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Roberts H, Woodman AG, Baines KJ, Jeyarajah MJ, Bourque SL, Renaud SJ. Maternal Iron Deficiency Alters Trophoblast Differentiation and Placental Development in Rat Pregnancy. Endocrinology 2021; 162:6396887. [PMID: 34647996 PMCID: PMC8559528 DOI: 10.1210/endocr/bqab215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Indexed: 02/06/2023]
Abstract
Iron deficiency, which occurs when iron demands chronically exceed intake, is prevalent in pregnant women. Iron deficiency during pregnancy poses major risks for the baby, including fetal growth restriction and long-term health complications. The placenta serves as the interface between a pregnant mother and her baby, and it ensures adequate nutrient provisions for the fetus. Thus, maternal iron deficiency may impact fetal growth and development by altering placental function. We used a rat model of diet-induced iron deficiency to investigate changes in placental growth and development. Pregnant Sprague-Dawley rats were fed either a low-iron or iron-replete diet starting 2 weeks before mating. Compared with controls, both maternal and fetal hemoglobin were reduced in dams fed low-iron diets. Iron deficiency decreased fetal liver and body weight, but not brain, heart, or kidney weight. Placental weight was increased in iron deficiency, due primarily to expansion of the placental junctional zone. The stimulatory effect of iron deficiency on junctional zone development was recapitulated in vitro, as exposure of rat trophoblast stem cells to the iron chelator deferoxamine increased differentiation toward junctional zone trophoblast subtypes. Gene expression analysis revealed 464 transcripts changed at least 1.5-fold (P < 0.05) in placentas from iron-deficient dams, including altered expression of genes associated with oxygen transport and lipoprotein metabolism. Expression of genes associated with iron homeostasis was unchanged despite differences in levels of their encoded proteins. Our findings reveal robust changes in placentation during maternal iron deficiency, which could contribute to the increased risk of fetal distress in these pregnancies.
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Affiliation(s)
- Hannah Roberts
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, N6A5C1, Canada
| | - Andrew G Woodman
- Department of Anesthesiology & Pain Medicine, University of Alberta, Edmonton, Alberta, T6G2E1, Canada
- Department of Pharmacology, University of Alberta, Edmonton, Alberta, T6G2E1, Canada
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, T6G2E1, Canada
| | - Kelly J Baines
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, N6A5C1, Canada
| | - Mariyan J Jeyarajah
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, N6A5C1, Canada
| | - Stephane L Bourque
- Department of Anesthesiology & Pain Medicine, University of Alberta, Edmonton, Alberta, T6G2E1, Canada
- Department of Pharmacology, University of Alberta, Edmonton, Alberta, T6G2E1, Canada
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, T6G2E1, Canada
| | - Stephen J Renaud
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, N6A5C1, Canada
- Children’s Health Research Institute, Lawson Health Research Institute, London, Ontario, N6C2V5, Canada
- Correspondence: Stephen J. Renaud, PhD, Department of Anatomy and Cell Biology, University of Western Ontario, 1151 Richmond St, London, Ontario, Canada N6A5C1.
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Manzan-Martins C, Paulesu L. Impact of bisphenol A (BPA) on cells and tissues at the human materno-fetal interface. Tissue Cell 2021; 73:101662. [PMID: 34628212 DOI: 10.1016/j.tice.2021.101662] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/30/2021] [Accepted: 10/04/2021] [Indexed: 02/07/2023]
Abstract
Bisphenol A (BPA) is an endocrine disruptor extensively used in the production of polycarbonate plastics and epoxy resins and a component of liquid and food containers. It is a hazard in the prenatal period because of its presence in the placenta, fetal membranes, amniotic fluid, maternal and fetal blood and its ability to cross the placenta and reach the fetus. Estimation of the risk of BPA exposure during in utero life is extremely important in order to prevent complications of pregnancy and fetal growth. This review describes in vitro models of the human materno-fetal interface. It also outlines the effects of BPA at doses indicated as "physiological", namely at the concentrations found in the general population, and at "supraphysiological" and "subphysiological" doses, i.e. above and below the physiological range. This work will help clarify the discrepancies observed in studies on the effects of BPA on human reproduction and pregnancy, and it will be useful for the choice of appropriate in vitro models for future studies aimed at identifying the potential impact of BPA on specific functional processes.
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Affiliation(s)
| | - L Paulesu
- Department of Life Sciences, University of Siena, Siena, Italy.
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Abstract
The perfect synchronization of maternal immune-endocrine mechanisms and those of the fetus is necessary for a successful pregnancy. In this report, decidual immune cells at the maternal-fetal interface were detected that expressed TIGIT (T cell immunoreceptor with Ig and ITIM domains), which is a co-inhibitory receptor that triggers immunological tolerance. We generated recombinant TIGIT-Fc fusion proteins by linking the extracellular domain of TIGIT and silent Fc fragments. The treatment with TIGIT-Fc of human decidual antigen presenting cells (APCs), the decidual dendritic cells (dDCs), and decidual macrophages (dMϕs) increased the production of interleukin 10 and induced the decidua APCs to powerfully polarize the decidual CD4+ T cells toward a classic TH2 phenotype. We further proposed that Notch signaling shows a pivotal effect on the transcriptional regulation in decidual immune cell subsets. Moreover, the administration of TIGIT-Fc to CBA/J pregnant mice at preimplantation induced CD4+ forkhead box P3+ (Foxp3+) regulatory T cells and tolerogenic dendritic cells and increased pregnancy rates in an abortion-prone animal model stress. The results suggested the therapeutic potential of the TIGIT-Fc fusion protein in reinstating immune tolerance in failing pregnancies.
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Affiliation(s)
- Wenyan Fu
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Renfei Cai
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zetong Ma
- Department of Biophysics, College of Basic Medical Sciences, Second Military Medical University, Shanghai, China
- Team SMMU-China of International Genetically Engineered Machine (iGEM) Competitions, Department of Biophysics, Second Military Medical University, Shanghai, China
| | - Tian Li
- Department of Biophysics, College of Basic Medical Sciences, Second Military Medical University, Shanghai, China
| | - Changhai Lei
- Department of Biophysics, College of Basic Medical Sciences, Second Military Medical University, Shanghai, China
- Team SMMU-China of International Genetically Engineered Machine (iGEM) Competitions, Department of Biophysics, Second Military Medical University, Shanghai, China
| | - Jian Zhao
- KOCHKOR Biotech, Inc., Shanghai, China
| | - Shi Hu
- Department of Biophysics, College of Basic Medical Sciences, Second Military Medical University, Shanghai, China
- Team SMMU-China of International Genetically Engineered Machine (iGEM) Competitions, Department of Biophysics, Second Military Medical University, Shanghai, China
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Guo F, Liu Y, Ding Z, Zhang C, Liu Z, Fan J. Supplemental iodine-containing prenatal multivitamins use and the potential effects on pregnancy outcomes in a mildly iodine-deficient region. J Endocrinol Invest 2021; 44:443-452. [PMID: 32514901 DOI: 10.1007/s40618-020-01321-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/01/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The use and contribution of prenatal multivitamins (PMV) as iodine source for pregnant women in China, especially in mildly iodine-deficient region, have not been well studied. This study aimed to explore the association between PMV intake during pregnancy and thyroid function in mothers and newborns. METHODS We performed a study involving women with a history of taking PMV during pregnancy between January 2013 and October 2015, in Shanghai, a mildly iodine-deficient region. Maternal thyroid function in early and late pregnancy, and neonatal TSH on postnatal d 3 were obtained from medical records. We compared the outcomes in pregnant women who took exclusively iodine-containing PMV (I + PMV) with those who took exclusively non-contained PMV (I- PMV). Propensity score matching (PSM) was used to identify women with similar baseline characteristics. RESULTS After PSM, 1280 women in I + PMV and 2560 in I- PMV had similar propensity scores and were included in the analyses. Introduction of I + PMV to women was associated with slightly higher maternal thyroid hormone production (higher maternal FT4, p = 0.01, non-significantly lower TSH, p = 0.79) and lower neonatal TSH levels (p < 0.0001). The frequency of adverse pregnancy outcomes or thyroid dysfunctions did not differ between groups in late pregnancy. Mothers received I + PMV (0.2 SD) had a stronger association of maternal TSH with neonatal TSH than those who received I- PMV (0.1 SD). These effects were only shown in TPOAb-negative mothers, not in TPOAb-positive mothers. CONCLUSION TPOAb-positive women display an impaired iodine transport in thyroid and placenta, and this may explain the lack of changes in maternal and neonatal thyroid parameters with I + PMV supplementation in these women. This phenomenon might suggest that these women require different iodine doses or treatment approach in comparison with TPOAb-negative women.
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Affiliation(s)
- F Guo
- Obstetrical Department, School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910 Hengshan Rd, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Y Liu
- Obstetrical Department, School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910 Hengshan Rd, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Z Ding
- Obstetrical Department, School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910 Hengshan Rd, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - C Zhang
- Obstetrical Department, School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910 Hengshan Rd, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Z Liu
- Obstetrical Department, School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910 Hengshan Rd, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - J Fan
- Obstetrical Department, School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910 Hengshan Rd, Shanghai, China.
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
- Shanghai Municipal Key Clinical Specialty, Shanghai, China.
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Zhu N, Ji X, Geng X, Yue H, Li G, Sang N. Maternal PM 2.5 exposure and abnormal placental nutrient transport. Ecotoxicol Environ Saf 2021; 207:111281. [PMID: 32919195 DOI: 10.1016/j.ecoenv.2020.111281] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/30/2020] [Accepted: 09/01/2020] [Indexed: 06/11/2023]
Abstract
Epidemiological studies of human and animal experiments indicated that gestational exposure to atmospheric pollutants could be followed by the abnormal placental development. However, the effects of this exposure on the placental transportation for nutrients have not been systematically investigated. In this study, fine particulate matters (PM2.5) samples were collected in Taiyuan and pregnant rodent models were administered with 3 mg/kg b.w. PM2.5 by oropharyngeal aspiration every other day starting on embryonic day 0.5 (E0.5). Then the pregnant mice were sacrificed and their placentas were collected at different time points. The results showed that maternal PM2.5 exposure (MPE) disrupted the expression of proliferating cell nuclear antigen (PCNA) at all time points and inhibited the cell proliferation in placenta. Following that, the capacity for placental nutrient transport was impaired. The changes at E18.5 were observed most significantly, showing the altered mRNA expression of amino acid, long-chain polyunsaturated fatty acid (LCPUFA), glucose and folate transporters. In addition, the glycogen content was elevated at E18.5, and the triglyceride content was increased at E13.5 and E15.5 and decreased at E18.5 in the placenta after MPE. In a word, the adverse effect induced by MPE revealed that MPE led tothe disruption on the nutrient supply to the developing fetus via modulating the abundance of placental nutrient transporters (PNT).
