1
|
Siboto A, Ludidi A, Sibiya N, Khathi A, Ngubane P. Maternal prediabetes as a risk factor of preeclampsia and placental dysfunction in pregnant female Sprague-Dawley rats. J OBSTET GYNAECOL 2024; 44:2379498. [PMID: 39084241 DOI: 10.1080/01443615.2024.2379498] [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: 07/28/2023] [Accepted: 06/24/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Prediabetes (PD) is associated with intermediate hyperglycaemia, dyslipidaemia, reduced nitric oxide (NO) bioavailability and moderate hypertension. All these factors are risk factor for preeclampsia (PE). However, the effects of the PD on placental function have not been shown. Accordingly, this study sought to investigate a possible link between maternal PD and the risk of developing PE. METHODS Pregnant female Sprague-Dawley rats (N = 18) were divided into normal, preeclamptic and prediabetic groups (n = 6 in each group) to study the effects of maternal PD on placenta function over the period of 19 days. Blood glucose and blood pressure were measured on gestational day (GND) 0, 9 and 18. Placental vascular endothelial growth factor (VEGF), placenta growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt-1) mRNA expression were measured terminally. Data were analysed using ANOVA followed by the Tukey-Kramer post hoc test. Values of p < .05 were used to indicate statistical significance. RESULTS Maternal PD and PE significantly increased blood glucose, decrease NO concentration and increase in MAP by comparison to the normal pregnant control group. Maternal PD significantly decreased VEGF, PlGF mRNA expression with a slight increase in sFlt-1 mRNA expression comparison to the normal pregnant control group. CONCLUSIONS Maternal PD is associated with placental dysfunction due to impaired glucose handling, endothelial dysfunction and an imbalance in angiogenic and antiangiogenic factors. Therefore, maternal PD is a risk factor of PE.
Collapse
Affiliation(s)
- Aneliswe Siboto
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Asiphaphola Ludidi
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Ntethelelo Sibiya
- Division of Pharmacology, Faculty of Pharmacy, Rhodes University, Makhanda, South Africa
| | - Andile Khathi
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Phikelelani Ngubane
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu Natal, Durban, South Africa
| |
Collapse
|
2
|
Koefoed AS, Knorr S, Fuglsang J, Leth-Møller M, Hulman A, Jensen DM, Andersen LLT, Rosbach AE, Damm P, Mathiesen ER, Sørensen A, Christensen TT, McIntyre HD, Ovesen P, Kampmann U. Hemoglobin A1c Trajectories During Pregnancy and Adverse Outcomes in Women With Type 2 Diabetes: A Danish National Population-Based Cohort Study. Diabetes Care 2024; 47:1211-1219. [PMID: 38771955 DOI: 10.2337/dc23-2304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/19/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVE To identify and characterize groups of pregnant women with type 2 diabetes with distinct hemoglobin A1c (HbA1c) trajectories across gestation and to examine the association with adverse obstetric and perinatal outcomes. RESEARCH DESIGN AND METHODS This was a retrospective Danish national cohort study including all singleton pregnancies in women with type 2 diabetes, giving birth to a liveborn infant, between 2004 and 2019. HbA1c trajectories were identified using latent class linear mixed-model analysis. Associations with adverse outcomes were examined with logistic regression models. RESULTS A total of 1,129 pregnancies were included. Three HbA1c trajectory groups were identified and named according to the glycemic control in early pregnancy (good, 59%; moderate, 32%; and poor, 9%). According to the model, all groups attained an estimated HbA1c <6.5% (48 mmol/mol) during pregnancy, with no differences between groups in the 3rd trimester. Women with poor glycemic control in early pregnancy had lower odds of having an infant with large-for-gestational-age (LGA) birth weight (adjusted odds ratio [aOR] 0.57, 95% CI 0.40-0.83), and higher odds of having an infant with small-for-gestational age (SGA) birth weight (aOR 2.49, 95% CI 2.00-3.10) and congenital malformation (CM) (aOR 4.60 95% CI 3.39-6.26) compared with women with good glycemic control. There was no evidence of a difference in odds of preeclampsia, preterm birth, and caesarean section between groups. CONCLUSIONS Women with poor glycemic control in early pregnancy have lower odds of having an infant with LGA birth weight, but higher odds of having an infant with SGA birth weight and CM.
Collapse
Affiliation(s)
- Anna S Koefoed
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Sine Knorr
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jens Fuglsang
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Magnus Leth-Møller
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Adam Hulman
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Dorte M Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Lise Lotte T Andersen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - A Emilie Rosbach
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Department of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth R Mathiesen
- Center for Pregnant Women with Diabetes, Department of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne Sørensen
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Trine T Christensen
- Steno Diabetes Center Aalborg, Aalborg University Hospital, Aalborg, Denmark
| | - H David McIntyre
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Mater Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Per Ovesen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ulla Kampmann
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| |
Collapse
|
3
|
Ning J, Yan J, Wang S, Cui Z, Xue Y, Juan J, Yang H. Demethylase FTO-mediated m6A modification of SIK1 modulates placental cytotrophoblast syncytialization in type 2 diabetes mellitus. iScience 2024; 27:109900. [PMID: 38883837 PMCID: PMC11177141 DOI: 10.1016/j.isci.2024.109900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 02/24/2024] [Accepted: 05/01/2024] [Indexed: 06/18/2024] Open
Abstract
Type 2 diabetes mellitus (T2DM) represents a common complication during pregnancy that affects fetoplacental development. We demonstrated the existence of impaired trophoblast syncytialization under hyperglycemic conditions. However, the exact mechanism remains unknown. RNA N6-methyladenosine (m6A) is an emerging regulatory mechanism of mRNA and participates in various biological processes. We described the global m6A modification pattern in T2DM placenta by the combined analysis of methylated RNA immunoprecipitation sequencing (MeRIP-Seq) and RNA sequencing (RNA-Seq). Both the m6A modification and expression of SIK1, which is critical for syncytialization, were significantly decreased in trophoblast exposed to hyperglycemic conditions. In addition, the m6A demethylase fat mass and obesity-associated protein (FTO) affects the expression and mRNA stability of SIK1 by binding to its 3'-untranslated region (UTR) m6A site. This work reveals that the FTO-m6A-SIK1 axis plays critical roles in regulating syncytialization in the placenta.
