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Suleri A, Salontaji K, Luo M, Neumann A, Mulder RH, Tiemeier H, Felix JF, Marioni RE, Bergink V, Cecil CAM. Prenatal exposure to common infections and newborn DNA methylation: A prospective, population-based study. Brain Behav Immun 2024; 121:244-256. [PMID: 39084542 DOI: 10.1016/j.bbi.2024.07.046] [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: 04/09/2024] [Revised: 07/08/2024] [Accepted: 07/28/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Infections during pregnancy have been robustly associated with adverse mental and physical health outcomes in offspring, yet the underlying molecular pathways remain largely unknown. Here, we examined whether exposure to common infections in utero associates with DNA methylation (DNAm) patterns at birth and whether this in turn relates to offspring health outcomes in the general population. METHODS Using data from 2,367 children from the Dutch population-based Generation R Study, we first performed an epigenome-wide association study to identify differentially methylated sites and regions at birth associated with prenatal infection exposure. We also examined the influence of infection timing by using self-reported cumulative infection scores for each trimester. Second, we sought to develop an aggregate methylation profile score (MPS) based on cord blood DNAm as an epigenetic proxy of prenatal infection exposure and tested whether this MPS prospectively associates with offspring health outcomes, including psychiatric symptoms, BMI, and asthma at ages 13-16 years. Third, we investigated whether prenatal infection exposure associates with offspring epigenetic age acceleration - a marker of biological aging. Across all analysis steps, we tested whether our findings replicate in 864 participants from an independent population-based cohort (ALSPAC, UK). RESULTS We observed no differentially methylated sites or regions in cord blood in relation to prenatal infection exposure, after multiple testing correction. 33 DNAm sites showed suggestive associations (p < 5e10 - 5; of which one was also nominally associated in ALSPAC), indicating potential links to genes associated with immune, neurodevelopmental, and cardiovascular pathways. While the MPS of prenatal infections associated with maternal reports of infections in the internal hold out sample in the Generation R Study (R2incremental = 0.049), it did not replicate in ALSPAC (R2incremental = 0.001), and it did not prospectively associate with offspring health outcomes in either cohort. Moreover, we observed no association between prenatal exposure to infections and epigenetic age acceleration across cohorts and clocks. CONCLUSION In contrast to prior studies, which reported DNAm differences in offspring exposed to severe infections in utero, we do not find evidence for associations between self-reported clinically evident common infections during pregnancy and DNAm or epigenetic aging in cord blood within the general pediatric population. Future studies are needed to establish whether associations exist but are too subtle to be statistically meaningful with present sample sizes, whether they replicate in a cohort with a more similar infection score as our discovery cohort, whether they occur in different tissues than cord blood, and whether other biological pathways may be more relevant for mediating the effect of prenatal common infection exposure on downstream offspring health outcomes.
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Affiliation(s)
- Anna Suleri
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, the Netherlands; The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Kristina Salontaji
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, the Netherlands; The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Mannan Luo
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, the Netherlands; The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Alexander Neumann
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, the Netherlands; The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Rosa H Mulder
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, the Netherlands; The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Riccardo E Marioni
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA; Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Charlotte A M Cecil
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, the Netherlands; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biomedical Data Sciences, Molecular Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
