1
|
Escobar VAP, Wyant WA, Debs LH, Jamshidi A, Kiehna EN, McCrea HJ. Evaluating the potential role of determinants of health on encephalocele patient outcomes - a combined retrospective study and systematic review. Childs Nerv Syst 2024; 40:1751-1763. [PMID: 38347306 DOI: 10.1007/s00381-024-06312-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 01/30/2024] [Indexed: 05/23/2024]
Abstract
INTRODUCTION To evaluate the outcomes and demographics of encephalocele patients who were born and received treatment in our neonatal ICU and conduct a PRISMA literature review. METHODS An Institutional Review Board (IRB)-approved retrospective cohort study was undertaken to investigate the results of treating encephalocele patients at Jackson Memorial Hospital (JMH) from 1998 to 2022. The study focused on assessing outcomes and the impact of maternal socioeconomic factors, such as religion, age, and education, along with the timing of diagnosis, in connection with a systematic review. RESULTS A total of 20 encephalocele patients were identified (13 females and 7 males), with 15 having available medical records for review. Most of these cases involved occipital encephaloceles (73.3%). Maternal ages at the time of delivery ranged from 15 to 42 years, with a mean age of 27.3 years. The average gestational age at birth was 37 weeks. Ten cases had a prenatal diagnosis documented, occurring between 12 and 24.5 weeks of gestation. Three of the surviving patients had records of prenatal counseling that included discussions about termination. No infections were reported. Among the 15 cases, 11 patients (73.3%) were alive at the last follow-up, with a mean age at follow-up of 4.12 years, ranging from 6 weeks to 15 years post-birth. Hydrocephalus was noted in 26.7%. Only 1 mother had completed high school. Most mothers were either on Medicaid (9 patients) or uninsured (3 patients), with only 3 having commercial insurance. Religious affiliations varied among the mothers, with 14 out of 15 identifying with a particular religion. The systematic review identified 22 articles from various countries, with 11 articles meeting the inclusion criteria for qualitative analysis. These articles revealed potential maternal risk factors for encephaloceles, including low-nutrient diets, inadequate folic acid intake, young maternal age, advanced maternal age, low socioeconomic status, and limited educational attainment. CONCLUSIONS In the twenty-first century, there is a positive trend in the survival rates of children born with encephalocele. However, maternal factors such as low socioeconomic status and limited educational attainment remain prominent, affecting their ability to access timely prenatal care and impacting follow-up medical care for these children.
Collapse
Affiliation(s)
- Victoria A Pinilla Escobar
- Department of Neurological Surgery, University of Miami Miller School of Medicine/Jackson Health System, 1095 NW 14th Terrace, Miami, FL, 33136, USA
| | - W Austin Wyant
- Department of Neurological Surgery, University of Miami Miller School of Medicine/Jackson Health System, 1095 NW 14th Terrace, Miami, FL, 33136, USA
| | - Luca H Debs
- Department of Neurological Surgery, Augusta University Medical Center, Augusta, GA, USA
| | - Aria Jamshidi
- Department of Neurological Surgery, University of Miami Miller School of Medicine/Jackson Health System, 1095 NW 14th Terrace, Miami, FL, 33136, USA
| | - Erin N Kiehna
- Department of Neurological Surgery, Novant Health, Charlotte, NC, USA
| | - Heather J McCrea
- Department of Neurological Surgery, University of Miami Miller School of Medicine/Jackson Health System, 1095 NW 14th Terrace, Miami, FL, 33136, USA.
- Department of Pediatrics, University of Miami Miller School of Medicine/Jackson Health System, Miami, FL, USA.
| |
Collapse
|
2
|
Zoghi S, Feili M, Mosayebi MA, Ansari A, Feili A, Masoudi MS, Taheri R. Surgical outcomes of myelomeningocele repair: A 20-year experience from a single center in a middle-income country. Clin Neurol Neurosurg 2024; 239:108214. [PMID: 38503112 DOI: 10.1016/j.clineuro.2024.108214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND AND PURPOSE Spina bifida is the second major cause of congenital disorders and the most common central nervous system congenital malformation compatible with life primarily. Herein, we describe the short-term outcome of post-natal Myelomeningocele (MMC) surgical management and predictors of its postoperative complications and mortality. METHODS This retrospective chart review studies the children who underwent post-natal surgical management for MMC in Namazi hospital, a tertiary referral center, in southern Iran from May 2001 to September 2020. RESULTS 248 patients were included in this study. The mean age at the operation was 8.47 ± 8.69 days. The most common site of involvement of MMC was Lumbosacral (86%, n = 204). At the evaluation conducted prior to the operation, cerebrospinal fluid leak was observed in 7% (n=16) of the patients. Postoperatively, 5.7% of the patients expired in the 30-day follow-up after the operation (n = 14), while 24% needed readmission (n = 47). The most common complications leading to readmission were wound dehiscence (n = 10, 42%) and wound purulence (n = 6, 25%). Only the site of the lesion (p-value = 0.035) was associated with postoperative complication. After controlling for potential confounders, the site of the lesion (adjusted odds ratio = 0.146, 95% confidence interval = 0.035-0.610, p-value = 0.008) and age at surgery (adjusted odds ratio = 1.048, 95% confidence interval = 1.002-1.096, p-value = 0.041) were significantly associated with mortality CONCLUSIONS: The age of the patients at the surgery and the site of the lesion are the two factors that were associated with mortality. However, further investigations into preoperative interventions and risk factors to mitigate the risk of complications and mortality are highly encouraged.
Collapse
Affiliation(s)
- Sina Zoghi
- Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Feili
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Ali Ansari
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Afrooz Feili
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Reza Taheri
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; School of Medicine, Fasa University of Medical Sciences, Fasa, Iran.
| |
Collapse
|
3
|
Koch VH, Lopes M, Furusawa E, Vaz K, Barroso U. Multidisciplinary management of people with spina bifida across the lifespan. Pediatr Nephrol 2024; 39:681-697. [PMID: 37501019 DOI: 10.1007/s00467-023-06067-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/09/2023] [Accepted: 06/19/2023] [Indexed: 07/29/2023]
Abstract
The average worldwide prevalence of neural tube defects (NTDs) is 1.0 per 1000 births. Its development is multifactorial due to genetic and non-genetic factors. Spina bifida (SB) is one of main representatives of NTD. The spinal cord lesion level is the main determinant of the level of paralysis, numbness, and difficulties with bladder/bowel functions. Myelomeningocele prenatal repair reduces hydrocephalus and hindbrain herniation and improves motor function. The severity of hydrocephalus is associated with poorer neurodevelopmental outcomes whether operated on prenatally or after birth. People with SB tend to have a lower IQ and cognitive difficulties. Early diagnosis, proactivity, and lifelong multidisciplinary follow-up are key protective issues. Invasive urological interventions should be considered in selected patients after failure of conservative treatment. Transition to adult care should be well planned as it is challenging. Health literacy is directly associated with success at transition. Sexuality and fertility should be addressed before/during puberty. Overall, the rates of fecal and urinary continence and skin breakdown increase with age, whereas the ability to ambulate declines with age. Bowel and urinary incontinence are independent predictors of lower health-related quality of life (HRQoL) in adults with SB. Bowel incontinence has negative impact on HRQoL regardless of frequency or amount. Long-term caregiver support should be offered at diagnosis. Survival at a mean of 50 years is poor, at 32%, due to central nervous system deaths, cancer, urological disease, and sepsis. Challenges to implementation of recommended practices exist, especially in low and middle-income countries.
Collapse
Affiliation(s)
- Vera H Koch
- Pediatric Nephrology Unit, Department of Pediatrics, University of São Paulo Medical School, Children's Hospital, Hospital das Clinicas, Sau Paulo, Brazil.
| | - MarcosTomasin Lopes
- Pediatric Nephrology Unit, Department of Pediatrics, University of São Paulo Medical School, Children's Hospital, Hospital das Clinicas, Sau Paulo, Brazil
| | - Erika Furusawa
- Pediatric Nephrology Unit, Department of Pediatrics, University of São Paulo Medical School, Children's Hospital, Hospital das Clinicas, Sau Paulo, Brazil
| | - Katharinne Vaz
- Division of Urology, Federal University of Bahia - UFBA, Salvador, BA, Brazil
| | - Ubirajara Barroso
- Division of Urology - Federal University of Bahia, Bahiana School of Medicine, Salvador, BA, Brazil
| |
Collapse
|
4
|
Oxman E, Li H, Wang HY, Zohn IE. Identification and functional analysis of rare HECTD1 missense variants in human neural tube defects. Hum Genet 2024; 143:263-277. [PMID: 38451291 PMCID: PMC11043113 DOI: 10.1007/s00439-024-02647-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 01/20/2024] [Indexed: 03/08/2024]
Abstract
Neural tube defects (NTDs) are severe malformations of the central nervous system that arise from failure of neural tube closure. HECTD1 is an E3 ubiquitin ligase required for cranial neural tube closure in mouse models. NTDs in the Hectd1 mutant mouse model are due to the failure of cranial mesenchyme morphogenesis during neural fold elevation. Our earlier research has linked increased extracellular heat shock protein 90 (eHSP90) secretion to aberrant cranial mesenchyme morphogenesis in the Hectd1 model. Furthermore, overexpression of HECTD1 suppresses stress-induced eHSP90 secretion in cell lines. In this study, we report the identification of five rare HECTD1 missense sequence variants in NTD cases. The variants were found through targeted next-generation sequencing in a Chinese cohort of 352 NTD cases and 224 ethnically matched controls. We present data showing that HECTD1 is a highly conserved gene, extremely intolerant to loss-of-function mutations and missense changes. To evaluate the functional consequences of NTD-associated missense variants, functional assays in HEK293T cells were performed to examine protein expression and the ability of HECTD1 sequence variants to suppress eHSP90 secretion. One NTD-associated variant (A1084T) had significantly reduced expression in HEK293T cells. All five NTD-associated variants (p.M392V, p.T801I, p.I906V, p.A1084T, and p.P1835L) reduced regulation of eHSP90 secretion by HECTD1, while a putative benign variant (p.P2474L) did not. These findings are the first association of HECTD1 sequence variation with NTDs in humans.
Collapse
Affiliation(s)
- Elias Oxman
- Center for Genetic Medicine Research, Children's Research Institute, Children's National Research and Innovation Campus, Children's National Hospital, Washington, DC, 20012, USA
| | - Huili Li
- Department of Molecular, Cellular and Developmental Biology, University of Colorado, Boulder, CO, 80309, USA
| | - Hong-Yan Wang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, State Key Laboratory of Genetic, Engineering at School of Life Sciences, Fudan University, Shanghai, 200011, China
| | - Irene E Zohn
- Center for Genetic Medicine Research, Children's Research Institute, Children's National Research and Innovation Campus, Children's National Hospital, Washington, DC, 20012, USA.
| |
Collapse
|
5
|
Oxman E, Li H, Wang HY, Zohn I. Identification and Functional Analysis of Rare HECTD1 Missense Variants in Human Neural Tube Defects. RESEARCH SQUARE 2024:rs.3.rs-3794712. [PMID: 38260607 PMCID: PMC10802691 DOI: 10.21203/rs.3.rs-3794712/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Neural tube defects (NTDs) are severe malformations of the central nervous system that arise from failure of neural tube closure. HECTD1 is an E3 ubiquitin ligase required for cranial neural tube closure in mouse models. NTDs in the Hectd1 mutant mouse model are due to the failure of cranial mesenchyme morphogenesis during neural fold elevation. Our earlier research has linked increased secretion of extracellular heat shock protein 90 (eHSP90) to aberrant cranial mesenchyme morphogenesis in the Hectd1 model. Furthermore, overexpression of HECTD1 suppresses stress-induced eHSP90 secretion in cell lines. In this study, we report the identification of five rare HECTD1 missense sequence variants in NTD cases. The variants were found through targeted next-generation sequencing in a Chinese cohort of 352 NTD cases and 224 ethnically matched controls. We present data showing that HECTD1 is a highly conserved gene, extremely intolerant to loss-of-function mutations and missense changes. To evaluate the functional consequences of NTD-associated missense variants, functional assays in HEK293T cells were performed to examine protein expression and the ability of HECTD1 sequence variants to suppress eHSP90 secretion. One NTD-associated variant (A1084T) had significantly reduced expression in HEK293T cells. All five NTD-associated variants (p.M392V, p.T801I, p.I906V, p.A1084T, and p.P1835L) reduced regulation of eHSP90 secretion by HECTD1, while a putative benign variant (p.P2474L) did not. These findings are the first association of HECTD1 sequence variation with human disease and suggest that sequence variation in HECTD1 may play a role in the etiology of human NTDs.
Collapse
Affiliation(s)
| | - Huili Li
- University of Colorado at Boulder
| | | | | |
Collapse
|
6
|
Chen X, Zhao S, Dong X, Liu J, Guo Y, Ju W, Chen P, Gao Y, Feng Q, Zhu X, Huang H, Lu X, Yang X, Yang F, Cheng C, Luo X, Cheng L, Zhong N. Incidence, distribution, disease spectrum, and genetic deficits of congenital heart defects in China: implementation of prenatal ultrasound screening identified 18,171 affected fetuses from 2,452,249 pregnancies. Cell Biosci 2023; 13:229. [PMID: 38115160 PMCID: PMC10731863 DOI: 10.1186/s13578-023-01172-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Congenital heart defects (CHDs) are the most common birth defects. Assessment of the incidence, distribution, disease spectrum, and genetic deficits of fetal CHDs in China is urgently needed. METHODS A national echocardiography screening program for fetal CHDs was implemented in 92 prenatal screening-diagnostic centers in China. FINDINGS A total of 18,171 fetal CHD cases were identified from 2,452,249 pregnancies, resulting in 7·4/1,000 as the national incidence rate of fetal CHD. The incidences of fetal CHD in the six geographical regions, the southern, central, eastern, southwestern, northern, and northwestern, were 7·647 (CI: 7·383-7·915), 7·839 (CI: 7·680-8·000), 7·647 (CI: 7·383-7·915), 7·562 (CI: 7·225-7·907), 5·618 (CI: 5·337-5·906), and 4·716 (CI: 4·341-5·108), respectively, per 1,000 pregnancies. Overall, ventricular septal defect was the most common fetal CHD, accounting for 17.04% of screened pregnancies nationwide, and tetralogy of Fallot, the most common anomaly in the major defect of fetal CHD, was the second most common, accounting for 9.72%. A total of 76.24% cases of fetal CHD were found to be an isolated intracardiac single defect. The remaining 23.76% of cases of fetal CHD had multiple heart defects. Among all extracardiac malformations, the central nervous system (CNS) was the most common tissue with extracardiac anomalies associated with CHD, accounting for 22.89% of fetal CHD cases. Chromosomal karyotyping identified trisomy 18 as the most common chromosomal abnormality in fetal CHD. We also documented that CHD-containing syndromes could be identified with a comprehensive approach integrating prenatal ultrasound, MRI, pathological autopsy, and cytogenetics and molecular genetics. CONCLUSION Implementation of prenatal echocardiography as a practically feasible platform to screen fetal CHD will reduce the financial and emotional burden of CHD, which may facilitate intrauterine and neonatal intervention of CHD.
