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Parameshwar PK, Li C, Arnauts K, Jiang J, Rostami S, Campbell BE, Lu H, Rosenzweig DH, Vaillancourt C, Moraes C. Directed biomechanical compressive forces enhance fusion efficiency in model placental trophoblast cultures. Sci Rep 2024; 14:11312. [PMID: 38760496 PMCID: PMC11101427 DOI: 10.1038/s41598-024-61747-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
The syncytiotrophoblast is a multinucleated structure that arises from fusion of mononucleated cytotrophoblasts, to sheath the placental villi and regulate transport across the maternal-fetal interface. Here, we ask whether the dynamic mechanical forces that must arise during villous development might influence fusion, and explore this question using in vitro choriocarcinoma trophoblast models. We demonstrate that mechanical stress patterns arise around sites of localized fusion in cell monolayers, in patterns that match computational predictions of villous morphogenesis. We then externally apply these mechanical stress patterns to cell monolayers and demonstrate that equibiaxial compressive stresses (but not uniaxial or equibiaxial tensile stresses) enhance expression of the syndecan-1 and loss of E-cadherin as markers of fusion. These findings suggest that the mechanical stresses that contribute towards sculpting the placental villi may also impact fusion in the developing tissue. We then extend this concept towards 3D cultures and demonstrate that fusion can be enhanced by applying low isometric compressive stresses to spheroid models, even in the absence of an inducing agent. These results indicate that mechanical stimulation is a potent activator of cellular fusion, suggesting novel avenues to improve experimental reproductive modelling, placental tissue engineering, and understanding disorders of pregnancy development.
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Affiliation(s)
| | - Chen Li
- Department of Chemical Engineering, McGill University, Montréal, Québec, Canada
| | - Kaline Arnauts
- Department of Chemical Engineering, McGill University, Montréal, Québec, Canada
| | - Junqing Jiang
- Department of Chemical Engineering, McGill University, Montréal, Québec, Canada
| | - Sabra Rostami
- Department of Chemical Engineering, McGill University, Montréal, Québec, Canada
| | - Benjamin E Campbell
- Department of Chemical Engineering, McGill University, Montréal, Québec, Canada
| | - Hongyan Lu
- Department of Chemical Engineering, McGill University, Montréal, Québec, Canada
| | - Derek Hadar Rosenzweig
- Department of Surgery, McGill University, Montréal, Québec, Canada
- Injury, Repair and Recovery Program, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Cathy Vaillancourt
- Institut National de la Recherche Scientifique (INRS)-Centre Armand-Frappier Santé Biotechnologie, Laval, Québec, Canada
- Department of Obstetrics and Gynecology, Université de Montréal, and Research Center Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Nord-de-L'Île-de-Montréal, Montréal, Québec, Canada
| | - Christopher Moraes
- Department of Biological and Biomedical Engineering, McGill University, Montréal, Québec, Canada.
- Department of Chemical Engineering, McGill University, Montréal, Québec, Canada.
- Goodman Cancer Research Centre, McGill University, Montréal, Québec, Canada.
- Division of Experimental Medicine, McGill University, Montréal, Québec, Canada.
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2
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Parameshwar PK, Vaillancourt C, Moraes C. Engineering placental trophoblast fusion: A potential role for biomechanics in syncytialization. Placenta 2024:S0143-4004(24)00054-7. [PMID: 38448351 DOI: 10.1016/j.placenta.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/07/2024] [Accepted: 02/21/2024] [Indexed: 03/08/2024]
Abstract
The process by which placental trophoblasts fuse to form the syncytiotrophoblast around the chorionic villi is not fully understood. Mechanical features of the in vivo and in vitro culture environments have recently emerged as having the potential to influence fusion efficiency, and considering these mechanical cues may ultimately allow predictive control of trophoblast syncytialization. Here, we review recent studies that suggest that biomechanical factors such as shear stress, tissue stiffness, and dimensionally-related stresses affect villous trophoblast fusion efficiency. We then discuss how these stimuli might arise in vivo and how they can be incorporated in cultures to study and enhance villous trophoblast fusion. We believe that this mechanical paradigm will provide novel insight into manipulating the syncytialization process to better engineer improved models, understand disease progression, and ultimately develop novel therapeutic strategies.
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Affiliation(s)
| | - Cathy Vaillancourt
- Institut National de la Recherche Scientifique (INRS)-Centre Armand-Frappier Santé Biotechnologie, Laval, QC, H7B 1B7, Canada; Department of Obstetrics and Gynecology, Université de Montréal, and Research Center Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Nord-de-l'Île-de-Montréal, Montréal, QC, H3L 1K5, Canada
| | - Christopher Moraes
- Department of Biological and Biomedical Engineering, McGill University, Montréal, QC, H3A 2B4, Canada; Department of Chemical Engineering, McGill University, Montréal, QC, H3A 0C5, Canada; Goodman Cancer Research Centre, McGill University, Montréal, QC, H3A 1A3, Canada; Division of Experimental Medicine, McGill University, Montréal, QC, H4A 3J1, Canada.
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3
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Chappell J, Aughwane R, Clark AR, Ourselin S, David AL, Melbourne A. A review of feto-placental vasculature flow modelling. Placenta 2023; 142:56-63. [PMID: 37639951 PMCID: PMC10873207 DOI: 10.1016/j.placenta.2023.08.068] [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: 06/19/2023] [Revised: 08/18/2023] [Accepted: 08/20/2023] [Indexed: 08/31/2023]
Abstract
The placenta provides the vital nutrients and removal of waste products required for fetal growth and development. Understanding and quantifying the differences in structure and function between a normally functioning placenta compared to an abnormal placenta is vital to provide insights into the aetiology and treatment options for fetal growth restriction and other placental disorders. Computational modelling of blood flow in the placenta allows a new understanding of the placental circulation to be obtained. This structured review discusses multiple recent methods for placental vascular model development including analysis of the appearance of the placental vasculature and how placental haemodynamics may be simulated at multiple length scales.
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Affiliation(s)
- Joanna Chappell
- School of Biomedical Engineering and Imaging Sciences (BMEIS), King's College, London, UK.
| | - Rosalind Aughwane
- Elizabeth Garrett Anderson Institute for Women's Health, University College, London, UK
| | | | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences (BMEIS), King's College, London, UK
| | - Anna L David
- Elizabeth Garrett Anderson Institute for Women's Health, University College, London, UK
| | - Andrew Melbourne
- School of Biomedical Engineering and Imaging Sciences (BMEIS), King's College, London, UK
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Firestein MR, Romeo RD, Winstead H, Goldman DA, Grobman WA, Haas D, Mercer B, Parker C, Parry S, Reddy U, Silver R, Simhan H, Wapner RJ, Champagne FA. Elevated prenatal maternal sex hormones, but not placental aromatase, are associated with child neurodevelopment. Horm Behav 2022; 140:105125. [PMID: 35131524 DOI: 10.1016/j.yhbeh.2022.105125] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 01/20/2022] [Accepted: 01/23/2022] [Indexed: 01/08/2023]
Abstract
Fetal exposure to testosterone may contribute to vulnerability for autism spectrum disorder (ASD). It is hypothesized that placental aromatase prevents fetal exposure to maternal testosterone, however, this pathway and the implications for child neurodevelopment have not been fully explored. We examined the relationships between prenatal maternal testosterone and estradiol at 19.2 ± 1.3 weeks, cord blood testosterone and estradiol at birth, placental aromatase mRNA expression, and neurodevelopment using the Social Communication Questionnaire (SCQ), the Behavioral Assessment System for Children, 3rd Edition (BASC-3), and the Empathizing Quotient for Children (EQ-C) at 4.5-6.5 years of age in a sample of 270 Nulliparous-Mothers-to-be (nuMoM2b) study participants. Maternal testosterone levels were positively associated with SCQ scores, but the association was not significant after adjusting for maternal age at delivery, nor was there a significant interaction with sex. Maternal estradiol levels were negatively associated with BASC-3 Clinical Probability scores among males (n = 139). We report a significant interaction effect of cord blood testosterone and fetal sex on both total SCQ scores and t-scores on the Developmental Social Disorders subscale. Placental aromatase was not associated with any neurodevelopmental or hormone measure, but under conditions of low placental aromatase expression, high maternal testosterone was positively associated with SCQ scores in males (n = 46). No other associations between hormone levels and neurodevelopment were significant. Our findings provide a foundation for further investigation of the mechanisms through which maternal sex hormones and placental steroidogenesis may affect fetal hormone production and neurobehavior.
