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Song R, Baker TL, Watters JJ, Kumar S. Obstructive Sleep Apnea-Associated Intermittent Hypoxia-Induced Immune Responses in Males, Pregnancies, and Offspring. Int J Mol Sci 2024; 25:1852. [PMID: 38339130 PMCID: PMC10856042 DOI: 10.3390/ijms25031852] [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: 12/27/2023] [Revised: 01/22/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
Obstructive sleep apnea (OSA), a respiratory sleep disorder associated with cardiovascular diseases, is more prevalent in men. However, OSA occurrence in pregnant women rises to a level comparable to men during late gestation, creating persistent effects on both maternal and offspring health. The exact mechanisms behind OSA-induced cardiovascular diseases remain unclear, but inflammation and oxidative stress play a key role. Animal models using intermittent hypoxia (IH), a hallmark of OSA, reveal several pro-inflammatory signaling pathways at play in males, such as TLR4/MyD88/NF-κB/MAPK, miRNA/NLRP3, and COX signaling, along with shifts in immune cell populations and function. Limited evidence suggests similarities in pregnancies and offspring. In addition, suppressing these inflammatory molecules ameliorates IH-induced inflammation and tissue injury, providing new potential targets to treat OSA-associated cardiovascular diseases. This review will focus on the inflammatory mechanisms linking IH to cardiovascular dysfunction in males, pregnancies, and their offspring. The goal is to inspire further investigations into the understudied populations of pregnant females and their offspring, which ultimately uncover underlying mechanisms and therapeutic interventions for OSA-associated diseases.
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Affiliation(s)
- Ruolin Song
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA; (R.S.); (T.L.B.); (J.J.W.)
| | - Tracy L. Baker
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA; (R.S.); (T.L.B.); (J.J.W.)
| | - Jyoti J. Watters
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA; (R.S.); (T.L.B.); (J.J.W.)
| | - Sathish Kumar
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA; (R.S.); (T.L.B.); (J.J.W.)
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53792, USA
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Wang R, Feng W, Wang Y, Jiang Y, Lin Y, Chen X. Maternal obstructive sleep apnea aggravates metabolic dysfunction-associated fatty liver disease via HMGB1-TLR4 signaling-mediated endoplasmic reticulum stress in male offspring rats. Biochim Biophys Acta Mol Basis Dis 2024; 1870:166889. [PMID: 37730152 DOI: 10.1016/j.bbadis.2023.166889] [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: 07/03/2023] [Revised: 09/09/2023] [Accepted: 09/15/2023] [Indexed: 09/22/2023]
Abstract
AIMS/HYPOTHESIS Maternal obstructive sleep apnea (MOSA) may inflict long-term metabolic effects on offspring. We hypothesize that MOSA increases the propensity for metabolic dysregulation in offspring and thus facilitates the development of metabolic dysfunction-associated fatty liver disease (MAFLD). This study aims to test the hypothesis and explore the underlying mechanism. METHODS The MOSA rat model of upper airway obstruction was established and fecundated. The postweaning male offspring (n = 171) from both the control group and MOSA group were randomly fed the normal chow diet (NCD, n = 89) or high-fat diet (HFD, n = 82) for the next 5 months. Liver function, lipid profile, glucose, and insulin levels were measured. Expression levels of fibrosis-related proteins and endoplasmic reticulum (ER) stress-related proteins in liver tissues were assessed using immunohistochemistry and western blotting. RESULTS MOSA increased body and liver weight in male offspring, along with augmented liver organ coefficient. Serum levels of aminotransferases, low-density lipoprotein, high-density lipoprotein, triglycerides, total cholesterol, total bile acid, fasting glucose, and insulin increased significantly. MOSA exacerbated HFD-induced hepatic steatosis and fibrosis. These effects were driven by the overactivated double-stranded RNA-activated protein kinase (PKR)-like eukaryotic initiation factor 2(PERK)-activating transcription factor (ATF)4-C/EBP homologous protein (CHOP) signaling pathway-induced ER stress, and hyperacetylation and release of high mobility group box-1(HMGB1) elicited above signaling in a TLR4-dependent manner. CONCLUSIONS These findings indicate that MOSA can exert prolonged adverse effects manifested as metabolic dysfunction in male offspring. Therefore, surveillance and management of OSA during pregnancy may be necessary to prevent and alleviate MAFLD in offspring.
