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Nemec-Bakk AS, Bel J, Niccoli S, Boreham DR, Tai TC, Lees SJ, Khaper N. Effects of prenatal dexamethasone exposure on adult C57BL/6J mouse metabolism and oxidative stress. Can J Physiol Pharmacol 2024; 102:180-195. [PMID: 38329060 DOI: 10.1139/cjpp-2023-0254] [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: 02/09/2024]
Abstract
Prenatal glucocorticoid exposure has been shown to alter hypothalamic-pituitary-adrenal axis function resulting in altered fetal development that can persist through adulthood. Fetal exposure to excess dexamethasone, a synthetic glucocorticoid, has been shown to alter adult behaviour and metabolism. This study investigated the effects prenatal dexamethasone exposure had on adult offspring cardiac and liver metabolism and oxidative stress. Pregnant C57BL/6 mice received a dose of 0.4 mg/kg dexamethasone on gestational days 15-17. Once pups were approximately 7 months old, glucose uptake was determined using positron emission tomography and insulin resistance (IR) was determined by homeostatic model assessment (HOMA) IR calculation. Oxidative stress was assessed by measuring 4-hydroxynonenal protein adduct formation and total reactive oxygen species. Female dexamethasone group had significantly increased glucose uptake when insulin stimulated compared to vehicle-treated mice. HOMA IR revealed no evidence of IR in either male or female offspring. There was also no change in oxidative stress markers in either cardiac or liver tissues of male or female offspring. These data suggest that prenatal dexamethasone exposure in male mice does not alter oxidative stress or metabolism. However, prenatal dexamethasone exposure increased glucocorticoids, cardiac glucose uptake, and pAkt signaling in female heart tissues in adult mice, suggesting there are sex differences in prenatal dexamethasone exposure.
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Affiliation(s)
- A S Nemec-Bakk
- Department of Science and Environmental studies, Lakehead University, Thunder Bay, ON P7B 5E1, Canada
| | - J Bel
- Department of Science and Environmental studies, Lakehead University, Thunder Bay, ON P7B 5E1, Canada
| | - S Niccoli
- Medical Science Division, NOSM University, Thunder Bay, ON P7B 5E1, Canada
| | - D R Boreham
- Medical Science Division, NOSM University, Sudbury, ON P3E 2C6, Canada
- Biomolecular Sciences, Laurentian University, Sudbury, ON P3E 2C6, Canada
| | - T C Tai
- Medical Science Division, NOSM University, Sudbury, ON P3E 2C6, Canada
- Biomolecular Sciences, Laurentian University, Sudbury, ON P3E 2C6, Canada
| | - S J Lees
- Medical Science Division, NOSM University, Thunder Bay, ON P7B 5E1, Canada
- Department of Biology, Lakehead University, Thunder Bay, ON P7B 5E1, Canada
| | - N Khaper
- Medical Science Division, NOSM University, Thunder Bay, ON P7B 5E1, Canada
- Biomolecular Sciences, Laurentian University, Sudbury, ON P3E 2C6, Canada
- Department of Biology, Lakehead University, Thunder Bay, ON P7B 5E1, Canada
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Briceño-Pérez C, Briceño-Sanabria L, Briceño-Sanabria C, Reyna-Villasmil E. Early life corticosteroid overexposure: Epigenetic and fetal origins of adult diseases. Int J Gynaecol Obstet 2024; 164:40-46. [PMID: 37318113 DOI: 10.1002/ijgo.14914] [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: 03/03/2023] [Revised: 04/30/2023] [Accepted: 05/25/2023] [Indexed: 06/16/2023]
Abstract
The relationship between events occurring during intrauterine development and later-life predisposition to long-term disease, has been described. The fetus responds to excess intrauterine exposure to high levels of corticosteroids, modifying their physiological development and stopping their growth. Fetal exposure to elevated levels of either endogenous (alterations in fetal hypothalamic-pituitary-adrenal axis) or synthetic corticosteroids, is one model of early-life adversity; to developing adult disease. At the molecular level, there are transcriptional changes in metabolic and growth pathways. Epigenetic mechanisms participate in transgenerational inheritance, not genomic. Exposures that change 11β-hydroxysteroid dehydrogenase type 2 enzyme methylation status in the placenta can result in transcriptional repression of the gene, causing the fetus to be exposed to higher levels of cortisol. More precise diagnosis and management of antenatal corticosteroids for preterm birth, would potentially decrease the risk of long-term adverse outcomes. More studies are needed to understand the potential roles of factors to alter fetal corticosteroid exposure. Long-term infant follow-up is required to determine whether methylation changes in placenta may represent useful biomarkers of later disease risk. This review, summarize recent advances in the programming of fetal effects of corticosteroid exposure, the role of corticosteroids in epigenetic gene regulation of placental 11β-hydroxysteroid dehydrogenase type 2 enzyme expression and transgenerational effects.
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Affiliation(s)
- Carlos Briceño-Pérez
- Department of Obstetrics and Gynecology, University of Zulia, Maracaibo, Venezuela
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3
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Liu L, Wen Y, Ni Q, Chen L, Wang H. Prenatal ethanol exposure and changes in fetal neuroendocrine metabolic programming. Biol Res 2023; 56:61. [PMID: 37978540 PMCID: PMC10656939 DOI: 10.1186/s40659-023-00473-y] [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: 06/07/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023] Open
Abstract
Prenatal ethanol exposure (PEE) (mainly through maternal alcohol consumption) has become widespread. However, studies suggest that it can cause intrauterine growth retardation (IUGR) and multi-organ developmental toxicity in offspring, and susceptibility to various chronic diseases (such as neuropsychiatric diseases, metabolic syndrome, and related diseases) in adults. Through ethanol's direct effects and its indirect effects mediated by maternal-derived glucocorticoids, PEE alters epigenetic modifications and organ developmental programming during fetal development, which damages the offspring health and increases susceptibility to various chronic diseases after birth. Ethanol directly leads to the developmental toxicity of multiple tissues and organs in many ways. Regarding maternal-derived glucocorticoid-mediated IUGR, developmental programming, and susceptibility to multiple conditions after birth, ethanol induces programmed changes in the neuroendocrine axes of offspring, such as the hypothalamus-pituitary-adrenal (HPA) and glucocorticoid-insulin-like growth factor 1 (GC-IGF1) axes. In addition, the differences in ethanol metabolic enzymes, placental glucocorticoid barrier function, and the sensitivity to glucocorticoids in various tissues and organs mediate the severity and sex differences in the developmental toxicity of ethanol exposure during pregnancy. Offspring exposed to ethanol during pregnancy have a "thrifty phenotype" in the fetal period, and show "catch-up growth" in the case of abundant nutrition after birth; when encountering adverse environments, these offspring are more likely to develop diseases. Here, we review the developmental toxicity, functional alterations in multiple organs, and neuroendocrine metabolic programming mechanisms induced by PEE based on our research and that of other investigators. This should provide new perspectives for the effective prevention and treatment of ethanol developmental toxicity and the early prevention of related fetal-originated diseases.
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Affiliation(s)
- Liang Liu
- Department of Orthopedic Surgery, Joint Disease Research Center of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Yinxian Wen
- Department of Orthopedic Surgery, Joint Disease Research Center of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Qubo Ni
- Department of Orthopedic Surgery, Joint Disease Research Center of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Liaobin Chen
- Department of Orthopedic Surgery, Joint Disease Research Center of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China.
| | - Hui Wang
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China.
- Department of Pharmacology, Wuhan University School of Basic Medical Sciences, Wuhan, 430071, China.
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Kondo R, Ozawa R, Satomi T, Funabayashi K, Iwata H, Kuwayama T, Shirasuna K. Severe maternal stress alters placental function, resulting in adipose tissue and liver dysfunction in offspring of mice. Mol Cell Endocrinol 2023; 560:111814. [PMID: 36356688 DOI: 10.1016/j.mce.2022.111814] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/26/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022]
Abstract
The developmental origins of health and disease (DOHaD) hypothesis is that future lifestyle diseases in offspring are associated with intrauterine origins in the mother; stress during pregnancy is a risk factor for these diseases in offspring. This study aimed to clarify association of maternal stress with placental dysfunction and offspring development in mice. We applied water stress for 24 h during late pregnancy to explore the metabolic response of offspring to a normal diet (ND) and high-fat diet (HFD). Placental functions were altered by maternal stress, reducing the birth weight of the offspring. In the later life of offspring fed with ND, maternal stress impaired systemic glucose tolerance and altered adipokine secretion in adipose tissue and/or liver. The female offspring of stress-induced dams were light in body weight with lower adipose tissue and smaller adipocytes in both the ND and HFD groups. Abnormal situations, such as dysregulation of plasma glucose levels and fatty liver despite and lower increases in body weight, were observed in the female offspring of stress-induced dams, especially in the HFD-treated group. These findings suggest that long-lasting abnormal conditions and responses to metabolic challenges in maternal stress-induced offspring are linked to placental dysregulation and fetal programming.
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Affiliation(s)
- Risa Kondo
- Laboratory of Animal Reproduction, Department of Animal Science, Tokyo University of Agriculture, Japan
| | - Ren Ozawa
- Laboratory of Animal Reproduction, Department of Animal Science, Tokyo University of Agriculture, Japan
| | - Taiyo Satomi
- Laboratory of Animal Reproduction, Department of Animal Science, Tokyo University of Agriculture, Japan
| | - Kaho Funabayashi
- Laboratory of Animal Reproduction, Department of Animal Science, Tokyo University of Agriculture, Japan
| | - Hisataka Iwata
- Laboratory of Animal Reproduction, Department of Animal Science, Tokyo University of Agriculture, Japan
| | - Takehito Kuwayama
- Laboratory of Animal Reproduction, Department of Animal Science, Tokyo University of Agriculture, Japan
| | - Koumei Shirasuna
- Laboratory of Animal Reproduction, Department of Animal Science, Tokyo University of Agriculture, Japan.
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Tarik M, Ramakrishnan L, Sinha S, Sachdev HPS, Tandon N, Roy A, Bhargava SK. The Relationship of Birth Size and Postnatal Growth with Cellular Senescence in Adults: Data from the New Delhi Birth Cohort. Indian J Pediatr 2023; 90:49-55. [PMID: 35704216 DOI: 10.1007/s12098-022-04174-4] [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: 09/30/2021] [Accepted: 01/25/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To assess the effect of birth size and postnatal body mass index (BMI) gain from birth to adulthood on leucocytes cellular senescence in adult life. METHODS Participants were aged 43.04 (± 0.92) y, and were enrolled from the New Delhi Birth Cohort study, who participated in phase 7 of the study (n = 210). Cellular senescence markers, p16 and p21 gene expression were determined by RT-qPCR in leucocytes and their association with birth size and conditional BMI gain at 2, 11, and 29 y were assessed in univariate and multivariate regression models. RESULTS Birth weight (regression coefficient; B = -0.087, p = 0.011) and birth BMI (unadjusted B = -0.024, p = 0.026; adjusted B = -0.032, p = 0.022) were inversely associated with p21 gene expression in adult life. The p16 gene expression was not associated with any birth parameters. Conditional BMI gain at 2 y, 11 y, and 29 y was not associated with either p16 or p21 gene expression. The p21 gene expression was inversely associated with circulating insulin (B = -0.065, p = 0.026) and C-peptide levels (unadjusted B = -0.097, p = 0.014; adjusted B = -0.133, p = 0.003). CONCLUSION Small size at birth is associated with accelerated cellular senescence in adult life. An altered senescent state is likely to be one of the links between LBW and adult chronic diseases.
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Affiliation(s)
- Mohamad Tarik
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Lakshmy Ramakrishnan
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Sikha Sinha
- Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - H P S Sachdev
- Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology & Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Ambuj Roy
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
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Purandare N, Kunji Y, Xi Y, Romero R, Gomez-Lopez N, Fribley A, Grossman LI, Aras S. Lipopolysaccharide induces placental mitochondrial dysfunction in murine and human systems by reducing MNRR1 levels via a TLR4-independent pathway. iScience 2022; 25:105342. [PMID: 36339251 PMCID: PMC9633742 DOI: 10.1016/j.isci.2022.105342] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/20/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022] Open
Abstract
Mitochondria play a key role in placental growth and development, and mitochondrial dysfunction is associated with inflammation in pregnancy pathologies. However, the mechanisms whereby placental mitochondria sense inflammatory signals are unknown. Mitochondrial nuclear retrograde regulator 1 (MNRR1) is a bi-organellar protein responsible for mitochondrial function, including optimal induction of cellular stress-responsive signaling pathways. Here, in a lipopolysaccharide-induced model of systemic placental inflammation, we show that MNRR1 levels are reduced both in mouse placental tissues in vivo and in human trophoblastic cell lines in vitro. MNRR1 reduction is associated with mitochondrial dysfunction, enhanced oxidative stress, and activation of pro-inflammatory signaling. Mechanistically, we uncover a non-conventional pathway independent of Toll-like receptor 4 (TLR4) that results in ATM kinase-dependent threonine phosphorylation that stabilizes mitochondrial protease YME1L1, which targets MNRR1. Enhancing MNRR1 levels abrogates the bioenergetic defect and induces an anti-inflammatory phenotype. We therefore propose MNRR1 as an anti-inflammatory therapeutic in placental inflammation.