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Affiliation(s)
- Morgan R Firestein
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.
| | - Russell D Romeo
- Departments of Psychology and Neuroscience and Behavior, Barnard College of Columbia University, New York, NY, USA
| | | | - Danielle A Goldman
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, USA
| | - William A Grobman
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - David Haas
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Brian Mercer
- Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, USA
| | | | - Samuel Parry
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA
| | - Uma Reddy
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Robert Silver
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA
| | - Hyagriv Simhan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ronald J Wapner
- Department of Obstetrics & Gynecology, Columbia University Medical Center, New York, NY, USA
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Firestein MR, Kliman HJ, Sania A, Brink LT, Holzer PH, Hofmann KM, Milano KM, Pini N, Shuffrey LC, Odendaal HJ, Fifer WP. Trophoblast inclusions and adverse birth outcomes. PLoS One 2022; 17:e0264733. [PMID: 35231069 PMCID: PMC8887719 DOI: 10.1371/journal.pone.0264733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/15/2022] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Trophoblast inclusions-cross sections of abnormal trophoblast bilayer infoldings-have previously been associated with aneuploidy, placenta accreta, and prematurity. This study was conducted to establish the relationship between trophoblast inclusions and a range of placental, pregnancy, and birth outcomes in a patient population with high smoking and alcohol exposure. Specifically, we sought to evaluate the association between the presence of trophoblast inclusions and 1) three primary birth outcomes: full-term birth, preterm birth, and stillbirth; 2) gestational age at delivery; and 3) specific placental pathologies. METHODS Two slides containing chorionic villi were evaluated from 589 placentas that were collected from Stellenbosch University in Cape Town, South Africa as part of the prospective, multicenter cohort Safe Passage Study of the Prenatal Alcohol and SIDS and Stillbirth Network. The subsample included 307 full-term live births, 212 preterm live births, and 70 stillbirths. RESULTS We found that the odds of identifying at least one trophoblast inclusion across two slides of chorionic villi was significantly higher for placentas from preterm compared to term liveborn deliveries (OR = 1.74; 95% CI: 1.22, 2.49, p = 0.002), with an even greater odds ratio for placentas from stillborn compared to term liveborn deliveries (OR = 4.95; 95% CI: 2.78, 8.80, p < 0.001). Gestational age at delivery was inversely associated with trophoblast inclusion frequency. Trophoblast inclusions were significantly associated with small for gestational age birthweight, induction of labor, villous edema, placental infarction, and inflammation of the chorionic plate. CONCLUSIONS The novel associations that we report warrant further investigation in order to understand the complex network of biological mechanisms through which the factors that lead to trophoblast inclusions may influence or reflect the trajectory and health of a pregnancy. Ultimately, this line of research may provide critical insights that could inform both clinical and research applications.
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Affiliation(s)
- Morgan R. Firestein
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, United States of America
- * E-mail: (MRF); (HJK)
| | - Harvey J. Kliman
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, United States of America
- * E-mail: (MRF); (HJK)
| | - Ayesha Sania
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Lucy T. Brink
- Faculty of Medicine and Health Science, Department of Obstetrics and Gynaecology, Stellenbosch University, Cape Town, Western Cape, South Africa
| | - Parker H. Holzer
- Department of Statistics & Data Science, Yale University, New Haven, Connecticut, United States of America
| | - Katherine M. Hofmann
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Kristin M. Milano
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Nicolò Pini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Lauren C. Shuffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Hein J. Odendaal
- Faculty of Medicine and Health Science, Department of Obstetrics and Gynaecology, Stellenbosch University, Cape Town, Western Cape, South Africa
| | - William P. Fifer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, United States of America
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, United States of America
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York, United States of America
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6
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Computational modeling in pregnancy biomechanics research. J Mech Behav Biomed Mater 2022; 128:105099. [DOI: 10.1016/j.jmbbm.2022.105099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/11/2022] [Accepted: 01/18/2022] [Indexed: 11/24/2022]
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Matsuzaki S. Mechanobiology of the female reproductive system. Reprod Med Biol 2021; 20:371-401. [PMID: 34646066 PMCID: PMC8499606 DOI: 10.1002/rmb2.12404] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Mechanobiology in the field of human female reproduction has been extremely challenging technically and ethically. METHODS The present review provides the current knowledge on mechanobiology of the female reproductive system. This review focuses on the early phases of reproduction from oocyte development to early embryonic development, with an emphasis on current progress. MAIN FINDINGS RESULTS Optimal, well-controlled mechanical cues are required for female reproductive system physiology. Many important questions remain unanswered; whether and how mechanical imbalances among the embryo, decidua, and uterine muscle contractions affect early human embryonic development, whether the biomechanical properties of oocytes/embryos are potential biomarkers for selecting high-quality oocytes/embryos, whether mechanical properties differ between the two major compartments of the ovary (cortex and medulla) in normally ovulating human ovaries, whether durotaxis is involved in several processes in addition to embryonic development. Progress in mechanobiology is dependent on development of technologies that enable precise physical measurements. CONCLUSION More studies are needed to understand the roles of forces and changes in the mechanical properties of female reproductive system physiology. Recent and future technological advancements in mechanobiology research will help us understand the role of mechanical forces in female reproductive system disorders/diseases.
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Affiliation(s)
- Sachiko Matsuzaki
- CHU Clermont‐FerrandChirurgie GynécologiqueClermont‐FerrandFrance
- Université Clermont AuvergneInstitut Pascal, UMR6602, CNRS/UCA/SIGMAClermont‐FerrandFrance
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8
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Katz J, Holzer PH, Kliman HJ. Genetics, not the uterine environment, drive the formation of trophoblast inclusions: Insights from a twin study. Placenta 2021; 114:133-138. [PMID: 33941390 DOI: 10.1016/j.placenta.2021.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/01/2021] [Accepted: 04/13/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Trophoblast inclusions (TIs) are associated with aneuploidy and pregnancy loss and have thus been considered to be a marker of genetic abnormality. However, to date, no study has specifically explored whether TIs are a manifestation of fetal genetics or, rather, the result of the intrauterine environment. The goal of this study was to compare the frequency of TIs in the placentas of monozygotic (MZ) and dizygotic (DZ) twin pairs in order to determine whether the formation of TIs is genetically driven or not. METHODS We performed a retrospective case series of placentas from 48 twin pairs. The placentas were grouped based on zygosity: MZ, DZ, or unknown (UZ). The average number of total TIs per slide was calculated for each twin individual and the mean absolute difference in the total TIs per slide between the twin pairs was calculated for each zygosity group and compared. RESULTS The mean difference in the total TIs per slide for DZ twins was significantly greater than the mean difference in the total TIs per slide for MZ twins (p = 0.003). The mean difference in the total TIs per slide for the UZ group was also significantly greater than the mean difference in total TIs per slide between MZ twin pairs (p = 0.028). DISCUSSION Our finding that MZ twins were significantly more concordant than DZ twins for the average number of TIs per slide supports the conclusion that TIs are intrinsic to the genetics of the fetus, not the uterine environment.