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Affiliation(s)
- Ruhua Wang
- Department of Gastroenterology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China
| | - Wei Feng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangdong Key Laboratory of Vascular Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510180, China
| | - Yan Wang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Yonghong Jiang
- Department of Gastroenterology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China
| | - Yiguang Lin
- Central Laboratory, Fist Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510080, China..
| | - Xueqing Chen
- Department of Gastroenterology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China.
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3
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Grajczyk A, Dżaman K, Czerwaty K, Kasperczak M, Zgliczyńska M, Stępień A, Kosińska-Kaczyńska K. A Relation between Obstructive Sleep Apnea in Pregnancy and Delivering Small for Gestational Age Infant-A Systematic Review. J Clin Med 2023; 12:5972. [PMID: 37762913 PMCID: PMC10532405 DOI: 10.3390/jcm12185972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/15/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Obstructive sleep apnea (OSA) during pregnancy can negatively affect both the mother and the baby. Our main goal is to show whether there is an association between OSA during pregnancy and delivering small for gestational age (SGA) infants. This systematic review was conducted according to the PRISMA 2020 statement using three databases: MEDLINE via PubMed, Scopus, and Cochrane Library. All databases were last accessed on 1 June 2023. The implemented systematic literature search identified 744 articles. After excluding reviews, meta-analyses, book chapters, case reports, and letters, 47 studies were analyzed, 18 of which finally met the inclusion criteria. The included studies mainly indicate that OSA during pregnancy may not significantly impact SGA, but some of them have shown the existence of this relation. Nevertheless, it is recommended that all pregnant women should be screened for symptoms of OSA and that sleep tests should be performed on those who show signs of it. Detecting and treating OSA early in pregnancy can help reduce the condition's negative effects. However, more extensive studies are still needed to gather clear evidence on the impact of an OSA diagnosis on mothers and babies.
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Affiliation(s)
- Alicja Grajczyk
- Department of Otolaryngology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland; (A.G.); (K.C.); (A.S.)
| | - Karolina Dżaman
- Department of Otolaryngology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland; (A.G.); (K.C.); (A.S.)
| | - Katarzyna Czerwaty
- Department of Otolaryngology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland; (A.G.); (K.C.); (A.S.)
| | - Monika Kasperczak
- Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland; (M.K.); (M.Z.)
| | - Magdalena Zgliczyńska
- Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland; (M.K.); (M.Z.)
| | - Anna Stępień
- Department of Otolaryngology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland; (A.G.); (K.C.); (A.S.)
| | - Katarzyna Kosińska-Kaczyńska
- Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland; (M.K.); (M.Z.)
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Valverde-Pérez E, Prieto-Lloret J, Gonzalez-Obeso E, Cabero MI, Nieto ML, Pablos MI, Obeso A, Gomez-Niño A, Cárdaba-García RM, Rocher A, Olea E. Effects of Gestational Intermittent Hypoxia on Placental Morphology and Fetal Development in a Murine Model of Sleep Apnea. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1427:73-81. [PMID: 37322337 DOI: 10.1007/978-3-031-32371-3_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Obstructive sleep apnea (OSA) during pregnancy is characterized by episodes of intermittent hypoxia (IH) during sleep, resulting in adverse health outcomes for mother and offspring. Despite a prevalence of 8-20% in pregnant women, this disorder is often underdiagnosed.We have developed a murine model of gestational OSA to study IH effects on pregnant mothers, placentas, fetuses, and offspring. One group of pregnant rats was exposed to IH during the last 2 weeks of gestation (GIH). One day before the delivery date, a cesarean section was performed. Other group of pregnant rats was allowed to give birth at term to study offspring's evolution.Preliminary results showed no significant weight differences in mothers and fetuses. However, the weight of GIH male offspring was significantly lower than the controls at 14 days (p < 0.01). The morphological study of the placentas showed an increase in fetal capillary branching, expansion of maternal blood spaces, and number of cells of the external trophectoderm in the tissues from GIH-exposed mothers. Additionally, the placentas from the experimental males were enlarged (p < 0.05). Further studies are needed to follow the long-term evolution of these changes to relate the histological findings of the placentas with functional development of the offspring in adulthood.
