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The origins and end-organ consequence of pre-eclampsia. Best Pract Res Clin Obstet Gynaecol 2011; 25:435-47. [PMID: 21367667 DOI: 10.1016/j.bpobgyn.2011.01.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 01/04/2011] [Indexed: 12/16/2022]
Abstract
Pre-eclampsia is a multisystem disorder with profound implications for both mother and fetus. Its origins lie in the earliest stages of pregnancy. Abnormal interactions between fetal trophoblast and maternal decidua, including the cells of the maternal immune system, lead to inadequate placental invasion and maternal vascular remodelling. However, abnormal placentation is only one step in the cascade of events that ultimately result in maternal organ dysfunction. Pre-existing maternal conditions predisposing to inflammation and vascular pathology, fetal factors, including multiple gestations and macrosomia, and environmental exposures, including infection, may contribute to the release of placental substances, including anti-angiogenic molecules, into the maternal circulation. These may act directly or indirectly upon the endothelia of end organs, including the kidney, liver and brain. The liberation of reactive oxygen species, cytokines, and microthrombi from damaged endothelia contribute further to organ damage. In studying the normal processes that occur during human placentation and early pregnancy, we will develop a greater understanding of what may go awry in pre-eclampsia. Such research will be crucial in discovering novel biomarkers for prediction of the disorder and, eventually, in finding targets for effective interventions.
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202
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Rosbottom A, Gibney H, Kaiser P, Hartley C, Smith RF, Robinson R, Kipar A, Williams DJL. Up regulation of the maternal immune response in the placenta of cattle naturally infected with Neospora caninum. PLoS One 2011; 6:e15799. [PMID: 21283810 PMCID: PMC3023762 DOI: 10.1371/journal.pone.0015799] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Accepted: 11/24/2010] [Indexed: 12/21/2022] Open
Abstract
Neospora caninum is an intracellular protozoan parasite which is a major cause of abortion in cattle worldwide. It forms persistent infections which recrudesce during pregnancy leading to foetal infection and in a proportion of cases, abortion. The mechanisms underlying abortion are not understood. In this study, recrudescence of a persistent infection in eight naturally infected cows occurred between 20 and 33 weeks of gestation. Animals were killed at the time of recrudescence and parasites were detected in the placentae and foetuses. An active maternal immune response consisting of an infiltration of CD4+ and CD8+ T cells and a 46–49 fold increase in interferon-γ and interleukin-4 mRNA was detected. Other cytokines, notably interleukin-12 p40, interleukin-10 and tumour necrosis factor-α were also significantly increased and Major Histocompatibility Class II antigen was expressed on maternal and foetal epithelial and stromal fibroblastoid cells. Significantly, despite the presence of an active maternal immune response in the placenta, all the foetuses were alive at the time of maternal euthanasia. There was evidence of parasites within foetal tissues; their distribution was restricted to the central nervous system and skeletal muscle and their presence was associated with tissue necrosis and a non-suppurative inflammatory response involving lymphocytes and macrophages, irrespective of the gestational age of the foetus. Whilst an active maternal immune response to a pathogen in the placenta is generally considered to be damaging to the foetal trophoblast, our findings suggest that the presence of a parasite-induced maternal immune response in the placenta is not detrimental to foetal survival but may contribute to the control of placental parasitosis.
