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Hill CJ, Phelan MM, Dutton PJ, Busuulwa P, Maclean A, Davison AS, Drury JA, Tempest N, Horne AW, Gutiérrez EC, Hapangama DK. Diagnostic utility of clinicodemographic, biochemical and metabolite variables to identify viable pregnancies in a symptomatic cohort during early gestation. Sci Rep 2024; 14:11172. [PMID: 38750192 PMCID: PMC11096363 DOI: 10.1038/s41598-024-61690-3] [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: 03/04/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024] Open
Abstract
A significant number of pregnancies are lost in the first trimester and 1-2% are ectopic pregnancies (EPs). Early pregnancy loss in general can cause significant morbidity with bleeding or infection, while EPs are the leading cause of maternal mortality in the first trimester. Symptoms of pregnancy loss and EP are very similar (including pain and bleeding); however, these symptoms are also common in live normally sited pregnancies (LNSP). To date, no biomarkers have been identified to differentiate LNSP from pregnancies that will not progress beyond early gestation (non-viable or EPs), defined together as combined adverse outcomes (CAO). In this study, we present a novel machine learning pipeline to create prediction models that identify a composite biomarker to differentiate LNSP from CAO in symptomatic women. This prospective cohort study included 370 participants. A single blood sample was prospectively collected from participants on first emergency presentation prior to final clinical diagnosis of pregnancy outcome: LNSP, miscarriage, pregnancy of unknown location (PUL) or tubal EP (tEP). Miscarriage, PUL and tEP were grouped together into a CAO group. Human chorionic gonadotrophin β (β-hCG) and progesterone concentrations were measured in plasma. Serum samples were subjected to untargeted metabolomic profiling. The cohort was randomly split into train and validation data sets, with the train data set subjected to variable selection. Nine metabolite signals were identified as key discriminators of LNSP versus CAO. Random forest models were constructed using stable metabolite signals alone, or in combination with plasma hormone concentrations and demographic data. When comparing LNSP with CAO, a model with stable metabolite signals only demonstrated a modest predictive accuracy (0.68), which was comparable to a model of β-hCG and progesterone (0.71). The best model for LNSP prediction comprised stable metabolite signals and hormone concentrations (accuracy = 0.79). In conclusion, serum metabolite levels and biochemical markers from a single blood sample possess modest predictive utility in differentiating LNSP from CAO pregnancies upon first presentation, which is improved by variable selection and combination using machine learning. A diagnostic test to confirm LNSP and thus exclude pregnancies affecting maternal morbidity and potentially life-threatening outcomes would be invaluable in emergency situations.
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Affiliation(s)
- Christopher J Hill
- Department of Women's and Children's Health, Centre for Women's Health Research, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK
| | - Marie M Phelan
- High Field NMR Facility, Liverpool Shared Research Facilities, University of Liverpool, Liverpool, L69 7TX, UK
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, L69 7ZB, UK
| | - Philip J Dutton
- Department of Women's and Children's Health, Centre for Women's Health Research, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK
- Liverpool Women's Hospital NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK
| | - Paula Busuulwa
- Department of Women's and Children's Health, Centre for Women's Health Research, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK
- Liverpool Women's Hospital NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK
| | - Alison Maclean
- Department of Women's and Children's Health, Centre for Women's Health Research, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK
| | - Andrew S Davison
- Department of Women's and Children's Health, Centre for Women's Health Research, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK
- Department of Clinical Biochemistry and Metabolic Medicine, Liverpool Clinical Laboratories, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L7 8SP, UK
| | - Josephine A Drury
- Department of Women's and Children's Health, Centre for Women's Health Research, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK
| | - Nicola Tempest
- Department of Women's and Children's Health, Centre for Women's Health Research, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK
- Liverpool Women's Hospital NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK
| | - Andrew W Horne
- Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, EH16 4UU, UK
| | - Eva Caamaño Gutiérrez
- High Field NMR Facility, Liverpool Shared Research Facilities, University of Liverpool, Liverpool, L69 7TX, UK
- Computational Biology Facility, Liverpool Shared Research Facilities, University of Liverpool, Liverpool, L69 7ZB, UK
| | - Dharani K Hapangama
- Department of Women's and Children's Health, Centre for Women's Health Research, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK.
- Liverpool Women's Hospital NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK.
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Zhang M, Lu X, Mi L, Song M, Wang L, Wang X. Investigation of amino acid profile alterations in maternal serum for early diagnosis of anembryonic pregnancy with high performance liquid chromatography-mass spectrometry. Eur J Obstet Gynecol Reprod Biol 2024; 294:49-54. [PMID: 38215601 DOI: 10.1016/j.ejogrb.2024.01.007] [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: 04/12/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/14/2024]
Abstract
BACKGROUND Anembryonic pregnancy affects 12-15 % of clinically recognized pregnancies and a previous anembryonic pregnancy is an independent risk factor for future anembryonic pregnancy. This study aimed to investigate alternations in maternal amino acid profiles and analyze the diagnostic accuracy of amino acid biomarkers for anembryonic pregnancy in the early stage. METHODS Fasting serum from anembryonic pregnancy patients (n = 103) and healthy pregnancies (n = 97) was collected, and amino acid concentrations were determined by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). A receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of each of the amino acid biomarkers and the amino acid profile index for anembryonic pregnancy screening. RESULTS The concentrations of 15 amino acids were significantly different between anembryonic pregnancy patients and healthy controls, and most of them were significantly higher at 7 weeks' gestational age in anembryonic pregnancy subjects. The area under the curve (AUC) based on an amino acid profile index combined with alanine, citrulline, aspartic acid, threonine, serine and isoleucine was 0.90 (sensitivity 82.76 %, specificity 83.64 %) for distinguishing early anembryonic pregnancy from healthy controls. CONCLUSION Maternal serum amino acid concentrations were significantly elevated in anembryonic pregnancy patients. The diagnostic potential of amino aicds for anembryonic pregnancy was verified, and the diagnostic efficiency was improved in the use of the amino acid profile index. The amino acid profile is expected to be applied for the risk screening of early-stage of anembryonic pregnancy in the future.
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Affiliation(s)
- Min Zhang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China; Department of Biochemistry and Immunology, Capital Institute of Pediatrics, Beijing 100020, China
| | - XiaoLin Lu
- Department of Biobank, Capital Institute of Pediatrics, Beijing 100020, China
| | - LaLa Mi
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Shanxi Medical University, Taiyuan 030001, China
| | - MeiYan Song
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Shanxi Medical University, Taiyuan 030001, China
| | - Li Wang
- Department of Biobank, Capital Institute of Pediatrics, Beijing 100020, China.
| | - XiaoYan Wang
- Department of Nutrition Center, Capital Institute of Pediatrics, Beijing, China.