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Affiliation(s)
- Julia Katz
- Yale College, Yale University, New Haven, CT, USA
| | - Parker H Holzer
- Department of Statistics & Data Science, Yale University, New Haven, CT, USA
| | - Harvey J Kliman
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA.
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Kliman HJ, Firestein MR, Hofmann KM, Milano KM, Holzer PH, Brink LT, Odendaal HJ, Fifer WP. Trophoblast inclusions in the human placenta: Identification, characterization, quantification, and interrelations of subtypes. Placenta 2021; 103:172-176. [PMID: 33152642 PMCID: PMC8448462 DOI: 10.1016/j.placenta.2020.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/23/2020] [Accepted: 10/12/2020] [Indexed: 11/26/2022]
Abstract
We sought to examine placentas enriched for trophoblast inclusions (TIs) in order to characterize, quantify, and examine the interrelations between subtypes of TIs to better understand their underlying biology. We examined a cohort of 600 placentas from deliveries between 200 and 430 weeks of gestation. Forty-five percent of the placentas had at least one TI in the two slides examined. Four percent of the placentas had 10 or more TIs and two placentas had more than 70 TIs. Four distinct TI subtypes were observed: inclusionoids (early forming inclusions), inclusions, calcified inclusions, and calcified bodies. We suggest this reflects a developmental trajectory of TI maturation, the timing of which might be useful when comparing TI expression to clinical outcomes.
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Affiliation(s)
- Harvey J Kliman
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA.
| | - Morgan R Firestein
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Kristin M Milano
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA
| | - Parker H Holzer
- Department of Statistics & Data Science, Yale University, New Haven, CT, USA
| | - Lucy T Brink
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, Western Cape, South Africa
| | - Hein J Odendaal
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, Western Cape, South Africa
| | - William P Fifer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA; Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, Western Cape, South Africa; Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, USA; Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
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Xiao W, Zhang H, Luo K, Mao C, Fan J. Immersed boundary method for multiphase transport phenomena. REV CHEM ENG 2020. [DOI: 10.1515/revce-2019-0076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Multiphase flows with momentum, heat, and mass transfer exist widely in a variety of industrial applications. With the rapid development of numerical algorithms and computer capacity, advanced numerical simulation has become a promising tool in investigating multiphase transport problems. Immersed boundary (IB) method has recently emerged as such a popular interface capturing method for efficient simulations of multiphase flows, and significant achievements have been obtained. In this review, we attempt to give an overview of recent progresses on IB method for multiphase transport phenomena. Firstly, the governing equations, the basic ideas, and different boundary conditions for the IB methods are introduced. This is followed by numerical strategies, from which the IB methods are classified into two types, namely the artificial boundary method and the authentic boundary method. Discussions on the implementation of various boundary conditions at the interphase surface with momentum, heat, and mass transfer for different IB methods are then presented, together with a summary. Then, the state-of-the-art applications of IB methods to multiphase flows, including the isothermal flows, the heat transfer flows, and the mass transfer problems are outlined, with particular emphasis on the latter two topics. Finally, the conclusions and future challenges are identified.
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Affiliation(s)
- Wei Xiao
- State Key Laboratory of Clean Energy Utilization , Zhejiang University , Hangzhou 310027 , P.R. China
| | - Hancong Zhang
- State Key Laboratory of Clean Energy Utilization , Zhejiang University , Hangzhou 310027 , P.R. China
| | - Kun Luo
- State Key Laboratory of Clean Energy Utilization , Zhejiang University , Hangzhou 310027 , P.R. China
| | - Chaoli Mao
- State Key Laboratory of Clean Energy Utilization , Zhejiang University , Hangzhou 310027 , P.R. China
| | - Jianren Fan
- State Key Laboratory of Clean Energy Utilization , Zhejiang University , Hangzhou 310027 , P.R. China
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Szilagyi A, Gelencser Z, Romero R, Xu Y, Kiraly P, Demeter A, Palhalmi J, Gyorffy BA, Juhasz K, Hupuczi P, Kekesi KA, Meinhardt G, Papp Z, Draghici S, Erez O, Tarca AL, Knöfler M, Than NG. Placenta-Specific Genes, Their Regulation During Villous Trophoblast Differentiation and Dysregulation in Preterm Preeclampsia. Int J Mol Sci 2020; 21:ijms21020628. [PMID: 31963593 PMCID: PMC7013556 DOI: 10.3390/ijms21020628] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 12/15/2022] Open
Abstract
The human placenta maintains pregnancy and supports the developing fetus by providing nutrition, gas-waste exchange, hormonal regulation, and an immunological barrier from the maternal immune system. The villous syncytiotrophoblast carries most of these functions and provides the interface between the maternal and fetal circulatory systems. The syncytiotrophoblast is generated by the biochemical and morphological differentiation of underlying cytotrophoblast progenitor cells. The dysfunction of the villous trophoblast development is implicated in placenta-mediated pregnancy complications. Herein, we describe gene modules and clusters involved in the dynamic differentiation of villous cytotrophoblasts into the syncytiotrophoblast. During this process, the immune defense functions are first established, followed by structural and metabolic changes, and then by peptide hormone synthesis. We describe key transcription regulatory molecules that regulate gene modules involved in placental functions. Based on transcriptomic evidence, we infer how villous trophoblast differentiation and functions are dysregulated in preterm preeclampsia, a life-threatening placenta-mediated obstetrical syndrome for the mother and fetus. In the conclusion, we uncover the blueprint for villous trophoblast development and its impairment in preterm preeclampsia, which may aid in the future development of non-invasive biomarkers for placental functions and early identification of women at risk for preterm preeclampsia as well as other placenta-mediated pregnancy complications.
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Affiliation(s)
- Andras Szilagyi
- Systems Biology of Reproduction Lendulet Group, Institute of Enzymology, Research Centre for Natural Sciences, H-1117 Budapest, Hungary; (A.S.); (Z.G.); (P.K.); (A.D.); (J.P.); (K.J.)
| | - Zsolt Gelencser
- Systems Biology of Reproduction Lendulet Group, Institute of Enzymology, Research Centre for Natural Sciences, H-1117 Budapest, Hungary; (A.S.); (Z.G.); (P.K.); (A.D.); (J.P.); (K.J.)
| | - Roberto Romero
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD 20692, and Detroit, MI 48201, USA; (R.R.); (Y.X.); (O.E.); (A.L.T.)
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824, USA
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48201, USA
- Detroit Medical Center, Detroit, MI 48201, USA
- Department of Obstetrics and Gynecology, Florida International University, Miami, FL 33199, USA
| | - Yi Xu
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD 20692, and Detroit, MI 48201, USA; (R.R.); (Y.X.); (O.E.); (A.L.T.)