Collapse
Affiliation(s)
- Jie Ning
- Department of Obstetrics and Gynecology and Reproductive Medicine, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China
- Peking University, Beijing, China
| | - Jie Yan
- Department of Obstetrics and Gynecology and Reproductive Medicine, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China
| | - Shuxian Wang
- Department of Obstetrics and Gynecology and Reproductive Medicine, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China
- Peking University, Beijing, China
| | - Zifeng Cui
- Department of Obstetrics and Gynecology and Reproductive Medicine, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China
- Peking University, Beijing, China
| | - Yiwei Xue
- Department of Obstetrics and Gynecology and Reproductive Medicine, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China
- Peking University, Beijing, China
| | - Juan Juan
- Department of Obstetrics and Gynecology and Reproductive Medicine, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China
| | - Huixia Yang
- Department of Obstetrics and Gynecology and Reproductive Medicine, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing, China
- Peking University, Beijing, China
| |
Collapse
|
4
|
Liu Q, Gui J, Wu L. Study on the regulation of trophoblast activity by abnormally expressed hsa_circ_0024838/miR-543/HIF1A in patients with gestational diabetes mellitus. Placenta 2024; 151:27-36. [PMID: 38701658 DOI: 10.1016/j.placenta.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 03/22/2024] [Accepted: 04/12/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION This study aimed to screen circRNAs involved in gestational diabetes mellitus (GDM)-related macrosomia. One differentially expressed circRNA (DEC), hsa_circ_0024838, was further tested for its potential role and mechanism in trophoblasts. METHODS DECs in GDM were selected through GSE182737 and GSE194119. The targets were predicted for DECs and microRNAs (miRNAs), to complete the construction of the circRNA-miRNA-gene network. Functional annotation and related biological pathway enrichment analysis were performed on the target genes of miRNAs in the network. Subsequently, the expression levels of hsa_circ_0024838, miR-543, and HIF1A mRNA were identified by real-time quantitative real-time PCR (RT-qPCR) in GDM patients. Trophoblast activity was assessed via CCK-8 assay, apoptosis assay, and Matrigel invasion assay. Finally, interactions between miR-543 and either hsa_circ_0024838 or HIF1A were confirmed using dual-luciferase reporter assays. RESULTS A GDM-related circRNA-miRNA-genes interaction network was constructed, consisting of 35 circRNAs, 46 miRNAs, and 122 target genes. Functional enrichment revealed that the enriched pathways were involved in GDM. Hsa_circ_0024838 and HIF1A mRNA expression levels were upregulated in GDM, while miR-543 expression levels were downregulated. A significant positive correlation between hsa_circ_0024838 and newborn weight was observed. Both hsa_circ_0024838 and HIF1A possessed binding sites for miR-543. Overexpressing hsa_circ_0024838 in high-glucose (HG)-cultured trophoblasts can partially reverse HG-induced reduction in trophoblast cell proliferation/migration and increase apoptosis. But this reversal can be negated by co-transfection with miR-543 mimics. The effects of miR-543 can be counteracted by HIF1A. DISCUSSION Hsa_circ_0024838 can regulate the expression of HIF1A by interacting with miR-543. This regulates the HIF1A signaling pathway and enhance vitality in trophoblast cells.
Collapse
Affiliation(s)
- Qian Liu
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Juan Gui
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Lianzhi Wu
- Department of Obstetrics, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
| |
Collapse
|
5
|
Ip PNP, Nguyen-Hoang L, Chaemsaithong P, Guo J, Wang X, Sahota DS, Chung JPW, Poon LCY. Ultrasonographic placental parameters at 11-13+6 weeks' gestation in the prediction of complications in pregnancy after assisted reproductive technology. Taiwan J Obstet Gynecol 2024; 63:341-349. [PMID: 38802197 DOI: 10.1016/j.tjog.2023.09.023] [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] [Accepted: 09/01/2023] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE To evaluate the performance of maternal factors, biophysical and biochemical markers at 11-13 + 6 weeks' gestation in the prediction of gestational diabetes mellitus with or without large for gestational age (GDM ± LGA) fetus and great obstetrical syndromes (GOS) among singleton pregnancy following in-vitro fertilisation (IVF)/embryo transfer (ET). MATERIALS AND METHODS A prospective cohort study was conducted between December 2017 and January 2020 including patients who underwent IVF/ET. Maternal mean arterial pressure (MAP), ultrasound markers including placental volume, vascularisation index (VI), flow index (FI) and vascularisation flow index (VFI), mean uterine artery pulsatility index (mUtPI) and biochemical markers including placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured at 11-13 + 6 weeks' gestation. Logistic regression analysis was performed to determine the significant predictors of complications. RESULTS Among 123 included pregnancies, 38 (30.9%) had GDM ± LGA fetus and 28 (22.8%) had GOS. The median maternal height and body mass index were significantly higher in women with GDM ± LGA fetus. Multivariate logistic regression analysis demonstrated that in the prediction of GDM ± LGA fetus and GOS, there were significant independent contributions from FI MoM (area under curve (AUROC) of 0.610, 95% CI 0.492-0.727; p = 0.062) and MAP MoM (AUROC of 0.645, 95% CI 0.510-0.779; p = 0.026), respectively. CONCLUSION FI and MAP are independent predictors for GDM ± LGA fetus and GOS, respectively. However, they have low predictive value. There is a need to identify more specific novel biomarkers in differentiating IVF/ET pregnancies that are at a higher risk of developing complications.
Collapse
Affiliation(s)
- Patricia Nga Ping Ip
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Long Nguyen-Hoang
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Piya Chaemsaithong
- Department of Obstetrics and Gynecology, Mahidol University, Bangkok, Thailand
| | - Jun Guo
- Department of Obstetrics and Gynaecology, Beijing Tongren Hospital, The Capital Medical University, Beijing, China
| | - Xueqin Wang
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Daljit Singh Sahota
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jacqueline Pui Wah Chung
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Liona Chiu Yee Poon
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
6
|
Moreno-Irusta A, Dominguez EM, Iqbal K, Zhang X, Wang N, Soares MJ. TAF7L regulates early stages of male germ cell development in the rat. FASEB J 2024; 38:e23376. [PMID: 38112167 PMCID: PMC11246239 DOI: 10.1096/fj.202301716rr] [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: 08/24/2023] [Revised: 11/14/2023] [Accepted: 12/04/2023] [Indexed: 12/20/2023]
Abstract
Male germ cell development is dependent on the orchestrated regulation of gene networks. TATA-box binding protein associated factors (TAFs) facilitate interactions of TATA-binding protein with the TATA element, which is known to coordinate gene transcription during organogenesis. TAF7 like (Taf7l) is situated on the X chromosome and has been implicated in testis development. We examined the biology of TAF7L in testis development using the rat. Taf7l was prominently expressed in preleptotene to leptotene spermatocytes. To study the impact of TAF7L on the testis we generated a global loss-of-function rat model using CRISPR/Cas9 genome editing. Exon 3 of the Taf7l gene was targeted. A founder was generated possessing a 110 bp deletion within the Taf7l locus, which resulted in a frameshift and the premature appearance of a stop codon. The mutation was effectively transmitted through the germline. Deficits in TAF7L did not adversely affect pregnancy or postnatal survival. However, the Taf7l disruption resulted in male infertility due to compromised testis development and failed sperm production. Mutant germ cells suffer meiotic arrest at late zygotene/early pachynema stages, with defects in sex body formation. This testis phenotype was more pronounced than previously described for the subfertile Taf7l null mouse. We conclude that TAF7L is essential for male germ cell development in the rat.