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Affiliation(s)
- Esther Valverde-Pérez
- Departamento de Bioquímica y Biología Molecular y Fisiología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
- Instituto de Biomedicina y Genética Molecular (IBGM), UVa-CSIC, Valladolid, Spain
| | - Jesús Prieto-Lloret
- Departamento de Bioquímica y Biología Molecular y Fisiología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
- Instituto de Biomedicina y Genética Molecular (IBGM), UVa-CSIC, Valladolid, Spain
| | - Elvira Gonzalez-Obeso
- Instituto de Biomedicina y Genética Molecular (IBGM), UVa-CSIC, Valladolid, Spain
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María I Cabero
- Instituto de Biomedicina y Genética Molecular (IBGM), UVa-CSIC, Valladolid, Spain
| | - Maria L Nieto
- Instituto de Biomedicina y Genética Molecular (IBGM), UVa-CSIC, Valladolid, Spain
| | - Marta I Pablos
- Departamento de Bioquímica y Biología Molecular y Fisiología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
| | - Ana Obeso
- Departamento de Bioquímica y Biología Molecular y Fisiología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
- Instituto de Biomedicina y Genética Molecular (IBGM), UVa-CSIC, Valladolid, Spain
| | - Angela Gomez-Niño
- Instituto de Biomedicina y Genética Molecular (IBGM), UVa-CSIC, Valladolid, Spain
- Departamento de Biología Celular, Genética, Histología y Farmacología, Universidad de Valladolid, Valladolid, Spain
| | - Rosa M Cárdaba-García
- Departamento de Enfermería, Grupo de Investigación en Cuidados Enfermeros (GICE), Facultad de Enfermeria, Universidad de Valladolid, Valladolid, Spain
| | - Asunción Rocher
- Departamento de Bioquímica y Biología Molecular y Fisiología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
- Instituto de Biomedicina y Genética Molecular (IBGM), UVa-CSIC, Valladolid, Spain
| | - Elena Olea
- Instituto de Biomedicina y Genética Molecular (IBGM), UVa-CSIC, Valladolid, Spain.
- Departamento de Enfermería, Grupo de Investigación en Cuidados Enfermeros (GICE), Facultad de Enfermeria, Universidad de Valladolid, Valladolid, Spain.
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Farré R, Almendros I, Martínez-García MÁ, Gozal D. Experimental Models to Study End-Organ Morbidity in Sleep Apnea: Lessons Learned and Future Directions. Int J Mol Sci 2022; 23:ijms232214430. [PMID: 36430904 PMCID: PMC9696027 DOI: 10.3390/ijms232214430] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/22/2022] Open
Abstract
Sleep apnea (SA) is a very prevalent sleep breathing disorder mainly characterized by intermittent hypoxemia and sleep fragmentation, with ensuing systemic inflammation, oxidative stress, and immune deregulation. These perturbations promote the risk of end-organ morbidity, such that SA patients are at increased risk of cardiovascular, neurocognitive, metabolic and malignant disorders. Investigating the potential mechanisms underlying SA-induced end-organ dysfunction requires the use of comprehensive experimental models at the cell, animal and human levels. This review is primarily focused on the experimental models employed to date in the study of the consequences of SA and tackles 3 different approaches. First, cell culture systems whereby controlled patterns of intermittent hypoxia cycling fast enough to mimic the rates of episodic hypoxemia experienced by patients with SA. Second, animal models consisting of implementing realistic upper airway obstruction patterns, intermittent hypoxia, or sleep fragmentation such as to reproduce the noxious events characterizing SA. Finally, human SA models, which consist either in subjecting healthy volunteers to intermittent hypoxia or sleep fragmentation, or alternatively applying oxygen supplementation or temporary nasal pressure therapy withdrawal to SA patients. The advantages, limitations, and potential improvements of these models along with some of their pertinent findings are reviewed.
