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Moreno RJ, Rose DR, Tancredi DJ, Schmidt RJ, Ozonoff SJ, Ashwood P. Cord blood cytokine profiles in children later diagnosed with autism spectrum disorder: Results from the prospective MARBLES study. Brain Behav Immun 2024; 122:339-344. [PMID: 39163910 DOI: 10.1016/j.bbi.2024.08.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 08/02/2024] [Accepted: 08/17/2024] [Indexed: 08/22/2024] Open
Abstract
In studies investigating the etiology and pathophysiology of autism spectrum disorder (ASD), immune dysregulation is commonly observed, with elevated levels of inflammatory cytokines frequently found in gestational tissues. However, studies investigating the relationship between early immune dysregulation within the umbilical cord blood (CB) compartment and neurodevelopmental outcomes remains limited. In this exploratory study, we utilized data from the prospective Markers for Autism Risk in Babies - Learning Early Signs (MARBLES) study to examine cytokine levels in the plasma fraction of CB in infants later diagnosed with ASD (n = 38) compared to infants typically developing (TD) at age 3 years (n = 103), using multiplex cytokine assays. Our findings reveal altered levels of several inflammatory cytokines in children later diagnosed with ASD, including increased granulocyte colony-stimulating factor (G-CSF) and decreased interleukin-1α (IL-1α), IL-1β, and IL-4 in CB. Furthermore, we identified several associations between behaviors and levels of cytokines, chemokines and growth factors. IL-1α, IL-17A, interferon γ-induced protein 10 (IP-10), and epidermal growth factor (EGF) were associated with worse scores on Autism Diagnostic Observation Schedule (ADOS) and the Mullen Scales of Early Learning (MSEL) assessments. In summary, our study demonstrates dysregulated levels of inflammatory cytokine mediators in the CB of children later diagnosed with ASD and that inflammatory mediators were associated with ASD severity, comorbid behaviors, and neurodevelopmental measures. These findings have important implications for the possible predictive value of early cytokine measures in neurodevelopmental outcomes and subsequent behavioral manifestations.
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Affiliation(s)
- Rachel J Moreno
- Department of Medical Microbiology and Immunology, University of California, Davis, CA, United States; MIND Institute, University of California, Sacramento, CA, United States
| | - Destanie R Rose
- Department of Medical Microbiology and Immunology, University of California, Davis, CA, United States; MIND Institute, University of California, Sacramento, CA, United States
| | - Daniel J Tancredi
- Department of Pediatrics, University of California, Sacramento, CA, United States
| | - Rebecca J Schmidt
- MIND Institute, University of California, Sacramento, CA, United States; Department of Public Health Sciences, University of California Davis, Davis, CA, United States
| | - Sally J Ozonoff
- MIND Institute, University of California, Sacramento, CA, United States; Department of Psychiatry and Behavioral Sciences, United States
| | - Paul Ashwood
- Department of Medical Microbiology and Immunology, University of California, Davis, CA, United States; MIND Institute, University of California, Sacramento, CA, United States.
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Gerstenberg J, Mishra S, Holtfreter M, Richter J, Davi SD, Okwu DG, Ramharter M, Mischlinger J, Schleenvoigt BT. Human Placental Schistosomiasis-A Systematic Review of the Literature. Pathogens 2024; 13:470. [PMID: 38921768 PMCID: PMC11206619 DOI: 10.3390/pathogens13060470] [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: 04/10/2024] [Revised: 05/22/2024] [Accepted: 05/29/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Schistosome egg deposition in pregnant women may affect the placenta of infected mothers and cause placental schistosomiasis (PS). Histopathological examination of placental tissue is an inadequate detection method due to low sensitivity. So far, there has not been any systematic review on PS. METHODS We conducted a systematic literature search on PubMed, EMBASE, and Medline and included all publications that reported microscopically confirmed cases of PS, as well as the relevant secondary literature found in the citations of the primarily included publications. RESULTS Out of 113 abstracts screened we found a total of 8 publications describing PS with a total of 92 cases describing egg deposition of dead and/or viable eggs and worms of S. haematobium and S. mansoni in placental tissue. One cross-sectional study investigating the prevalence of PS and its association with adverse birth outcomes, found 22% of placentas to be infested using a maceration technique but only <1% using histologic examination. Additionally, no direct link to deleterious pregnancy outcomes could be shown. CONCLUSIONS PS is a highly unattended and underdiagnosed condition in endemic populations, due to a lack of awareness as well as low sensitivity of histopathological examinations. However, PS may play an important role in mediating or reinforcing adverse birth outcomes (ABO) such as fetal growth restriction (FGR) in maternal schistosomiasis, possibly by placental inflammation.
