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Kolmaga A, Trafalska E, Gaszyńska E, Murlewska J, Witkowski S, Sylwestrzak O, Sokołowski Ł, Respondek-Liberska M, Strzelecka I. Folic Acid and Selected Risk Factors for Fetal Heart Defects-Preliminary Study Results. Nutrients 2024; 16:3024. [PMID: 39275339 PMCID: PMC11396940 DOI: 10.3390/nu16173024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 08/30/2024] [Accepted: 09/05/2024] [Indexed: 09/16/2024] Open
Abstract
BACKGROUND The available data on the relationship between diet/folic acid and congenital heart disease (CHD) are not consistent. This study aimed to investigate the relationship between the intake and supplementation of folic acid and other selected factors in mothers and the risk of congenital heart defects in fetuses. METHODS A case-control study was conducted. The study group included pregnant women with fetuses from singleton pregnancies with prenatally diagnosed heart defects in the fetus (n = 79) and pregnant women whose course of pregnancy was normal with no heart defects or other developmental anomalies diagnosed in the fetus (n = 121). The patients were diagnosed at a reference center in Poland. The women completed a lifestyle questionnaire and FFQ and precisely described their use of dietary supplements. A univariate logistic regression model was used to evaluate the association between folic acid and selected risk factors and CHD. The association was significant and included such risk factors such as nutritional status, medications taken, smoking, and alcohol consumption. Additionally, the time of starting folic acid supplementation turned out to be statistically significant. The reference period of supplementation was the period before pregnancy. RESULTS Lack of supplementation increases the risk of heart defects in children by more than four times compared to supplementation before pregnancy (OR = 4.19; p = 0.0117), whereas supplementation beyond the eighth week of gestation increases the risk almost threefold (OR = 2.90; p = 0.0474). The presence of congenital defects in the family is also an important factor. CONCLUSIONS A history of congenital heart defects or other defects, lack of periconceptional folic acid supplementation, and lack of dietary supplementation before pregnancy were associated with congenital heart defects in the fetus. Place of residence, parents' education, lifestyle habits such as smoking and alcohol consumption, nutritional status before pregnancy, and mother's diseases did not show a significant relationship with congenital heart defects in the children. There is an urgent need to develop preventive strategies and conduct extensive public education.
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Affiliation(s)
- Agnieszka Kolmaga
- Department of Nutrition and Epidemiology, Medical University of Lodz, 90-752 Lodz, Poland
| | - Elżbieta Trafalska
- Department of Nutrition and Epidemiology, Medical University of Lodz, 90-752 Lodz, Poland
| | - Ewelina Gaszyńska
- Department of Nutrition and Epidemiology, Medical University of Lodz, 90-752 Lodz, Poland
| | - Julia Murlewska
- Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland
| | - Sławomir Witkowski
- Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland
| | - Oskar Sylwestrzak
- Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland
- Department of Gynecology and Obstetrics, Polish Mother's Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland
| | - Łukasz Sokołowski
- Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland
- Department of Gynecology and Obstetrics, Polish Mother's Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland
| | - Maria Respondek-Liberska
- Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland
- Department of Diagnoses and Prevention of Fetal Malformations, Medical University of Lodz, 90-419 Lodz, Poland
| | - Iwona Strzelecka
- Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland
- Department of Diagnoses and Prevention of Fetal Malformations, Medical University of Lodz, 90-419 Lodz, Poland
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Jiang M, Hu Z, Huang Y, Chen XD, Wu P. Impact of wall materials and DHA sources on the release, digestion and absorption of DHA microcapsules: Advancements, challenges and future directions. Food Res Int 2024; 191:114646. [PMID: 39059932 DOI: 10.1016/j.foodres.2024.114646] [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: 04/03/2024] [Revised: 05/24/2024] [Accepted: 06/14/2024] [Indexed: 07/28/2024]
Abstract
Docosahexaenoic acid (DHA), an essential omega-3 fatty acid, offers significant health benefits but faces challenges such as distinct odor, oxidation susceptibility, and limited intestinal permeability, hindering its broad application. Microencapsulation, widely employed, enhances DHA performance by facilitating controlled release, digestion, and absorption in the gastrointestinal tract. Despite extensive studies on DHA microcapsules and related delivery systems, understanding the mechanisms governing encapsulated DHA release, digestion, and absorption, particularly regarding the influence of wall materials and DHA sources, remains limited. This review starts with an overview of current techniques commonly applied for DHA microencapsulation. It then proceeds to outline up-to-date advances in the release, digestion and absorption of DHA microcapsules, highlighting the roles of wall materials and DHA sources. Importantly, it proposes strategies for overcoming challenges and exploiting opportunities to enhance the bioavailability of DHA microcapsules. Notably, spray drying dominates DHA microencapsulation (over 90 % usage), while complex coacervation shows promise for future applications. The combination of proteins and carbohydrates or phospholipids as wall material exhibits potential in controlling release and digestion of DHA microcapsules. The source of DHA, particularly algal oil, demonstrates higher lipid digestibility and absorptivity of free fatty acids (FFAs) than fish oil. Future advancements in DHA microcapsule development include formulation redesign (e.g., using plant proteins as wall material and algal oil as DHA source), technique optimization (such as co-microencapsulation and pre-digestion), and creation of advanced in vitro systems for assessing DHA digestion and absorption kinetics.