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Peter Kiraly
- Systems Biology of Reproduction Lendulet Group, Institute of Enzymology, Research Centre for Natural Sciences, H-1117 Budapest, Hungary; (A.S.); (Z.G.); (P.K.); (A.D.); (J.P.); (K.J.)
| | - Amanda Demeter
- Systems Biology of Reproduction Lendulet Group, Institute of Enzymology, Research Centre for Natural Sciences, H-1117 Budapest, Hungary; (A.S.); (Z.G.); (P.K.); (A.D.); (J.P.); (K.J.)
| | - Janos Palhalmi
- Systems Biology of Reproduction Lendulet Group, Institute of Enzymology, Research Centre for Natural Sciences, H-1117 Budapest, Hungary; (A.S.); (Z.G.); (P.K.); (A.D.); (J.P.); (K.J.)
| | - Balazs A. Gyorffy
- Laboratory of Proteomics, Institute of Biology, Eotvos Lorand University, H-1117 Budapest, Hungary; (B.A.G.); (K.A.K.)
| | - Kata Juhasz
- Systems Biology of Reproduction Lendulet Group, Institute of Enzymology, Research Centre for Natural Sciences, H-1117 Budapest, Hungary; (A.S.); (Z.G.); (P.K.); (A.D.); (J.P.); (K.J.)
| | - Petronella Hupuczi
- Maternity Private Clinic of Obstetrics and Gynecology, H-1126 Budapest, Hungary; (P.H.); (Z.P.)
| | - Katalin Adrienna Kekesi
- Laboratory of Proteomics, Institute of Biology, Eotvos Lorand University, H-1117 Budapest, Hungary; (B.A.G.); (K.A.K.)
- Department of Physiology and Neurobiology, Eotvos Lorand University, H-1117 Budapest, Hungary
| | - Gudrun Meinhardt
- Department of Obstetrics and Gynecology, Reproductive Biology Unit, Medical University of Vienna, Vienna A-1090, Austria; (G.M.); (M.K.)
| | - Zoltan Papp
- Maternity Private Clinic of Obstetrics and Gynecology, H-1126 Budapest, Hungary; (P.H.); (Z.P.)
- Department of Obstetrics and Gynecology, Semmelweis University, H-1088 Budapest, Hungary
| | - Sorin Draghici
- Department of Computer Science, Wayne State University College of Engineering, Detroit, MI 48202, USA;
| | - Offer Erez
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD 20692, and Detroit, MI 48201, USA; (R.R.); (Y.X.); (O.E.); (A.L.T.)
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel
| | - Adi Laurentiu Tarca
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD 20692, and Detroit, MI 48201, USA; (R.R.); (Y.X.); (O.E.); (A.L.T.)
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Martin Knöfler
- Department of Obstetrics and Gynecology, Reproductive Biology Unit, Medical University of Vienna, Vienna A-1090, Austria; (G.M.); (M.K.)
| | - Nandor Gabor Than
- Systems Biology of Reproduction Lendulet Group, Institute of Enzymology, Research Centre for Natural Sciences, H-1117 Budapest, Hungary; (A.S.); (Z.G.); (P.K.); (A.D.); (J.P.); (K.J.)
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD 20692, and Detroit, MI 48201, USA; (R.R.); (Y.X.); (O.E.); (A.L.T.)
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Maternity Private Clinic of Obstetrics and Gynecology, H-1126 Budapest, Hungary; (P.H.); (Z.P.)
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, H-1085 Budapest, Hungary
- Correspondence: ; Tel.: +36-1-382-6788
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Firestein MR, Abellar R, Myers MM, Welch MG. Increased trophoblast inclusions in placentas from prematurely born infants: A potential marker of risk for preterm neurodevelopmental outcomes. Placenta 2017; 60:61-63. [PMID: 29208241 DOI: 10.1016/j.placenta.2017.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 10/13/2017] [Accepted: 10/21/2017] [Indexed: 01/21/2023]
Abstract
Trophoblast inclusions (TIs) are placental abnormalities of the trophoblast bilayer. Present in 2-8% of full-term placentas, they are associated with poor neurodevelopment, including autism. Although previously unstudied, examination of chorionic villi from 108 preterm births revealed a ∼4 fold increase in the frequency of TIs (30.5%). Frequency of TIs was inversely related to gestational age (GA); 43% of placentas <30 weeks and 20% of placentas ≥32 weeks had TIs (χ2 = 4.41, p = 0.036). This increased prevalence in preterm infants suggests that TIs may indicate adverse intrauterine processes or undetected genetic abnormalities and could identify infants at risk for poor neurodevelopment.
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Affiliation(s)
| | - Rosanna Abellar
- Department of Pathology & Cell Biology, Columbia University Medical Center, New York, NY, 10032, USA
| | - Michael M Myers
- Department of Pediatrics, Columbia University Medical Center, New York, NY, 10032, USA; Department of Psychiatry, Columbia University Medical Center, New York, NY, 10032, USA
| | - Martha G Welch
- Department of Pathology & Cell Biology, Columbia University Medical Center, New York, NY, 10032, USA; Department of Pediatrics, Columbia University Medical Center, New York, NY, 10032, USA; Department of Psychiatry, Columbia University Medical Center, New York, NY, 10032, USA
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Fletcher AG, Cooper F, Baker RE. Mechanocellular models of epithelial morphogenesis. Philos Trans R Soc Lond B Biol Sci 2017; 372:rstb.2015.0519. [PMID: 28348253 DOI: 10.1098/rstb.2015.0519] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2016] [Indexed: 01/13/2023] Open
Abstract
Embryonic epithelia achieve complex morphogenetic movements, including in-plane reshaping, bending and folding, through the coordinated action and rearrangement of individual cells. Technical advances in molecular and live-imaging studies of epithelial dynamics provide a very real opportunity to understand how cell-level processes facilitate these large-scale tissue rearrangements. However, the large datasets that we are now able to generate require careful interpretation. In combination with experimental approaches, computational modelling allows us to challenge and refine our current understanding of epithelial morphogenesis and to explore experimentally intractable questions. To this end, a variety of cell-based modelling approaches have been developed to describe cell-cell mechanical interactions, ranging from vertex and 'finite-element' models that approximate each cell geometrically by a polygon representing the cell's membrane, to immersed boundary and subcellular element models that allow for more arbitrary cell shapes. Here, we review how these models have been used to provide insights into epithelial morphogenesis and describe how such models could help future efforts to decipher the forces and mechanical and biochemical feedbacks that guide cell and tissue-level behaviour. In addition, we discuss current challenges associated with using computational models of morphogenetic processes in a quantitative and predictive way.This article is part of the themed issue 'Systems morphodynamics: understanding the development of tissue hardware'.
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Affiliation(s)
- Alexander G Fletcher
- School of Mathematics and Statistics, University of Sheffield, Sheffield S3 7RH, UK .,Bateson Centre, University of Sheffield, Sheffield S10 2TN, UK
| | - Fergus Cooper
- Mathematical Institute, University of Oxford, Oxford OX2 6GG, UK
| | - Ruth E Baker
- Mathematical Institute, University of Oxford, Oxford OX2 6GG, UK
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Feng H, Ou BC, Zhao JK, Yin S, Lu AG, Oechsle E, Thasler WE. Homogeneous pancreatic cancer spheroids mimic growth pattern of circulating tumor cell clusters and macrometastases: displaying heterogeneity and crater-like structure on inner layer. J Cancer Res Clin Oncol 2017; 143:1771-1786. [PMID: 28497169 DOI: 10.1007/s00432-017-2434-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 04/21/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE Pancreatic cancer 3D in vitro models including multicellular tumor spheroid (MCTS), single cell-derived tumor spheroid (SCTS), tissue-derived tumor spheroid, and organotypic models provided powerful platforms to mimic in vivo tumor. Recent work supports that circulating tumor cell (CTC) clusters are more efficient in metastasis seeding than single CTCs. The purpose of this study is to establish 3D culture models which can mimic single CTC, monoclonal CTC clusters, and the expansion of macrometastases. METHODS Seven pancreatic ductal adenocarcinoma cell lines were used to establish MCTS and SCTS using hanging drop and ultra-low attachment plates. Spheroid immunofluorescence staining, spheroid formation assay, immunoblotting, and literature review were performed to investigate molecular biomarkers and the morphological characteristics of pancreatic tumor spheroids. RESULTS Single cells experienced different growth patterns to form SCTS, like signet ring-like cells, blastula-like structures, and solid core spheroids. However, golf ball-like hollow spheroids could also be detected, especially when DanG and Capan-1 cells were cultivated with fibroblast-conditioned medium (p < 0.05). The size of golf ball-like hollow spheroids hardly grew after getting matured. Only DanG and Capan-1 could establish SCTS- and MCTS-derived hollow spheroids using hanging drop plates and ultra-low attachment plates. Other PDA cell lines could also establish tumor spheroid with hanging drop plates by adding methylated cellulose. Tumor spheroids derived from pancreatic cancer cell line DanG possessed asymmetrically distributed proliferation center, immune-checkpoint properties. ß-catenin, Ki-67, and F-actin were active surrounding the crater-like structure distributing on the inner layer of viable rim cover of the spheroids, which was relevant to well-differentiated tumor cells. CONCLUSIONS It is possible to establish 3D CTC cluster models from homogenous PDA cell lines using hanging drop and ultra-low attachment plates. PDA cell line displays its own intrinsic properties or heterogeneity. The mechanism of formation of the crater-like structure as well as golf ball-like structure needs further exploration.
