51
|
Cassiano RGM, Provenzi L, Linhares MBM, Gaspardo CM, Montirosso R. Maternal sociodemographic factors differentially affect the risk of behavioral problems in Brazilian and Italian preterm toddlers. Infant Behav Dev 2018; 50:165-173. [DOI: 10.1016/j.infbeh.2017.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 11/17/2017] [Accepted: 12/26/2017] [Indexed: 11/24/2022]
|
52
|
Provenzi L, Scotto di Minico G, Giorda R, Montirosso R. Telomere Length in Preterm Infants: A Promising Biomarker of Early Adversity and Care in the Neonatal Intensive Care Unit? Front Endocrinol (Lausanne) 2017; 8:295. [PMID: 29163364 PMCID: PMC5671586 DOI: 10.3389/fendo.2017.00295] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 10/16/2017] [Indexed: 11/13/2022] Open
Abstract
Preterm infants present an immature neurobehavioral profile at birth, even in absence of severe brain injuries and perinatal complications. As such, they require a long-lasting hospitalization in the Neonatal Intensive Care Unit (NICU), which is thought to grant at-risk newborns' survival, but still entails a number of physical, painful, and socio-emotional stressors. Hence, preterm birth and NICU stay represent an early adverse experience, which has been linked to detrimental consequences for neurological, neuro-endocrinal, behavioral, and socio-emotional development, as well as to disease later in life. Recent advances in the behavioral epigenetic field are helping us to unveil the potential mechanisms through which early NICU-related stress may lead to negative developmental outcomes. From this perspective, telomere regulation might be a key programming mechanism. Telomeres are the terminal portion of chromosomes and are known to get shorter with age. Moreover, telomere length (TL) is affected by the exposure to stress during early development. As such, TL might be an innovative biomarker of early adverse exposures in young infants and children. Unfortunately, there is paucity of studies investigating TL in populations of preterm infants and its association with known NICU-related stressors remains unexplored. In the present paper, the potential relevance of TL for research and clinical work with preterm infants will be underlined in the light of recent contributions linking progressive telomere shortening and early exposure to adverse experiences and stressful environments in humans. Finally, insights will be provided to guide clinically relevant translational research on TL in the field of VPT birth and NICU stay.
Collapse
Affiliation(s)
- Livio Provenzi
- 0–3 Center for the At-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| | | | - Roberto Giorda
- Molecular Biology Laboratory, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Rosario Montirosso
- 0–3 Center for the At-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| |
Collapse
|
53
|
Provenzi L, Cassiano RGM, Scotto di Minico G, Linhares MBM, Montirosso R. Study Protocol for the Preschooler Regulation of Emotional Stress (PRES) Procedure. Front Psychol 2017; 8:1653. [PMID: 29018383 PMCID: PMC5615862 DOI: 10.3389/fpsyg.2017.01653] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 09/08/2017] [Indexed: 01/04/2023] Open
Abstract
Background: Emotional stress regulation (ESR) rapidly develops during the first months of age and includes different behavioral strategies which largely contribute to children’s behavioral and emotional adjustment later in life. The assessment of ESR during the first years of life is critical to identify preschool children who are at developmental risk. Although ESR is generally included in larger temperament batteries [e.g., the Laboratory Temperament Assessment Battery (Lab-TAB)], there is no standardized observational procedure to specifically assess and measure ESR in preschool aged children. Aim: Here, we describe the development of an observational procedure to assess ESR in preschool aged children [i.e., the Preschooler Regulation of Emotional Stress (PRES) Procedure] and the related coding system. Methods: Four Lab-TAB emotional stress episodes (i.e., the Stranger, the Perfect Circle, the Missing Sticker, and the Transparent Box) have been selected. Independent coders developed a list of ESR codes resulting in two general indexes (i.e., active engagement and stress level) and five specific indexes (i.e., anger, control, fear, inhibition, sadness). Finally, specific actions have been planned to assess the validity and the coding system reliability of PRES procedure. Ethics and Dissemination: The study has been approved by the Ethical Committee of the Scientific Institute IRCCS Eugenio Medea, Bosisio Parini (Italy). The PRES validation and reliability assessment as well as its use with healthy and at-risk populations of preschool children will be object of future scientific publications and international conference presentations.
