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Loscalzo G, Scheel J, Ibañez-Cabellos JS, García-Lopez E, Gupta S, García-Gimenez JL, Mena-Mollá S, Perales-Marín A, Morales-Roselló J. Overexpression of microRNAs miR-25-3p, miR-185-5p and miR-132-3p in Late Onset Fetal Growth Restriction, Validation of Results and Study of the Biochemical Pathways Involved. Int J Mol Sci 2021; 23:ijms23010293. [PMID: 35008715 PMCID: PMC8745308 DOI: 10.3390/ijms23010293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/21/2021] [Accepted: 12/24/2021] [Indexed: 11/27/2022] Open
Abstract
In a prospective study, 48 fetuses were evaluated with Doppler ultrasound after 34 weeks and classified, according to the cerebroplacental ratio (CPR) and estimated fetal weight (EFW), into fetuses with normal growth and fetuses with late-onset fetal growth restriction (LO-FGR). Overexpression of miRNAs from neonatal cord blood belonging to LO-FGR fetuses, was validated by real-time PCR. In addition, functional characterization of overexpressed miRNAs was performed by analyzing overrepresented pathways, gene ontologies, and prioritization of synergistically working miRNAs. Three miRNAs: miR-25-3p, miR-185-5p and miR-132-3p, were significantly overexpressed in cord blood of LO-FGR fetuses. Pathway and gene ontology analysis revealed over-representation of certain molecular pathways associated with cardiac development and neuron death. In addition, prioritization of synergistically working miRNAs highlighted the importance of miR-185-5p and miR-25-3p in cholesterol efflux and starvation responses associated with LO-FGR phenotypes. Evaluation of miR-25-3p; miR-132-3p and miR-185-5p might serve as molecular biomarkers for the diagnosis and management of LO-FGR; improving the understanding of its influence on adult disease.
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Affiliation(s)
- Gabriela Loscalzo
- Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain; (A.P.-M.); (J.M.-R.)
- Department of Obstetrics and Gynecology, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain
- Correspondence: (G.L.); (J.S.)
| | - Julia Scheel
- Department of Systems Biology and Bioinformatics, University Rostock, 18055 Rostock, Germany;
- Correspondence: (G.L.); (J.S.)
| | - José Santiago Ibañez-Cabellos
- EpiDisease S.L, Parc Científic, University of Valencia, 46980 Paterna, Spain; (J.S.I.-C.); (E.G.-L.); (J.L.G.-G.); (S.M.-M.)
- Consortium Center for Biomedical Network Research on Rare Diseases (CIBERER), Carrer d’Alvaro de Bazan, 10, 46010 Valencia, Spain
| | - Eva García-Lopez
- EpiDisease S.L, Parc Científic, University of Valencia, 46980 Paterna, Spain; (J.S.I.-C.); (E.G.-L.); (J.L.G.-G.); (S.M.-M.)
| | - Shailendra Gupta
- Department of Systems Biology and Bioinformatics, University Rostock, 18055 Rostock, Germany;
| | - José Luis García-Gimenez
- EpiDisease S.L, Parc Científic, University of Valencia, 46980 Paterna, Spain; (J.S.I.-C.); (E.G.-L.); (J.L.G.-G.); (S.M.-M.)
- Consortium Center for Biomedical Network Research on Rare Diseases (CIBERER), Carrer d’Alvaro de Bazan, 10, 46010 Valencia, Spain
- Institute of Health Carlos III, Biomedical Research Institute INCLIVA, 46010 Valencia, Spain
- Department of Physiology, School of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Salvador Mena-Mollá
- EpiDisease S.L, Parc Científic, University of Valencia, 46980 Paterna, Spain; (J.S.I.-C.); (E.G.-L.); (J.L.G.-G.); (S.M.-M.)
- Institute of Health Carlos III, Biomedical Research Institute INCLIVA, 46010 Valencia, Spain
- Department of Physiology, School of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Alfredo Perales-Marín
- Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain; (A.P.-M.); (J.M.-R.)
- Department of Obstetrics and Gynecology, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain
- Department of Pediatrics, Obstetrics and Gynecology, School of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - José Morales-Roselló
- Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain; (A.P.-M.); (J.M.-R.)