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Affiliation(s)
- Hao Feng
- Department of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China. .,Medical Faculty, University Hospital of LMU Munich, 81377, Munich, Germany.
| | - Bao-Chi Ou
- Department of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
| | - Jing-Kun Zhao
- Department of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
| | - Shuai Yin
- Medical Faculty, University Hospital of LMU Munich, 81377, Munich, Germany
| | - Ai-Guo Lu
- Department of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
| | - Eva Oechsle
- Medical Faculty, University Hospital of LMU Munich, 81377, Munich, Germany.,Eurofins BioPharma Product Testing Germany, 82152, Munich, Germany
| | - Wolfgang E Thasler
- Department of General and Visceral Surgery, Red Cross Hospital, 80634, Munich, Germany.
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15
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Clark AR, Kruger JA. Mathematical modeling of the female reproductive system: from oocyte to delivery. WILEY INTERDISCIPLINARY REVIEWS-SYSTEMS BIOLOGY AND MEDICINE 2016; 9. [PMID: 27612162 DOI: 10.1002/wsbm.1353] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 06/08/2016] [Accepted: 06/28/2016] [Indexed: 12/30/2022]
Abstract
From ovulation to delivery, and through the menstrual cycle, the female reproductive system undergoes many dynamic changes to provide an optimal environment for the embryo to implant, and to develop successfully. It is difficult ethically and practically to observe the system over the timescales involved in growth and development (often hours to days). Even in carefully monitored conditions clinicians and biologists can only see snapshots of the development process. Mathematical models are emerging as a key means to supplement our knowledge of the reproductive process, and to tease apart complexity in the reproductive system. These models have been used successfully to test existing hypotheses regarding the mechanisms of female infertility and pathological fetal development, and also to provide new experimentally testable hypotheses regarding the process of development. This new knowledge has allowed for improvements in assisted reproductive technologies and is moving toward translation to clinical practice via multiscale assessments of the dynamics of ovulation, development in pregnancy, and the timing and mechanics of delivery. WIREs Syst Biol Med 2017, 9:e1353. doi: 10.1002/wsbm.1353 For further resources related to this article, please visit the WIREs website.
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Affiliation(s)
- Alys R Clark
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Jennifer A Kruger
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
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Serov AS, Salafia C, Grebenkov DS, Filoche M. The role of morphology in mathematical models of placental gas exchange. J Appl Physiol (1985) 2015; 120:17-28. [PMID: 26494446 DOI: 10.1152/japplphysiol.00543.2015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/08/2015] [Indexed: 02/07/2023] Open
Abstract
The performance of the placenta as a gas exchanger has a direct impact on the future health of the newborn. To provide accurate estimates of respiratory gas exchange rates, placenta models need to account for both the physiology of exchange and the organ morphology. While the former has been extensively studied, accounting for the latter is still a challenge. The geometrical complexity of placental structure requires use of carefully crafted approximations. We present here the state of the art of respiratory gas exchange placenta modeling and demonstrate the influence of the morphology description on model predictions. Advantages and shortcomings of various classes of models are discussed, and experimental techniques that may be used for model validation are summarized. Several directions for future development are suggested.
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Affiliation(s)
- A S Serov
- Physique de la Matière Condensée, Centre National de la Recherche Scientifique, Ecole Polytechnique, Palaiseau, France; and
| | - C Salafia
- Placental Analytics, LLC, Larchmont, New York
| | - D S Grebenkov
- Physique de la Matière Condensée, Centre National de la Recherche Scientifique, Ecole Polytechnique, Palaiseau, France; and
| | - M Filoche
- Physique de la Matière Condensée, Centre National de la Recherche Scientifique, Ecole Polytechnique, Palaiseau, France; and
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Tanaka S, Sichau D, Iber D. LBIBCell: a cell-based simulation environment for morphogenetic problems. Bioinformatics 2015; 31:2340-7. [PMID: 25770313 DOI: 10.1093/bioinformatics/btv147] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 03/10/2015] [Indexed: 11/13/2022] Open
Abstract
MOTIVATION The simulation of morphogenetic problems requires the simultaneous and coupled simulation of signalling and tissue dynamics. A cellular resolution of the tissue domain is important to adequately describe the impact of cell-based events, such as cell division, cell-cell interactions and spatially restricted signalling events. A tightly coupled cell-based mechano-regulatory simulation tool is therefore required. RESULTS We developed an open-source software framework for morphogenetic problems. The environment offers core functionalities for the tissue and signalling models. In addition, the software offers great flexibility to add custom extensions and biologically motivated processes. Cells are represented as highly resolved, massless elastic polygons; the viscous properties of the tissue are modelled by a Newtonian fluid. The Immersed Boundary method is used to model the interaction between the viscous and elastic properties of the cells, thus extending on the IBCell model. The fluid and signalling processes are solved using the Lattice Boltzmann method. As application examples we simulate signalling-dependent tissue dynamics. AVAILABILITY AND IMPLEMENTATION The documentation and source code are available on http://tanakas.bitbucket.org/lbibcell/index.html
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Affiliation(s)
- Simon Tanaka
- Department for Biosystems Science and Engineering, ETH Zurich, Mattenstrasse 26, 4058 Basel, Switzerland and Swiss Institute of Bioinformatics, Basel, Switzerland
| | - David Sichau
- Department for Biosystems Science and Engineering, ETH Zurich, Mattenstrasse 26, 4058 Basel, Switzerland and
| | - Dagmar Iber
- Department for Biosystems Science and Engineering, ETH Zurich, Mattenstrasse 26, 4058 Basel, Switzerland and Swiss Institute of Bioinformatics, Basel, Switzerland
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Abstract
During embryonic development tissue morphogenesis and signaling are tightly coupled. It is therefore important to simulate both tissue morphogenesis and signaling simultaneously in in silico models of developmental processes. The resolution of the processes depends on the questions of interest. As part of this chapter we introduce different descriptions of tissue morphogenesi s. In the simplest approximation tissue is a continuous domain and tissue expansion is described according to a predefined function of time (and possibly space). In a slightly more advanced version the expansion speed and direction of the tissue may depend on a signaling variable that evolves on the domain. Both versions will be referred to as "prescribed growth." Alternatively tissue can be regarded as incompressible fluid and can be described with Navier-Stokes equations. Local cell expansion, proliferation, and death are then incorporated by a source term. In other applications the cell boundaries may be important and cell-based models must be introduced. Finally, cells may move within the tissue, a process best described by agent-based models.