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Affiliation(s)
- Jacob Gerstenberg
- Institute for Tropical Medicine, Eberhard-Karls University Tübingen, 72074 Tübingen, Germany;
- Centre de Recherches Médicales de Lambaréné, Lambaréné 242, Gabon
| | - Sasmita Mishra
- Department of Obstetrics and Gynecology, Heidekreis Klinikum, 29664 Walsrode, Germany
| | - Martha Holtfreter
- Tropical Medicine Unit, Department of Gastroenterology, Hepatology and Infectious Diseases, Faculty of Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Joachim Richter
- Institute of International Health, Global Health Center, Charité University Medicine, 13353 Berlin, Germany
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
| | - Saskia Dede Davi
- Center for Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20359 Hamburg, Germany
- German Centre for Infection Research (DZIF), Partner Site Hamburg-Luebeck-Borstel, 20359 Hamburg, Germany
| | | | - Michael Ramharter
- Center for Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20359 Hamburg, Germany
- German Centre for Infection Research (DZIF), Partner Site Hamburg-Luebeck-Borstel, 20359 Hamburg, Germany
| | - Johannes Mischlinger
- Center for Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20359 Hamburg, Germany
- German Centre for Infection Research (DZIF), Partner Site Hamburg-Luebeck-Borstel, 20359 Hamburg, Germany
| | - Benjamin T. Schleenvoigt
- Institute of Infectious Diseases and Infection Control, Jena University Hospital, Friedrich-Schiller-University, 07747 Jena, Germany
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Barry CV, Chrysanthopoulou SA, Tallo V, Jarilla B, Vargas Z, McDonald E, Gundogan F, Friedman JF. The Impact of Prenatal Alcohol Exposure on Longitudinal Growth, Nutritional Status, and Insulin-Like Growth Factor 1 in Early Childhood in Leyte, the Philippines. J Pediatr 2024; 269:113977. [PMID: 38401788 PMCID: PMC11096041 DOI: 10.1016/j.jpeds.2024.113977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 01/24/2024] [Accepted: 02/16/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVE To assess the impact and potential mechanistic pathways of prenatal alcohol exposure (PAE) on longitudinal growth and nutritional status in early childhood. STUDY DESIGN A cohort of 296 mother-infant dyads (32% with PAE vs 68% unexposed) were recruited in Leyte, the Philippines, and followed from early gestation through 24 months of age. PAE was assessed using serum phosphatidylethanol (PEth) captured twice prenatally and in cord blood and supplemented with self-reported alcohol consumption. Linear mixed models were used to examine longitudinal effects of PAE on growth from birth through 2 years including key potential mediating factors (placental histopathology, and infant serum leptin and Insulin-like Growth Factor 1 [IGF-1]). RESULTS After adjusting for potential confounders, we found that PAE was significantly associated with a delayed blunting of linear growth trajectories (height-for-age z-score, body length) and weight (weight-for-age z-score, body weight) that manifested between 4 and 6 months and continued through 12-24 months. PAE was also associated with a decreased rate of mid-upper-arm circumference growth from birth to 12 months, and a lower mean IGF-1 levels at birth and 6 months. CONCLUSION This study demonstrates a delayed impact of PAE on growth that manifested around 6 months of age, underscoring the importance of routine clinical monitoring in early childhood. Furthermore, the findings supported prior animal model findings that suggest a mechanistic role for IGF-1 in PAE-induced growth delay.
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Affiliation(s)
- Christopher V Barry
- Warren Alpert Medical School of Brown University, Providence, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI
| | | | - Veronica Tallo
- Research Institute for Tropical Medicine, Manila, Philippines
| | - Blanca Jarilla
- Research Institute for Tropical Medicine, Manila, Philippines
| | - Zorimel Vargas
- Center for International Health Research, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
| | - Emily McDonald
- Center for International Health Research, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI
| | - Fusun Gundogan
- Department of Pathology, Warren Alpert Medical School of Brown University, Providence, RI; Women and Infants' Hospital, Care New England, Providence, RI
| | - Jennifer F Friedman
- Warren Alpert Medical School of Brown University, Providence, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI; Center for International Health Research, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI
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Lee Y, McDonald E, Gundogan F, Barry CV, Tallo V, Colt S, Friedman JF. Early-life matters: The role of fetal adrenal steroids in the relationship between cytokines within the placental circulation and cognitive development among infants in the Philippines. Brain Behav Immun 2024; 118:510-520. [PMID: 38431237 DOI: 10.1016/j.bbi.2024.02.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 02/08/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024] Open
Abstract
Prenatal exposure to inflammation is related to the risk for cognitive impairment in offspring. However, mechanisms underlying the link between inflammatory cytokines at the maternal-fetal interface and human cognitive development are largely unknown. This study addressed this research gap by examining whether i) cytokines within the placenta are associated with different domains of neurocognitive development during infancy, and ii) if DHEA-S in cord blood mediates these associations. We also explored the role of early-life socioeconomic status (SES) in moderating the effect of fetal adrenal steroids on cognitive development in low- and middle-income country contexts. A cohort of 242 mother-infant dyads in Leyte, the Philippines participated in the study and all of them were followed from early pregnancy until 12-months. Concentrations of pro- and anti-inflammatory cytokines in the placenta, and DHEA-S in cord blood collected at delivery were evaluated. The multifactorial aspects of the infant's cognitive functioning were assessed based on the Bayley Scales of Infant Development, third edition (BSID-III). We used Structural Equation Modelling (SEM) with an orthogonal rotation to examine associated paths among latent variables of pro- and anti-inflammatory cytokines in the placenta, fetal neuroendocrine factors, and cognitive development. Pathway analyses showed that both pro- and anti-inflammatory cytokines in the placenta were indirectly related to cognitive (p < 0.05) and language developmental outcomes (p < 0.1) via DHEA-S in cord blood among the low SES group. Yet, we found no statistically significant indirect effect of pro- or anti-inflammatory cytokines on neurocognitive development among the high SES sub-sample. This study extends our understanding of how early-life socioeconomic conditions modify biological pathways underlying the relationship between prenatal factors and postpartum cognitive development.