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Wimberly CE, Gulrajani NB, Russ JB, Landi D, Wiemels JL, Towry L, Wiencke JK, Walsh KM. Maternal Prenatal Use of Alcohol, Tobacco, and Illicit Drugs and Associations with Childhood Cancer Subtypes. Cancer Epidemiol Biomarkers Prev 2024; 33:347-354. [PMID: 38112788 DOI: 10.1158/1055-9965.epi-23-1027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/17/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND The association between childhood cancer risk and maternal prenatal substance use/abuse remains uncertain due to modest sample sizes and heterogeneous study designs. METHODS We surveyed parents of children with cancer regarding maternal gestational use of tobacco, alcohol, and illicit drugs, using a Likert-type scale, and demographic, perinatal, and clinical variables. Multivariable log-Poisson regression assessed differences in frequency of prenatal substance use across fifteen childhood cancer subtypes, adjusting for birthweight, gestational age, and demographic factors. RESULTS Respondents from 3,145 unique families completed the survey (92% biological mothers). A minority reported gestational use of tobacco products (14%), illicit drugs including marijuana or cocaine (4%), or more than a moderate amount of alcohol (2%). Prenatal illicit drug use was associated with increased prevalence of intracranial embryonal tumors [prevalence ratio (PR) = 1.94; confidence interval [CI], 1.05-3.58], including medulloblastoma (PR = 1.82) and supratentorial primitive neuroectodermal tumors (PNET; PR = 2.66), and was also associated with retinoblastoma (PR = 3.11; CI, 1.20-8.08). Moderate to heavy alcohol consumption was strongly associated with elevated prevalence of non-Hodgkin lymphoma (PR = 5.94; CI, 1.84-19.21). Prenatal smoking was not associated with elevated prevalence of any childhood cancer subtype. CONCLUSIONS We identify novel associations between illicit drug use during pregnancy and increased prevalence of nonglioma central nervous system tumors, including medulloblastoma, supratentorial PNETs, and retinoblastoma. Gestational exposure to alcohol was positively associated with non-Hodgkin lymphoma. IMPACT Although alcohol and tobacco use during pregnancy has declined, gestational cannabis use has risen. Investigating its impact on neurodevelopment and brain tumorigenesis is vital, with important implications for childhood cancer research and public health education.
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Affiliation(s)
- Courtney E Wimberly
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina
- Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, North Carolina
| | - Natalie B Gulrajani
- Children's Health and Discovery Institute, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Jeffrey B Russ
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Daniel Landi
- Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, North Carolina
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Joseph L Wiemels
- Center for Genetic Epidemiology, Norris Comprehensive Cancer Center, and Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California
| | - Lisa Towry
- Alex's Lemonade Stand Foundation, Bala Cynwyd, Pennsylvania
| | - John K Wiencke
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California
| | - Kyle M Walsh
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina
- Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, North Carolina
- Children's Health and Discovery Institute, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
- Duke Cancer Institute, Duke University School of Medicine, Durham, North Carolina
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Schrott R, Song A, Ladd-Acosta C. Epigenetics as a Biomarker for Early-Life Environmental Exposure. Curr Environ Health Rep 2022; 9:604-624. [PMID: 35907133 DOI: 10.1007/s40572-022-00373-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW There is interest in evaluating the developmental origins of health and disease (DOHaD) which emphasizes the role of prenatal and early-life environments on non-communicable health outcomes throughout the life course. The ability to rigorously assess and identify early-life risk factors for later health outcomes, including those with childhood onset, in large population samples is often limited due to measurement challenges such as impractical costs associated with prospective studies with a long follow-up duration, short half-lives for some environmental toxicants, and lack of biomarkers that capture inter-individual differences in biologic response to external environments. RECENT FINDINGS Epigenomic patterns, and DNA methylation in particular, have emerged as a potential objective biomarker to address some of these study design and exposure measurement challenges. In this article, we summarize the literature to date on epigenetic changes associated with specific prenatal and early-life exposure domains as well as exposure mixtures in human observational studies and their biomarker potential. Additionally, we highlight evidence for other types of epigenetic patterns to serve as exposure biomarkers. Evidence strongly supports epigenomic biomarkers of exposure that are detectable across the lifespan and across a range of exposure domains. Current and future areas of research in this field seek to expand these lines of evidence to other environmental exposures, to determine their specificity, and to develop predictive algorithms and methylation scores that can be used to evaluate early-life risk factors for health outcomes across the life span.