- Department of Obstetrics and Gynecology, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain
- Department of Pediatrics, Obstetrics and Gynecology, School of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
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Feist H, Bajwa S, Pecks U. Hypertensive disease, preterm birth, fetal growth restriction and chronic inflammatory disorders of the placenta: experiences in a single institution with a standardized protocol of investigation. Arch Gynecol Obstet 2021; 306:337-347. [PMID: 34693459 DOI: 10.1007/s00404-021-06293-3] [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: 05/09/2021] [Accepted: 10/13/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Chronic inflammatory disorders of the placenta, in particular villitis of unknown etiology (VUE), chronic deciduitis (CD), chronic chorioamnionitis (CC), chronic histiocytic intervillositis (CHI), and eosinophilic/T-cell chorionic vasculitis (ETCV) can exclusively be diagnosed histologically. Using a standardized procedure for submission and pathological-anatomical examination of placentas in a single perinatal care center, we analyzed the association of chronic placental lesions to perinatal complications. METHODS We reviewed all singleton placentas and miscarriages that were examined histologically over a period of ten years after having implemented a standardized protocol for placental submission in our hospital. Cases with chronic inflammatory lesions were identified, and clinical data were analyzed and compared with a focus on preterm birth, hypertensive disorders, and fetal growth restriction and/or fetal demise. RESULTS In 174 placentas, at least one of the chronic inflammatory entities was diagnosed. CD was the most frequent disorder (n = 95), and had strong associations with preterm birth (47.3% of all cases with CD) and intrauterine fetal demise. VUE (n = 74) was exclusively diagnosed in the third trimester. This disorder was associated with a birth weight below the 10th percentile (45% of the cases) and hypertensive disease in pregnancy. Miscarriage and intrauterine fetal demise were associated with CHI (in 66.7% of cases, n = 18). CONCLUSIONS Chronic inflammatory disorders are frequently observed and contribute to major obstetric and perinatal complications. Further studies are needed to get a better picture of the connection between adverse obstetric outcomes and chronic inflammation to aid in the better counseling of patients.
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Affiliation(s)
- Henning Feist
- Department of Pathology, Diakonissenkrankenhaus Flensburg, Knuthstraße 1, 24939, Flensburg, Germany.
| | - Simin Bajwa
- Department of Obstetrics and Gynecology, Diakonissenkrankenhaus Flensburg, Flensburg, Germany
| | - Ulrich Pecks
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Kiel, Germany
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Abstract
Almost 2 billion adults in the world are overweight, and more than half of them are classified as obese, while nearly one-third of children globally experience poor growth and development. Given the vast amount of knowledge that has been gleaned from decades of research on growth and development, a number of questions remain as to why the world is now in the midst of a global epidemic of obesity accompanied by the "double burden of malnutrition," where overweight coexists with underweight and micronutrient deficiencies. This challenge to the human condition can be attributed to nutritional and environmental exposures during pregnancy that may program a fetus to have a higher risk of chronic diseases in adulthood. To explore this concept, frequently called the developmental origins of health and disease (DOHaD), this review considers a host of factors and physiological mechanisms that drive a fetus or child toward a higher risk of obesity, fatty liver disease, hypertension, and/or type 2 diabetes (T2D). To that end, this review explores the epidemiology of DOHaD with discussions focused on adaptations to human energetics, placental development, dysmetabolism, and key environmental exposures that act to promote chronic diseases in adulthood. These areas are complementary and additive in understanding how providing the best conditions for optimal growth can create the best possible conditions for lifelong health. Moreover, understanding both physiological as well as epigenetic and molecular mechanisms for DOHaD is vital to most fully address the global issues of obesity and other chronic diseases.