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Affiliation(s)
- Anne Rosbottom
- Department of Veterinary Pathology, School of Veterinary Science, University of Liverpool, Liverpool, United Kingdom
| | - Helen Gibney
- Department of Veterinary Pathology, School of Veterinary Science, University of Liverpool, Liverpool, United Kingdom
| | - Peter Kaiser
- Institute for Animal Health, Compton, Berkshire, United Kingdom
| | - Catherine Hartley
- Department of Veterinary Pathology, School of Veterinary Science, University of Liverpool, Liverpool, United Kingdom
| | - Robert F. Smith
- Department of Veterinary Clinical Science, Veterinary Teaching Hospital, Leahurst, Neston, United Kingdom
| | - Rebecca Robinson
- Department of Veterinary Pathology, School of Veterinary Science, University of Liverpool, Liverpool, United Kingdom
| | - Anja Kipar
- Department of Veterinary Pathology, School of Veterinary Science, University of Liverpool, Liverpool, United Kingdom
| | - Diana J. L. Williams
- Department of Veterinary Pathology, School of Veterinary Science, University of Liverpool, Liverpool, United Kingdom
- * E-mail:
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203
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Seaward AVC, Burke SD, Croy BA. Interferon gamma contributes to preimplantation embryonic development and to implantation site structure in NOD mice. Hum Reprod 2010; 25:2829-39. [PMID: 20813805 PMCID: PMC2957476 DOI: 10.1093/humrep/deq236] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Pre-eclampsia, a syndrome usually accompanied by incomplete spiral arterial modification, occurs at an increased frequency in diabetic women. Hyperglycemia in non-obese type 1 diabetic (NOD) mice impairs gestational spiral arterial remodeling despite high local levels of interferon gamma (Ifng), the triggering cytokine in mice. Pregnancies in NOD.Ifng(-/-) mice were assessed to investigate this issue. METHODS Fecundity was assessed using the breeding history, flushing of preimplantation embryos and histological and morphometric studies of implantation sites in normoglycemic (n-) and hyperglycemic (d-) females of NOD.Ifng(-/-) and NOD genotypes. RESULTS NOD.Ifng(-/-) but not NOD mice are mostly infertile. In NOD.Ifng(-/-), copulation often does not result in a post-implantation pregnancy. Defective fertilization and delayed preimplantation development limit n-NOD.Ifng(-/-) fertility, and both mechanisms are exacerbated by hyperglycemia. At mid-gestation, implantation sites in n-NOD.Ifng(-/-) and n-NOD mice are histologically similar. However, in d-NOD.Ifng(-/-), there is minimal development of spiral arteries, hypertrophy of the myometrial region containing uterine Natural Killer (uNK) cells and a deficit in cytoplasmic granule formation in the uNK cells. CONCLUSIONS Ifng contributes to the success of fertilization and to the rate of preimplantation mouse embryo development in normogylcemic and hyperglycemic pregnancies. A physiological role for this cytokine in human preimplantation development merits investigation.
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Affiliation(s)
- A V C Seaward
- Department of Anatomy and Cell Biology, Queen's University, Room 915, Botterell Hall, Kingston, ON, Canada
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204
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Hatta K, Carter AL, Chen Z, Leno-Durán E, Ruiz-Ruiz C, Olivares EG, Tse MY, Pang SC, Croy BA. Expression of the vasoactive proteins AT1, AT2, and ANP by pregnancy-induced mouse uterine natural killer cells. Reprod Sci 2010; 18:383-90. [PMID: 20959647 DOI: 10.1177/1933719110385136] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Angiotensin II receptor type 1 (AT1) activation leads to vasoconstriction and type 2 receptor (AT2) leads to vasodilation. Atrial natriuretic peptide (ANP) antagonizes the effects of AT1. In human and murine pregnancies, uterine natural killer (uNK) cells closely associate with decidual blood vessels. Protein localization of AT1, AT2, and ANP to mouse uNK cells was examined between gestation days (gds) 6 and 12, the interval of uNK cell expansion. Percentages of uNK cells expressing AT1 or AT2 changed between gd6 and gd10. Atrial natriuretic peptide did not localize to uNK cells at gd6 or 8, but did colocalize to uNK cells at gd10 and 12, times immediately after spiral arterial modification. This is the first report of AT1, AT2, and ANP expression in uterine immune cells. Expression of these molecules suggests that uNK cells have the potential to contribute to the changes in blood pressure that occur between days 5 and 12 of pregnancy in mice.
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Affiliation(s)
- Kota Hatta
- Division of Cardiovascular Surgery and Department of Surgery, Toronto General Research Institute and University of Toronto, Toronto, Ontario, Canada.
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205
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Rowland RRR. The interaction between PRRSV and the late gestation pig fetus. Virus Res 2010; 154:114-22. [PMID: 20832434 PMCID: PMC7172144 DOI: 10.1016/j.virusres.2010.09.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Accepted: 06/17/2010] [Indexed: 12/12/2022]
Abstract
Porcine reproductive and respiratory syndrome virus (PRRSV) crosses the placenta during late gestation and productively infects the fetus. Virus replication and cytokine responses were measured in tissues of fetuses recovered at 109–112 days of gestation, just prior to parturition. At the time of recovery, gross anatomical abnormalities were evident in both infected and non-infected fetuses from the infected dams. Virus isolation and immunohistochemistry identified the thymus as the primary site of virus replication. Steady state RT-PCR amplification of inflammatory, Th1 and Th2 cytokines, showed elevated IFN-γ and TNF-α mRNAs in tissues from infected fetuses, which corresponded to elevated cytokine proteins in serum but not amniotic fluid. Further evidence for induction of immunity was found in the hyperplastic response of lymph nodes, which included the development of germinal centers occupied CDw75+ B cells. Collectively, these data support the notion that the immunocompetent fetus is capable of initiating an antiviral response, which is compartmentalized within the infected fetus. Furthermore, fetal pathology may not be a direct result of virus replication in the fetus.