Collapse
Affiliation(s)
- Ayelen Moreno-Irusta
- Institute for Reproductive and Developmental Sciences, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Esteban M. Dominguez
- Institute for Reproductive and Developmental Sciences, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Khursheed Iqbal
- Institute for Reproductive and Developmental Sciences, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Xiaoyu Zhang
- Institute for Reproductive and Developmental Sciences, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Ning Wang
- Institute for Reproductive and Developmental Sciences, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Michael J. Soares
- Institute for Reproductive and Developmental Sciences, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, Kansas, USA
- Center for Perinatal Research, Children’s Mercy Research Institute, Children’s Mercy, Kansas City, Missouri, USA
| |
Collapse
|
7
|
Chatzakis C, Eleftheriades M, Demertzidou E, Eleftheriades A, Koletsos N, Lavasidis L, Zikopoulos A, Dinas K, Sotiriadis A. Uterine Arteries Resistance in Pregnant Women with Gestational Diabetes Mellitus, Diabetes Mellitus Type 1, Diabetes Mellitus Type 2, and Uncomplicated Pregnancies. Biomedicines 2023; 11:3106. [PMID: 38137327 PMCID: PMC10741004 DOI: 10.3390/biomedicines11123106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND The examination of the uterine arteries using Doppler in the first trimester of pregnancy serves as a valuable tool for evaluating the uteroplacental circulation. Diabetes mellitus is associated with altered placental implantation and pregnancy-related pathologies, such as preeclampsia. The aim of this study was to compare the uterine arteries' pulsatility indices (UtA PI) in women with diabetes mellitus type 1 (DM1), diabetes mellitus type 2 (DM2), gestational diabetes mellitus (GDM), and uncomplicated pregnancies. METHODS This was a retrospective case-control trial including pregnant women with DM1, DM2, GDM, and uncomplicated pregnancies, presenting for first-trimester ultrasound screening in two tertiary university hospitals between 2013 and 2023. The first-trimester UtA pulsatility index (PI), expressed in multiples of medians (MoMs), was compared between the four groups. RESULTS Out of 15,638 pregnant women, 58 women with DM1, 67 women with DM2, 65 women with GDM, and 65 women with uncomplicated pregnancies were included. The mean UtA PI were 1.00 ± 0.26 MoMs, 1.04 ± 0.32 MoMs, 1.02 ± 0.31 MoMs, and 1.08 ± 0.33 MoMs in pregnant women with DM1, DM2, GDM, and uncomplicated pregnancies, respectively (p > 0.05). CONCLUSIONS Potential alterations in the implantation of the placenta in pregnant women with diabetes were not displayed in the first-trimester pulsatility indices of the uterine arteries, as there were no changes between the groups.
Collapse
Affiliation(s)
- Christos Chatzakis
- Second Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (C.C.)
| | - Makarios Eleftheriades
- Second Department of Obstetrics and Gynecology, Medical School, National and Capodistrian University of Athens, 115 28 Athens, Greece; (M.E.); (A.E.)
| | - Eleftheria Demertzidou
- Second Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (C.C.)
| | - Anna Eleftheriades
- Second Department of Obstetrics and Gynecology, Medical School, National and Capodistrian University of Athens, 115 28 Athens, Greece; (M.E.); (A.E.)
| | - Nikolaos Koletsos
- Department of Rheumatology, University of Ioannina, 451 10 Ioannina, Greece;
| | - Lazaros Lavasidis
- Second Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (C.C.)
| | | | - Konstantinos Dinas
- Second Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (C.C.)
| | - Alexandros Sotiriadis
- Second Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (C.C.)
| |
Collapse
|
8
|
Zhao H, Wong RJ, Stevenson DK. The placental vasculature is affected by changes in gene expression and glycogen-rich cells in a diet-induced obesity mouse model. PLoS One 2023; 18:e0294185. [PMID: 37948457 PMCID: PMC10637699 DOI: 10.1371/journal.pone.0294185] [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: 07/22/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
Maternal obesity is a risk factor for pregnancy complications. Obesity caused by a high-fat diet (HFD) may alter maternal glucose/glycogen metabolism. Here, our objective was to investigate whether the placental vasculature is altered via changes in gene expression and glycogen-rich cells using a preclinical mouse model of diet-induced obesity. We subjected female FVB/N mice to one of three feeding regimens: regular chow (RC) given at preconception and during pregnancy (Control); RC given at preconception and then a HFD during pregnancy (HFD-P); or HFD initiated 4 weeks preconception and during pregnancy (HFD-PreCP). Daily food consumption and weekly maternal weights were recorded. Maternal blood glucose levels were measured at preconception and 4 gestational epochs (E6.5-E9.5, E10.5-E12.5, E13.5-E15.5, E16.5-E19.5). At E8.5-E16.5, total RNA in placentas were isolated for gene expression analyses. Placentas were also collected for HE and periodic acid Schiff's (PAS) staining and glycogen content assays. Dams in the HFD-P and HFD-PreCP groups gained significantly more weight than controls. Pre- and antenatal glucose levels were also significantly higher (15%-30%) in HFD-PreCP dams. Expression of several placental genes were also altered in HFD dams compared with controls. Consumption of the HFD also led to phenotypic and morphologic changes in glycogen trophoblasts (GlyTs) and uterine natural killer (uNK) cells. Alterations in vascularity were also observed in the labyrinth of HFD-PreCP placentas, which correlated with decreased placental efficiency. Overall, we observed that a HFD induces gestational obesity in mice, alters expression of placental genes, affects glucose homeostasis, and alters glycogen-positive GlyTs and uNK cells. All these changes may lead to impaired placental vascular development, and thus heighten the risk for pregnancy complications.