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Affiliation(s)
- Yeonjin Lee
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States; Department of Sociology, Kookmin University, Seoul, South Korea.
| | - Emily McDonald
- Center for International Health Research, Rhode Island Hospital, Providence, RI, United States; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Fusun Gundogan
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Christopher V Barry
- Center for International Health Research, Rhode Island Hospital, Providence, RI, United States; Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Veronica Tallo
- Research Institute for Tropical Medicine, Manila, Philippines
| | - Susannah Colt
- Center for International Health Research, Rhode Island Hospital, Providence, RI, United States; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Jennifer F Friedman
- Center for International Health Research, Rhode Island Hospital, Providence, RI, United States; Warren Alpert Medical School of Brown University, Providence, RI, United States; Department of Epidemiology, Brown University, Providence, RI, United States; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, United States
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Rakotozandrindrainy R, Rakotoarivelo RA, Kislaya I, Marchese V, Rasamoelina T, Solonirina J, Ratiaharison EF, Razafindrakoto R, Razafindralava NM, Rakotozandrindrainy N, Radomanana M, Andrianarivelo MR, Klein P, Lorenz E, Jaeger A, Hoekstra PT, Corstjens PLAM, Schwarz NG, van Dam GJ, May J, Fusco D. Schistosome infection among pregnant women in the rural highlands of Madagascar: A cross-sectional study calling for public health interventions in vulnerable populations. PLoS Negl Trop Dis 2024; 18:e0011766. [PMID: 38626192 PMCID: PMC11051649 DOI: 10.1371/journal.pntd.0011766] [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: 11/03/2023] [Revised: 04/26/2024] [Accepted: 03/26/2024] [Indexed: 04/18/2024] Open
Abstract
INTRODUCTION Schistosomiasis is a parasitic infection highly prevalent in sub-Saharan Africa (SSA) with Madagascar being among the countries with highest burden of the disease worldwide. Despite WHO recommendations, suggesting treatment of pregnant women after the first trimester, this group is still excluded from Mass Drug Administration programs. Our study, had the objective to measure the prevalence of schistosome infection among pregnant women in Madagascar in order to inform public health policies for treatment in this vulnerable population. METHODS Women were recruited for this cross-sectional study between April 2019 and February 2020 when attending Antenatal Care Services (ANCs) at one of 42 included Primary Health Care Centers. The urine-based upconverting reporter particle, lateral flow (UCP-LF) test detecting circulating anodic antigen was used for the detection of schistosome infections. To identify factors associated with the prevalence of schistosome infection crude and adjusted prevalence ratios and 95% CIs were estimated using mixed-effect Poisson regression. RESULTS Among 4,448 participating women aged between 16 and 47 years, the majority (70.4%, 38 n = 3,133) resided in rural settings. Overall, the prevalence of schistosome infection was 55.9% (n = 2486, CI 95%: 53.3-58.5). A statistically significant association was found with age group (increased prevalence in 31-47 years old, compared to 16-20 years old (aPR = 1.15, CI 95%: 1.02-1.29) and with uptake of antimalaria preventive treatment (decreased prevalence, aPR = 0.85, CI 95%: 0.77-0.95). No other associations of any personal characteristics or contextual factors with schistosome infection were found in our multivariate regression analysis. DISCUSSION AND CONCLUSION The high prevalence of schistosome infection in pregnant women supports the consideration of preventive schistosomiasis treatment in ANCs of the Malagasy highlands. We strongly advocate for adapting schistosomiasis programs in highly endemic contexts. This, would contribute to both the WHO and SDGs agendas overall to improving the well-being of women and consequently breaking the vicious cycle of poverty perpetuated by schistosomiasis.