Collapse
Affiliation(s)
- Livio Provenzi
- 0-3 Center for the at-Risk Infant, Scientific Institute IRCCS Eugenio MedeaBosisio Parini, Italy
| | - Rafaela G M Cassiano
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São PauloRibeirão Preto, Brazil
| | - Giunia Scotto di Minico
- 0-3 Center for the at-Risk Infant, Scientific Institute IRCCS Eugenio MedeaBosisio Parini, Italy
| | - Maria B M Linhares
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São PauloRibeirão Preto, Brazil
| | - Rosario Montirosso
- 0-3 Center for the at-Risk Infant, Scientific Institute IRCCS Eugenio MedeaBosisio Parini, Italy
| |
Collapse
|
54
|
Provenzi L, Fumagalli M, Giorda R, Morandi F, Sirgiovanni I, Pozzoli U, Mosca F, Borgatti R, Montirosso R. Maternal Sensitivity Buffers the Association between SLC6A4 Methylation and Socio-Emotional Stress Response in 3-Month-Old Full Term, but not very Preterm Infants. Front Psychiatry 2017; 8:171. [PMID: 28959218 PMCID: PMC5604082 DOI: 10.3389/fpsyt.2017.00171] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 08/30/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Very preterm (VPT) infants are hospitalized in Neonatal Intensive Care Units (NICUs) and are exposed to life-saving procedures eliciting pain-related stress. Recent research documented that pain-related stress might result in birth-to-discharge increased methylation of serotonin transporter gene (SLC6A4) in VPT infants, leading to poorer stress regulation at 3 months of age in VPT infants compared to their full-term (FT) counterparts. Maternal sensitivity is thought to support infants' stress response, but its role in moderating the effects of altered SLC6A4 methylation is unknown. MAIN AIM To assess the role of maternal sensitivity in moderating the association between altered SLC6A4 methylation and stress response in 3-month-old VPT and FT infants. METHODS 53 infants (27 VPTs, 26 FTs) and their mothers were enrolled. SLC6A4 methylation was obtained from peripheral blood samples at NICU discharge for VPT infants and from cord blood at birth for FT infants. At 3 months (age corrected for prematurity), both groups participated to the face-to-face still-face (FFSF) paradigm to measure both infants' stress response (i.e., negative emotionality) and maternal sensitivity. RESULTS Maternal sensitivity did not significantly differ between VPT and FT infants' mothers. In VPT infants, higher SLC6A4 methylation at hospital discharge associates with higher negative emotionality during the FFSF. In FT infants, SLC6A4 methylation and maternal sensitivity significantly interacted to predict stress response: a positive significant association between SLC6A4 methylation and negative emotionality emerged only in FT infants of less-sensitive mothers. DISCUSSION Although no differences emerged in caregiving behavior in the two groups of mothers, maternal sensitivity was effective in moderating the effects of SLC6A4 methylation in FT infants, but not in VPT infants at 3 months. Speculatively, the buffering effect of maternal sensitivity observed in FT infants was disrupted by the altered early mother-infant contact due to NICU stay of the VPT group. These findings indirectly support that the effects of maternal sensitivity on infants' socio-emotional development might be time dependent, and that mother-infant interventions in the NICU need to be provided precociously within a narrow sensitive period after VPT birth.
Collapse
Affiliation(s)
- Livio Provenzi
- 0-3 Center for the at-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| | - Monica Fumagalli
- NICU, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberto Giorda
- Molecular Biology Laboratory, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| | | | - Ida Sirgiovanni
- NICU, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Uberto Pozzoli
- Bioinformatic Lab, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| | - Fabio Mosca
- NICU, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Renato Borgatti
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| | - Rosario Montirosso
- 0-3 Center for the at-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| |
Collapse
|
55
|
Provenzi L, Guida E, Montirosso R. Preterm behavioral epigenetics: A systematic review. Neurosci Biobehav Rev 2017; 84:262-271. [PMID: 28867654 DOI: 10.1016/j.neubiorev.2017.08.020] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 06/28/2017] [Accepted: 08/30/2017] [Indexed: 12/24/2022]
Abstract
Behavioral epigenetics is revealing new pathways that lead individuals from early adversity exposures to later-in-life detrimental outcomes. Preterm birth constitutes one of the major adverse events in human development. Preterm infants are hospitalized in the Neonatal Intensive Care Unit (NICU) where they are exposed to life-saving yet pain-inducing procedures and to protective care. The application of behavioral epigenetics to the field of preterm studies (i.e., Preterm Behavioral Epigenetics, PBE) is rapidly growing and holds promises to provide valid insights for research and clinical activity. Here, the evidence of the epigenetic correlates of prenatal adversities, NICU-related environment and development of preterm infants is systematically reviewed. The findings suggest that a number of prenatal adverse (e.g., maternal depression and stress) and post-natal (e.g., NICU-related pain-related stress) events affect the developmental trajectories of preterm infants and children via epigenetic alterations of imprinted and stress-related genes. Nonetheless, the potential epigenetic vestiges of early care and protective interventions in NICU have not been investigated yet and this represents a fascinating challenge for future PBE research.