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Wu Z, Yang Y, Wang B, Gebeyew K, Tang S, Han X, He Z, Tan Z. Blood Metabolites and Faecal Microbial Communities in Nonpregnant and Early Gestation Ewes in Highly Cold Areas. BIOLOGY 2023; 12:1436. [PMID: 37998035 PMCID: PMC10669436 DOI: 10.3390/biology12111436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023]
Abstract
Ewes undergo complex metabolic changes during pregnancy. Understanding the specific process of these changes is a necessary prerequisite in ewes for regulating and intervening in order to maintain pregnancies. However, there have been relatively few studies on the specific changes that occur in nutritional metabolism in pregnant ewes during early gestation, especially for some landrace ewes in highly cold areas. Therefore, this study aimed to (1) elucidate the changes in metabolites and microbial communities in pregnant ewes during early gestation using metabolomics and 16S ribosomal RNA gene (rDNA) amplicon sequencing approaches, and to (2) discover novel early pregnancy-induced biomarkers in the blood and faeces. Rams were placed together with ewes on D0 and removed on D45. During early gestation, blood and faecal samples were collected from ewes in a highly cold area for analysing the metabolites and microbial communities; these were retrospectively classified as the early gestation pregnant (EP) ewe group or the nonpregnant (NP) ewe group based on the lambing status recorded during the expected delivery period. The differences in the plasma biochemical parameters, plasma metabolites, and faecal microbial communities of pregnant and nonpregnant ewes were characterised. The GC, IL-6, O-acetyl-l-serine, L-glutamine, and 6-acetamido-2-oxohexanoic acid were screened out as potential biomarkers for evaluating the occurrence of early pregnancy. These novel early pregnancy-induced metabolites discovered in ewes might allow for the development of technologies to detect early pregnancies in sheep in highly cold areas.
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Affiliation(s)
- Zhiwu Wu
- CAS Key Laboratory for Agro-Ecological Processes in Subtropical Region, National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Hunan Provincial Key Laboratory of Animal Nutritional Physiology and Metabolic Process, Institute of Subtropical Agriculture, The Chinese Academy of Sciences, Changsha 410125, China; (Z.W.); (K.G.); (S.T.); (Z.T.)
- University of Chinese Academy of Sciences, Beijing 101408, China
| | - Yanyan Yang
- Inner Mongolia Academy of Agricultural and Animal Husbandry Sciences, Hohhot 010031, China; (Y.Y.); (B.W.)
| | - Biao Wang
- Inner Mongolia Academy of Agricultural and Animal Husbandry Sciences, Hohhot 010031, China; (Y.Y.); (B.W.)
| | - Kefyalew Gebeyew
- CAS Key Laboratory for Agro-Ecological Processes in Subtropical Region, National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Hunan Provincial Key Laboratory of Animal Nutritional Physiology and Metabolic Process, Institute of Subtropical Agriculture, The Chinese Academy of Sciences, Changsha 410125, China; (Z.W.); (K.G.); (S.T.); (Z.T.)
- University of Chinese Academy of Sciences, Beijing 101408, China
| | - Shaoxun Tang
- CAS Key Laboratory for Agro-Ecological Processes in Subtropical Region, National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Hunan Provincial Key Laboratory of Animal Nutritional Physiology and Metabolic Process, Institute of Subtropical Agriculture, The Chinese Academy of Sciences, Changsha 410125, China; (Z.W.); (K.G.); (S.T.); (Z.T.)
| | - Xuefeng Han
- CAS Key Laboratory for Agro-Ecological Processes in Subtropical Region, National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Hunan Provincial Key Laboratory of Animal Nutritional Physiology and Metabolic Process, Institute of Subtropical Agriculture, The Chinese Academy of Sciences, Changsha 410125, China; (Z.W.); (K.G.); (S.T.); (Z.T.)
- University of Chinese Academy of Sciences, Beijing 101408, China
| | - Zhixiong He
- CAS Key Laboratory for Agro-Ecological Processes in Subtropical Region, National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Hunan Provincial Key Laboratory of Animal Nutritional Physiology and Metabolic Process, Institute of Subtropical Agriculture, The Chinese Academy of Sciences, Changsha 410125, China; (Z.W.); (K.G.); (S.T.); (Z.T.)
- University of Chinese Academy of Sciences, Beijing 101408, China
| | - Zhiliang Tan
- CAS Key Laboratory for Agro-Ecological Processes in Subtropical Region, National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Hunan Provincial Key Laboratory of Animal Nutritional Physiology and Metabolic Process, Institute of Subtropical Agriculture, The Chinese Academy of Sciences, Changsha 410125, China; (Z.W.); (K.G.); (S.T.); (Z.T.)
- University of Chinese Academy of Sciences, Beijing 101408, China
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Merrill AK, Sobolewski M, Susiarjo M. Exposure to endocrine disrupting chemicals impacts immunological and metabolic status of women during pregnancy. Mol Cell Endocrinol 2023; 577:112031. [PMID: 37506868 PMCID: PMC10592265 DOI: 10.1016/j.mce.2023.112031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/12/2023] [Accepted: 07/24/2023] [Indexed: 07/30/2023]
Affiliation(s)
- Alyssa K Merrill
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, NY, USA
| | - Marissa Sobolewski
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, NY, USA
| | - Martha Susiarjo
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, NY, USA.
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5
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van Uden L, Tchirikov M. A Study of the Literature on Intrauterine Treatment Options for Chronic Placental Insufficiency with Intrauterine Growth Restriction Using Intrauterine Intravascular Amino Acid Supplementation. Life (Basel) 2023; 13:1232. [PMID: 37374014 DOI: 10.3390/life13061232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Intrauterine growth retardation (IUGR) is a very serious prenatal condition with 3-5% incidence of all pregnancies. It results from numerous factors, including chronic placental insufficiency. IUGR is associated with an increased risk of mortality and morbidity and is considered a major cause of fetal mortality. Currently, treatment options are significantly limited and often result in preterm delivery. Postpartum, IUGR infants also have higher risks of disease and neurological abnormalities. METHODS The PubMed database was searched using the keywords "IUGR", "fetal growth restriction", "treatment", "management" and "placental insufficiency" for the period between 1975 and 2023. These terms were also combined together. RESULTS There were 4160 papers, reviews and articles dealing with the topic of IUGR. In total, only 15 papers directly dealt with a prepartum therapy of IUGR; 10 of these were based on an animal model. Overall, the main focus was on maternal intravenous therapy with amino acids or intraamniotic infusion. Treatment methods have been tested since the 1970s to supplement the fetuses with nutrients lacking due to chronic placental insufficiency in various ways. In some studies, pregnant women were implanted with a subcutaneous intravascular perinatal port system, thus infusing the fetuses with a continuous amino acid solution. Prolongation of pregnancy was achieved, as well as improvement in fetal growth. However, insufficient benefit was observed in infusion with commercial amino acid solution in fetuses below 28 weeks' gestation. The authors attribute this primarily to the enormous variation in amino acid concentrations of the commercially available solutions compared with those observed in the plasma of preterm infants. These different concentrations are particularly important because differences in the fetal brain caused by metabolic changes have been demonstrated in the rabbit model. Several brain metabolites and amino acids were significantly decreased in IUGR brain tissue samples, resulting in abnormal neurodevelopment with decreased brain volume. DISCUSSION There are currently only a few studies and case reports with correspondingly low case numbers. Most of the studies refer to prenatal treatment by supplementation of amino acids and nutrients to prolong pregnancy and support fetal growth. However, there is no infusion solution that matches the amino acid concentrations found in fetal plasma. The commercially available solutions have mismatched amino acid concentrations and have not shown sufficient benefit in fetuses below 28 weeks' gestation. More treatment avenues need to be explored and existing ones improved to better treat multifactorial IUGR fetuses.