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Affiliation(s)
| | | | - Irina Kislaya
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Valentina Marchese
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | | | | | | | | | | | | | - Mickael Radomanana
- Infectious diseases service, University Hospital Tambohobe, Fianarantsoa, Madagascar
| | | | - Philipp Klein
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Eva Lorenz
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Anna Jaeger
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | | | | | - Norbert Georg Schwarz
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
| | | | - Jürgen May
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Daniela Fusco
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
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Abioye AI, Hughes MD, Sudfeld CR, Premji Z, Aboud S, Hamer DH, Roberts DJ, Duggan CP, Fawzi WW. The effect of iron supplementation on maternal iron deficiency anemia does not differ by baseline anemia type among Tanzanian pregnant women without severe iron deficiency anemia. Eur J Nutr 2023; 62:987-1001. [PMID: 36344770 PMCID: PMC9987582 DOI: 10.1007/s00394-022-03029-0] [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: 01/09/2022] [Accepted: 10/05/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE Whether anemia type modifies the risk of pregnancy and newborn outcomes and the effectiveness of iron supplementation is unclear. We examined the association of iron deficiency anemia (IDA) and non-iron deficiency anemia (NIDA) on the risks of these outcomes and the extent to which anemia type modifies the impact of prenatal iron supplementation. METHODS This was a secondary analysis of a placebo-controlled trial of iron supplementation among 1450 HIV-negative women in Tanzania. Eligibility criteria included gestational age < 27 weeks, hemoglobin > 85 g/L, and ferritin > 12 µg/L. Individuals were categorized as non-anemia, IDA or NIDA using hemoglobin, ferritin and CRP. Analyses were conducted using regression models and likelihood ratio tests. RESULTS Compared to the non-anemia group, delivery hemoglobin was lower by 15 g/L (95% CI 10.9, 19.3) in the baseline IDA group, and 7.3 g/L (95% CI 3.1, 11.5) in the baseline NIDA group. The RRs of anemia severity, iron deficiency, placental malaria, stillbirths, perinatal mortality, birthweight, and preterm birth were not different among women in the baseline NIDA group (vs. non-anemia) compared to the baseline IDA group (vs. non-anemia). The difference in the mean delivery hemoglobin for iron supplementation and placebo arms was 8 g/L (95% CI 6, 11) in the non-anemia group, 7 g/L (95% CI 2, 13) in the NIDA group, and 16 g/L (95% CI 10, 22) in the IDA group. CONCLUSION Iron supplementation is effective even among pregnant women with NIDA. TRIAL REGISTRATION NCT01119612 (May 7, 2010).
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Affiliation(s)
- Ajibola Ibraheem Abioye
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard T.H. School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - Michael D Hughes
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christopher R Sudfeld
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard T.H. School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Said Aboud
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Davidson H Hamer
- Department of Global Health, School of Public Health, Boston University, Boston, MA, USA
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Drucilla J Roberts
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Christopher P Duggan
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard T.H. School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - Wafaie W Fawzi
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard T.H. School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Desale H, Buekens P, Alger J, Cafferata ML, Harville EW, Herrera C, Truyens C, Dumonteil E. Epigenetic signature of exposure to maternal Trypanosoma cruzi infection in cord blood cells from uninfected newborns. Epigenomics 2022; 14:913-927. [PMID: 36039408 PMCID: PMC9475499 DOI: 10.2217/epi-2022-0153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aims: To assess the epigenetic effects of in utero exposure to maternal Trypanosoma cruzi infection. Methods: We performed an epigenome-wide association study to compare the DNA methylation patterns of umbilical cord blood cells from uninfected babies from chagasic and uninfected mothers. DNA methylation was measured using Infinium EPIC arrays. Results: We identified a differential DNA methylation signature of fetal exposure to maternal T. cruzi infection, in the absence of parasite transmission, with 12 differentially methylated sites in B cells and CD4+ T cells, including eight protein-coding genes. Conclusion: These genes participate in hematopoietic cell differentiation and the immune response and may be involved in immune disorders. They also have been associated with several developmental disorders and syndromes.