Collapse
Affiliation(s)
- Livio Provenzi
- 0-3 Centre for the at-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, LC, Italy.
| | - Elena Guida
- 0-3 Centre for the at-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, LC, Italy
| | - Rosario Montirosso
- 0-3 Centre for the at-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, LC, Italy
| |
Collapse
|
56
|
Cassiano RGM, Gaspardo CM, Faciroli RADD, Martinez FE, Linhares MBM. Temperament and behavior in toddlers born preterm with related clinical problems. Early Hum Dev 2017. [PMID: 28628773 DOI: 10.1016/j.earlhumdev.2017.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of this study was to compare temperament and behavior profiles among groups of preterm toddlers differentiated by level of prematurity and the presence of bronchopulmonary dysplasia (BPD) or retinopathy of prematurity (ROP), controlling for neonatal clinical conditions and chronological age. METHOD The sample comprised 100 preterm toddlers segregated according to level of prematurity (75 very preterm and 25 moderate/late preterm) and presence of BPD (n=36) and ROP (n=63). Temperament was assessed by the Early Childhood Behavior Questionnaire and behavior by the Child Behavior Checklist. The MANOVA was performed with a post-hoc univariate test. RESULTS The level of prematurity and the presence of BPD and ROP did not affect temperament and behavioral problems in toddlers born preterm. However, the covariates age and length of stay in NICU (Neonatal Intensive Care Unit) affected temperament and behavioral problems, respectively. The older toddlers showed higher inhibitory control and lower activity levels than younger toddlers (range of 18-36months-old). Additionally, toddlers who stayed in the NICU longer showed more pervasive development and emotionally reactive problems than toddlers who stayed in NICU for less time. CONCLUSION The level of prematurity and the presence of bronchopulmonary dysplasia and retinopathy of prematurity did not affect temperament and behavioral problems in toddlers born preterm. However, a longer stay in the NICU increased the risk for behavioral problems, and age enhanced the regulation of temperament at toddlerhood.
Collapse
Affiliation(s)
- Rafaela Guilherme Monte Cassiano
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Claudia Maria Gaspardo
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ricardo Augusto de Deus Faciroli
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Francisco Eulógio Martinez
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Maria Beatriz Martins Linhares
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| |
Collapse
|
57
|
Sorrentino G, Fumagalli M, Milani S, Cortinovis I, Zorz A, Cavallaro G, Mosca F, Plevani L. The impact of automatic devices for capillary blood collection on efficiency and pain response in newborns: A randomized controlled trial. Int J Nurs Stud 2017; 72:24-29. [DOI: 10.1016/j.ijnurstu.2017.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 03/29/2017] [Accepted: 04/04/2017] [Indexed: 01/12/2023]
|
58
|
EDIN Scale Implemented by Gestational Age for Pain Assessment in Preterms: A Prospective Study. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9253710. [PMID: 28271074 PMCID: PMC5320371 DOI: 10.1155/2017/9253710] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/11/2016] [Accepted: 12/28/2016] [Indexed: 11/17/2022]
Abstract
Background. Chronic neonatal pain can lead to long-term adverse effects on the immature brain. EDIN scale for prolonged pain might not be fully suitable for premature infants. We aimed to test a modified EDIN scale, adding postmenstrual age (PMA) as a sixth item (EDIN6). Methods. In a two-phase prospective study, pain was assessed in all neonates admitted in our NICU. In T1 EDIN was applied; in T2 EDIN6 with additional scores of 2, 1, and 0, respectively, for 25–32, 33–37, and >37 weeks PCA was tested. Scores > 6 suggested pain. The nursing staff was given a questionnaire to evaluate EDIN and EDIN6. Results. A total of 15960 pain assessments were recorded (8693 in T1; 7267 in T2). With EDIN6, cumulative detection of pain almost tripled (117/7267 versus 52/8693, p = 0.001). Main differences were found among less mature categories (50/1472 versus 17/1734, p = 0.001 in PCA 25–32; 26/2606 versus 10/4335, p = 0.001 in PMA 33–37; 41/3189 versus 25/2624, p = 0.26 in PMA > 37). Adequacy of pain assessment in lower PMA was judged “medium-high” in 13,4% of nurses in T1 and 71,4% in T2. Conclusions. EDIN6 may allow improved evaluation of pain in preterm infants.