Collapse
Affiliation(s)
- Hui Zhao
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Ronald J. Wong
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - David K. Stevenson
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| |
Collapse
|
9
|
Liang X, Fu Y, Lu S, Shuai M, Miao Z, Gou W, Shen L, Liang Y, Xu F, Tian Y, Wang J, Zhang K, Xiao C, Jiang Z, Shi MQ, Wu YY, Wang XH, Hu WS, Zheng JS. Continuous glucose monitoring-derived glycemic metrics and adverse pregnancy outcomes among women with gestational diabetes: a prospective cohort study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 39:100823. [PMID: 37927990 PMCID: PMC10625020 DOI: 10.1016/j.lanwpc.2023.100823] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/11/2023] [Accepted: 05/30/2023] [Indexed: 11/07/2023]
Abstract
Background Continuous glucose monitoring (CGM) has shown potential in improving maternal and neonatal outcomes in individuals with type 1/2 diabetes, but data in gestational diabetes mellitus (GDM) is limited. We aimed to explore the relationship between CGM-derived metrics during pregnancy and pregnancy outcomes among women with GDM. Methods We recruited 1302 pregnant women with GDM at a mean gestational age of 26.0 weeks and followed them until delivery. Participants underwent a 14-day CGM measurement upon recruitment. The primary outcome was any adverse pregnancy outcome, defined as having at least one of the outcomes: preterm birth, large-for-gestational-age (LGA) birth, fetal distress, premature rupture of membranes, and neonatal intensive care unit (NICU) admission. The individual outcomes included in the primary outcome were considered as secondary outcomes. We conducted multivariable logistic regression to evaluate the association of CGM-derived metrics with these outcomes. Findings Per 1-SD difference in time above range (TAR), glucose area under the curve (AUC), nighttime mean blood glucose (MBG), daytime MBG, and daily MBG was associated with higher risk of any adverse pregnancy outcome, with odds ratio: 1.22 (95% CI 1.08-1.36), 1.22 (95% CI 1.09-1.37), 1.18 (95% CI 1.05-1.32), 1.21 (95% CI 1.07-1.35), and 1.22 (95% CI 1.09-1.37), respectively. Time in range, TAR, AUC, nighttime MBG, daytime MBG, daily MBG, and mean amplitude of glucose excursions were positively associated, while time blow range was inversely associated with the risk of LGA. Additionally, higher value for TAR was associated with higher risk of NICU admission. We further summarized the potential thresholds of TAR (2.5%) and daily MBG (4.8 mmol/L) to distinguish individuals with and without any adverse pregnancy outcome. Interpretation The CGM-derived metrics may help identify individuals at higher risk of adverse pregnancy outcomes. These CGM biomarkers could serve as potential new intervention targets to maintain a healthy pregnancy status among women with GDM. Funding National Key R&D Program of China, National Natural Science Foundation of China, and Westlake Laboratory of Life Sciences and Biomedicine.
Collapse
Affiliation(s)
- Xinxiu Liang
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
| | - Yuanqing Fu
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, China
| | - Sha Lu
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
- Department of Obstetrics and Gynecology, The Affiliated Hangzhou Women’s Hospital of Hangzhou Normal University, Hangzhou, China
| | - Menglei Shuai
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
| | - Zelei Miao
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, China
| | - Wanglong Gou
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, China
| | - Luqi Shen
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, China
| | - Yuhui Liang
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
| | - Fengzhe Xu
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
| | - Yunyi Tian
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
| | - Jiali Wang
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
| | - Ke Zhang
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
| | - Congmei Xiao
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
| | - Zengliang Jiang
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, China
| | - Mei-Qi Shi
- Department of Nutrition, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
| | - Ying-Ying Wu
- Department of Nursing, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
| | - Xu-Hong Wang
- Department of Nutrition, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
| | - Wen-Sheng Hu
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
- Department of Obstetrics and Gynecology, The Affiliated Hangzhou Women’s Hospital of Hangzhou Normal University, Hangzhou, China
| | - Ju-Sheng Zheng
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, China
| |
Collapse
|
10
|
Keuls RA, Finnell RH, Parchem RJ. Maternal metabolism influences neural tube closure. Trends Endocrinol Metab 2023; 34:539-553. [PMID: 37468429 PMCID: PMC10529122 DOI: 10.1016/j.tem.2023.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 07/21/2023]
Abstract
Changes in maternal nutrient availability due to diet or disease significantly increase the risk of neural tube defects (NTDs). Because the incidence of metabolic disease continues to rise, it is urgent that we better understand how altered maternal nutrient levels can influence embryonic neural tube development. Furthermore, primary neurulation occurs before placental function during a period of histiotrophic nutrient exchange. In this review we detail how maternal metabolites are transported by the yolk sac to the developing embryo. We discuss recent advances in understanding how altered maternal levels of essential nutrients disrupt development of the neuroepithelium, and identify points of intersection between metabolic pathways that are crucial for NTD prevention.
Collapse
Affiliation(s)
- Rachel A Keuls
- Development, Disease Models, and Therapeutics Graduate Program, Baylor College of Medicine. Houston, TX 77030, USA; Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA; Stem Cells and Regenerative Medicine Center, Baylor College of Medicine, Houston, TX 77030, USA; Department of Neuroscience, Baylor College of Medicine, Houston, TX 77030, USA
| | - Richard H Finnell
- Departments of Molecular and Human Genetics and Medicine, Baylor College of Medicine, Houston, TX 77030, USA; Center for Precision Environmental Health, Department of Molecular and Cellular Biology and Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Ronald J Parchem
- Development, Disease Models, and Therapeutics Graduate Program, Baylor College of Medicine. Houston, TX 77030, USA; Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA; Stem Cells and Regenerative Medicine Center, Baylor College of Medicine, Houston, TX 77030, USA; Department of Neuroscience, Baylor College of Medicine, Houston, TX 77030, USA.
| |
Collapse
|
11
|
Wilson RC, Lo JO, Romero Jimenez G, Lindner JR, Slayden OD, Roberts VHJ. Utilizing Contrast-Enhanced Ultrasonography with Phosphatidylserine Microbubbles to Detect Placental Inflammation in Rhesus Macaques. Molecules 2023; 28:2894. [PMID: 37049657 PMCID: PMC10096139 DOI: 10.3390/molecules28072894] [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: 02/03/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
The ability to comprehensively monitor physiological and detect pathophysiologic processes early during pregnancy can reduce maternal and fetal morbidity and mortality. Contrast-enhanced ultrasound (CEUS) is a non-invasive imaging technology that utilizes the acoustic detection of microbubbles to examine vascular spaces. Furthermore, microbubbles conjugated to specific compounds can focus studies on precise physiological pathways. We hypothesized that CEUS with phosphatidylserine microbubbles (MB-PS) could be employed to monitor placental inflammation. We tested this hypothesis in rhesus macaques (Macaca mulatta), a translational and relevant animal model of human placental health. As placental inflammation impacts many at-risk pregnancies, we performed CEUS with MB-PS in pregnant macaques fed a high-fat diet (e.g., a western-style diet, WSD) in the presence or absence of testosterone (T) to mimic the increased risk of polycystic ovary syndrome and subfertility. We have previously demonstrated a placental inflammation phenotype in this model, and, thus, we related the MB-PS CEUS signal intensity to placental inflammation markers: selectin p and angiopoietins. Testosterone exposure increased the MB-PS signal in the placental microcirculation on the maternal side compared to control animals. We found that T increased placental weight and decreased angiopoietin 2 (ANGPT2) immunoreactivity. Furthermore, a significant inverse correlation was found between MB-PS signal and ANGPT2. This indicated that CEUS with MB-PS can be used to monitor placental parameters. We propose that CEUS with MB-PS could aid in the identification of pregnancies at risk of placental vascular compromise.