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Affiliation(s)
- Maoshuai Jiang
- Life Quality Engineering Interest Group, School of Chemical and Environmental Engineering, College of Chemistry, Chemical Engineering and Materials Science, Soochow University, Suzhou, Jiangsu 215123, China
| | - Zejun Hu
- Life Quality Engineering Interest Group, School of Chemical and Environmental Engineering, College of Chemistry, Chemical Engineering and Materials Science, Soochow University, Suzhou, Jiangsu 215123, China; Xiao Dong Pro-health (Suzhou) Instrumentation Co Ltd, Suzhou, Suzhou, Jiangsu 215152, China.
| | - Yixiao Huang
- Life Quality Engineering Interest Group, School of Chemical and Environmental Engineering, College of Chemistry, Chemical Engineering and Materials Science, Soochow University, Suzhou, Jiangsu 215123, China
| | - Xiao Dong Chen
- Life Quality Engineering Interest Group, School of Chemical and Environmental Engineering, College of Chemistry, Chemical Engineering and Materials Science, Soochow University, Suzhou, Jiangsu 215123, China
| | - Peng Wu
- Life Quality Engineering Interest Group, School of Chemical and Environmental Engineering, College of Chemistry, Chemical Engineering and Materials Science, Soochow University, Suzhou, Jiangsu 215123, China.
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Biete M, Vasudevan S. Gestational diabetes mellitus: Impacts on fetal neurodevelopment, gut dysbiosis, and the promise of precision medicine. Front Mol Biosci 2024; 11:1420664. [PMID: 39055983 PMCID: PMC11269231 DOI: 10.3389/fmolb.2024.1420664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/11/2024] [Indexed: 07/28/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is a common metabolic disorder affecting approximately 16.5% of pregnancies worldwide and causing significant health concerns. GDM is a serious pregnancy complication caused by chronic insulin resistance in the mother and has been associated with the development of neurodevelopmental disorders in offspring. Emerging data support the notion that GDM affects both the maternal and fetal microbiome, altering the composition and function of the gut microbiota, resulting in dysbiosis. The observed dysregulation of microbial presence in GDM pregnancies has been connected to fetal neurodevelopmental problems. Several reviews have focused on the intricate development of maternal dysbiosis affecting the fetal microbiome. Omics data have been instrumental in deciphering the underlying relationship among GDM, gut dysbiosis, and fetal neurodevelopment, paving the way for precision medicine. Microbiome-associated omics analyses help elucidate how dysbiosis contributes to metabolic disturbances and inflammation, linking microbial changes to adverse pregnancy outcomes such as those seen in GDM. Integrating omics data across these different layers-genomics, transcriptomics, proteomics, metabolomics, and microbiomics-offers a comprehensive view of the molecular landscape underlying GDM. This review outlines the affected pathways and proposes future developments and possible personalized therapeutic interventions by integrating omics data on the maternal microbiome, genetics, lifestyle factors, and other relevant biomarkers aimed at identifying women at high risk of developing GDM. For example, machine learning tools have emerged with powerful capabilities to extract meaningful insights from large datasets.
