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Waszkiewicz EM, Zmijewska A, Kozlowska W, Franczak A. Effects of LH and FSH on androgen and oestrogen release in the myometrium of pigs during the oestrous cycle and early pregnancy. Reprod Fertil Dev 2021; 32:1200-1211. [PMID: 33002394 DOI: 10.1071/rd20148] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/17/2020] [Indexed: 02/02/2023] Open
Abstract
The porcine myometrium possesses steroidogenic activity. LH and FSH are hypothesised to regulate the myometrial production of androstenedione (A4), testosterone (T), oestrone (E1) and 17β-oestradiol (E2). In this study, we used myometrium collected from cycling (n=15) and pregnant (n=15) pigs on Days 10-11, 12-13 and 15-16 of the oestrous cycle or pregnancy to determine: (1) the abundance of LH and FSH receptor (LH/choriogonadotrophin receptor (CGR) and FSHR) mRNA and protein; (2) activity of 17β-hydroxysteroid dehydrogenase 1 (17βHSD1); and (3) A4, T, E1 and E2 release in response to LH and FSH treatment, used at doses 10 or 100ng mL-1 for 6h. In results, the myometrium possesses LH/CGR and FSHR with minor alterations in their expression in the course of the oestrous cycle or early pregnancy. 17βHSD1 activity was the highest on Days 12-13 of the oestrous cycle and the lowest on Days 15-16 of the oestrus cycle and pregnancy, when compared to the other studied days of the oestrous cycle or pregnancy. The LH and FSH treatment increased A4 release on Days 12-13 of the oestrous cycle, and E1 and E2 release on Days 15-16 of the oestrous cycle. Moreover, on Days 12-13 E2 release was increased in response to FSH treatment (100ng mL-1) in cycling pigs and in response to LH (100ng mL-1) in pregnant pigs. In conclusion, the myometrium of pregnant and non-pregnant pigs expresses LH/CGR and FSHR and has 17βHSD1 activity. In addition, the amount of A4, E1, and E2 release from the myometrium is altered in response to LH and FSH, especially in cycling pigs. LH and FSH appear to be important regulators of myometrial oestrogen release in pigs mostly during luteolysis.
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Affiliation(s)
- Ewa M Waszkiewicz
- Department of Animal Anatomy and Physiology, Faculty of Biology and Biotechnology, University of Warmia and Mazury in Olsztyn, Oczapowskiego 1A, 10-718 Olsztyn, Poland
| | - Agata Zmijewska
- Department of Animal Anatomy and Physiology, Faculty of Biology and Biotechnology, University of Warmia and Mazury in Olsztyn, Oczapowskiego 1A, 10-718 Olsztyn, Poland
| | - Wiktoria Kozlowska
- Department of Animal Anatomy and Physiology, Faculty of Biology and Biotechnology, University of Warmia and Mazury in Olsztyn, Oczapowskiego 1A, 10-718 Olsztyn, Poland
| | - Anita Franczak
- Department of Animal Anatomy and Physiology, Faculty of Biology and Biotechnology, University of Warmia and Mazury in Olsztyn, Oczapowskiego 1A, 10-718 Olsztyn, Poland; and Corresponding author.
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Stilley JAW, Segaloff DL. FSH Actions and Pregnancy: Looking Beyond Ovarian FSH Receptors. Endocrinology 2018; 159:4033-4042. [PMID: 30395176 PMCID: PMC6260061 DOI: 10.1210/en.2018-00497] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 10/11/2018] [Indexed: 12/13/2022]
Abstract
By mediating estrogen synthesis and follicular growth in response to FSH, the ovarian FSH receptor (FSHR) is essential for female fertility. Indeed, ovarian stimulation via administration of FSH to women with infertility is part of the primary therapeutic intervention used in assisted reproductive technology. In physiological and therapeutic contexts, current dogma dictates that once ovulation has occurred, FSH/FSHR signaling is no longer required for successful pregnancy outcomes. However, a continued role for FSH during pregnancy is suggested by recent studies demonstrating extraovarian FSHR in the female reproductive tract. Furthermore, functional roles for FSHR in placenta and in uterine myometrium have now been demonstrated. In placenta, vascular endothelial FSHR of fetal vessels within the chorionic villi (human) or labyrinth (mouse) mediate angiogenesis, and it has further been shown that deletion of placental Fshr in mice has deleterious effects on pregnancy. In uterine myometrium, changes in the densities of FSHR in muscle fiber and stroma in the nonpregnant state, early pregnancy, and term pregnancy differentially regulate contractile activity, suggesting that signaling through myometrial FSHR may contribute to the quieting of contractile activity required for successful implantation and that the temporal upregulation of the FSHR at term pregnancy may be required for the appropriate timing of parturition. In addition, extraovarian expression of mRNAs encoding the glycoprotein hormone α subunit and the FSH β subunit has been demonstrated, suggesting that these novel aspects of extraovarian FSH/FSHR signaling during pregnancy may be mediated by locally synthesized FSH.