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Affiliation(s)
- Hans Desale
- Department of Tropical Medicine, Tulane University School of Public Health & Tropical Medicine & Tulane University Vector-Borne & Infectious Disease Research Center, New Orleans, LA 70112, USA
| | - Pierre Buekens
- Department of Epidemiology, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA
| | - Jackeline Alger
- Instituto de Enfermedades Infecciosas y Parasitologia Antonio Vidal, Tegucigalpa, Honduras.,Ministry of Health, Hospital Escuela, Tegucigalpa, Honduras
| | - Maria Luisa Cafferata
- Unidad de Investigación Clínica y Epidemiológica Montevideo (UNICEM), Hospital de Clínicas, Montevideo, 11600, Uruguay
| | - Emily Wheeler Harville
- Department of Epidemiology, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA
| | - Claudia Herrera
- Department of Tropical Medicine, Tulane University School of Public Health & Tropical Medicine & Tulane University Vector-Borne & Infectious Disease Research Center, New Orleans, LA 70112, USA
| | - Carine Truyens
- Laboratory of Parasitology, Faculty of Medicine, & ULB Center for Research in Immunology (UCRI), Université Libre de Bruxelles, Brussels, Belgium
| | - Eric Dumonteil
- Department of Tropical Medicine, Tulane University School of Public Health & Tropical Medicine & Tulane University Vector-Borne & Infectious Disease Research Center, New Orleans, LA 70112, USA
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Barry MA, Colt S, Vargas Z, Barry CV, Tallo V, Sagliba MJ, Amoylen AJ, Friedman JF, McDonald EA. Impaired Intrauterine Growth in the Context of Maternal Hookworm Infection During Gestation. J Infect Dis 2022; 225:1856-1860. [PMID: 35091745 PMCID: PMC9113511 DOI: 10.1093/infdis/jiac025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/25/2022] [Indexed: 01/31/2023] Open
Abstract
Hookworm infection is associated with poor nutritional outcomes, anemia, and impaired cognitive performance. We examined the association between maternal hookworm infection and birth outcomes in a cohort of women in Leyte, Philippines. We observed poor intrauterine growth characteristics associated with maternal hookworm only among male offspring, with lower birth weight, head circumference, and placental surface area. Male neonates also had higher insulin-like growth factor 2 (IGF-2) and lower adiponectin in cord blood. These data intriguingly suggest nutritional impacts of maternal hookworm infection during pregnancy may be divergent based on sex of the offspring.
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Affiliation(s)
- Meagan A Barry
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Susannah Colt
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Zorimel Vargas
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Christopher V Barry
- Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Veronica Tallo
- Research Institute of Tropical Medicine, Manila, Philippines
| | | | | | - Jennifer F Friedman
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA,Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Emily A McDonald
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA,Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA,Correspondence: Emily McDonald, PhD, Center for International Health Research, Rhode Island Hospital, Warren Alpert Medical School, Brown University, 55 Claverick Street, Room 320, Providence, RI 02903 ()
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9
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Lee AC, Abate FW, Mullany LC, Baye E, Berhane YY, Derebe MM, Eglovitch M, Fasil N, Olson IE, Kidane WT, Shiferaw T, Shiferie F, Tsegaye F, Tsegaye S, Yibeltal K, Chan GJ, Christian P, Isanaka S, Kang Y, Lu C, Mengistie MM, Molina RL, Stojanov MD, Van Dyk F, Tadesse AW, Wondale AT, Wylie BJ, Worku A, Berhane Y. Enhancing Nutrition and Antenatal Infection Treatment (ENAT) study: protocol of a pragmatic clinical effectiveness study to improve birth outcomes in Ethiopia. BMJ Paediatr Open 2022; 6:e001327. [PMID: 36053580 PMCID: PMC8762145 DOI: 10.1136/bmjpo-2021-001327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/07/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The WHO Nutrition Target aims to reduce the global prevalence of low birth weight by 30% by the year 2025. The Enhancing Nutrition and Antenatal Infection Treatment (ENAT) study will test the impact of packages of pregnancy interventions to enhance maternal nutrition and infection management on birth outcomes in rural Ethiopia. METHODS AND ANALYSIS ENAT is a pragmatic, open-label, 2×2 factorial, randomised clinical effectiveness study implemented in 12 rural health centres in Amhara, Ethiopia. Eligible pregnant women presenting at antenatal care (ANC) visits at <24 weeks gestation are enrolled (n=2400). ANC quality is strengthened across all centres. Health centres are randomised to receive an enhanced nutrition package (ENP) or standard nutrition care, and within each health centre, individual women are randomised to receive an enhanced infection management package (EIMP) or standard infection care. At ENP centres, women receive a regular supply of adequately iodised salt and iron-folate (IFA), enhanced nutrition counselling and those with mid-upper arm circumference of <23 cm receive a micronutrient fortified balanced energy protein supplement (corn soya blend) until delivery. In standard nutrition centres, women receive routine counselling and IFA. EIMP women have additional screening/treatment for urinary and sexual/reproductive tract infections and intensive deworming. Non-EIMP women are managed syndromically per Ministry of Health Guidelines. Participants are followed until 1-month post partum, and a subset until 6 months. The primary study outcomes are newborn weight and length measured at <72 hours of age. Secondary outcomes include preterm birth, low birth weight and stillbirth rates; newborn head circumference; infant weight and length for age z-scores at birth; maternal anaemia; and weight gain during pregnancy. ETHICS AND DISSEMINATION ENAT is approved by the Institutional Review Boards of Addis Continental Institute of Public Health (001-A1-2019) and Mass General Brigham (2018P002479). Results will be disseminated to local and international stakeholders. REGISTRATION NUMBER ISRCTN15116516.