Collapse
Affiliation(s)
- Xinlin Chen
- Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Sheng Zhao
- Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Xiaoyan Dong
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Juntao Liu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Yulin Guo
- Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Weina Ju
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Peiwen Chen
- Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Yanduo Gao
- Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Qian Feng
- Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Xia Zhu
- Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Hui Huang
- Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Xiaojun Lu
- Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Xiaohong Yang
- Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Fan Yang
- Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Chen Cheng
- Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Xishun Luo
- Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Longxian Cheng
- Maternal and Child Health Hospital of Hubei Province, Wuhan, China.
| | - Nanbert Zhong
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA.
| |
Collapse
|
7
|
Wang D, Song Z, Zhang Y, Zhang L, Jin L, Ren A, Li Z, Liu J. Prevalence and Trends of Birth Defects - Five Counties, Shanxi Province, China, 2003-2022. China CDC Wkly 2023; 5:797-802. [PMID: 37771624 PMCID: PMC10527404 DOI: 10.46234/ccdcw2023.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/02/2023] [Indexed: 09/30/2023] Open
Abstract
What is already known about this topic? The Shanxi Province, located in northern China, holds the highest prevalence of birth defects (BDs) across the country. Following the implementation of a nationwide folic acid supplementation program in 2009, a significant reduction of 53.89% in the prevalence of neural tube defects (NTDs) was observed in Shanxi from 2012 to 2017. However, despite this decrease, the prevalence rate for congenital heart defects (CHDs) in 2017 was over four times that of the 2012 rate. Since 2014, CHDs have emerged as the most predominant BD in Shanxi. What is added by this report? The present study has identified a marked reduction in the prevalence of both total BDs and NTDs in five counties within Shanxi over the past two decades. As of 2017-2022, NTDs continue to be the most prevalent BDs recorded in this region. Contrarily, there has been a noteworthy increase in the prevalence of CHDs, ranking them among the top five most common BDs in the region between 2017 and 2022, though their rate remains below the national average. Additionally, the proportion of external anomalies remains high. Nevertheless, due to constrained access to primary healthcare services and diagnostic facilities, the early detection rate for internal anomalies, particularly CHDs, may be underestimated in the region. What are the implications for public health practice? The results of this study underscore the necessity for augmented efforts in promoting folic acid supplementation as a preventive measure for NTDs. Moreover, improvements in the distribution of medical resources within this region are recommended, particularly the introduction and enforcement of local training programs aimed at enhancing CHD screening and diagnostic processes in these respective counties.
Collapse
Affiliation(s)
- Duoduo Wang
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zhijiao Song
- Department of Health Education, Shanxi Women and Children Health Hospital, Taiyuan City, Shanxi Province, China
| | - Yali Zhang
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Le Zhang
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lei Jin
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Aiguo Ren
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zhiwen Li
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jufen Liu
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| |
Collapse
|
8
|
Kidane M, Sime Y, Gashaw A, Chane G. Neural tube defects among new borns: a cross-sectional study. Front Pediatr 2023; 11:1191556. [PMID: 37284290 PMCID: PMC10241160 DOI: 10.3389/fped.2023.1191556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/03/2023] [Indexed: 06/08/2023] Open
Abstract
Background Neural tube defects are a major public health issue that contributes significantly to morbidity and mortality, particularly in low-income countries such as Ethiopia. In Ethiopia, particularly in the study setting, there is a paucity of data on the prevalence, magnitude, and associated factors of neural tube defects. As a result, the purpose of this study was to evaluate neural tube defects and associated factors in JUMC. Methods This study was an institution-based cross-sectional study conducted from June to September 2021. Data was collected using a structured questionnaire adapted from previous literature. Data were analyzed using SPSS version 26 software. Logistic regression analysis was performed to assess the association between dependent and independent variables. Independent variables with a p-value < 0.05 were taken as statistically significant with neural tube defects. Results The prevalence of NTDs in this study was 3.6%. Preterm newborns with GA < 34 AOR 2.9(1.2-9.7), newborns with birth weight b/n 1,000-1,499 AOR 5.2(1.1-9.4), born with weight b/n 1,500-2,499 AOR 2.1(1.3-8.7), exposure to smoke AOR 2.1(1.2-8.8), radiation AOR 6.8(1.3-14.5), at least one history of abortion AOR 10.1(7.2-21.0) and mothers with AED intake AOR 5.7(2.3-18.4) were found to be associated significantly. Conclusion The results indicated a significant frequency of neural tube abnormalities in newborns. The use of AEDs, abortion, and radiation have all been linked to those NTD cases. Pregnant women are advised to learn more about the need of beginning prenatal care as soon as possible because the aforementioned issues will be addressed during this treatment.
Collapse
Affiliation(s)
- Mahder Kidane
- Departments of Medicine, Mizan Tepi University, Mizan, Ethiopia
| | - Yohanes Sime
- Departments of Psychatry, Dilla University, Dilla, Ethiopia
| | - Anteneh Gashaw
- Departments of Midwifery, Dilla University, Dilla, Ethiopia
| | - Getachew Chane
- Departments of Anatomy, Jimma University, Jimma, Ethiopia
| |
Collapse
|
9
|
Rai S, Leydier L, Sharma S, Katwala J, Sahu A. A quest for genetic causes underlying signaling pathways associated with neural tube defects. Front Pediatr 2023; 11:1126209. [PMID: 37284286 PMCID: PMC10241075 DOI: 10.3389/fped.2023.1126209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 02/28/2023] [Indexed: 06/08/2023] Open
Abstract
Neural tube defects (NTDs) are serious congenital deformities of the nervous system that occur owing to the failure of normal neural tube closures. Genetic and non-genetic factors contribute to the etiology of neural tube defects in humans, indicating the role of gene-gene and gene-environment interaction in the occurrence and recurrence risk of neural tube defects. Several lines of genetic studies on humans and animals demonstrated the role of aberrant genes in the developmental risk of neural tube defects and also provided an understanding of the cellular and morphological programs that occur during embryonic development. Other studies observed the effects of folate and supplementation of folic acid on neural tube defects. Hence, here we review what is known to date regarding altered genes associated with specific signaling pathways resulting in NTDs, as well as highlight the role of various genetic, and non-genetic factors and their interactions that contribute to NTDs. Additionally, we also shine a light on the role of folate and cell adhesion molecules (CAMs) in neural tube defects.
Collapse
Affiliation(s)
- Sunil Rai
- Department of Molecular Biology, Medical University of the Americas, Charlestown, Saint Kitts and Nevis
| | - Larissa Leydier
- Department of Molecular Biology, Medical University of the Americas, Charlestown, Saint Kitts and Nevis
| | - Shivani Sharma
- Department of Molecular Biology, Medical University of the Americas, Charlestown, Saint Kitts and Nevis
| | - Jigar Katwala
- Department of Molecular Biology, Medical University of the Americas, Charlestown, Saint Kitts and Nevis
| | - Anurag Sahu
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| |
Collapse
|
10
|
Wang F, Gu YH, Guo J, Bao Y, Qiu Z, Zheng P, Ushijima M, Matsuura M, Zhang T. Polymorphisms of Placental Iodothyronine Deiodinase Genes in a Rural Area of Northern China with High Prevalence of Neural Tube Defects. Hum Hered 2023; 88:29-37. [PMID: 36944328 DOI: 10.1159/000530112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 03/07/2023] [Indexed: 03/23/2023] Open
Abstract
INTRODUCTION We have reported that high total homocysteine and the coexistence of inadequate thyroid hormones in maternal serum increase the risk of fetal neural tube defects (NTDs). Placental iodothyronine deiodinases (DIOs: DIO1, DIO2, and DIO3) play a role in regulating the conversions between different forms of maternal thyroid hormones. This study hypothesized that single nucleotide polymorphisms (SNPs) in placental DIOs genes could be related to NTDs. METHODS We performed a case-control study from 2007 to 2009 that included pregnant women from Lüliang, Shanxi Province, China. Nine distinct SNPs in DIOs genes were analyzed, and placental samples were obtained from 83 pregnant women with NTD fetuses and 90 pregnant women with normal fetuses. The nine SNPs were analyzed using the Cochran-Armitage test and the Fisher's exact test. RESULTS There were no statistically significant differences between case and control in the nine SNPs of DIOs (p > 0.05). CONCLUSIONS The results of this study suggested that SNPs of DIO genes in the placenta among pregnant women have no statistically significant difference between the two groups, suggesting that other factors might be involved in metabolism of maternal thyroid hormone provided to fetuses, such as epigenetic modification of methylation and homocysteinylation and genomic imprinting in the placenta. Further functional studies on placenta samples are necessary.
Collapse
Affiliation(s)
- Fang Wang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China,
| | - Yan-Hong Gu
- Japan China Care Association, Tokyo, Japan
- Department of Hygiene and Public Health, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Jin Guo
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China
| | - YiHua Bao
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China
| | - ZhiYong Qiu
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China
| | - Ping Zheng
- Beijing FangShan District Maternal and Child Health Care Hospital, Beijing, China
| | - Masaru Ushijima
- Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | - Ting Zhang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China
| |
Collapse
|
11
|
Cao R, Xie J, Zhang L. Abnormal methylation caused by folic acid deficiency in neural tube defects. Open Life Sci 2022; 17:1679-1688. [PMID: 36589786 PMCID: PMC9784971 DOI: 10.1515/biol-2022-0504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/27/2022] [Accepted: 09/01/2022] [Indexed: 12/24/2022] Open
Abstract
Neural tube closure disorders, including anencephaly, spina bifida, and encephalocele, cause neural tube defects (NTDs). This congenital disability remained not only a major contributor to the prevalence of stillbirths and neonatal deaths but also a significant cause of lifelong physical disability in surviving infants. NTDs are complex diseases caused by multiple etiologies, levels, and mechanisms. Currently, the pathogenesis of NTDs is considered to be associated with both genetic and environmental factors. Here, we aimed to review the research progress on the etiology and mechanism of NTDs induced by methylation modification caused by folic acid deficiency. Folic acid supplementation in the diet is reported to be beneficial in preventing NTDs. Methylation modification is one of the most important epigenetic modifications crucial for brain neurodevelopment. Disturbances in folic acid metabolism and decreased S-adenosylmethionine levels lead to reduced methyl donors and methylation modification disorders. In this review, we summarized the relationship between NTDs, folic acid metabolism, and related methylation of DNA, imprinted genes, cytoskeletal protein, histone, RNA, and non-coding RNA, so as to clarify the role of folic acid and methylation in NTDs and to better understand the various pathogenesis mechanisms of NTDs and the effective prevention.
Collapse
Affiliation(s)
- Rui Cao
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Key Laboratory for Cellular Physiology of Ministry of Education, Shanxi Medical University, No. 56, Xinjian South Road, Yingze District, Taiyuan, Shanxi Province, China,Shanxi Key Laboratory of Pharmaceutical Biotechnology, Shanxi Biological Research Institute Co., Ltd, Taiyuan, China
| | - Jun Xie
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Key Laboratory for Cellular Physiology of Ministry of Education, Shanxi Medical University, No. 56, Xinjian South Road, Yingze District, Taiyuan, Shanxi Province, China
| | - Li Zhang
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Key Laboratory for Cellular Physiology of Ministry of Education, Shanxi Medical University, No. 56, Xinjian South Road, Yingze District, Taiyuan, Shanxi Province, China,Department of Hepatobiliary and Pancreatic Surgery and Liver Transplant Center, The First Hospital of Shanxi Medical University, No. 56, Xinjian South Road, Yingze District, Taiyuan, Shanxi Province, China
| |
Collapse
|
12
|
Salari N, Fatahi B, Fatahian R, Mohammadi P, Rahmani A, Darvishi N, Keivan M, Shohaimi S, Mohammadi M. Global prevalence of congenital anencephaly: a comprehensive systematic review and meta-analysis. Reprod Health 2022; 19:201. [PMID: 36253858 PMCID: PMC9575217 DOI: 10.1186/s12978-022-01509-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 09/29/2022] [Indexed: 11/22/2022] Open
Abstract
Background Anencephaly is a fatal congenital anomaly characterized by the absence of brain hemispheres and cranial arch. Timely preventive measures can be taken by knowing the exact prevalence of this common neural tube defect; thus, carried out through systematic review and meta-analysis, the present study was conducted to determine the worldwide prevalence, incidence and mortality of anencephaly. Methods Cochran’s seven-step instructions were used as the guideline. Having determined the research question and inclusion and exclusion criteria, we studied MagIran, SID, Science Direct, WoS, Web of Science, Medline (PubMed), Scopus, and Google Scholar databases. Moreover, the search strategy in each database included using all possible keyword combinations with the help of “AND” and “OR” operators with no time limit to 2021. The I2 test was used to calculate study heterogeneity, and Begg and Mazumdar rank correlation tests were employed to assess the publication bias. Data were analyzed by Comprehensive Meta-Analysis software (Version 2). Results In this study, the statements of Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) were used. In the first stage, 1141 articles were found, of which 330 duplicate studies were omitted. 371 articles were deleted based on the inclusion and exclusion criteria by reviewing the title and abstract of the study. 58 articles were removed by reviewing the full text of the article because it was not relevant to the research. 360 studies with a sample size of 207,639,132 people were considered for the meta-analysis. Overall estimate of the prevalence, incidence and attenuation of anencephaly worldwide were 5.1 per ten thousand births (95% confidence interval 4.7–5.5 per ten thousand births), 8.3 per ten thousand births (95% confidence interval 5.5–9.9 per ten thousand births), 5.5 per ten thousand births (95% confidence interval 1.8–15 per ten thousand births) respectively the highest of which according to the subgroup analysis, belonged to the Australian continent with 8.6 per ten thousand births (95% confidence interval 7.7–9.5 per ten thousand births). Conclusion The overall prevalence of anencephaly in the world is significant, indicating the urgent need for preventive and treating measures. Anencephaly is a fatal congenital anomaly characterized by the absence of brain hemispheres and cranial arch. Cochran’s seven-step instructions were used as the guideline. Having determined the research question and inclusion and exclusion criteria, we studied MagIran, SID, Science Direct, WoS, Web of Science, Medline (PubMed), Scopus, and Google Scholar databases. Moreover, the search strategy in each database included using all possible keyword combinations with the help of “AND” and “OR” operators with no time limit to 2021. Out of 1141 initial articles found, and after excluding repetitive ones in various databases and those irrelevant to inclusion criteria, 360 studies with a sample size of 207,639,132 people were considered for the meta-analysis. Overall estimate of the prevalence, incidence and attenuation of anencephaly worldwide were 5.1 per ten thousand births (95% confidence interval 4.7–5.5 per ten thousand births), 8.3 per ten thousand births (95% confidence interval 5.5–9.9 per ten thousand births), 5.5 per ten thousand births (95% confidence interval 1.8–15 per ten thousand births) respectively the highest of which according to the subgroup analysis, belonged to the Australian continent with 8.6 per ten thousand births (95% confidence interval 7.7–9.5 per ten thousand births). The overall prevalence of anencephaly in the world is significant, indicating the urgent need for preventive and treating measures.