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Affiliation(s)
- Julie A W Stilley
- Department of Molecular Physiology and Biophysics, The University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Deborah L Segaloff
- Department of Molecular Physiology and Biophysics, The University of Iowa Carver College of Medicine, Iowa City, Iowa
- Correspondence: Deborah L. Segaloff, PhD, Department of Molecular Physiology and Biophysics, The University of Iowa Carver College of Medicine, 5-470 Bowen Science Building, 51 Newton Road, Iowa City, Iowa 52242. E-mail:
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Stilley JAW, Segaloff DL. Deletion of fetoplacental Fshr inhibits fetal vessel angiogenesis in the mouse placenta. Mol Cell Endocrinol 2018; 476:79-83. [PMID: 29715497 PMCID: PMC6120782 DOI: 10.1016/j.mce.2018.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 04/26/2018] [Accepted: 04/27/2018] [Indexed: 02/07/2023]
Abstract
It has been shown in both human and mouse placentas that follicle stimulating hormone receptor (FSHR) is expressed in fetal vascular endothelium. There are conflicting reports, however, on the role of FSH to stimulate angiogenesis in vitro in cultured endothelial cells from umbilical veins. Therefore, in this study we undertook an in vivo approach utilizing Fshr null mice to definitively address this question. In the context where all pregnant dams have identical Fshr genotypes, we generated fetuses and associated fetal portions of placenta that were Fshr wt or Fshr null and analyzed angiogenesis within the placental labyrinths. Quantitative morphometric analyses of placentas obtained at mid-gestation revealed that the percentage of the placenta composed of labyrinth is significantly decreased in Fshr null placentas relative to wt placentas. Furthermore, data presented demonstrate that within the Fshr null labyrinths, fetal vessel angiogenesis was significantly reduced relative to wt labyrinths. The results obtained with this combination of in vivo and genetic approaches conclusively demonstrate that signaling through endothelial FSHR does indeed stimulate angiogenesis and that placental Fshr is essential for normal angiogenesis of the fetal placental vasculature.
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Affiliation(s)
- Julie A W Stilley
- Department of Molecular Physiology and Biophysics, The University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Deborah L Segaloff
- Department of Molecular Physiology and Biophysics, The University of Iowa Carver College of Medicine, Iowa City, IA, United States.
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Abudureyimu A, Cai Y, Huo S, Ren R, Zang R, Yang J, Ma Z, Cui Y. Expression and localization of follicle-stimulating hormone receptor in the yak uterus during different stages of the oestrous cycle. Reprod Domest Anim 2018; 53:1539-1545. [PMID: 30120840 DOI: 10.1111/rda.13313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/26/2018] [Indexed: 11/30/2022]
Abstract
Morphological changes of the uterus and alterations in its secretory activity under the influence of steroid hormones been well documented. The oestrous cycle is also associated with significant changes in plasma follicle-stimulating hormone (FSH), whose effects are mediated through its receptor (FSHR). Reports showed that in many mammals, FSHR was expressed in gonadal and extragonadal tissues including cervix, female reproductive tract, and pituitary gland. Follicle-stimulating hormone (FSH) signals through endothelial FSHR directly stimulate angiogenesis and involved in the timing of birth in human, and the presence of FSHR in the placenta is essential for normal pregnancy in mice. But little is known about FSHR expression in the yak uterus. The main objective of the present study was to determine the expression and localization of FSHR in the yak uterus during different phases of the oestrous cycle. Results showed that FSHR protein was localized in the surface and glandular epithelial cells, stroma cells, myometrial smooth muscle cells and blood vessel endothelial cells. The expression of FSHR protein peaked at oestrus, significantly decreased at dioestrus (p < 0.05) and increased again at proestrus. FSHR mRNA was highly expressed at both proestrus and oestrus, and decreased at metestrus with the lowest values at dioestrus (p < 0.05). In conclusion, FSHR expression in the yak uterus changed with the stage of the oestrous cycle suggesting that FSHR plays an essential role in regulating the endometrial and myometrial functions during the oestrus cycle in the yak.