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Affiliation(s)
- Anne Cc Lee
- Department of Pediatric Newborn Medicine, Global Advancement of Infants and Mothers, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - Luke C Mullany
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Estifanos Baye
- Department of Pediatric Newborn Medicine, Global Advancement of Infants and Mothers, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | | | | | - Michelle Eglovitch
- Department of Pediatric Newborn Medicine, Global Advancement of Infants and Mothers, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Nebiyou Fasil
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Ingrid E Olson
- Department of Pediatric Newborn Medicine, Global Advancement of Infants and Mothers, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Tigest Shiferaw
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Fisseha Shiferie
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Fitsum Tsegaye
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Sitota Tsegaye
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | | | - Grace J Chan
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Medical Critical Care, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Parul Christian
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sheila Isanaka
- Departments of Nutrition and Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Yunhee Kang
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Chunling Lu
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Rose L Molina
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Michele D Stojanov
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Fred Van Dyk
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Amare Worku Tadesse
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Asresie T Wondale
- Debretabor Referral Hospital, Amhara Regional Health Bureau, Bahir Dar, Ethiopia
| | - Blair J Wylie
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Alemayehu Worku
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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10
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Salam RA, Das JK, Bhutta ZA. Effect of mass deworming with antihelminthics for soil-transmitted helminths during pregnancy. Cochrane Database Syst Rev 2021; 5:CD005547. [PMID: 33998661 PMCID: PMC8127571 DOI: 10.1002/14651858.cd005547.pub4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Helminthiasis is an infestation of the human body with parasitic worms. It is estimated to affect 44 million pregnancies, globally, each year. Intestinal helminthiasis (hookworm infestation) is associated with blood loss and decreased supply of nutrients for erythropoiesis, resulting in iron-deficiency anaemia. Over 50% of the pregnant women in low- and middle-income countries (LMIC) suffer from iron-deficiency anaemia. Though iron-deficiency anaemia is multifactorial, hookworm infestation is a major contributory cause in women of reproductive age in endemic areas. Antihelminthics are highly efficacious, but evidence of their beneficial effect and safety when given during pregnancy has not been established. This is an update of a Cochrane Review last published in 2015. OBJECTIVES To determine the effects of mass deworming with antihelminthics for soil-transmitted helminths (STH) during the second or third trimester of pregnancy on maternal and pregnancy outcomes. SEARCH METHODS For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform (ICTRP) (8 March 2021) and reference lists of retrieved studies. SELECTION CRITERIA We included all prospective randomised controlled trials evaluating the effect of administration of antihelminthics versus placebo or no treatment during the second or third trimester of pregnancy; both individual-randomised and cluster-randomised trials were eligible. We excluded quasi-randomised trials and studies that were only available as abstracts with insufficient information. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and risk of bias, extracted data, checked accuracy and assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We included a total of six trials (24 reports) that randomised 7873 pregnant women. All of the included trials were conducted in antenatal clinics within hospitals in LMICs (Uganda, Nigeria, Peru, India, Sierra Leone and Tanzania). Among primary outcomes, five trials reported maternal anaemia, one trial reported preterm birth and three trials reported perinatal mortality. Among secondary outcomes, included trials reported maternal worm prevalence, low birthweight (LBW) and birthweight. None of the included studies reported maternal anthropometric measures or infant survival at six months. Overall, we judged the included trials to be generally at low risk of bias for most domains, while the certainty of evidence ranged from low to moderate. Analysis suggests that administration of a single dose of antihelminthics in the second trimester of pregnancy may reduce maternal anaemia by 15% (average risk ratio (RR) 0.85, 95% confidence interval (CI) 0.72 to 1.00; I²= 86%; 5 trials, 5745 participants; low-certainty evidence). We are uncertain of the effect of antihelminthics during pregnancy on preterm birth (RR 0.84, 95% CI 0.38 to 1.86; 1 trial, 1042 participants; low-certainty evidence) or perinatal mortality (RR 1.01, 95% CI 0.67 to 1.52; 3 trials, 3356 participants; low-certainty evidence). We are uncertain of the effect of antihelminthics during pregnancy on hookworm (average RR 0.31, 95% CI 0.05 to 1.93; Tau² = 1.76, I² = 99%; 2 trials, 2488 participants; low-certainty evidence). Among other secondary outcomes, findings suggest that administration of antihelminthics during pregnancy may reduce the prevalence of trichuris (average RR 0.68, 95% CI 0.48 to 0.98; I²=75%; 2 trials, 2488 participants; low-certainty evidence) and ascaris (RR 0.24, 95% CI 0.19 to 0.29; I²= 0%; 2 trials, 2488 participants; moderate-certainty evidence). Antihelminthics during pregnancy probably make little or no difference to LBW (RR 0.89, 95% CI 0.69 to 1.16; 3 trials, 2960 participants; moderate-certainty evidence) and birthweight (mean difference 0.00 kg, 95% CI -0.03 kg to 0.04 kg; 3 trials, 2960 participants; moderate-certainty evidence). AUTHORS' CONCLUSIONS The evidence suggests that administration of a single dose of antihelminthics in the second trimester of pregnancy may reduce maternal anaemia and worm prevalence when used in settings with high prevalence of maternal helminthiasis. Further data is needed to establish the benefit of antihelminthic treatment on other maternal and pregnancy outcomes. Future research should focus on evaluating the effect of these antihelminthics among various subgroups in order to assess whether the effect varies. Future studies could also assess the effectiveness of co-interventions and health education along with antihelminthics for maternal and pregnancy outcomes.