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Affiliation(s)
- Raymond R R Rowland
- Department of Diagnostic Medicine and Pathobiology, 1800 Denison Ave, Kansas State University, Manhattan, KS 66506, USA.
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206
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Noronha LE, Antczak DF. Maternal immune responses to trophoblast: the contribution of the horse to pregnancy immunology. Am J Reprod Immunol 2010; 64:231-44. [PMID: 20618178 DOI: 10.1111/j.1600-0897.2010.00895.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The horse has proven to be a distinctively informative species in the study of pregnancy immunology for several reasons. First, unique aspects of the anatomy and physiology of the equine conceptus facilitate approaches that are not possible in other model organisms, such as non-surgical recovery of early stage embryos and conceptuses and isolation of pure trophoblast cell populations. Second, pregnant mares make strong cytotoxic antibody responses to paternal major histocompatibility complex class I antigens expressed by the chorionic girdle cells, permitting detailed evaluation of the antigenicity of these invasive trophoblasts and how they affect the maternal immune system. Third, there is abundant evidence for local maternal cellular immune responses to the invading trophoblasts in the pregnant mare. The survival of the equine fetus in the face of strong maternal immune responses highlights the complex immunoregulatory mechanisms that result in materno-fetal tolerance. Finally, the parallels between human and horse trophoblast cell types, their gene expression, and function make the study of equine pregnancy highly relevant to human health. Here, we review the most pertinent aspects of equine reproductive immunology and how studies of the pregnant mare have contributed to our understanding of maternal acceptance of the allogeneic fetus.
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Affiliation(s)
- Leela E Noronha
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
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207
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Heparin inhibits interferon-γ signaling in human endometrial stromal cells by interference with the cellular binding of interferon-γ. Fertil Steril 2010; 95:1272-7. [PMID: 20542267 DOI: 10.1016/j.fertnstert.2010.04.061] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 04/21/2010] [Accepted: 04/26/2010] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine the impact of heparins on interferon-γ (IFN-γ) signaling in human endometrial stromal cells (ESCs) in vitro. DESIGN In vitro experiment. SETTING Research laboratory at a medical university center. PATIENT(S) Premenopausal women undergoing hysterectomy for benign reasons. INTERVENTION(S) The ESCs were isolated from hysterectomy specimens, decidualized in vitro using P and 17β-E(2), and incubated with recombinant IFN-γ, unfractionated heparin, and low molecular weight heparins (LMWHs). MAIN OUTCOME MEASURE(S) Interferon response factor 1 (IRF-1) and N-myc interactor (Nmi) messenger RNA (mRNA) were measured using real-time reverse transcriptase-polymerase chain reaction (RT-PCR). Phosphorylation of signal transducer and activator of transcription 1 (STAT-1) was detected by an in-cell Western assay, expression of the IFN-γ receptor by flow cytometry. Cell-bound IFN-γ was determined in lysates by an ELISA. RESULT(S) Heparin and LMWHs inhibit the IFN-γ-mediated induction of IRF-1, but not Nmi in undifferentiated and decidualized ESCs. The phosphorylation of signal transducer and activator of transcription 1 STAT-1 upon IFN-γ stimulation is inhibited as well. Heparin has no effect on the IFN-γ receptor in ESCs, but inhibits the binding of IFN-γ to the cells. CONCLUSION(S) Unfractionated heparin, as well as LMWHs, are able to inhibit IFN-γ signaling in human ESCs and therefore might be clinically interesting agents to modulate the actions of this proinflammatory cytokine at the implantation site.