Collapse
Affiliation(s)
- Rachel C. Wilson
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR 97006, USA
| | - Jamie O. Lo
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR 97239, USA
| | - Gabriel Romero Jimenez
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR 97006, USA
| | - Jonathan R. Lindner
- Cardiovascular Division, University of Virginia Medical Center, Charlottesville, VA 22903, USA
| | - Ov D. Slayden
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR 97006, USA
| | - Victoria H. J. Roberts
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR 97006, USA
| |
Collapse
|
12
|
Griffith JA, Dunn A, DeVallance E, Schafner KJ, Engles KJ, Batchelor TP, Goldsmith WT, Wix K, Hussain S, Bowdridge EC, Nurkiewicz TR. Maternal nano-titanium dioxide inhalation alters fetoplacental outcomes in a sexually dimorphic manner. FRONTIERS IN TOXICOLOGY 2023; 5:1096173. [PMID: 36950144 PMCID: PMC10025460 DOI: 10.3389/ftox.2023.1096173] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/16/2023] [Indexed: 03/08/2023] Open
Abstract
The placenta plays a critical role in nutrient-waste exchange between the maternal and fetal circulations, thus functioning as an interface that profoundly impacts fetal growth and development. The placenta has long been considered an asexual organ, but, due to its embryonic origin it shares the same sex as the fetus. Exposures to toxicant such as diesel exhaust, have been shown to result in sexually dimorphic outcomes like decreased placental mass in exposed females. Therefore, we hypothesize that maternal nano-TiO2 inhalation exposure during gestation alters placental hemodynamics in a sexually dimorphic manner. Pregnant Sprague-Dawley rats were exposed from gestational day 10-19 to nano-TiO2 aerosols (12.17 ± 1.69 mg/m3) or filtered air (sham-control). Dams were euthanized on GD20, and fetal tissue was collected based on fetal sex: whole placentas, placental junctional zone (JZ), and placental labyrinth zone (LZ). Fetal mass, placental mass, and placental zone percent areas were assessed for sex-based differences. Exposed fetal females were significantly smaller compared to their exposed male counterparts (2.65 ± 0.03 g vs 2.78 ± 0.04 g). Nano-TiO2 exposed fetal females had a significantly decreased percent junctional zone area compared to the sham-control females (24.37 ± 1.30% vs 30.39 ± 1.54%). The percent labyrinth zone area was significantly increased for nano-TiO2 females compared to sham-control females (75.63 ± 1.30% vs 69.61 ± 1.54%). Placental flow and hemodynamics were assessed with a variety of vasoactive substances. It was found that nano-TiO2 exposed fetal females only had a significant decrease in outflow pressure in the presence of the thromboxane (TXA2) mimetic, U46619, compared to sham-control fetal females (3.97 ± 1.30 mm Hg vs 9.10 ± 1.07 mm Hg) and nano-TiO2 fetal males (9.96 ± 0.66 mm Hg). Maternal nano-TiO2 inhalation exposure has a greater effect on fetal female mass, placental zone mass and area, and adversely impacts placental vasoreactivity. This may influence the female growth and development later in life, future studies need to further study the impact of maternal nano-TiO2 inhalation exposure on zone specific mechanisms.
Collapse
Affiliation(s)
- Julie A. Griffith
- Department of Physiology, Pharmacology, and Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Allison Dunn
- Department of Physiology, Pharmacology, and Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Evan DeVallance
- Department of Physiology, Pharmacology, and Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Kallie J. Schafner
- Department of Physiology, Pharmacology, and Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Kevin J. Engles
- Department of Physiology, Pharmacology, and Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Thomas P. Batchelor
- Department of Physiology, Pharmacology, and Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
| | - William T. Goldsmith
- Department of Physiology, Pharmacology, and Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Kimberley Wix
- Department of Physiology, Pharmacology, and Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Salik Hussain
- Department of Physiology, Pharmacology, and Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Elizabeth C. Bowdridge
- Department of Physiology, Pharmacology, and Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Timothy R. Nurkiewicz
- Department of Physiology, Pharmacology, and Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, United States
| |
Collapse
|
13
|
Kozai K, Moreno-Irusta A, Iqbal K, Winchester ML, Scott RL, Simon ME, Muto M, Parrish MR, Soares MJ. The AKT1-FOXO4 axis reciprocally regulates hemochorial placentation. Development 2023; 150:dev201095. [PMID: 36607602 PMCID: PMC10110493 DOI: 10.1242/dev.201095] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/21/2022] [Indexed: 01/07/2023]
Abstract
Hemochorial placentation involves the differentiation of invasive trophoblast cells, specialized cells that possess the capacity to exit the placenta and invade into the uterus where they restructure the vasculature. Invasive trophoblast cells arise from a well-defined compartment within the placenta, referred to as the junctional zone in rat and the extravillous trophoblast cell column in human. In this study, we investigated roles for AKT1, a serine/threonine kinase, in placental development using a genome-edited/loss-of-function rat model. Disruption of AKT1 resulted in placental, fetal and postnatal growth restriction. Forkhead box O4 (Foxo4), which encodes a transcription factor and known AKT substrate, was abundantly expressed in the junctional zone and in invasive trophoblast cells of the rat placentation site. Foxo4 gene disruption using genome editing resulted in placentomegaly, including an enlarged junctional zone. AKT1 and FOXO4 regulate the expression of many of the same transcripts expressed by trophoblast cells, but in opposite directions. In summary, we have identified AKT1 and FOXO4 as part of a regulatory network that reciprocally controls critical indices of hemochorial placenta development.
Collapse
Affiliation(s)
- Keisuke Kozai
- Institute for Reproductive and Developmental Sciences, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Ayelen Moreno-Irusta
- Institute for Reproductive and Developmental Sciences, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Khursheed Iqbal
- Institute for Reproductive and Developmental Sciences, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Mae-Lan Winchester
- Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Regan L. Scott
- Institute for Reproductive and Developmental Sciences, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Mikaela E. Simon
- Institute for Reproductive and Developmental Sciences, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Masanaga Muto
- Institute for Reproductive and Developmental Sciences, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Marc R. Parrish
- Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Michael J. Soares
- Institute for Reproductive and Developmental Sciences, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
- Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, KS 66160, USA
- Center for Perinatal Research, Children's Mercy Research Institute, Children's Mercy, Kansas City, MO 64108, USA
| |
Collapse
|
14
|
Zhu Y, Liu X, Xu Y, Lin Y. Hyperglycemia disturbs trophoblast functions and subsequently leads to failure of uterine spiral artery remodeling. Front Endocrinol (Lausanne) 2023; 14:1060253. [PMID: 37091848 PMCID: PMC10113679 DOI: 10.3389/fendo.2023.1060253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
Uterine spiral artery remodeling is necessary for fetal growth and development as well as pregnancy outcomes. During remodeling, trophoblasts invade the arteries, replace the endothelium and disrupt the vascular smooth muscle, and are strictly regulated by the local microenvironment. Elevated glucose levels at the fetal-maternal interface are associated with disorganized placental villi and poor placental blood flow. Hyperglycemia disturbs trophoblast proliferation and invasion via inhibiting the epithelial-mesenchymal transition, altering the protein expression of related proteases (MMP9, MMP2, and uPA) and angiogenic factors (VEGF, PIGF). Besides, hyperglycemia influences the cellular crosstalk between immune cells, trophoblast, and vascular cells, leading to the failure of spiral artery remodeling. This review provides insight into molecular mechanisms and signaling pathways of hyperglycemia that influence trophoblast functions and uterine spiral artery remodeling.