Collapse
|
59
|
Conradt E. Using Principles of Behavioral Epigenetics to Advance Research on Early-Life Stress. CHILD DEVELOPMENT PERSPECTIVES 2017; 11:107-112. [PMID: 29081832 DOI: 10.1111/cdep.12219] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
While the negative effects of early-life stress on children's developmental outcomes are well documented, we know little about how these processes unfold and which children are more susceptible to these exposures. In this article, I outline how studying the effects of early-life stress on children's development can be advanced by considering how epigenetic processes may contribute to the emergence of children's behavior. The study of epigenetics can help pinpoint the mechanisms by which early-life stress may affect developmental outcomes and identify which children may be most sensitive to the effects of these exposures. I conclude by highlighting the challenges inherent in studying epigenetics in children and offer possible solutions.
Collapse
|
60
|
Provenzi L, Giorda R, Beri S, Montirosso R. SLC6A4 methylation as an epigenetic marker of life adversity exposures in humans: A systematic review of literature. Neurosci Biobehav Rev 2016; 71:7-20. [DOI: 10.1016/j.neubiorev.2016.08.021] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 07/18/2016] [Accepted: 08/23/2016] [Indexed: 12/29/2022]
|
61
|
An integrative review of methylation at the serotonin transporter gene and its dialogue with environmental risk factors, psychopathology and 5-HTTLPR. Neurosci Biobehav Rev 2016; 72:190-209. [PMID: 27880876 DOI: 10.1016/j.neubiorev.2016.11.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 11/04/2016] [Accepted: 11/06/2016] [Indexed: 11/24/2022]
Abstract
Gene-environment (G×E) interactions have largely been regarded as the root of many complex disorders, including several psychiatric disorders. In this regard, it has been hypothesized that epigenetic mechanisms may be the main mediators of such interactions. Of particular interest is the previously described interaction between psychosocial stress and genetic variability of the serotonin transporter gene (SLC6A4) in its polymorphic region 5-HTTLPR. Here we review the literature concerning SLC6A4 methylation in association with environmental, clinical or genetic variables. While SLC6A4 hypermethylation has typically been described to be independently associated with both early life stress and depressive disorders, only a few papers address whether methylation could mediate the interaction between stress and 5-HTTLPR in predicting psychopathological risk. Nevertheless, research preliminarily indicates a methylation-driven increased vulnerability of carriers of the short allele of 5-HTTLPR to psychiatric disorders when exposed to early stress or soon after exposure to stress.
Collapse
|
62
|
Montirosso R, Tronick E, Borgatti R. Promoting Neuroprotective Care in Neonatal Intensive Care Units and Preterm Infant Development: Insights From the Neonatal Adequate Care for Quality of Life Study. CHILD DEVELOPMENT PERSPECTIVES 2016. [DOI: 10.1111/cdep.12208] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
63
|
Davidov M, Vaish A, Knafo-Noam A, Hastings PD. The Motivational Foundations of Prosocial Behavior From A Developmental Perspective-Evolutionary Roots and Key Psychological Mechanisms: Introduction to the Special Section. Child Dev 2016; 87:1655-1667. [DOI: 10.1111/cdev.12639] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
64
|
Nikolova YS, Swartz JR, Hariri AR. Can we identify meaningful epigenetic effects on human brain function and related risk for mental illness? Epigenomics 2016; 8:1307-1310. [PMID: 27600374 DOI: 10.2217/epi-2016-0099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Yuliya S Nikolova
- Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Johnna R Swartz
- Department of Human Ecology, University of California, Davis, CA 95616, USA
| | - Ahmad R Hariri
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, NC 27708, USA
| |
Collapse
|
65
|
Keating DP. Transformative Role of Epigenetics in Child Development Research: Commentary on the Special Section. Child Dev 2016; 87:135-42. [DOI: 10.1111/cdev.12488] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
66
|
Abstract
Epigenetics provides the opportunity to revolutionize our understanding of the role of genetics and the environment in explaining human behavior, although the use of epigenetics to study human behavior is just beginning. In this introduction, the authors present the basics of epigenetics in a way that is designed to make this exciting field accessible to a wide readership. The authors describe the history of human behavioral epigenetic research in the context of other disciplines and graphically illustrate the burgeoning of research in the application of epigenetic methods and principles to the study of human behavior. The role of epigenetics in normal embryonic development and the influence of biological and environmental factors altering behavior through epigenetic mechanisms and developmental programming are discussed. Some basic approaches to the study of epigenetics are reviewed. The authors conclude with a discussion of challenges and opportunities, including intervention, as the field of human behavioral epigenetics continue to grow.