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Affiliation(s)
- Na Zhu
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi, 030006, PR China
| | - Xiaotong Ji
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi, 030006, PR China
| | - Xilin Geng
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi, 030006, PR China
| | - Huifeng Yue
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi, 030006, PR China.
| | - Guangke Li
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi, 030006, PR China
| | - Nan Sang
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi, 030006, PR China
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Mincham KT, Jones AC, Bodinier M, Scott NM, Lauzon-Joset JF, Stumbles PA, Bosco A, Holt PG, Strickland DH. Transplacental Innate Immune Training via Maternal Microbial Exposure: Role of XBP1-ERN1 Axis in Dendritic Cell Precursor Programming. Front Immunol 2020; 11:601494. [PMID: 33424847 PMCID: PMC7793790 DOI: 10.3389/fimmu.2020.601494] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/05/2020] [Indexed: 12/19/2022] Open
Abstract
We recently reported that offspring of mice treated during pregnancy with the microbial-derived immunomodulator OM-85 manifest striking resistance to allergic airways inflammation, and localized the potential treatment target to fetal conventional dendritic cell (cDC) progenitors. Here, we profile maternal OM-85 treatment-associated transcriptomic signatures in fetal bone marrow, and identify a series of immunometabolic pathways which provide essential metabolites for accelerated myelopoiesis. Additionally, the cDC progenitor compartment displayed treatment-associated activation of the XBP1-ERN1 signalling axis which has been shown to be crucial for tissue survival of cDC, particularly within the lungs. Our forerunner studies indicate uniquely rapid turnover of airway mucosal cDCs at baseline, with further large-scale upregulation of population dynamics during aeroallergen and/or pathogen challenge. We suggest that enhanced capacity for XBP1-ERN1-dependent cDC survival within the airway mucosal tissue microenvironment may be a crucial element of OM-85-mediated transplacental innate immune training which results in postnatal resistance to airway inflammatory disease.
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Affiliation(s)
- Kyle T. Mincham
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia
| | - Anya C. Jones
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia
| | - Marie Bodinier
- INRA Pays de la Loire, UR 1268 Biopolymers Interactions Assemblies (BIA) Nantes, Nantes, France
| | - Naomi M. Scott
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia
| | - Jean-Francois Lauzon-Joset
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia
- Centre de recherche de I‘Institut de Cardiologie et de Pneumologie de Québec, Université, Laval, QC, Canada
| | - Philip A. Stumbles
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia
- College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, Australia
| | - Anthony Bosco
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia
| | - Patrick G. Holt
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia
- Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia
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Bae H, Yang C, Lee JY, Park S, Bazer FW, Song G, Lim W. Melatonin improves uterine-conceptus interaction via regulation of SIRT1 during early pregnancy. J Pineal Res 2020; 69:e12670. [PMID: 32421880 DOI: 10.1111/jpi.12670] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 02/06/2023]
Abstract
Melatonin has been shown to improve in vitro fertilization and offspring survival after bacterial infection, but its role in regulating maternal-fetal communication during early pregnancy has not been investigated. Results of this study demonstrated expression of abundant melatonin receptors in conceptus and endometrium during early pregnancy. In gilts, expression of melatonin receptor 1A (MTNR1A or MT1) and melatonin receptor 1B (MTNR1B or MT2) increased in trophectoderm (Tr) and uterine luminal epithelium (LE) with advancing days during early pregnancy in a different manner. Melatonin increased proliferation and migration of porcine trophectoderm (pTr) cell, the percent pTr cells in the G2 phase of the cell cycle, and the expression of implantation-related genes by pTr cells and endometrial luminal epithelium (pLE). Melatonin also attenuated the production of LPS-induced pro-inflammatory cytokines and tunicamycin-induced endoplasmic reticulum (ER) stress-sensing proteins. The expression of sirtuin 1 (SIRT1) as a potential target of melatonin increased between Days 9 and 14 of gestation. Co-treatment with SIRT1 inhibitor EX527 and melatonin restored cell-cell interactions through PI3K and MAPK signaling. Knockdown of SIRT1 decreased the expression of implantation-related genes, as well as migration of pTr and pLE cells. The expression of microRNAs regulated by SIRT1 was suppressed in response to melatonin. Furthermore, melatonin significantly increased lipopolysaccharide (LPS)-reduced fertilization and embryogenesis in zebrafish model. These results suggest that melatonin may improve the uterine-conceptus interactions via the regulation of SIRT1 during early pregnancy.
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Affiliation(s)
- Hyocheol Bae
- Department of Biotechnology, Institute of Animal Molecular Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, Korea
| | - Changwon Yang
- Department of Biotechnology, Institute of Animal Molecular Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, Korea
| | - Jin-Young Lee
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sunwoo Park
- Department of Biotechnology, Institute of Animal Molecular Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, Korea
| | - Fuller W Bazer
- Department of Animal Science, Center for Animal Biotechnology and Genomics, Texas A&M University, College Station, TX, USA
| | - Gwonhwa Song
- Department of Biotechnology, Institute of Animal Molecular Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, Korea
| | - Whasun Lim
- Department of Food and Nutrition, College of Science and Technology, Kookmin University, Seoul, Korea
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Salisbury AL, Papandonatos GD, Stroud LR, Smith AK, Brennan PA. Prenatal antidepressant exposures and gastrointestinal complaints in childhood: A gut-brain axis connection? Dev Psychobiol 2020; 62:816-828. [PMID: 32167584 PMCID: PMC7709733 DOI: 10.1002/dev.21966] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/27/2019] [Accepted: 02/13/2020] [Indexed: 01/16/2023]
Abstract
Selective serotonin/norepinephrine reuptake inhibitors (collectively, SRIs) are the most commonly prescribed antidepressant agents for the treatment of depression in pregnancy. SRIs affect maternal and placental serotonin signaling, which might impact fetal brain development. Alterations in serotonin signaling might also impact the developing gut-brain axis (GBA) via alterations in the fetal enteric nervous system (ENS). Emerging evidence suggests that gestational SRI exposure may be associated with offspring gastrointestinal problems. However, prospective human studies of the effects of fetal SRI exposure on the ENS and function are absent in the literature. In this paper we present data demonstrating significant associations between prenatal SRI exposure and children's gastrointestinal (GI) problems in two well-characterized, prospective cohorts of preschool and later childhood individuals. The results support the hypothesis that prenatal SRI exposure can increase the risk for childhood GI difficulties. Further research is warranted on the potential SRI-induced changes to the child gut including the role of the microbiome and the GBA in the development of GI problems.
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Affiliation(s)
- Amy L. Salisbury
- Brown Center for the Study of Children at Risk, Women and Infants Hospital of Rhode Island, Providence, RI, USA
- Department of Pediatrics, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | | | - Laura R. Stroud
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Alicia K. Smith
- Department of Gynecology and Obstetrics, Dept of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA 30322
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Rolfo A, Nuzzo AM, De Amicis R, Moretti L, Bertoli S, Leone A. Fetal-Maternal Exposure to Endocrine Disruptors: Correlation with Diet Intake and Pregnancy Outcomes. Nutrients 2020; 12:E1744. [PMID: 32545151 PMCID: PMC7353272 DOI: 10.3390/nu12061744] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/25/2020] [Accepted: 06/07/2020] [Indexed: 02/06/2023] Open
Abstract
Endocrine-disrupting chemicals (EDCs) are exogenous substances able to mimic or to interfere with the endocrine system, thus altering key biological processes such as organ development, reproduction, immunity, metabolism and behavior. High concentrations of EDCs are found in several everyday products including plastic bottles and food containers and they could be easily absorbed by dietary intake. In recent years, considerable interest has been raised regarding the biological effects of EDCs, particularly Bisphenol A (BPA) and phthalates, on human pregnancy and fetal development. Several evidence obtained on in vitro and animal models as well as by epidemiologic and population studies strongly indicated that endocrine disruptors could negatively impact fetal and placental health by interfering with the embryonic developing epigenome, thus establishing disease paths into adulthood. Moreover, EDCs could cause and/or contribute to the onset of severe gestational conditions as Preeclampsia (PE), Fetal Growth Restriction (FGR) and gestational diabetes in pregnancy, as well as obesity, diabetes and cardiovascular complications in reproductive age. Therefore, despite contrasting data being present in the literature, endocrine disruptors must be considered as a therapeutic target. Future actions aimed at reducing or eliminating EDC exposure during the perinatal period are mandatory to guarantee pregnancy success and preserve fetal and adult health.
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Affiliation(s)
- Alessandro Rolfo
- Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, 10126 Turin, Italy; (A.M.N.); (L.M.)
| | - Anna Maria Nuzzo
- Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, 10126 Turin, Italy; (A.M.N.); (L.M.)
| | - Ramona De Amicis
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Via Sandro Botticelli 21, 20133 Milan, Italy; (R.D.A.); (S.B.); (A.L.)
| | - Laura Moretti
- Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, 10126 Turin, Italy; (A.M.N.); (L.M.)
| | - Simona Bertoli
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Via Sandro Botticelli 21, 20133 Milan, Italy; (R.D.A.); (S.B.); (A.L.)
- Istituto Auxologico Italiano, IRCCS, Lab of Nutrition and Obesity Research, 20145 Milan, Italy
| | - Alessandro Leone
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Via Sandro Botticelli 21, 20133 Milan, Italy; (R.D.A.); (S.B.); (A.L.)
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Benincasa L, Mandalà M, Paulesu L, Barberio L, Ietta F. Prenatal Nutrition Containing Bisphenol A Affects Placenta Glucose Transfer: Evidence in Rats and Human Trophoblast. Nutrients 2020; 12:nu12051375. [PMID: 32403449 PMCID: PMC7284709 DOI: 10.3390/nu12051375] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 02/07/2023] Open
Abstract
This work aims to clarify the effect of dietary supplementation with Bisphenol A (BPA), a chemical widely present in beverage and food containers, on placental glucose transfer and pregnancy outcome. The study was performed on female Sprague Dawley rats fed with a diet containing BPA (2.5, 25 or 250 μg/Kg/day) for a period of a month (virgin state) plus 20 days during pregnancy. Western blot analysis and immunohistochemistry were performed in placental tissues for glucose type 1 transporter (GLUT1). Furthermore, human trophoblast, HTR8-SV/neo cells, were used to evaluate the effect of BPA on glucose transport and uptake. Studies in rats showed that food supplementation with BPA, produces a higher fetal weight (FW) to placenta weight (PW) ratio at the lowest BPA concentration. Such low concentrations also reduced maternal weight gain in late pregnancy and up-regulated placental expression of GLUT1. Treatment of HTR8-SV/neo with the non-toxic dose of 1 nM BPA confirmed up-regulation of GLUT1 expression and revealed higher activity of the transporter with an increase in glucose uptake and GLUT1 membrane translocation. Overall, these results indicate that prenatal exposure to BPA affects pregnancy and fetal growth producing changes in the placental nutrients-glucose transfer.
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Affiliation(s)
- Linda Benincasa
- Department of Life Science, University of Siena, 53100 Siena, Italy; (L.B.); (F.I.)
| | - Maurizio Mandalà
- Department of Biology, Ecology and Earth Sciences, University of Calabria, 87036 Rende, Italy; (M.M.); (L.B.)
| | - Luana Paulesu
- Department of Life Science, University of Siena, 53100 Siena, Italy; (L.B.); (F.I.)