Collapse
Affiliation(s)
- Yueyue Zhu
- Reproductive Medicine Center, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China
| | - Xiaorui Liu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China
| | - Yichi Xu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China
| | - Yi Lin
- Reproductive Medicine Center, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Yi Lin,
| |
Collapse
|
15
|
Roberts DJ, Baergen RN, Boyd TK, Carreon CK, Duncan VE, Ernst LM, Faye-Petersen OM, Folkins AK, Hecht JL, Heerema-McKenney A, Heller DS, Linn RL, Polizzano C, Ravishankar S, Redline RW, Salafia CM, Torous VF, Castro EC. Criteria for placental examination for obstetrical and neonatal providers. Am J Obstet Gynecol 2022; 228:497-508.e4. [PMID: 36549567 DOI: 10.1016/j.ajog.2022.12.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/28/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
Pathologic examination of the placenta can provide insight into likely (and unlikely) causes of antepartum and intrapartum events, diagnoses with urgent clinical relevance, prognostic information for mother and infant, support for practice evaluation and improvement, and insight into advancing the sciences of obstetrics and neonatology. Although it is true that not all placentas require pathologic examination (although alternative opinions have been expressed), prioritization of placentas for pathologic examination should be based on vetted indications such as maternal comorbidities or pregnancy complications in which placental pathology is thought to be useful for maternal or infant care, understanding pathophysiology, or practice modifications. Herein we provide placental triage criteria for the obstetrical and neonatal provider based on publications and expert opinion of 16 placental pathologists and a pathologists' assistant, formulated using a modified Delphi approach. These criteria include indications in which placental pathology has clinical relevance, such as pregnancy loss, maternal infection, suspected abruption, fetal growth restriction, preterm birth, nonreassuring fetal heart testing requiring urgent delivery, preeclampsia with severe features, or neonates with early evidence of multiorgan system failure including neurologic compromise. We encourage a focused gross examination by the provider or an attendant at delivery for all placentas and provide guidance for this examination. We recommend that any placenta that is abnormal on gross examination undergo a complete pathology examination. In addition, we suggest practice criteria for placental pathology services, including a list of critical values to be used by the relevant provider. We hope that these sets of triage indications, criteria, and practice suggestions will facilitate appropriate submission of placentas for pathologic examination and improve its relevance to clinical care.
Collapse
Affiliation(s)
- Drucilla J Roberts
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX.
| | - Rebecca N Baergen
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Theonia K Boyd
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Chrystalle Katte Carreon
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Virginia E Duncan
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Linda M Ernst
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Ona M Faye-Petersen
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Ann K Folkins
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Jonathon L Hecht
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Amy Heerema-McKenney
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Debra S Heller
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Rebecca L Linn
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Carolyn Polizzano
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Sanjita Ravishankar
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Raymond W Redline
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Carolyn M Salafia
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Vanda F Torous
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| | - Eumenia C Castro
- Massachusetts General Hospital Department of Pathology and Harvard Medical School, Boston, MA; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY; Texas Children's Hospital Department of Pathology, Houston, TX; Boston's Children's Hospital Department of Pathology and Harvard Medical School, Boston, MA; University of Alabama at Birmingham Department of Pathology, Division of Women's Health, Birmingham, AL; NorthShore University Health System, Department of Pathology, Evanston, IL; Heersink School of Medicine, University of Alabama at Birmingham, Departments of Pathology and Obstetrics and Gynecology, Birmingham, AL; Stanford Healthcare Department of Pathology and Stanford University, Stanford, CA; Beth Israel Deaconess Medical Center Department of Pathology and Harvard Medical School, Boston, MA; Cleveland Clinic, Cleveland, OH; Rutgers-New Jersey Medical School, Newark, NJ; Children's Hospital of Philadelphia, Department of Pathology, Philadelphia, PA; MidState Medical Center Department of Pathology, Meriden, CT; Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center Department of Pathology, Cleveland, OH; Case Western Reserve University School of Medicine Departments of Pathology and Reproductive Biology and University Hospitals Cleveland Medical Center, Cleveland, OH; Placental Analytics LLC, New Rochelle, NY; Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, TX
| |
Collapse
|
16
|
Shukla V, Soares MJ. Modeling Trophoblast Cell-Guided Uterine Spiral Artery Transformation in the Rat. Int J Mol Sci 2022; 23:ijms23062947. [PMID: 35328368 PMCID: PMC8950824 DOI: 10.3390/ijms23062947] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 12/20/2022] Open
Abstract
The rat possesses hemochorial placentation with deep intrauterine trophoblast cell invasion and trophoblast-guided uterine spiral artery remodeling, which resembles human placentation. Uterine spiral arteries are extensively remodeled to deliver sufficient supply of maternal blood and nutrients to the developing fetus. Inadequacies in these key processes negatively impact fetal growth and development. Recent innovations in genome editing combined with effective phenotyping strategies have provided new insights into placental development. Application of these research approaches has highlighted both conserved and species-specific features of hemochorial placentation. The review provides foundational information on rat hemochorial placental development and function during physiological and pathological states, especially as related to the invasive trophoblast cell-guided transformation of uterine spiral arteries. Our goal is to showcase the utility of the rat as a model for in vivo mechanistic investigations targeting regulatory events within the uterine-placental interface.