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Du X, Osterfield M, Shvartsman SY. Computational analysis of three-dimensional epithelial morphogenesis using vertex models. Phys Biol 2014; 11:066007. [PMID: 25410646 DOI: 10.1088/1478-3975/11/6/066007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The folding of epithelial sheets, accompanied by cell shape changes and rearrangements, gives rise to three-dimensional structures during development. Recently, some aspects of epithelial morphogenesis have been modeled using vertex models, in which each cell is approximated by a polygon; however, these models have been largely confined to two dimensions. Here, we describe an adaptation of these models in which the classical two-dimensional vertex model is embedded in three dimensions. This modification allows for the construction of complex three-dimensional shapes from simple sheets of cells. We describe algorithmic, computational, and biophysical aspects of our model, with the view that it may be useful for formulating and testing hypotheses regarding the mechanical forces underlying a wide range of morphogenetic processes.
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Affiliation(s)
- XinXin Du
- Molecular and Cellular Physiology Department, Stanford University, Stanford, CA, USA. Bioengineering Department, Stanford University, Stanford, CA, USA
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21
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Mkrtchyan A, Åström J, Karttunen M. A new model for cell division and migration with spontaneous topology changes. SOFT MATTER 2014; 10:4332-4339. [PMID: 24793724 DOI: 10.1039/c4sm00489b] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Tissue topology, in particular proliferating epithelium topology, is remarkably similar between various species. Understanding the mechanisms that result in the observed topologies is needed for better insight into the processes governing tissue formation. We present a two-dimensional single-cell based model for cell divisions and tissue growth. The model accounts for cell mechanics and allows cell migration. Cells do not have pre-existing shapes or topologies. Shape changes and local rearrangements occur naturally as a response to the evolving cellular environment and cell-cell interactions. We show that the commonly observed tissue topologies arise spontaneously from this model. We consider different cellular rearrangements that accompany tissue growth and study their effects on tissue topology.
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Affiliation(s)
- Anna Mkrtchyan
- Department of Applied Mathematics, University of Western Ontario, London, Ontario, Canada
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Trophoblast inclusions are significantly increased in the placentas of children in families at risk for autism. Biol Psychiatry 2013; 74:204-11. [PMID: 23623455 PMCID: PMC3755347 DOI: 10.1016/j.biopsych.2013.03.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 02/23/2013] [Accepted: 03/10/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND Gestation is a critical window for neurodevelopmental vulnerability. This study examined whether the presence of trophoblast inclusions (TIs) in the placenta could serve as a predictor for children at elevated risk for autism spectrum disorder (ASD). METHODS Placentas were obtained from 117 births in the MARBLES (Markers of Autism Risk in Babies-Learning Early Signs) cohort of families who have one or more previous biological children with ASD, placing their newborn at elevated risk for neurodevelopmental compromise. Control samples were obtained from 100 uncomplicated term pregnancies of multiparous women with one or more typically developing biological children. Frequency of TIs was compared across the two groups. RESULTS Placentas from at-risk pregnancies had an eightfold increased odds of having two or more TIs compared with control samples (odds ratio: 8.0, 95% confidence interval: 3.6-18.0). The presence of≥2 TIs yielded a sensitivity of 41% and a specificity of 92% for predicting ASD risk status, whereas≥4 TIs yielded a sensitivity of 19%, a specificity of 99.9%, and a positive likelihood ratio of 242 and conservatively predicted an infant with a 74% probability of being at risk for ASD. CONCLUSIONS Our findings suggest that the placentas from women whose fetuses are at elevated risk for autism are markedly different from control placentas. These differences are manifested histologically as TIs. Their identification has the possibility of identifying newborns at risk for ASD who might benefit from targeted early interventions aimed at preventing or ameliorating behavioral symptoms and optimizing developmental outcomes.
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Rejniak KA. Investigating dynamical deformations of tumor cells in circulation: predictions from a theoretical model. Front Oncol 2012; 2:111. [PMID: 23024961 PMCID: PMC3444760 DOI: 10.3389/fonc.2012.00111] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 08/15/2012] [Indexed: 12/14/2022] Open
Abstract
It is inevitable for tumor cells to deal with various mechanical forces in order to move from primary to metastatic sites. In particular, the circulating tumor cells that have detached from the primary tumor and entered into the bloodstream need to survive in a completely new microenvironment. They must withstand hemodynamic forces and overcome the effects of fluid shear before they can leave the vascular system (extravasate) to establish new metastatic foci. One of the hypotheses of the tumor cell extravasation process is based on the so called “adhesion cascade” that was formulated and observed in the context of leukocytes circulating in the vascular system. During this process, the cell needs to switch between various locomotion strategies, from floating with the blood stream, to rolling on the endothelial wall, to tumor cell arrest and crawling, and finally tumor cell transmigration through the endothelial layer. The goal of this project is to use computational mechanical modeling to investigate the fundamental biophysical parameters of tumor cells in circulation. As a first step to build a robust in silico model, we consider a single cell exposed to the blood flow. We examine parameters related to structure of the actin network, cell nucleus and adhesion links between the tumor and endothelial cells that allow for successful transition between different transport modes of the adhesion cascade.
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Affiliation(s)
- Katarzyna A Rejniak
- Integrated Mathematical Oncology, H. Lee Moffitt Cancer Center and Research Institute Tampa, FL, USA ; Department of Oncologic Sciences, College of Medicine, University of South Florida Tampa, FL, USA
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Meseguer M, Kruhne U, Laursen S. Full in vitro fertilization laboratory mechanization: toward robotic assisted reproduction? Fertil Steril 2012; 97:1277-86. [PMID: 22480821 DOI: 10.1016/j.fertnstert.2012.03.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 03/10/2012] [Accepted: 03/12/2012] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To describe the current efforts made to standardize different steps of assisted reproductive technology processes by the introduction of new technologies for the nonsubjective sperm selection process, oocyte denudation by mechanical removal of cumulus cells, oocyte positioning, sperm motility screening, fertilization, embryo culture, media replacement by microfluidics, and monitoring of embryo development by time-lapse photography, embryo secretions, and/or O(2) consumption. These technologies could be integrated in a unique and fully automated device. DESIGN Pubmed database and research and development data from authors. SETTING University-affiliated private center. PATIENT(S) None. INTERVENTION(S) None. MAIN OUTCOME MEASUREMENT(S) None. RESULT(S) Several technologies would be useful for: 1) selection of sperm based on viability; 2) manipulation and removal of the cumulus cells' narrow channel regions combined with microfluidics; 3) advances in oocyte positioning precision through the use of joystick-controlled micromanipulators; 4) microfluidics allowing the gradual change of a culture medium, which might result in better embryo development as well as reduce the amount of embryo manipulation; 5) time-lapse, proteomic, and metabolic scoring of the developing embryo, allowing multiple and optimized selection of the embryos. The technologies described in this review have not yet reported reliable clinical proofs. CONCLUSION(S) We already have available some of the technologies described, but we envisage an integrated device, i.e., an IVF lab-on-a-chip, by which oocyte and sperm would be processed to achieve a perfect embryo ready to be delivered into the uterus. With such a device, sample preparation, chemical or biologic reactions, and data collection would be integrated.