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208
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Dose-response effect of interleukin (IL)-1β, tumour necrosis factor (TNF)-α, and interferon-γ on the in vitro production of epithelial neutrophil activating peptide-78 (ENA-78), IL-8, and IL-6 by human endometrial stromal cells. Arch Gynecol Obstet 2010; 283:1291-6. [PMID: 20505949 DOI: 10.1007/s00404-010-1520-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Accepted: 05/10/2010] [Indexed: 01/01/2023]
Abstract
PURPOSE The production of epithelial neutrophil activating peptide-78 (NA-78) and the interleukins IL-8 and IL-6 by endometrial stromal cells is stimulated by pro-inflammatory interleukin-1 (IL-1) and tumour necrosis factor-α (TNF-α). IL-8 is suggested to play a role in the pathogenesis of endometriosis, and in these women the peritoneal fluid concentrations of ENA-78 and IL-8 are increased. TNF-α has been tested together with interferon-γ because of their cooperative stimulation of IL-6. The release of IL-8, however, is inhibited with increasing interferon levels. The aim of the study was the analysis of the production of ENA-78, IL-6 and IL-8 by cultured human endometrial stromal cells in the presence of varying concentrations of IL-1β, TNF-α, and interferon-γ. METHODS Eutopic endometrial tissue was obtained from seven cycling, endometriosis-free women undergoing laparoscopy for reasons of infertility or pain. The release of ENA-78, IL-8 and IL-6 by the isolated and monolayer cultured stromal cell fraction in the presence of IL-1β (0.08 to 50 ng/mL), TNF-α, and interferon-γ (both 20 to 500 ng/mL) was determined. RESULTS IL-1β stimulated the production of IL-8, IL-6, and ENA-78 dose dependently from 0.08 to 2.0 ng/mL (ENA-78) or to 10 ng/mL (IL-8, IL-6); at 50 ng/mL a decrease in release was observed for IL-8 and IL-6. TNF-α stimulation yielded a plateau between 20 and 100 ng/mL. Interferon-γ stimulated IL-6 and inhibited IL-8 production above 20 ng/mL. ENA-78 release was largely unaffected by interferon-γ. CONCLUSIONS IL-1β and TNF-α stimulate stromal cytokine production cumulatively with different dose-response curves. The presence of interferon-γ has opposite effects on IL-8 and IL-6. TNF-α and interferon-γ should be investigated separately in future in vitro studies with endometrial cells and explants.
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209
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Clark DA. Anti-TNFα therapy in immune-mediated subfertility: State of the art. J Reprod Immunol 2010; 85:15-24. [DOI: 10.1016/j.jri.2010.01.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Revised: 12/04/2009] [Accepted: 01/14/2010] [Indexed: 12/30/2022]
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210
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O'Gorman GM, Al Naib A, Naib AA, Ellis SA, Mamo S, O'Doherty AM, Lonergan P, Fair T. Regulation of a bovine nonclassical major histocompatibility complex class I gene promoter. Biol Reprod 2010; 83:296-306. [PMID: 20427761 DOI: 10.1095/biolreprod.109.082560] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Studies have shown in humans and other species that the major histocompatibility complex class I (MHC-I) region is involved at a number of levels in the establishment and maintenance of pregnancy. The aim of this study was to characterize how a bovine nonclassical MHC-I gene (NC1) is regulated. Initial serial deletion experiments of a 2-kb fragment of the NC1 promoter identified regions with positive regulatory elements in the proximal promoter and evidence for a silencer module(s) further upstream that cooperatively contributed to constitutive NC1 expression. The cytokines interferon tau (IFNT), interferon gamma (IFNG), and interleukin 4 (IL4) significantly increased luciferase expression in NC1 promoter reporter constructs and endogenous NC1 mRNA levels in a bovine endometrial cell line. In addition, IFNG, IL3, IL4, and progesterone significantly increased Day 7 bovine blastocyst NC1 mRNA expression when supplemented during in vitro embryo culture. Site-directed mutagenesis analysis identified a STAT6 binding site that conferred IL4 responsiveness in the NC1 proximal promoter. Furthermore, methylation treatment of the proximal promoter, which contains a CpG island, completely abrogated constitutive NC1 expression. Overall, the findings presented here suggest that constitutive NC1 expression is regulated positively by elements in the proximal promoter, which are further controlled by upstream silencer modules. The promoter is responsive to IFNT, IFNG, and IL4, suggesting possible roles for these cytokines in bovine preimplantation embryo survival and/or maternal-fetal tolerance. Our studies also suggest that methylation of the proximal promoter, in particular, could play a significant role in regulating NC1 expression.