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Affiliation(s)
- Neeraja Purandare
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD 20892, Detroit, MI 48201, USA
- Center for Molecular Medicine and Genetics, Wayne State University; Detroit, MI 48201, USA
| | - Yusef Kunji
- Center for Molecular Medicine and Genetics, Wayne State University; Detroit, MI 48201, USA
| | - Yue Xi
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Roberto Romero
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD 20892, Detroit, MI 48201, USA
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48104, USA
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824, USA
- Center for Molecular Medicine and Genetics, Wayne State University; Detroit, MI 48201, USA
- Detroit Medical Center, Detroit, MI 48201, USA
| | - Nardhy Gomez-Lopez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD 20892, Detroit, MI 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Andrew Fribley
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Lawrence I. Grossman
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD 20892, Detroit, MI 48201, USA
- Center for Molecular Medicine and Genetics, Wayne State University; Detroit, MI 48201, USA
| | - Siddhesh Aras
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD 20892, Detroit, MI 48201, USA
- Center for Molecular Medicine and Genetics, Wayne State University; Detroit, MI 48201, USA
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7
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Tao S, Du J, Chi X, Zhu Y, Wang X, Meng Q, Ling X, Diao F, Song C, Jiang Y, Lv H, Lu Q, Qin R, Huang L, Xu X, Liu C, Ding Y, Jiang T, Ma H, Xia Y, Liu J, Lin Y, Jin G, Hu Z. Associations between antenatal corticosteroid exposure and neurodevelopment in infants. Am J Obstet Gynecol 2022; 227:759.e1-759.e15. [PMID: 35667419 DOI: 10.1016/j.ajog.2022.05.060] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/21/2022] [Accepted: 05/31/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND It has been well recognized that antenatal administration of dexamethasone to pregnant women at risk of preterm delivery may markedly accelerate fetal maturation and reduce the risk of adverse perinatal outcomes in their preterm infants, particularly for births before 34 weeks of gestation. Since 2015, antenatal corticosteroid administration has been extended beyond 34 weeks of gestation by clinical guidelines, as it might have beneficial effects on fetal maturation and perinatal outcomes. However, concerns regarding the potential influence of antenatal corticosteroid treatment on offspring neurodevelopment have been raised. OBJECTIVE This study aimed to investigate whether maternal antenatal corticosteroid administration was associated with neurodevelopment in infants at 1 year of age. STUDY DESIGN In this prospective and longitudinal birth cohort study, women were followed up throughout gestation, and their infants underwent a Bayley Scales of Infant and Toddler Development, Third Edition, screening test at 1 year of age between December 2018 and September 2020. Finally, 1609 pregnant women and 1759 infants were included in the current study. Using a generalized linear mixed model, we examined the association between antenatal corticosteroid exposure and infant neurodevelopment in cognitive, receptive communication, expressive communication, fine motor, and gross motor functions. RESULTS Of the 1759 infants eligible for this study, 1453 (82.6%) were singletons. A total of 710 infants were exposed to antenatal corticosteroids, among whom 415 were dexamethasone exposed and 483 were prednisone exposed. Dexamethasone was prescribed most often in late pregnancy, whereas prednisone was often used before 8 weeks of gestation among women who conceived through assisted reproductive technology. Compared with those who had no exposure, antenatal corticosteroid exposure was associated with an increased risk of infants being noncompetent in the cognitive development domain after adjusting for conventional risk factors (adjusted risk ratio, 1.53; 95% confidence interval, 1.08-2.18; P=.017). For medication-specific exposure, those exposed vs not exposed to antenatal dexamethasone were 1.62-fold (95% confidence interval, 1.10-2.38; P=.014) more likely to be noncompetent in the cognitive development domain at 1 year. The association did not vary markedly between preterm and term infants, singletons and twins, or assisted reproductive technology-conceived and spontaneously conceived infants (all P>.05 for heterogeneity). In contrast, a null association was observed for the risk of being noncompetent in any domain of neurodevelopment with antenatal prednisone exposure at early pregnancy. CONCLUSION Here, antenatal corticosteroid, particularly dexamethasone exposure, was markedly associated with an increased risk of infants being noncompetent in the cognitive development domain at 1 year of age. These findings may provide new information when weighing the benefits and potential risks of maternal antenatal corticosteroid administration.
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Affiliation(s)
- Shiyao Tao
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiangbo Du
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), Nanjing Medical University Affiliated Suzhou Hospital, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Xia Chi
- Department of Child Health Care, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, China
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Xiaoyan Wang
- Department of Obstetrics, Nanjing Medical University Affiliated Suzhou Hospital, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Qingxia Meng
- State Key Laboratory of Reproductive Medicine (Suzhou Centre), Nanjing Medical University Affiliated Suzhou Hospital, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China; Reproductive Genetic Center, Nanjing Medical University Affiliated Suzhou Hospital, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Xiufeng Ling
- Department of Reproduction, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, China
| | - Feiyang Diao
- Clinical Center of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ci Song
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yangqian Jiang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hong Lv
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), Nanjing Medical University Affiliated Suzhou Hospital, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Qun Lu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Rui Qin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lei Huang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xin Xu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Cong Liu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuqing Ding
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Tao Jiang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hongxia Ma
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), Nanjing Medical University Affiliated Suzhou Hospital, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiayin Liu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), Nanjing Medical University Affiliated Suzhou Hospital, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China; Clinical Center of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuan Lin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), Nanjing Medical University Affiliated Suzhou Hospital, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China; Department of Maternal, Child, and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Guangfu Jin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), Nanjing Medical University Affiliated Suzhou Hospital, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Zhibin Hu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), Nanjing Medical University Affiliated Suzhou Hospital, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.
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8
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Gardella B, Gritti A, Scatigno AL, Gallotti AMC, Perotti F, Dominoni M. Adrenal crisis during pregnancy: Case report and obstetric perspective. Front Med (Lausanne) 2022; 9:891101. [PMID: 36186806 PMCID: PMC9521595 DOI: 10.3389/fmed.2022.891101] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Adrenal dysfunction (AD) and, in particular, adrenal crisis are uncommon events in pregnant women, but associated with significant maternal and fetal morbidity and mortality if untreated or undiagnosed. Adrenal crisis may be confused with the common symptoms of pregnancy: the obstetricians should be able to promptly diagnose and treat it in order to avoid the adverse outcomes regarding the mother and the fetus. For this reason, AD must be treated by an expert multidisciplinary team. We presented a case report of a young pregnant woman with adrenal crisis due to tuberculosis, cocaine abuse, and massive bilateral hemorrhage with symptoms of emesis, hypotension, sudden abdominal pain, and leukocytosis. The most common issues of diagnosis and treatment are discussed and analyzed. Finally, we performed a review of the literature regarding adrenal crisis and adrenal insufficiency (AI) in pregnancy in order to clarify the management of these diseases in obstetrics setting.
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Affiliation(s)
- Barbara Gardella
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
- Department Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Gritti
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
- Department Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- *Correspondence: Andrea Gritti,
| | - Annachiara Licia Scatigno
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
- Department Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Francesca Perotti
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
- Department Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Mattia Dominoni
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
- Department Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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9
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Qi J, Wu B, Chen X, Wei W, Yao X. Diagnostic biomolecules and combination therapy for pre-eclampsia. Reprod Biol Endocrinol 2022; 20:136. [PMID: 36068569 PMCID: PMC9446775 DOI: 10.1186/s12958-022-01003-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
Pre-eclampsia (PE), associated with placental malperfusion, is the primary reason for maternal and perinatal mortality and morbidity that can cause vascular endothelial injury and multi-organ injury. Despite considerable research efforts, no pharmaceutical has been shown to stop disease progression. If women precisely diagnosed with PE can achieve treatment at early gestation, the maternal and fetal outcomes can be maximally optimized by expectant management. Current diagnostic approaches applying maternal characteristics or biophysical markers, including blood test, urine analysis and biophysical profile, possess limitations in the precise diagnosis of PE. Biochemical factor research associated with PE development has generated ambitious diagnostic targets based on PE pathogenesis and dissecting molecular phenotypes. This review focuses on current developments in biochemical prediction of PE and the corresponding interventions to ameliorate disease progression, aiming to provide references for clinical diagnoses and treatments.
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Affiliation(s)
- Jingqi Qi
- International Institutes of Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, No. N1, Shangcheng Avenue, Yiwu, 322000, China
- Zhejiang University-University of Edinburgh Institute (ZJU-UoE Institute), Zhejiang University School of Medicine, International Campus, Zhejiang University, 718 East Haizhou Road, Haining, 314400, China
| | - Bingbing Wu
- International Institutes of Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, No. N1, Shangcheng Avenue, Yiwu, 322000, China
| | - Xiuying Chen
- International Institutes of Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, No. N1, Shangcheng Avenue, Yiwu, 322000, China
| | - Wei Wei
- International Institutes of Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, No. N1, Shangcheng Avenue, Yiwu, 322000, China.
| | - Xudong Yao
- International Institutes of Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, No. N1, Shangcheng Avenue, Yiwu, 322000, China.
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10
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Nemec-Bakk AS, Niccoli S, Davidson C, Roy D, Stoa L, Sreetharan S, Simard A, Boreham DR, Wilson JY, Tai T, Lees SJ, Khaper N. Lasting Effects of Low to Non-Lethal Radiation Exposure during Late Gestation on Offspring's Cardiac Metabolism and Oxidative Stress. Antioxidants (Basel) 2021; 10:antiox10050816. [PMID: 34065524 PMCID: PMC8160807 DOI: 10.3390/antiox10050816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/12/2021] [Accepted: 05/15/2021] [Indexed: 01/24/2023] Open
Abstract
Ionizing radiation (IR) is known to cause fetal programming, but the physiological effects of low-dose IR are not fully understood. This study examined the effect of low (50 mGy) to non-lethal (300 and 1000 mGy) radiation exposure during late gestation on cardiac metabolism and oxidative stress in adult offspring. Pregnant C57BL/6J mice were exposed to 50, 300, or 1000 mGy of gamma radiation or Sham irradiation on gestational day 15. Sixteen weeks after birth, 18F-Fluorodeoxyglucose (FDG) uptake was examined in the offspring using Positron Emission Tomography imaging. Western blot was used to determine changes in oxidative stress, antioxidants, and insulin signaling related proteins. Male and female offspring from irradiated dams had lower body weights when compared to the Sham. 1000 mGy female offspring demonstrated a significant increase in 18F-FDG uptake, glycogen content, and oxidative stress. 300 and 1000 mGy female mice exhibited increased superoxide dismutase activity, decreased glutathione peroxidase activity, and decreased reduced/oxidized glutathione ratio. We conclude that non-lethal radiation during late gestation can alter glucose uptake and increase oxidative stress in female offspring. These data provide evidence that low doses of IR during the third trimester are not harmful but higher, non-lethal doses can alter cardiac metabolism later in life and sex may have a role in fetal programming.
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Affiliation(s)
- Ashley S. Nemec-Bakk
- Department of Science and Environmental Studies, Lakehead University, Thunder Bay, ON P7B 5E1, Canada;
| | - Sarah Niccoli
- Department of Biology, Lakehead University, Thunder Bay, ON P7B 5E1, Canada; (S.N.); (C.D.); (S.J.L.)
| | - Caitlund Davidson
- Department of Biology, Lakehead University, Thunder Bay, ON P7B 5E1, Canada; (S.N.); (C.D.); (S.J.L.)
| | - Danika Roy
- Northern Ontario School of Medicine, Laurentian University, Sudbury, ON P3E 2C6, Canada; (D.R.); (A.S.); (D.R.B.); (T.C.T.)
| | - Lisa Stoa
- Department of Biology, McMaster University, Hamilton, ON L8S 4L8, Canada; (L.S.); (S.S.); (J.Y.W.)
| | - Shayenthiran Sreetharan
- Department of Biology, McMaster University, Hamilton, ON L8S 4L8, Canada; (L.S.); (S.S.); (J.Y.W.)
| | - Alain Simard
- Northern Ontario School of Medicine, Laurentian University, Sudbury, ON P3E 2C6, Canada; (D.R.); (A.S.); (D.R.B.); (T.C.T.)
| | - Douglas R. Boreham
- Northern Ontario School of Medicine, Laurentian University, Sudbury, ON P3E 2C6, Canada; (D.R.); (A.S.); (D.R.B.); (T.C.T.)
- Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON P7B 5E1, Canada
- Biomolecular Sciences, Laurentian University, Sudbury, ON P3E 2C6, Canada
| | - Joanna Y. Wilson
- Department of Biology, McMaster University, Hamilton, ON L8S 4L8, Canada; (L.S.); (S.S.); (J.Y.W.)
| | - T.C. Tai
- Northern Ontario School of Medicine, Laurentian University, Sudbury, ON P3E 2C6, Canada; (D.R.); (A.S.); (D.R.B.); (T.C.T.)
- Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON P7B 5E1, Canada
- Biomolecular Sciences, Laurentian University, Sudbury, ON P3E 2C6, Canada
| | - Simon J. Lees
- Department of Biology, Lakehead University, Thunder Bay, ON P7B 5E1, Canada; (S.N.); (C.D.); (S.J.L.)
- Northern Ontario School of Medicine, Laurentian University, Sudbury, ON P3E 2C6, Canada; (D.R.); (A.S.); (D.R.B.); (T.C.T.)
- Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON P7B 5E1, Canada
| | - Neelam Khaper
- Department of Biology, Lakehead University, Thunder Bay, ON P7B 5E1, Canada; (S.N.); (C.D.); (S.J.L.)
- Northern Ontario School of Medicine, Laurentian University, Sudbury, ON P3E 2C6, Canada; (D.R.); (A.S.); (D.R.B.); (T.C.T.)
- Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON P7B 5E1, Canada
- Biomolecular Sciences, Laurentian University, Sudbury, ON P3E 2C6, Canada
- Correspondence:
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11
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Lassi M, Tomar A, Comas-Armangué G, Vogtmann R, Dijkstra DJ, Corujo D, Gerlini R, Darr J, Scheid F, Rozman J, Aguilar-Pimentel A, Koren O, Buschbeck M, Fuchs H, Marschall S, Gailus-Durner V, Hrabe de Angelis M, Plösch T, Gellhaus A, Teperino R. Disruption of paternal circadian rhythm affects metabolic health in male offspring via nongerm cell factors. SCIENCE ADVANCES 2021; 7:7/22/eabg6424. [PMID: 34039610 PMCID: PMC8153725 DOI: 10.1126/sciadv.abg6424] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/02/2021] [Indexed: 06/12/2023]
Abstract
Circadian rhythm synchronizes each body function with the environment and regulates physiology. Disruption of normal circadian rhythm alters organismal physiology and increases disease risk. Recent epidemiological data and studies in model organisms have shown that maternal circadian disruption is important for offspring health and adult phenotypes. Less is known about the role of paternal circadian rhythm for offspring health. Here, we disrupted circadian rhythm in male mice by night-restricted feeding and showed that paternal circadian disruption at conception is important for offspring feeding behavior, metabolic health, and oscillatory transcription. Mechanistically, our data suggest that the effect of paternal circadian disruption is not transferred to the offspring via the germ cells but initiated by corticosterone-based parental communication at conception and programmed during in utero development through a state of fetal growth restriction. These findings indicate paternal circadian health at conception as a newly identified determinant of offspring phenotypes.