- Correspondence:
| | - Laura Barberio
- Department of Biology, Ecology and Earth Sciences, University of Calabria, 87036 Rende, Italy; (M.M.); (L.B.)
| | - Francesca Ietta
- Department of Life Science, University of Siena, 53100 Siena, Italy; (L.B.); (F.I.)
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Mishra JS, Zhao H, Hattis S, Kumar S. Elevated Glucose and Insulin Levels Decrease DHA Transfer across Human Trophoblasts via SIRT1-Dependent Mechanism. Nutrients 2020; 12:nu12051271. [PMID: 32365792 PMCID: PMC7284516 DOI: 10.3390/nu12051271] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/20/2020] [Accepted: 04/26/2020] [Indexed: 12/30/2022] Open
Abstract
Gestational diabetes mellitus (GDM) results in reduced docosahexaenoic acid (DHA) transfer to the fetus, likely due to placental dysfunction. Sirtuin-1 (SIRT1) is a nutrient sensor and regulator of lipid metabolism. This study investigated whether the high glucose and insulin condition of GDM regulates DHA transfer and expression of fatty acid transporters and if this effect is related to SIRT1 expression and function. Syncytialized primary human trophoblasts were treated with and without glucose (25 mmol/L) and insulin (10-7 mol/L) for 72 h to mimic the insulin-resistance conditions of GDM pregnancies. In control conditions, DHA transfer across trophoblasts increased in a time- and dose-dependent manner. Exposure to GDM conditions significantly decreased DHA transfer, but increased triglyceride accumulation and fatty acid transporter expression (CD36, FABP3, and FABP4). GDM conditions significantly suppressed SIRT1 mRNA and protein expression. The SIRT1 inhibitor decreased DHA transfer across control trophoblasts, and recombinant SIRT1 and SIRT1 activators restored the decreased DHA transport induced by GDM conditions. The results demonstrate a novel role of SIRT1 in the regulation of DHA transfer across trophoblasts. The suppressed SIRT1 expression and the resultant decrease in placental DHA transfer caused by high glucose and insulin levels suggest new insights of molecular mechanisms linking GDM to fetal DHA deficiency.
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Affiliation(s)
- Jay S. Mishra
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA; (J.S.M.); (H.Z.); (S.H.)
| | - Hanjie Zhao
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA; (J.S.M.); (H.Z.); (S.H.)
| | - Sari Hattis
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA; (J.S.M.); (H.Z.); (S.H.)
| | - Sathish Kumar
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA; (J.S.M.); (H.Z.); (S.H.)
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53792, USA
- Correspondence: ; Tel.: +1-608-265-1046
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12
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Faure Bardon V, Peytavin G, Lê MP, Guilleminot T, Elefant E, Stirnemann J, Leruez-Ville M, Ville Y. Placental transfer of Letermovir & Maribavir in the ex vivo human cotyledon perfusion model. New perspectives for in utero treatment of congenital cytomegalovirus infection. PLoS One 2020; 15:e0232140. [PMID: 32353010 PMCID: PMC7192425 DOI: 10.1371/journal.pone.0232140] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/07/2020] [Indexed: 01/11/2023] Open
Abstract
Background Congenital cytomegalovirus infection can lead to severe sequelae. When fetal infection is confirmed, we hypothesize that fetal treatment could improve the outcome. Maternal oral administration of an effective drug crossing the placenta could allow fetal treatment. Letermovir (LMV) and Maribavir (MBV) are new CMV antivirals, and potential candidates for fetal treatment. Methods The objective was to investigate the placental transfer of LMV and MBV in the ex vivo method of the human perfused cotyledon. Term placentas were perfused, in an open-circuit model, with LMV or MBV at concentrations in the range of clinical peak plasma concentrations. Concentrations were measured using ultraperformance liquid chromatography coupled with tandem mass spectrometry. Mean fetal transfer rate (FTR) (fetal (FC) /maternal concentration), clearance index (CLI), accumulation index (AI) (retention of each drug in the cotyledon tissue) were measured. Mean FC were compared with half maximal effective concentrations of the drugs (EC50(LMV) and EC50(MBV)). Results For LMV, the mean FC was (± standard deviation) 1.1 ± 0.2 mg/L, 1,000-fold above the EC50(LMV). Mean FTR, CLI and AI were 9 ± 1%, 35 ± 6% and 4 ± 2% respectively. For MBV, the mean FC was 1.4 ± 0.2 mg/L, 28-fold above the EC50(MBV). Mean FTR, CLI and AI were 10 ± 1%, 50 ± 7% and 2 ± 1% respectively. Conclusions Drugs’ concentrations in the fetal side should be in the range for in utero treatment of fetuses infected with CMV as the mean FC was superior to the EC50 for both molecules.
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Affiliation(s)
- Valentine Faure Bardon
- APHP, Fetal Medicine and Obstetric Department, Necker-Enfants Malades Hospital, Paris, France
- EHU7328, IMAGINE Institute, University Paris Descartes, Paris, France
| | - Gilles Peytavin
- APHP, Pharmacology & Toxicology Laboratory and IAME, Inserm UMR 1137, Université Paris, Paris, France
| | - Minh Patrick Lê
- APHP, Pharmacology & Toxicology Laboratory and IAME, Inserm UMR 1137, Université Paris, Paris, France
| | - Tiffany Guilleminot
- EHU7328, IMAGINE Institute, University Paris Descartes, Paris, France
- APHP, Virology Laboratory, National Reference Laboratory for congenital CMV, Necker-Enfants Malades Hospital, Paris, France
| | - Elisabeth Elefant
- CRAT, Reference Centre on Teratogenic Agents, APHP, Trousseau Hospital, Paris, France
| | - Julien Stirnemann
- APHP, Fetal Medicine and Obstetric Department, Necker-Enfants Malades Hospital, Paris, France
- EHU7328, IMAGINE Institute, University Paris Descartes, Paris, France
| | - Marianne Leruez-Ville
- EHU7328, IMAGINE Institute, University Paris Descartes, Paris, France
- APHP, Virology Laboratory, National Reference Laboratory for congenital CMV, Necker-Enfants Malades Hospital, Paris, France
| | - Yves Ville
- APHP, Fetal Medicine and Obstetric Department, Necker-Enfants Malades Hospital, Paris, France
- EHU7328, IMAGINE Institute, University Paris Descartes, Paris, France
- * E-mail:
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13
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Cougnoux A, Fellmeth M, Gu T, Davidson CD, Gibson AL, Pavan WJ, Porter FD. Maternal immune activation modifies the course of Niemann-pick disease, type C1 in a gender specific manner. Mol Genet Metab 2020; 129:165-170. [PMID: 31668555 PMCID: PMC7002177 DOI: 10.1016/j.ymgme.2019.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/10/2019] [Accepted: 10/01/2019] [Indexed: 01/16/2023]
Abstract
Niemann-Pick disease, type C1 (NPC1) is a rare neurodegenerative lysosomal storage disease with a wide spectrum of clinical manifestation. Multiple genetic factors influence the NPC1 mouse phenotype, but very little attention has been given to prenatal environmental factors that might have long-term effects on the neuroinflammatory component of NPC1 pathology. Studies in other mouse models of cerebellar ataxia have shown that developmental exposures lead to Purkinje neuron degeneration later in life, suggesting that environmental exposures during development can impact cerebellar biology. Thus, we evaluated the potential effect of maternal immune activation (MIA) on disease progression in an Npc1 mouse model. The MIA paradigm used mimics viral infection using the toll like receptor 3 agonist polyinosinic-polycytidilic acid during gestation. Through phenotypic and pathologic tests, we measured motor and behavioral changes as well as cerebellar neuroinflammation and neurodegeneration. We observed a gender and genotype dependent effect of MIA on the cerebellum. While the effects of MIA have been previously shown to primarily affect male progeny, we observed increased sensitivity of female mutant progeny to prenatal exposure to treatment with polyinosinic-polycytidilic acid. Specifically, prenatal MIA resulted in female NPC1 mutant progeny with greater motor deficits and a corresponding decrease in cerebellar Purkinje neurons. Our data suggest that prenatal environmental exposures may be one factor contributing to the phenotypic variability observed in individuals with NPC1.
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Affiliation(s)
- Antony Cougnoux
- Division of Translational Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD 20892, United States of America
| | - Mason Fellmeth
- Division of Translational Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD 20892, United States of America
| | - Tansy Gu
- National Human Genome Research Institute, National Institutes of Health, DHHS, Bethesda, MD 20892, United States of America
| | - Cristin D Davidson
- National Human Genome Research Institute, National Institutes of Health, DHHS, Bethesda, MD 20892, United States of America
| | - Alana L Gibson
- National Human Genome Research Institute, National Institutes of Health, DHHS, Bethesda, MD 20892, United States of America
| | - William J Pavan
- National Human Genome Research Institute, National Institutes of Health, DHHS, Bethesda, MD 20892, United States of America
| | - Forbes D Porter
- Division of Translational Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD 20892, United States of America.
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14
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Abstract
Normal pregnancy outcome is accomplished, in part, by rapid and expansive physiological adaptations to the systemic circulation, the extent of which is specific to gestational day (GD) and anatomical location. Pregnancy-related hemodynamic changes in uterine placental blood flow stimulate compensatory vascular signaling and remodeling that begins early and continues throughout gestation. Exposure of the maternal environment to engineered nanomaterials (ENM) during pregnancy has been shown to impact health of the dam, fetus, and adult offspring; however, the consequences of specific temporal (gestational age) and spatial (vascular location) considerations are largely undetermined. We exposed pregnant Sprague-Dawley rats to nano-TiO2 aerosols at three critical periods of fetal development (GD 4, 12, and 17) to identify vascular perturbations associated with ENM exposure at these developmental milestones. Vascular reactivity of the maternal thoracic aorta, the uterine artery, the umbilical vein, and the fetal thoracic aorta were evaluated using wire myography on GD 20. While impairments were noted at each level of the maternofetal vascular tree and at each exposure day, our results indicate the greatest effects may be identified within the fetal vasculature (umbilical vein and fetal aorta), wherein effects of a single maternal inhalational exposure to nano-TiO2 on GD 4 modified responses to cholinergic, NO, and α-adrenergic signaling.
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Affiliation(s)
- S B Fournier
- Environmental and Occupational Health Sciences Institute, 170 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
| | - S Kallontzi
- Materials Science and Engineering, Rutgers University, 607 Taylor Rd, Piscataway, NJ, 08854, USA
| | - L Fabris
- Materials Science and Engineering, Rutgers University, 607 Taylor Rd, Piscataway, NJ, 08854, USA
| | - C Love
- Biology and Environmental Studies, Grinnell College, 1116 Eighth Ave, Grinnell, IA, 50112, USA
| | - P A Stapleton
- Environmental and Occupational Health Sciences Institute, 170 Frelinghuysen Rd, Piscataway, NJ, 08854, USA.
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Rutgers University, 160 Frelinghuysen Rd, Piscataway, NJ, 08854, USA.