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MESH Headings
- Female
- Humans
- Pregnancy
- Albendazole/administration & dosage
- Anemia, Iron-Deficiency/parasitology
- Anemia, Iron-Deficiency/prevention & control
- Anthelmintics/administration & dosage
- Bias
- Helminthiasis/drug therapy
- Helminthiasis/transmission
- Intestinal Diseases, Parasitic/drug therapy
- Iron Compounds/administration & dosage
- Perinatal Mortality
- Pregnancy Complications, Hematologic/parasitology
- Pregnancy Complications, Hematologic/prevention & control
- Pregnancy Complications, Parasitic/drug therapy
- Pregnancy Complications, Parasitic/etiology
- Pregnancy Outcome
- Pregnancy Trimester, Second
- Pregnancy Trimester, Third
- Randomized Controlled Trials as Topic
- Soil/parasitology
- Infant, Newborn
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Affiliation(s)
- Rehana A Salam
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Jai K Das
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
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11
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Adam I, ALhabardi NA, Al-Wutayd O, Khamis AH. Prevalence of schistosomiasis and its association with anemia among pregnant women: a systematic review and meta-analysis. Parasit Vectors 2021; 14:133. [PMID: 33653391 PMCID: PMC7923606 DOI: 10.1186/s13071-021-04642-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 02/16/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Schistosomiasis is a highly prevalent parasitic disease that can lead to adverse maternal and perinatal outcomes. To our knowledge, there has been no systematic review and meta-analysis of schistosomiasis during pregnancy. METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant published studies were searched in international databases (PubMed, Science Direct, Scopus, Web of Science, and Google Scholar), from their inception until May 31, 2020. The retrieved studies were assessed for quality using the Modified Newcastle-Ottawa Scale. OpenMeta Analyst software was used for the statistical analysis. RESULTS Thirty-two studies enrolling 21024 pregnant women were included in this meta-analysis. All 32 of these studies were conducted in Africa. Of these studies, 19, 11, and 2 investigated S. mansoni, S. haematobium, and combined S. mansoni and S. haematobium infections, respectively. The pooled prevalence estimate of schistosomiasis during pregnancy was 13.2% (95 CI 11.0-15.4). A random model was used because of high heterogeneity (Q = 99.14; P < 0.001). In subgroup analyses, the pooled prevalence estimate of S. haematobium was significantly higher than the pooled prevalence estimates of S. mansoni [22.5% (95% CI 1.6-43.5) vs 8.7% (95% CI 6.0-11.3, P = 0.016), respectively]. The results of meta-regression analyses showed a non-significant difference in the prevalence of schistosomiasis during pregnancy according to the study sample sizes and year of publication. Only six studies evaluated the association between schistosomiasis during pregnancy and anemia. Schistosomiasis was associated with anemia in these six studies (OR = 3.02, 95% = 1.25‒7.28, P = 0.014). CONCLUSION The present meta-analysis suggests that schistosomiasis during pregnancy is an existing health problem. This meta-analysis also highlights the lack of data on the determinants and outcomes of schistosomiasis during pregnancy. Preventive measures are needed and could be part of antenatal care in areas endemic with schistosomiasis.
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Affiliation(s)
- Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | - Nadiah A. ALhabardi
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | - Osama Al-Wutayd
- Department of Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | - Ammar H. Khamis
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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12
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Rio-Aige K, Azagra-Boronat I, Massot-Cladera M, Selma-Royo M, Parra-Llorca A, González S, García-Mantrana I, Castell M, Rodríguez-Lagunas MJ, Collado MC, Pérez Cano FJ. Association of Maternal Microbiota and Diet in Cord Blood Cytokine and Immunoglobulin Profiles. Int J Mol Sci 2021; 22:ijms22041778. [PMID: 33579027 PMCID: PMC7916816 DOI: 10.3390/ijms22041778] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/04/2021] [Accepted: 02/06/2021] [Indexed: 12/16/2022] Open
Abstract
Mothers confer natural passive immunization to their infants through the transplacental pathway during the gestation period. The objective of the present study was to establish at birth the maternal and cord plasma concentration and relationship of immunoglobulins (Igs), cytokines (CKs), and adipokines. In addition, the impact of the maternal microbiota and diet was explored. The plasma profile of these components was different between mothers and babies, with the levels of many CKs, IgM, IgG2a, IgE, IgA, and leptin significantly higher in mothers than in the cord sample. Moreover, the total Igs, all IgG subtypes, IgE, and the Th1/Th2 ratio positively correlated in the mother–infant pair. Maternal dietary components such as monounsaturated fatty acids-polyunsaturated fatty acids and fiber were positively associated with some immune factors such as IgA in cord samples. The microbiota composition clustering also influenced the plasma profile of some factors (i.e., many CKs, some Ig, and adiponectin). In conclusion, we have established the concentration of these immunomodulatory factors in the maternal–neonatal pair at birth, some positive associations, and the influence of maternal diet and the microbiota composition, suggesting that the immune status during pregnancy, in terms of CKs and Igs levels, can influence the immune status of the infant at birth.