Collapse
Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behnaz Fatahi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Fatahian
- Department of Neurosurgery, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Payam Mohammadi
- Department of Neurology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Niloofar Darvishi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mona Keivan
- Student Research Committee, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
| |
Collapse
|
13
|
Che X, Liu J, Galea GL, Zhang Y, Greene NDE, Zhang L, Jin L, Wang L, Ren A, Li Z. Non-Isolated Neural Tube Defects with Comorbid Malformations Are Responsive to Population-Level Folic Acid Supplementation in Northern China. BIOLOGY 2022; 11:biology11091371. [PMID: 36138850 PMCID: PMC9495576 DOI: 10.3390/biology11091371] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022]
Abstract
Simple Summary Neural tube defects are severe congenital malformations of the central nervous system. Some cases also have comorbid malformations in other organ systems, which cause morbidity and mortality in affected individuals. Although folic acid is effective in preventing neural tube defects, whether folic acid prevents those cases which have comorbid malformations, or only isolated neural tube defects is unknown. In this study, we described the epidemiology of neural tube defects with comorbid malformations and assessed the impact of folic acid supplementation. We found the prevalence of neural tube defects with comorbid malformations decreased after population-level folic acid supplementation in northern China. Malformations of various organ systems are more common in people with neural tube defects, suggesting common etiology. For fetuses with NTDs, clinicians are also suggested to consider screening for possible comorbid congenital malformations. Abstract Objective: Comorbid congenital malformation of multiple organs may indicate a shared genetic/teratogenic causality. Folic acid supplementation reduces the population-level prevalence of isolated neural tube defects (NTDs), but whether complex cases involving independent malformations are also responsive is unknown. We aimed to describe the epidemiology of NTDs with comorbid malformations in a Chinese population and assess the impact of folic acid supplementation. Study Design: Data from five counties in Northern China were obtained between 2002 and 2021 through a population-based birth defects surveillance system. All live births, stillbirths, and terminations because of NTDs at any gestational age were recorded. NTDs were classified as spina bifida, anencephaly, or encephalocele. Isolated NTDs included spina bifida cases with presumed secondary malformations (hydrocephalus, hip dislocation, talipes). Non-isolated NTDs were those with independent concomitant malformations. Results: A total of 296,306 births and 2031 cases of NTDs were recorded from 2002–2021. A total of 4.8% of NTDs (97/2031) had comorbid defects, which primarily affected the abdominal wall (25/97), musculoskeletal system (24/97), central nervous system (22/97), and face (15/97). The relative risk of cleft lip and/or palate, limb reduction defects, hip dislocation, gastroschisis, omphalocele, hydrocephalus, and urogenital system defects was significantly greater in infants with NTDs than in the general population. Population-level folic acid supplementation significantly reduced the prevalence of both isolated and non-isolated NTDs. Conclusion: Epidemiologically, non-isolated NTDs follow similar trends as isolated cases and are responsive to primary prevention by folic acid supplementation. Various clinically-important congenital malformations are over-represented in individuals with NTDs, suggesting a common etiology.
Collapse
Affiliation(s)
- Xiaoyu Che
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing 100191, China; (X.C.); (Y.Z.); (L.Z.); (L.J.); (L.W.); (A.R.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Jufen Liu
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing 100191, China; (X.C.); (Y.Z.); (L.Z.); (L.J.); (L.W.); (A.R.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Correspondence: (J.L.); (Z.L.)
| | - Gabriel L Galea
- Developmental Biology and Cancer Department, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1E, UK; (G.L.G.); (N.D.E.G.)
| | - Yali Zhang
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing 100191, China; (X.C.); (Y.Z.); (L.Z.); (L.J.); (L.W.); (A.R.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Nicholas D. E. Greene
- Developmental Biology and Cancer Department, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1E, UK; (G.L.G.); (N.D.E.G.)
| | - Le Zhang
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing 100191, China; (X.C.); (Y.Z.); (L.Z.); (L.J.); (L.W.); (A.R.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Lei Jin
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing 100191, China; (X.C.); (Y.Z.); (L.Z.); (L.J.); (L.W.); (A.R.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Linlin Wang
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing 100191, China; (X.C.); (Y.Z.); (L.Z.); (L.J.); (L.W.); (A.R.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Aiguo Ren
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing 100191, China; (X.C.); (Y.Z.); (L.Z.); (L.J.); (L.W.); (A.R.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Zhiwen Li
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing 100191, China; (X.C.); (Y.Z.); (L.Z.); (L.J.); (L.W.); (A.R.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Correspondence: (J.L.); (Z.L.)
| |
Collapse
|
14
|
Li C, Ye K, Zhang W, Xu Y, Xu J, Li J, Mawusi SK, Shrestha P, Xue C, Liu G. User behavior, influence factors, and impacts on real-world pollutant emissions from the household heating stoves in rural China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 823:153718. [PMID: 35149075 DOI: 10.1016/j.scitotenv.2022.153718] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/29/2022] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
Household heating stoves are commonly used for heating in rural China during winter and are responsible for a large portion of the particulate matter in the atmosphere. Pollutant emissions from household stoves are influenced by user behaviors in actual use, in addition to purely technological reasons (i.e., type and age of appliance) and installation conditions (i.e., the natural draft of chimney system). The variability in user behavior is one of the reasons for uncertainty in household emission inventories. In this study, household stove user behaviors, including ignition frequency, heating with or without cooking, smoldering duration, and fuel-adding times, were investigated through face-to-face surveys in Shanxi province, north China. The survey of user behaviors showed that the majority of the RHS users (81.3%) and approximately half of the WHS users (49.4%) used their stoves for both cooking and heating, whereas the remaining users used their stoves just for heating. Approximately 80% of surveyed households (97.4% for water heating stove and 68.7% for radiant heating stove) kept the stoves smoldering at night, whereas the remaining users ignited their stoves every day. The highest frequency of smoldering duration and highest frequency of fuel-adding operation were 8-9 h and 4-7 times, respectively. Principal component analysis showed that stove type, permanent population, and annual income are the potential influencing factors of user behavior. The smoldering duration was positively related to indoor air pollutant concentrations and fuel-adding times had a significant impact on outdoor PM2.5 emission factors. The results from this research will be beneficial for understanding the cause of fluctuation in emissions and designing heating appliances for real-life operations.
Collapse
Affiliation(s)
- Chuang Li
- Biomass Energy and Environmental Engineering Research Center, College of Chemical Engineering, Beijing University of Chemical Technology, Beijing 100029, PR China
| | - Kun Ye
- Biomass Energy and Environmental Engineering Research Center, College of Chemical Engineering, Beijing University of Chemical Technology, Beijing 100029, PR China
| | - Wenting Zhang
- Biomass Energy and Environmental Engineering Research Center, College of Chemical Engineering, Beijing University of Chemical Technology, Beijing 100029, PR China
| | - Yinhong Xu
- Biomass Energy and Environmental Engineering Research Center, College of Chemical Engineering, Beijing University of Chemical Technology, Beijing 100029, PR China
| | - Jiangdong Xu
- Biomass Energy and Environmental Engineering Research Center, College of Chemical Engineering, Beijing University of Chemical Technology, Beijing 100029, PR China
| | - Jie Li
- Biomass Energy and Environmental Engineering Research Center, College of Chemical Engineering, Beijing University of Chemical Technology, Beijing 100029, PR China
| | - Sylvester K Mawusi
- Biomass Energy and Environmental Engineering Research Center, College of Chemical Engineering, Beijing University of Chemical Technology, Beijing 100029, PR China
| | - Prabin Shrestha
- Biomass Energy and Environmental Engineering Research Center, College of Chemical Engineering, Beijing University of Chemical Technology, Beijing 100029, PR China
| | - Chunyu Xue
- Biomass Energy and Environmental Engineering Research Center, College of Chemical Engineering, Beijing University of Chemical Technology, Beijing 100029, PR China.
| | - Guangqing Liu
- Biomass Energy and Environmental Engineering Research Center, College of Chemical Engineering, Beijing University of Chemical Technology, Beijing 100029, PR China.
| |
Collapse
|
15
|
Li J, Lin S, Wu J, Pei L, Shang X. OUP accepted manuscript. Int Health 2022; 15:299-308. [PMID: 35521756 PMCID: PMC10153556 DOI: 10.1093/inthealth/ihac027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/15/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Maternal exposure to pesticides during early pregnancy is associated with increased risks of birth defects, while the association between maternal exposure to chemical fertilizer during pregnancy and the risk of birth defects remains unknown. METHODS Data were from a population-based birth defects surveillance system between 2007 and 2012 in Pingding County, Shanxi Province, northern China. A total of 14 074 births with 235 birth defects were used to estimate spatial clustering and correlations at the village level. A population-based case-control study of 157 cases with birth defects and 204 controls was performed to investigate the association between maternal chemical fertilizer exposure and the risk of birth defects by a two-level logistic model. RESULTS The total prevalence of birth defects between 2007 and 2012 was 167.0/10 000 births. The spatial analysis indicated a remarkable high-risk area of birth defects in the southeast of Pingding County and the use of chemical fertilizer was associated with the risk of birth defects at the village level. After adjusting for confounders at the individual level, mothers who live in villages with chemical fertilizer application ≥65 tons/y had an increased risk of birth defects (adjusted odds ratio 2.06 [95% confidence interval 1.23 to 3.46]) compared with those of <65 tons/y. CONCLUSIONS Our findings suggest that the risk of birth defects may be associated with the use of chemical fertilizer in rural northern China. The findings must be cautiously interpreted and need to be investigated on larger samples.
Collapse
Affiliation(s)
| | | | - Jilei Wu
- Institute of Population Research/China Center on Population Health and Development, Peking University, No. 5 Yiheyuan Road, Haidian District, Beijing,100871, China
| | - Lijun Pei
- Corresponding authors: Tel: +86 010-62751974; E-mail:
| | - Xuejun Shang
- Corresponding authors: Tel: +86 025-84815775; E-mail:
| |
Collapse
|
16
|
Zhang L, Cao R, Li D, Sun Y, Zhang J, Wang X, Khan A, Liu Z, Niu B, Xu J, Xie J. Ethionine-mediated reduction of S-adenosylmethionine is responsible for the neural tube defects in the developing mouse embryo-mediated m6A modification and is involved in neural tube defects via modulating Wnt/β-catenin signaling pathway. Epigenetics Chromatin 2021; 14:52. [PMID: 34863249 PMCID: PMC8645112 DOI: 10.1186/s13072-021-00426-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/16/2021] [Indexed: 11/16/2022] Open
Abstract
Neural tube defects (NTDs) remain one of the most life-threatening birth defects affecting infants. Most patients with NTDs eventually develop lifelong disability, which cause significant morbidity and mortality and seriously reduce the quality of life. Our previous study has found that ethionine inhibits cell viability by disrupting the balance between proliferation and apoptosis, and preventing neural stem cells from differentiating into neurons and astrocytes. However, how ethionine participates in the pathogenesis of neural tube development through N6-methyladenosine (m6A) modification remains unknown. This study aims to investigate METTL3- and ALKBH5-mediated m6A modification function and mechanism in NTDs. Herein, our results demonstrate that SAM play not only a compensatory role, it also leads to changes of m6A modification in neural tube development and regulation. Additionally, these data implicate that METTL3 is enriched in HT-22 cells, and METTL3 knockdown reduces cell proliferation and increases apoptosis through suppressing Wnt/β-catenin signaling pathway. Significantly, overexpression of ALKBH5 can only inhibit cell proliferation, but cannot promote cell apoptosis. This research reveals an important role of SAM in development of NTDs, providing a good theoretical basis for further research on NTDs. This finding represents a novel epigenetic mechanism underlying that the m6A modification has profound and lasting implications for neural tube development.
Collapse
Affiliation(s)
- Li Zhang
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, 030001, Shanxi, China.,Department of Hepatobiliary and Pancreatic Surgery, First Clinical Medical College, Shanxi Medical University, Taiyuan, 030001, Shanxi, China.,Institute of Liver Diseases and Organ Transplantation, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Rui Cao
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, 030001, Shanxi, China.,Biology Institute of Shanxi, Taiyuan, 030001, Shanxi, China
| | - Dandan Li
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Yuqing Sun
- Department of Hepatobiliary and Pancreatic Surgery, First Clinical Medical College, Shanxi Medical University, Taiyuan, 030001, Shanxi, China.,Institute of Liver Diseases and Organ Transplantation, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Juan Zhang
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Xiuwei Wang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China
| | - Ajab Khan
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Zhizhen Liu
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Bo Niu
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, 030001, Shanxi, China.
| | - Jun Xu
- Department of Hepatobiliary and Pancreatic Surgery, First Clinical Medical College, Shanxi Medical University, Taiyuan, 030001, Shanxi, China. .,Institute of Liver Diseases and Organ Transplantation, Shanxi Medical University, Taiyuan, 030001, Shanxi, China.
| | - Jun Xie
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, 030001, Shanxi, China.
| |
Collapse
|
17
|
Gu YH, Zhang Q, Guo J, Wang F, Bao Y, Qiu Z, Zheng P, Ushijima M, Matsuura M, Xie X, Zhang T. Higher serum homocysteine and lower thyroid hormone levels in pregnant women are associated with neural tube defects. J Trace Elem Med Biol 2021; 68:126814. [PMID: 34243025 DOI: 10.1016/j.jtemb.2021.126814] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study tested the hypothesis that abnormal maternal metabolism of both homocysteine and thyroid hormone network in pregnant women is associated with neural tube defects (NTDs) in a part of China with high NTD prevalence. METHODS A case-control study was performed between 2007 and 2009 in Lüliang Mountains, Shanxi Province. This study included 83 pregnant women who had fetuses with NTDs (cases) and 90 pregnant women with normal fetuses (controls). In addition, a cell model to illustrate the epidemiological findings was established. RESULTS Fetuses of mother who had both high total homocysteine (tHcy) and inadequate free thyroxine were 3 times more at risk of developing NTDs (adjusted odds ratio = 3.5; 95 % confidence interval = 1.2-10.4; cases vs. controls) using multivariate logistic regression models. Furthermore, biological interaction between metabolisms of Hcy and thyroid hormones was demonstrated in vitro. In homocysteine thiolactone of a metabolite of Hcy-treated mouse embryonic neural stem NE4C cells, genes (Bmp7, Ctnnb1, Notch 1, Gli2, and Rxra) related to both neural tube closure and thyroid hormone network were shown to be regulated by H3K79 homocysteinylation, which increased their expression levels. CONCLUSIONS The effect of maternal serum high tHcy on risk of developing NTDs is depended on maternal serum level of thyroxine. Meanwhile, a higher level of tHcy might also affect both maternal metabolism of thyroid hormone and neural tube closure in embryogenesis through homocysteinylation of histones.