Collapse
Affiliation(s)
- Barry M Lester
- Alpert Medical School of Brown University and Women and Infants Hospital of Rhode Island
| | | | | |
Collapse
|
67
|
Provenzi L, Fumagalli M, Sirgiovanni I, Giorda R, Pozzoli U, Morandi F, Beri S, Menozzi G, Mosca F, Borgatti R, Montirosso R. Pain-related stress during the Neonatal Intensive Care Unit stay and SLC6A4 methylation in very preterm infants. Front Behav Neurosci 2015; 9:99. [PMID: 25941480 PMCID: PMC4403508 DOI: 10.3389/fnbeh.2015.00099] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 04/04/2015] [Indexed: 11/13/2022] Open
Abstract
Very preterm (VPT) infants need long-lasting hospitalization in the Neonatal Intensive Care Unit (NICU) during which they are daily exposed to pain-related stress. Alterations of DNA methylation at the promoter region of the SLC6A4 have been associated with early adverse experiences in infants. The main aim of the present work was to investigate the association between level of exposure to pain-related stress during hospitalization and changes in SLC6A4 DNA methylation at NICU discharge in VPT infants. In order to exclude the potential effect of birth status (i.e., preterm vs. full-term birth) on SLC6A4 methylation, we preliminarily assessed SLC6A4 epigenetic differences between VPT and full-term (FT) infants at birth. Fifty-six VPT and thirty-two FT infants participated in the study. The level of exposure to pain-related stress was quantified on the basis of the amount of skin-breaking procedures to which they were exposed. VPT infants were divided in two sub-groups: low-pain exposure (LPE, N = 25) and high-pain exposure (HPE, N = 31). DNA methylation was evaluated at birth for both VPT and FT infants, assessing 20 CpG sites within the SLC6A4 promoter region. The same CpG sites were re-evaluated for variations in DNA methylation at NICU discharge in LPE and HPE VPT infants. No differences in SLC6A4 CpG sites' methylation emerged between FT and VPT infants at birth. Methylation at CpG sites 5 and 6 significantly increased from birth to NICU discharge only for HPE VPT infants. Findings show that preterm birth per se is not associated with epigenetic alterations of the SLC6A4, whereas higher levels of pain-related stress exposure during NICU stay might alter the transcriptional functionality of the serotonin transporter gene.
Collapse
Affiliation(s)
- Livio Provenzi
- 0-3 Center for the Study of Social Emotional Development of the at-Risk Infant, Scientific Institute, IRCCS Eugenio Medea Bosisio Parini (LC), Italy
| | - Monica Fumagalli
- NICU, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan, Italy
| | - Ida Sirgiovanni
- NICU, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan, Italy
| | - Roberto Giorda
- Molecular Biology Lab, Scientific Institute, IRCCS Eugenio Medea Bosisio Parini (LC), Italy
| | - Uberto Pozzoli
- Bioinformatic Lab, Scientific Institute, IRCCS Eugenio Medea Bosisio Parini (LC), Italy
| | | | - Silvana Beri
- Molecular Biology Lab, Scientific Institute, IRCCS Eugenio Medea Bosisio Parini (LC), Italy
| | - Giorgia Menozzi
- Bioinformatic Lab, Scientific Institute, IRCCS Eugenio Medea Bosisio Parini (LC), Italy
| | - Fabio Mosca
- NICU, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan, Italy
| | - Renato Borgatti
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute, IRCCS Eugenio Medea Bosisio Parini (LC), Italy
| | - Rosario Montirosso
- 0-3 Center for the Study of Social Emotional Development of the at-Risk Infant, Scientific Institute, IRCCS Eugenio Medea Bosisio Parini (LC), Italy
| |
Collapse
|