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Affiliation(s)
- Maximilian Lassi
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
- German Center for Diabetes Research (DZD) Neuherberg, Germany
| | - Archana Tomar
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
- German Center for Diabetes Research (DZD) Neuherberg, Germany
| | - Gemma Comas-Armangué
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
- German Center for Diabetes Research (DZD) Neuherberg, Germany
| | - Rebekka Vogtmann
- Department of Gynecology and Obstetrics-University Hospital Essen - Essen, Germany
| | - Dorieke J Dijkstra
- University of Groningen, University Medical Center Groningen, Department of Obstetrics and Gynecology, Groningen, Netherlands
| | - David Corujo
- Cancer and Leukemia Epigenetics and Biology Program, Josep Carreras Institute for Leukemia Research (IJC) Badalona, Spain
| | - Raffaele Gerlini
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
- German Center for Diabetes Research (DZD) Neuherberg, Germany
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
| | - Jonatan Darr
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
- German Center for Diabetes Research (DZD) Neuherberg, Germany
| | - Fabienne Scheid
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
- German Center for Diabetes Research (DZD) Neuherberg, Germany
| | - Jan Rozman
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
- German Center for Diabetes Research (DZD) Neuherberg, Germany
- Czech Centre for Phenogenomics, Institute of Molecular Genetics of the Czech Academy of Sciences, BIOCEV, Prumyslova 595, 252 50, Vestec, Czech Republic
| | - Antonio Aguilar-Pimentel
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
- German Center for Diabetes Research (DZD) Neuherberg, Germany
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
| | - Omry Koren
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Marcus Buschbeck
- Cancer and Leukemia Epigenetics and Biology Program, Josep Carreras Institute for Leukemia Research (IJC) Badalona, Spain
- Program for Predictive and Personalized Medicine of Cancer, Germans Trias i Pujol Research Institute (PMPPC-IGTP), 08916 Badalona, Spain
| | - Helmut Fuchs
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
- German Center for Diabetes Research (DZD) Neuherberg, Germany
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
| | - Susan Marschall
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
- German Center for Diabetes Research (DZD) Neuherberg, Germany
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
| | - Valerie Gailus-Durner
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
- German Center for Diabetes Research (DZD) Neuherberg, Germany
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
| | - Martin Hrabe de Angelis
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
- German Center for Diabetes Research (DZD) Neuherberg, Germany
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany
- Chair of Experimental Genetics, School of Life Science Weihenstephan, Technische Universität München Freising, Germany
| | - Torsten Plösch
- University of Groningen, University Medical Center Groningen, Department of Obstetrics and Gynecology, Groningen, Netherlands
| | - Alexandra Gellhaus
- Department of Gynecology and Obstetrics-University Hospital Essen - Essen, Germany
| | - Raffaele Teperino
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg, Germany.
- German Center for Diabetes Research (DZD) Neuherberg, Germany
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12
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Rensel MA, Schlinger BA. 11ß hydroxysteroid dehydrogenases regulate circulating glucocorticoids but not central gene expression. Gen Comp Endocrinol 2021; 305:113734. [PMID: 33548254 PMCID: PMC7954975 DOI: 10.1016/j.ygcen.2021.113734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/17/2021] [Accepted: 01/30/2021] [Indexed: 11/15/2022]
Abstract
Regulation of glucocorticoids (GCs), important mediators of physiology and behavior at rest and during stress, is multi-faceted and dynamic. The 11ß hydroxysteroid dehydrogenases 11ß-HSD1 and 11ß-HSD2 catalyze the regeneration and inactivation of GCs, respectively, and provide peripheral and central control over GC actions in mammals. While these enzymes have only recently been investigated in just two songbird species, central expression patterns suggest that they may function differently in birds and mammals, and little is known about how peripheral expression regulates circulating GCs. In this study, we utilized the 11ß-HSD inhibitor carbenoxolone (CBX) to probe the functional effects of 11ß-HSD activity on circulating GCs and central GC-dependent gene expression in the adult zebra finch (Taeniopygia guttata). Peripheral CBX injection produced a marked increase in baseline GCs 60 min after injection, suggestive of a dominant role for 11ß-HSD2 in regulating circulating GCs. In the adult zebra finch brain, where 11ß-HSD2 but not 11ß-HSD1 is expressed, co-incubation of micro-dissected brain regions with CBX and stress-level GCs had no impact on expression of several GC-dependent genes. These results suggest that peripheral 11ß-HSD2 attenuates circulating GCs, whereas central 11ß-HSD2 has little impact on gene expression. Instead, rapid 11ß-HSD2-based regulation of local GC levels might fine-tune membrane GC actions in brain. These results provide new insights into the dynamics of GC secretion and action in this important model organism.
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Affiliation(s)
- Michelle A Rensel
- Institute for Society and Genetics, University of California Los Angeles, 621 Charles E Young Drive S, Los Angeles, CA 90095, USA; Laboratory of Neuroendocrinology, Brain Research Institute UCLA, Box 951761, University of California Los Angeles, Los Angeles, CA 90095, USA.
| | - Barney A Schlinger
- Laboratory of Neuroendocrinology, Brain Research Institute UCLA, Box 951761, University of California Los Angeles, Los Angeles, CA 90095, USA; Department of Integrative Biology and Physiology, University of California Los Angeles, 610 Charles E Young Drive E, Los Angeles, CA 90095, USA; Department of Ecology and Evolutionary Biology, University of California Los Angeles, 621 Charles E Young Drive S, Los Angeles, CA 90095, USA
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13
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Lamothe J, Khurana S, Tharmalingam S, Williamson C, Byrne CJ, Lees SJ, Khaper N, Kumar A, Tai T. Oxidative Stress Mediates the Fetal Programming of Hypertension by Glucocorticoids. Antioxidants (Basel) 2021; 10:antiox10040531. [PMID: 33805403 PMCID: PMC8066984 DOI: 10.3390/antiox10040531] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/19/2021] [Accepted: 03/25/2021] [Indexed: 11/16/2022] Open
Abstract
The field of cardiovascular fetal programming has emphasized the importance of the uterine environment on postnatal cardiovascular health. Studies have linked increased fetal glucocorticoid exposure, either from exogenous sources (such as dexamethasone (Dex) injections), or from maternal stress, to the development of adult cardiovascular pathologies. Although the mechanisms are not fully understood, alterations in gene expression driven by altered oxidative stress and epigenetic pathways are implicated in glucocorticoid-mediated cardiovascular programming. Antioxidants, such as the naturally occurring polyphenol epigallocatechin gallate (EGCG), or the superoxide dismutase (SOD) 4-hydroxy-TEMPO (TEMPOL), have shown promise in the prevention of cardiovascular dysfunction and programming. This study investigated maternal antioxidant administration with EGCG or TEMPOL and their ability to attenuate the fetal programming of hypertension via Dex injections in WKY rats. Results from this study indicate that, while Dex-programming increased blood pressure in male and female adult offspring, administration of EGCG or TEMPOL via maternal drinking water attenuated Dex-programmed increases in blood pressure, as well as changes in adrenal mRNA and protein levels of catecholamine biosynthetic enzymes phenylalanine hydroxylase (PAH), tyrosine hydroxylase (TH), dopamine beta hydroxylase (DBH), and phenylethanolamine N-methyltransferase (PNMT), in a sex-specific manner. Furthermore, programmed male offspring displayed reduced antioxidant glutathione peroxidase 1 (Gpx1) expression, increased superoxide dismutase 1 (SOD1) and catalase (CAT) expression, and increased pro-oxidant NADPH oxidase activator 1 (Noxa1) expression in the adrenal glands. In addition, prenatal Dex exposure alters expression of epigenetic regulators histone deacetylase (HDAC) 1, 5, 6, 7, 11, in male and HDAC7 in female offspring. These results suggest that glucocorticoids may mediate the fetal programming of hypertension via alteration of epigenetic machinery and oxidative stress pathways.
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Affiliation(s)
- Jeremy Lamothe
- Biomolecular Sciences, Laurentian University, Sudbury, ON P3E 2C6, Canada; (J.L.); (S.T.); (N.K.); (A.K.)
| | - Sandhya Khurana
- Medical Science Division, Northern Ontario School of Medicine, Sudbury, ON P3E 2C6, Canada;
| | - Sujeenthar Tharmalingam
- Biomolecular Sciences, Laurentian University, Sudbury, ON P3E 2C6, Canada; (J.L.); (S.T.); (N.K.); (A.K.)
- Medical Science Division, Northern Ontario School of Medicine, Sudbury, ON P3E 2C6, Canada;
- Chemistry and Biochemistry, Laurentian University, Sudbury, ON P3E 2C6, Canada
- Biology, Laurentian University, Sudbury, ON P3E 2C6, Canada; (C.W.); (C.J.B.)
| | - Chad Williamson
- Biology, Laurentian University, Sudbury, ON P3E 2C6, Canada; (C.W.); (C.J.B.)
| | - Collin J. Byrne
- Biology, Laurentian University, Sudbury, ON P3E 2C6, Canada; (C.W.); (C.J.B.)
| | - Simon J. Lees
- Biology, Lakehead University, Thunder Bay, ON P3E 2C6, Canada;
- Medical Science Division, Northern Ontario School of Medicine, Thunder Bay, ON P7B 5E1, Canada
| | - Neelam Khaper
- Biomolecular Sciences, Laurentian University, Sudbury, ON P3E 2C6, Canada; (J.L.); (S.T.); (N.K.); (A.K.)
- Biology, Lakehead University, Thunder Bay, ON P3E 2C6, Canada;
- Medical Science Division, Northern Ontario School of Medicine, Thunder Bay, ON P7B 5E1, Canada
| | - Aseem Kumar
- Biomolecular Sciences, Laurentian University, Sudbury, ON P3E 2C6, Canada; (J.L.); (S.T.); (N.K.); (A.K.)
- Medical Science Division, Northern Ontario School of Medicine, Sudbury, ON P3E 2C6, Canada;
- Chemistry and Biochemistry, Laurentian University, Sudbury, ON P3E 2C6, Canada
- Biology, Laurentian University, Sudbury, ON P3E 2C6, Canada; (C.W.); (C.J.B.)
| | - T.C. Tai
- Biomolecular Sciences, Laurentian University, Sudbury, ON P3E 2C6, Canada; (J.L.); (S.T.); (N.K.); (A.K.)
- Medical Science Division, Northern Ontario School of Medicine, Sudbury, ON P3E 2C6, Canada;
- Chemistry and Biochemistry, Laurentian University, Sudbury, ON P3E 2C6, Canada
- Biology, Laurentian University, Sudbury, ON P3E 2C6, Canada; (C.W.); (C.J.B.)
- Correspondence:
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14
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Inderbinen SG, Zogg M, Kley M, Smieško M, Odermatt A. Species-specific differences in the inhibition of 11β-hydroxysteroid dehydrogenase 2 by itraconazole and posaconazole. Toxicol Appl Pharmacol 2020; 412:115387. [PMID: 33387577 DOI: 10.1016/j.taap.2020.115387] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/11/2020] [Accepted: 12/23/2020] [Indexed: 11/17/2022]
Abstract
11β-hydroxysteroid dehydrogenase 2 (11β-HSD2) converts active 11β-hydroxyglucocorticoids to their inactive 11-keto forms, thereby preventing inappropriate mineralocorticoid receptor activation by glucocorticoids. Disruption of 11β-HSD2 activity by genetic defects or inhibitors causes the syndrome of apparent mineralocorticoid excess (AME), characterized by hypokalemia, hypernatremia and hypertension. Recently, the azole antifungals itraconazole and posaconazole were identified to potently inhibit human 11β-HSD2, and several case studies described patients with acquired AME. To begin to understand why this adverse drug effect was missed during preclinical investigations, the inhibitory potential of itraconazole, its main metabolite hydroxyitraconazole (OHI) and posaconazole against 11β-HSD2 from human and three commonly used experimental animals was assessed. Whilst human 11β-HSD2 was potently inhibited by all three compounds (IC50 values in the nanomolar range), the rat enzyme was moderately inhibited (1.5- to 6-fold higher IC50 values compared to human), and mouse and zebrafish 11β-HSD2 were very weakly inhibited (IC50 values above 7 μM). Sequence alignment and application of newly generated homology models for human and mouse 11β-HSD2 revealed significant differences in the C-terminal region and the substrate binding pocket. Exchange of the C-terminus and substitution of residues Leu170,Ile172 in mouse 11β-HSD2 by the corresponding residues His170,Glu172 of the human enzyme resulted in a gain of sensitivity to itraconazole and posaconazole, resembling human 11β-HSD2. The results provide an explanation for the observed species-specific 11β-HSD2 inhibition by the studied azole antifungals. The obtained structure-activity relationship information should facilitate future assessments of 11β-HSD2 inhibitors and aid choosing adequate animal models for efficacy and safety studies.
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Affiliation(s)
- Silvia G Inderbinen
- Swiss Centre for Applied Human Toxicology and Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, Basel 4056, Switzerland
| | - Michael Zogg
- Swiss Centre for Applied Human Toxicology and Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, Basel 4056, Switzerland
| | - Manuel Kley
- Swiss Centre for Applied Human Toxicology and Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, Basel 4056, Switzerland
| | - Martin Smieško
- Computational Pharmacy, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 61, Basel 4056, Switzerland
| | - Alex Odermatt
- Swiss Centre for Applied Human Toxicology and Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, Basel 4056, Switzerland.