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Affiliation(s)
- Ramon Farré
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain
- CIBER de Enfermedades Respiratorias, 1964603 Madrid, Spain
- Institut Investigacions Biomediques August Pi Sunyer, 08036 Barcelona, Spain
- Correspondence: (R.F.); (D.G.)
| | - Isaac Almendros
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain
- CIBER de Enfermedades Respiratorias, 1964603 Madrid, Spain
- Institut Investigacions Biomediques August Pi Sunyer, 08036 Barcelona, Spain
| | - Miguel-Ángel Martínez-García
- CIBER de Enfermedades Respiratorias, 1964603 Madrid, Spain
- Pneumology Department, University and Polytechnic La Fe Hospital, 46026 Valencia, Spain
| | - David Gozal
- Department of Child Health and Child Health Research Institute, School of Medicine, The University of Missouri, Columbia, MO 65201, USA
- Correspondence: (R.F.); (D.G.)
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6
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Wilson EN, Mabry S, Bradshaw JL, Gardner JJ, Rybalchenko N, Engelland R, Fadeyibi O, Osikoya O, Cushen SC, Goulopoulou S, Cunningham RL. Gestational hypoxia in late pregnancy differentially programs subcortical brain maturation in male and female rat offspring. Biol Sex Differ 2022; 13:54. [PMID: 36175941 PMCID: PMC9524087 DOI: 10.1186/s13293-022-00463-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/22/2022] [Indexed: 11/23/2022] Open
Abstract
Background Hypoxia is associated with pregnancy complications, such as preeclampsia, placental abruption, and gestational sleep apnea. Hypoxic insults during gestation can impact the brain maturation of cortical and subcortical pathways, such as the nigrostriatal pathway. However, the long-term effects of in utero hypoxic stress exposure on brain maturation in offspring are unclear, especially exposure during late gestation. The purpose of this study was to determine the impact of gestational hypoxia in late pregnancy on developmental programming of subcortical brain maturation by focusing on the nigrostriatal pathway. Methods Timed pregnant Long–Evans rats were exposed to chronic intermittent hypoxia or room air normoxia from gestational day (GD) 15–19 (term 22–23 days). Male and female offspring were assessed during two critical periods: puberty from postnatal day (PND) 40–45 or young adulthood (PND 60–65). Brain maturation was quantified by examining (1) the structural development of the nigrostriatal pathway via analysis of locomotor behaviors and the substantia nigra dopaminergic neuronal cell bodies and (2) the refinement of the nigrostriatal pathway by quantifying ultrasonic vocalizations (USVs). Results The major findings of this study are gestational hypoxia has age- and sex-dependent effects on subcortical brain maturation in offspring by adversely impacting the refinement of the nigrostriatal pathway in the absence of any effects on the structural development of the pathway. During puberty, female offspring were impacted more than male offspring, as evidenced by decreased USV call frequency, chirp USV call duration, and simple call frequency. In contrast, male offspring were impacted more than female offspring during young adulthood, as evidenced by increased latency to first USV, decreased simple USV call intensity, and increased harmonic USV call bandwidth. No effects of gestational hypoxia on the structural development of the nigrostriatal pathway were observed. Conclusions These novel findings demonstrate hypoxic insults during pregnancy mediate developmental programming of the cortical and subcortical pathways, in which male offspring exhibit long-term adverse effects compared to female offspring. Impairment of cortical and subcortical pathways maturation, such as the nigrostriatal pathway, may increase risk for neuropsychiatric disorders (e.g., mood disorders, cognitive dysfunction, brain connectivity dysfunction). Supplementary Information The online version contains supplementary material available at 10.1186/s13293-022-00463-x. Brain maturation of the nigrostriatal pathway is sex- and age- dependent. Exposure to hypoxia in late pregnancy impacts brain maturation of the nigrostriatal pathway that can be observed during puberty and young adulthood. Gestational hypoxia impacted female offspring during puberty more than males, whereas it impacted male offspring during young adulthood more than females. These novel findings demonstrate that hypoxic insults during pregnancy mediate developmental programming of the cortical and subcortical pathways, in which male offspring exhibit long-term adverse effects compared to female offspring. Long-term adverse effects of gestational hypoxia in offspring can occur in the absence of pregnancy complications, especially if they occur within critical embryological developmental periods.