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Affiliation(s)
- Lisa van Uden
- University Clinic of Obstetrics and Prenatal Medicine, Center of Fetal Surgery, University Medical Center Halle (Saale), Martin Luther University Halle-Wittenberg, Ernst-Grube Strasse 40, 06120 Halle (Saale), Germany
| | - Michael Tchirikov
- University Clinic of Obstetrics and Prenatal Medicine, Center of Fetal Surgery, University Medical Center Halle (Saale), Martin Luther University Halle-Wittenberg, Ernst-Grube Strasse 40, 06120 Halle (Saale), Germany
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6
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Enthoven LF, Shi Y, Fay EE, Moreni S, Mao J, Honeyman EM, Smith CK, Whittington D, Brockerhoff SE, Isoherranen N, Totah RA, Hebert MF. The Effects of Pregnancy on Amino Acid Levels and Nitrogen Disposition. Metabolites 2023; 13:242. [PMID: 36837861 PMCID: PMC9961409 DOI: 10.3390/metabo13020242] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/31/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023] Open
Abstract
Limited data are available on the effects of pregnancy on the maternal metabolome. Therefore, the objective of this study was to use metabolomics analysis to determine pathways impacted by pregnancy followed by targeted confirmatory analysis to provide more powerful conclusions about metabolic alterations during pregnancy. Forty-seven pregnant women, 18-50 years of age were included in this study, with each subject serving as their own control. Plasma samples were collected between 25 and 28 weeks gestation and again ≥3 months postpartum for metabolomics analysis utilizing an HILIC/UHPLC/MS/MS assay with confirmatory targeted specific concentration analysis for 10 of the significantly altered amino acids utilizing an LC/MS assay. Principle component analysis (PCA) on metabolomics data clearly separated pregnant and postpartum groups and identified outliers in a preliminary assessment. Of the 980 metabolites recorded, 706 were determined to be significantly different between pregnancy and postpartum. Pathway analysis revealed three significantly impacted pathways, arginine biosynthesis (p = 2 × 10-5 and FDR = 1 × 10-3), valine, leucine, and isoleucine metabolism (p = 2 × 10-5 and FDR = 2 × 10-3), and xanthine metabolism (p = 4 × 10-5 and FDR = 4 × 10-3). Of these we focused analysis on arginine biosynthesis and branched-chain amino acid (BCAA) metabolism due to their clinical importance and interconnected roles in amino acid metabolism. In the confirmational analysis, 7 of 10 metabolites were confirmed as significant and all 10 confirmed the direction of change of concentrations observed in the metabolomics analysis. The data support an alteration in urea nitrogen disposition and amino acid metabolism during pregnancy. These changes could also impact endogenous nitric oxide production and contribute to diseases of pregnancy. This study provides evidence for changes in both the ammonia-urea nitrogen and the BCAA metabolism taking place during pregnancy.
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Affiliation(s)
- Luke F. Enthoven
- Department of Pharmacy, University of Washington, Seattle, WA 98195, USA
| | - Yuanyuan Shi
- Department of Medicinal Chemistry, University of Washington, Seattle, WA 98195, USA
| | - Emily E. Fay
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA 98195, USA
| | - Sue Moreni
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA 98195, USA
| | - Jennie Mao
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA 98195, USA
| | - Emma M. Honeyman
- Department of Pharmacy, University of Washington, Seattle, WA 98195, USA
| | - Chase K. Smith
- Department of Pharmacy, University of Washington, Seattle, WA 98195, USA
| | - Dale Whittington
- Department of Medicinal Chemistry, University of Washington, Seattle, WA 98195, USA
| | | | - Nina Isoherranen
- Department of Pharmaceutics, University of Washington, Seattle, WA 98195, USA
| | - Rheem A. Totah
- Department of Medicinal Chemistry, University of Washington, Seattle, WA 98195, USA
| | - Mary F. Hebert
- Department of Pharmacy, University of Washington, Seattle, WA 98195, USA
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA 98195, USA
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van Zundert SKM, Broekhuizen M, Smit AJP, van Rossem L, Mirzaian M, Willemsen SP, Danser AHJ, De Rijke YB, Reiss IKM, Merkus D, Steegers-Theunissen RPM. The Role of the Kynurenine Pathway in the (Patho) physiology of Maternal Pregnancy and Fetal Outcomes: A Systematic Review. Int J Tryptophan Res 2022; 15:11786469221135545. [PMID: 36467775 PMCID: PMC9716456 DOI: 10.1177/11786469221135545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 10/10/2022] [Indexed: 08/04/2023] Open
Abstract
INTRODUCTION Tryptophan is the precursor of kynurenine pathway (KP) metabolites which regulate immune tolerance, energy metabolism, and vascular tone. Since these processes are important during pregnancy, changes in KP metabolite concentrations may play a role in the pathophysiology of pregnancy complications. We hypothesize that KP metabolites can serve as novel biomarkers and preventive therapeutic targets. This review aimed to provide more insight into associations between KP metabolite concentrations in maternal and fetal blood, and in the placenta, and adverse maternal pregnancy and fetal outcomes. METHODS A systematic search was performed on 18 February 2022 comprising all KP metabolites, and keywords related to maternal pregnancy and fetal outcomes. English-written human studies measuring KP metabolite(s) in maternal or fetal blood or in the placenta in relation to pregnancy complications, were included. Methodological quality was assessed using the ErasmusAGE quality score (QS) (range: 0-10). A meta-analysis of the mean maternal tryptophan and kynurenine concentrations in uncomplicated pregnancies was conducted. RESULTS Of the 6262 unique records, 37 were included (median QS = 5). Tryptophan was investigated in most studies, followed by kynurenine, predominantly in maternal blood (n = 28/37), and in the second and third trimester of pregnancy (n = 29/37). Compared to uncomplicated pregnancies, decreased tryptophan in maternal blood was associated with an increased prevalence of depression, gestational diabetes mellitus, fetal growth restriction, spontaneous abortion, and preterm birth. Elevated tryptophan was only observed in women with pregnancy-induced hypertension compared to normotensive pregnant women. In women with preeclampsia, only kynurenic acid was altered; elevated in the first trimester of pregnancy, and positively associated with proteinuria in the third trimester of pregnancy. CONCLUSIONS KP metabolite concentrations were altered in a variety of maternal pregnancy and fetal complications. This review implies that physiological pregnancy requires a tight balance of KP metabolites, and that disturbances in either direction are associated with adverse maternal pregnancy and fetal outcomes.