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Affiliation(s)
| | - Sona Vasudevan
- Department of Biochemistry, Molecular and Cellular Biology, Georgetown University Medical Center, Washington, DC, United States
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Yu Z, Zhou L, Chen Z, Chen L, Hong K, He D, Lei F. Fabrication and Characterization of Docosahexaenoic Acid Algal Oil Pickering Emulsions Stabilized Using the Whey Protein Isolate-High-Methoxyl Pectin Complex. Foods 2024; 13:2159. [PMID: 38998664 PMCID: PMC11240950 DOI: 10.3390/foods13132159] [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: 05/07/2024] [Revised: 06/19/2024] [Accepted: 07/05/2024] [Indexed: 07/14/2024] Open
Abstract
In this study, the whey protein isolate-high-methoxyl pectin (WPI-HMP) complex prepared by electrostatic interaction was utilized as an emulsifier in the preparation of docosahexaenoic acid (DHA) algal oils in order to improve their physicochemical properties and oxidation stability. The results showed that the emulsions stabilized using the WPI-HMP complex across varying oil-phase volume fractions (30-70%) exhibited consistent particle size and enhanced stability compared to emulsions stabilized solely using WPI or HMP at different ionic concentrations and heating temperatures. Furthermore, DHA algal oil emulsions stabilized using the WPI-HMP complex also showed superior storage stability, as they exhibited no discernible emulsification or oil droplet overflow and the particle size variation remained relatively minor throughout the storage at 25 °C for 30 days. The accelerated oxidation of the emulsions was assessed by measuring the rate of DHA loss, lipid hydroperoxide levels, and malondialdehyde levels. Emulsions stabilized using the WPI-HMP complex exhibited a lower rate of DHA loss and reduced levels of lipid hydroperoxides and malondialdehyde. This indicated that WPI-HMP-stabilized Pickering emulsions exhibit a greater rate of DHA retention. The excellent stability of these emulsions could prove valuable in food processing for DHA nutritional enhancement.
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Affiliation(s)
- Zhe Yu
- College of Food Science and Engineering, Wuhan Polytechnic University, Wuhan 430023, China; (Z.Y.); (L.Z.); (L.C.); (K.H.); (D.H.)
| | - Li Zhou
- College of Food Science and Engineering, Wuhan Polytechnic University, Wuhan 430023, China; (Z.Y.); (L.Z.); (L.C.); (K.H.); (D.H.)
- Key Laboratory of Edible Oil Quality and Safety for State Market Regulation, Wuhan 430023, China;
- Wuhan Institute for Food and Cosmetic Control, Wuhan 430023, China
| | - Zhe Chen
- Key Laboratory of Edible Oil Quality and Safety for State Market Regulation, Wuhan 430023, China;
- Wuhan Institute for Food and Cosmetic Control, Wuhan 430023, China
| | - Ling Chen
- College of Food Science and Engineering, Wuhan Polytechnic University, Wuhan 430023, China; (Z.Y.); (L.Z.); (L.C.); (K.H.); (D.H.)
| | - Kunqiang Hong
- College of Food Science and Engineering, Wuhan Polytechnic University, Wuhan 430023, China; (Z.Y.); (L.Z.); (L.C.); (K.H.); (D.H.)
- Key Laboratory of Edible Oil Quality and Safety for State Market Regulation, Wuhan 430023, China;
- Key Laboratory for Deep Processing of Major Grain and Oil, Ministry of Education, Wuhan 430023, China
| | - Dongping He
- College of Food Science and Engineering, Wuhan Polytechnic University, Wuhan 430023, China; (Z.Y.); (L.Z.); (L.C.); (K.H.); (D.H.)
- Key Laboratory of Edible Oil Quality and Safety for State Market Regulation, Wuhan 430023, China;
- Key Laboratory for Deep Processing of Major Grain and Oil, Ministry of Education, Wuhan 430023, China
| | - Fenfen Lei
- College of Food Science and Engineering, Wuhan Polytechnic University, Wuhan 430023, China; (Z.Y.); (L.Z.); (L.C.); (K.H.); (D.H.)