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15
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Zhang H, Kalluri HV, Bastian JR, Chen H, Alshabi A, Caritis SN, Venkataramanan R. Gestational changes in buprenorphine exposure: A physiologically-based pharmacokinetic analysis. Br J Clin Pharmacol 2018; 84:2075-2087. [PMID: 29873094 PMCID: PMC6089832 DOI: 10.1111/bcp.13642] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 05/04/2018] [Accepted: 05/10/2018] [Indexed: 12/27/2022] Open
Abstract
AIMS Buprenorphine (BUP) is approved by the US Food and Drug Administration for the treatment of opioid addiction. The current dosing regimen of BUP in pregnant women is based on recommendations designed for nonpregnant adults. However, physiological changes during pregnancy may alter BUP exposure and efficacy. The objectives of this study were to develop a physiologically-based pharmacokinetic (PBPK) model for BUP in pregnant women, to predict changes in BUP exposure at different stages of pregnancy, and to demonstrate the utility of PBPK modelling in optimizing BUP pharmacotherapy during pregnancy. METHODS A full PBPK model for BUP was initially built and validated in healthy subjects. A fetoplacental compartment was included as a combined compartment in this model to simulate pregnancy induced anatomical and physiological changes. Further, gestational changes in physiological parameters were incorporated in this model. The PBPK model predictions of BUP exposure in pregnancy and during the postpartum period were compared to published data from a prospective clinical study. RESULTS The predicted BUP plasma concentration-time profiles in the virtual pregnant populations are consistent with the observed data in the 2nd and 3rd trimesters, and the postpartum period. The differences in the predicted means of dose normalized area under the plasma drug concentration-time curve up to 12 h, average concentration and maximum concentration were within ±25% of the corresponding observed means with the exception of average concentration in the 3rd trimester (-26.3%). CONCLUSION PBPK model-based simulation may be a useful tool to optimize BUP pharmacotherapy during pregnancy, obviating the need to perform pharmacokinetic studies in each trimester and the postpartum period that normally require intensive blood sampling.
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Affiliation(s)
- Hongfei Zhang
- University of PittsburghDepartment of Pharmaceutical Sciences, School of PharmacyPittsburghPA
| | - Hari V. Kalluri
- University of PittsburghDepartment of Pharmaceutical Sciences, School of PharmacyPittsburghPA
| | | | - Huijun Chen
- Tsinghua UniversitySchool of Pharmaceutical SciencesChina
| | - Ali Alshabi
- University of PittsburghDepartment of Pharmaceutical Sciences, School of PharmacyPittsburghPA
| | - Steve N. Caritis
- University of PittsburghDepartment of Obstetrics, Gynecology, and Reproductive Sciences, School of MedicinePittsburghPA
| | - Raman Venkataramanan
- University of PittsburghDepartment of Pharmaceutical Sciences, School of PharmacyPittsburghPA
- University of PittsburghDepartment of PathologyPittsburghPA
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Tomatis L, Turusov V, Terracini B, Day N, Barthel WF, Charles RT, Collins GB, Boiocchi M. Storage Levels of Ddt Metabolites in Mouse Tissues following Long Term Exposure to Technical DDT. Tumori 2018; 57:377-96. [PMID: 5148163 DOI: 10.1177/030089167105700603] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The storage levels of DDT and its metabolites, following the long term administration of technical DDT at the dose levels of 2, 20, 50 and 250 ppm to mice, were evaluated in the fat tissue, liver, kidney, brain and reproductive organs. In addition, storage levels were evaluated in foetuses and newborns of DDT-treated mothers. Apart from op'-DDT, there was a direct relationship between the concentration of each metabolite in each organ and the dose to which the animal was exposed. The highest concentration of DDT and metabolites was found in the fat tissue followed by reproductive organs, liver and kidney together, and lastly brain. The most prevalent metabolite was pp'-DDT, except in the liver, where pp'-DDD showed the highest concentration. Pregnant females had lower concentrations of all metabolites than non-pregnant females. The concentration of residues in samples of total foetal litters was directly related to the concentration of DDT fed to the mother. There was a strong negative correlation between the concentration of pp'-DDT and that of pp'-DDD in the foetuses and the placentas of the same litter. A significant increase in whole body DDT concentration was observed shortly after birth.
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17
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Gandhi K, Li C, German N, Skobowiat C, Carrillo M, Kallem RR, Larumbe E, Martinez S, Chuecos M, Ventolini G, Nathanielsz P, Schlabritz-Loutsevitch N. Effect of maternal high-fat diet on key components of the placental and hepatic endocannabinoid system. Am J Physiol Endocrinol Metab 2018; 314:E322-E333. [PMID: 29138223 PMCID: PMC5966752 DOI: 10.1152/ajpendo.00119.2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 10/31/2017] [Accepted: 11/01/2017] [Indexed: 02/06/2023]
Abstract
Maternal obesity in pregnancy has been linked to a spectrum of adverse developmental changes. Involvement of eCBs in obesity is well characterized. However, information regarding eCB physiology in obesity associated with pregnancy is sparse. This study evaluated fetomaternal hepatic, systemic, and placental eCB molecular changes in response to maternal consumption of a HFD. From ≥9 mo before conception, nonpregnant baboons ( Papio spp.) were fed a diet of either 45 (HFD; n = 11) or 12% fat or a control diet (CTR; n = 11), and dietary intervention continued through pregnancy. Maternal and fetal venous plasma samples were evaluated using liquid chromatography-mass spectrometry to quantify AEA and 2-AG. Placental, maternal and fetal hepatic tissues were analyzed using RT-PCR, Western blot, and immunohistochemistry. mRNA and protein expression of endocannabinoid receptors (CB1R and CB2R), FAAH, DAGL, MAGL, and COX-2 were determined. Statistical analyses were performed with the nonparametric Scheirer-Ray-Hare extension of the Kruskal-Wallis test to analyze the effects of diet (HFD vs. CTR), fetal sex (male vs. female), and the diet × sex interaction. Fetal weight was influenced by fetal sex but not by maternal diet. The increase in maternal weight in animals fed the HFD vs. the CTR diet approached significance ( P = 0.055). Maternal circulating 2-AG concentrations increased, and fetal circulating concentrations decreased in the HFD group, independently of fetal sex. CB1R receptor expression was detected in syncytiotrophoblasts (HFD) and the fetal endothelium (CTR and HFD). Placental CB2R protein expression was higher in males and lower in female fetuses in the HFD group. Fetal hepatic CB2R, FAAH, COX-2 (for both fetal sexes), and DAGLα (in male fetuses) protein expression decreased in the HFD group compared with the CTR group. We conclude that consumption of a HFD during pregnancy results in fetal systemic 2-AG and hepatic eCB deficiency.
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Affiliation(s)
- Kushal Gandhi
- School of Medicine, Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin , Odessa, Texas
| | - Cun Li
- Department of Animal Science, University of Wyoming , Laramie, Wyoming
- Texas Biomedical Research Institute and Southwest National Primate Research Center , San Antonio, Texas
| | - Nadezhda German
- School of Pharmacy, Texas Tech University Health Sciences Center , Amarillo, Texas
| | | | - Maira Carrillo
- School of Medicine, Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin , Odessa, Texas
| | - Raja Reddy Kallem
- School of Pharmacy, Texas Tech University Health Sciences Center , Amarillo, Texas
| | - Eneko Larumbe
- Clinical Research Institute, Texas Tech University Health Sciences , Lubbock, Texas
| | - Stacy Martinez
- School of Medicine, Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin , Odessa, Texas
| | - Marcel Chuecos
- School of Medicine, Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin , Odessa, Texas
| | - Gary Ventolini
- School of Medicine, Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin , Odessa, Texas
| | - Peter Nathanielsz
- Department of Animal Science, University of Wyoming , Laramie, Wyoming
- Texas Biomedical Research Institute and Southwest National Primate Research Center , San Antonio, Texas
| | - Natalia Schlabritz-Loutsevitch
- School of Medicine, Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin , Odessa, Texas
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18
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Abstract
Drug bioavailability to the developing brain is a major concern in the treatment of neonates and infants as well as pregnant and breast-feeding women. Central adverse drug reactions can have dramatic consequences for brain development, leading to major neurological impairment. Factors setting the cerebral bioavailability of drugs include protein-unbound drug concentration in plasma, local cerebral blood flow, permeability across blood-brain interfaces, binding to neural cells, volume of cerebral fluid compartments, and cerebrospinal fluid secretion rate. Most of these factors change during development, which will affect cerebral drug concentrations. Regarding the impact of blood-brain interfaces, the blood-brain barrier located at the cerebral endothelium and the blood-cerebrospinal fluid barrier located at the choroid plexus epithelium both display a tight phenotype early on in embryos. However, the developmental regulation of some multispecific efflux transporters that also limit the entry of numerous drugs into the brain through barrier cells is expected to favor drug penetration in the neonatal brain. Finally, drug cerebral bioavailability is likely to be affected following perinatal injuries that alter blood-brain interface properties. A thorough investigation of these mechanisms is mandatory for a better risk assessment of drug treatments in pregnant or breast-feeding women, and in neonate and pediatric patients.
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Affiliation(s)
- Jean-François Ghersi-Egea
- FLUID Team, Lyon Neurosciences Research Center, INSERM U1028 CRNS UMR 5292, Université Claude Bernard Lyon-1, 69008, Lyon, France.
- Blood-Brain Interfaces Exploratory Platform BIP, Lyon Neurosciences Research Center, 69008, Lyon, France.
| | - Elodie Saudrais
- FLUID Team, Lyon Neurosciences Research Center, INSERM U1028 CRNS UMR 5292, Université Claude Bernard Lyon-1, 69008, Lyon, France
- Blood-Brain Interfaces Exploratory Platform BIP, Lyon Neurosciences Research Center, 69008, Lyon, France
| | - Nathalie Strazielle
- FLUID Team, Lyon Neurosciences Research Center, INSERM U1028 CRNS UMR 5292, Université Claude Bernard Lyon-1, 69008, Lyon, France
- Blood-Brain Interfaces Exploratory Platform BIP, Lyon Neurosciences Research Center, 69008, Lyon, France
- Brain-I, 69008, Lyon, France
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Abstract
Neonatal seizures are frequent in neonatal intensive care and the most common cause is perinatal asphyxia. Among other causes, toxin exposure is rare.We present a boy with an uneventful vaginal birth, who presented one hour after birth with apnea, hypotonia, mydriasis, tongue fasciculation, and tonic seizures. There was no hypoxic ischemic encephalopathy and brain imaging was normal. Toxicology screening revealed a toxic concentration of lidocaine in his blood. The intoxication was transplacental, as a cord blood sample confirmed the toxic level. This was probably due to maternal perineal nerve block with lidocaine.Perineal local infiltration of lidocaine is not without risk for the newborn. Toxicology screen remains an important tool in the work-up of neonatal seizures and sudden unexpected postnatal collapse.