Collapse
Affiliation(s)
- Yan-Hong Gu
- Department of Hygiene and Public Health, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan.
| | - Qin Zhang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China
| | - Jin Guo
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China
| | - Fang Wang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China
| | - YiHua Bao
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China
| | - ZhiYong Qiu
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China
| | - Ping Zheng
- Beijing FangShan District Maternal and Child Health Care Hospital, Beijing 102488, China
| | - Masaru Ushijima
- Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan
| | | | - XiangHui Xie
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China.
| | - Ting Zhang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China
| |
Collapse
|
18
|
Wang B, Pang Y, Zhang Y, Zhang L, Ye R, Yan L, Li Z, Ren A. Thorium and fetal neural tube defects: an epidemiological evidence from large case-control study. Genes Environ 2021; 43:51. [PMID: 34823609 PMCID: PMC8614024 DOI: 10.1186/s41021-021-00227-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 11/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Thorium is ubiquitous in the environment and its relationship with birth defects is still under discussion. This study aimed to investigate the associations of maternal exposure to thorium with risk of neural tube defects (NTDs) by using a case–control study, as well as the relationship between thorium exposure and the indoor air pollution from coal combustion. Methods This study was conducted in 11 local healthcare hospitals during 2003–2007 in Shanxi and Hebei provinces, China. A total of 774 mothers were included as participants who delivering 263 fetuses with NTDs including 123 with anencephaly, 115 with spina bifida, 18 with encephalocele, and 7 other NTD subtypes (cases), and 511 health fetuses without NTDs (controls). Their hair samples were collected as close as to the occipital posterior scalp, of which those grew from 3 months before to 3 months after conception was cut to measure the thorium concentration by inductively coupled plasma-mass spectrometry. Results We found a higher hair thorium concentration in the total NTD cases with 0.901 (0.588–1.382) ng/g hair [median (inter-quartile range)] than that in the controls with a value of 0.621 (0.334–1.058) ng/g hair. Similar results were found for the three concerned NTD subtypes. Maternal hair thorium concentration above its median of the controls was associated with an increased risk of the total NTDs with an adjusted odds ratio of 1.80 [95% confidence interval (CI), 1.23–2.63)] by adjusting for all confounders. There was obvious dose-response relationship between maternal hair thorium concentration and the risk of total NTDs, as well as their two subtypes (i.e. anencephaly and spina bifida). Maternal hair thorium concentration was positive associated with their exposure level to indoor air pollution from coal combustion during cooking. Conclusions Overall, our findings revealed that maternal periconceptional thorium exposure was associated with the risk of NTDs in North China. Reducing the coal usage in the household cooking activities may decrease maternal thorium exposure level. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s41021-021-00227-w.
Collapse
Affiliation(s)
- Bin Wang
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing, 100191, P. R. China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, P. R. China
| | - Yiming Pang
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing, 100191, P. R. China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, P. R. China
| | - Yali Zhang
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing, 100191, P. R. China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, P. R. China
| | - Le Zhang
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing, 100191, P. R. China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, P. R. China
| | - Rongwei Ye
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing, 100191, P. R. China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, P. R. China
| | - Lailai Yan
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, P. R. China.
| | - Zhiwen Li
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing, 100191, P. R. China. .,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, P. R. China.
| | - Aiguo Ren
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing, 100191, P. R. China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, P. R. China
| |
Collapse
|
19
|
Huang W, Gu H, Yuan Z. Identifying biomarkers for prenatal diagnosis of neural tube defects based on "omics". Clin Genet 2021; 101:381-389. [PMID: 34761376 DOI: 10.1111/cge.14087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 11/27/2022]
Abstract
Neural tube defects (NTDs) are the most severe birth defects and the main cause of newborn death; posing a great challenge to the affected children, families, and societies. Presently, the clinical diagnosis of NTDs mainly relies on ultrasound images combined with certain indices, such as alpha-fetoprotein levels in the maternal serum and amniotic fluid. Recently, the discovery of additional biomarkers in maternal tissue has presented new possibilities for prenatal diagnosis. Over the past 20 years, "omics" techniques have provided the premise for the study of biomarkers. This review summarizes recent advances in candidate biomarkers for the prenatal diagnosis of fetal NTDs based on omics techniques using maternal biological specimens of different origins, including amniotic fluid, blood, and urine, which may provide a foundation for the early prenatal diagnosis of NTDs.
Collapse
Affiliation(s)
- Wanqi Huang
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| | - Hui Gu
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| | - Zhengwei Yuan
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| |
Collapse
|
20
|
Lin S, Zhang Y, Li J, Wu J, Pei L. Trends of Adverse Pregnancy Outcomes in a High Prevalence Region of Birth Defects - Shanxi Province, China, 2007-2019. China CDC Wkly 2021; 3:661-664. [PMID: 34594963 PMCID: PMC8392908 DOI: 10.46234/ccdcw2021.167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/09/2021] [Indexed: 11/27/2022] Open
Abstract
What is already known about this topic? Shanxi Province in northern China has been identified as a region with the highest prevalence of birth defects nationwide. With large amounts of financial support devoted for prevention and related interventions for birth defects, huge progress has been made as a 60% decrease in its prevalence was observed from 2009 to 2014. What is added by this report? The study presented a recent trend of adverse pregnancy outcomes (APOs) in Shanxi Province, a region with high prevalence of birth defects in China from 2007–2019. The prevalence of serious APOs including birth defects, stillbirths, and neonatal deaths remained at a relatively low level, yet macrosomia, low birth weight (LBW), preterm births, and spontaneous abortion comprised a majority of all APOs, with macrosomia showing an obvious upward trend from 2007 to 2012. What are the implications for public health practice? These findings provide new evidence for prevention and intervention strategies of APOs in northern China. Future research should focus on comprehensive interventions for multiple APOs, especially macrosomia, LBW, preterm births, and spontaneous abortion.
Collapse
Affiliation(s)
- Shiqi Lin
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
| | - Yuan Zhang
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China.,National Research Institute for Health and Family Planning, Beijing, China
| | - Jiajia Li
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
| | - Jilei Wu
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
| | - Lijun Pei
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
| |
Collapse
|
21
|
Liu M, Yu J, Su Z, Sun Y, Liu Y, Xie Q, Li Z, Wang L, Zhang J, Jin L, Ren A. Associations between prenatal exposure to cadmium and lead with neural tube defect risks are modified by single-nucleotide polymorphisms of fetal MTHFR and SOD2: a case-control study. Environ Health 2021; 20:66. [PMID: 34090432 PMCID: PMC8180011 DOI: 10.1186/s12940-021-00752-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 05/24/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Prenatal exposure to heavy metals is implicated in the etiology of birth defects. We investigated whether concentrations of cadmium (Cd) and lead (Pb) in umbilical cord tissue are associated with risk for neural tube defects (NTDs) and whether selected genetic variants of the fetus modify their associations. METHODS This study included 166 cases of NTD fetuses/newborns and 166 newborns without congenital malformations. Umbilical cord tissue was collected at birth or elective pregnancy termination. Cd and Pb concentrations were assessed by inductively coupled plasma-mass spectrometry, and 20 single-nucleotide polymorphisms (SNPs) in 9 genes were genotyped. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to estimate the risk for NTDs in association with metal concentrations or genotype using logistic regression. Multiplicative-scale interactions between the metals and genotypes on NTD risk were assessed with logistic regression, and additive-scale interactions were estimated with a non-linear mixed effects model. RESULTS Higher concentrations of Cd were observed in the NTD group than in the control group, but no difference was found for Pb. Concentrations of Cd above the median level showed a risk effect, while the association between Pb and NTD risk was not significant in univariate analyses. The association of Cd was attenuated after adjusting for periconceptional folic acid supplementation. Fetuses with the AG and GG genotypes of rs4880 in SOD2 (superoxide dismutase 2) tended to have a lower risk, but fetuses with the CT and TT genotypes of rs1801133 in MTHFR (5,10-methylenetetrahydrofolatereductase) have a higher risk for NTDs when compared to their respective wild-type. rs4880 and Cd exhibited a multiplicative-scale interaction on NTD risk: the association between higher Cd and the risk for NTDs was increased by over fourfold in fetuses carrying the G allele [OR 4.43 (1.30-15.07)] compared to fetuses with the wild-type genotype. rs1801133 and Cd exposure showed an additive interaction, with a significant relative excess risk of interaction [RERI 0.64 (0.02-1.25)]. CONCLUSIONS Prenatal exposure to Cd may be a risk factor for NTDs, and the risk effect may be enhanced in fetuses who carry the G allele of rs4880 in SOD2 and T allele of rs1801133 in MTHFR.
Collapse
Affiliation(s)
- Mengyuan Liu
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jinhui Yu
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zaiming Su
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Ying Sun
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yaqiong Liu
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Qing Xie
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zhiwen Li
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Linlin Wang
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jie Zhang
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lei Jin
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Aiguo Ren
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
22
|
Zhang N, Liao Y, Ren Z. Evaluating an intervention for neural tube defects in coal mining cites in China: a temporal and spatial analysis. Int Health 2021; 13:161-169. [PMID: 32905578 PMCID: PMC7902274 DOI: 10.1093/inthealth/ihaa035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/23/2020] [Accepted: 09/03/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Neural tube defects (NTDs) are congenital birth defects of the central nervous system that affect 0.5-2 per 1000 pregnancies worldwide. Therefore effective interventions for birth defects, especially NTDs, are very important. METHODS Yuanping City is a coal mining city in Shanxi Province, China, with a high incidence of NTDs. This study evaluates the effects of NTD interventions in this city after adjusting for covariates that characterize the native environment. The number of NTD cases and births for the 18 towns in Yuanping City from 2007 to 2014 were included in the study. A shared-component zero-inflated Poisson regression was applied to analyse the temporal-spatial variance among the incidence rates of NTDs in Yuanping City before and after the interventions. RESULTS The results showed that existing interventions to mitigate birth defects, such as folic acid supplementation, reduced the incidence of NTDs by 53.5% in coal mining areas in Yuanping City. However, the NTD risk in areas near coal mines, especially unrestored coal mines, was still high, even after the intervention. CONCLUSIONS The government should focus on health hazards related to mining and agricultural production and should provide education and resources to reduce environmental exposure. Reducing environmental risks should be regarded as an early intervention strategy to mitigate birth defects.
Collapse
Affiliation(s)
- Ningxu Zhang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, 11A, Datun Road, Chaoyang District, Beijing, 100101, China.,Sinomaps Press, No. 3, Baizhifangxi Road, Xuanwu District, Beijing, 100054, China
| | - Yilan Liao
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, 11A, Datun Road, Chaoyang District, Beijing, 100101, China.,Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, No. 1, Wenyuan Road Qixia District, Nanjing, 210023, China
| | - Zhoupeng Ren
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, 11A, Datun Road, Chaoyang District, Beijing, 100101, China
| |
Collapse
|
23
|
Bonnard C, Navaratnam N, Ghosh K, Chan PW, Tan TT, Pomp O, Ng AYJ, Tohari S, Changede R, Carling D, Venkatesh B, Altunoglu U, Kayserili H, Reversade B. A loss-of-function NUAK2 mutation in humans causes anencephaly due to impaired Hippo-YAP signaling. J Exp Med 2021; 217:152044. [PMID: 32845958 PMCID: PMC7953732 DOI: 10.1084/jem.20191561] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 02/21/2020] [Accepted: 05/19/2020] [Indexed: 01/18/2023] Open
Abstract
Failure of neural tube closure during embryonic development can result in anencephaly, one of the most common birth defects in humans. A family with recurrent anencephalic fetuses was investigated to understand its etiology and pathogenesis. Exome sequencing revealed a recessive germline 21-bp in-frame deletion in NUAK2 segregating with the disease. In vitro kinase assays demonstrated that the 7–amino acid truncation in NUAK2, a serine/threonine kinase, completely abrogated its catalytic activity. Patient-derived disease models including neural progenitor cells and cerebral organoids showed that loss of NUAK2 activity led to decreased Hippo signaling via cytoplasmic YAP retention. In neural tube–like structures, endogenous NUAK2 colocalized apically with the actomyosin network, which was disrupted in patient cells, causing impaired nucleokinesis and apical constriction. Our results establish NUAK2 as an indispensable kinase for brain development in humans and suggest that a NUAK2-Hippo signaling axis regulates cytoskeletal processes that govern cell shape during neural tube closure.