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Affiliation(s)
- Daniel J Hoffman
- Department of Nutritional Sciences, Program in International Nutrition, and Center for Childhood Nutrition Research, New Jersey Institute for Food, Nutrition, and Health, Rutgers, the State University of New Jersey, New Brunswick, New Jersey
| | - Theresa L Powell
- Department of Pediatrics and Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, School of Public Health and Division of Exposure Science and Epidemiology, Rutgers Environmental and Occupational Health Sciences Institute, Rutgers, the State University of New Jersey, New Brunswick, New Jersey
| | - Daniel B Hardy
- Department of Biostatistics and Epidemiology, School of Public Health and Division of Exposure Science and Epidemiology, Rutgers Environmental and Occupational Health Sciences Institute, Rutgers, the State University of New Jersey, New Brunswick, New Jersey
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Pecks U, Bornemann V, Klein A, Segger L, Maass N, Alkatout I, Eckmann-Scholz C, Elessawy M, Lütjohann D. Estimating fetal cholesterol synthesis rates by cord blood analysis in intrauterine growth restriction and normally grown fetuses. Lipids Health Dis 2019; 18:185. [PMID: 31653257 PMCID: PMC6815065 DOI: 10.1186/s12944-019-1117-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 09/12/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cholesterol is an essential component in human development. In fetuses affected by intrauterine growth restriction (IUGR), fetal blood cholesterol levels are low. Whether this is the result of a reduced materno-fetal cholesterol transport, or due to low fetal de novo synthesis rates, remains a matter of debate. By analyzing cholesterol interbolites and plant sterols we aimed at deeper insights into transplacental cholesterol transport and fetal cholesterol handling in IUGR with potential targets for future therapy. We hypothesized that placental insufficiency results in a diminished cholesterol supply to the fetus. METHODS Venous umbilical cord sera were sampled post-partum from fetuses delivered between 24 weeks of gestation and at full term. IUGR fetuses were matched to 49 adequate-for-age delivered preterm and term neonates (CTRL) according to gestational age at delivery. Cholesterol was measured by gas chromatography-flame ionization detection using 5a-cholestane as internal standard. Cholesterol precursors and synthesis markers, such as lanosterol, lathosterol, and desmosterol, the absorption markers, 5α-cholestanol and plant sterols, such as campesterol and sitosterol, as well as enzymatically oxidized cholesterol metabolites (oxysterols), such as 24S- or 27-hydroxycholesterol, were analyzed by gas chromatography-mass spectrometry, using epicoprostanol as internal standard for the non-cholesterol sterols and deuterium labeled oxysterols for 24S- and 27-hydroxycholesterol. RESULTS Mean cholesterol levels were 25% lower in IUGR compared with CTRL (p < 0.0001). Lanosterol and lathosterol to cholesterol ratios were similar in IUGR and CTRL. In relation to cholesterol mean, desmosterol, 24S-hydroxycholesterol, and 27-hydroxycholesterol levels were higher by 30.0, 39.1 and 60.7%, respectively, in IUGR compared to CTRL (p < 0.0001). Equally, 5α-cholestanol, campesterol, and β-sitosterol to cholesterol ratios were higher in IUGR than in CTRL (17.2%, p < 0.004; 33.5%, p < 0.002; 29.3%, p < 0.021). CONCLUSIONS Cholesterol deficiency in IUGR is the result of diminished fetal de novo synthesis rates rather than diminished maternal supply. However, increased oxysterol- and phytosterol to cholesterol ratios suggest a lower sterol elimination rate. This is likely caused by a restricted hepatobiliary function. Understanding the fetal cholesterol metabolism is important, not only for neonatal nutrition, but also for the development of strategies to reduce the known risk of future cardiovascular diseases in the IUGR fetus.
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Affiliation(s)
- Ulrich Pecks
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany.
| | - Verena Bornemann
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Anika Klein
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Laura Segger
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Nicolai Maass
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Christel Eckmann-Scholz
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Mohamed Elessawy
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Dieter Lütjohann
- Institute for Clinical Chemistry and Clinical Pharmacology, University Clinics of Bonn, Bonn, Germany
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Contini C, Winkler BS, Maass N, Alkatout I, Winkler K, Pecks U. Concomitant intrauterine growth restriction alters the lipoprotein profile in preeclampsia. Pregnancy Hypertens 2018; 15:154-160. [PMID: 30825913 DOI: 10.1016/j.preghy.2018.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/03/2018] [Accepted: 12/29/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Preeclampsia and intrauterine growth restriction (IUGR) are related conditions. We aimed to characterise common lipid changes. METHODS Triglyceride and cholesterol levels of patients 24-42 weeks of gestation with IUGR (n = 52), hypertensive IUGR (HIUGR, n = 28), and preeclampsia without IUGR (PE, n = 56) were compared to a control group (CTRL, n = 167). In addition, 60 sera (n = 10 of each pathology IUGR, HIUGR, PE (without IUGR) compared to n = 30 matched CTRL) of severe early onset cases <34 weeks of gestation were chosen and further analysed by ultracentrifugation lipid subfractionation including VLDL, IDL, LDL, and HDL composition. RESULTS In the full cohort we found low cholesterol in IUGR (p = 0.0405), while triglyceride levels were high in PE (p < 0.0001). Lipid concentrations in HIUGR did not differ significantly from CTRL. In the 60 patients analysed by lipid subfractionation, triglyceride levels were increased in the VLDL subfraction in PE (p < 0.01), however, LDL-bound ApoB and cholesterol levels were lower in IUGR and HIUGR (p < 0.0001 for total cholesterol and p < 0.001 for ApoB in both groups), but not in PE when compared to CTRL. CONCLUSION Low cholesterol, especially LDL cholesterol levels are a feature of IUGR while high triglyceride levels are a feature of preeclampsia. Increased VLDL-triglycerides suggest a disturbed conversion to LDL in preeclampsia. Of note, the presence of IUGR in hypertensive disorders further alters lipid profiles, which may explain heterogeneous data on lipid values for preeclampsia in the literature. Study groups have to be selected carefully to avoid misinterpretation.