- Key Laboratory of Edible Oil Quality and Safety for State Market Regulation, Wuhan 430023, China;
- Key Laboratory for Deep Processing of Major Grain and Oil, Ministry of Education, Wuhan 430023, China
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Lu D, Yao D, Hu G, Zhou J, Shen X, Qian L. Maternal docosahexaenoic acid supplementation during lactation improves exercise performance, enhances intestinal glucose absorption and modulates gut microbiota in weaning offspring mice. Front Nutr 2024; 11:1423576. [PMID: 39036494 PMCID: PMC11258037 DOI: 10.3389/fnut.2024.1423576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 06/19/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Intestinal dysfunction induced by weaning stress is common during breastfeeding period. Docosahexaenoic acid (DHA) is well known for promoting visual and brain development, but its effects on early intestinal development remain unknown. This study investigated the impact of maternal DHA supplementation during lactation on intestinal glucose absorption and gut microbiota in weaning offspring mice. Materials and methods Dams were supplemented with vehicle (control), 150 mg/(kg body weight · day) DHA (L-DHA), or 450 mg/(kg body weight · day) DHA (H-DHA) throughout lactation by oral administration. After weaning, pups were randomly divided into three groups for athletic analysis, microbial and proteomic analysis, biochemical analysis, 4-deoxy-4-fluoro-D-glucose (4-FDG) absorption test, and gene expression quantitation of glucose transport-associated proteins and mTOR signaling components. Results The H-DHA group exhibited enhanced grip strength and prolonged swimming duration compared to the control group. Additionally, there were significant increases in jejunal and ileal villus height, and expanded surface area of jejunal villi in the H-DHA group. Microbial analyses revealed that maternal DHA intake increased the abundance of beneficial gut bacteria and promoted metabolic pathways linked to carbohydrate and energy metabolism. Proteomic studies indicated an increased abundance of nutrient transport proteins and enrichment of pathways involved in absorption and digestion in the H-DHA group. This group also showed higher concentrations of glucose in the jejunum and ileum, as well as elevated glycogen levels in the liver and muscles, in contrast to lower glucose levels in the intestinal contents and feces compared to the control group. The 4-FDG absorption test showed more efficient absorption after oral 4-FDG gavage in the H-DHA group. Moreover, the expressions of glucose transport-associated proteins, GLUT2 and SGLT1, and the activation of mTOR pathway were enhanced in the H-DHA group compared to the control group. The L-DHA group also showed similar but less pronounced improvements in these aspects relative to the H-DHA group. Conclusion Our findings suggested that maternal DHA supplementation during lactation improves the exercise performance, enhances the intestinal glucose absorption by increasing the expressions of glucose transporters, and beneficially alters the structure of gut microbiome in weaning offspring mice.
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Affiliation(s)
- Dalu Lu
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute for Pediatric Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Die Yao
- Department of Clinical Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gaoli Hu
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute for Pediatric Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiefei Zhou
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute for Pediatric Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiuhua Shen
- Department of Clinical Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linxi Qian
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute for Pediatric Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Clinical Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Padilla-Valdez MM, Díaz-Iñiguez MI, Ortuño-Sahagún D, Rojas-Mayorquín AE. Neuroinflammation in fetal alcohol spectrum disorders and related novel therapeutic approaches. Biochim Biophys Acta Mol Basis Dis 2024; 1870:166854. [PMID: 37611676 DOI: 10.1016/j.bbadis.2023.166854] [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: 04/03/2023] [Revised: 07/21/2023] [Accepted: 08/18/2023] [Indexed: 08/25/2023]
Abstract
Fetal alcohol spectrum disorders (FASD) is an umbrella term to describe the neurological effects of prenatal alcohol exposure (PAE). It has been extensively characterized that PAE causes cell proliferation disruption, heterotopias, and malformations in various brain regions and there is increasing evidence that neuroinflammation is responsible for some of these neurotoxic effects. Despite evidence of its importance, neuroinflammation is not usually considered at diagnosis or treatment for FASD. Here, we discuss the literature regarding anti- inflammatory drugs and nutraceuticals, which hold promise for future therapeutical interventions in these disorders.
