 2) compared to lipopolysaccharide group. CONCLUSION Maternal pomegranate juice supplementation may attenuate maternal inflammation-induced fetal brain injury. Pomegranate juice neuroprotective effects might be secondary to the suppression of both the maternal inflammatory response and inhibition of fetal brain apoptosis, neuronal nitric oxide synthase, and nuclear factor-κB activation.
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Belica AL, Ćetković NB, Milić NB, Milošević NP. Herbal Therapy in Pregnancy-What to Expect when you Expect? Nat Prod Commun 2017. [DOI: 10.1177/1934578x1701201236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The use of herbal therapy in pregnancy is common for pregnancy related nausea, vomiting, gestational diabetes, anxiety, insomnia, and preparation for labor, as well as for treating infections. Many conventional drugs may interfere with fetal development and herbal products are considered to be safe. However, herbal therapy requires competent healthcare professional advice before prescribing. Knowledge about the possible adverse effects of active compounds of the herbs on pregnancy outcome is limited. Interference of herbal ingredients with conventional medication or the ailment should also not be excluded. For many herbal products, the pharmacological effect is not clinically proven, and the safe usage in pregnancy is not guaranteed. Here, based on published clinical trials, an overview is given of the efficacy and safety for fetal development and pregnancy outcome of the most frequently used herbs: ginger, cranberry, echinacea, mint, chamomile, valerian, flaxseed, tea and raspberry leaf.
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Affiliation(s)
- Artur L. Belica
- University of Novi Sad, Faculty of Medicine, Department of Gynecology and Obstetrics, Clinics for Gynecology and Obstetrics, Clinical Centre Vojvodina, Hajduk Veljkova 3-9, Novi Sad, Serbia
| | - Nenad B. Ćetković
- University of Novi Sad, Faculty of Medicine, Department of Gynecology and Obstetrics, Clinics for Gynecology and Obstetrics, Clinical Centre Vojvodina, Hajduk Veljkova 3-9, Novi Sad, Serbia
| | - Nataša B. Milić
- University of Novi Sad, Faculty of Medicine, Department of Pharmacy, Hajduk Veljkova 3, Novi Sad, Serbia
| | - Nataša P. Milošević
- University of Novi Sad, Faculty of Medicine, Department of Pharmacy, Hajduk Veljkova 3, Novi Sad, Serbia
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Reply on "Constriction of the ductus arteriosus, severe right ventricular hypertension, and a right ventricular aneurysm in a fetus after maternal use of a topical treatment for striae gravidarum". Cardiol Young 2017; 27:823-824. [PMID: 28260549 DOI: 10.1017/s1047951117000129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Hahn M, Baierle M, Charão MF, Bubols GB, Gravina FS, Zielinsky P, Arbo MD, Cristina Garcia S. Polyphenol-rich food general and on pregnancy effects: a review. Drug Chem Toxicol 2016; 40:368-374. [DOI: 10.1080/01480545.2016.1212365] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Marla Hahn
- Laboratory of Toxicology (LATOX), Department of Analysis, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
| | - Marília Baierle
- Laboratory of Toxicology (LATOX), Department of Analysis, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Post-Graduate Program in Pharmaceutical Sciences (PPGCF), Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
| | - Mariele F. Charão
- Laboratory of Toxicology (LATOX), Department of Analysis, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Toxicological Analysis Laboratory, Institute of Health Sciences, Feevale University, Novo Hamburgo, RS, Brazil,
| | - Guilherme B. Bubols
- Laboratory of Toxicology (LATOX), Department of Analysis, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Post-Graduate Program in Pharmaceutical Sciences (PPGCF), Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
| | - Fernanda S. Gravina
- Laboratory of Toxicology (LATOX), Department of Analysis, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
| | - Paulo Zielinsky
- Cardiology Institute, University Foundation of Cardiology, Porto Alegre, RS, Brazil, and
| | - Marcelo D. Arbo
- Laboratory of Toxicology (LATOX), Department of Analysis, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Post-Graduate Program in Pharmaceutical Sciences (PPGCF), Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Department of Veterinary Clinical Pathology, Faculty of Veterinary, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Solange Cristina Garcia
- Laboratory of Toxicology (LATOX), Department of Analysis, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Post-Graduate Program in Pharmaceutical Sciences (PPGCF), Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Cardiology Institute, University Foundation of Cardiology, Porto Alegre, RS, Brazil, and
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Constriction of the ductus arteriosus, severe right ventricular hypertension, and a right ventricular aneurysm in a fetus after maternal use of a topical treatment for striae gravidarum. Cardiol Young 2016; 26:796-8. [PMID: 26443450 DOI: 10.1017/s1047951115001924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Fetal constriction of the ductus arteriosus is a complication of maternal non-steroidal anti-inflammatory drug use and polyphenol-rich food intake. It is unclear as to whether polyphenol-containing topical treatments have similar effects. We present a case of fetal constriction of the ductus arteriosus, severe right ventricular hypertension, and a right ventricular aneurysm associated with maternal use of a topical treatment for striae gravidarum.