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Affiliation(s)
- Christine Contini
- Institute of Clinical Chemistry and Laboratory Medicine, Medical Center - University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany.
| | - B Sophia Winkler
- Department of Obstetrics and Gynecology, University Hospital of the RWTH, Pauwelsstraße 30, 52074 Aachen, Germany.
| | - Nicolai Maass
- Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany.
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany.
| | - Karl Winkler
- Institute of Clinical Chemistry and Laboratory Medicine, Medical Center - University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany.
| | - Ulrich Pecks
- Department of Obstetrics and Gynecology, University Hospital of the RWTH, Pauwelsstraße 30, 52074 Aachen, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany.
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Maršál K. Physiological adaptation of the growth-restricted fetus. Best Pract Res Clin Obstet Gynaecol 2018; 49:37-52. [PMID: 29753694 DOI: 10.1016/j.bpobgyn.2018.02.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 02/14/2018] [Indexed: 01/07/2023]
Abstract
The growth-restricted fetus in utero is exposed to a hostile environment and suffers undernutrition and hypoxia. To cope with the stress, the fetus changes its physiological functions. These adaptive changes aid intrauterine survival; however, they can lead to permanent functional and structural changes that can contribute to the development of serious chronic diseases later in life. Epigenetic mechanisms are an important part of the pathophysiological processes behind this "developmental origin of adult diseases." The dominant cardiovascular adaptive change is the redistribution of blood flow in hypoxic fetuses, with preferential supply of blood to the fetal brain, myocardium, and adrenal glands. The proportion of blood from the umbilical vein to the ductus venosus and foramen ovale increases, which increases the cardiac output of the left heart ventricle. The increased perfusion of fetal brain can be followed with Doppler ultrasound as increased diastolic velocities and decreased pulsatility index in the middle cerebral artery.
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Affiliation(s)
- Karel Maršál
- Department of Obstetrics and Gynecology, Clinical Sciences Lund, Lund University, Skane University Hospital, S-221 85, Lund, Sweden.
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Apolipoprotein E Genotype in Very Preterm Neonates with Intrauterine Growth Restriction: An Analysis of the German Neonatal Network Cohort. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2837027. [PMID: 28480219 PMCID: PMC5396432 DOI: 10.1155/2017/2837027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/08/2017] [Accepted: 03/23/2017] [Indexed: 12/21/2022]
Abstract
Aim. Cord blood of intrauterine growth restricted (IUGR) neonates displays lipid changes towards atherosclerotic profiles. Apolipoprotein E (ApoE) and its isoforms (e2, e3, and e4) are involved in the regulation of lipid metabolism. Specifically, ApoE e4 has been associated with atherosclerotic diseases, while e2 has a favorable effect. We therefore hypothesized that ApoE e4 haplotype is frequently observed in IUGR neonates and contributes to impaired fetal growth and the association of IUGR with cardiovascular and metabolic diseases later in life. Methods. A cohort of 4885 preterm infants (≥22+0 and <32+0 weeks of gestation and birth weight below 1500 g) from the GNN study cohort was analyzed. Neonates were categorized into subgroups of <3rd, 3rd–10th, and >10th birth weight percentile. Analysis of the single nucleotides rs429358 and rs7412, identifying the ApoE genotype, was carried out using TaqMan® SNP genotyping assays. The proportional odds model was used to assess data. Results. No association was found between genotype and birth weight percentiles in each of the subgroups. Conclusion. ApoE genotype and low birth weight depict two distinct risk factors for cardiovascular disease without being directly associated.
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