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Affiliation(s)
- Marcos Meseguer
- Instituto Valenciano de Infertilidad, Universidad de Valencia, Valencia, Spain
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Lim S, Peskin CS. Fluid-mechanical interaction of flexible bacterial flagella by the immersed boundary method. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2012; 85:036307. [PMID: 22587180 DOI: 10.1103/physreve.85.036307] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 01/30/2012] [Indexed: 05/21/2023]
Abstract
Flagellar bundling is an important aspect of locomotion in bacteria such as Escherichia coli. To study the hydrodynamic behavior of helical flagella, we present a computational model that is based on the geometry of the bacterial flagellar filament at the micrometer scale. We consider two model flagella, each of which has a rotary motor at its base with the rotation rate of the motor set at 100 Hz. Bundling occurs when both flagella are left-handed helices turning counterclockwise (when viewed from the nonmotor end of the flagellum looking back toward the motor) or when both flagella are right-handed helices turning clockwise. Helical flagella of the other combinations of handedness and rotation direction do not bundle.
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Affiliation(s)
- Sookkyung Lim
- Department of Mathematical Sciences, University of Cincinnati, 4199 French Hall West, Cincinnati, Ohio 45221, USA.
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Rejniak KA, Wang SE, Bryce NS, Chang H, Parvin B, Jourquin J, Estrada L, Gray JW, Arteaga CL, Weaver AM, Quaranta V, Anderson ARA. Linking changes in epithelial morphogenesis to cancer mutations using computational modeling. PLoS Comput Biol 2010; 6:e1000900. [PMID: 20865159 PMCID: PMC2928778 DOI: 10.1371/journal.pcbi.1000900] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 07/23/2010] [Indexed: 11/19/2022] Open
Abstract
Most tumors arise from epithelial tissues, such as mammary glands and lobules, and their initiation is associated with the disruption of a finely defined epithelial architecture. Progression from intraductal to invasive tumors is related to genetic mutations that occur at a subcellular level but manifest themselves as functional and morphological changes at the cellular and tissue scales, respectively. Elevated proliferation and loss of epithelial polarization are the two most noticeable changes in cell phenotypes during this process. As a result, many three-dimensional cultures of tumorigenic clones show highly aberrant morphologies when compared to regular epithelial monolayers enclosing the hollow lumen (acini). In order to shed light on phenotypic changes associated with tumor cells, we applied the bio-mechanical IBCell model of normal epithelial morphogenesis quantitatively matched to data acquired from the non-tumorigenic human mammary cell line, MCF10A. We then used a high-throughput simulation study to reveal how modifications in model parameters influence changes in the simulated architecture. Three parameters have been considered in our study, which define cell sensitivity to proliferative, apoptotic and cell-ECM adhesive cues. By mapping experimental morphologies of four MCF10A-derived cell lines carrying different oncogenic mutations onto the model parameter space, we identified changes in cellular processes potentially underlying structural modifications of these mutants. As a case study, we focused on MCF10A cells expressing an oncogenic mutant HER2-YVMA to quantitatively assess changes in cell doubling time, cell apoptotic rate, and cell sensitivity to ECM accumulation when compared to the parental non-tumorigenic cell line. By mapping in vitro mutant morphologies onto in silico ones we have generated a means of linking the morphological and molecular scales via computational modeling. Thus, IBCell in combination with 3D acini cultures can form a computational/experimental platform for suggesting the relationship between the histopathology of neoplastic lesions and their underlying molecular defects.
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Affiliation(s)
- Katarzyna A Rejniak
- Integrated Mathematical Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, United States of America.
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Jamali Y, Azimi M, Mofrad MRK. A sub-cellular viscoelastic model for cell population mechanics. PLoS One 2010; 5:e12097. [PMID: 20856895 PMCID: PMC2938372 DOI: 10.1371/journal.pone.0012097] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Accepted: 06/21/2010] [Indexed: 11/19/2022] Open
Abstract
Understanding the biomechanical properties and the effect of biomechanical force on epithelial cells is key to understanding how epithelial cells form uniquely shaped structures in two or three-dimensional space. Nevertheless, with the limitations and challenges posed by biological experiments at this scale, it becomes advantageous to use mathematical and 'in silico' (computational) models as an alternate solution. This paper introduces a single-cell-based model representing the cross section of a typical tissue. Each cell in this model is an individual unit containing several sub-cellular elements, such as the elastic plasma membrane, enclosed viscoelastic elements that play the role of cytoskeleton, and the viscoelastic elements of the cell nucleus. The cell membrane is divided into segments where each segment (or point) incorporates the cell's interaction and communication with other cells and its environment. The model is capable of simulating how cells cooperate and contribute to the overall structure and function of a particular tissue; it mimics many aspects of cellular behavior such as cell growth, division, apoptosis and polarization. The model allows for investigation of the biomechanical properties of cells, cell-cell interactions, effect of environment on cellular clusters, and how individual cells work together and contribute to the structure and function of a particular tissue. To evaluate the current approach in modeling different topologies of growing tissues in distinct biochemical conditions of the surrounding media, we model several key cellular phenomena, namely monolayer cell culture, effects of adhesion intensity, growth of epithelial cell through interaction with extra-cellular matrix (ECM), effects of a gap in the ECM, tensegrity and tissue morphogenesis and formation of hollow epithelial acini. The proposed computational model enables one to isolate the effects of biomechanical properties of individual cells and the communication between cells and their microenvironment while simultaneously allowing for the formation of clusters or sheets of cells that act together as one complex tissue.
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Affiliation(s)
- Yousef Jamali
- Molecular Cell Biomechanics Laboratory, Department of Bioengineering, University of California, Berkeley, California, United States of America
| | - Mohammad Azimi
- Molecular Cell Biomechanics Laboratory, Department of Bioengineering, University of California, Berkeley, California, United States of America
| | - Mohammad R. K. Mofrad
- Molecular Cell Biomechanics Laboratory, Department of Bioengineering, University of California, Berkeley, California, United States of America
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A 3D Motile Rod-Shaped Monotrichous Bacterial Model. Bull Math Biol 2009; 71:1228-63. [DOI: 10.1007/s11538-009-9400-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2008] [Accepted: 01/15/2009] [Indexed: 10/21/2022]
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Anderson ARA, Rejniak KA, Gerlee P, Quaranta V. Microenvironment driven invasion: a multiscale multimodel investigation. J Math Biol 2009; 58:579-624. [PMID: 18839176 PMCID: PMC5563464 DOI: 10.1007/s00285-008-0210-2] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Revised: 02/25/2008] [Indexed: 12/01/2022]
Abstract
Cancer is a complex, multiscale process, in which genetic mutations occurring at a subcellular level manifest themselves as functional and morphological changes at the cellular and tissue scale. The importance of interactions between tumour cells and their microenvironment is currently of great interest in experimental as well as computational modelling. Both the immediate microenvironment (e.g. cell-cell signalling or cell-matrix interactions) and the extended microenvironment (e.g. nutrient supply or a host tissue structure) are thought to play crucial roles in both tumour progression and suppression. In this paper we focus on tumour invasion, as defined by the emergence of a fingering morphology, which has previously been shown to be dependent upon harsh microenvironmental conditions. Using three different modelling approaches at two different spatial scales we examine the impact of nutrient availability as a driving force for invasion. Specifically we investigate how cell metabolism (the intrinsic rate of nutrient consumption and cell resistance to starvation) influences the growing tumour. We also discuss how dynamical changes in genetic makeup and morphological characteristics, of the tumour population, are driven by extreme changes in nutrient supply during tumour development. The simulation results indicate that aggressive phenotypes produce tumour fingering in poor nutrient, but not rich, microenvironments. The implication of these results is that an invasive outcome appears to be co-dependent upon the evolutionary dynamics of the tumour population driven by the microenvironment.