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Affiliation(s)
- V Demeulemeester
- Neonatology, UZ Brussel, Vrije Universiteit Brussel (VUB), Jette, Belgium
| | - H Van Hautem
- Pediatrics, Saint-Maria Hospital, Halle, Belgium
| | - F Cools
- Neonatology, UZ Brussel, Vrije Universiteit Brussel (VUB), Jette, Belgium
| | - J Lefevere
- Neonatology, UZ Brussel, Vrije Universiteit Brussel (VUB), Jette, Belgium
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20
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Abstract
The risk factors for preeclampsia, extremes of maternal age, changing paternity, concomitant maternal autoimmunity, and/or birth intervals greater than 5 years, suggest an underlying immunopathology. We used peripheral blood and lymphocytes from the UteroPlacental Interface (UPI) of 3rd trimester healthy pregnant women in multicolor flow cytometry-and in vitro suppression assays. The major end-point was the characterization of activation markers, and potential effector functions of different CD4-and CD8 subsets as well as T regulatory cells (Treg). We observed a significant shift of peripheral CD4 -and CD8- T cells from naïve to memory phenotype in preeclamptic women compared to healthy pregnant women consistent with long-standing immune activation. While the proportions of the highly suppressive Cytokine and Activated Treg were increased in preeclampsia, Treg tolerance toward fetal antigens was dysfunctional. Thus, our observations indicate a long-standing inflammatory derangement driving immune activation in preeclampsia; in how far the Treg dysfunction is caused by/causes this immune activation in preeclampsia will be the object of future studies.
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Affiliation(s)
- Tina A. Nguyen
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, United States of America
| | - Daniel A. Kahn
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, United States of America
| | - Andrea I. Loewendorf
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, United States of America
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21
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Roselli CE, Amodei R, Gribbin KP, Corder K, Stormshak F, Estill CT. Excess Testosterone Exposure Alters Hypothalamic-Pituitary-Testicular Axis Dynamics and Gene Expression in Sheep Fetuses. Endocrinology 2016; 157:4234-4245. [PMID: 27673555 PMCID: PMC5086533 DOI: 10.1210/en.2016-1411] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Prenatal exposure to excess androgen may result in impaired adult fertility in a variety of mammalian species. However, little is known about what feedback mechanisms regulate gonadotropin secretion during early gestation and how they respond to excess T exposure. The objective of this study was to determine the effect of exogenous exposure to T on key genes that regulate gonadotropin and GnRH secretion in fetal male lambs as compared with female cohorts. We found that biweekly maternal testosterone propionate (100 mg) treatment administered from day 30 to day 58 of gestation acutely decreased (P < .05) serum LH concentrations and reduced the expression of gonadotropin subunit mRNA in both sexes and the levels of GnRH receptor mRNA in males. These results are consistent with enhanced negative feedback at the level of the pituitary and were accompanied by reduced mRNA levels for testicular steroidogenic enzymes, suggesting that Leydig cell function was also suppressed. The expression of kisspeptin 1 mRNA, a key regulator of GnRH neurons, was significantly greater (P < .01) in control females than in males and reduced (P < .001) in females by T exposure, indicating that hypothalamic regulation of gonadotropin secretion was also affected by androgen exposure. Although endocrine homeostasis was reestablished 2 weeks after maternal testosterone propionate treatment ceased, additional differences in the gene expression of GnRH, estrogen receptor-β, and kisspeptin receptor (G protein coupled receptor 54) emerged between the treatment cohorts. These changes suggest the normal trajectory of hypothalamic-pituitary axis development was disrupted, which may, in turn, contribute to negative effects on fertility later in life.
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Affiliation(s)
- Charles E Roselli
- Department of Physiology and Pharmacology (C.E.R., R.A., K.P.G.), Oregon Health and Science University, Portland, Oregon 97239-3098; and Department of Animal and Rangeland Sciences (K.C., F.S., C.T.E.) and College of Veterinary Medicine (C.T.E.), Oregon State University, Corvallis, Oregon 97331-4501
| | - Rebecka Amodei
- Department of Physiology and Pharmacology (C.E.R., R.A., K.P.G.), Oregon Health and Science University, Portland, Oregon 97239-3098; and Department of Animal and Rangeland Sciences (K.C., F.S., C.T.E.) and College of Veterinary Medicine (C.T.E.), Oregon State University, Corvallis, Oregon 97331-4501
| | - Kyle P Gribbin
- Department of Physiology and Pharmacology (C.E.R., R.A., K.P.G.), Oregon Health and Science University, Portland, Oregon 97239-3098; and Department of Animal and Rangeland Sciences (K.C., F.S., C.T.E.) and College of Veterinary Medicine (C.T.E.), Oregon State University, Corvallis, Oregon 97331-4501
| | - Keely Corder
- Department of Physiology and Pharmacology (C.E.R., R.A., K.P.G.), Oregon Health and Science University, Portland, Oregon 97239-3098; and Department of Animal and Rangeland Sciences (K.C., F.S., C.T.E.) and College of Veterinary Medicine (C.T.E.), Oregon State University, Corvallis, Oregon 97331-4501
| | - Fred Stormshak
- Department of Physiology and Pharmacology (C.E.R., R.A., K.P.G.), Oregon Health and Science University, Portland, Oregon 97239-3098; and Department of Animal and Rangeland Sciences (K.C., F.S., C.T.E.) and College of Veterinary Medicine (C.T.E.), Oregon State University, Corvallis, Oregon 97331-4501
| | - Charles T Estill
- Department of Physiology and Pharmacology (C.E.R., R.A., K.P.G.), Oregon Health and Science University, Portland, Oregon 97239-3098; and Department of Animal and Rangeland Sciences (K.C., F.S., C.T.E.) and College of Veterinary Medicine (C.T.E.), Oregon State University, Corvallis, Oregon 97331-4501
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Anto SK, Koyada N, Khan S, Jena G. α-Lipoic acid attenuates transplacental nicotine-induced germ cell and oxidative DNA damage in adult mice. J Basic Clin Physiol Pharmacol 2016; 27:585-593. [PMID: 27658139 DOI: 10.1515/jbcpp-2015-0151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 06/07/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Smoking during pregnancy is associated with numerous fetal and developmental complications and reproductive dysfunctions in the offspring. Nicotine is one of the key chemicals of tobacco responsible for addiction. The present study was aimed to investigate the protective role of α-lipoic acid (ALA) during the transplacental nicotine-induced germ cell and DNA damage in the offspring of Swiss mice. METHODS Pregnant mice were treated with nicotine (20 mg/kg/day) in drinking water from 10 to 20 days of gestation period, and ALA (120 mg/kg/day) was administered orally for the same period. Endpoint of evaluation includes general observations at delivery and throughout the study, litter weight and size, sperm count and sperm head morphology, while structural damages and protein expression were assessed by histology and immunohistochemistry, respectively. RESULTS Maternal nicotine exposure led to decreased growth rate, litter and testicular weight, testosterone level, 3β-HSD expression and sperm count as well as increased sperm head abnormalities, micronucleus frequency and 8-oxo-dG positive cells, and the effects have been restored by ALA supplementation. CONCLUSIONS The present study clearly demonstrated that ALA ameliorates nicotine-associated oxidative stress, DNA damage and testicular toxicity in the offspring by improving steroidogenesis, spermatogenesis and sperm count.
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Abstract
BACKGROUND When administering psychotropic drugs during pregnancy not only the potential teratogenic effects on the child must be addressed but also the fetotoxic implications for pregnancy and/or the peripartum phase as well as possible neurocognitive developmental disorders must be considered. OBJECTIVE Evaluation of the risks and benefits of administering psychotropic drugs during pregnancy or for women who wish to become pregnant. METHODS The literature has been reviewed with the purpose of providing information on psychotropic drugs which can safely be administered during pregnancy. The review considers antipsychotics as well as tranquilizers and hypnotics. RESULTS Data are available for a multitude of psychotropic drugs that allow a safe estimation on their suitability for use during pregnancy. CONCLUSION When treating mental illnesses during pregnancy the option of administering drugs must not principally be ruled out. What is required is an individual assessment of benefits and risks. The risk of an untreated mental illness versus the benefit of a suitable treatment, which may include the use of medication and the potential harm to the infant must be evaluated. If certain rules are observed and a suitable drug is selected the risk to the newborn child and/or mother during pregnancy can be minimized. During pregnancy, therapeutic drug monitoring is indicated and increases the safety for use of drugs and preventing harm to both mother and infant.
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Affiliation(s)
- N Bergemann
- Sächsisches Krankenhaus Rodewisch, Zentrum für Psychiatrie, Psychotherapie, Psychosomatik und Neurologie, Bahnhofstraße 1, 08228, Rodewisch, Deutschland.
| | - W E Paulus
- Institut für Reproduktionstoxikologie, Krankenhaus St. Elisabeth, Ravensburg, Deutschland
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Abstract
Two peptides, pramlintide (37 amino acids), an analog of human amylin, and exenatide, synthetic exendin-4 (39 amino acids), are both in late-stage clinical development as potential new treatments for people with diabetes. Both are potential long-term treatments, and there is the likelihood that some women will become pregnant while using one of these peptide therapies. Therefore, it was important to evaluate the potential for each peptide to cross the placental barrier and thereby result in exposure to the fetus. This was examined using ex vivo perfusions of human placentas. The fetal and maternal side of a cotyledon were cannulated and perfused first with buffer, and then with radioactive antipyrine in order to establish the integrity of the system and the perfusion constants. Either pramlintide or exenatide was then added to each acceptable cotyledon perfusate on the maternal side. Each peptide was evaluated at an initial concentration near the therapeutic plasma concentration and at approximately 10-50 times that concentration in each of the three cotyledons. Maternal and fetal perfusate samples were assayed for peptide concentrations using an immunoassay. The ratio of fetal-to-maternal peptide concentrations during equilibrium perfusion were extremely low (pramlintide ≤ 0.006, exenatide 5 ≤ 0.017). These data demonstrate negligible passage of either peptide across the placental barrier. It is, therefore, likely that maternal use of either peptide during gestation will result in negligible exposure to the fetus.
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Weiser MJ, Mucha B, Denheyer H, Atkinson D, Schanz N, Vassiliou E, Benno RH. Dietary docosahexaenoic acid alleviates autistic-like behaviors resulting from maternal immune activation in mice. Prostaglandins Leukot Essent Fatty Acids 2016; 106:27-37. [PMID: 26703213 DOI: 10.1016/j.plefa.2015.10.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 10/30/2015] [Accepted: 10/30/2015] [Indexed: 10/22/2022]
Abstract
The prevalence of autism spectrum disorders over the last several decades has risen at an alarming rate. Factors such as broadened clinical definitions and increased parental age only partially account for this precipitous increase, suggesting that recent changes in environmental factors may also be responsible. One such factor could be the dramatic decrease in consumption of anti-inflammatory dietary omega-3 (n-3) polyunsaturated fatty acids (PUFAs) relative to the amount of pro-inflammatory omega-6 (n-6) PUFAs and saturated fats in the Western diet. Docosahexaenoic acid (DHA) is the principle n-3 PUFA found in neural tissue and is important for optimal brain development, especially during late gestation when DHA rapidly and preferentially accumulates in the brain. In this study, we tested whether supplementation of a low n-3 PUFA diet with DHA throughout development could improve measures related to autism in a mouse model of maternal immune activation. We found that dietary DHA protected offspring from the deleterious effects of gestational exposure to the viral mimetic polyriboinosinic-polyribocytidilic acid on behavioral measures of autism and subsequent adulthood immune system reactivity. These data suggest that elevated dietary levels of DHA, especially during pregnancy and nursing, may help protect normal neurodevelopment from the potentially adverse consequences of environmental insults like maternal infection.