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Affiliation(s)
- E Nicole Wilson
- Department of Pharmaceutical Sciences, UNT System College of Pharmacy, School of Pharmacy, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA
| | - Steve Mabry
- Department of Pharmaceutical Sciences, UNT System College of Pharmacy, School of Pharmacy, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA
| | - Jessica L Bradshaw
- Department of Pharmaceutical Sciences, UNT System College of Pharmacy, School of Pharmacy, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA
| | - Jennifer J Gardner
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, 76107, USA.,Department of Pharmaceutical Sciences, UNT System College of Pharmacy, School of Pharmacy, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA
| | - Nataliya Rybalchenko
- Department of Pharmaceutical Sciences, UNT System College of Pharmacy, School of Pharmacy, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA
| | - Rachel Engelland
- Department of Pharmaceutical Sciences, UNT System College of Pharmacy, School of Pharmacy, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA
| | - Oluwadarasimi Fadeyibi
- Department of Pharmaceutical Sciences, UNT System College of Pharmacy, School of Pharmacy, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA
| | - Oluwatobiloba Osikoya
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, 76107, USA
| | - Spencer C Cushen
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, 76107, USA.,Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, 76107, USA
| | - Styliani Goulopoulou
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, 76107, USA.,Department of Basic Sciences, Lawrence D. Longo, MD Center for Perinatal Biology, Loma Linda University School of Medicine, Loma Linda, CA, 92350, USA
| | - Rebecca L Cunningham
- Department of Pharmaceutical Sciences, UNT System College of Pharmacy, School of Pharmacy, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA.
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7
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Prenatal Hypoxia Affects Foetal Cardiovascular Regulatory Mechanisms in a Sex- and Circadian-Dependent Manner: A Review. Int J Mol Sci 2022; 23:ijms23052885. [PMID: 35270026 PMCID: PMC8910900 DOI: 10.3390/ijms23052885] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 02/28/2022] [Accepted: 03/05/2022] [Indexed: 11/17/2022] Open
Abstract
Prenatal hypoxia during the prenatal period can interfere with the developmental trajectory and lead to developing hypertension in adulthood. Prenatal hypoxia is often associated with intrauterine growth restriction that interferes with metabolism and can lead to multilevel changes. Therefore, we analysed the effects of prenatal hypoxia predominantly not associated with intrauterine growth restriction using publications up to September 2021. We focused on: (1) The response of cardiovascular regulatory mechanisms, such as the chemoreflex, adenosine, nitric oxide, and angiotensin II on prenatal hypoxia. (2) The role of the placenta in causing and attenuating the effects of hypoxia. (3) Environmental conditions and the mother's health contribution to the development of prenatal hypoxia. (4) The sex-dependent effects of prenatal hypoxia on cardiovascular regulatory mechanisms and the connection between hypoxia-inducible factors and circadian variability. We identified that the possible relationship between the effects of prenatal hypoxia on the cardiovascular regulatory mechanism may vary depending on circadian variability and phase of the days. In summary, even short-term prenatal hypoxia significantly affects cardiovascular regulatory mechanisms and programs hypertension in adulthood, while prenatal programming effects are not only dependent on the critical period, and sensitivity can change within circadian oscillations.