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15
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McGoldrick E, Stewart F, Parker R, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev 2020; 12:CD004454. [PMID: 33368142 PMCID: PMC8094626 DOI: 10.1002/14651858.cd004454.pub4] [Citation(s) in RCA: 156] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Respiratory morbidity including respiratory distress syndrome (RDS) is a serious complication of preterm birth and the primary cause of early neonatal mortality and disability. Despite early evidence indicating a beneficial effect of antenatal corticosteroids on fetal lung maturation and widespread recommendations to use this treatment in women at risk of preterm delivery, some uncertainty remains about their effectiveness particularly with regard to their use in lower-resource settings, different gestational ages and high-risk obstetric groups such as women with hypertension or multiple pregnancies. This updated review (which supersedes an earlier review Crowley 1996) was first published in 2006 and subsequently updated in 2017. OBJECTIVES To assess the effects of administering a course of corticosteroids to women prior to anticipated preterm birth (before 37 weeks of pregnancy) on fetal and neonatal morbidity and mortality, maternal mortality and morbidity, and on the child in later life. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (3 September 2020), ClinicalTrials.gov, the databases that contribute to the WHO International Clinical Trials Registry Platform (ICTRP) (3 September 2020), and reference lists of the retrieved studies. SELECTION CRITERIA We considered all randomised controlled comparisons of antenatal corticosteroid administration with placebo, or with no treatment, given to women with a singleton or multiple pregnancy, prior to anticipated preterm delivery (elective, or following rupture of membranes or spontaneous labour), regardless of other co-morbidity, for inclusion in this review. DATA COLLECTION AND ANALYSIS We used standard Cochrane Pregnancy and Childbirth methods for data collection and analysis. Two review authors independently assessed trials for inclusion, assessed risk of bias, evaluated trustworthiness based on predefined criteria developed by Cochrane Pregnancy and Childbirth, extracted data and checked them for accuracy, and assessed the certainty of the evidence using the GRADE approach. Primary outcomes included perinatal death, neonatal death, RDS, intraventricular haemorrhage (IVH), birthweight, developmental delay in childhood and maternal death. MAIN RESULTS We included 27 studies (11,272 randomised women and 11,925 neonates) from 20 countries. Ten trials (4422 randomised women) took place in lower- or middle-resource settings. We removed six trials from the analysis that were included in the previous version of the review; this review only includes trials that meet our pre-defined trustworthiness criteria. In 19 trials the women received a single course of steroids. In the remaining eight trials repeated courses may have been prescribed. Fifteen trials were judged to be at low risk of bias, two had a high risk of bias in two or more domains and we ten trials had a high risk of bias due to lack of blinding (placebo was not used in the control arm. Overall, the certainty of evidence was moderate to high, but it was downgraded for IVH due to indirectness; for developmental delay due to risk of bias and for maternal adverse outcomes (death, chorioamnionitis and endometritis) due to imprecision. Neonatal/child outcomes Antenatal corticosteroids reduce the risk of: - perinatal death (risk ratio (RR) 0.85, 95% confidence interval (CI) 0.77 to 0.93; 9833 infants; 14 studies; high-certainty evidence; 2.3% fewer, 95% CI 1.1% to 3.6% fewer), - neonatal death (RR 0.78, 95% CI 0.70 to 0.87; 10,609 infants; 22 studies; high-certainty evidence; 2.6% fewer, 95% CI 1.5% to 3.6% fewer), - respiratory distress syndrome (RR 0.71, 95% CI 0.65 to 0.78; 11,183 infants; studies = 26; high-certainty evidence; 4.3% fewer, 95% CI 3.2% to 5.2% fewer). Antenatal corticosteroids probably reduce the risk of IVH (RR 0.58, 95% CI 0.45 to 0.75; 8475 infants; 12 studies; moderate-certainty evidence; 1.4% fewer, 95% CI 0.8% to1.8% fewer), and probably have little to no effect on birthweight (mean difference (MD) -14.02 g, 95% CI -33.79 to 5.76; 9551 infants; 19 studies; high-certainty evidence). Antenatal corticosteroids probably lead to a reduction in developmental delay in childhood (RR 0.51, 95% CI 0.27 to 0.97; 600 children; 3 studies; moderate-certainty evidence; 3.8% fewer, 95% CI 0.2% to 5.7% fewer). Maternal outcomes Antenatal corticosteroids probably result in little to no difference in maternal death (RR 1.19, 95% CI 0.36 to 3.89; 6244 women; 6 studies; moderate-certainty evidence; 0.0% fewer, 95% CI 0.1% fewer to 0.5% more), chorioamnionitis (RR 0.86, 95% CI 0.69 to 1.08; 8374 women; 15 studies; moderate-certainty evidence; 0.5% fewer, 95% CI 1.1% fewer to 0.3% more), and endometritis (RR 1.14, 95% CI 0.82 to 1.58; 6764 women; 10 studies; moderate-certainty; 0.3% more, 95% CI 0.3% fewer to 1.1% more) The wide 95% CIs in all of these outcomes include possible benefit and possible harm. AUTHORS' CONCLUSIONS Evidence from this updated review supports the continued use of a single course of antenatal corticosteroids to accelerate fetal lung maturation in women at risk of preterm birth. Treatment with antenatal corticosteroids reduces the risk of perinatal death, neonatal death and RDS and probably reduces the risk of IVH. This evidence is robust, regardless of resource setting (high, middle or low). Further research should focus on variations in the treatment regimen, effectiveness of the intervention in specific understudied subgroups such as multiple pregnancies and other high-risk obstetric groups, and the risks and benefits in the very early or very late preterm periods. Additionally, outcomes from existing trials with follow-up into childhood and adulthood are needed in order to investigate any longer-term effects of antenatal corticosteroids. We encourage authors of previous studies to provide further information which may answer any remaining questions about the use of antenatal corticosteroids without the need for further randomised controlled trials. Individual patient data meta-analyses from published trials are likely to provide answers for most of the remaining clinical uncertainties.
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Affiliation(s)
- Emma McGoldrick
- Obstetrics Directorate, Liverpool Women's NHS Foundation Trust, Liverpool, UK
| | - Fiona Stewart
- Cochrane Children and Families Network, c/o Cochrane Pregnancy and Childbirth, Department of Women's and Children's Health, The University of Liverpool, Liverpool, UK
| | - Roses Parker
- Musculoskeletal, Oral, Skin and Sensory Network, Oxford University Hospitals NHS Foundation Trust Second Floor, OUH Cowley Unipart House Business Centre, Oxford, UK
| | - Stuart R Dalziel
- Departments of Surgery and Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
- Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand
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16
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Zhang Y, Mehta N, Muhari-Stark E, Burckart GJ, van den Anker J, Wang J. Pediatric Renal Ontogeny and Applications in Drug Development. J Clin Pharmacol 2020; 59 Suppl 1:S9-S20. [PMID: 31502684 DOI: 10.1002/jcph.1490] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 06/25/2019] [Indexed: 12/17/2022]
Abstract
The clinical applications of renal ontogeny mainly include renal function evaluation and optimal dosing of renally eliminated drugs in pediatric patients, which rely on pharmacometric models and/or bedside estimated glomerular filtration rate equations. However, these applications in drug development are based on an understanding of renal function development, especially when considering premature infants, and the renal biomarkers that can be used for renal function assessment. This review provides a general overview on (1) renal function development, (2) the biomarkers that are used to assess renal function, and (3) the practical application of this knowledge to drug dosing for renally eliminated drugs during pediatric development. While pharmacometric approaches for estimating renal function during development have improved considerably, the number of drug development programs that have studied premature infants is small and suggests that caution should be taken in estimating doses for renally eliminated drugs during periods of rapid change in renal function.
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Affiliation(s)
- Yifei Zhang
- Office of Drug Evaluation IV, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Neha Mehta
- Office of Drug Evaluation IV, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | | | - Gilbert J Burckart
- Office of Clinical Pharmacology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - John van den Anker
- Division of Clinical Pharmacology, Children's National Health System, Washington, DC, USA.,Pediatric Pharmacology and Pharmacometrics Research Center, University of Basel Children's Hospital, Basel, Switzerland
| | - Jian Wang
- Office of Drug Evaluation IV, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
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17
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Jung E, Romero R, Yeo L, Diaz-Primera R, Marin-Concha J, Para R, Lopez AM, Pacora P, Gomez-Lopez N, Yoon BH, Kim CJ, Berry SM, Hsu CD. The fetal inflammatory response syndrome: the origins of a concept, pathophysiology, diagnosis, and obstetrical implications. Semin Fetal Neonatal Med 2020; 25:101146. [PMID: 33164775 PMCID: PMC10580248 DOI: 10.1016/j.siny.2020.101146] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The fetus can deploy a local or systemic inflammatory response when exposed to microorganisms or, alternatively, to non-infection-related stimuli (e.g., danger signals or alarmins). The term "Fetal Inflammatory Response Syndrome" (FIRS) was coined to describe a condition characterized by evidence of a systemic inflammatory response, frequently a result of the activation of the innate limb of the immune response. FIRS can be diagnosed by an increased concentration of umbilical cord plasma or serum acute phase reactants such as C-reactive protein or cytokines (e.g., interleukin-6). Pathologic evidence of a systemic fetal inflammatory response indicates the presence of funisitis or chorionic vasculitis. FIRS was first described in patients at risk for intraamniotic infection who presented preterm labor with intact membranes or preterm prelabor rupture of the membranes. However, FIRS can also be observed in patients with sterile intra-amniotic inflammation, alloimmunization (e.g., Rh disease), and active autoimmune disorders. Neonates born with FIRS have a higher rate of complications, such as early-onset neonatal sepsis, intraventricular hemorrhage, periventricular leukomalacia, and death, than those born without FIRS. Survivors are at risk for long-term sequelae that may include bronchopulmonary dysplasia, neurodevelopmental disorders, such as cerebral palsy, retinopathy of prematurity, and sensorineuronal hearing loss. Experimental FIRS can be induced by intra-amniotic administration of bacteria, microbial products (such as endotoxin), or inflammatory cytokines (such as interleukin-1), and animal models have provided important insights about the mechanisms responsible for multiple organ involvement and dysfunction. A systemic fetal inflammatory response is thought to be adaptive, but, on occasion, may become dysregulated whereby a fetal cytokine storm ensues and can lead to multiple organ dysfunction and even fetal death if delivery does not occur ("rescued by birth"). Thus, the onset of preterm labor in this context can be considered to have survival value. The evidence so far suggests that FIRS may compound the effects of immaturity and neonatal inflammation, thus increasing the risk of neonatal complications and long-term morbidity. Modulation of a dysregulated fetal inflammatory response by the administration of antimicrobial agents, anti-inflammatory agents, or cell-based therapy holds promise to reduce infant morbidity and mortality.
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Affiliation(s)
- Eunjung Jung
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Roberto Romero
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA; Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA; Detroit Medical Center, Detroit, MI, USA; Department of Obstetrics and Gynecology, Florida International University, Miami, FL, USA.
| | - Lami Yeo
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ramiro Diaz-Primera
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Julio Marin-Concha
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Robert Para
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ashley M Lopez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Percy Pacora
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Nardhy Gomez-Lopez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Biochemistry, Microbiology and Immunology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Bo Hyun Yoon
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chong Jai Kim
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Stanley M Berry
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Chaur-Dong Hsu
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Physiology, Wayne State University School of Medicine, Detroit, MI, USA
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18
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Marecková K, Klasnja A, Bencurova P, Andrýsková L, Brázdil M, Paus T. Prenatal Stress, Mood, and Gray Matter Volume in Young Adulthood. Cereb Cortex 2020; 29:1244-1250. [PMID: 29425268 DOI: 10.1093/cercor/bhy030] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 01/19/2018] [Indexed: 01/22/2023] Open
Abstract
This study aimed to determine whether prenatal stress, measured by the number of stressful life events during the first 20 weeks of pregnancy, might relate to mood dysregulation and altered brain structure in young adulthood. Participants included 93 young adults from a community-based birth cohort from the Czech Republic. Information on prenatal stress exposure was collected from their mothers in 1990-1992. Magnetic resonance imaging (MRI) and mood-related data were collected from the young adults in 2015. MRI analyses focused on overall gray matter (GM) volume and GM volume of cortical regions previously associated with major depression. Higher prenatal stress predicted more mood dysregulation, lower overall GM volume, and lower GM volume in mid-dorsolateral frontal cortex, anterior cingulate cortex, and precuneus in young adulthood. We observed no prenatal stress by sex interactions for any of the relations. We conclude that prenatal stress is an important risk factor that relates to worse mood states and altered brain structure in young adulthood irrespective of sex. Our results point to the importance and long-lasting effects of prenatal programming and suggest that offspring of mothers who went through substantial stress during pregnancy might benefit from early intervention that would reduce the odds of mental illness in later life.
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Affiliation(s)
- Klára Marecková
- Brain and Mind Research Programme, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Anja Klasnja
- Rotman Research Institute, Baycrest, Toronto, ON, Canada
| | - Petra Bencurova
- Brain and Mind Research Programme, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Lenka Andrýsková
- Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, MU, Brno, Czech Republic
| | - Milan Brázdil
- Brain and Mind Research Programme, Central European Institute of Technology, Masaryk University, Brno, Czech Republic.,Department of Neurology, St. Anne's University Hospital and Faculty of medicine, MU, Brno, Czech Republic
| | - Tomáš Paus
- Rotman Research Institute, Baycrest, Toronto, ON, Canada.,Departments of Psychology and Psychiatry, University of Toronto, Toronto, ON, Canada.,Child Mind Institute, New York, NY, USA
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19
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Castelli V, Lavanco G, Brancato A, Plescia F. Targeting the Stress System During Gestation: Is Early Handling a Protective Strategy for the Offspring? Front Behav Neurosci 2020; 14:9. [PMID: 32082129 PMCID: PMC7006220 DOI: 10.3389/fnbeh.2020.00009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/15/2020] [Indexed: 12/28/2022] Open
Abstract
The perinatal window is a critical developmental time when abnormal gestational stimuli may alter the development of the stress system that, in turn, influences behavioral and physiological responses in the newborns. Individual differences in stress reactivity are also determined by variations in maternal care, resulting from environmental manipulations. Despite glucocorticoids are the primary programming factor for the offspring's stress response, therapeutic corticosteroids are commonly used during late gestation to prevent preterm negative outcomes, exposing the offspring to potentially aberrant stress reactivity later in life. Thus, in this study, we investigated the consequences of one daily s.c. injection of corticosterone (25 mg/kg), from gestational day (GD) 14-16, and its interaction with offspring early handling, consisting in a brief 15-min maternal separation until weaning, on: (i) maternal behavior; and (ii) behavioral reactivity, emotional state and depressive-like behavior in the adolescent offspring. Corticosterone plasma levels, under non-shock- and shock-induced conditions, were also assessed. Our results show that gestational exposure to corticosterone was associated with diminished maternal care, impaired behavioral reactivity, increased emotional state and depressive-like behavior in the offspring, associated with an aberrant corticosterone response. The early handling procedure, which resulted in increased maternal care, was able to counteract the detrimental effects induced by gestational corticosterone exposure both in the behavioral- and neurochemical parameters examined. These findings highlight the potentially detrimental consequences of targeting the stress system during pregnancy as a vulnerability factor for the occurrence of emotional and affective distress in the adolescent offspring. Maternal extra-care proves to be a protective strategy that confers resiliency and restores homeostasis.