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Affiliation(s)
- Michael J Weiser
- DSM Nutritional Products, Human Nutrition and Health, Boulder, CO, United States.
| | - Brittany Mucha
- William Paterson University, Dept. of Biology, Wayne, NJ, United States
| | - Heather Denheyer
- William Paterson University, Dept. of Biology, Wayne, NJ, United States
| | - Devon Atkinson
- William Paterson University, Dept. of Biology, Wayne, NJ, United States
| | - Norman Schanz
- William Paterson University, Dept. of Biology, Wayne, NJ, United States
| | - Evros Vassiliou
- Kean University, Dept. of Biological Sciences, Union, NJ, United States
| | - Robert H Benno
- William Paterson University, Dept. of Biology, Wayne, NJ, United States
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Abstract
AIMS Studies have highlighted that antenatal steroids could have an effect on neonatal skin maturation. This study examined if there was a relationship between the administration of antenatal glucocorticoids for mothers and the skin injuries in their neonates. Data from skin injury audit were extracted from the neonatal database and analyzed to determine differences in the prevalence of neonates with pressure injuries [cases] whose mothers had received antenatal steroids, compared to those without pressure injuries [control]. RESULTS Of 247 neonates audited, 77 [31%], had documented pressure injuries, 170 [69%] had no documented injury. The median birth weight and gestation were 1400 g [IQR 893-2268 g] and 30.3 weeks [IQR 26.3-40.0 weeks] respectively. Of the neonates born less than 34 weeks, 80% were exposed to antenatal steroids and were equally distributed across patient genders. Within the 77 cases, 53 [66%] were exposed to antenatal steroids compared to controls in which 88 [53%] had not. The effect between cases and controls was not statistically significant [χ2 = 2.81, P = 0.09]. However a difference was noted between genders, as female neonates benefited from the exposure to steroids [OR = 0.317, 95% [CI 0.105-0.956], p value -0.041]. CONCLUSION Antenatal glucocorticoids appear to be beneficial in reducing pressure injury prevalence in female neonates.
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Affiliation(s)
- D August
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- Department of Neonatology, Townsville Hospital and Health Service, Angus Smith Dr. Douglas, QLD, Australia
| | - Y Kandasamy
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- Department of Neonatology, Townsville Hospital and Health Service, Angus Smith Dr. Douglas, QLD, Australia
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Towers CV, Terry PD, Lewis D, Howard B, Chambers W, Armistead C, Weitz B, Porter S, Borman CJ, Kennedy RCM, Chen J. Transplacental passage of antimicrobial paraben preservatives. J Expo Sci Environ Epidemiol 2015; 25:604-7. [PMID: 25944699 DOI: 10.1038/jes.2015.27] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 02/25/2015] [Accepted: 02/26/2015] [Indexed: 05/27/2023]
Abstract
Parabens are widely used preservatives suspected of being endocrine disruptors, with implications for human growth and development. The most common paraben found in consumer products is methylparaben. To date, no study has examined whether these substances cross the human placenta. A total of 100 study subjects (50 mother-child pairs) were enrolled at two medical institutions, serving primarily African-American and Caucasian women, respectively. A maternal blood sample was drawn on admission and a paired cord blood sample was obtained at delivery. Of the 50 mothers, 47 (94%) showed methylparaben in their blood (mean level 20.41 ng/l), and 47 in cords bloods (mean level 36.54 ng/l). There were 45 mother-child pairs where methylparaben was found in both samples. Of these, the fetal level was higher than the maternal level in 23 (51%). For butylparaben, only 4 mothers (8%) showed detectable levels (mean 40.54 ng/l), whereas 8 cord blood samples (16%) were positive (mean 32.5 ng/l). African-American mothers and infants showed higher prevalence of detectable levels (P=0.017). Methylparaben and butylparaben demonstrate transplacental passage. Additional studies are needed to examine potential differences in exposure by geography and demographics, what products are used by pregnant women that contain these preservatives, as well as any potential long-term effects in the growth and development of exposed children.
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Affiliation(s)
- Craig V Towers
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal, Medicine, University of Tennessee Medical Center, Knoxville, TN, USA
| | - Paul D Terry
- Department of Surgery, University of Tennessee Medical Center, Knoxville, TN, USA
- Department of Public Health, University of Tennessee, Knoxville, TN, USA
| | - David Lewis
- Department of Obstetrics and Gynecology, University of South Alabama, Mobile, AL, USA
| | - Bobby Howard
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal, Medicine, University of Tennessee Medical Center, Knoxville, TN, USA
| | - Wesley Chambers
- Department of Obstetrics and Gynecology, University of South Alabama, Mobile, AL, USA
| | - Casey Armistead
- Department of Obstetrics and Gynecology, University of South Alabama, Mobile, AL, USA
| | - Beth Weitz
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal, Medicine, University of Tennessee Medical Center, Knoxville, TN, USA
| | - Stephanie Porter
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal, Medicine, University of Tennessee Medical Center, Knoxville, TN, USA
| | - Christopher J Borman
- Center for Environmental Biotechnology, University of Tennessee, Knoxville, TN, USA
| | | | - Jiangang Chen
- Department of Public Health, University of Tennessee, Knoxville, TN, USA
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Meyers K, Qian H, Wu Y, Lao Y, Chen Q, Dong X, Li H, Yang Y, Jiang C, Zhou Z. Early Initiation of ARV During Pregnancy to Move towards Virtual Elimination of Mother-to-Child-Transmission of HIV-1 in Yunnan, China. PLoS One 2015; 10:e0138104. [PMID: 26407096 PMCID: PMC4583380 DOI: 10.1371/journal.pone.0138104] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/25/2015] [Indexed: 11/18/2022] Open
Abstract
Objective To identify factors associated with mother-to-child-transmission and late access to prevention of maternal to child transmission (PMTCT) services among HIV-infected women; and risk factors for infant mortality among HIV-exposed infants in order to assess the feasibility of virtual elimination of vertical transmission and pediatric HIV in this setting. Design Observational study evaluating the impact of a provincial PMTCT program. Methods The intervention was implemented in 26 counties of Yunnan Province, China at municipal and tertiary health care settings. Log linear regression models with generalized estimating equations were used to identify unadjusted and adjusted correlates for late ARV intervention and MTCT. Cox proportional hazard models with robust sandwich estimation were applied to examine correlates of infant mortality. Results Mother-to-child- transmission rate of HIV was controlled to 2%, with late initiation of maternal ARV showing a strong association with vertical transmission and infant mortality. Risk factors for late initiation of maternal ARV were age, ethnicity, education, and having a husband not tested for HIV. Mortality rate among HIV-exposed infants was 2.9/100 person-years. In addition to late initiation of maternal ARV, ethnicity, low birth weight and preterm birth were associated with infant mortality. Conclusions This PMTCT program in Yunnan achieved low rates of MTCT. However the infant mortality rate in this cohort of HIV-exposed children was almost three times the provincial rate. Virtual elimination of MTCT of HIV is an achievable goal in China, but more attention needs to be paid to HIV-free survival.
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Affiliation(s)
- Kathrine Meyers
- Aaron Diamond AIDS Research Center, New York, New York, United States of America
| | - Haoyu Qian
- Aaron Diamond AIDS Research Center, New York, New York, United States of America
| | | | - Yunfei Lao
- Yunnan AIDS Care Center, Kunming, Yunnan, China
| | | | - Xingqi Dong
- Yunnan AIDS Care Center, Kunming, Yunnan, China
| | - Huiqin Li
- Yunnan AIDS Care Center, Kunming, Yunnan, China
| | - Yiqing Yang
- Linxiang Maternal and Child Hospital, Lincang, Yunnan, China
| | - Chengqin Jiang
- Mangshi Maternal and Child Hospital, Dehong, Yunnan, China
| | - Zengquan Zhou
- Yunnan AIDS Care Center, Kunming, Yunnan, China
- Yunnan AIDS Initiative, Kunming, Yunnan, China
- * E-mail:
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Gomez DE, Kuthiala S, Liu HL, Durosier DL, Cao M, Burns P, Desrochers A, Fecteau G, Frasch MG. Effect of maternal ketoacidosis on the ovine fetus. Can Vet J 2015; 56:863-866. [PMID: 26246634 PMCID: PMC4502857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Ketoacidosis during pregnancy carries significant risk of intrauterine fetal demise, but little is known about the impact of ketoacids on the ovine fetus. We report a case series of maternal ketoacidosis in ewes. Maternal ketoacidosis may result in biochemical and acid-base fetal abnormalities associated with changes in feto-placental unit perfusion.
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Chan F, Koren G. Is periconceptional opioid use safe? Can Fam Physician 2015; 61:431-433. [PMID: 26167561 PMCID: PMC4430058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
QUESTION A patient in my practice who takes buprenorphine for chronic pain would like to conceive. Is it safe for her to continue taking her medication? ANSWER The literature regarding periconceptional opioid use is conflicted as to whether opioids pose an elevated risk of birth defects. Confounding factors such as socioeconomic status, stress, and alcohol consumption might play a role. The first trimester of pregnancy is the critical period of development for many organ systems in the embryo. A chemical or environmental insult is more likely to produce major congenital malformations such as neural tube defects or mental retardation if it occurs within this window. Medical practitioners should judiciously consider a risk-benefit analysis before making their decisions.
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Abstract
As development proceeds from the embryonic to fetal stages, cardiac energy demands increase substantially, and oxidative phosphorylation of ADP to ATP in mitochondria becomes vital. Relatively little, however, is known about the signaling mechanisms regulating the transition from anaerobic to aerobic metabolism that occurs during the embryonic period. The main objective of this study was to test the hypothesis that adrenergic hormones provide critical stimulation of energy metabolism during embryonic/fetal development. We examined ATP and ADP concentrations in mouse embryos lacking adrenergic hormones due to targeted disruption of the essential dopamine β-hydroxylase (Dbh) gene. Embryonic ATP concentrations decreased dramatically, whereas ADP concentrations rose such that the ATP/ADP ratio in the adrenergic-deficient group was nearly 50-fold less than that found in littermate controls by embryonic day 11.5. We also found that cardiac extracellular acidification and oxygen consumption rates were significantly decreased, and mitochondria were significantly larger and more branched in adrenergic-deficient hearts. Notably, however, the mitochondria were intact with well-formed cristae, and there was no significant difference observed in mitochondrial membrane potential. Maternal administration of the adrenergic receptor agonists isoproterenol or l-phenylephrine significantly ameliorated the decreases in ATP observed in Dbh-/- embryos, suggesting that α- and β-adrenergic receptors were effective modulators of ATP concentrations in mouse embryos in vivo. These data demonstrate that adrenergic hormones stimulate cardiac energy metabolism during a critical period of embryonic development.