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Johns EC, Halligan DL, Tammsalu T, Hill EA, Riha RL, Denison FC, Reynolds RM. Gene expression profiling of placentae from obese women with obstructive sleep apnoea. Placenta 2022; 121:53-60. [DOI: 10.1016/j.placenta.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/26/2022] [Accepted: 03/01/2022] [Indexed: 11/15/2022]
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9
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Vanderplow AM, Kermath BA, Bernhardt CR, Gums KT, Seablom EN, Radcliff AB, Ewald AC, Jones MV, Baker TL, Watters JJ, Cahill ME. A feature of maternal sleep apnea during gestation causes autism-relevant neuronal and behavioral phenotypes in offspring. PLoS Biol 2022; 20:e3001502. [PMID: 35113852 PMCID: PMC8812875 DOI: 10.1371/journal.pbio.3001502] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 11/29/2021] [Indexed: 12/26/2022] Open
Abstract
Mounting epidemiologic and scientific evidence indicates that many psychiatric disorders originate from a complex interplay between genetics and early life experiences, particularly in the womb. Despite decades of research, our understanding of the precise prenatal and perinatal experiences that increase susceptibility to neurodevelopmental disorders remains incomplete. Sleep apnea (SA) is increasingly common during pregnancy and is characterized by recurrent partial or complete cessations in breathing during sleep. SA causes pathological drops in blood oxygen levels (intermittent hypoxia, IH), often hundreds of times each night. Although SA is known to cause adverse pregnancy and neonatal outcomes, the long-term consequences of maternal SA during pregnancy on brain-based behavioral outcomes and associated neuronal functioning in the offspring remain unknown. We developed a rat model of maternal SA during pregnancy by exposing dams to IH, a hallmark feature of SA, during gestational days 10 to 21 and investigated the consequences on the offspring's forebrain synaptic structure, synaptic function, and behavioral phenotypes across multiples stages of development. Our findings represent a rare example of prenatal factors causing sexually dimorphic behavioral phenotypes associated with excessive (rather than reduced) synapse numbers and implicate hyperactivity of the mammalian target of rapamycin (mTOR) pathway in contributing to the behavioral aberrations. These findings have implications for neuropsychiatric disorders typified by superfluous synapse maintenance that are believed to result, at least in part, from largely unknown insults to the maternal environment.
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Affiliation(s)
- Amanda M. Vanderplow
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Bailey A. Kermath
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Cassandra R. Bernhardt
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Kimberly T. Gums
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Erin N. Seablom
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Abigail B. Radcliff
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Andrea C. Ewald
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Mathew V. Jones
- Department of Neuroscience, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Tracy L. Baker
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Jyoti J. Watters
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Michael E. Cahill
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
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10
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Cortese R, Khalyfa A, Bao R, Gozal D. Gestational sleep apnea perturbations induce metabolic disorders by divergent epigenomic regulation. Epigenomics 2021; 13:751-765. [PMID: 33929266 DOI: 10.2217/epi-2020-0435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Late-gestational sleep fragmentation (LG-SF) and intermittent hypoxia (LG-IH), two hallmarks of obstructive sleep apnea, lead to metabolic dysfunction in the offspring. We investigated specific biological processes that are epigenetically regulated by LG-SF and LG-IH. Materials & methods: We analyzed DNA methylation profiles in offspring visceral white adipose tissues by MeDIP-chip followed by pathway analysis. Results: We detected 1187 differentially methylated loci (p < 0.01) between LG-SF and LG-IH. Epigenetically regulated genes in LG-SF offspring were associated with lipid and glucose metabolism, whereas those in LG-IH were related to inflammatory signaling and cell proliferation. Conclusion: While LG-SF and LG-IH will result in equivalent phenotypic alterations in offspring, each paradigm appears to operate through epigenetic regulation of different biological processes.