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Affiliation(s)
- Rose Schrott
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ashley Song
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Christine Ladd-Acosta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
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Cosin-Tomas M, Cilleros-Portet A, Aguilar-Lacasaña S, Fernandez-Jimenez N, Bustamante M. Prenatal Maternal Smoke, DNA Methylation, and Multi-omics of Tissues and Child Health. Curr Environ Health Rep 2022; 9:502-512. [PMID: 35670920 PMCID: PMC9363403 DOI: 10.1007/s40572-022-00361-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Maternal tobacco smoking during pregnancy is of public health concern, and understanding the biological mechanisms can help to promote smoking cessation campaigns. This non-systematic review focuses on the effects of maternal smoking during pregnancy on offspring's epigenome, consistent in chemical modifications of the genome that regulate gene expression. RECENT FINDINGS Recent meta-analyses of epigenome-wide association studies have shown that maternal smoking during pregnancy is consistently associated with offspring's DNA methylation changes, both in the placenta and blood. These studies indicate that effects on blood DNA methylation can persist for years, and that the longer the duration of the exposure and the higher the dose, the larger the effects. Hence, DNA methylation scores have been developed to estimate past exposure to maternal smoking during pregnancy as biomarkers. There is robust evidence for DNA methylation alterations associated with maternal smoking during pregnancy; however, the role of sex, ethnicity, and genetic background needs further exploration. Moreover, there are no conclusive studies about exposure to low doses or during the preconception period. Similarly, studies on tissues other than the placenta and blood are scarce, and cell-type specificity within tissues needs further investigation. In addition, biological interpretation of DNA methylation findings requires multi-omics data, poorly available in epidemiological settings. Finally, although several mediation analyses link DNA methylation changes with health outcomes, they do not allow causal inference. For this, a combination of data from multiple study designs will be essential in the future to better address this topic.
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Affiliation(s)
- Marta Cosin-Tomas
- ISGlobal, Institute for Global Health, Barcelona, Spain. .,Universitat Pompeu Fabra (UPF), Barcelona, Spain. .,CIBER Epidemiología Y Salud Pública, Madrid, Spain.
| | - Ariadna Cilleros-Portet
- Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country (UPV/EHU) and Biocruces-Bizkaia Health Research Institute, Basque Country, Spain
| | - Sofía Aguilar-Lacasaña
- ISGlobal, Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología Y Salud Pública, Madrid, Spain
| | - Nora Fernandez-Jimenez
- Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country (UPV/EHU) and Biocruces-Bizkaia Health Research Institute, Basque Country, Spain
| | - Mariona Bustamante
- ISGlobal, Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología Y Salud Pública, Madrid, Spain
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Sequí-Canet JM, Sequí-Sabater JM, Marco-Sabater A, Corpas-Burgos F, Collar del Castillo JI, Orta-Sibú N. Maternal factors associated with smoking during gestation and consequences in newborns: Results of an 18-year study. J Clin Transl Res 2022; 8:6-19. [PMID: 35097236 PMCID: PMC8791242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/06/2021] [Accepted: 11/12/2021] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Tobacco use is one of the most important causes of obstetric and perinatal pathologies. Its frequency during pregnancy is high and could be related to various socioeconomic and cultural characteristics of the mothers. AIM The aim of this study is to determine the trend and prevalence of smoking in pregnant mothers in our area over the years and the socio-cultural or obstetric factors associated with smoking as well as the repercussions on the newborns related to its consumption. METHODS Retrospective study of 18,959 mothers of healthy newborns in the maternity ward of the regional hospital during the years 2002-2019. The variable under study was maternal smoking during pregnancy compared with various maternal, obstetric, and perinatal factors. RESULTS A mean percentage of 20.4% of the mothers smoked, with significantly decreasing percentages over the years. There was a significant association between smoking and mothers' age, origin, level of education, the occurrence of previous abortions, parity, type of breastfeeding at discharge, type of delivery, low birth weight, and need for neonatal resuscitation. CONCLUSIONS This defines a profile of pregnant smokers on whom it is important to act: young, Spanish, with a low level of education, multiparous, and with previous miscarriages. Its repercussions are also evident with a lower birth weight in newborns. Knowledge of these factors will make it possible to design more effective intervention strategies to reduce smoking during pregnancy. RELEVANCE FOR PATIENTS Any effort that reduces smoking habits can improve the health status of mothers and newborns and the first step is to know who are risk pregnants.