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Affiliation(s)
- Candice N Baker
- Burnett School of Biomedical Sciences, University of Central Florida, College of Medicine, Orlando, Florida; and
| | - Sarah A Gidus
- Burnett School of Biomedical Sciences, University of Central Florida, College of Medicine, Orlando, Florida; and
| | - George F Price
- Department of Electron Microscopy, Department of Pathology, Orlando Regional Medical Center, Orlando, Florida
| | - Jessica N R Peoples
- Burnett School of Biomedical Sciences, University of Central Florida, College of Medicine, Orlando, Florida; and
| | - Steven N Ebert
- Burnett School of Biomedical Sciences, University of Central Florida, College of Medicine, Orlando, Florida; and
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Dooley R, Dooley J, Antone I, Guilfoyle J, Gerber-Finn L, Kakekagumick K, Cromarty H, Hopman W, Muileboom J, Brunton N, Kelly L. Narcotic tapering in pregnancy using long-acting morphine: an 18-month prospective cohort study in northwestern Ontario. Can Fam Physician 2015; 61:e88-e95. [PMID: 25821873 PMCID: PMC4325877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To document the management of and outcomes for patients receiving narcotic replacement and tapering with long-acting morphine preparations during pregnancy. DESIGN A prospective cohort study over 18 months. SETTING Northwestern Ontario. PARTICIPANTS All 600 births at Meno Ya Win Health Centre in Sioux Lookout, Ont, from January 1, 2012, to June 30, 2013, including 166 narcotic-exposed pregnancies. INTERVENTION Narcotic replacement and tapering of narcotic use with long-acting morphine preparations. MAIN OUTCOME MEASURES Prenatal management of maternal narcotic use, incidence of neonatal abstinence syndrome, and other neonatal outcomes. RESULTS The incidence of neonatal abstinence syndrome fell significantly to 18.1% of pregnancies exposed to narcotics (from 29.5% in a previous 2010 study, P = .003) among patients using narcotic replacement and tapering with long-acting morphine preparations. Neonatal outcomes were otherwise equivalent to those of the nonexposed pregnancies. CONCLUSION In many patients, long-acting morphine preparations can be safely used and tapered in pregnancy, with a subsequent decrease in observed neonatal withdrawal symptoms.
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Fraser J. Drug use v drug abuse. Pract Midwife 2015; 18:5. [PMID: 26310081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Fu L, Yu Z, Chen YH, Xia MZ, Wang H, Zhang C, Tao FB, Xu DX. Orally administered melatonin prevents lipopolysaccharide-induced neural tube defects in mice. PLoS One 2014; 9:e113763. [PMID: 25420102 PMCID: PMC4242665 DOI: 10.1371/journal.pone.0113763] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 10/29/2014] [Indexed: 01/06/2023] Open
Abstract
Lipopolysaccharide (LPS) has been associated with adverse pregnant outcomes, including fetal demise, intra-uterine growth restriction (IUGR), neural tube defects (NTDs) and preterm delivery in rodent animals. Previous studies demonstrated that melatonin protected against LPS-induced fetal demise, IUGR and preterm delivery. The aim of the present study was to investigate the effects of melatonin on LPS-induced NTDs. All pregnant mice except controls were intraperitoneally injected with LPS (25 µg/kg) daily from gestational day (GD)8 to GD12. Some pregnant mice were orally administered with melatonin (MT, 50 mg/kg) before each LPS injection. A five-day LPS injection resulted in 27.5% of fetuses with anencephaly, exencephaly or encephalomeningocele. Additional experiment showed that maternal LPS exposure significantly down-regulated placental proton-coupled folate transporter (pcft) and disturbed folate transport from maternal circulation through the placentas into the fetus. Interestingly, melatonin significantly attenuated LPS-induced down-regulation of placental pcft. Moreover, melatonin markedly improved the transport of folate from maternal circulation through the placentas into the fetus. Correspondingly, orally administered melatonin reduced the incidence of LPS-induced anencephaly, exencephaly or encephalomeningocele. Taken together, these results suggest that orally administered melatonin prevents LPS-induced NTDs through alleviating LPS-induced disturbance of folate transport from maternal circulation through the placenta into the fetus.
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Affiliation(s)
- Lin Fu
- Department of Toxicology, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
| | - Zhen Yu
- Department of Toxicology, Anhui Medical University, Hefei, China
| | - Yuan-Hua Chen
- Department of Toxicology, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
| | - Mi-Zhen Xia
- School of Life Science, Anhui Medical University, Hefei, China
| | - Hua Wang
- Department of Toxicology, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
| | - Cheng Zhang
- Department of Toxicology, Anhui Medical University, Hefei, China
| | - Fang-Biao Tao
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
- * E-mail: (FBT); (DXX)
| | - De-Xiang Xu
- Department of Toxicology, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
- * E-mail: (FBT); (DXX)
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Audette MC, Challis JRG, Jones RL, Sibley CP, Matthews SG. Synthetic glucocorticoid reduces human placental system a transport in women treated with antenatal therapy. J Clin Endocrinol Metab 2014; 99:E2226-33. [PMID: 25105735 DOI: 10.1210/jc.2014-2157] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
CONTEXT Synthetic glucocorticoids (sGCs) are routinely given to women with threatened preterm labor and have been linked to fetal growth restriction and developmental programming. Reductions in fetal growth are likely to be mediated by placental dysfunction, including altered nutrient transport. sGCs modify the system A neutral amino acid transporter in vitro, but there are no in vivo comparable data in human placenta. OBJECTIVE Because ∼ 30% of women who receive sGCs carry to term, our objective was to examine the short- and longer-term consequences of antenatal sGCs on placental system A transport. METHODS AND PATIENTS Placental tissue was collected from women treated with sGCs between 24 hours and 14 days before delivery (24h-14d), 14 days after treatment but before term (14d-term), or at term, compared with healthy term (control) deliveries to measure system A-mediated activity (Na(+)-dependent [(14)C]methylaminoisobutyric acid uptake per gram placenta) and mRNA expression. RESULTS After sGC treatment, system A activity was significantly reduced at term compared with both sGC placentas delivered 24h-14d and compared with controls. Placentae from women treated with sGCs who delivered between 14d-term also had significantly reduced system A activity compared with 24h-14d placentas. SLC38A1 and SLC38A2 mRNA expression was unaffected. However, SLC38A4 was significantly reduced by sGCs at term compared with placentas delivered between 14d-term. CONCLUSION We conclude that women who are at risk of preterm labor and receive sGCs but deliver at term have significantly reduced placental system A amino acid transporter activity. Altered placental transporter function could affect fetal growth and may contribute to developmental programming reported in both animal and clinical studies.
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Affiliation(s)
- Melanie C Audette
- Departments of Physiology (M.C.A., J.R.G.C., S.G.M.), Obstetrics and Gynecology (J.R.G.C., S.G.M.), and Medicine (M.C.A., J.R.G.C., S.G.M.) University of Toronto, Toronto, Ontario Canada M5A 1A8; and Maternal and Fetal Heath Research Centre (J.R.G.C., R.L.J., C.P.S.), School Institute of Human Development, Manchester Academic Health Sciences Centre, University of Manchester, St. Mary's Hospital, Central Manchester University Hospitals National Health Service Foundation Trust, Manchester M13 9WL, United Kingdom
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Nevers W, Pupco A, Koren G, Bozzo P. Safety of tacrolimus in pregnancy. Can Fam Physician 2014; 60:905-906. [PMID: 25316742 PMCID: PMC4196812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
QUESTION I have a 30-year-old patient who had a kidney transplant 2 years ago. She is now planning a pregnancy. She has been treated with tacrolimus since her transplant. Will it be safe for the fetus if she continues to take it during the pregnancy or should she switch to a different antirejection medication? ANSWER If your patient is stable while taking tacrolimus, there is no reason to switch. The current available information does not suggest that tacrolimus increases the risk of major congenital malformations above the baseline risk in the general population. Premature birth and low birth weight are often reported in this population; however, these effects are frequently reported in pregnant transplant patients treated with other immunosuppressant agents and probably reflect the effects of the maternal condition. As there are some reports of hyperkalemia and renal impairment in infants exposed to tacrolimus in utero, kidney function and electrolytes should be monitored in exposed neonates.
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Jing YH, Song YF, Yao YM, Yin J, Wang DG, Gao LP. Retardation of fetal dendritic development induced by gestational hyperglycemia is associated with brain insulin/IGF-I signals. Int J Dev Neurosci 2014; 37:15-20. [PMID: 24953263 DOI: 10.1016/j.ijdevneu.2014.06.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 06/12/2014] [Accepted: 06/12/2014] [Indexed: 01/26/2023] Open
Abstract
Hyperglycemia is an essential risk factor for mothers and fetuses in gestational diabetes. Clinical observation has indicated that the offspring of mothers with diabetes shows impaired somatosensory function and IQ. However, only a few studies have explored the effects of hyperglycemia on fetal brain development. Neurodevelopment is susceptible to environmental conditions. Thus, this study aims to investigate the effects of maternal hyperglycemia on fetal brain development and to evaluate insulin and insulin-like growth factor-I (IGF-I) signals in fetal brain under hyperglycemia or controlled hyperglycemia. At day 1 of pregnancy, gestational rats were intraperitoneally injected with streptozocin (60 mg/kg). Some of the hyperglycemic gestational rats were injected with insulin (20 IU, two times a day) to control hyperglycemia; the others were injected with saline of equal volume. The gestational rats were sacrificed at days 14, 16, and 18 of embryo development. The dendritic spines of subplate cortex neurons in the fetal brain were detected by Golgi-Cox staining. The mRNA levels of insulin receptors (IRs) and IGF-IR in the fetal brain were measured using qRT-PCR. The protein levels of synaptophysin, IR, and IGF-IR in the fetal brain were detected by western blot. No significant difference in fetal brain formation was observed between the maternal hyperglycemic group and insulin-treated group. By contrast, obvious retardation of dendritic development in the fetus was observed in the maternal hyperglycemic group. Similarly, synaptophysin expression was lower in the fetus of the maternal hyperglycemic group than in that of the insulin-treated group. The mRNA and protein expression levels of IRs in the fetal brain were higher in the hyperglycemic group than in the insulin-treated group. By contrast, the levels of IGF-IR in the brain were lower in the fetus of the maternal hyperglycemic group than in that of the insulin-treated group. These results suggested that maternal hyperglycemia can retard dendritic development in the fetal brain and that these changes partially resulted from abnormal insulin/IGF-I signaling in the fetal brain.