Collapse
Affiliation(s)
- Vinay Shukla
- Institute for Reproduction and Perinatal Research, Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
- Correspondence: (V.S.); (M.J.S.)
| | - Michael J. Soares
- Institute for Reproduction and Perinatal Research, Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
- Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, KS 66160, USA
- Center for Perinatal Research, Children’s Mercy Research Institute, Children’s Mercy, Kansas City, MO 64108, USA
- Correspondence: (V.S.); (M.J.S.)
| |
Collapse
|
17
|
Roberts H, Woodman AG, Baines KJ, Jeyarajah MJ, Bourque SL, Renaud SJ. Maternal Iron Deficiency Alters Trophoblast Differentiation and Placental Development in Rat Pregnancy. Endocrinology 2021; 162:6396887. [PMID: 34647996 PMCID: PMC8559528 DOI: 10.1210/endocr/bqab215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Indexed: 02/06/2023]
Abstract
Iron deficiency, which occurs when iron demands chronically exceed intake, is prevalent in pregnant women. Iron deficiency during pregnancy poses major risks for the baby, including fetal growth restriction and long-term health complications. The placenta serves as the interface between a pregnant mother and her baby, and it ensures adequate nutrient provisions for the fetus. Thus, maternal iron deficiency may impact fetal growth and development by altering placental function. We used a rat model of diet-induced iron deficiency to investigate changes in placental growth and development. Pregnant Sprague-Dawley rats were fed either a low-iron or iron-replete diet starting 2 weeks before mating. Compared with controls, both maternal and fetal hemoglobin were reduced in dams fed low-iron diets. Iron deficiency decreased fetal liver and body weight, but not brain, heart, or kidney weight. Placental weight was increased in iron deficiency, due primarily to expansion of the placental junctional zone. The stimulatory effect of iron deficiency on junctional zone development was recapitulated in vitro, as exposure of rat trophoblast stem cells to the iron chelator deferoxamine increased differentiation toward junctional zone trophoblast subtypes. Gene expression analysis revealed 464 transcripts changed at least 1.5-fold (P < 0.05) in placentas from iron-deficient dams, including altered expression of genes associated with oxygen transport and lipoprotein metabolism. Expression of genes associated with iron homeostasis was unchanged despite differences in levels of their encoded proteins. Our findings reveal robust changes in placentation during maternal iron deficiency, which could contribute to the increased risk of fetal distress in these pregnancies.
Collapse
Affiliation(s)
- Hannah Roberts
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, N6A5C1, Canada
| | - Andrew G Woodman
- Department of Anesthesiology & Pain Medicine, University of Alberta, Edmonton, Alberta, T6G2E1, Canada
- Department of Pharmacology, University of Alberta, Edmonton, Alberta, T6G2E1, Canada
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, T6G2E1, Canada
| | - Kelly J Baines
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, N6A5C1, Canada
| | - Mariyan J Jeyarajah
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, N6A5C1, Canada
| | - Stephane L Bourque
- Department of Anesthesiology & Pain Medicine, University of Alberta, Edmonton, Alberta, T6G2E1, Canada
- Department of Pharmacology, University of Alberta, Edmonton, Alberta, T6G2E1, Canada
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, T6G2E1, Canada
| | - Stephen J Renaud
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, N6A5C1, Canada
- Children’s Health Research Institute, Lawson Health Research Institute, London, Ontario, N6C2V5, Canada
- Correspondence: Stephen J. Renaud, PhD, Department of Anatomy and Cell Biology, University of Western Ontario, 1151 Richmond St, London, Ontario, Canada N6A5C1.
| |
Collapse
|
18
|
Ballasy NN, Jadli AS, Edalat P, Kang S, Fatehi Hassanabad A, Gomes KP, Fedak PWM, Patel VB. Potential role of epicardial adipose tissue in coronary artery endothelial cell dysfunction in type 2 diabetes. FASEB J 2021; 35:e21878. [PMID: 34469050 DOI: 10.1096/fj.202100684rr] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/11/2022]
Abstract
Cardiovascular disease is the most prevalent cause of morbidity and mortality in diabetes. Epicardial adipose tissue (EAT) lies in direct contact with the myocardium and coronary arteries and can influence cardiac (patho) physiology through paracrine signaling pathways. This study hypothesized that the proteins released from EAT represent a critical molecular link between the diabetic state and coronary artery endothelial cell dysfunction. To simulate type 2 diabetes-associated metabolic and inflammatory status in an ex vivo tissue culture model, human EAT samples were treated with a cocktail composed of high glucose, high palmitate, and lipopolysaccharide (gplEAT) and were compared with control EAT (conEAT). Compared to conEAT, gplEAT showed a markedly increased gene expression profile of proinflammatory cytokines, corroborating EAT inflammation, a hallmark feature observed in patients with type 2 diabetes. Luminex assay of EAT-secretome identified increased release of various proinflammatory cytokines, including tumor necrosis factor-alpha (TNF-alpha), interferon-alpha 2 (IFNA2), interleukin 1 beta (IL1B), interleukin 5 (IL5), interleukin 13 (IL13), and CCL5, among others, in response to high glucose, high palmitate, and lipopolysaccharide. Conditioned culture media was used to collect the concentrated proteins (CPs). In response to gplEAT-CPs, human coronary artery endothelial cells (HCAECs) exhibited an inflammatory endothelial cell phenotype, featuring a significantly increased gene expression of proinflammatory cytokines and cell surface expression of VCAM-1. Moreover, gplEAT-CPs severely decreased Akt-eNOS signaling, nitric oxide production, and angiogenic potential of HCAECs, when compared with conEAT-CPs. These findings indicate that EAT inflammation may play a key role in coronary artery endothelial cell dysfunction in type 2 diabetes.
Collapse
Affiliation(s)
- Noura N Ballasy
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Anshul S Jadli
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Pariya Edalat
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Sean Kang
- Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.,Section of Cardiac Surgery, Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ali Fatehi Hassanabad
- Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.,Section of Cardiac Surgery, Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Karina P Gomes
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Paul W M Fedak
- Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.,Section of Cardiac Surgery, Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Vaibhav B Patel
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
19
|
ASCL2 reciprocally controls key trophoblast lineage decisions during hemochorial placenta development. Proc Natl Acad Sci U S A 2021; 118:2016517118. [PMID: 33649217 DOI: 10.1073/pnas.2016517118] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Invasive trophoblast cells are critical to spiral artery remodeling in hemochorial placentation. Insufficient trophoblast cell invasion and vascular remodeling can lead to pregnancy disorders including preeclampsia, preterm birth, and intrauterine growth restriction. Previous studies in mice identified achaete-scute homolog 2 (ASCL2) as essential to extraembryonic development. We hypothesized that ASCL2 is a critical and conserved regulator of invasive trophoblast cell lineage development. In contrast to the mouse, the rat possesses deep intrauterine trophoblast cell invasion and spiral artery remodeling similar to human placentation. In this study, we investigated invasive/extravillous trophoblast (EVT) cell differentiation using human trophoblast stem (TS) cells and a loss-of-function mutant Ascl2 rat model. ASCL2 transcripts are expressed in the EVT column and junctional zone, which represent tissue sources of invasive trophoblast progenitor cells within human and rat placentation sites, respectively. Differentiation of human TS cells into EVT cells resulted in significant up-regulation of ASCL2 and several other transcripts indicative of EVT cell differentiation. Disruption of ASCL2 impaired EVT cell differentiation, as indicated by cell morphology and transcript profiles. RNA sequencing analysis of ASCL2-deficient trophoblast cells identified both down-regulation of EVT cell-associated transcripts and up-regulation of syncytiotrophoblast-associated transcripts, indicative of dual activating and repressing functions. ASCL2 deficiency in the rat impacted placental morphogenesis, resulting in junctional zone dysgenesis and failed intrauterine trophoblast cell invasion. ASCL2 acts as a critical and conserved regulator of invasive trophoblast cell lineage development and a modulator of the syncytiotrophoblast lineage.