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Affiliation(s)
- Sofie KM van Zundert
- Department of Obstetrics and
Gynecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Clinical Chemistry,
Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Michelle Broekhuizen
- Division of Neonatology, Department of
Pediatrics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Division of Pharmacology and Vascular
Medicine, Department of Internal Medicine, Erasmus MC University Medical Center,
Rotterdam, The Netherlands
- Division of Experimental Cardiology,
Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The
Netherlands
| | - Ashley JP Smit
- Department of Obstetrics and
Gynecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Lenie van Rossem
- Department of Obstetrics and
Gynecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Mina Mirzaian
- Department of Clinical Chemistry,
Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Sten P Willemsen
- Department of Obstetrics and
Gynecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Biostatistics, Erasmus MC
University Medical Center, Rotterdam, The Netherlands
| | - AH Jan Danser
- Division of Pharmacology and Vascular
Medicine, Department of Internal Medicine, Erasmus MC University Medical Center,
Rotterdam, The Netherlands
| | - Yolanda B De Rijke
- Department of Clinical Chemistry,
Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Irwin KM Reiss
- Division of Neonatology, Department of
Pediatrics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Daphne Merkus
- Division of Experimental Cardiology,
Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The
Netherlands
- Walter Brendel Center of Experimental
Medicine, University Clinic Munich, Ludwig Maximillian University Munich, Munich,
Germany
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Zaitsu K, Asano T, Kawakami D, Chang J, Hisatsune K, Taniguchi M, Iguchi A. Metabolomics and Data-Driven Bioinformatics Revealed Key Maternal Metabolites Related to Fetal Lethality via Di(2-ethylhexyl)phthalate Exposure in Pregnant Mice. ACS OMEGA 2022; 7:23717-23726. [PMID: 35847272 PMCID: PMC9280929 DOI: 10.1021/acsomega.2c02338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We performed serum metabolome analysis of di(2-ethylhexyl)phthalate (DEHP)-exposed and control pregnant mice. Pregnant mice (n = 5) were fed a DEHP-containing diet (0.1% or 0.2% DEHP) or a normal diet (control) from gestational days 0-18. After maternal exposure to 0.2% DEHP there were no surviving fetuses, indicating its strong fetal lethality. There were no significant differences in the numbers of fetuses and placentas between the 0.1% DEHP and control groups, although fetal viability differed significantly between them, suggesting that maternal exposure to 0.1% DEHP could inhibit fetal growth. Metabolomics successfully detected 169 metabolites in serum. Principal component analysis (PCA) demonstrated that the three groups were clearly separated on PCA score plots. The biological interpretation of PC1 was fetal lethality, whereas PC2 meant metabolic alteration of pregnant mice via DEHP exposure without fetal lethality. In particular, the first component was significantly correlated with fetal viability, demonstrating that maternal metabolome changes via DEHP exposure were strongly related to fetal lethality. Levels of some amino acids were significantly increased in the DEHP-exposed groups, whereas those of some fatty acids, nicotinic acid, and 1,5-anhydroglucitol were significantly decreased in the DEHP groups. DEHP-induced increases in glycine levels could cause fetal neurological disorders, and decreases in nicotinic acid could inhibit fetal growth. In addition, a machine-learning Random forest could determine 16 potential biomarkers of DEHP exposure, and data-driven network analysis revealed that nicotinic acid was the most influential hub metabolite in the metabolic network. These findings will be useful for understanding the effects of DEHP on the maternal metabolome in pregnancy and their relationship to fetal lethality.
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Affiliation(s)
- Kei Zaitsu
- Multimodal
Informatics and Wide-data Analytics Laboratory, Department of Computational
Systems Biology, Faculty of Biology-Oriented Science and Technology, Kindai University, 930 Nishi Mitani, Kinokawa, Wakayama 649-6493, Japan
- In
Vivo Real-time Omics Laboratory, Institute for Advanced Research, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
| | - Tomomi Asano
- Department
of Human Life and Environment, Kinjo Gakuin
University, 2-1723 Omori, Moriyama-ku, Nagoya 463-8521, Japan
| | - Daisuke Kawakami
- Shimadzu
Corporation, 1, Nishinokyo-Kuwabaracho
Nakagyo-ku, Kyoto, 604-8511, Japan
| | - Jiarui Chang
- In
Vivo Real-time Omics Laboratory, Institute for Advanced Research, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
| | - Kazuaki Hisatsune
- Forensic
Science Laboratory, Aichi Prefectural Police
Headquarters, 2-1-1,
Sannomaru, Naka-ku, Nagoya 460-8502, Japan
| | - Masaru Taniguchi
- Nagoya City
Public Health Research Institute, Shimoshidami, Moriyama-ku, Nagoya 463-8585, Japan
| | - Akira Iguchi
- Marine Geo-Environment
Research Group, Institute of Geology and Geoinformation, National Institute of Advanced Industrial Science
and Technology (AIST), AIST Tsukuba Central 7, 1-1-1 Higashi, Tsukuba, Ibaraki 305-8567 Japan
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Feigenbaum A, Lamale-Smith L, Weinstein L. Considerations for prenatal and postpartum management of a female patient with ornithine transcarbamylase deficiency. Mol Genet Metab Rep 2022; 33:100894. [PMID: 36620386 PMCID: PMC9817480 DOI: 10.1016/j.ymgmr.2022.100894] [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: 05/13/2022] [Revised: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 01/11/2023] Open
Abstract
We report on pregnancy management and outcomes in a 27-year-old female patient with ornithine transcarbamylase (OTC) deficiency, the most common inherited enzyme deficiency in the urea cycle. Our patient was diagnosed during childhood after hyperammonemia associated with surgery and steroid treatment and was well-controlled with nitrogen scavenger treatment, low-protein diet, and L-citrulline supplementation. OTC gene sequencing identified a variant of unknown significance that has more recently been classified as likely pathogenic. Women with OTC deficiency are at increased risk of hyperammonemia during pregnancy and the postpartum period, therefore monthly follow up and laboratory assessments are critical in management decision making. Our patient was maintained on glycerol phenylbutyrate, L-citrulline and essential amino acid supplements, along with restricted protein intake during pregnancy. A multidisciplinary approach with the obstetrics, prenatal genetics, high risk obstetric, and anesthesia teams was also necessary for optimal management during pregnancy, throughout labor and delivery, and during the postpartum period. After successful childbirth and discharge, our patient experienced a hyperammonemic crisis related to poor enteral nutrition, and acute management protocols were implemented to stabilize her. For her newborn son, acute hyperammonemia protocols were on standby, and newborn screening and laboratory testing were expedited to assess his risk. He was healthy and did not experience symptoms of concern. In this case report, we emphasize the importance of close collaboration with maternal-fetal medicine team members during and immediately after pregnancy to ensure successful management of a female patient with OTC deficiency and her newborn.