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Affiliation(s)
- Yu-Hong Jing
- Institute of Anatomy and Embryology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, PR China; Key Laboratory of Preclinical Study for New Drugs of Gansu Province, Lanzhou University, Lanzhou, PR China.
| | - Yan-Feng Song
- Institute of Anatomy and Embryology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, PR China
| | - Ya-Ming Yao
- Institute of Anatomy and Embryology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, PR China
| | - Jie Yin
- Institute of Anatomy and Embryology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, PR China
| | - De-Gui Wang
- Institute of Anatomy and Embryology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, PR China
| | - Li-Ping Gao
- Institute of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, PR China
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Helseth R, Vanky E, Stridsklev S, Vogt C, Carlsen SM. Maternal and fetal insulin levels at birth in women with polycystic ovary syndrome: data from a randomized controlled study on metformin. Eur J Endocrinol 2014; 170:769-75. [PMID: 24595965 DOI: 10.1530/eje-13-0859] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
CONTEXT Metformin is suggested to reduce pregnancy complications in women with polycystic ovary syndrome (PCOS). Metformin crosses the placenta and therapeutic concentrations are measured in the fetal circulation. Whether metformin treatment in pregnant PCOS women affects maternal and fetal insulin concentrations at birth is not clarified. OBJECTIVES To investigate the possible effect of metformin on insulin concentrations in umbilical cord blood and the possible association between maternal and fetal insulin concentrations. DESIGN Post-hoc analysis of a subgroup of PCOS women participating in a double-blind randomized controlled trial. SETTING University hospital setting. PARTICIPANTS Women with PCOS (n=118), aged 19-39 years. MAIN OUTCOME MEASURES Maternal and umbilical cord insulin concentrations immediately after birth. RESULTS At delivery women randomized to metformin had lower insulin concentrations than those randomized to placebo (259±209 vs 361±261 pmol/l; P=0.020). No difference was found in insulin concentrations in umbilical venous (P=0.95) and arterial (P=0.39) blood between the metformin and placebo groups. The arteriovenous difference was also equal between the groups (P=0.38). Insulin concentrations were higher in the umbilical vein than in the umbilical artery independent of randomization (70±51 vs 45±48 pmol/l; P<0.0005). CONCLUSIONS In PCOS, metformin treatment during pregnancy resulted in lower maternal insulin concentrations at delivery. Metformin treatment did not affect fetal insulin concentrations. Higher insulin concentrations in the umbilical vein indicate that the placenta somehow secretes insulin to the fetus. The possibility of placental insulin secretion to the fetus deserves further investigations.
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Affiliation(s)
- Ragnhild Helseth
- Department of Internal Medicine, Drammen Hospital, Vestre Viken, Dronninggata 28, 3004 Drammen, Norway
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Abstract
When considering whether to administer drugs to women during pregnancy and lactation, we have to take into account that these substances may expose the fetus or neonate to multiple effects. This occurs because there is a unique situation where the maternal compartment is connected with the fetal or neonatal compartment through, respectively, the placental barrier or breast milk. The fetus in utero and the breast-fed neonate are to be considered as organisms exposed and sensitive to the effects of drugs that cross the placenta or enter the breast milk. This review focuses on the most frequently used antibiotics during pregnancy and lactation and presents useful suggestions for daily practice. Drugs that must be avoided are clearly underlined.
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Affiliation(s)
- A Reali
- Neonatal Pathology and Intensive Care Unit, University of Cagliari, Italy
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Schonfeld T, Schmid KK, Brown JS, Amoura NJ, Gordon B. A pregnancy testing policy for women enrolled in clinical trials. IRB 2013; 35:9-15. [PMID: 24437001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
| | - Kendra K Schmid
- Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - N Jean Amoura
- Department of Obstetrics and Gynecology, University of Nebraska Medical Center, Omaha NE, USA
| | - Bruce Gordon
- University of Nebraska Medical Center, Omaha, NE, USA
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Zelner I, Koren G. Pharmacokinetics of ethanol in the maternal-fetal unit. J Popul Ther Clin Pharmacol 2013; 20:e259-e265. [PMID: 24142064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Due to its wide range of deleterious effects on the unborn baby, knowledge on the disposition of ethanol in the maternal-fetal unit is critical. This review summarizes and updates the existing evidence on ethanol disposition in the mother, the placenta and the fetus, and relates them to their potential fetal effects.
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Querfeld U, Keil T, Beyer K, Stock P, Pilz S, März W, Weisse K, Lehmann I. Vitamin D in early life: good or bad for food allergies? Allergy 2013; 68:1081-3. [PMID: 23968384 DOI: 10.1111/all.12178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Pomeroy EC, Parrish DE. Online training on fetal alcohol spectrum disorders for court-appointed special advocates volunteers. Health Soc Work 2013; 38:159-166. [PMID: 24437021 DOI: 10.1093/hsw/hlt014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Fetal alcohol spectrum disorders (FASDs) are a leading cause of developmental disabilities. Children within the child welfare system are five to 10 times more likely than other children to experience these symptoms. Court Appointed Special Advocates (CASA) volunteers are uniquely positioned to identify these children and refer them for assessment and services. This study used a one-group pretest-posttest design to assess the impact of a three-hour online FASDs training on CASA workers' knowledge of FASDs and their comfort and confidence in identifying children with FASDs for referral, advocating for them, and linking them to services. The training and assessment measures were completed by 338 CASA volunteers and staff from 55 CASA locations in Texas. Wilcoxon matched-pairs tests and paired t tests were used to assess change in each of the dependent measures. All comfort and confidence items showed significant improvement from pretest to posttest; there was also a significant improvement in knowledge. These results support the potential of this online training to enhance CASA volunteers' ability to help children with FASDs.
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Affiliation(s)
- Elizabeth C Pomeroy
- Institute for Grief, Loss, and Family Survival, School of Social Work, University of Texas at Austin, TX 78712, USA.
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Rebagliato M, Murcia M, Alvarez-Pedrerol M, Espada M, Fernández-Somoano A, Lertxundi N, Navarrete-Muñoz EM, Forns J, Aranbarri A, Llop S, Julvez J, Tardón A, Ballester F. Iodine supplementation during pregnancy and infant neuropsychological development. INMA Mother and Child Cohort Study. Am J Epidemiol 2013; 177:944-53. [PMID: 23548753 DOI: 10.1093/aje/kws333] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Iodine supplementation during pregnancy is a common practice in developed countries. However, scant evidence is available regarding the safety and effectiveness of maternal iodine supplementation with regard to child neuropsychological development. We previously reported an inverse association between iodine supplementation and the psychomotor development of infants in a birth cohort from Valencia, Spain. In the present study, we assessed this association in a wider sample of mother and child pairs from 3 other regions in Spain. Neuropsychological development was assessed using the Bayley Scales of Infant Development in 1,519 infants (median age, 16 months) between 2006 and 2009. In multivariate analyses, maternal consumption of 150 μg/day or more of iodine from supplements was related to a 1.5-fold increase in the odds of a psychomotor score less than 85 (95% confidence interval: 0.8, 2.9) and to a 1.7-fold increase in the odds of a mental score less than 85 (95% confidence interval: 0.9, 3.0). Findings previously reported in the Valencia cohort were only partially verified. The results of the present study suggest that, at least in these regions, iodine supplementation does not improve infant neuropsychological development at 1 year of age. Further research is needed on the risks and benefits of supplementary iodine for both maternal thyroid function and child neurodevelopment.
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Sanghavi DM. A novel method of fetal cardioversion. Pediatr Cardiol 2013; 34:700-1. [PMID: 22526215 DOI: 10.1007/s00246-012-0316-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 03/31/2012] [Indexed: 11/25/2022]
Abstract
The ideal treatment for fetal arrhythmias associated with hydrops is not known. This case report describes a novel approach to fetal cardioversion using oral maternal bolus dosing of flecainide.
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Affiliation(s)
- Darshak M Sanghavi
- Department of Pediatric Cardiology, University of Massachusetts Medical School, Room S 5-715, 55 Lake Avenue North, Worcester, MA 01655, USA.
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Waterman JM, Nadeem E, Paczkowski E, Foster JC, Lavner JA, Belin T, Miranda J. Pre-placement risk and longitudinal cognitive development for children adopted from foster care. Child Welfare 2013; 92:9-30. [PMID: 24851473 PMCID: PMC4772770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study examined the trajectory of cognitive development over the first five years of adoptive placement among children adopted from foster care and how pre-adoption risk factors relate to this development. Overall, children's cognitive scores increased significantly, with the most rapid improvement occurring in the first year post-placement. By five years post-placement, children's mean cognitive and achievement scores were in the average range. Adoption is a positive intervention for children's cognitive development.
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Ma YS, Zhou J, Liu H, Du Y, Lin XM. [Erythropoietin through the placenta barrier and fetal blood-brain barrier with transient uteroplacental ischemia]. Sichuan Da Xue Xue Bao Yi Xue Ban 2012; 43:687-724. [PMID: 23230739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To observe the permeability of recombinant human erythropoietin through placenta barrier and fetal blood-brain barrier after transient uteroplacental ischemia. METHODS Rats on days 19 of pregnancy were divided into rhEPO treated group, ischemia-reperfusion group and sham operated group. Fetal ischemia in rhEPO treated group and ischemia-reperfusion group was induced by bilateral occlusion of the utero-ovarian artery for 20 minutes. Different dosage of 125I-rhEPO (2500 U/kg, 5000 U/kg, 7500 U/kg) was injected into the rats through caudal veins 30 min before injury in rhEPO treated group and sham-operated group. Saline was administered intravenously 30 min before the induction of hypoxic-ischemic injury in ischemia-reperfusion group. The amniotic fluid, placenta and fetal organs including brain, liver, heart, lung and kidney were collected to measure the radioactivity at 24h after injury. RESULTS 125I-rhEPO was detected in amniotic fluid, placenta and fetal organs. The radioactivity of 125I-rhEPO in these tissues increased gradually with the increased dose injected in rhEPO treated group and sham-operated group. There were significant differences in the radioactivity of 125I-rhEPO between rhEPO treated group and sham-operated group (P < 0.05). CONCLUSION The permeability of rhEPO through placental barrier and blood-brain barrier increased under the condition of fetal ischemia and hypoxia.
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Affiliation(s)
- Yu-Shan Ma
- Department of Anesthesia, West China Second Hospital, Sichuan University, Chengdu 610041, China
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Szałek E, Tomczak H, Seremak-Mrozikiewicz A, Bartkowiak-Wieczorek J, Grześkowiak E. [Optimization of antibiotic therapy in pregnancy--clinical implications]. Ginekol Pol 2012; 83:462-468. [PMID: 22880468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
The aim of the antibacterial therapy during pregnancy is to select a proper antibiotic and determine its effective dose, at the same time excluding the risk of potential teratogenic effect. Pregnancy is characterized by many physiological, disease-predisposing changes, particularly of bacterial etiology that have an influence on different pharmacokinetic of drugs. When determining an effective dose of an antibiotic, one should take into account changes in the pharmacokinetics (PK) of drugs in pregnant women, involving mainly the phase of distribution (increased volume of body fluids, cardiac output, reduced concentration of albumins), metabolism (induction of hepatic enzymes: CYP3A4, CYP2D6, CYP2C9, UGT1A4, UGT2B7, inhibition of CYP1A2, CYP2C19), and excretion (increased glomerular filtration rate). Results of few pharmacokinetic studies on pregnant patients point to the need of increasing the dose or reducing dosage intervals for some antibiotics (e.g. penicillin V ampicillin, piperacillin, imipenem, clindamycin). The aim of this study was to summarize current knowledge regarding the PK of antibiotics during pregnancy.
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Affiliation(s)
- Edyta Szałek
- Katedra i Zakład Farmacji Klinicznej i Biofarmacji, UM Poznań, Polska.
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