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Affiliation(s)
- Rene Cortese
- Department of Child Health, Child Health Research Institute, School of Medicine, University of Missouri, Columbia, MO 65212, USA
| | - Abdelnaby Khalyfa
- Department of Child Health, Child Health Research Institute, School of Medicine, University of Missouri, Columbia, MO 65212, USA
| | - Riyue Bao
- Hillman Cancer Center, UPMC, Pittsburgh, PA 15232, USA
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - David Gozal
- Department of Child Health, Child Health Research Institute, School of Medicine, University of Missouri, Columbia, MO 65212, USA
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Watkins VY, Frolova AI, Stout MJ, Carter EB, Macones GA, Cahill AG, Raghuraman N. The relationship between maternal anemia and umbilical cord oxygen content at delivery. Am J Obstet Gynecol MFM 2021; 3:100270. [PMID: 33451626 PMCID: PMC7811574 DOI: 10.1016/j.ajogmf.2020.100270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/06/2020] [Accepted: 10/16/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Anemia is one of the most commonly diagnosed comorbidities in pregnancy and is known to increase the risk of obstetrical complications. However, little is known about the effect of anemia on placental oxygen transfer and fetal oxygenation. OBJECTIVE This study examined the relationship between maternal anemia and fetal oxygenation status at delivery as measured by umbilical cord partial pressure of oxygen. STUDY DESIGN This is a secondary analysis of a prospective cohort study of singleton term deliveries with universal admission complete blood count and umbilical cord gases between 2010 and 2014. Maternal anemia was defined as hemoglobin of ≤10 g/dL on admission. The primary outcomes were umbilical artery and vein partial pressure of oxygen; the secondary outcomes were acidemia (umbilical artery pH of <7.1), hypoxemia (umbilical artery or umbilical vein partial pressure of oxygen at the <5th percentile), and hyperoxemia (umbilical artery/umbilical vein partial pressure of oxygen at the >90th percentile). Outcomes were compared between patients with and without anemia. RESULTS Maternal anemia was associated with a significantly higher umbilical artery partial pressure of oxygen (median [interquartile range], 20 [16-24] vs 19 [15-24] mm Hg; P=.01) and umbilical vein partial pressure of oxygen (median [interquartile range], 30 [25-36] vs 29 [23-34] mm Hg; P<.01). Neonates born to anemic mothers were more likely to have umbilical vein hyperoxemia (15.7% vs 10.9%; adjusted odds ratio, 1.51; 95% confidence interval, 1.26-1.81) with no difference in umbilical artery hyperoxemia. There was no difference in the rates of umbilical artery or umbilical vein hypoxemia. Although maternal anemia was associated with a significant difference in umbilical artery pH (7.28±0.060 vs 7.27±0.065; P<.01), there was no difference in the rate of neonatal acidemia between groups (1.6% vs 1.9%; adjusted odds ratio, 0.93; 95% confidence interval, 0.55-1.55). CONCLUSION Umbilical cord oxygen content is higher in anemic mothers. Maternal anemia may lead to adaptations in maternal, placental, and fetal physiology, allowing for easier unloading of oxygen to the placenta and increased oxygen transfer to the fetus.
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Affiliation(s)
- Virginia Y Watkins
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO.
| | - Antonina I Frolova
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
| | - Molly J Stout
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI
| | - Ebony B Carter
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
| | - George A Macones
- Department of Obstetrics and Gynecology, Dell Medical School, The University of Texas at Austin, Austin, TX
| | - Alison G Cahill
- Department of Obstetrics and Gynecology, Dell Medical School, The University of Texas at Austin, Austin, TX
| | - Nandini Raghuraman
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
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Ryan S, Cummins EP, Farre R, Gileles-Hillel A, Jun JC, Oster H, Pepin JL, Ray DW, Reutrakul S, Sanchez-de-la-Torre M, Tamisier R, Almendros I. Understanding the pathophysiological mechanisms of cardiometabolic complications in obstructive sleep apnoea: towards personalised treatment approaches. Eur Respir J 2020; 56:13993003.02295-2019. [PMID: 32265303 DOI: 10.1183/13993003.02295-2019] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/15/2020] [Indexed: 12/19/2022]
Abstract
In January 2019, a European Respiratory Society research seminar entitled "Targeting the detrimental effects of sleep disturbances and disorders" was held in Dublin, Ireland. It provided the opportunity to critically review the current evidence of pathophysiological responses of sleep disturbances, such as sleep deprivation, sleep fragmentation or circadian misalignment and of abnormalities in physiological gases such as oxygen and carbon dioxide, which occur frequently in respiratory conditions during sleep. A specific emphasis of the seminar was placed on the evaluation of the current state of knowledge of the pathophysiology of cardiovascular and metabolic diseases in obstructive sleep apnoea (OSA). Identification of the detailed mechanisms of these processes is of major importance to the field and this seminar offered an ideal platform to exchange knowledge, and to discuss pitfalls of current models and the design of future collaborative studies. In addition, we debated the limitations of current treatment strategies for cardiometabolic complications in OSA and discussed potentially valuable alternative approaches.