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Affiliation(s)
- Valentina Castelli
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Gianluca Lavanco
- INSERM U1215, Neuro Centre Magendie, Bordeaux, France.,University of Bordeaux, Bordeaux, France.,Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
| | - Anna Brancato
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "Giuseppe D'Alessandro", University of Palermo, Palermo, Italy
| | - Fulvio Plescia
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "Giuseppe D'Alessandro", University of Palermo, Palermo, Italy
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20
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Rabiepoor S, Abedi M, Saboory E, Khalkhali HR. Stress during pregnancy affected neonatal outcomes and changed cortisol and leptin levels both in mothers and newborns. J Neonatal Perinatal Med 2020; 12:209-219. [PMID: 30741697 DOI: 10.3233/npm-1818] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The present study aimed to determine the effect of perceived stress during pregnancy on neonatal outcomes and cortisol and leptin levels in mothers and their newborns. METHODS This longitudinal study was carried out on 110 pregnant women in Miandoab city, Iran. Mothers, who had singleton pregnancies and gestational age of 24 to 28 weeks, were included in the study. The participants were asked to fill out Cohen's Perceived Stress Scale (PSS). The mothers were then tracked in gestational ages of 28-32 weeks, 32-36 weeks, and the time of delivery. The maternal and umbilical cord blood samples were obtained during labor in order to measure leptin and cortisol levels. RESULTS Umbilical cortisol level was significantly higher in newborns who had meconium stained amniotic fluid than those who did not. Maternal blood leptin levels at delivery were significantly higher in the mothers whose neonates had respiratory distress, low birth weight, low head circumference, low Apgar score, and were premature than those whose neonates did not have such problems. The level of leptin in umbilical cord blood was significantly higher in neonates who had respiratory distress than those who did not. The results also showed a significant correlation between maternal cortisol levels and PSS during weeks 24-28 and the entire pregnancy. A significant relationship was observed between umbilical leptin and maternal leptin levels. CONCLUSIONS It can be concluded that stress during pregnancy is accompanied by fetal distress. The probable reason for newborns distress may be related to increased maternal leptin levels.
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Affiliation(s)
- S Rabiepoor
- Department of Midwifery & Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - M Abedi
- Urmia University of Medical Sciences, Urmia, Iran
| | - E Saboory
- Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - H R Khalkhali
- Department of Biostatistics & Inpatient's Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
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21
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Tributyltin and triphenyltin induce 11β-hydroxysteroid dehydrogenase 2 expression and activity through activation of retinoid X receptor α. Toxicol Lett 2020; 322:39-49. [PMID: 31927052 DOI: 10.1016/j.toxlet.2020.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/17/2019] [Accepted: 01/05/2020] [Indexed: 02/07/2023]
Abstract
Exposure to the environmental pollutants organotins is of toxicological concern for the marine ecosystem and sensitive human populations, including pregnant women and their unborn children. Using a placenta cell model, we investigated whether organotins at nanomolar concentrations affect the expression and activity of 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2). 11β-HSD2 represents a placental barrier controlling access of maternal glucocorticoids to the fetus. The organotins tributyltin (TBT) and triphenyltin (TPT) induced 11β-HSD2 expression and activity in JEG-3 placenta cells, an effect confirmed at the mRNA level in primary human trophoblast cells. Inhibition/knock-down of retinoid X receptor alpha (RXRα) in JEG-3 cells reduced the effect of organotins on 11β-HSD2 activity, mRNA and protein levels, revealing involvement of RXRα. Experiments using RNA and protein synthesis inhibitors indicated that the effect of organotins on 11β-HSD2 expression was direct and caused by increased transcription. Induction of placental 11β-HSD2 activity by TBT, TPT and other endocrine disrupting chemicals acting as RXRα agonists may affect placental barrier function by altering the expression of glucocorticoid-dependent genes and resulting in decreased availability of active glucocorticoids for the fetus, disturbing development and increasing the risk for metabolic and cardiovascular complications in later life.
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22
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Tarik M, Ramakrishnan L, Sinha S, Sachdev HPS, Tandon N, Roy A, Bhargava SK. Association of birth outcomes and postnatal growth with adult leukocyte telomere length: Data from New Delhi Birth Cohort. MATERNAL AND CHILD NUTRITION 2019; 15:e12857. [PMID: 31216382 DOI: 10.1111/mcn.12857] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/23/2019] [Accepted: 06/05/2019] [Indexed: 12/12/2022]
Abstract
Born small for gestational age due to undernutrition in utero and subsequent catch-up growth is associated with risk of developing chronic diseases in adulthood. Telomere length has been shown to be a predictor of these age-related diseases and may be a link between birth size, a surrogate for foetal undernutrition, and adult chronic diseases. We assessed the relationship of leukocyte telomere length in adult life with birth outcomes and serial change in body mass index (BMI) from birth to adulthood. Leukocyte relative telomere length (RTL) was measured by MMqPCR in 1,309 subjects from New Delhi Birth Cohort who participated in two phases of the study between 2006-2009 (Phase 6) and 2012-2015 (Phase 7) at a mean age of 39.08 (±3.29), and its association with birth outcomes and conditional BMI gain at 2, 11, and 29 years was assessed in a mixed regression model. We did not find any significant association of RTL with body size at birth including birthweight, birth length, and birth BMI. Gestational age was positively associated with RTL (P = .017, multivariate model: P = .039). Conditional BMI gain at 2 and 11 years was not associated with RTL. BMI gain at 29 year was negatively associated with RTL in multivariate model (P = .015). Born small for gestational age was not associated with RTL in adulthood. Leukocyte telomere attrition was observed in those born before 37 weeks of gestational age as well as in those who gained weight as adults, which may predispose to chronic diseases.
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Affiliation(s)
- Mohamad Tarik
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Lakshmy Ramakrishnan
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Sikha Sinha
- Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - Harsh Pal Singh Sachdev
- Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Ambuj Roy
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
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23
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Liu Q, Jin S, Sun X, Sheng X, Mao Z, Jiang Y, Liu H, Hu C, Xia W, Li Y, Xu S. Maternal Blood Pressure, Cord Glucocorticoids, and Child Neurodevelopment at 2 Years of Age: A Birth Cohort Study. Am J Hypertens 2019; 32:524-530. [PMID: 30772907 DOI: 10.1093/ajh/hpz024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/06/2019] [Accepted: 02/14/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Pregnancy hypertensive disorders have impaired neurodevelopment in offspring. We aimed to explore the association of normal range maternal blood pressure (BP) with child neurodevelopment, as well as the possible role of placental 11-beta-hydroxysteroid dehydrogenase type 2 (11β-HSD2) therein. METHODS Among 1,008 mother-child pairs recruited in Wuhan, China, in 2013-2015, we measured maternal third-trimester BP (systolic BP (SBP) and diastolic BP (DBP)) and cord glucocorticoids (cortisol and cortisone), a marker reflecting placental 11β-HSD2 activity. We evaluated child neurodevelopment using the Bayley Scales of Infant Development (BSID) with obtaining the Mental and Psychomotor Development Index (MDI and PDI). Multiple regression and mediation analysis were performed to estimate the effect. RESULTS Each 5 mm Hg increase in maternal third-trimester SBP was associated with 1.54 points decrease in MDI (95% confidence interval (CI) = -2.60, -0.48) and 1.23 points decrease in PDI (95% CI = -2.14, -0.31); similar association was observed between DBP and BSID (adjusted β = -1.32; 95% CI = -2.53, -0.10 for MDI and -1.37; 95% CI = -2.42, -0.33 for PDI). Also, we found significant associations between cord cortisol/cortisone ratio and PDI (adjusted β = 2.95; 95% CI = 0.91, 4.99), as well as between maternal BP and cord cortisol/cortisone ratio (adjusted β = -0.03; 95% CI = -0.06, -0.01 for both SBP and DBP). Mediation analysis revealed that cord cortisol/cortisone ratio explained 6.29% of the association between SBP and PDI, and 6.85% between DBP and PDI. CONCLUSIONS Increased maternal normal range BP may affect child neurodevelopment. Furthermore, placental 11β-HSD2 activity might be involved in the process.
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Affiliation(s)
- Qi Liu
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shuna Jin
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaojie Sun
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xia Sheng
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yangqian Jiang
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hongxiu Liu
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chen Hu
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Baud O, Berkane N. Hormonal Changes Associated With Intra-Uterine Growth Restriction: Impact on the Developing Brain and Future Neurodevelopment. Front Endocrinol (Lausanne) 2019; 10:179. [PMID: 30972026 PMCID: PMC6443724 DOI: 10.3389/fendo.2019.00179] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/04/2019] [Indexed: 12/14/2022] Open
Abstract
The environment in which a fetus develops is not only important for its growth and maturation but also for its long-term postnatal health and neurodevelopment. Several hormones including glucocorticosteroids, estrogens and progesterone, insulin growth factor and thyroid hormones, carefully regulate the growth of the fetus and its metabolism during pregnancy by controlling the supply of nutrients crossing the placenta. In addition to fetal synthesis, hormones regulating fetal growth are also expressed and regulated in the placenta, and they play a key role in the vulnerability of the developing brain and its maturation. This review summarizes the current understanding and evidence regarding the involvement of hormonal dysregulation associated with intra-uterine growth restriction and its consequences on brain development.
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Affiliation(s)
- Olivier Baud
- Division of Neonatology and Pediatric Intensive Care, Department of Women-Children-Teenagers, University Hospitals Geneva, Geneva, Switzerland
- Inserm U1141, Sorbonne, Paris Diderot University, Paris, France
- *Correspondence: Olivier Baud
| | - Nadia Berkane
- Division of Obstetrics and Gynecology, Department of Women-Children-Teenagers, University Hospitals Geneva, Geneva, Switzerland
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Chen Z, Zhao Z, Li Y, Zhang X, Li B, Chen L, Wang H. Course-, dose-, and stage-dependent toxic effects of prenatal dexamethasone exposure on fetal articular cartilage development. Toxicol Lett 2018; 286:1-9. [DOI: 10.1016/j.toxlet.2018.01.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 12/17/2017] [Accepted: 01/09/2018] [Indexed: 12/25/2022]
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What is fetal programming?: a lifetime health is under the control of in utero health. Obstet Gynecol Sci 2017; 60:506-519. [PMID: 29184858 PMCID: PMC5694724 DOI: 10.5468/ogs.2017.60.6.506] [Citation(s) in RCA: 169] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/09/2017] [Accepted: 08/21/2017] [Indexed: 01/10/2023] Open
Abstract
The "Barker hypothesis" postulates that a number of organ structures and associated functions undergo programming during embryonic and fetal life, which determines the set point of physiological and metabolic responses that carry into adulthood. Hence, any stimulus or insult at a critical period of embryonic and fetal development can result in developmental adaptations that produce permanent structural, physiological and metabolic changes, thereby predisposing an individual to cardiovascular, metabolic and endocrine disease in adult life. This article will provide evidence linking these diseases to fetal undernutrition and an overview of previous studies in this area as well as current advances in understanding the mechanism and the role of the placenta in fetal programming.
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Abstract
Early - intrauterine - environmental factors are linked to the development of cardiovascular disease in later life. Traditionally, these factors are considered to be maternal factors such as maternal under and overnutrition, exposure to toxins, lack of micronutrients, and stress during pregnancy. However, in the recent years, it became obvious that also paternal environmental factors before conception and during sperm development determine the health of the offspring in later life. We will first describe clinical observational studies providing evidence for paternal programming of adulthood diseases in progeny. Next, we describe key animal studies proving this relationship, followed by a detailed analysis of our current understanding of the underlying molecular mechanisms of paternal programming. Alterations of noncoding sperm micro-RNAs, histone acetylation, and targeted as well as global DNA methylation seem to be in particular involved in paternal programming of offspring's diseases in later life.