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Affiliation(s)
- Mayra Madeleine Padilla-Valdez
- Departamento de Ciencias Ambientales, Universidad de Guadalajara, Centro Universitario de Ciencias Biológicas y Agropecuarias, Guadalajara 45200, Mexico; Laboratorio de Neuroinmunobiología Molecular, Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, C.P 44340 Guadalajara, JAL, Mexico
| | - María Isabel Díaz-Iñiguez
- Departamento de Ciencias Ambientales, Universidad de Guadalajara, Centro Universitario de Ciencias Biológicas y Agropecuarias, Guadalajara 45200, Mexico; Laboratorio de Neuroinmunobiología Molecular, Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, C.P 44340 Guadalajara, JAL, Mexico
| | - Daniel Ortuño-Sahagún
- Laboratorio de Neuroinmunobiología Molecular, Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, C.P 44340 Guadalajara, JAL, Mexico.
| | - Argelia Esperanza Rojas-Mayorquín
- Departamento de Ciencias Ambientales, Universidad de Guadalajara, Centro Universitario de Ciencias Biológicas y Agropecuarias, Guadalajara 45200, Mexico.
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Powell TL, Barentsen K, Vaughan O, Uhlson C, Zemski Berry K, Erickson K, Faer K, Chassen SS, Jansson T. Knockdown of Placental Major Facilitator Superfamily Domain Containing 2a in Pregnant Mice Reduces Fetal Brain Growth and Phospholipid Docosahexaenoic Acid Content. Nutrients 2023; 15:4956. [PMID: 38068814 PMCID: PMC10708493 DOI: 10.3390/nu15234956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/20/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Docosahexaenoic acid (DHA) is an n-3 long chain polyunsaturated fatty acid critical for fetal brain development that is transported to the fetus from the mother by the placenta. The lysophosphatidylcholine (LPC) transporter, Major Facilitator Superfamily Domain Containing 2a (MFSD2a), is localized in the basal plasma membrane of the syncytiotrophoblast of the human placenta, and MFSD2a expression correlates with umbilical cord blood LPC-DHA levels in human pregnancy. We hypothesized that placenta-specific knockdown of MFSD2a in pregnant mice reduces phospholipid DHA accumulation in the fetal brain. METHODS Mouse blastocysts (E3.5) were transduced with an EGFP-expressing lentivirus containing either an shRNA targeting MFSD2a or a non-coding sequence (SCR), then transferred to pseudopregnant females. At E18.5, fetuses were weighed and their placenta, brain, liver and plasma were collected. MFSD2a mRNA expression was determined by qPCR in the brain, liver and placenta and phospholipid DHA was quantified by LC-MS/MS. RESULTS MFSD2a-targeting shRNA reduced placental mRNA MFSD2a expression by 38% at E18.5 (n = 45, p < 0.008) compared with SCR controls. MFSD2a expression in the fetal brain and liver were unchanged. Fetal brain weight was reduced by 13% (p = 0.006). Body weight, placenta and liver weights were unaffected. Fetal brain phosphatidyl choline and phosphatidyl ethanolamine DHA content was lower in fetuses with placenta-specific MFSD2a knockdown. CONCLUSIONS Placenta-specific reduction in expression of the LPC-DHA transporter MFSD2a resulted in reduced fetal brain weight and lower phospholipid DHA content in the fetal brain. These data provide mechanistic evidence that placental MFSD2a mediates maternal-fetal transfer of LPC-DHA, which is critical for brain growth.
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Affiliation(s)
- Theresa L. Powell
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, USA
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, USA
| | - Kenneth Barentsen
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, USA
| | - Owen Vaughan
- Department of Maternal and Fetal Medicine, EGA Institute for Women’s Heath, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK
| | - Charis Uhlson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, USA
| | - Karin Zemski Berry
- Department of Medicine, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, USA
| | - Kathryn Erickson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, USA
| | - Kelsey Faer
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, USA
| | - Stephanie S. Chassen
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, USA
| | - Thomas Jansson
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, USA
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