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Affiliation(s)
- Grace M O'Gorman
- School of Agriculture, Food Science & Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland
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211
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Neta GI, von Ehrenstein OS, Goldman LR, Lum K, Sundaram R, Andrews W, Zhang J. Umbilical cord serum cytokine levels and risks of small-for-gestational-age and preterm birth. Am J Epidemiol 2010; 171:859-67. [PMID: 20348155 DOI: 10.1093/aje/kwq028] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
While elevated levels of proinflammatory cytokines are clearly associated with preterm birth, the relation between cytokines and fetal growth is unclear. The authors examined associations between umbilical cord serum cytokine concentrations and risk of small-for-gestational-age (SGA) and preterm birth. This cross-sectional analysis was nested within a National Institute of Child Health and Human Development-University of Alabama population-based cohort study of high-risk prenatal care patients in Jefferson County, Alabama. Patients were enrolled between 1985 and 1988. For 370 singletons, umbilical cord serum concentrations of interferon gamma (IFN-gamma), tumor necrosis factor alpha, and interleukins 12p70, 4, and 10 were determined. Associations between each cytokine and SGA and preterm delivery were evaluated using log binomial regression. Increasing log concentration of tumor necrosis factor alpha was associated with an increased risk of preterm birth (risk ratio (RR) = 2.00, 95% confidence interval (CI): 1.31, 3.06). IFN-gamma was associated with a decreased risk of SGA birth (RR = 0.78, 95% CI: 0.61, 1.01). After stratification for preterm birth status, the association between IFN-gamma concentration and SGA birth was pronounced among preterm babies (RR = 0.56, 95% CI: 0.31, 1.01). The observations regarding IFN-gamma, which is involved in the activation of adaptive immune responses and regulation of trophoblast function, suggest that IFN-gamma levels at birth may be related to fetal growth restriction.
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Affiliation(s)
- Gila I Neta
- Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6100 Executive Blvd., Rockville, MD 20852, USA.
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212
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Østrup E, Bauersachs S, Blum H, Wolf E, Hyttel P. Differential endometrial gene expression in pregnant and nonpregnant sows. Biol Reprod 2010; 83:277-85. [PMID: 20393170 DOI: 10.1095/biolreprod.109.082321] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
In an attempt to unveil molecular processes controlling the porcine placentation, we have investigated the pregnancy-induced gene expression in the endometrium using the Affymetrix GeneChip Porcine Genome Array. At Day 14 after insemination, at the time of initial placentation, samples were obtained from the endometrium of pregnant sows and sows inseminated with inactivated semen. Analysis of the microarray data revealed 263 genes to be significantly differentially expressed between the pregnant and nonpregnant sows. Most gene ontology terms significantly enriched at pregnancy had allocated more up-regulated genes than down-regulated genes. These terms included developmental process, transporter activity, calcium ion binding, apoptosis, cell motility, enzyme-linked receptor protein signaling pathway, positive regulation of cell proliferation, ion homeostasis, and hormone activity. Only the three terms oxidoreductase activity, lipid metabolic process, and organic acid metabolic process had an overrepresentation of down-regulated genes. A gene interaction network based on the genes identified in the gene ontology term developmental processes identified genes likely to be involved in the process of placentation. Pregnancy-specific localization of IL11RA to the surface epithelium of the endometrium suggests a role of interleukin 11 signaling in formation of the porcine epitheliochorial placenta. Furthermore, up-regulation of FGF9 mRNA in pregnant endometrium and localization of FGF9 to the apical cell domain of the glandular epithelium suggest the concept of endometrial FGF9 acting as an embryonic growth factor in the pig.
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Affiliation(s)
- Esben Østrup
- Department of Basic Animal and Veterinary Sciences, Faculty of Life Sciences, University of Copenhagen, Frederiksberg, Denmark.