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Affiliation(s)
- Silke Ryan
- Pulmonary and Sleep Disorders Unit, St Vincent's University Hospital, Dublin, Ireland .,School of Medicine, Conway Institute, University College Dublin, Dublin, Ireland
| | - Eoin P Cummins
- School of Medicine, Conway Institute, University College Dublin, Dublin, Ireland
| | - Ramon Farre
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona-IDIBAPS, and CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - Alex Gileles-Hillel
- Pediatric Pulmonology and Sleep Unit, Dept of Pediatrics, and The Wohl Institute for Translational Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Jonathan C Jun
- Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Henrik Oster
- Institute of Neurobiology, University of Lübeck, Lübeck, Germany
| | | | - David W Ray
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK.,Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Sirimon Reutrakul
- Division of Endocrinology, Diabetes, and Metabolism, Dept of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Manuel Sanchez-de-la-Torre
- Group of Precision Medicine in Chronic Diseases, Hospital Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Renaud Tamisier
- HP2 INSERM U1042, Université Grenoble Alpes, Grenoble, France
| | - Isaac Almendros
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona-IDIBAPS, and CIBER Enfermedades Respiratorias, Barcelona, Spain
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13
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Crespo A, Baillieul S, Marhuenda E, Bradicich M, Andrianopoulos V, Louvaris Z, Marillier M, Almendros I. ERS International Congress, Madrid, 2019: highlights from the Sleep and Clinical Physiology Assembly. ERJ Open Res 2020; 6:00373-2019. [PMID: 32714963 PMCID: PMC7369446 DOI: 10.1183/23120541.00373-2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 05/13/2020] [Indexed: 12/12/2022] Open
Abstract
The 2019 European Respiratory Society (ERS) International Congress took place in Madrid, Spain, and served as a platform to find out the latest advances in respiratory diseases research. The research aims are to understand the physiology and consequences of those diseases, as well as the improvement in their diagnoses, treatments and patient care. In particular, the scientific sessions arranged by ERS Assembly 4 provided novel insights into sleep-disordered breathing and new knowledge in respiratory physiology. This article, divided by session, will summarise the most relevant studies presented at the ERS International Congress. Each section has been written by Early Career Members specialising in the different fields of this interdisciplinary assembly.
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Affiliation(s)
- Andrea Crespo
- Multidisciplinary Sleep Unit, Dept of Pulmonology, Rio Hortega University Hospital, Valladolid, Spain
- Biomedical Engineering Group, University of Valladolid, Valladolid, Spain
- All authors contributed equally to this work
| | - Sébastien Baillieul
- HP2 Laboratory, INSERM U1042, Grenoble Alpes University, Grenoble, France
- FCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France
- All authors contributed equally to this work
| | - Esther Marhuenda
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias CIBERES, Madrid, Spain
- All authors contributed equally to this work
| | - Matteo Bradicich
- Dept of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland
- All authors contributed equally to this work
| | - Vasileios Andrianopoulos
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- All authors contributed equally to this work
| | - Zafeiris Louvaris
- Faculty of Kinesiology and Rehabilitation Sciences, Division of Respiratory Rehabilitation, Department Rehabilitation Sciences KU Leuven, University Hospitals Leuven, Leuven, Belgium
- All authors contributed equally to this work
| | - Mathieu Marillier
- Laboratory of Clinical Exercise Physiology, Queen's University, Kingston, ON, Canada
- All authors contributed equally to this work
| | - Isaac Almendros
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias CIBERES, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- All authors contributed equally to this work
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