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Zielinsky P, Martignoni FV, Vian I. Deleterious effects of maternal ingestion of cocoa upon fetal ductus arteriosus in late pregnancy. Front Pharmacol 2014; 5:281. [PMID: 25566077 PMCID: PMC4273632 DOI: 10.3389/fphar.2014.00281] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 12/02/2014] [Indexed: 01/07/2023] Open
Abstract
Cocoa powder has twice more antioxidants than red wine and three times more than green tea. Ten percent of its weight is made up of flavonoids. Cocoa has antioxidant and anti-inflammatory effects by downregulating cyclooxigenase-2 receptors expression in the endothelium and enhancing nitric oxide bioavailability. There are evidences that while polyphenols ingestion have cardioprotective effects in the adult, it may have deleterious effect on the fetus if ingested by the mother on the third trimester of pregnancy, causing intrauterine fetal ductus arteriosus (DA) constriction. Polyphenols present in many foods and their anti-inflammatory and antinociceptive activities have been shown to be as or more powerful than those of indomethacin. These effects are dependent on the inhibition of modulation of the arachidonic acid and the synthesis of prostaglandins, especially E-2, which is responsible for fetal DA patency. So, we hypothesized that this same mechanism is responsible for the harmful effect of polyphenol-rich foods, such as cocoa, upon the fetal DA after maternal intake of such substances in the third trimester of pregnancy, thereby rising the perspective of a note of caution for pregnant women diet.
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Affiliation(s)
- Paulo Zielinsky
- Fetal Cardiology Unit, Institute of Cardiology of Rio Grande do Sul Porto Alegre, Brazil
| | - Felipe V Martignoni
- Fetal Cardiology Unit, Institute of Cardiology of Rio Grande do Sul Porto Alegre, Brazil
| | - Izabele Vian
- Fetal Cardiology Unit, Institute of Cardiology of Rio Grande do Sul Porto Alegre, Brazil
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Ly C, Yockell-Lelièvre J, Ferraro ZM, Arnason JT, Ferrier J, Gruslin A. The effects of dietary polyphenols on reproductive health and early development†. Hum Reprod Update 2014; 21:228-48. [DOI: 10.1093/humupd/dmu058] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Bubols GB, Zielinsky P, Piccoli AL, Nicoloso LH, Vian I, Moro AM, Charão MF, Brucker N, Bulcão RP, Nascimento SN, Baierle M, Alievi MM, Moresco RN, Markoski M, Garcia SC. Nitric oxide and reactive species are modulated in the polyphenol-induced ductus arteriosus constriction in pregnant sheep. Prenat Diagn 2014; 34:1268-76. [PMID: 25043716 DOI: 10.1002/pd.4463] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 07/12/2014] [Accepted: 07/14/2014] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Because we have previously demonstrated the relation between polyphenol-rich foods (PRF) consumption and ductus arteriosus constriction, in this work, pregnant sheep were submitted to oral PRF intake for 14 days to understand how this process occurs. Fetal Doppler echocardiography, oxidative and inflammatory biomarkers and total polyphenol excretion were evaluated. RESULTS The high polyphenol intake induced ductus arteriosus constriction by 71.6% increase in systolic (P = 0.001) and 57.8% in diastolic velocities (P = 0.002), and 18.9% decrease in pulsatility index (P = 0.033), along with 1.7-fold increase in total polyphenol excretion, 2.3-fold decrease in inflammatory mediator nitric oxide and following redox status changes (mean ± standard deviation): higher protein carbonyls (1.09 ± 0.09 and 1.49 ± 0.31), catalase (0.69 ± 0.39 and 1.44 ± 0.33) and glutathione peroxidase (37.23 ± 11.19 and 62.96 ± 15.03) in addition to lower lipid damage (17.22 ± 2.05 and 12.53 ± 2.11) and nonprotein thiols (0.11 ± 0.04 and 0.04 ± 0.01) found before and after treatment, respectively. Ductal parameters correlated to NOx , catalase, glutathione peroxidase and protein carbonyl. CONCLUSION Our results highlight the need to reduce maternal PRF intake in late pregnancy to prevent fetal duct constriction through NO-mediated vasoconstrictive action of polyphenols.
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Affiliation(s)
- Guilherme B Bubols
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Laboratório de Toxicologia (LATOX), Departamento de Análises Clínicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Zielinsky P, Busato S. Prenatal effects of maternal consumption of polyphenol-rich foods in late pregnancy upon fetal ductus arteriosus. ACTA ACUST UNITED AC 2014; 99:256-74. [PMID: 24339037 PMCID: PMC4065350 DOI: 10.1002/bdrc.21051] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 10/24/2013] [Indexed: 12/13/2022]
Abstract
Fetal circulation has characteristic features, being morphologically and functionally different from extrauterine circulation. The ductus arteriosus plays a fundamental role in directing the blood flow to fetal inferior body parts. Basically, the ductus arteriosus directs 80-85% of the right ventricular output arising from the superior vena cava, coronary sinus, and a small part from the inferior vena cava to descending aorta. Its histological structure is made up predominantly by a thick muscular layer, differently from the aorta and the pulmonary artery, which increases with gestational age. The fibers have a circumferential orientation, especially at the external layers, facilitating and making effective ductal constriction. These factors may generate lumen alterations which may cause fetal and neonatal complications, such as heart failure, hydrops, neonatal pulmonary hypertension, and even death. Classically, maternal administration of indomethacin and/or other antiinflammatory drugs interfere in prostaglandins metabolism, causing ductal constriction. However, many cases of fetal ductal constriction, as well as of persistent neonatal pulmonary artery hypertension, remain without an established etiology, being referred as "idiopathic." In recent years, a growing body of evidence has shown that herbs, fruits, nuts, and a wide diversity of substances commonly used in daily diets have definitive effects upon the metabolic pathway of inflammation, with consequent inhibition of prostaglandins synthesis. This antiinflammatory action, especially of polyphenols, when ingested during the third trimester of pregnancy, may influence the dynamics of fetal ductus arteriosus flow. The goal of this review is to present these new observations and findings, which may influence dietary orientation during pregnancy.