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Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev 2017; 3:CD004454. [PMID: 28321847 PMCID: PMC6464568 DOI: 10.1002/14651858.cd004454.pub3] [Citation(s) in RCA: 451] [Impact Index Per Article: 64.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Respiratory morbidity including respiratory distress syndrome (RDS) is a serious complication of preterm birth and the primary cause of early neonatal mortality and disability. While researching the effects of the steroid dexamethasone on premature parturition in fetal sheep in 1969, Liggins found that there was some inflation of the lungs of lambs born at gestations at which the lungs would be expected to be airless. Liggins and Howie published the first randomised controlled trial in humans in 1972 and many others followed. OBJECTIVES To assess the effects of administering a course of corticosteroids to the mother prior to anticipated preterm birth on fetal and neonatal morbidity and mortality, maternal mortality and morbidity, and on the child in later life. SEARCH METHODS We searched Cochrane Pregnancy and Childbirth's Trials Register (17 February 2016) and reference lists of retrieved studies. SELECTION CRITERIA We considered all randomised controlled comparisons of antenatal corticosteroid administration (betamethasone, dexamethasone, or hydrocortisone) with placebo, or with no treatment, given to women with a singleton or multiple pregnancy, prior to anticipated preterm delivery (elective, or following spontaneous labour), regardless of other co-morbidity, for inclusion in this review. Most women in this review received a single course of steroids; however, nine of the included trials allowed for women to have weekly repeats. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The quality of the evidence was assessed using the GRADE approach. MAIN RESULTS This update includes 30 studies (7774 women and 8158 infants). Most studies are of low or unclear risk for most bias domains. An assessment of high risk usually meant a trial had potential for performance bias due to lack of blinding. Two trials had low risks of bias for all risk of bias domains.Treatment with antenatal corticosteroids (compared with placebo or no treatment) is associated with a reduction in the most serious adverse outcomes related to prematurity, including: perinatal death (average risk ratio (RR) 0.72, 95% confidence interval (CI) 0.58 to 0.89; participants = 6729; studies = 15; Tau² = 0.05, I² = 34%; moderate-quality); neonatal death (RR 0.69, 95% CI 0.59 to 0.81; participants = 7188; studies = 22), RDS (average RR 0.66, 95% CI 0.56 to 0.77; participants = 7764; studies = 28; Tau² = 0.06, I² = 48%; moderate-quality); moderate/severe RDS (average RR 0.59, 95% CI 0.38 to 0.91; participants = 1686; studies = 6; Tau² = 0.14, I² = 52%); intraventricular haemorrhage (IVH) (average RR 0.55, 95% CI 0.40 to 0.76; participants = 6093; studies = 16; Tau² = 0.10, I² = 33%; moderate-quality), necrotising enterocolitis (RR 0.50, 95% CI 0.32 to 0.78; participants = 4702; studies = 10); need for mechanical ventilation (RR 0.68, 95% CI 0.56 to 0.84; participants = 1368; studies = 9); and systemic infections in the first 48 hours of life (RR 0.60, 95% CI 0.41 to 0.88; participants = 1753; studies = 8).There was no obvious benefit for: chronic lung disease (average RR 0.86, 95% CI 0.42 to 1.79; participants = 818; studies = 6; Tau² = 0.38 I² = 65%); mean birthweight (g) (MD -18.47, 95% CI -40.83 to 3.90; participants = 6182; studies = 16; moderate-quality); death in childhood (RR 0.68, 95% CI 0.36 to 1.27; participants = 1010; studies = 4); neurodevelopment delay in childhood (RR 0.64, 95% CI 0.14 to 2.98; participants = 82; studies = 1); or death into adulthood (RR 1.00, 95% CI 0.56 to 1.81; participants = 988; studies = 1).Treatment with antenatal corticosteroids does not increase the risk of chorioamnionitis (RR 0.83, 95% CI 0.66 to 1.06; participants = 5546; studies = 15; moderate-quality evidence) or endometritis (RR 1.20, 95% CI 0.87 to 1.63; participants = 4030; studies = 10; Tau² = 0.11, I² = 28%; moderate-quality). No increased risk in maternal death was observed. However, the data on maternal death is based on data from a single trial with two deaths; four other trials reporting maternal death had zero events (participants = 3392; studies = 5; moderate-quality).There is no definitive evidence to suggest that antenatal corticosteroids work differently in any pre-specified subgroups (singleton versus multiple pregnancy; membrane status; presence of hypertension) or for different study protocols (type of corticosteroid; single course or weekly repeats).GRADE outcomes were downgraded to moderate-quality. Downgrading decisions (for perinatal death, RDS, IVH, and mean birthweight) were due to limitations in study design or concerns regarding precision (chorioamnionitis, endometritis). Maternal death was downgraded for imprecision due to few events. AUTHORS' CONCLUSIONS Evidence from this update supports the continued use of a single course of antenatal corticosteroids to accelerate fetal lung maturation in women at risk of preterm birth. A single course of antenatal corticosteroids could be considered routine for preterm delivery. It is important to note that most of the evidence comes from high income countries and hospital settings; therefore, the results may not be applicable to low-resource settings with high rates of infections.There is little need for further trials of a single course of antenatal corticosteroids versus placebo in singleton pregnancies in higher income countries and hospital settings. However, data are sparse in lower income settings. There are also few data regarding risks and benefits of antenatal corticosteroids in multiple pregnancies and other high-risk obstetric groups. Further information is also required concerning the optimal dose-to-delivery interval, and the optimal corticosteroid to use.We encourage authors of previous studies to provide further information, which may answer any remaining questions about the use of antenatal corticosteroids in such pregnancies without the need for further randomised controlled trials. Individual patient data meta-analysis from published trials is likely to answer some of the evidence gaps. Follow-up studies into childhood and adulthood, particularly in the late preterm gestation and repeat courses groups, are needed. We have not examined the possible harmful effects of antenatal corticosteroids in low-resource settings in this review. It would be particularly relevant to explore this finding in adequately powered prospective trials.
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Affiliation(s)
- Devender Roberts
- Liverpool Women's NHS Foundation TrustObstetrics DirectorateCrown StreetLiverpoolUKL8 7SS
| | - Julie Brown
- The University of AucklandLiggins InstitutePark RdGraftonAucklandNew Zealand1142
| | - Nancy Medley
- The University of LiverpoolCochrane Pregnancy and Childbirth Group, Department of Women's and Children's HealthFirst Floor, Liverpool Women's NHS Foundation TrustCrown StreetLiverpoolUKL8 7SS
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Thornburg KL, Kolahi K, Pierce M, Valent A, Drake R, Louey S. Biological features of placental programming. Placenta 2016; 48 Suppl 1:S47-S53. [PMID: 27817870 DOI: 10.1016/j.placenta.2016.10.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 10/14/2016] [Accepted: 10/17/2016] [Indexed: 01/06/2023]
Abstract
The placenta is a key organ in programming the fetus for later disease. This review outlines nine of many structural and physiological features of the placenta which are associated with adult onset chronic disease. 1) Placental efficiency relates the placental mass to the fetal mass. Ratios at the extremes are related to cardiovascular disease risk later in life. 2) Placental shape predicts a large number of disease outcomes in adults but the regulators of placental shape are not known. 3) Non-human primate studies suggest that at about mid-gestation, the placenta becomes less plastic and less able to compensate for pathological stresses. 4) Recent studies suggest that lipids have an important role in regulating placental metabolism and thus the future health of offspring. 5) Placental inflammation affects nutrient transport to the fetus and programs for later disease. 6) Placental insufficiency leads to inadequate fetal growth and elevated risks for later life disease. 7) Maternal height, fat and muscle mass are important in combination with placental size and shape in predicting adult disease. 8) The placenta makes a host of hormones that influence fetal growth and are related to offspring disease. Unfortunately, our knowledge of placental growth and function lags far behind that of other organs. An investment in understanding placental growth and function will yield enormous benefits to human health because it is a key player in the origins of the most expensive and deadly chronic diseases that humans face.
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Affiliation(s)
- Kent L Thornburg
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA; Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, USA; Department of Medicine, Oregon Health and Science University, Portland, OR, USA; Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA; Moore Institute for Nutrition and Wellness, Oregon Health and Science University, Portland, OR, USA.
| | - Kevin Kolahi
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA; Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, USA
| | - Melinda Pierce
- Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA
| | - Amy Valent
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA
| | - Rachel Drake
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA
| | - Samantha Louey
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA; Moore Institute for Nutrition and Wellness, Oregon Health and Science University, Portland, OR, USA
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Affiliation(s)
- Lucy R. Green
- Centre for Fetal Origins of Adult Disease, Universiy of Southampton, 887(F) Princess Anne Hospital, Coxford Road, Southanmpton SO16 5YA United Kingdom
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Holemans K, Aerts L, Van Assche FA. Fetal Growth Restriction and Consequences for the Offspring in Animal Models. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/s1071-55760300134-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K. Holemans
- Department of Obstetrics and Gynaecology, Katholieke Universiteit Leuven, Leuven, Belgium; UZ Gasthuisberg, Department of Obstetrics and Gynaecology, Herestraat 49, B-3000 Leuven, Belgium
| | | | - F. A. Van Assche
- Department of Obstetrics and Gynaecology, Katholieke Universiteit Leuven, Leuven, Belgium
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Johnstone JF, Bocking AD, Unlugedik E, Challis JRG. The Effects of Chorioamnionitis and Betamethasone on 11β, Hydroxysteroid Dehydrogenase Types 1 and 2 and the Glucocorticoid Receptor in Preterm Human Placenta. ACTA ACUST UNITED AC 2016; 12:238-45. [PMID: 15866114 DOI: 10.1016/j.jsgi.2005.01.029] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Preterm birth is one of the major problems faced in perinatal medicine and is often associated with underlying clinical infection. Treatment with maternal betamethasone has helped to improve neonatal morbidity and mortality. We hypothesized that betamethasone treatment and chorioamnionitis would alter the bioavailability of placental glucocorticoids through the regulation of the 11beta hydroxysteroid dehydrogenase (11beta HSD) isozymes and the glucocorticoid receptor (GR). METHODS Placental samples were obtained from three groups of women who delivered prematurely: (1) those who delivered in the absence of infection, (2) those who received betamethasone treatment before delivering without infection, and (3) those who had pregnancies complicated with chorioamnionitis. Western blotting was used to determine 11beta HSD-1, 11beta HSD-2, GRT, and GRalpha expression, and 11beta HSD-2 activity was determined in each group. JEG-3 cells were used to study the regulation of the 11beta HSD isozymes. RESULTS In cases of chorioamnionitis where mothers had not been treated with betamethasone, placental 32-kd 11beta HSD-1 protein expression was increased. In cases of chorioamnionitis regardless of betamethasone treatment, placental 11beta HSD-2 expression and activity was decreased compared to controls. In these placental samples, the expression of GRT and GRalpha did not change significantly. In JEG-3 cells, 11beta HSD-1 32-kd expression was increased with interleukin (IL)-1beta and tumor necrosis factor alpha (TNF-alpha), while 11beta HSD-2 expression was unaffected. CONCLUSION These data suggest that there could be an increased fetal exposure to maternal glucocorticoids in cases of chorioamnionitis as a result of changes in the expression and activity of the placental 11beta HSD isozymes.
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Affiliation(s)
- Jim F Johnstone
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada.
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Thorsell A, Nätt D. Maternal stress and diet may influence affective behavior and stress-response in offspring via epigenetic regulation of central peptidergic function. ENVIRONMENTAL EPIGENETICS 2016; 2:dvw012. [PMID: 29492293 PMCID: PMC5804527 DOI: 10.1093/eep/dvw012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 06/15/2016] [Accepted: 06/26/2016] [Indexed: 06/08/2023]
Abstract
It has been shown that maternal stress and malnutrition, or experience of other adverse events, during the perinatal period may alter susceptibility in the adult offspring in a time-of-exposure dependent manner. The mechanism underlying this may be epigenetic in nature. Here, we summarize some recent findings on the effects on gene-regulation following maternal malnutrition, focusing on epigenetic regulation of peptidergic activity. Numerous neuropeptides within the central nervous system are crucial components in regulation of homeostatic energy-balance, as well as affective health (i.e. health events related to affective disorders, psychiatric disorders also referred to as mood disorders). It is becoming evident that expression, and function, of these neuropeptides can be regulated via epigenetic mechanisms during fetal development, thereby contributing to the development of the adult phenotype and, possibly, modulating disease susceptibility. Here, we focus on two such neuropeptides, neuropeptide Y (NPY) and corticotropin-releasing hormone (CRH), both involved in regulation of endocrine function, energy homeostasis, as well as affective health. While a number of published studies indicate the involvement of epigenetic mechanisms in CRH-dependent regulation of the offspring adult phenotype, NPY has been much less studied in this context and needs further work.
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Affiliation(s)
- Annika Thorsell
- Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience, Linköping University, SE 581 83, Linköping, Sweden
| | - Daniel Nätt
- Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience, Linköping University, SE 581 83, Linköping, Sweden
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Hocher B, Haumann H, Rahnenführer J, Reichetzeder C, Kalk P, Pfab T, Tsuprykov O, Winter S, Hofmann U, Li J, Püschel GP, Lang F, Schuppan D, Schwab M, Schaeffeler E. Maternal eNOS deficiency determines a fatty liver phenotype of the offspring in a sex dependent manner. Epigenetics 2016; 11:539-52. [PMID: 27175980 PMCID: PMC4939931 DOI: 10.1080/15592294.2016.1184800] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Maternal environmental factors can impact on the phenotype of the offspring via the induction of epigenetic adaptive mechanisms. The advanced fetal programming hypothesis proposes that maternal genetic variants may influence the offspring's phenotype indirectly via epigenetic modification, despite the absence of a primary genetic defect. To test this hypothesis, heterozygous female eNOS knockout mice and wild type mice were bred with male wild type mice. We then assessed the impact of maternal eNOS deficiency on the liver phenotype of wild type offspring. Birth weight of male wild type offspring born to female heterozygous eNOS knockout mice was reduced compared to offspring of wild type mice. Moreover, the offspring displayed a sex specific liver phenotype, with an increased liver weight, due to steatosis. This was accompanied by sex specific differences in expression and DNA methylation of distinct genes. Liver global DNA methylation was significantly enhanced in both male and female offspring. Also, hepatic parameters of carbohydrate metabolism were reduced in male and female offspring. In addition, male mice displayed reductions in various amino acids in the liver. Maternal genetic alterations, such as partial deletion of the eNOS gene, can affect liver metabolism of wild type offspring without transmission of the intrinsic defect. This occurs in a sex specific way, with more detrimental effects in females. This finding demonstrates that a maternal genetic defect can epigenetically alter the phenotype of the offspring, without inheritance of the defect itself. Importantly, these acquired epigenetic phenotypic changes can persist into adulthood.