Collapse
Affiliation(s)
- Carine Bonnard
- Human Genetics and Embryology Laboratory, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore
| | - Naveenan Navaratnam
- Medical Research Council London Institute of Medical Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Kakaly Ghosh
- Human Genetics and Embryology Laboratory, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore
| | - Puck Wee Chan
- Human Genetics and Embryology Laboratory, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore
| | - Thong Teck Tan
- Human Genetics and Embryology Laboratory, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore
| | - Oz Pomp
- Human Genetics and Embryology Laboratory, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore
| | - Alvin Yu Jin Ng
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research, Singapore
| | - Sumanty Tohari
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research, Singapore
| | - Rishita Changede
- Mechanobiology Institute, National University of Singapore, Singapore
| | - David Carling
- Medical Research Council London Institute of Medical Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Byrappa Venkatesh
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research, Singapore.,Department of Paediatrics, National University of Singapore, Singapore
| | - Umut Altunoglu
- Medical Genetics Department, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.,Medical Genetics Department, Koç University School of Medicine, Istanbul, Turkey
| | - Hülya Kayserili
- Medical Genetics Department, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.,Medical Genetics Department, Koç University School of Medicine, Istanbul, Turkey
| | - Bruno Reversade
- Human Genetics and Embryology Laboratory, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore.,Institute of Molecular and Cell Biology, Agency for Science, Technology and Research, Singapore.,Department of Paediatrics, National University of Singapore, Singapore.,Medical Genetics Department, Koç University School of Medicine, Istanbul, Turkey
| |
Collapse
|
24
|
Corona-Rivera JR, Olvera-Molina S, Pérez-Molina JJ, Aranda-Sánchez CI, Bobadilla-Morales L, Corona-Rivera A, Peña-Padilla C, Ruiz-Gómez A, Morales-Domínguez GE. Prevalence of open neural tube defects and risk factors related to isolated anencephaly and spina bifida in live births from the "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara (Jalisco, Mexico). Congenit Anom (Kyoto) 2021; 61:46-54. [PMID: 33118203 DOI: 10.1111/cga.12399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/13/2020] [Accepted: 10/23/2020] [Indexed: 01/18/2023]
Abstract
We determine the prevalence and trends of open neural tube defects (ONTDs) during 1991 to 2019 at the "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara (Mexico). Also, details of potential risks were obtained in 662 newborns, including those 143 patients with anencephaly and open spina bifida (OSB) classified as isolated (cases) and 519 controls. Data were analyzed using multivariable logistic regression. Among 267 201 live births during the study period, 336 were born with ONTDs, yielding an overall prevalence of 12.6 per 10 000. After folic acid (FA)-related programs began in Mexico (2003-2019), only OSB showed a decline of 20.6%. For anencephaly, associated risks included relatives with neural tube defects (NTDs) (adjusted odds ratio [aOR]: 67.9, 95% confidence interval [95% CI]: 11.3-409.8), pre-pregnancy body mass index (BMI) ≥25 kg/m2 (aOR: 2.6, 95% CI: 1.1-6.0), insufficient gestational weight gain (aOR: 3.0, 95% CI: 1.3-7.1), parity ≥4 (aOR: 3.2, 95% CI: 1.3-7.7), and exposure to analgesic/antipyretic drugs (aOR: 9.0; 95% CI: 2.5-33.0). For OSB, associated risks included consanguinity (aOR: 14.0, 95% CI: 3.5-55.9), relatives with NTDs (aOR: 22.4, 95% CI: 4.5-112.9), BMI ≥25 kg/m2 (aOR: 2.5, 95% CI: 1.6-4.2), insufficient gestational weight gain (aOR: 1.9, 95% CI: 1.1-3.1), and exposures to hyperthermia (aOR: 2.3, 95% CI: 1.2-4.3), common cold (aOR: 6.8, 95% CI: 3.6-12.7), and analgesic/antipyretic drugs (aOR: 3.6, 95% CI: 1.3-10.0). Our high rate probably results from exposures to preventable risks, most related to FA, indicating a need for strengthening existing FA-related programs in Mexico.
Collapse
Affiliation(s)
- Jorge Román Corona-Rivera
- Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara, Guadalajara, Mexico.,"Dr. Enrique Corona-Rivera" Institute of Human Genetics, Department of Molecular Biology and Genomics, Health Sciences University Center, University of Guadalajara, Guadalajara, Mexico
| | - Sandra Olvera-Molina
- Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara, Guadalajara, Mexico
| | - J Jesús Pérez-Molina
- Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara, Guadalajara, Mexico
| | - Cristian Irela Aranda-Sánchez
- Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara, Guadalajara, Mexico
| | - Lucina Bobadilla-Morales
- Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara, Guadalajara, Mexico.,"Dr. Enrique Corona-Rivera" Institute of Human Genetics, Department of Molecular Biology and Genomics, Health Sciences University Center, University of Guadalajara, Guadalajara, Mexico
| | - Alfredo Corona-Rivera
- Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara, Guadalajara, Mexico.,"Dr. Enrique Corona-Rivera" Institute of Human Genetics, Department of Molecular Biology and Genomics, Health Sciences University Center, University of Guadalajara, Guadalajara, Mexico
| | - Christian Peña-Padilla
- Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara, Guadalajara, Mexico
| | - Adolfo Ruiz-Gómez
- Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara, Guadalajara, Mexico
| | - Guadalupe Elena Morales-Domínguez
- Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara, Guadalajara, Mexico
| |
Collapse
|
25
|
KESİLMEZ EC, YÜKSEL Z. KAHRAMANMARAŞ İLİNDE NÖRAL TÜP DEFEKTİ OLGULARININ DEMOGRAFİK ÖZELLİKLERİ. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.837546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
26
|
Perrotta M, Gasparroni G, Chiavaroli V, Massimi L, Cognigni R, Sabatini L, Topazio T, Carinci S, Sebastiani M, Mohn A, Di Valerio S. A case report of confusing meningoencephalocele. Clin Case Rep 2021; 9:109-112. [PMID: 33489143 PMCID: PMC7812997 DOI: 10.1002/ccr3.3470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 12/05/2022] Open
Abstract
The clinical approach plays a pivotal role in neonates with evidence of a skull mass, together with the need of monitoring unclear cases. Indeed, apparently transient alterations of the skull may be neural tube defects, which need prompt treatment.
Collapse
Affiliation(s)
- Marika Perrotta
- Department of PediatricsGabriele d'Annunzio University of Chieti and PescaraChietiItaly
| | - Giorgia Gasparroni
- Department of PediatricsGabriele d'Annunzio University of Chieti and PescaraChietiItaly
| | - Valentina Chiavaroli
- Pescara Public HospitalNeonatal Intensive Care UnitPescaraItaly
- The University of AucklandLiggins InstituteAucklandNew Zealand
| | - Luca Massimi
- Policlinico Universitario Agostino GemelliNeurochirurgia InfantileRomaItaly
- Università Cattolica del Sacro Cuore Facoltà di Medicina e ChirurgiaIstituto di NeurochirurgiaRomaItaly
| | - Rita Cognigni
- Pescara Public HospitalNeonatal Intensive Care UnitPescaraItaly
| | - Laura Sabatini
- Pescara Public HospitalNeonatal Intensive Care UnitPescaraItaly
| | - Teresa Topazio
- Pescara Public HospitalNeonatal Intensive Care UnitPescaraItaly
| | - Silvia Carinci
- Pescara Public HospitalNeonatal Intensive Care UnitPescaraItaly
| | | | - Angelika Mohn
- Department of PediatricsGabriele d'Annunzio University of Chieti and PescaraChietiItaly
| | | |
Collapse
|
27
|
Goley SM, Sakula-Barry S, Adofo-Ansong N, Isaaya Ntawunga L, Tekyiwa Botchway M, Kelly AH, Wright N. Investigating the use of ultrasonography for the antenatal diagnosis of structural congenital anomalies in low-income and middle-income countries: a systematic review. BMJ Paediatr Open 2020; 4:e000684. [PMID: 32864479 PMCID: PMC7443309 DOI: 10.1136/bmjpo-2020-000684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Congenital anomalies are the fifth leading cause of under-5 mortality globally. The greatest burden is faced by those in low/middle-income countries (LMICs), where over 95% of deaths occur. Many of these deaths may be preventable through antenatal diagnosis and early intervention. This systematic literature review investigates the use of antenatal ultrasound to diagnose congenital anomalies and improve the health outcomes of infants in LMICs. METHODS A systematic literature review was conducted using three search strings: (1) structural congenital anomalies; (2) LMICs; and (3) antenatal diagnosis. The search was conducted on the following databases: Medline, Embase, PubMed and the Cochrane Library. Title, abstract and full-text screening was undertaken in duplicate by two reviewers independently. Consensus among the wider authorship was sought for discrepancies. The primary analysis focused on the availability and effectiveness of antenatal ultrasound for diagnosing structural congenital anomalies. Secondary outcomes included neonatal morbidity and mortality, termination rates, referral rates for further antenatal care and training level of the ultrasonographer. Relevant policy data were sought. RESULTS The search produced 4062 articles; 97 were included in the review. The median percentage of women receiving an antenatal ultrasound examination was 50.0% in African studies and 90.7% in Asian studies (range 6.8%-98.8%). Median detection rates were: 16.7% Africa, 34.3% South America, 34.7% Asia and 47.3% Europe (range 0%-100%). The training level of the ultrasound provider may affect detection rates. Four articles compared morbidity and mortality outcomes, with inconclusive results. Significant variations in termination rates were found (0%-98.3%). No articles addressed referral rates. CONCLUSION Antenatal detection of congenital anomalies remains highly variable across LMICs and is particularly low in sub-Saharan Africa. Further research is required to investigate the role of antenatal diagnosis for improving survival from congenital anomalies in LMICs. PROSPERO REGISTRATION NUMBER CRD42019105620.
Collapse
Affiliation(s)
| | | | - Nana Adofo-Ansong
- Department of Paediatrics, Mafikeng Provincial Hospital, Mafikeng, South Africa
| | | | - Maame Tekyiwa Botchway
- Department of Paediatric Surgery, University of the Witwatersrand, Johannesburg-Braamfontein, Gauteng, South Africa
| | - Ann Horton Kelly
- Department of Global Health & Social Medicine, King’s College London, London, UK
| | - Naomi Wright
- King’s Centre for Global Health and Health Partnerships, King’s College London, London, UK
| |
Collapse
|
28
|
Liu L, Liu W, Shi Y, Li L, Gao Y, Lei Y, Finnell R, Zhang T, Zhang F, Jin L, Li H, Tao W, Wang H. DVL mutations identified from human neural tube defects and Dandy-Walker malformation obstruct the Wnt signaling pathway. J Genet Genomics 2020; 47:301-310. [PMID: 32900645 DOI: 10.1016/j.jgg.2020.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 06/18/2020] [Accepted: 06/21/2020] [Indexed: 11/18/2022]
Abstract
Wnt signaling pathways, including the canonical Wnt/β-catenin pathway, planar cell polarity pathway, and Wnt/Ca2+ signaling pathway, play important roles in neural development during embryonic stages. The DVL genes encode the hub proteins for Wnt signaling pathways. The mutations in DVL2 and DVL3 were identified from patients with neural tube defects (NTDs), but their functions in the pathogenesis of human neural diseases remain elusive. Here, we sequenced the coding regions of three DVL genes in 176 stillborn or miscarried fetuses with NTDs or Dandy-Walker malformation (DWM) and 480 adult controls from a Han Chinese population. Four rare mutations were identified: DVL1 p.R558H, DVL1 p.R606C, DVL2 p.R633W, and DVL3 p.R222Q. To assess the effect of these mutations on NTDs and DWM, various functional analyses such as luciferase reporter assay, stress fiber formation, and in vivo teratogenic assay were performed. The results showed that the DVL2 p.R633W mutation destabilized DVL2 protein and upregulated activities for all three Wnt signalings (Wnt/β-catenin signaling, Wnt/planar cell polarity signaling, and Wnt/Ca2+ signaling) in mammalian cells. In contrast, DVL1 mutants (DVL1 p.R558H and DVL1 p.R606C) decreased canonical Wnt/β-catenin signaling but increased the activity of Wnt/Ca2+ signaling, and DVL3 p.R222Q only decreased the activity of Wnt/Ca2+ signaling. We also found that only the DVL2 p.R633W mutant displayed more severe teratogenicity in zebrafish embryos than wild-type DVL2. Our study demonstrates that these four rare DVL mutations, especially DVL2 p.R633W, may contribute to human neural diseases such as NTDs and DWM by obstructing Wnt signaling pathways.
Collapse
Affiliation(s)
- Lingling Liu
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering at School of Life Sciences, Fudan University, Shanghai, 200011, China; NHC Key Lab of Reproduction (Shanghai Institute of Planned Parenthood Research), Institute of Reproduction and Development, Fudan University, Shanghai, 200032, China
| | - Weiqi Liu
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering at School of Life Sciences, Fudan University, Shanghai, 200011, China; NHC Key Lab of Reproduction (Shanghai Institute of Planned Parenthood Research), Institute of Reproduction and Development, Fudan University, Shanghai, 200032, China
| | - Yan Shi
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering at School of Life Sciences, Fudan University, Shanghai, 200011, China
| | - Ling Li
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering at School of Life Sciences, Fudan University, Shanghai, 200011, China
| | - Yunqian Gao
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering at School of Life Sciences, Fudan University, Shanghai, 200011, China
| | - Yunping Lei
- Departments of Molecular and Cellular Biology and Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Richard Finnell
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering at School of Life Sciences, Fudan University, Shanghai, 200011, China; Departments of Molecular and Cellular Biology and Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Ting Zhang
- Capital Institute of Pediatrics, Beijing, 100020, China
| | - Feng Zhang
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering at School of Life Sciences, Fudan University, Shanghai, 200011, China; NHC Key Lab of Reproduction (Shanghai Institute of Planned Parenthood Research), Institute of Reproduction and Development, Fudan University, Shanghai, 200032, China
| | - Li Jin
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering at School of Life Sciences, Fudan University, Shanghai, 200011, China; NHC Key Lab of Reproduction (Shanghai Institute of Planned Parenthood Research), Institute of Reproduction and Development, Fudan University, Shanghai, 200032, China
| | - Huili Li
- Molecular, Cellular and Developmental Biology, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Wufan Tao
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering at School of Life Sciences, Fudan University, Shanghai, 200011, China; Insititute of Developmental Biology and Molecular Medicine, Fudan University, Shanghai, 200433, China.
| | - Hongyan Wang
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering at School of Life Sciences, Fudan University, Shanghai, 200011, China; NHC Key Lab of Reproduction (Shanghai Institute of Planned Parenthood Research), Institute of Reproduction and Development, Fudan University, Shanghai, 200032, China; Children's Hospital and Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China.
| |
Collapse
|
29
|
WDR34 mutation from anencephaly patients impaired both SHH and PCP signaling pathways. J Hum Genet 2020; 65:985-993. [PMID: 32576942 DOI: 10.1038/s10038-020-0793-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 12/16/2022]
Abstract
Neural tube defects (NTDs) are debilitating human congenital abnormalities due to failure of neural tube closure. Sonic Hedgehog (SHH) signaling is required for dorsal-ventral patterning of the neural tube. The loss of activation in SHH signaling normally causes holoprosencephaly while the loss of inhibition causes exencephaly due to failure in neural tube closure. WDR34 is a dynein intermedia chain component which is required for SHH activation. However, Wdr34 knockout mouse exhibit exencephaly. Here we screened mutations in WDR34 gene in 100 anencephaly patients of Chinese Han population. Compared to 1000 Genome Project data, two potentially disease causing missense mutations of WDR34 gene (c.1177G>A; p.G393S and c.1310A>G; p.Y437C) were identified in anencephaly patients. These two mutations did not affect the protein expression level of WDR34. Luciferase reporter and endogenous target gene expression level showed that both mutations are lose-of-function mutations in SHH signaling. Surprisingly, WDR34 could promote planar cell polarity (PCP) signaling and the G393S lost this promoting effect on PCP signaling. Morpholino knockdown of wdr34 in zebrafish caused severe convergent extension defects and pericardial abnormalities. The G393S mutant has less rescuing effects than both WT and Y437C WDR34 in zebrafish. Our results suggested that mutation in WDR34 could contribute to human NTDs by affecting both SHH and PCP signaling.