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Key Words
- BCAA, branched-chain amino acids
- BID, twice daily
- D10, 10% dextrose
- EAA, essential amino acids
- GPB, glycerol phenylbutyrate
- IV, intravenous
- NICU, neonatal intensive care unit
- OTC, ornithine transcarbamylase
- Ornithine transcarbamylase deficiency
- PICC, peripherally inserted central catheter
- PO, per os/orally
- Peripartum management
- Pregnancy
- TID, three times daily
- UCD, urea cycle disorder
- Urea cycle disorder
- X-linked, hyperammonemia
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Affiliation(s)
- Annette Feigenbaum
- Department of Pediatrics and Biochemical Genetics, Rady Children's Hospital-San Diego, University of California San Diego, 3020 Children's Way #5031, San Diego, CA 92123, USA
- Corresponding author at: 3020 Children's Way #5031, San Diego, CA 92123, USA.
| | - Leah Lamale-Smith
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, 9300 Campus Point Drive, #7433, San Diego, CA 92037, USA
| | - Lawrence Weinstein
- Department of Anesthesiology, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
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Comparison of Diagnostic Values of Maternal Arginine Concentration for Different Pregnancy Complications: A Systematic Review and Meta-Analysis. Biomedicines 2022; 10:biomedicines10010166. [PMID: 35052844 PMCID: PMC8773782 DOI: 10.3390/biomedicines10010166] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/08/2022] [Accepted: 01/10/2022] [Indexed: 02/04/2023] Open
Abstract
Abnormal arginine metabolism contributes to the development of intrauterine growth restriction (IUGR), preeclampsia (PE), and gestational diabetes mellitus (GDM), which increase the health burden of mothers and induce adverse birth outcomes. However, associations between maternal arginine concentration and different pregnancy complications have not been systematically compared. The PubMed, ScienceDirect, and Web of Science databases were searched for peer-reviewed publications to evaluate the diagnostic value of plasma arginine concentration in complicated pregnancies. Standardized mean difference (SMD) of the arginine concentration was pooled by a random effects model. The results show that increased maternal arginine concentrations were observed in IUGR (SMD: 0.48; 95% CI: 0.20, 0.76; I2 = 47.0%) and GDM (SMD: 0.46; 95% CI: 0.11, 0.81; I2 = 82.3%) cases but not in PE patients (SMD: 0.21; 95% CI: −0.04, 0.47; I2 = 80.3%) compared with the normal cohorts. Subgroup analyses indicated that the non-fasting circulating arginine concentration in third trimester was increased significantly in GDM and severe IUGR pregnancies, but the change mode was dependent on ethnicity. Additionally, only severe PE persons were accompanied by higher plasma arginine concentrations. These findings suggest that maternal arginine concentration is an important reference for assessing the development of pregnancy complications.
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Longitudinal Plasma Metabolomics Profile in Pregnancy-A Study in an Ethnically Diverse U.S. Pregnancy Cohort. Nutrients 2021; 13:nu13093080. [PMID: 34578958 PMCID: PMC8471130 DOI: 10.3390/nu13093080] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/30/2021] [Accepted: 08/30/2021] [Indexed: 12/30/2022] Open
Abstract
Amino acids, fatty acids, and acylcarnitine metabolites play a pivotal role in maternal and fetal health, but profiles of these metabolites over pregnancy are not completely established. We described longitudinal trajectories of targeted amino acids, fatty acids, and acylcarnitines in pregnancy. We quantified 102 metabolites and combinations (37 fatty acids, 37 amino acids, and 28 acylcarnitines) in plasma samples from pregnant women in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies—Singletons cohort (n = 214 women at 10–14 and 15–26 weeks, 107 at 26–31 weeks, and 103 at 33–39 weeks). We used linear mixed models to estimate metabolite trajectories and examined variation by body mass index (BMI), race/ethnicity, and fetal sex. After excluding largely undetected metabolites, we analyzed 77 metabolites and combinations. Levels of 13 of 15 acylcarnitines, 7 of 25 amino acids, and 18 of 37 fatty acids significantly declined over gestation, while 8 of 25 amino acids and 10 of 37 fatty acids significantly increased. Several trajectories appeared to differ by BMI, race/ethnicity, and fetal sex although no tests for interactions remained significant after multiple testing correction. Future studies merit longitudinal measurements to capture metabolite changes in pregnancy, and larger samples to examine modifying effects of maternal and fetal characteristics.
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12
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Ramirez-Hincapie S, Giri V, Keller J, Kamp H, Haake V, Richling E, van Ravenzwaay B. Influence of pregnancy and non-fasting conditions on the plasma metabolome in a rat prenatal toxicity study. Arch Toxicol 2021; 95:2941-2959. [PMID: 34327559 DOI: 10.1007/s00204-021-03105-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/17/2021] [Indexed: 11/25/2022]
Abstract
The current parameters for determining maternal toxicity (e.g. clinical signs, food consumption, body weight development) lack specificity and may underestimate the extent of effects of test compounds on the dams. Previous reports have highlighted the use of plasma metabolomics for an improved and mechanism-based identification of maternal toxicity. To establish metabolite profiles of healthy pregnancies and evaluate the influence of food consumption as a confounding factor, metabolite profiling of rat plasma was performed by gas- and liquid-chromatography-tandem mass spectrometry techniques. Metabolite changes in response to pregnancy, food consumption prior to blood sampling (non-fasting) as well as the interaction of both conditions were studied. In dams, both conditions, non-fasting and pregnancy, had a marked influence on the plasma metabolome and resulted in distinct individual patterns of changed metabolites. Non-fasting was characterized by increased plasma concentrations of amino acids and diet related compounds and lower levels of ketone bodies. The metabolic profile of pregnant rats was characterized by lower amino acids and glucose levels and higher concentrations of plasma fatty acids, triglycerides and hormones, capturing the normal biochemical changes undergone during pregnancy. The establishment of metabolic profiles of pregnant non-fasted rats serves as a baseline to create metabolic fingerprints for prenatal and maternal toxicity studies.
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Affiliation(s)
- S Ramirez-Hincapie
- Experimental Toxicology and Ecology, BASF SE, 67056, Ludwigshafen, Germany
| | - V Giri
- Experimental Toxicology and Ecology, BASF SE, 67056, Ludwigshafen, Germany
| | - J Keller
- Experimental Toxicology and Ecology, BASF SE, 67056, Ludwigshafen, Germany
| | - H Kamp
- Experimental Toxicology and Ecology, BASF SE, 67056, Ludwigshafen, Germany
| | - V Haake
- BASF Metabolome Solution GmbH, Berlin, Germany
| | - E Richling
- Food Chemistry and Toxicology, Department of Chemistry, University of Kaiserslautern, Kaiserslautern, Germany
| | - B van Ravenzwaay
- Experimental Toxicology and Ecology, BASF SE, 67056, Ludwigshafen, Germany.