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Affiliation(s)
- Ayimuguli Abudureyimu
- Life Science and Engineering College of Northwest University for Nationalities, Lanzhou, China.,College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, China
| | - Yong Cai
- Experimental Center of Northwest University for Nationalities, Lanzhou, China
| | - Shengdong Huo
- Life Science and Engineering College of Northwest University for Nationalities, Lanzhou, China
| | - Rui Ren
- Life Science and Engineering College of Northwest University for Nationalities, Lanzhou, China
| | - Rongxin Zang
- Life Science and Engineering College of Northwest University for Nationalities, Lanzhou, China
| | - Jutian Yang
- Life Science and Engineering College of Northwest University for Nationalities, Lanzhou, China
| | - Zhongren Ma
- Life Science and Engineering College of Northwest University for Nationalities, Lanzhou, China
| | - Yan Cui
- College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, China
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Li M, Jia Y, Ling Y, Chen Y, Zhang L, Luo D, Lai L, Guo M, Zhang D, Ren M, Xu H, Kuang H. Reduced expression of follicle stimulating hormone receptor mRNA and protein in pregnancies complicated by pre-eclampsia. Mol Med Rep 2017; 16:367-372. [DOI: 10.3892/mmr.2017.6599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 03/16/2017] [Indexed: 11/06/2022] Open
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Stilley JAW, Guan R, Santillan DA, Mitchell BF, Lamping KG, Segaloff DL. Differential Regulation of Human and Mouse Myometrial Contractile Activity by FSH as a Function of FSH Receptor Density. Biol Reprod 2016; 95:36. [PMID: 27335068 PMCID: PMC5029472 DOI: 10.1095/biolreprod.116.141648] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 06/15/2016] [Indexed: 01/05/2023] Open
Abstract
Previous studies from our laboratory revealed that the follicle-stimulating hormone receptor (FSHR) is expressed at low levels in nonpregnant human myometrium and that it is up-regulated in pregnant term nonlaboring myometrium; however, the physiological relevance of these findings was unknown. Herein, we examined signaling pathways stimulated by FSH in immortalized uterine myocytes expressing recombinant FSHR at different densities and showed that cAMP accumulation is stimulated in all cases but that inositol phosphate accumulation is stimulated only at high FSHR densities. Because an increase in cAMP quiets myometrial contractile activity but an increase in 1,4,5-triphosphoinositol stimulates contractile activity, we hypothesized that FSHR density dictates whether FSH quiets or stimulates myometrial contractility. Indeed, in human and mouse nonpregnant myometrium, which express low levels of FSHR, application of FSH resulted in a quieting of contractile activity. In contrast, in pregnant term nonlaboring myometrium, which expresses higher levels of FSHR, application of FSH resulted in increased contractile activity. Examination of pregnant mouse myometrium from different stages of gestation revealed that FSHR levels remained low throughout most of pregnancy. Accordingly, through mid-gestation, the application of FSH resulted in a quieting of contractile activity. At Pregnancy Day (PD) 16.5, FSHR was up-regulated, although not yet sufficiently to mediate stimulation of contractility in response to FSH. This outcome was not observed until PD 19.5, when FSHR was further up-regulated. Our studies describe a novel FSHR signaling pathway that regulates myometrial contractility, and suggest that myometrial FSHR levels dictate the quieting vs. stimulation of uterine contractility in response to FSH.