Collapse
|
30
|
Aoulad Fares D, Schalekamp-Timmermans S, Nawrot TS, Steegers-Theunissen RPM. Preconception telomere length as a novel maternal biomarker to assess the risk of spina bifida in the offspring. Birth Defects Res 2020; 112:645-651. [PMID: 32359029 PMCID: PMC7432172 DOI: 10.1002/bdr2.1682] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/26/2020] [Accepted: 04/02/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Periconception interactions between maternal conditions and environmental and genetic factors are involved in the pathogenesis and prevention of neural tube defects (NTD), such as spina bifida. These factors have in common that they can impair the oxidative pathway, resulting in excessive (chronic) oxidative stress and inflammation. METHODS Review of the literature concerning underlying mechanisms and biomarkers of aging particularly during reproduction. A number of molecular markers for biological aging have been identified, including telomere length (TL). Excessive telomere shortening is an index of senescence, causes genomic instability and is associated with a higher risk of age-related diseases. Furthermore, TL shortening is associated with the similar environmental and lifestyle exposures associated with NTD risk. RESULTS Embryonic mice deficient in the telomerase gene show shorter TL and failure of closure of the neural tube as the main defect, suggesting that this developmental process is among the most sensitive to telomere loss and chromosomal instability. CONCLUSIONS From this background, we hypothesize that preconceptional long term exposure to harmful environmental and lifestyle risk factors accelerates a woman's aging process, which can be measured by TL, and thereby her underlying risk of NTD offspring. Alternatively, it might be that women with an increased NTD risk already exhibit a more advanced biological age before the onset of pregnancy compared to women of identical calendar age.
Collapse
Affiliation(s)
- Damiat Aoulad Fares
- Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Tim S Nawrot
- Department of Environmental Sciences, Hasselt University, Hasselt, Belgium.,Department of Public Health & Primary Care, Leuven University, Leuven, Belgium
| | | |
Collapse
|
31
|
Zhang L, Dong Y, Wang W, Zhao T, Huang T, Khan A, Wang L, Liu Z, Xie J, Niu B. Ethionine Suppresses Mitochondria Autophagy and Induces Apoptosis via Activation of Reactive Oxygen Species in Neural Tube Defects. Front Neurol 2020; 11:242. [PMID: 32318018 PMCID: PMC7154092 DOI: 10.3389/fneur.2020.00242] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/13/2020] [Indexed: 01/18/2023] Open
Abstract
Abnormal development of central nervous system (CNS) caused by neural tube defects (NTDs) is not only remained the major contributor in the prevalence of stillbirths and neonatal deaths, but also represents a significant cause of lifelong physical disability in the surviving infants. Ethionine is a non-proteinogenic amino acid and antagonist of methionine. Methionine cycle is essential for the elimination of reactive oxygen species (ROS), while lysosomes are involved in the initiation of autophagy. However, its role in ethionine-induced cell death in neural tube defects, still need to be explored. In this study, we investigated the effect of ethionine on NTDs as well as the underlying mechanism involved in this process. Following the establishment of NTDs model using ethionine-induced C57BL/6 mice, ethionine was intraperitoneally injected at a dose of 500 mg/kg in E7.5. Our study revealed that ethionine has induced mitochondrial apoptosis in NTDs by reducing mitochondrial autophagy both in vivo and in vitro. These results provided a possible molecular mechanism for redox regulation of autophagic process.
Collapse
Affiliation(s)
- Li Zhang
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, China
| | - Yanting Dong
- Department of Respiratory and Critical Care Medicine, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Wenzhuo Wang
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, China
| | - Taoran Zhao
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, China
| | - Tingjuan Huang
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, China
| | - Ajab Khan
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, China
| | - Lei Wang
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, China
| | - Zhizhen Liu
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, China
| | - Jun Xie
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, China
| | - Bo Niu
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, China.,Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China
| |
Collapse
|
32
|
Sirico A, Raffone A, Lanzone A, Saccone G, Travaglino A, Sarno L, Rizzo G, Zullo F, Maruotti GM. First trimester detection of fetal open spina bifida using BS/BSOB ratio. Arch Gynecol Obstet 2020; 301:333-340. [PMID: 31875250 DOI: 10.1007/s00404-019-05422-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 12/17/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Despite the well-known second trimester ultrasound signs, current possibilities of in utero surgical repair of open spina bifida require a timely detection of the spine defect. OBJECTIVE To evaluate the diagnostic accuracy of the ratio between brain stem (BS) diameter and its distance to the occipital bone (BSOB) (BS/BSOB ratio) in the detection of fetuses with open spina bifida at first trimester ultrasound. METHODS A systematic review and meta-analysis of diagnostic accuracy was performed by searching seven electronic databases from their inception to February 2019 for all studies assessing the association between BS/BSOB ratio and diagnosis of spine bifida. Diagnostic accuracy of BS/BSOB ratio in prenatal diagnosis of spine bifida was assessed as sensitivity, specificity, positive and negative likelihood ratios (LR + and LR-), and area under the curve (AUC) on SROC curves. RESULTS Four studies, including 17,598 fetuses with 23 cases of open spina bifida, were included in the meta-analysis. BS/BSOB ratio showed pooled sensitivity of 0.70 (95% CI 0.47-0.87; I2 = 78.3%), specificity of 1.00 (95% CI 0.99-1.0; I2 = 99.2%), LR + and LR- of 51.44 (95% CI 9.53-277.64; I2 = 85.5%) and 0.23 (95% CI 0.04-1.17; I2 = 64.8%), respectively, and an AUC of 0.9649. CONCLUSION First trimester BS/BSOB ratio has a high diagnostic accuracy in detecting fetuses with open spina bifida.
Collapse
Affiliation(s)
- Angelo Sirico
- Obstetrics and High-Risk Unit, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive and Dentistry Sciences, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive and Dentistry Sciences, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - Antonio Lanzone
- Obstetrics and High-Risk Unit, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - Gabriele Saccone
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive and Dentistry Sciences, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Laura Sarno
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive and Dentistry Sciences, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Giuseppe Rizzo
- Division of Maternal and Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergada, Rome, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive and Dentistry Sciences, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Giuseppe Maria Maruotti
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive and Dentistry Sciences, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| |
Collapse
|
33
|
Yang W, Xiao Y, Tian T, Jin L, Wang L, Ren A. Genetic variants in GRHL3 and risk for neural tube defects: A case-control and case-parent triad/control study. Birth Defects Res 2019; 111:1468-1478. [PMID: 31332962 DOI: 10.1002/bdr2.1556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 07/10/2019] [Accepted: 07/11/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Neural tube defects (NTDs) are the most common severe birth defects with complex etiologies. Previous studies conducted on animals have suggested that the Grhl3 gene is essential for closure of the spinal neural tube, but little evidence from human studies on the variants of GRHL3 gene has been provided, especially the common genetic variants. METHODS To investigate the relationship between common genetic variants of GRHL3 and the risk for NTDs, we performed a case-control study and a case-parent triad/control study. Fast-target enrichment sequencing was performed to screen exon regions from 503 NTD cases, and three tag SNPs (single nucleotide polymorphisms, including rs12030057, rs2486668, and rs545809) were selected according to the sequencing results. Then, Sequenom MassARRAY genotyping was performed in 757 case parents and 519 controls to obtain genotype information of the target variant sites among all NTD triads and controls. RESULTS The genotype distributions of all SNPs were in accordance with Hardy-Weinberg Equilibrium (HWE) in the control population. In the case-control study, significant associations were found between C27G genetic variants on rs2486668 and risk for spina bifida and encephalocele, respectively, under different genetic models. Consistently, in the case-parent triad/control study, GG genotype on rs2486668 was associated with increased risk for spina bifida, with a RR of 2.15 (95% CI: 1.20-3.83). However, no parent-of-origin effect was found for any tag SNPs. CONCLUSION The GRHL3 C67G missense variant may increase the risk for spina bifida and encephalocele phenotypes.
Collapse
Affiliation(s)
- Wenlei Yang
- Institute of Reproductive and Child Health, NHC Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yanhui Xiao
- Institute of Reproductive and Child Health, NHC Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Tian Tian
- Institute of Reproductive and Child Health, NHC Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Lei Jin
- Institute of Reproductive and Child Health, NHC Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Linlin Wang
- Institute of Reproductive and Child Health, NHC Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Aiguo Ren
- Institute of Reproductive and Child Health, NHC Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| |
Collapse
|
34
|
A functional indel polymorphism rs34396413 in TFAP2A intron-5 significantly increases female encephalocele risk in Han Chinese population. Childs Nerv Syst 2019; 35:965-972. [PMID: 31020390 DOI: 10.1007/s00381-019-04131-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/18/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Transcription factor AP-2 alpha (TFAP2A) is an important transcriptional factor involved in various aspects of embryo development including neural tube closure. Tfap2a deficiency led to the failure of cranial neural-tube closure in mice and other model organisms. However, it remains largely unknown about the relationship between TFAP2A variants and human cranial neural tube defects (NTDs). The aim of this study was to find the association between TFAP2A intronic SNP rs3439413 and NTDs and to explore its function. METHODS We found an indel polymorphism rs3439413 in TFAP2A intron-5 from our previous target sequencing project. In this study, we validate its association with human NTDs in Shanxi group containing 266 NTD cases and 295 matched controls. Then, we investigated its function on transcriptional activity by dual-luciferase assays and EMSA. RESULTS The minor allele of rs34396413 significantly increased the risk of NTD in a Han Chinese population of Shanxi Province (P = 0.0082, OR = 1.45, 95%CI = 1.10-1.90), especially the risk of encephalocele for female (P = 0.0064, OR = 2.46, 95%CI = 1.22-4.94). Functional analysis revealed the minor allele of rs34396413 decreases transcriptional activity and attenuates transcription factor binding affinity. CONCLUSION We have demonstrated that the minor allele of rs34396413 was a risk factor of NTD in the Shanxi group, providing new insight into the study of NTD etiology.
Collapse
|
35
|
Zhang X, Liu J, Jin Y, Yang S, Song Z, Jin L, Wang L, Ren A. Folate of pregnant women after a nationwide folic acid supplementation in China. MATERNAL AND CHILD NUTRITION 2019; 15:e12828. [PMID: 30970178 DOI: 10.1111/mcn.12828] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 03/26/2019] [Accepted: 04/04/2019] [Indexed: 11/30/2022]
Abstract
Folate insufficiency during the periconceptional period increases the risk of neural tube defects (NTDs) in offspring, and folic acid supplementation substantially reduces the risk. Widespread large-scale folic acid supplementation (0.4-mg folic acid tablet) has been adopted as a main strategy to prevent NTDs in China since 2009. We examined folate concentrations in plasma and red blood cells (RBCs) of pregnant women and the factors associated with blood folate concentrations in a population with a high prevalence of NTDs in northern China. A cross-sectional survey was conducted in 2014, and 1,107 pregnant women were recruited from 11 county or city maternal and child health centres across Shanxi province. Microbiological assays were used to determine folate concentrations. Factors associated with blood folate insufficiency were identified. The median (25th and 75th percentiles) folate concentrations were 28.4 (17.6, 45.2) nmol L-1 and 1,001.2 (658.7, 1,402.5) nmol L-1 in plasma and RBCs, respectively. According to the proposed RBC (906 nmol L-1 ) concentrations for optimal NTD prevention, 42.4% participants had RBC folate insufficiency. Rural women had a higher proportion of folate insufficiency than urban women. Folic acid supplementation was the only factor associated with RBC folate insufficiency. A large proportion of women had RBC folate concentrations that are not optimal for the prevention of NTDs despite free access to folic acid supplements. Actions that aim to improve folic acid supplementation compliance are needed to reach the full potential of the nationwide folic acid supplementation programme in terms of NTD prevention.
Collapse
Affiliation(s)
- Xuejuan Zhang
- Health Education Division, Shanxi Children's Hospital/Shanxi Maternal and Child Health Care Hospital, Taiyuan, P. R. China
| | - Jufen Liu
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yongsheng Jin
- Department of Maternal and Child Health, Health Commission of Shanxi Province, Taiyuan, P. R. China
| | - Shuang Yang
- Department of Child and Adolescences, School of Public Health, Shanxi Medical University, Taiyuan, P. R. China
| | - Zhijiao Song
- Health Education Division, Shanxi Children's Hospital/Shanxi Maternal and Child Health Care Hospital, Taiyuan, P. R. China
| | - Lei Jin
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Linlin Wang
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Aiguo Ren
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| |
Collapse
|
36
|
Wang B, Zhu Y, Yan L, Zhang J, Wang X, Cheng H, Li Z, Ye R, Ren A. Association of maternal chronic arsenic exposure with the risk of neural tube defects in Northern China. ENVIRONMENT INTERNATIONAL 2019; 126:222-227. [PMID: 30807959 DOI: 10.1016/j.envint.2019.02.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/14/2019] [Accepted: 02/05/2019] [Indexed: 06/09/2023]
Abstract
Numerous animal studies have shown that high arsenic exposure can induce neural tube defect (NTD) formation. However, epidemiological evidence related to this finding is scarce. The key objective of our study is to evaluate whether maternal arsenic exposure is associated with NTD risk in Northern China. Our case-control study was conducted in 11 countries or cities in Shanxi and Hebei provinces during 2003-2007. A total of 774 mothers were included as participants: 511 controls and 263 cases (including 123 with anencephaly, 115 with spina bifida, 18 with encephalocele, and 7 with other NTD subtypes). The arsenic concentration was measured in a specific section of hair that grew from 3 months before to 3 months after conception. We found a higher hair arsenic concentration in the NTD cases with median (inter-quartile range) of 0.093 (0.025-0.387) μg/g hair than that in the controls with a value of 0.082 (0.030-0.414) μg/g hair. Maternal hair arsenic concentration above its median of the controls was associated with an increased risk of the total NTDs with an adjusted odds ratio (OR) of 1.32 [95% confidence interval (CI): (0.91-1.92)], which was not statistically significant (p = 0.14), although the crude OR without adjusting for the confounders of 1.68 (95% CI: 1.24-2.27; p < 0.001) suggested that hair arsenic is a risk factor of NTDs. There was no dose-response relationship between maternal hair arsenic concentration and the risk of total NTDs. Similar phenomena were found for anencephaly and spina bifida, respectively. Overall, our findings showed that maternal periconceptional arsenic exposure may not significantly contribute to the risk of NTD development in Northern China; other risk factors need to be further examined in future studies.