Collapse
|
20
|
Kozai K, Iqbal K, Moreno-Irusta A, Scott RL, Simon ME, Dhakal P, Fields PE, Soares MJ. Protective role of IL33 signaling in negative pregnancy outcomes associated with lipopolysaccharide exposure. FASEB J 2021; 35:e21272. [PMID: 33423320 DOI: 10.1096/fj.202001782rr] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/15/2020] [Accepted: 11/30/2020] [Indexed: 01/21/2023]
Abstract
Interleukin 33 (IL33) signaling has been implicated in the establishment and maintenance of pregnancy and in pregnancy disorders. The goal of this project was to evaluate the role of IL33 signaling in rat pregnancy. The rat possesses hemochorial placentation with deep intrauterine trophoblast invasion; features also characteristic of human placentation. We generated and characterized a germline mutant rat model for IL33 using CRISPR/Cas9 genome editing. IL33 deficient rats exhibited deficits in lung responses to an inflammatory stimulus (Sephadex G-200) and to estrogen-induced uterine eosinophilia. Female rats deficient in IL33 were fertile and exhibited pregnancy outcomes (gestation length and litter size) similar to wild-type rats. Placental weight was adversely affected by the disruption of IL33 signaling. A difference in pregnancy-dependent adaptations to lipopolysaccharide (LPS) exposure was observed between wild-type and IL33 deficient pregnancies. Pregnancy in wild-type rats treated with LPS did not differ significantly from pregnancy in vehicle-treated wild-type rats. In contrast, LPS treatment decreased fetal survival rate, fetal and placental weights, and increased fetal growth restriction in IL33 deficient rats. In summary, a new rat model for investigating IL33 signaling has been established. IL33 signaling participates in the regulation of placental development and protection against LPS-induced fetal and placental growth restriction.
Collapse
Affiliation(s)
- Keisuke Kozai
- Institute for Reproduction and Perinatal Research, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas, KS, USA
| | - Khursheed Iqbal
- Institute for Reproduction and Perinatal Research, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas, KS, USA
| | - Ayelen Moreno-Irusta
- Institute for Reproduction and Perinatal Research, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas, KS, USA
| | - Regan L Scott
- Institute for Reproduction and Perinatal Research, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas, KS, USA
| | - Mikaela E Simon
- Institute for Reproduction and Perinatal Research, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas, KS, USA
| | - Pramod Dhakal
- Institute for Reproduction and Perinatal Research, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas, KS, USA
| | - Patrick E Fields
- Institute for Reproduction and Perinatal Research, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas, KS, USA
| | - Michael J Soares
- Institute for Reproduction and Perinatal Research, Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas, KS, USA.,Department of Pediatrics, University of Kansas Medical Center, Kansas, KS, USA.,Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas, KS, USA.,Center for Perinatal Research, Children's Mercy Research Institute, Children's Mercy, Kansas, MO, USA
| |
Collapse
|
21
|
Tumminia A, Scalisi NM, Milluzzo A, Ettore G, Vigneri R, Sciacca L. Maternal Diabetes Impairs Insulin and IGF-1 Receptor Expression and Signaling in Human Placenta. Front Endocrinol (Lausanne) 2021; 12:621680. [PMID: 33776919 PMCID: PMC7988311 DOI: 10.3389/fendo.2021.621680] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/26/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Maternal high blood glucose during pregnancy increases the risk for both maternal and fetal adverse outcomes. The mechanisms underlying the regulator effects of hyperglycemia on placental development and growth have not been fully illustrated yet. The placenta expresses high amounts of both insulin receptor (IR) and insulin-like growth factor receptor (IGF-1R). It has been reported that the placenta of diabetic women has structural and functional alterations and the insulin/IGF system is likely to play a role in these changes. The aim of the present study was to measure the content of IR and IGF-1R and their phosphorylation in the placenta of women with type 1 diabetes mellitus (T1D) or with gestational diabetes mellitus (GDM) compared to women with normal glucose tolerance (NGT) during pregnancy. METHODS Placental tissues were obtained from 80 Caucasian women with a singleton pregnancy. In particular, we collected placenta samples from 20 T1D patients, 20 GDM patients and 40 NGT women during pregnancy. Clinical characteristics and anthropometric measures of all women as well as delivery and newborn characteristics were recorded. Patients were also subdivided on the basis of peripartum glycemia either ≥90 mg/dl or <90 mg/dl, regardless of the diagnosis. RESULTS In T1D patients, a higher rate of adverse outcomes was observed. Compared to the GDM women, the T1D group showed significantly higher average capillary blood glucose levels at the third trimester of pregnancy and at peripartum, and higher third-trimester HbA1c values. In both T1D and GDM women, HbA1c values during pregnancy correlated with glucose values in the peripartum period (R-squared 0.14, p=0.02). A positive correlation was observed between phosphorylation of placental IR and the glucose levels during the third trimester of GDM and T1D pregnancy (R-squared 0.21, p=0.003). In the placenta of T1D patients, IGF-1R phosphorylation and IR isoform A (IR-A) expression were significantly increased (p=0.006 and p=0.040, respectively), compared to the NGT women. Moreover, IGF-1R phosphorylation was significantly increased (p<0.0001) in the placenta of patients with peripartum glucose >90 mg/dl, while IR-A expression was increased in those with peripartum blood glucose higher than 120 mg/dl (p=0.046). CONCLUSIONS To the best of our knowledge, our study represents the first one in which an increased maternal blood glucose level during pregnancy is associated with an increased IGF-1R phosphorylation and IR-A expression in the placenta. Both these mechanisms can promote an excessive fetal growth.
Collapse
Affiliation(s)
- Andrea Tumminia
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania Medical School, Catania, Italy
| | - Nunzio M. Scalisi
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania Medical School, Catania, Italy
| | - Agostino Milluzzo
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania Medical School, Catania, Italy
| | - Giuseppe Ettore
- Obstetrics and Gynecology Unit, Azienda di Rilievo Nazionale e di Alta Specializzazione (ARNAS) Garibaldi, Catania, Italy
| | - Riccardo Vigneri
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania Medical School, Catania, Italy
- Catania Section, Institute of Crystallography, National Research Council, CNR, Catania, Italy
| | - Laura Sciacca
- Endocrinology, Department of Clinical and Experimental Medicine, University of Catania Medical School, Catania, Italy
- *Correspondence: Laura Sciacca,
| |
Collapse
|