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Affiliation(s)
- Julie A W Stilley
- Department of Molecular Physiology and Biophysics, the University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Rongbin Guan
- Department of Molecular Physiology and Biophysics, the University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Donna A Santillan
- Department of Obstetrics and Gynecology, the University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Bryan F Mitchell
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | - Kathryn G Lamping
- Departments of Internal Medicine and Pharmacology, the University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Deborah L Segaloff
- Department of Molecular Physiology and Biophysics, the University of Iowa Carver College of Medicine, Iowa City, Iowa
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Stilley JAW, Christensen DE, Dahlem KB, Guan R, Santillan DA, England SK, Al-Hendy A, Kirby PA, Segaloff DL. FSH receptor (FSHR) expression in human extragonadal reproductive tissues and the developing placenta, and the impact of its deletion on pregnancy in mice. Biol Reprod 2014; 91:74. [PMID: 25100706 DOI: 10.1095/biolreprod.114.118562] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Expression and function of the follicle-stimulating hormone receptor (FSHR) in females were long thought to be limited to the ovary. Here, however, we identify extragonadal FSHR in both the human female reproductive tract and the placenta, and test its physiological relevance in mice. We show that in nonpregnant women FSHR is present on: endothelial cells of blood vessels in the endometrium, myometrium, and cervix; endometrial glands of the proliferative and secretory endometrium; cervical glands and the cervical stroma; and (at low levels) stromal cells and muscle fibers of the myometrium. In pregnant women, placental FSHR was detected as early as 8-10 wk of gestation and continued through term. It was expressed on: endothelial cells in fetal portions of the placenta and the umbilical cord; epithelial cells of the amnion; decidualized cells surrounding the maternal arteries in the maternal decidua; and the stromal cells and muscle fibers of the myometrium, with particularly strong expression at term. These findings suggest that FSHR expression is upregulated during decidualization and upregulated in myometrium as a function of pregnancy. The presence of FSHR in the placental vasculature suggests a role in placental angiogenesis. Analysis of genetically modified mice in which Fshr is lacking in fetal portions of the placenta revealed adverse effects on fetoplacental development. Our data further demonstrate FSHB and CGA mRNAs in placenta and uterus, consistent with potential local sources of FSH. Collectively, our data suggest heretofore unappreciated roles of extragonadal FSHR in female reproductive physiology.
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Affiliation(s)
- Julie A W Stilley
- Department of Molecular Biophysics and Physiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa
| | - Debora E Christensen
- Department of Molecular Biophysics and Physiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa
| | - Kristin B Dahlem
- Department of Molecular Biophysics and Physiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa
| | - Rongbin Guan
- Department of Molecular Biophysics and Physiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa
| | - Donna A Santillan
- Department of Obstetrics and Gynecology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa
| | - Sarah K England
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, Meharry Medical Center, Nashville, Tennessee
| | - Patricia A Kirby
- Department of Pathology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa
| | - Deborah L Segaloff
- Department of Molecular Biophysics and Physiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa
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Chun S, Plunkett J, Teramo K, Muglia LJ, Fay JC. Fine-mapping an association of FSHR with preterm birth in a Finnish population. PLoS One 2013; 8:e78032. [PMID: 24205076 PMCID: PMC3812121 DOI: 10.1371/journal.pone.0078032] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 09/09/2013] [Indexed: 12/18/2022] Open
Abstract
Preterm birth is a complex disorder defined by gestations of less than 37 weeks. While preterm birth is estimated to have a significant genetic component, relative few genes have been associated with preterm birth. Polymorphism in one such gene, follicle-stimulating hormone receptor (FSHR), has been associated with preterm birth in Finnish and African American mothers but not other populations. To refine the genetic association of FSHR with preterm birth we conducted a fine-mapping study at the FSHR locus in a Finnish cohort. We sequenced a total of 44 kb, including protein-coding and conserved non-coding regions, in 127 preterm and 135 term mothers. Overall, we identified 288 single nucleotide variants and 65 insertion/deletions of 1-2 bp across all subjects. While no common SNPs in protein-coding regions were associated with preterm birth, including one previously associated with timing of fertilization, multiple SNPs spanning the first and second intron showed the strongest associations. Analysis of the associated SNPs revealed that they form both a protective (OR = 0.50, 95% CI = 0.25-0.93) as well as a risk (OR = 1.89, 95% CI = 1.08-3.39) haplotype with independent effects. In these haplotypes, two SNPs, rs12052281 and rs72822025, were predicted to disrupt ZEB1 and ELF3 transcription factor binding sites, respectively. Our results show that multiple haplotypes at FSHR are associated with preterm birth and we discuss the frequency and structure of these haplotypes outside of the Finnish population as a potential explanation for the absence of FSHR associations in some populations.