Collapse
Affiliation(s)
- Bin Wang
- Institute of Reproductive and Child Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, PR China.
| | - Yibing Zhu
- Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350005, PR China
| | - Lailai Yan
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing 100191, PR China
| | - Jingxu Zhang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, PR China
| | - Xilong Wang
- Institute of Reproductive and Child Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, PR China; College of Urban and Environmental Sciences, Peking University, 100871, PR China
| | - Hefa Cheng
- College of Urban and Environmental Sciences, Peking University, 100871, PR China
| | - Zhiwen Li
- Institute of Reproductive and Child Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, PR China.
| | - Rongwei Ye
- Institute of Reproductive and Child Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, PR China
| | - Aiguo Ren
- Institute of Reproductive and Child Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, PR China
| |
Collapse
|
37
|
A propensity-matched study of the association between optimal folic acid supplementation and birth defects in Shaanxi province, Northwestern China. Sci Rep 2019; 9:5271. [PMID: 30918271 PMCID: PMC6437303 DOI: 10.1038/s41598-019-41584-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 03/07/2019] [Indexed: 11/17/2022] Open
Abstract
The association between folic acid supplementation and birth defects other than neural tube defects remains unclear. We utilized data from a large population-based survey to examine the association between folic acid supplementation and birth defects in Northwestern China. A total of 29,204 women with infants born between 2010 and 2013 were surveyed in Shaanxi province, Northwestern China, using a stratified multistage sampling method. Propensity scores were used to match 9,293 women with optimal folic acid supplementation with 9,293 women with nonoptimal folic acid supplementation, and the effects of optimal folic acid supplementation on birth defects were assessed by a conditional logistic regression model. After propensity score matching, the overall birth defect rate, cardiovascular system defect rate and nervous system defect rate for the women with optimal folic acid supplementation were lower than those for the women with nonoptimal folic acid supplementation (overall birth defects: OR = 0.71, 95% CI = 0.57–0.89, P = 0.003; cardiovascular system defects: OR = 0.65, 95% CI = 0.44–0.96, P = 0.032; nervous system defects: OR = 0.13, 95% CI = 0.02–0.99, P = 0.049). Optimal folic acid supplementation was associated with a decreased prevalence of birth defects, especially in the cardiovascular system and nervous system. Our findings have important implications for birth defect intervention with folic acid supplementation for countries with a high prevalence of birth defects, such as China.
Collapse
|
38
|
Liu J, Li Z, Ye R, Liu J, Ren A. Periconceptional folic acid supplementation and sex difference in prevention of neural tube defects and their subtypes in China: results from a large prospective cohort study. Nutr J 2018; 17:115. [PMID: 30541549 PMCID: PMC6291989 DOI: 10.1186/s12937-018-0421-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 11/22/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Folic acid (FA) supplementation is known to prevent neural tube defects (NTDs). We examined whether this preventive effect differs by the sex of the infant. METHODS Data were gathered from a large population-based cohort study in China that evaluated the effects of FA supplementation on NTDs. All births at 20 complete gestational weeks, including live births, stillbirths, and pregnancy terminations, and all NTDs, regardless of gestational age, were recorded. In a northern China province, a total of 30,801 singleton live births to women whose use of FA supplements during the first trimester was known at the time were included in the study. The birth prevalence of NTDs was classified by sex, subtype, and maternal FA supplementation. Male to female rate ratios [RR] and their 95% confidence intervals [CI] were calculated. RESULTS A total of 106 NTDs cases were recorded. The overall prevalence of NTDs was 2.5‰ among males and 4.4‰ among females; NTDs were less prevalent among males than among females (RR, 0.58; 95% CI, 0.54-0.63). There was a higher prevalence of anencephaly (RR, 0.34; 95% CI, 0.27-0.43) and spina bifida (RR, 0.73; 95% CI, 0.63-0.84) among females. However, FA supplementation led to significantly greater decreases in the rates of anencephaly (4.8‰) and total NTDs (7.6‰) in females than in males (1.6‰ and 2.8‰, respectively). CONCLUSIONS FA supplementation successfully reduces the prevalence of NTDs in both male and female infants, although we found a significantly greater decrease in anencephaly and total NTDs in females than in males. How the protective effects of FA supplementation affect the sexes differently needs to be studied further.
Collapse
Affiliation(s)
- Jufen Liu
- Institute of Reproductive and Child Health / Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, 100191 People’s Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191 People’s Republic of China
| | - Zhiwen Li
- Institute of Reproductive and Child Health / Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, 100191 People’s Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191 People’s Republic of China
| | - Rongwei Ye
- Institute of Reproductive and Child Health / Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, 100191 People’s Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191 People’s Republic of China
| | - Jianmeng Liu
- Institute of Reproductive and Child Health / Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, 100191 People’s Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191 People’s Republic of China
| | - Aiguo Ren
- Institute of Reproductive and Child Health / Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, 100191 People’s Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191 People’s Republic of China
| |
Collapse
|
39
|
Vidmar M, Grželj J, Mlinarič-Raščan I, Geršak K, Dolenc MS. Medicines associated with folate-homocysteine-methionine pathway disruption. Arch Toxicol 2018; 93:227-251. [PMID: 30499019 DOI: 10.1007/s00204-018-2364-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 11/20/2018] [Indexed: 12/18/2022]
Abstract
Folate is vital for cell development and growth. It is involved in one-carbon transfer reactions essential for the synthesis of purines and pyrimidines. It also acts in conjunction with cobalamin (vitamin B12) as a fundamental cofactor in the remethylation cycle that converts homocysteine to methionine. A deficiency in folate or vitamin B12 can lead to elevated homocysteine level, which has been identified as an independent risk factor in several health-related conditions. Adequate folate levels are essential in women of childbearing age and in pregnant women, and folate deficiency is associated with several congenital malformations. Low folate levels can be caused by dietary deficiencies, a genetic predisposition or treatment with medicines that affect folate concentration. Women who are pregnant or of child-bearing age commonly use medicines, so it is important to identify the basic biochemical mechanisms by which medicines interfere with the folate-homocysteine-methionine pathway. This review focuses on prescription medicines associated with folate disruption. It also summarizes their undesirable/toxic effects. Recommendations regarding folate supplementation during medical therapy are also reviewed.
Collapse
Affiliation(s)
- M Vidmar
- Research Unit, Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, Šlajmarjeva 3, Ljubljana, Slovenia.,University of Ljubljana, Faculty of Pharmacy, Aškerčeva 7, Ljubljana, Slovenia
| | - J Grželj
- University of Ljubljana, Faculty of Pharmacy, Aškerčeva 7, Ljubljana, Slovenia.,Krka, d.d., Novo mesto, Šmarješka 6, Novo mesto, Slovenia
| | - I Mlinarič-Raščan
- University of Ljubljana, Faculty of Pharmacy, Aškerčeva 7, Ljubljana, Slovenia
| | - K Geršak
- Research Unit, Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, Šlajmarjeva 3, Ljubljana, Slovenia
| | - M Sollner Dolenc
- University of Ljubljana, Faculty of Pharmacy, Aškerčeva 7, Ljubljana, Slovenia.
| |
Collapse
|
40
|
Berihu BA, Welderufael AL, Berhe Y, Magana T, Mulugeta A, Asfaw S, Gebreselassie K. High burden of neural tube defects in Tigray, Northern Ethiopia: Hospital-based study. PLoS One 2018; 13:e0206212. [PMID: 30427877 PMCID: PMC6235279 DOI: 10.1371/journal.pone.0206212] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 10/05/2018] [Indexed: 11/18/2022] Open
Abstract
Introduction Neural tube defects are the major causes of fetal loss and considerable disabilities in infants. Currently, there is no significant research on the incidence of Neural tube defects in the Tigray region of Ethiopia. Objective To determine the incidence and clinical pattern of the Neural Tube Defects. Methods A hospital-based cross-sectional study was conducted from October 2016 to June 2017. All pregnancy outcomes were examined for any externally visible birth defects and neurological integrity by trained midwives under the supervision of senior obstetrics and gynecology and a neurosurgeon. Data were collected using a survey tool to collect maternal and newborn demographic data and a checklist developed to capture newborns with Neural Tube Defects. Data were analyzed using SPSS version 20. The prevalence of NTDs was calculated per 10,000 births. Result Out of the 14,903 births during the study period, a total of 195 infants were born afflicted with Neural Tube Defects. The burden of infants with anencephaly and spina bifida was 66.4 and 64.4 per 10, 000 births, respectively. The overall incidence rate of NTDs in this study was 131 per 10, 000 births of which 23% were liveborn and 77% were stillborn. The highest burden of Neural Tube Defects was observed in Adigrat Hospital from Eastern Zone of Tigray (174 per 10,000 births) and Lemlem Karl Hospital from Southern Zone of Tigray (304 per 10,000 births) compared to Kahsay Abera Hospital from Western Zone (72.8 per 10,000 births) and Sihul Hospital from North Western Zone of Tigray (69.8 per 10,000 births). Conclusion and recommendation Assuming that the non folic acid preventable rate should be 5 per 10,000 births, our prevalence rate is 131 per 10,000 births, and then we have a rate or an epidemic that is 26 times what it should be. This just emphasizes the urgency to implement effective programs to get all women of reproductive age to have adequate folic acid to prevent all of folic acid-preventable spina bifida and anencephaly, which would prevent 96% (125/130) of spina bifida and anencephaly in the Tigray Provence.
Collapse
Affiliation(s)
- Birhane Alem Berihu
- Department of Anatomy, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
- * E-mail:
| | - Abadi Leul Welderufael
- Department of pediatrics and child health, School of medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Yibrah Berhe
- Department of Obstetrics and Gynecology, School of medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Tony Magana
- Department of Surgery, School of medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Afework Mulugeta
- Department of nutrition, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Selemawit Asfaw
- Department of nutrition, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - kibrom Gebreselassie
- Department of Surgery, School of medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| |
Collapse
|
41
|
Avagliano L, Massa V, George TM, Qureshy S, Bulfamante GP, Finnell RH. Overview on neural tube defects: From development to physical characteristics. Birth Defects Res 2018; 111:1455-1467. [PMID: 30421543 DOI: 10.1002/bdr2.1380] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 07/29/2018] [Indexed: 12/18/2022]
Abstract
Neural tube defects (NTDs) are the second most common congenital malformations in humans affecting the development of the central nervous system. Although NTD pathogenesis has not yet been fully elucidated, many risk factors, both genetic and environmental, have been extensively reported. Classically divided in two main sub-groups (open and closed defects) NTDs present extremely variable prognosis mainly depending on the site of the lesion. Herein, we review the literature on the histological and pathological features, epidemiology, prenatal diagnosis, and prognosis, based on the type of defect, with the aim of providing important information based on NTDs classification for clinicians and scientists.
Collapse
Affiliation(s)
- Laura Avagliano
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy
| | - Valentina Massa
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy
| | - Timothy M George
- Pediatric Neurosurgery, Dell Children's Medical Center, Department of Neurosurgery, The University of Texas at Austin Dell Medical School, Austin, Texas
| | - Sarah Qureshy
- Department of Pediatrics, The University of Texas at Austin Dell Medical School, Austin, Texas
| | | | - Richard H Finnell
- Department of Pediatrics, The University of Texas at Austin Dell Medical School, Austin, Texas.,Center for Precision Environmental Health, Department of Molecular and Cellular Biology and Medicine, Baylor College of Medicine, Houston, Texas
| |
Collapse
|
42
|
Liu J, Xie J, Li Z, Greene NDE, Ren A. Sex differences in the prevalence of neural tube defects and preventive effects of folic acid (FA) supplementation among five counties in northern China: results from a population-based birth defect surveillance programme. BMJ Open 2018; 8:e022565. [PMID: 30413501 PMCID: PMC6231556 DOI: 10.1136/bmjopen-2018-022565] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Sex differences in prevalence of neural tube defects (NTDs) have previously been recognised; however, the different susceptibility of men and women have not been examined in relation to the effects of folic acid (FA) supplementation. We hypothesised that FA may have a disproportionate effect that alters the sex-specific prevalence of NTDs. SETTING Data from two time points, before (2003-2004) and after (2011-2016) the start of the supplementation programme, were obtained from a population-based birth defect surveillance programme among five counties in northern China. All live births (28 or more complete gestational weeks), all stillbirths of at least 20 weeks' gestational age and pregnancy terminations at any gestational age following the prenatal diagnosis of NTDs were included. PARTICIPANTS A total of 25 249 and 83 996 births before and after the programme were included respectively. PRIMARY AND SECONDARY OUTCOME MEASURES The prevalence of NTDs by sex and subtype, Male:female rate ratios and their 95% CI were calculated. RESULTS Overall, NTDs were less prevalent among men than among women (rate ratio (RR) 0.92; 95% CI 0.90 to 0.94), so was anencephaly (RR 0.77; 95% CI 0.73 to 0.81) and encephalocele (RR 0.75; 95% CI 0.61 to 0.92), while spina bifida showed a male predominance (RR 1.10; 95% CI 1.05 to 1.15). The overall prevalence of NTDs decreased by 78/10 000 in men and 108.7/10 000 in women from 2003 to 2004 to 2011 to 2016. There was a significant sex difference in the magnitude of reduction, being greater in women than men, particularly for anencephaly. CONCLUSIONS The prevalence of NTDs decreased in both sexes after the implementation of a massive FA supplementation programme. While female predominance was observed in open NTDs and total NTDs, they also had a greater rate of decrease in NTDs after the supplementation programme.
Collapse
Affiliation(s)
- Jufen Liu
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jing Xie
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zhiwen Li
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Nicholas D E Greene
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Aiguo Ren
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| |
Collapse
|
43
|
Amitai Y, Koren G. High risk for neural tube defects; the role of arsenic in drinking water and rice in Asia. Med Hypotheses 2018; 119:88-90. [PMID: 30122498 DOI: 10.1016/j.mehy.2018.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 06/24/2018] [Accepted: 07/21/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Neural tube defects (NTDs) affect >300,000 children annually worldwide. The incidence of NTDs in Northern India (7.7/1000), is tenfold higher than in the US (0.7/1000). Higher rates were previously reported in Northern China. The causes of these trends have not been elucidated. Arsenic is a teratogen shown in animals to induce NTDs. The main potential sources for environmental arsenic exposure, groundwater and rice as a staple food, are high in India and China. OBJECTIVES To discuss the possible association between high environmental arsenic exposure through drinking water and rice with the high NTDs rates in these regions. DISCUSSION Arsenic contamination of groundwater is the main source of environmental arsenic exposure. The locations of toxic arsenic regions in China and India correspond in most cases to the northern regions where the NTDs rates were high. Rice, the staple food in India and China, can absorb up to 10 times more arsenic than other crops, such as wheat and might further increase arsenic exposure. CONCLUSIONS We hypothesize that this NTD-arsenic in drinking water and rice association may explain why these areas in the northern regions of both countries have the highest incidence of NTDs. If proven true, this has major public health implications.