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Morishita Y, Iwasa Y. Growth based morphogenesis of vertebrate limb bud. Bull Math Biol 2008; 70:1957-78. [PMID: 18668295 PMCID: PMC2792361 DOI: 10.1007/s11538-008-9334-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2007] [Accepted: 04/29/2008] [Indexed: 11/03/2022]
Abstract
Many genes and their regulatory relationships are involved in developmental phenomena. However, by chemical information alone, we cannot fully understand changing organ morphologies through tissue growth because deformation and growth of the organ are essentially mechanical processes. Here, we develop a mathematical model to describe the change of organ morphologies through cell proliferation. Our basic idea is that the proper specification of localized volume source (e.g., cell proliferation) is able to guide organ morphogenesis, and that the specification is given by chemical gradients. We call this idea "growth-based morphogenesis." We find that this morphogenetic mechanism works if the tissue is elastic for small deformation and plastic for large deformation. To illustrate our concept, we study the development of vertebrate limb buds, in which a limb bud protrudes from a flat lateral plate and extends distally in a self-organized manner. We show how the proportion of limb bud shape depends on different parameters and also show the conditions needed for normal morphogenesis, which can explain abnormal morphology of some mutants. We believe that the ideas shown in the present paper are useful for the morphogenesis of other organs.
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Affiliation(s)
- Yoshihiro Morishita
- PRESTO, Japan Science and Technology Agency, 4-1-8 Honcho Kawaguchi, Saitama, Japan.
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31
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In silico zebrafish pattern formation. Dev Biol 2008; 315:397-403. [DOI: 10.1016/j.ydbio.2007.12.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2007] [Revised: 12/11/2007] [Accepted: 12/22/2007] [Indexed: 11/20/2022]
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Rejniak KA, Anderson ARA. A computational study of the development of epithelial acini: I. Sufficient conditions for the formation of a hollow structure. Bull Math Biol 2008; 70:677-712. [PMID: 18188652 DOI: 10.1007/s11538-007-9274-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2007] [Accepted: 09/04/2007] [Indexed: 11/25/2022]
Abstract
Normal hollow epithelial acini are 3-dimensional culture structures that resemble the architecture and functions of normal breast glands and lobules. This experimental model enables in vitro investigations of genotypic and molecular abnormalities associated with epithelial cancers. However, the way in which the acinar structure is formed is not yet completely understood. Gaining more information about consecutive stages of acini development-starting from a single cell that gives rise to a cluster of randomly oriented cells, followed by cell differentiation that leads to a layer of polarised cells enclosing the hollow lumen-will provide insight into the transformations of eukaryotic cells that are necessary for their successful arrangement into an epithelium. In this paper, we introduce a two-dimensional single-cell-based model representing the cross section of a typical acinus. Using this model, we investigate mechanisms that lead to the unpolarised cell growth, cell polarisation, stabilisation of the acinar structure and maintenance of the hollow lumen and discuss the sufficient conditions for each stage of acinar formation. In the follow-up paper (Rejniak and Anderson, A computational study of the development of epithelial acini. II. Necessary conditions for structure and lumen stability), we investigate what morphological changes are observable in the growing acini when some assumptions of this model are relaxed.
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Affiliation(s)
- Katarzyna A Rejniak
- Division of Mathematics, University of Dundee, Dundee, DD1 4HN, Scotland, UK.
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Rejniak KA. An immersed boundary framework for modelling the growth of individual cells: an application to the early tumour development. J Theor Biol 2007; 247:186-204. [PMID: 17416390 DOI: 10.1016/j.jtbi.2007.02.019] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2006] [Revised: 02/22/2007] [Accepted: 02/26/2007] [Indexed: 10/23/2022]
Abstract
A biomechanical approach in modelling the growth and division of a single fully deformable cell by using an immersed boundary method with distributed sources is presented, and its application to model the early tumour development is discussed. This mathematical technique couples a continuous description of a viscous incompressible cytoplasm with the dynamics of separate elastic cells, containing their own point nuclei, elastic plasma membranes with membrane receptors, and individually regulated cell processes. This model enables one to focus on the biomechanical properties of individual cells and on communication between cells and their microenvironment, simultaneously allowing for the formation of clusters or sheets of cells that act together as one complex tissue. Several examples of early tumours growing in various geometrical configurations and with distinct conditions of their initiation and progression are also presented to show the strength of our approach in modelling different topologies of the growing tissues in distinct biochemical conditions of the surrounding media.
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Affiliation(s)
- Katarzyna A Rejniak
- Division of Mathematics, University of Dundee, Dundee DD1 4HN, Scotland, UK.
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Anderson GM, Jacobs-Stannard A, Chawarska K, Volkmar FR, Kliman HJ. Placental trophoblast inclusions in autism spectrum disorder. Biol Psychiatry 2007; 61:487-91. [PMID: 16806106 DOI: 10.1016/j.biopsych.2006.03.068] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2005] [Revised: 03/21/2006] [Accepted: 03/21/2006] [Indexed: 01/10/2023]
Abstract
BACKGROUND Microscopic examination of placental tissue may provide a route to assessing risk and understanding underlying biology of autism. METHODS Occurrence of a distinctive microscopic placental morphological abnormality, the trophoblast inclusion, was assessed using archived placental tissue. The rate of occurrence of trophoblast inclusion-positive slides observed for 13 individuals with autism spectrum disorder (ASD) was compared to the rate in an anonymous consecutive birth cohort. RESULTS The occurrence of inclusion positive slides was significantly greater in the ASD group compared to the control group (6/27 slides, 22.2% vs. 12/154, 7.8%; Fisher Exact Test, two-tailed p = .033; relative risk 2.85). The proportion of positive cases was also greater in the ASD group (5/13 cases, 38.5% vs. 8/61, 13.1%; Fisher Exact, two-tailed p = .044; relative risk 2.93). Behavioral severity scores did not differ across groups of inclusion positive (N = 4) and negative (N = 8) ASD individuals. CONCLUSIONS Although probably not functionally detrimental or causative, the greater occurrence of placental trophoblast inclusions observed in ASD individuals may reflect altered early developmental processes. Further research is required to replicate the basic finding, to understand the basis for the trophoblastic abnormality, and to determine the utility of the measure in early detection of ASD.
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Affiliation(s)
- George M Anderson
- The Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA.
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Kharfi A, Bureau M, Giguère Y, Moutquin JM, Forest JC. Dissociation between increased apoptosis and expression of the tumor necrosis factor-alpha system in term placental villi with preeclampsia. Clin Biochem 2006; 39:646-51. [PMID: 16499896 DOI: 10.1016/j.clinbiochem.2006.01.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2005] [Revised: 11/30/2005] [Accepted: 01/25/2006] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To analyse in situ the placental expression of tumor necrosis factor-alpha (TNF-alpha), its receptors TNFRp55 and TNFRp75, and apoptosis in normotensive and preeclamptic pregnancies. DESIGN AND METHODS We simultaneously analyzed the immunostaining of TNF-alpha, its receptors and apoptosis in term placentas of 15 patients with preeclampsia and 15 normotensive pregnant women as controls. RESULTS In normotensive villi TNF-alpha and TNFRp75 were expressed more in syncytiotrophoblasts than cytotrophoblasts or stromal cells, and were almost absent in endothelial cells. TNFRp55 was expressed uniformly in all types of placental cells. Apoptosis was more marked in syncytiotrophoblasts than cytotrophoblasts. In preeclamptic trophoblasts apoptosis was exaggerated whereas expression of TNF-alpha and its receptors remained unchanged. CONCLUSIONS Placental expression of TNF-alpha and TNFRp75 appear inter-adaptative and follow the same pattern, whereas TNFRp55 and TNF-alpha appear independent. In addition, the exaggerated apoptosis of preeclamptic trophoblasts may be dependent on factors other than the TNF-alpha system alone.
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Affiliation(s)
- Abdelaziz Kharfi
- Département d'Obstétrique-Gynécologie, Centre Universitaire de Sherbrooke, Québec, Canada.
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