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13
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Graf A, Trofimova L, Ksenofontov A, Baratova L, Bunik V. Hypoxic Adaptation of Mitochondrial Metabolism in Rat Cerebellum Decreases in Pregnancy. Cells 2020; 9:E139. [PMID: 31936131 PMCID: PMC7016955 DOI: 10.3390/cells9010139] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/29/2019] [Accepted: 01/02/2020] [Indexed: 02/07/2023] Open
Abstract
Function of brain amino acids as neurotransmitters or their precursors implies changes in the amino acid levels and/or metabolism in response to physiological and environmental challenges. Modelling such challenges by pregnancy and/or hypoxia, we characterize the amino acid pool in the rat cerebellum, quantifying the levels and correlations of 15 amino acids and activity of 2-oxoglutarate dehydrogenase complex (OGDHC). The parameters are systemic indicators of metabolism because OGDHC limits the flux through mitochondrial TCA cycle, where amino acids are degraded and their precursors synthesized. Compared to non-pregnant state, pregnancy increases the cerebellar content of glutamate and tryptophan, decreasing interdependence between the quantified components of amino acid metabolism. In response to hypoxia, the dependence of cerebellar amino acid pool on OGDHC and the average levels of arginine, glutamate, lysine, methionine, serine, phenylalanine, and tryptophan increase in non-pregnant rats only. This is accompanied by a higher hypoxic resistance of the non-pregnant vs. pregnant rats, pointing to adaptive significance of the hypoxia-induced changes in the cerebellar amino acid metabolism. These adaptive mechanisms are not effective in the pregnancy-changed metabolic network. Thus, the cerebellar amino acid levels and OGDHC activity provide sensitive markers of the physiology-dependent organization of metabolic network and its stress adaptations.
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Affiliation(s)
- Anastasia Graf
- Faculty of Biology, Lomonosov Moscow State University, 119234 Moscow, Russia; (A.G.); (L.T.)
- Faculty of Nano-, Bio-, Informational and Cognitive and Socio-humanistic Sciences and Technologies at Moscow Institute of Physics and Technology, 123098 Moscow, Russia
| | - Lidia Trofimova
- Faculty of Biology, Lomonosov Moscow State University, 119234 Moscow, Russia; (A.G.); (L.T.)
| | - Alexander Ksenofontov
- A.N. Belozersky Institute of Physicochemical Biology, Lomonosov Moscow State University, 119992 Moscow, Russia; (A.K.); (L.B.)
| | - Lyudmila Baratova
- A.N. Belozersky Institute of Physicochemical Biology, Lomonosov Moscow State University, 119992 Moscow, Russia; (A.K.); (L.B.)
| | - Victoria Bunik
- A.N. Belozersky Institute of Physicochemical Biology, Lomonosov Moscow State University, 119992 Moscow, Russia; (A.K.); (L.B.)
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, 119234 Moscow, Russia
- Вiochemistry Department, Sechenov University, 119048 Moscow, Russia
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14
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Gilley SP, Weaver NE, Sticca EL, Jambal P, Palacios A, Kerns ME, Anand P, Kemp JF, Westcott JE, Figueroa L, Garcés AL, Ali SA, Pasha O, Saleem S, Hambidge KM, Hendricks AE, Krebs NF, Borengasser SJ. Longitudinal Changes of One-Carbon Metabolites and Amino Acid Concentrations during Pregnancy in the Women First Maternal Nutrition Trial. Curr Dev Nutr 2020; 4:nzz132. [PMID: 32175519 PMCID: PMC7064164 DOI: 10.1093/cdn/nzz132] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 10/09/2019] [Accepted: 11/15/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Maternal dietary restriction and supplementation of one-carbon (1C) metabolites can impact offspring growth and DNA methylation. However, longitudinal research of 1C metabolite and amino acid (AA) concentrations over the reproductive cycle of human pregnancy is limited. OBJECTIVE To investigate longitudinal 1C metabolite and AA concentrations prior to and during pregnancy and the effects of a small-quantity lipid-based nutrition supplement (LNS) containing >20 micronutrients and prepregnancy BMI (ppBMI). METHODS This study was an ancillary study of the Women First Trial (NCT01883193, clinicaltrials.gov) focused on a subset of Guatemalan women (n = 134), 49% of whom entered pregnancy with a BMI ≥25 kg/m2. Ninety-five women received LNS during pregnancy (+LNS group), while the remainder did not (-LNS group). A subset of women from the Pakistan study site (n = 179) were used as a replication cohort, 124 of whom received LNS. Maternal blood was longitudinally collected on dried blood spot (DBS) cards at preconception, and at 12 and 34 wk gestation. A targeted metabolomics assay was performed on DBS samples at each time point using LC-MS/MS. Longitudinal analyses were performed using linear mixed modeling to investigate the influence of time, LNS, and ppBMI. RESULTS Concentrations of 23 of 27 metabolites, including betaine, choline, and serine, changed from preconception across gestation after application of a Bonferroni multiple testing correction (P < 0.00185). Sixteen of those metabolites showed similar changes in the replication cohort. Asymmetric and symmetric dimethylarginine were decreased by LNS in the participants from Guatemala. Only tyrosine was statistically associated with ppBMI at both study sites. CONCLUSIONS Time influenced most 1C metabolite and AA concentrations with a high degree of similarity between the 2 diverse study populations. These patterns were not significantly altered by LNS consumption or ppBMI. Future investigations will focus on 1C metabolite changes associated with infant outcomes, including DNA methylation. This trial was registered at clinicaltrials.gov as NCT01883193.