Collapse
Affiliation(s)
- Yona Amitai
- Department of Management, Public Health and Health Management, Bar Ilan University, Ramat Gan, Israel
| | - Gideon Koren
- Maccabi-Kahn Institute of Research and Innovation, Tel Aviv, Israel; Motherisk Israel Program, Tel Aviv University, Israel.
| |
Collapse
|
44
|
Liu SY, Huang Q, Gu X, Zhang B, Shen W, Tian P, Zeng Y, Qin LZ, Ye LX, Ni ZM, Wang Q. Association of Bone Turnover Levels with MTHFR Gene Polymorphisms among Pregnant Women in Wuhan, China. Curr Med Sci 2018; 38:602-609. [PMID: 30128868 DOI: 10.1007/s11596-018-1920-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 01/01/2018] [Indexed: 11/28/2022]
Abstract
Pregnancy is a critical stimulator of bone mineral resorption. We used to find the MTHFR gene polymorphisms are related with blood lead levels among pregnant women. Pregnancy-stimulated bone turnover may be associated with MTHFR gene polymorphisms too. In this article, we aimed to determine the relationship between MTHFR gene polymorphisms and bone turnover rates among the pregnant women. The participants including pregnant and non-pregnant women were selected and recruited during their routine prenatal or physical examination from July to October in 2012. A total of 1000 participants, including 250 pregnant women in the first, second, and third trimesters and 250 non-pregnant women, were enrolled in the study. Finally, after excluding 27 participants unable to provide blood samples, 973 eligible participants (i.e., 234,249, and 248 pregnant women in the first, second, and third trimesters, respectively, and 242 non-pregnant women) were included in the research. The MTHFR gene 1298CC homozygote carriers were more susceptible to yield higher plasma homocysteine levels than the 1298AA/AC carriers, with standardized coefficients of 0.086 (P<0.05) and 0.104 (P<0.01) of all the participants and the pregnant women, respectively. The MTHFR gene 1793AA homozygote carriers more likely showed higher plasma osteocalcin levels (standardized β=0.091,P<0.01) than the 1793GG/GA carriers among all the subjects. Plasma homocysteine levels were positively correlated with blood lead levels among the participants and the pregnant women with standardized coefficients of 0.320 (P<0.01) and 0.179 (P<0.01), respectively. Plasma osteocalcin levels were positively associated with blood lead levels among pregnant and non-pregnant women with standardized coefficients of 0.084 (P<0.05) and 0.125 (P<0.01), respectively. In conclusion, homocysteine and osteocalcin contents in plasma are associated with the MTHFR gene A1298C polymorphism and blood lead levels among pregnant women. The MTHFR gene A1298C polymorphism-related homocysteine is a possible risk factor for increased blood lead levels among Chinese women.
Collapse
Affiliation(s)
- Shu-Yun Liu
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qin Huang
- Department of Rehabilitation Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xue Gu
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Bin Zhang
- Wuhan Women and Children Medical Care Center, Wuhan, 430016, China
| | - Wei Shen
- Department of Rehabilitation Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Ping Tian
- Department of Rehabilitation Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yun Zeng
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ling-Zhi Qin
- Department of Rehabilitation Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Lin-Xiang Ye
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ze-Min Ni
- Women and Children Medical Center of Jiang-an District, Wuhan, 430017, China
| | - Qi Wang
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| |
Collapse
|
45
|
Mazumdar M. Does arsenic increase the risk of neural tube defects among a highly exposed population? A new case-control study in Bangladesh. Birth Defects Res 2018; 109:92-98. [PMID: 27801974 DOI: 10.1002/bdra.23577] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 08/01/2016] [Accepted: 08/12/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Neural tube defects are debilitating birth defects that occur when the developing neural plate fails to close in early gestation. Arsenic induces neural tube defects in animal models, but whether environmental arsenic exposure increases risk of neural tube defects in humans is unknown. METHODS We describe a new case-control study in Bangladesh, a country currently experiencing an epidemic of arsenic poisoning through contaminated drinking water. We plan to understand how arsenic influences risk of neural tube defects in humans through mechanisms that include disruption of maternal glucose and folate metabolism, as well as epigenetic effects. We also investigate whether sweat chloride concentration, a potential new biomarker for arsenic toxicity, can be used to identify women at higher risk for having a child affected by neural tube defect. We will collect dural tissue from cases, obtained at the time of surgical closure of the defect, and believe investigation of these samples will provide insight into the epigenetic mechanisms by which prenatal arsenic exposure affects the developing nervous system. CONCLUSION These studies explore mechanisms by which arsenic may increase risk of neural tube defects in humans and use a unique population with high arsenic exposure to test hypotheses. If successful, these studies may assist countries with high arsenic exposure such as Bangladesh to identify populations at high risk of neural tube defects, as well as direct development of novel screening strategies for maternal risk.Birth Defects Research 109:92-98, 2017.© 2016 The Authors Birth Defects Research Published by Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Maitreyi Mazumdar
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts.,Department of Neurology, Harvard Medical School, Boston, Massachusetts.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| |
Collapse
|
46
|
Liu J, Jin L, Li Z, Zhang Y, Zhang L, Wang L, Ren A. Prevalence and trend of isolated and complicated congenital hydrocephalus and preventive effect of folic acid in northern China, 2005-2015. Metab Brain Dis 2018; 33:837-842. [PMID: 29388147 DOI: 10.1007/s11011-017-0172-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022]
Abstract
Congenital hydrocephalus (CH) was a major birth defect of the central nervous system besides neural tube defects (NTDs). Few studies have focused on both the prevalence and trend of isolated and complicated CH in China. Data were drawn from a population-based birth defects surveillance program in five rural counties in northern China from 2005 to 2015. All livebirths and pregnancy terminations at any gestational age affected with CH were recorded. The prevalence and trend of isolated and complicated CH were examined. During the 11-year period, a total of 176,223 births and 357 CH cases were recorded, resulting in a prevalence rate of 20.3 CH cases per 10,000 births. Of the CH cases, 146 were isolated CH, resulting in a prevalence rate of 8.3 per 10,000 births. The pre-perinatal prevalence (<28 gestational weeks) was higher than the perinatal prevalence for both isolated and total CH. The prevalence rates of total and isolated CH showed a similar downward trend during the 11-year period. This downward trend was statistically significant after 2009 (p < 0.05), when a massive folic acid supplementation program was introduced. Although it decreased over time, the prevalence of CH remains high in this population which has a high prevalence of neural tube defects.
Collapse
Affiliation(s)
- Jufen Liu
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lei Jin
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zhiwen Li
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yali Zhang
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Le Zhang
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Linlin Wang
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Aiguo Ren
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Peking University, Beijing, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
- Institute of Reproductive and Child Health, Peking University Health Science Center, 38 College Rd, Haidian District, Beijing, 100191, China.
| |
Collapse
|
47
|
Stokes BA, Sabatino JA, Zohn IE. High levels of iron supplementation prevents neural tube defects in the Fpn1 ffe mouse model. Birth Defects Res 2018; 109:81-91. [PMID: 28008752 DOI: 10.1002/bdra.23542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/11/2016] [Accepted: 06/05/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Periconception maternal nutrition and folate in particular are important factors influencing the incidence of neural tube defects (NTDs). Many but not all NTDs are prevented by folic acid supplementation and there is a pressing need for additional strategies to prevent these birth defects. Other micronutrients such as iron are potential candidates, yet a clear role for iron deficiency in contributing to NTDs is lacking. Our previous studies with the flatiron (ffe) mouse model of Ferroportin1 (Fpn1) deficiency suggest that iron is required for neural tube closure and forebrain development raising the possibility that iron supplementation could prevent NTDs. METHODS We determined the effect of periconception iron and/or folic acid supplementation on the penetrance of NTDs in the Fpn1ffe mouse model. Concurrently, measurements of folate and iron were made to ensure supplementation had the intended effects. RESULTS High levels of iron supplementation significantly reduced the incidence of NTDs in Fpn1ffe mutants. Fpn1 deficiency resulted in reduced folate levels in both pregnant dams and embryos. Yet folic acid supplementation did not prevent NTDs in the Fpn1ffe model. Similarly, forebrain truncations were rescued with iron. Surprisingly, the high levels of iron supplementation used in this study caused folate deficiency in wild-type dams and embryos. CONCLUSION Our results demonstrate that iron supplementation can prevent NTDs and forebrain truncations in the Fpn1ffe model. Surprisingly, high levels of iron supplementation and iron overload can cause folate deficiency. If iron is essential for neural tube closure, it is possible that iron deficiency might contribute to NTDs. Birth Defects Research 109:81-91, 2017. © 2016 The Authors Birth Defects Research Published by Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Bethany A Stokes
- Department of Biology, The George Washington University, Washington, DC.,Center for Neuroscience Research, Children's Research Institute, Children's National Medical Center, Washington, DC
| | - Julia A Sabatino
- Center for Neuroscience Research, Children's Research Institute, Children's National Medical Center, Washington, DC
| | - Irene E Zohn
- Center for Neuroscience Research, Children's Research Institute, Children's National Medical Center, Washington, DC
| |
Collapse
|
48
|
Wang L, Xiao Y, Tian T, Jin L, Lei Y, Finnell RH, Ren A. Digenic variants of planar cell polarity genes in human neural tube defect patients. Mol Genet Metab 2018; 124:94-100. [PMID: 29573971 PMCID: PMC5966321 DOI: 10.1016/j.ymgme.2018.03.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 03/15/2018] [Accepted: 03/15/2018] [Indexed: 02/07/2023]
Abstract
Neural tube defects (NTDs) are considered to be a complex genetic disorder, although the identity of the genetic factors remains largely unknown. Mouse model studies suggest a multifactorial oligogenic pattern of inheritance for NTDs, yet evidence from published human studies is surprisingly absent. In the present study, targeted next-generation sequencing was performed to screen for DNA variants in the entire coding regions and intron-exon boundaries of targeted genes using DNA samples from 510 NTD cases. These candidate genes were PCP genes, including VANGL1, VANGL2, CELSR1, SCRIB, DVL2, DVL3 and PTK7. Candidate variants were validated using Sanger sequencing. A total of 397 single nucleotide variants(SNVs) were identified with a mean depth of approximately 570×. Of these identified SNVs, 74 were predicted to affect protein function and had a minor allele frequency of <0.01 or unknown. Among these 74 missense SNVs, 10 were identified from six NTD cases that carried two mutated genes. Of the six NTD cases, three spina bifida cases and one anencephaly case carried digenic variants in the CELSR1 and SCRIB gene; one anencephaly case carried variants in the CELSR1 and DVL3 gene; and one spina bifida case carried variants in the PTK7 and SCRIB genes. Three cases that parental samples were available were confirmed to be compound heterozygous. None of the digenic variants were found in the 1000 genome database. The findings imply that genetic variation might interact in a digenic fashion to generate the visible NTD phenotypes and emphasize the importance of these genetic interactions in the development of NTDs in humans.
Collapse
Affiliation(s)
- Linlin Wang
- Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yanhui Xiao
- Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Tian Tian
- Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Lei Jin
- Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yunping Lei
- Departments of Molecular and Cellular Biology and Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Richard H Finnell
- Departments of Molecular and Cellular Biology and Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Aiguo Ren
- Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
| |
Collapse
|
49
|
Wan C, Liu X, Bai B, Cao H, Li H, Zhang Q. Regulation of the expression of tumor necrosis factor‑related genes by abnormal histone H3K27 acetylation: Implications for neural tube defects. Mol Med Rep 2018; 17:8031-8038. [PMID: 29693124 PMCID: PMC5983976 DOI: 10.3892/mmr.2018.8900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 06/20/2017] [Indexed: 11/20/2022] Open
Abstract
The association between apoptosis and neural tube defects (NTDs) is recognized as important, however, the precise link remains to be elucidated. Epigenetic modifications in human NTDs have been detected previously. In the present study, the occurrence of epigenetic modifications in apoptosis-related genes was investigated in a retinoic acid (RA)-induced mouse NTD model. Among 84 key genes involved in programmed cell death, 13 genes, including tumor necrosis factor (Tnf), annexin A5, apoptosis inhibitor 5, Bcl2-associated athanogene 3, baculoviral IAP repeat-containing 3, caspase (Casp)12, Casp4, Casp8, lymphotoxin β receptor, NLR family, apoptosis inhibitory protein 2, TNF receptor superfamily (Tnfrsf)1a, TNF superfamily (Tnfs)f10 and Tnfsf12, were downregulated, whereas nucleolar protein 3 was upregulated in the RA-induced NTD mice. Chromatin immunoprecipitation assays revealed that the regulatory regions of these differentially expressed TNF-related genes showed reduced histone H3K27 acetylation in NTDs, compared with control mice without NTDs. Reverse transcription-quantitative polymerase chain reaction revealed that H3K27ac-binding to the differentially regulated genes was markedly decreased in the NTD mice, whereas binding to the unchanged genes Casp3 and Nfkb1 was unaffected. In conclusion, certain TNF-related genes appeared to be downregulated in NTDs, possibly as a result of abnormal histone H3K27 acetylation. These results shed new light on the epigenetic dysregulation of apoptosis-related genes in NTDs.
Collapse
Affiliation(s)
- Chunlei Wan
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Peking University Teaching Hospital, Beijing 100020, P.R. China
| | - Xiaozhen Liu
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Peking University Teaching Hospital, Beijing 100020, P.R. China
| | - Baoling Bai
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Peking University Teaching Hospital, Beijing 100020, P.R. China
| | - Haiyan Cao
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Peking University Teaching Hospital, Beijing 100020, P.R. China
| | - Huili Li
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Peking University Teaching Hospital, Beijing 100020, P.R. China
| | - Qin Zhang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Peking University Teaching Hospital, Beijing 100020, P.R. China
| |
Collapse
|
50
|
Strobbe S, Van Der Straeten D. Toward Eradication of B-Vitamin Deficiencies: Considerations for Crop Biofortification. FRONTIERS IN PLANT SCIENCE 2018; 9:443. [PMID: 29681913 PMCID: PMC5897740 DOI: 10.3389/fpls.2018.00443] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/21/2018] [Indexed: 05/08/2023]
Abstract
'Hidden hunger' involves insufficient intake of micronutrients and is estimated to affect over two billion people on a global scale. Malnutrition of vitamins and minerals is known to cause an alarming number of casualties, even in the developed world. Many staple crops, although serving as the main dietary component for large population groups, deliver inadequate amounts of micronutrients. Biofortification, the augmentation of natural micronutrient levels in crop products through breeding or genetic engineering, is a pivotal tool in the fight against micronutrient malnutrition (MNM). Although these approaches have shown to be successful in several species, a more extensive knowledge of plant metabolism and function of these micronutrients is required to refine and improve biofortification strategies. This review focuses on the relevant B-vitamins (B1, B6, and B9). First, the role of these vitamins in plant physiology is elaborated, as well their biosynthesis. Second, the rationale behind vitamin biofortification is illustrated in view of pathophysiology and epidemiology of the deficiency. Furthermore, advances in biofortification, via metabolic engineering or breeding, are presented. Finally, considerations on B-vitamin multi-biofortified crops are raised, comprising the possible interplay of these vitamins in planta.
Collapse
|