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Affiliation(s)
- Jose Miguel Sequí-Canet
- 1Department of Paediatrics, University Hospital “Francisco de Borja”, Gandía, Spain,
Corresponding author: Jose Miguel Sequí-Canet Department of Paediatrics, University Hospital “Francisco de Borja”, Av. de la Medicina 646702-Gandia, Spain. Tel: +34 962849732
| | | | - Ana Marco-Sabater
- 1Department of Paediatrics, University Hospital “Francisco de Borja”, Gandía, Spain
| | - Francisca Corpas-Burgos
- 3Department of Statistics, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Área de Desigualdades en Salud, Spain
| | | | - Nelson Orta-Sibú
- 1Department of Paediatrics, University Hospital “Francisco de Borja”, Gandía, Spain
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Exposure to Stress and Air Pollution from Bushfires during Pregnancy: Could Epigenetic Changes Explain Effects on the Offspring? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147465. [PMID: 34299914 PMCID: PMC8305161 DOI: 10.3390/ijerph18147465] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 12/20/2022]
Abstract
Due to climate change, bushfires are becoming a more frequent and more severe phenomenon which contributes to poor health effects associated with air pollution. In pregnancy, environmental exposures can have lifelong consequences for the fetus, but little is known about these consequences in the context of bushfire smoke exposure. In this review we summarise the current knowledge in this area, and propose a potential mechanism linking bushfire smoke exposure in utero to poor perinatal and respiratory outcomes in the offspring. Bushfire smoke exposure is associated with poor pregnancy outcomes including reduced birth weight and an increased risk of prematurity. Some publications have outlined the adverse health effects on young children, particularly in relation to emergency department presentations and hospital admissions for respiratory problems, but there are no studies in children who were exposed to bushfire smoke in utero. Prenatal stress is likely to occur as a result of catastrophic bushfire events, and stress is known to be associated with poor perinatal and respiratory outcomes. Changes to DNA methylation are potential epigenetic mechanisms linking both smoke particulate exposure and prenatal stress to poor childhood respiratory health outcomes. More research is needed in large pregnancy cohorts exposed to bushfire events to explore this further, and to design appropriate mitigation interventions, in this area of global public health importance.
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Epigenetic Alterations of Maternal Tobacco Smoking during Pregnancy: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105083. [PMID: 34064931 PMCID: PMC8151244 DOI: 10.3390/ijerph18105083] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/29/2021] [Accepted: 05/04/2021] [Indexed: 12/11/2022]
Abstract
In utero exposure to maternal tobacco smoking is the leading cause of birth complications in addition to being associated with later impairment in child’s development. Epigenetic alterations, such as DNA methylation (DNAm), miRNAs expression, and histone modifications, belong to possible underlying mechanisms linking maternal tobacco smoking during pregnancy and adverse birth outcomes and later child’s development. The aims of this review were to provide an update on (1) the main results of epidemiological studies on the impact of in utero exposure to maternal tobacco smoking on epigenetic mechanisms, and (2) the technical issues and methods used in such studies. In contrast with miRNA and histone modifications, DNAm has been the most extensively studied epigenetic mechanism with regard to in utero exposure to maternal tobacco smoking. Most studies relied on cord blood and children’s blood, but placenta is increasingly recognized as a powerful tool, especially for markers of pregnancy exposures. Some recent studies suggest reversibility in DNAm in certain genomic regions as well as memory of smoking exposure in DNAm in other regions, upon smoking cessation before or during pregnancy. Furthermore, reversibility could be more pronounced in miRNA expression compared to DNAm. Increasing evidence based on longitudinal data shows that maternal smoking-associated DNAm changes persist during childhood. In this review, we also discuss some issues related to cell heterogeneity as well as downstream statistical analyses used to relate maternal tobacco smoking during pregnancy and epigenetics. The epigenetic effects of maternal smoking during pregnancy have been among the most widely investigated in the epigenetic epidemiology field. However, there are still huge gaps to fill in, including on the impact on miRNA expression and histone modifications to get a better view of the whole epigenetic machinery. The consistency of maternal tobacco smoking effects across epigenetic marks and across tissues will also provide crucial information for future studies. Advancement in bioinformatic and biostatistics approaches is key to develop a comprehensive analysis of these biological systems.
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