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Affiliation(s)
- Stephanie P Gilley
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nicholas E Weaver
- Mathematical and Statistical Sciences, University of Colorado Denver, Denver, CO, USA
| | - Evan L Sticca
- Human Medical Genetics and Genomics Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Purevsuren Jambal
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alexandra Palacios
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mattie E Kerns
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Pratibha Anand
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jennifer F Kemp
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jamie E Westcott
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lester Figueroa
- Institute of Nutrition in Central America and Panama, Guatemala City, Guatemala
| | - Ana Lucía Garcés
- Institute of Nutrition in Central America and Panama, Guatemala City, Guatemala
| | - Sumera A Ali
- Aga Khan University, Department of Community Health Sciences, Karachi, Pakistan
| | - Omrana Pasha
- Aga Khan University, Department of Community Health Sciences, Karachi, Pakistan
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sarah Saleem
- Aga Khan University, Department of Community Health Sciences, Karachi, Pakistan
| | - K Michael Hambidge
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Audrey E Hendricks
- Mathematical and Statistical Sciences, University of Colorado Denver, Denver, CO, USA
- Human Medical Genetics and Genomics Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nancy F Krebs
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sarah J Borengasser
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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15
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Leite DFB, Morillon AC, Melo Júnior EF, Souza RT, McCarthy FP, Khashan A, Baker P, Kenny LC, Cecatti JG. Examining the predictive accuracy of metabolomics for small-for-gestational-age babies: a systematic review. BMJ Open 2019; 9:e031238. [PMID: 31401613 PMCID: PMC6701563 DOI: 10.1136/bmjopen-2019-031238] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/13/2019] [Accepted: 07/17/2019] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION To date, there is no robust enough test to predict small-for-gestational-age (SGA) infants, who are at increased lifelong risk of morbidity and mortality. OBJECTIVE To determine the accuracy of metabolomics in predicting SGA babies and elucidate which metabolites are predictive of this condition. DATA SOURCES Two independent researchers explored 11 electronic databases and grey literature in February 2018 and November 2018, covering publications from 1998 to 2018. Both researchers performed data extraction and quality assessment independently. A third researcher resolved discrepancies. STUDY ELIGIBILITY CRITERIA Cohort or nested case-control studies were included which investigated pregnant women and performed metabolomics analysis to evaluate SGA infants. The primary outcome was birth weight <10th centile-as a surrogate for fetal growth restriction-by population-based or customised charts. STUDY APPRAISAL AND SYNTHESIS METHODS Two independent researchers extracted data on study design, obstetric variables and sampling, metabolomics technique, chemical class of metabolites, and prediction accuracy measures. Authors were contacted to provide additional data when necessary. RESULTS A total of 9181 references were retrieved. Of these, 273 were duplicate, 8760 were removed by title or abstract, and 133 were excluded by full-text content. Thus, 15 studies were included. Only two studies used the fifth centile as a cut-off, and most reports sampled second-trimester pregnant women. Liquid chromatography coupled to mass spectrometry was the most common metabolomics approach. Untargeted studies in the second trimester provided the largest number of predictive metabolites, using maternal blood or hair. Fatty acids, phosphosphingolipids and amino acids were the most prevalent predictive chemical subclasses. CONCLUSIONS AND IMPLICATIONS Significant heterogeneity of participant characteristics and methods employed among studies precluded a meta-analysis. Compounds related to lipid metabolism should be validated up to the second trimester in different settings. PROSPERO REGISTRATION NUMBER CRD42018089985.
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Affiliation(s)
- Debora Farias Batista Leite
- Department of Tocogynecology, Campinas' State University, Campinas, Brazil
- Department of Maternal and Child Health, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Aude-Claire Morillon
- Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork National University of Ireland, Cork, Ireland
| | | | - Renato T Souza
- Obstetrics and Gynecology, Universidade Estadual de Campinas, Campinas, Brazil
| | - Fergus P McCarthy
- Department of Gynaecology and Obstetrics, St Thomas Hospital, Cork, UK
| | - Ali Khashan
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Philip Baker
- College of Medicine, University of Leicester, Leicester, UK
| | - Louise C Kenny
- Department of Women's and Children's Health, University of Liverpool School of Life Sciences, Liverpool, UK
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16
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Lefrère B, Ulmann G, Chartier M, Patkaï J, Cynober L, Neveux N. Malnutrition with hypoaminoacidemia in a 22-year-old pregnant patient masking a likely ornithine transcarbamylase deficiency. Clin Nutr ESPEN 2019; 30:89-93. [PMID: 30904234 DOI: 10.1016/j.clnesp.2019.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/03/2019] [Accepted: 02/01/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Symptoms and clinical presentations of OTC deficiency vary widely according to the remaining activity of the enzyme. Three factors determine the residual enzyme activity. First, as the OTC gene is carried on the X chromosome, a complete inactivation of this enzyme in a newborn boy results an acute ammonia intoxication. Second, the female mosaicism due to lyonization (differential randomized X-inactivation) leads to differential OTC expression in hepatocytes. Third, the degree of severity depends on the mutation and the level of remaining activity it leaves to the protein. Published cases of OTC deficiency during pregnancy are scant. Most often, diagnosis of the metabolic disease is made before pregnancy or during the post-partum period. METHODS We report the case of a 22-year-old woman's successful pregnancy with a moderate form of ornithine transcarbamylase (OTC) deficiency, unsuspected before pregnancy, biochemically consistent with plasma aminoacidogram and orotic acid analysis, and initially masked by malnutrition. RESULTS - CONCLUSION Although maternal ammonia was subnormal and the neonate was safe, an OTC deficiency was revealed by stress factors such as the pregnancy itself and infection, and associated with uncontrollable maternal vomiting and psychiatric syndrome. However, this metabolic disease, revealed by aminoacidogram and urine orotic acid analysis, fortunately did not prevent a successful pregnancy. Even if infrequent, this situation deserves to be highlighted.
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Affiliation(s)
- B Lefrère
- Clinical Chemistry Laboratory, Cochin Hospital, AP-HP, 27 Rue du Faubourg Saint-Jacques, Paris, France.
| | - G Ulmann
- Clinical Chemistry Laboratory, Cochin Hospital, AP-HP, 27 Rue du Faubourg Saint-Jacques, Paris, France; Laboratory of Biological Nutrition, Faculty of Pharmacy, Paris Descartes University, 4 Avenue de l'Observatoire, EA 4466, France
| | - M Chartier
- Department of Obstetrics, Cochin Hospital, AP-HP, 27 Rue du Faubourg Saint-Jacques, Paris, France
| | - J Patkaï
- Department of Neonatology, Cochin Hospital, AP-HP, 27 Rue du Faubourg Saint-Jacques, Paris, France
| | - L Cynober
- Clinical Chemistry Laboratory, Cochin Hospital, AP-HP, 27 Rue du Faubourg Saint-Jacques, Paris, France; Laboratory of Biological Nutrition, Faculty of Pharmacy, Paris Descartes University, 4 Avenue de l'Observatoire, EA 4466, France
| | - N Neveux
- Clinical Chemistry Laboratory, Cochin Hospital, AP-HP, 27 Rue du Faubourg Saint-Jacques, Paris, France; Laboratory of Biological Nutrition, Faculty of Pharmacy, Paris Descartes University, 4 Avenue de l'Observatoire, EA 4466, France
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Phenylalanine and tyrosine measurements across gestation by tandem mass spectrometer on dried blood spot cards from normal pregnant women. Genet Med 2019; 21:1821-1826. [PMID: 30626901 PMCID: PMC6620164 DOI: 10.1038/s41436-018-0407-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 12/05/2018] [Indexed: 12/22/2022] Open
Abstract
Purpose: Maternal phenylketonuria (MPKU) requires strict control of phenylalanine (Phe) and supplemental tyrosine (Tyr). Monitoring during pregnancy using dried blood spot (DBS) cards by tandem mass spectrometry (MS/MS) is now standard practice, however there are no Phe and Tyr reference ranges for DBS MS/MS method in healthy pregnant women. Methods: DBS cards (63 −1364 days in storage) from healthy women with singleton pregnancies were analyzed by MS/MS. 390 DBS cards from 170 pregnancies (5/1–39/6 weeks’ gestation), were tested. Results: Both Phe and Tyr levels declined from the first trimester (Phe: 36.2 +/− 10.6; Tyr 25.7 +/−9.7 micromol/L) to the second trimester (Phe 33.4 +/− 9.3; Tyr 21.7 +/− 6.7 micromol/L) and remained stable in the third trimester (Phe 32.3 +/− 8.7; Tyr 21.0 +/− 6.6 micromol/L). Phe and Tyr levels declined over time since collection (Phe: 0.004 micromol/L per day; Tyr 0.002 micromol/L). Nomograms by gestational age were created using raw data and data adjusted for time from sample collection. Reference ranges by trimester are provided. Conclusion: Both Phe and Tyr decline quickly during the first trimester and remain relatively constant over the second and third trimesters. These nomograms will provide a valuable resource for care of MPKU.