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Affiliation(s)
- Berthold Hocher
- a Department of Basic Medicine , Medical College of Hunan Normal University , Changsha , China.,b Institute of Nutritional Science, University of Potsdam , Nuthetal , Germany.,c IFLb, Laboratoriumsmedizin Berlin GmbH , Berlin , Germany
| | - Hannah Haumann
- d Department of Internal Medicine IV/Nephrology (UKBF) , Charité Campus Benjamin Franklin , Berlin , Germany.,e Center for Cardiovascular Research, Charité Campus Mitte , Berlin , Germany
| | - Jan Rahnenführer
- b Institute of Nutritional Science, University of Potsdam , Nuthetal , Germany
| | | | - Philipp Kalk
- d Department of Internal Medicine IV/Nephrology (UKBF) , Charité Campus Benjamin Franklin , Berlin , Germany.,e Center for Cardiovascular Research, Charité Campus Mitte , Berlin , Germany
| | - Thiemo Pfab
- d Department of Internal Medicine IV/Nephrology (UKBF) , Charité Campus Benjamin Franklin , Berlin , Germany.,f Diaverum Deutschland , Potsdam , Germany
| | - Oleg Tsuprykov
- b Institute of Nutritional Science, University of Potsdam , Nuthetal , Germany.,e Center for Cardiovascular Research, Charité Campus Mitte , Berlin , Germany
| | - Stefan Winter
- g Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology , Stuttgart , Germany.,h University of Tübingen , Tübingen , Germany
| | - Ute Hofmann
- g Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology , Stuttgart , Germany.,h University of Tübingen , Tübingen , Germany
| | - Jian Li
- a Department of Basic Medicine , Medical College of Hunan Normal University , Changsha , China
| | - Gerhard P Püschel
- b Institute of Nutritional Science, University of Potsdam , Nuthetal , Germany
| | - Florian Lang
- i Institute of Physiology, University of Tübingen , Tübingen , Germany
| | - Detlef Schuppan
- j Institute of Translational Immunology, University Medical Center of the Johannes Gutenberg University Mainz , Mainz , Germany.,k Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School , Boston , MA , USA
| | - Matthias Schwab
- g Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology , Stuttgart , Germany.,l Department of Clinical Pharmacology , University Hospital Tübingen , Tübingen , Germany.,m Department of Pharmacy and Biochemistry , University Tübingen , Tübingen , Germany
| | - Elke Schaeffeler
- g Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology , Stuttgart , Germany.,h University of Tübingen , Tübingen , Germany
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Perrone S, Santacroce A, Picardi A, Buonocore G. Fetal programming and early identification of newborns at high risk of free radical-mediated diseases. World J Clin Pediatr 2016; 5:172-181. [PMID: 27170927 PMCID: PMC4857230 DOI: 10.5409/wjcp.v5.i2.172] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 10/30/2015] [Accepted: 02/16/2016] [Indexed: 02/06/2023] Open
Abstract
Nowadays metabolic syndrome represents a real outbreak affecting society. Paradoxically, pediatricians must feel involved in fighting this condition because of the latest evidences of developmental origins of adult diseases. Fetal programming occurs when the normal fetal development is disrupted by an abnormal insult applied to a critical point in intrauterine life. Placenta assumes a pivotal role in programming the fetal experience in utero due to the adaptive changes in structure and function. Pregnancy complications such as diabetes, intrauterine growth restriction, pre-eclampsia, and hypoxia are associated with placental dysfunction and programming. Many experimental studies have been conducted to explain the phenotypic consequences of fetal-placental perturbations that predispose to the genesis of metabolic syndrome, obesity, diabetes, hyperinsulinemia, hypertension, and cardiovascular disease in adulthood. In recent years, elucidating the mechanisms involved in such kind of process has become the challenge of scientific research. Oxidative stress may be the general underlying mechanism that links altered placental function to fetal programming. Maternal diabetes, prenatal hypoxic/ischaemic events, inflammatory/infective insults are specific triggers for an acute increase in free radicals generation. Early identification of fetuses and newborns at high risk of oxidative damage may be crucial to decrease infant and adult morbidity.
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Mehta N, Chen KK, Kroumpouzos G. Skin disease in pregnancy: The approach of the obstetric medicine physician. Clin Dermatol 2016; 34:320-6. [DOI: 10.1016/j.clindermatol.2016.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Tang W, Cheng J, Wang ZY, Chen KY, Han ZM, Wang QH, Yao YY. The Synergistic Roles of the Chronic Prenatal and Offspring Stress Exposures in Impairing Offspring Learning and Memory. J Alzheimers Dis 2016; 53:221-36. [PMID: 27128656 DOI: 10.3233/jad-160011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In Alzheimer's disease (AD), extensive experimental studies have demonstrated a negative impact of chronic stress during various stages of life (including prenatal phase) on some aspects of AD pathology. Nevertheless, presently, few studies have been involved in the learning and memory impairments, as well as neuropathology elicited by the chronic prenatal stress (CPS) and the chronic offspring stress (COS) exposures simultaneously, particularly for the adult male APPswe/PS1dE9 murine offspring. Therefore, the aim of the present study was to investigate the influence of CPS on learning and memory impairments induced by COS in 6-month-old male APPswe/PS1dE9 offspring mice and the related mechanism. Our study firstly demonstrates that 14-day exposure to CPS could exacerbate the learning and memory impairments, as well as neuropathological damages in the CA3 regions of the hippocampus and cortex neurons, which is induced by the 28-day exposure to COS in 6-month-old male APPswe/PS1dE9 offspring mice. In addition, CPS could potentiate the production of AβPP, Aβ42, and corticosterone in 6-month-old male APPswe/PS1dE9 offspring that also suffer COS. In conclusion, our novel findings strongly implicate the synergistic roles of the CPS and COS exposures in impairing offspring learning and memory. Moreover, CPS potentiating the production of Aβ42 might be mediated by glucocorticoids through increasing the expression of APP and BACE1 gene.
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Affiliation(s)
- Wei Tang
- Department of Laboratory Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.,Department of Clinical Laboratory Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Juan Cheng
- Department of Laboratory Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zheng-Yu Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Ke-Yang Chen
- Department of Clinical Laboratory Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Zhen-Min Han
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Qi-Hong Wang
- Hefei Meikang Medical Equipment Co., Ltd., Hefei, Anhui, China
| | - Yu-You Yao
- Department of Clinical Laboratory Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui, China
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Broughton Pipkin F, Mistry HD, Roy C, Dick B, Waugh J, Chikhi R, Kurlak LO, Mohaupt MG. Born from pre-eclamptic pregnancies predisposes infants to altered cortisol metabolism in the first postnatal year. Endocr Connect 2015; 4:233-41. [PMID: 26378058 PMCID: PMC4621850 DOI: 10.1530/ec-15-0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 09/16/2015] [Indexed: 11/15/2022]
Abstract
Pre-eclampsia leads to disturbed fetal organ development, including metabolic syndrome, attributed to altered pituitary-adrenal feedback loop. We measured cortisol metabolites in infants born from pre-eclamptic and normotensive women and hypothesised that glucocorticoid exposure would be exaggerated in the former. Twenty-four hour urine was collected from infants at months 3 and 12. Cortisol metabolites and apparent enzyme activities were analysed by gas chromatography-mass spectrometry. From 3 to 12 months, excretion of THS, THF and pregnandiol had risen in both groups; THF also rose in the pre-eclamptic group. No difference was observed with respect to timing of the visit or to hypertensive status for THE or total F metabolites (P>0.05). All apparent enzymes activities, except 17α-hydroxylase, were lower in infants at 12 compared to 3 months in the normotensive group. In the pre-eclamptic group, only 11β-HSD activities were lower at 12 months.17α-hydroxylase and 11β-HSD activities of tetrahydro metabolites were higher in the pre-eclamptic group at 3 months (P<0.05). 11β-hydroxylase activity increased in the pre-eclamptic group at 12 months. Cortisol excretion, determined by increased 11β-hydroxylase, compensates for high 11β-HSD-dependent cortisol degradation at 3 months and at 12 months counterbalances the reduced cortisol substrate availability in infants born from pre-eclamptic mothers.
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Affiliation(s)
- Fiona Broughton Pipkin
- Department of Obstetrics and GynaecologySchool of Medicine, University of Nottingham, Nottingham, NG5 1PB, UKDepartment of NephrologyHypertension and Clinical Pharmacology, Clinical Research, University of Bern, 3010 Berne, SwitzerlandLeicester Royal InfirmaryLeicester, LE1 5WW, UK
| | - Hiten D Mistry
- Department of Obstetrics and GynaecologySchool of Medicine, University of Nottingham, Nottingham, NG5 1PB, UKDepartment of NephrologyHypertension and Clinical Pharmacology, Clinical Research, University of Bern, 3010 Berne, SwitzerlandLeicester Royal InfirmaryLeicester, LE1 5WW, UK
| | - Chandrima Roy
- Department of Obstetrics and GynaecologySchool of Medicine, University of Nottingham, Nottingham, NG5 1PB, UKDepartment of NephrologyHypertension and Clinical Pharmacology, Clinical Research, University of Bern, 3010 Berne, SwitzerlandLeicester Royal InfirmaryLeicester, LE1 5WW, UK
| | - Bernhard Dick
- Department of Obstetrics and GynaecologySchool of Medicine, University of Nottingham, Nottingham, NG5 1PB, UKDepartment of NephrologyHypertension and Clinical Pharmacology, Clinical Research, University of Bern, 3010 Berne, SwitzerlandLeicester Royal InfirmaryLeicester, LE1 5WW, UK
| | - Jason Waugh
- Department of Obstetrics and GynaecologySchool of Medicine, University of Nottingham, Nottingham, NG5 1PB, UKDepartment of NephrologyHypertension and Clinical Pharmacology, Clinical Research, University of Bern, 3010 Berne, SwitzerlandLeicester Royal InfirmaryLeicester, LE1 5WW, UK
| | - Rebecca Chikhi
- Department of Obstetrics and GynaecologySchool of Medicine, University of Nottingham, Nottingham, NG5 1PB, UKDepartment of NephrologyHypertension and Clinical Pharmacology, Clinical Research, University of Bern, 3010 Berne, SwitzerlandLeicester Royal InfirmaryLeicester, LE1 5WW, UK
| | - Lesia O Kurlak
- Department of Obstetrics and GynaecologySchool of Medicine, University of Nottingham, Nottingham, NG5 1PB, UKDepartment of NephrologyHypertension and Clinical Pharmacology, Clinical Research, University of Bern, 3010 Berne, SwitzerlandLeicester Royal InfirmaryLeicester, LE1 5WW, UK
| | - Markus G Mohaupt
- Department of Obstetrics and GynaecologySchool of Medicine, University of Nottingham, Nottingham, NG5 1PB, UKDepartment of NephrologyHypertension and Clinical Pharmacology, Clinical Research, University of Bern, 3010 Berne, SwitzerlandLeicester Royal InfirmaryLeicester, LE1 5WW, UK
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Abbassy M, Kshettry VR, Hamrahian AH, Johnston PC, Dobri GA, Avitsian R, Woodard TD, Recinos PF. Surgical management of recurrent Cushing's disease in pregnancy: A case report. Surg Neurol Int 2015; 6:S640-5. [PMID: 26682090 PMCID: PMC4672578 DOI: 10.4103/2152-7806.170472] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 08/21/2015] [Indexed: 12/20/2022] Open
Abstract
Background: Cushing's disease is a condition rarely encountered during pregnancy. It is known that hypercortisolism is associated with increased maternal and fetal morbidity and mortality. When hypercortisolism from Cushing's disease does occur in pregnancy, the impact of achieving biochemical remission on fetal outcomes is unknown. We sought to clarify the impact of successful surgical treatment by presenting such a case report. Case Description: A 38-year-old pregnant woman with recurrent Cushing's disease after 8 years of remission. The patient had endoscopic transsphenoidal of her pituitary adenoma in her 18th week of pregnancy. The patient had postoperative biochemical remission and normal fetal outcome with no maternal complications. Conclusion: Transsphenoidal surgery for Cushing's disease can be performed safely during the second trimester of pregnancy.
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Affiliation(s)
- Mahmoud Abbassy
- Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA ; Minimally Invasive Cranial Base and Pituitary Surgery Program, Cleveland Clinic, Cleveland, Ohio, USA
| | - Varun R Kshettry
- Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA ; Minimally Invasive Cranial Base and Pituitary Surgery Program, Cleveland Clinic, Cleveland, Ohio, USA
| | - Amir H Hamrahian
- Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, Ohio, USA
| | - Philip C Johnston
- Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, Ohio, USA
| | - Georgianna A Dobri
- Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, Ohio, USA
| | - Rafi Avitsian
- Department of Anesthesiology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Troy D Woodard
- Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA ; Minimally Invasive Cranial Base and Pituitary Surgery Program, Cleveland Clinic, Cleveland, Ohio, USA ; Section of Skull Base Rhinology and Sinus Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Pablo F Recinos
- Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA ; Minimally Invasive Cranial Base and Pituitary Surgery Program, Cleveland Clinic, Cleveland, Ohio, USA ; Section of Skull Base Rhinology and Sinus Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA
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40
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Behavioral epigenetics and the developmental origins of child mental health disorders. J Dev Orig Health Dis 2015; 3:395-408. [PMID: 25084292 DOI: 10.1017/s2040174412000426] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Advances in understanding the molecular basis of behavior through epigenetic mechanisms could help explain the developmental origins of child mental health disorders. However, the application of epigenetic principles to the study of human behavior is a relatively new endeavor. In this paper we discuss the 'Developmental Origins of Health and Disease' including the role of fetal programming. We then review epigenetic principles related to fetal programming and the recent application of epigenetics to behavior. We focus on the neuroendocrine system and develop a simple heuristic stress-related model to illustrate how epigenetic changes in placental genes could predispose the infant to neurobehavioral profiles that interact with postnatal environmental factors potentially leading to mental health disorders. We then discuss from an 'Evo-Devo' perspective how some of these behaviors could also be adaptive. We suggest how elucidation of these mechanisms can help to better define risk and protective factors and populations at risk.
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41
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Ghodki PS, Harnagle KD, Thombre SK. A very rare case of Cushing's disease for cesarean section: What the anesthesiololgist needs to know. Anesth Essays Res 2015; 5:95-7. [PMID: 25885309 PMCID: PMC4173382 DOI: 10.4103/0259-1162.84182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Cushing's syndrome is uncommon in pregnancy, and Cushing's disease being the cause for this syndrome is still rare. We had the opportunity to manage such a patient admitted for cesarean section. Here, we describe the evaluation of a patient with Cushing's syndrome in pregnancy along with its anesthetic implications. By describing this case, we intend to emphasize the role of the anaesthesiologist as a peri operative physician.