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Affiliation(s)
- Karla Rio-Aige
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.M.-C.); (M.C.); (F.J.P.C.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Ignasi Azagra-Boronat
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.M.-C.); (M.C.); (F.J.P.C.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Malén Massot-Cladera
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.M.-C.); (M.C.); (F.J.P.C.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Marta Selma-Royo
- Institute of Agrochemistry and Food Technology (IATA-CSIC), National Research Council, 46980 Valencia, Spain; (M.S.-R.); (I.G.-M.); (M.C.C.)
| | - Anna Parra-Llorca
- Neonatal Research Group, Health Research Institute La Fe, 46026 Valencia, Spain;
| | - Sonia González
- Department of Functional Biology, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Spain;
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (DIMISA, ISPA), 33011 Oviedo, Spain
| | - Izaskun García-Mantrana
- Institute of Agrochemistry and Food Technology (IATA-CSIC), National Research Council, 46980 Valencia, Spain; (M.S.-R.); (I.G.-M.); (M.C.C.)
| | - Margarida Castell
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.M.-C.); (M.C.); (F.J.P.C.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - María J. Rodríguez-Lagunas
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.M.-C.); (M.C.); (F.J.P.C.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
- Correspondence:
| | - María Carmen Collado
- Institute of Agrochemistry and Food Technology (IATA-CSIC), National Research Council, 46980 Valencia, Spain; (M.S.-R.); (I.G.-M.); (M.C.C.)
| | - Francisco José Pérez Cano
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.M.-C.); (M.C.); (F.J.P.C.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
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13
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Should obstetricians working in non-endemic countries care about emerging tropical diseases? Eur J Obstet Gynecol Reprod Biol 2020; 257:25-34. [PMID: 33359921 DOI: 10.1016/j.ejogrb.2020.11.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/25/2020] [Accepted: 11/26/2020] [Indexed: 11/22/2022]
Abstract
Due to migration and international travels, obstetricians are increasingly faced with a globalized obstetric setting and should adapt their daily clinical and diagnostic approach to the modifications of tropical and subtropical infections epidemiology. This paper is focused on five emerging infectious diseases, namely Chagas disease, HTLV-1 infection, malaria, schistosomiasis and Zika virus infection, having a high prevalence in migrant populations and which can affect international travelers. These diseases frequently pass unrecognized since they are characterized by few or no symptoms during pregnancy, however they may cause a relevant maternal, fetal and neonatal impact. Specific and reliable diagnostic and treatment options are available but are rarely used during routine obstetrical practice.
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Parris KM, Amabebe E, Cohen MC, Anumba DO. Placental microbial-metabolite profiles and inflammatory mechanisms associated with preterm birth. J Clin Pathol 2020; 74:10-18. [PMID: 32796048 DOI: 10.1136/jclinpath-2020-206536] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 12/27/2022]
Abstract
There is growing emphasis on the potential significance of the placental microbiome and microbiome-metabolite interactions in immune responses and subsequent pregnancy outcome, especially in relation to preterm birth (PTB). This review discusses in detail the pathomechanisms of placental inflammatory responses and the resultant maternal-fetal allograft rejection in both microbial-induced and sterile conditions. It also highlights some potential placental-associated predictive markers of PTB for future investigation. The existence of a placental microbiome remains debatable. Therefore, an overview of our current understanding of the state and role of the placental microbiome (if it exists) and metabolome in human pregnancy is also provided. We critical evaluate the evidence for a placental microbiome, discuss its functional capacity through the elaborated metabolic products and also describe the consequent and more established fetomaternal inflammatory responses that stimulate the pathway to preterm premature rupture of membranes, preterm labour and spontaneous PTB.
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Affiliation(s)
- Kerry M Parris
- Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | | | - Marta C Cohen
- Oncology and Metabolism, University of Sheffield, Sheffield, UK.,Histopathology, Sheffield Childrens Hospital NHS Foundation Trust, Sheffield, UK
| | - Dilly O Anumba
- Oncology and Metabolism, University of Sheffield, Sheffield, UK
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Loftis JM, Byrne ML, Measelle J. Special Issue: Contexts and Consequences of Childhood Inflammation. Brain Behav Immun 2020; 86:1-3. [PMID: 31726087 PMCID: PMC7402616 DOI: 10.1016/j.bbi.2019.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Jennifer M. Loftis
- Research & Development Service, VA Portland Health Care System, Portland, OR, USA,Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
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