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Affiliation(s)
- Paulo Zielinsky
- are from the Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
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[Partial closure of the intrauterine arteriosus ductus resulting from a maternal consumption of flavonoids]. An Pediatr (Barc) 2014; 81:e40-1. [PMID: 24598789 DOI: 10.1016/j.anpedi.2013.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 11/15/2013] [Accepted: 11/18/2013] [Indexed: 11/22/2022] Open
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Santangelo C, Varì R, Scazzocchio B, Filesi C, Masella R. Management of reproduction and pregnancy complications in maternal obesity: which role for dietary polyphenols? Biofactors 2014; 40:79-102. [PMID: 23983164 DOI: 10.1002/biof.1126] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 06/28/2013] [Accepted: 07/02/2013] [Indexed: 02/06/2023]
Abstract
Obesity is a global and dramatic public health problem; maternal obesity represents one of the main risk factors of infertility and pregnancy complications as it is associated with adverse maternal and offspring outcomes. In the last few years, adipose tissue dysfunction associated with altered adipocytokine secretion has been suggested to play a critical role in all the phases of reproductive process. Obesity is a nutrition-related disorder. In this regard, dietary intervention strategies, such as high intake of fruit and vegetables, have shown significant effects in both preserving health and counteracting obesity-associated diseases. Evidence has been provided that polyphenols, important constituents of plant-derived food, can influence developmental program of oocyte and embryo, as well as pregnancy progression by modulating several cellular pathways. This review will examine the controversial results so far obtained on adipocytokine involvement in fertility impairment and pregnancy complications. Furthermore, the different effects exerted by polyphenols on oocyte, embryo, and pregnancy development will be also taken in account.
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Affiliation(s)
- Carmela Santangelo
- Department of Veterinary Public Health and Food Safety, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
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Zielinsky P, Piccoli AL, Vian I, Zílio AM, Naujorks AA, Nicoloso LH, Barbisan CW, Busato S, Lopes M, Klein C. Maternal restriction of polyphenols and fetal ductal dynamics in normal pregnancy: an open clinical trial. Arq Bras Cardiol 2013; 101:217-25. [PMID: 23949325 PMCID: PMC4032301 DOI: 10.5935/abc.20130166] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 06/20/2013] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND We have recently demonstrated reversal of fetal ductal constriction after dietary maternal restriction of polyphenol-rich foods (PRF), due to its inhibitory action on prostaglandin synthesis. OBJECTIVE To test the hyphotesis that normal third trimester fetuses also improve ductus arteriosus dynamics after maternal restriction of polyphenols. METHODS Open clinical trial with 46 fetuses with gestational age (GA) > 28 weeks submitted to 2 Doppler echocardiographic studies with an interval of at least 2 weeks, being the examiners blinded to maternal dietary habits. A validated food frequency questionnaire was applied and a diet based on polyphenol-poor foods (<30 mg/100 mg) was recommended. A control group of 26 third trimester fetuses was submitted to the same protocol. Statistics used t test for independent samples. RESULTS Mean GA was 33 ± 2 weeks. Mean daily maternal estimated polyphenol intake (DMPI) was 1277 mg, decreasing to 126 mg after dietary orientation (p=0.0001). Significant decreases in systolic (SDV) and diastolic (DDV) ductal velocities, and RV/LV diameters ratio, as well as increase in ductal PI were observed [DSV = 1.2 ± 0.4 m/s (0.7-1.6) to 0.9 ± 0.3 m/s (0.6-1.3) (p = 0.018); DDV = 0.21 ± 0.09 m/s (0.15-0.32) to 0.18 ± 0.06 m/s (0.11-0.25) (p = 0.016); RV/LV ratio = 1.3 ± 0.2 (0.9-1.4) to 1.1 ± 0.2 (0.8-1.3) (p=0.004); ductal PI = 2.2 ± 0.03 (2.0-2.7) to 2.4 ± 0.4(2.2-2.9) (p = 0.04)]. In the control group, with GA of 32 ± 4 weeks, there were no significant differences in DMPI, mean SDV, DDV, PI and RV/LV ratio. CONCLUSION The oriented restriction of third trimester maternal ingestion of polyphenol-rich foods for a period of 2 weeks or more improve fetal ductus arteriosus flow dynamics and right ventricular dimensions.
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Affiliation(s)
- Paulo Zielinsky
- Mailing Address: Paulo Zielinsky, Av. Princesa Isabel, 370, Santana.
Postal Code 90620-000, Porto Alegre, RS - Brazil. E-mail:
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