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Affiliation(s)
- Poonam S Ghodki
- Department of Anaesthesiology, Shrimati Kashibai Navale Gneral Hospital and Medical College, Narhe, Pune, Maharashtra, India
| | - K D Harnagle
- Department of Anaesthesiology, Shrimati Kashibai Navale Gneral Hospital and Medical College, Narhe, Pune, Maharashtra, India
| | - S K Thombre
- Department of Anaesthesiology, Shrimati Kashibai Navale Gneral Hospital and Medical College, Narhe, Pune, Maharashtra, India
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The impact of maternal synthetic glucocorticoid administration in late pregnancy on fetal and early neonatal hypothalamic-pituitary-adrenal axes regulatory genes is dependent upon dose and gestational age at exposure. J Dev Orig Health Dis 2015; 4:77-89. [PMID: 25080184 DOI: 10.1017/s2040174412000591] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In this study, we determined the gene and/or protein expression of hypothalamic-pituitary-adrenal (HPA) axis regulatory molecules following synthetic glucocorticoid exposures. Pregnant sheep received intramuscular saline or betamethasone (BET) injections at 104 (BET-1), 104 and 111(BET-2) or 104, 111 and 118 (BET-3) days of gestation (dG). Samples were collected at numerous time-points between 75 dG and 12 weeks postnatal age. In the BET-3 treatment group, fetal plasma cortisol levels were lower at 145 dG than controls and gestational length was lengthened significantly. The cortisol:adrenocorticotropic hormone (ACTH) ratio in fetal plasma of control and BET-3 fetuses rose significantly between132 and 145 dG, and remained elevated in lambs at 6 and 12 weeks of age; this rise was truncated at day 145 in fetuses of BET-3 treated mothers. After BET treatment, fetal and postnatal pituitary proopiomelanocortin mRNA levels were reduced from 109 dG to 12 weeks postnatal age; pituitary prohormone convertase 1 and 2 mRNA levels were reduced at 145 dG and postnatally; hypothalamic arginine vasopressin mRNA levels were lowered at all time-points, but corticotrophin-releasing hormone mRNA levels were reduced only in postnatal lambs. Maternal BET increased late fetal and/or postnatal adrenal mRNA levels of ACTH receptor and 3β hydroxysteroid dehydrogenase but decreased steroidogenic acute regulatory protein and P450 17-α hydroxylase. The altered mRNA levels of key HPA axis regulatory proteins after maternal BET injections suggests processes that may subserve long-term changes in HPA activity in later life after prenatal exposure to synthetic glucocorticoids.
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Penailillo R, Guajardo A, Llanos M, Hirsch S, Ronco AM. Folic acid supplementation during pregnancy induces sex-specific changes in methylation and expression of placental 11β-hydroxysteroid dehydrogenase 2 in rats. PLoS One 2015; 10:e0121098. [PMID: 25793274 PMCID: PMC4368185 DOI: 10.1371/journal.pone.0121098] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 02/09/2015] [Indexed: 02/03/2023] Open
Abstract
In the placenta, 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) limits fetal glucocorticoid exposure and its inhibition has been associated to low birth weight. Its expression, encoded by the HSD11B2 gene is regulated by DNA methylation. We hypothesized that maternal diets supplemented with folic acid (FA) during pregnancy modify the expression of placental HSD11B2 through gene methylation. Wistar rats were fed with high (8 mg/kg) or normal low (1mg/kg, control) levels of FA during pregnancy. Concentrations of mRNA and protein in placentas were determined by qRT-PCR and Western blot respectively. Methylation in five CpG sites of the placental HSD11B2 promoter (-378 to -275) was analyzed by bacterial cloning and subsequent sequencing. In the FA-supplemented group, mRNA and protein levels of 11β-HSD2 decreased by 58% and increased by 89%, respectively, only in placentas attached to males. In controls, most CpG sites were not methylated except for the CpG2 site which was 80% methylated. CpG2 methylation level increased under the FA treatment; however, only in placentas attached to females was this increase significant (113%). This change was not related to HSD11B2 expression. Fetal weight of females from FA- supplemented mothers was 6% higher than females from control mothers. In conclusion, this is the first study reporting that FA over supplementation during pregnancy modifies the placental HSD11B2 gene expression and methylation in a sex-dependent manner, suggesting that maternal diets with high content of FA can induce early sex-specific responses, which may lead to long-term consequences for the offspring.
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Affiliation(s)
- Reyna Penailillo
- Laboratory of Nutrition and Metabolic Regulation, Human Nutrition Unit, Institute of Nutrition and Food Technology (INTA), Universidad de Chile, Santiago, Chile
| | - Angelica Guajardo
- Laboratory of Nutrition and Metabolic Regulation, Human Nutrition Unit, Institute of Nutrition and Food Technology (INTA), Universidad de Chile, Santiago, Chile
| | - Miguel Llanos
- Laboratory of Nutrition and Metabolic Regulation, Human Nutrition Unit, Institute of Nutrition and Food Technology (INTA), Universidad de Chile, Santiago, Chile
| | - Sandra Hirsch
- Laboratory of Nutrition and Metabolic Regulation, Human Nutrition Unit, Institute of Nutrition and Food Technology (INTA), Universidad de Chile, Santiago, Chile
| | - Ana Maria Ronco
- Laboratory of Nutrition and Metabolic Regulation, Human Nutrition Unit, Institute of Nutrition and Food Technology (INTA), Universidad de Chile, Santiago, Chile
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44
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Yam KY, Naninck EFG, Schmidt MV, Lucassen PJ, Korosi A. Early-life adversity programs emotional functions and the neuroendocrine stress system: the contribution of nutrition, metabolic hormones and epigenetic mechanisms. Stress 2015; 18:328-42. [PMID: 26260665 DOI: 10.3109/10253890.2015.1064890] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Clinical and pre-clinical studies have shown that early-life adversities, such as abuse or neglect, can increase the vulnerability to develop psychopathologies and cognitive decline later in life. Remarkably, the lasting consequences of stress during this sensitive period on the hypothalamic-pituitary-adrenal axis and emotional function closely resemble the long-term effects of early malnutrition and suggest a possible common pathway mediating these effects. During early-life, brain development is affected by both exogenous factors, like nutrition and maternal care as well as by endogenous modulators including stress hormones. These elements, while mostly considered for their independent actions, clearly do not act alone but rather in a synergistic manner. In order to better understand how the programming by early-life stress takes place, it is important to gain further insight into the exact interplay of these key elements, the possible common pathways as well as the underlying molecular mechanisms that mediate their effects. We here review evidence that exposure to both early-life stress and early-life under-/malnutrition similarly lead to life-long alterations on the neuroendocrine stress system and modify emotional functions. We further discuss how the different key elements of the early-life environment interact and affect one another and next suggest a possible role for the early-life adversity induced alterations in metabolic hormones and nutrient availability in shaping later stress responses and emotional function throughout life, possibly via epigenetic mechanisms. Such knowledge will help to develop intervention strategies, which gives the advantage of viewing the synergistic action of a more complete set of changes induced by early-life adversity.
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Affiliation(s)
- Kit-Yi Yam
- a Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam , XH Amsterdam , The Netherlands and
| | - Eva F G Naninck
- a Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam , XH Amsterdam , The Netherlands and
| | - Mathias V Schmidt
- b Department Stress Neurobiology and Neurogenetics , Max Planck Institute of Psychiatry , Munich , Germany
| | - Paul J Lucassen
- a Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam , XH Amsterdam , The Netherlands and
| | - Aniko Korosi
- a Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam , XH Amsterdam , The Netherlands and
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45
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Itoh H, Kanayama N. Nutritional conditions in early life and risk of non-communicable diseases (NCDs) from the perspective of preemptive medicine in perinatal care. HYPERTENSION RESEARCH IN PREGNANCY 2015. [DOI: 10.14390/jsshp.3.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Hiroaki Itoh
- Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine
| | - Naohiro Kanayama
- Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine
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Sun Z, Hu S, Zuo N, Yang S, He Z, Ao Y, Wang H. Prenatal nicotine exposure induced GDNF/c-Ret pathway repression-related fetal renal dysplasia and adult glomerulosclerosis in male offspring. Toxicol Res (Camb) 2015. [DOI: 10.1039/c5tx00040h] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Prenatal nicotine exposure could induce fetal renal dysplasia associated with the suppression of the GDNF/c-Ret pathway and adult glomerulosclerosis in male offspring, which might be mediated by alterations in angiotensin II receptors.
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Affiliation(s)
- Zhaoxia Sun
- Department of Pharmacology
- Wuhan University School of Basic Medical Sciences
- Wuhan 430071
- China
| | - Shuangshuang Hu
- Department of Pharmacology
- Wuhan University School of Basic Medical Sciences
- Wuhan 430071
- China
| | - Na Zuo
- Department of Pharmacology
- Wuhan University School of Basic Medical Sciences
- Wuhan 430071
- China
| | - Shuailong Yang
- Department of Pharmacology
- Wuhan University School of Basic Medical Sciences
- Wuhan 430071
- China
| | - Zheng He
- Department of Pharmacology
- Wuhan University School of Basic Medical Sciences
- Wuhan 430071
- China
| | - Ying Ao
- Department of Pharmacology
- Wuhan University School of Basic Medical Sciences
- Wuhan 430071
- China
- Hubei Provincial Key Laboratory of Developmentally Originated Disorder
| | - Hui Wang
- Department of Pharmacology
- Wuhan University School of Basic Medical Sciences
- Wuhan 430071
- China
- Hubei Provincial Key Laboratory of Developmentally Originated Disorder
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47
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Schreuder MF, Bueters RRG, Allegaert K. The interplay between drugs and the kidney in premature neonates. Pediatr Nephrol 2014; 29:2083-91. [PMID: 24217783 DOI: 10.1007/s00467-013-2651-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 09/24/2013] [Accepted: 09/26/2013] [Indexed: 02/06/2023]
Abstract
The kidney plays a central role in the clearance of drugs. However, renal drug handling entails more than glomerular filtration and includes tubular excretion and reabsorption, and intracellular metabolization by cellular enzyme systems, such as the Cytochrome P450 isoenzymes. All these processes show maturation from birth onwards, which is one of the reasons why drug dosing in children is not simply similar to dosing in small adults. As kidney development normally finishes around the 36th week of gestation, being born prematurely will result in even more immature renal drug handling. Environmental effects, such as extra-uterine growth restriction, sepsis, asphyxia, or drug treatments like caffeine, aminoglycosides, or non-steroidal anti-inflammatory drugs, may further hamper drug handling in the kidney. Dosing in preterm neonates is therefore dependent on many factors that need to be taken into account. Drug treatment may significantly hamper postnatal kidney development in preterm neonates, just like renal immaturity has an impact on drug handling. The restricted kidney development results in a lower number of nephrons that may have several long-term sequelae, such as hypertension, albuminuria, and renal failure. This review focuses on the interplay between drugs and the kidney in premature neonates.
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Affiliation(s)
- Michiel F Schreuder
- Department of Pediatric Nephrology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands,
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48
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Hocher B. More than genes: the advanced fetal programming hypothesis. J Reprod Immunol 2014; 104-105:8-11. [DOI: 10.1016/j.jri.2014.03.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 02/26/2014] [Accepted: 03/04/2014] [Indexed: 01/24/2023]
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49
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Prenatal xenobiotic exposure and intrauterine hypothalamus-pituitary-adrenal axis programming alteration. Toxicology 2014; 325:74-84. [PMID: 25194749 DOI: 10.1016/j.tox.2014.08.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 08/23/2014] [Accepted: 08/28/2014] [Indexed: 12/18/2022]
Abstract
The hypothalamic-pituitary-adrenal (HPA) axis is one of the most important neuroendocrine axes and plays an important role in stress defense responses before and after birth. Prenatal exposure to xenobiotics, including environmental toxins (such as smoke, sulfur dioxide and carbon monoxide), drugs (such as synthetic glucocorticoids), and foods and beverage categories (such as ethanol and caffeine), affects fetal development indirectly by changing the maternal status or damaging the placenta. Certain xenobiotics (such as caffeine, ethanol and dexamethasone) may also affect the fetus directly by crossing the placenta into the fetus due to their lipophilic properties and lower molecular weights. All of these factors probably result in intrauterine programming alteration of the HPA axis, which showed a low basal activity but hypersensitivity to chronic stress. These alterations will, therefore, increase the susceptibility to adult neuropsychiatric (such as depression and schizophrenia) and metabolic diseases (such as hypertension, diabetes and non-alcoholic fatty liver disease). The "over-exposure of fetuses to maternal glucocorticoids" may be the main initiation factor by which the fetal HPA axis programming is altered. Meantime, xenobiotics can directly induce abnormal epigenetic modifications and expression on the important fetal genes (such as hippocampal glucocorticoid receptor, adrenal steroidogenic acute regulatory protein, et al) or damage by in situ oxidative metabolism of fetal adrenals, which may also be contributed to the programming alteration of fetal HPA axis.
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50
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Lawn JE, Segre J, Barker P, Smith J, De La Torre I, Stones W. Antenatal corticosteroids to reduce preterm deaths in low-income settings. LANCET GLOBAL HEALTH 2014; 2:e446. [PMID: 25103512 DOI: 10.1016/s2214-109x(14)70263-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Joy E Lawn
- London School Hygiene and Tropical Medicine, University College London, UK; Save the Children, South Africa.
| | - Joel Segre
- Consultant to Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Pierre Barker
- Institute for Healthcare Improvement, Cambridge, MA, USA; Gillings School of Global Public Health, University of North Carolina Chapel Hill, NC, USA
| | | | - Irene De La Torre
- University of Puerto Rico, San Juan, Puerto Rico and International Confederation of Midwives, The Hague, Netherlands
| | - William Stones
- University of St Andrews, St Andrews, UK; FIGO Committee on Safe Motherhood and Newborn Health, London, UK
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