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213
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Laresgoiti-Servitje E, Gomez-Lopez N, Olson DM. An immunological insight into the origins of pre-eclampsia. Hum Reprod Update 2010; 16:510-24. [DOI: 10.1093/humupd/dmq007] [Citation(s) in RCA: 149] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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214
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Abstract
In March, 2009, a novel strain of swine-origin influenza-A H1N1 caused human infection in Mexico, and spread to all regions in the world in the following three months. On June 11, 2009, the World Health Organization declared that a global pandemic of influenza A H1N1 was underway. This action was a reflection of the spread of the new H1N1 virus, not the severity of illness caused by the virus. As of October, 2009, there are about 400,000 confirmed cases and 5000 mortalities due to pandemic H1N1 all over the world. The symptoms are usually mild: fever, cough, sore throat, muscle aches, and they usually disappear spontaneously within 3-7 days. Recommendations suggest staying at home with mild symptoms, and avoiding the contact with other people. In case of warning signs of complications or emergency symptoms, medical care is required, and antiviral treatment, hospitalization might be needed. The most important duty against pandemic H1N1 is prevention, which means first of all the adherence of hygienic rules and the use of vaccination. Based on epidemiologic data and worldwide experiences on influenza vaccination, both seasonal and H1N1 vaccinations are recommended for anyone 6 months of age or older who is at risk of becoming ill or of transmitting the viruses to others. Pregnant women during the first trimester are not recommended for vaccination, due to the lack of experiences. Overall, the rates and seriousness of a possible complication of influenza vaccination are much smaller than the risk of serious complications and mortality of influenza infection.
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Affiliation(s)
- János Osztovits
- Fovárosi Bajcsy-Zsilinszky Kórház III. Belgyógyászati Osztály Budapest Maglódi út 89-91. 1106 Semmelweis Egyetem Doktori Iskola Budapest.
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215
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Clark DA, Chaouat G, Wong K, Gorczynski RM, Kinsky R. REVIEW ARTICLE: Tolerance Mechanisms in Pregnancy: A Reappraisal of the Role of Class I Paternal MHC Antigens*. Am J Reprod Immunol 2009; 63:93-103. [DOI: 10.1111/j.1600-0897.2009.00774.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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216
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Zhang J, Croy BA. Using ultrasonography to define fetal-maternal relationships: moving from humans to mice. Comp Med 2009; 59:527-533. [PMID: 20034427 PMCID: PMC2799334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 09/11/2009] [Accepted: 09/28/2009] [Indexed: 05/28/2023]
Abstract
Ultrasound scanning is a noninvasive, accurate, and cost-effective method to create images of the female reproductive tract clinically and in research. Ultrasonography is particularly valuable for studying the dynamic relationships among mother, placenta, and fetus during pregnancy because this modality does not disturb the ongoing course of gestation. Importantly, the complex vascular changes in the mother induced by pregnancy and the vascular system generated to support placental function can be assessed quantitatively and functionally by ultrasonography. Many mouse models are available that address aspects of human placental function and dysfunction, but high-quality microultrasound technology suitable for use in pregnant mice has become widely available only recently. This technical advance now enables real-time recording of maternal-fetal interactions in pregnant rodents. The ability to perform microultrasonic analyses of parameters such as uterine arterial remodeling, hemodynamic changes, placental development, and fetal growth in mice now permits research that uses the same imaging platform as that for human patients. This capability will enhance the translation of information derived from rodent studies to the clinic.
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217
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Cooper MA, Colonna M, Yokoyama WM. Hidden talents of natural killers: NK cells in innate and adaptive immunity. EMBO Rep 2009; 10:1103-10. [PMID: 19730434 DOI: 10.1038/embor.2009.203] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Accepted: 08/06/2009] [Indexed: 12/31/2022] Open
Abstract
Natural killer (NK) cells are innate immune lymphocytes capable of killing target cells and producing immunoregulatory cytokines. Herein, we discuss recent studies that indicate that NK cells span the conventional boundaries between innate and adaptive immunity. For example, it was recently discovered that NK cells have the capacity for memory-like responses, a property that was previously thought to be limited to adaptive immunity. NK cells have also been identified in multiple tissues, and a subset of cells that specialize in the production of the T(H)17 cytokine IL-22, NK-22s, was recently described in mucosal-associated lymphoid tissue. Finally, we review work that shows that NK cells develop at sites that were traditionally thought to be occupied only by adaptive immune cells, including the thymus and lymph nodes.
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Affiliation(s)
- Megan A Cooper
- Department of Pediatrics, Division of Rheumatology and Howard Hughes Medical Institute, Washington University School of Medicine, St Louis, MO 63110, USA
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