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Affiliation(s)
- Sung Chun
- Computational and Systems Biology Program, Washington University, St. Louis, Missouri, United States of America
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Plunkett J, Doniger S, Orabona G, Morgan T, Haataja R, Hallman M, Puttonen H, Menon R, Kuczynski E, Norwitz E, Snegovskikh V, Palotie A, Peltonen L, Fellman V, DeFranco EA, Chaudhari BP, McGregor TL, McElroy JJ, Oetjens MT, Teramo K, Borecki I, Fay J, Muglia L. An evolutionary genomic approach to identify genes involved in human birth timing. PLoS Genet 2011; 7:e1001365. [PMID: 21533219 PMCID: PMC3077368 DOI: 10.1371/journal.pgen.1001365] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Accepted: 03/07/2011] [Indexed: 01/06/2023] Open
Abstract
Coordination of fetal maturation with birth timing is essential for mammalian reproduction. In humans, preterm birth is a disorder of profound global health significance. The signals initiating parturition in humans have remained elusive, due to divergence in physiological mechanisms between humans and model organisms typically studied. Because of relatively large human head size and narrow birth canal cross-sectional area compared to other primates, we hypothesized that genes involved in parturition would display accelerated evolution along the human and/or higher primate phylogenetic lineages to decrease the length of gestation and promote delivery of a smaller fetus that transits the birth canal more readily. Further, we tested whether current variation in such accelerated genes contributes to preterm birth risk. Evidence from allometric scaling of gestational age suggests human gestation has been shortened relative to other primates. Consistent with our hypothesis, many genes involved in reproduction show human acceleration in their coding or adjacent noncoding regions. We screened >8,400 SNPs in 150 human accelerated genes in 165 Finnish preterm and 163 control mothers for association with preterm birth. In this cohort, the most significant association was in FSHR, and 8 of the 10 most significant SNPs were in this gene. Further evidence for association of a linkage disequilibrium block of SNPs in FSHR, rs11686474, rs11680730, rs12473870, and rs1247381 was found in African Americans. By considering human acceleration, we identified a novel gene that may be associated with preterm birth, FSHR. We anticipate other human accelerated genes will similarly be associated with preterm birth risk and elucidate essential pathways for human parturition. The control of birth timing in humans is the greatest unresolved question in reproductive biology, and preterm birth is the most important medical issue in maternal and child health. To begin to address this critical problem, we test the hypothesis that genes accelerated in their rate of evolution in humans, as compared with other primates and mammals, are involved in birth timing. We first show that human gestational length has been altered relative to other non-human primates and mammals. Using allometric scaling, we demonstrate that human gestation is shorter than predicted based upon gestational length in other mammalian species. Next, we show that genes with rate acceleration in humans—in coding or regulatory regions—are plausible candidates to be involved in birth timing. Finally, we find that polymorphisms in the human accelerated gene (FSHR), not before implicated in the timing for birth, may alter risk for human preterm birth. Our understanding of pathways for birth timing in humans is limited, yet its elucidation remains one of the most important issues in biology and medicine. The evolutionary genetic approach that we apply should be applicable to many human disorders and assist other investigators studying preterm birth.
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Affiliation(s)
- Jevon Plunkett
- Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, United States of America
- Human and Statistic Genetics Program, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Scott Doniger
- Computational Biology Program, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Guilherme Orabona
- Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, United States of America
- Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Thomas Morgan
- Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, United States of America
- Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Ritva Haataja
- Institute of Clinical Medicine, Department of Pediatrics, University of Oulu, Oulu, Finland
| | - Mikko Hallman
- Institute of Clinical Medicine, Department of Pediatrics, University of Oulu, Oulu, Finland
| | - Hilkka Puttonen
- Departments of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland
| | - Ramkumar Menon
- The Perinatal Research Center, Nashville, Tennessee, United States of America
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Edward Kuczynski
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Errol Norwitz
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Victoria Snegovskikh
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Aarno Palotie
- Finnish Institute of Molecular Medicine, University of Helsinki, Helsinki, Finland
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
- Wellcome Trust Sanger Institute, Cambridge, United Kingdom
| | - Leena Peltonen
- Finnish Institute of Molecular Medicine, University of Helsinki, Helsinki, Finland
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
- Wellcome Trust Sanger Institute, Cambridge, United Kingdom
| | - Vineta Fellman
- Department of Pediatrics, Lund University, Lund, Sweden
- Department of Pediatrics, University of Helsinki, Helsinki, Finland
| | - Emily A. DeFranco
- Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
| | - Bimal P. Chaudhari
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Tracy L. McGregor
- Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, United States of America
| | - Jude J. McElroy
- Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, United States of America
- Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Matthew T. Oetjens
- Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Kari Teramo
- Departments of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland
| | - Ingrid Borecki
- Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Justin Fay
- Department of Genetics and Center for Genome Sciences, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Louis Muglia
- Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, United States of America
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
- Vanderbilt Kennedy Center for Human Development, Vanderbilt University, Nashville, Tennessee, United States of America
- * E-mail:
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