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18
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Mohan R, Baumann D, Alejandro EU. Fetal undernutrition, placental insufficiency, and pancreatic β-cell development programming in utero. Am J Physiol Regul Integr Comp Physiol 2018; 315:R867-R878. [PMID: 30110175 DOI: 10.1152/ajpregu.00072.2018] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The prevalence of obesity and type 2 (T2D) diabetes is a major health concern in the United States and around the world. T2D is a complex disease characterized by pancreatic β-cell failure in association with obesity and insulin resistance in peripheral tissues. Although several genes associated with T2D have been identified, it is speculated that genetic variants account for only <10% of the risk for this disease. A strong body of data from both human epidemiological and animal studies shows that fetal nutrient factors in utero confer significant susceptibility to T2D. Numerous studies done in animals have shown that suboptimal maternal environment or placental insufficiency causes intrauterine growth restriction (IUGR) in the fetus, a critical factor known to predispose offspring to obesity and T2D, in part by causing permanent consequences in total functional β-cell mass. This review will focus on the potential contribution of the placenta in fetal programming of obesity and TD and its likely impact on pancreatic β-cell development and growth.
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Affiliation(s)
- Ramkumar Mohan
- Department of Integrative Biology and Physiology, University of Minnesota , Minneapolis, Minnesota
| | - Daniel Baumann
- Department of Integrative Biology and Physiology, University of Minnesota , Minneapolis, Minnesota
| | - Emilyn Uy Alejandro
- Department of Integrative Biology and Physiology, University of Minnesota , Minneapolis, Minnesota
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19
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Delplancke TDJ, de Seymour JV, Tong C, Sulek K, Xia Y, Zhang H, Han TL, Baker PN. Analysis of sequential hair segments reflects changes in the metabolome across the trimesters of pregnancy. Sci Rep 2018; 8:36. [PMID: 29311683 PMCID: PMC5758601 DOI: 10.1038/s41598-017-18317-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 12/08/2017] [Indexed: 01/03/2023] Open
Abstract
The hair metabolome has been recognized as a valuable source of information in pregnancy research, as it provides stable metabolite information that could assist with studying biomarkers or metabolic mechanisms of pregnancy and its complications. We tested the hypothesis that hair segments could be used to reflect a metabolite profile containing information from both endogenous and exogenous compounds accumulated during the nine months of pregnancy. Segments of hair samples corresponding to the trimesters were collected from 175 pregnant women in New Zealand. The hair samples were analysed using gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry. In healthy pregnancies, 56 hair metabolites were significantly different between the first and second trimesters, while 62 metabolites were different between the first and third trimesters (p < 0.05). Additionally, three metabolites in the second trimester hair samples were significantly different between healthy controls and women who delivered small-for-gestational-age infants (p < 0.05), and ten metabolites in third trimester hair were significantly different between healthy controls and women with gestational diabetes mellitus (p < 0.01). The findings from this pilot study provide improved insight into the changes of the hair metabolome during pregnancy, as well as highlight the potential of the maternal hair metabolome to differentiate pregnancy complications from healthy pregnancies.
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Affiliation(s)
- Thibaut D J Delplancke
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- International Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
| | | | - Chao Tong
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- International Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Karolina Sulek
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej, 3b, 6.6.24, Copenhagen, Denmark
| | - Yinyin Xia
- Department of Occupational and Environmental Hygiene, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Hua Zhang
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- International Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Ting-Li Han
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
- International Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China.
- Liggins Institute, University of Auckland, Auckland, New Zealand.
| | - Philip N Baker
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- International Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
- College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, United Kingdom
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20
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Metabolic profiling of stages of healthy pregnancy in Hu sheep using nuclear magnetic resonance (NMR). Theriogenology 2017; 92:121-128. [DOI: 10.1016/j.theriogenology.2017.01.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 01/12/2017] [Accepted: 01/15/2017] [Indexed: 01/03/2023]
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21
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Tchirikov M, Zhumadilov ZS, Bapayeva G, Bergner M, Entezami M. The effect of intraumbilical fetal nutrition via a subcutaneously implanted port system on amino acid concentration by severe IUGR human fetuses. J Perinat Med 2017; 45:227-236. [PMID: 27533115 DOI: 10.1515/jpm-2016-0155] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 07/04/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine if intrauterine intraumbilical supplementation with amino acids (AA) and glucose can improve neonatal outcome of severe growth restricted human fetuses (IUGR). METHODS Prospective pilot study of intrauterine treatment of severe IUGR fetuses [n=14, 27 weeks of gestation (range 23-31)] with cerebroplacental ratio <1, with long-term intraumbilical AA and glucose supplementation (10% of feto-placental blood volume/day) using a perinatal port system alone (n=5) or combined with hyperbaric oxygenation (n=1, HBO) vs. control group (n=8). RESULTS The duration of continuous intraumbilical AA/glucose supplementation was 11 (6-13) days. Daily intravascular fetal nutrition significantly prolonged the brain sparing to delivery interval by 24 (14-33) days vs. 5.6 (2-12) days in controls. Fetal nutrition reduced blood flow resistance in the placental circulation but did not affect the Doppler profile of cerebral arteries. Higher weight gain of 113.5 (36-539) g was observed following supplementation compared to 33.3 (8-98) g in the control group (P<0.05). In spite of this, fetuses below 28 weeks of gestation did not sufficiently benefit from infused commercial AA. We found a reduced fetal plasma concentration of the essential AA histidine, threonine, lysine and arginine, and non-essential AA taurine, in severe IUGR fetuses in both groups. Long-term supplementation with a commercial AA formula led to a slight, but not significant, reduction of histidine, threonine, lysine, arginine, asparagine and glutamine. However, the concentration of tryptophan and glutamic acid slightly increased. HBO can be combined with AA supplementation via a port system. In one case, the port system was also successfully used for fetal blood transfusion. CONCLUSIONS Intravascular treatment of IUGR with fetal nutrition can prolong pregnancy with severe placental insufficiency and brain sparing for many weeks. However, rather than normalizing AA concentrations, an enhanced AA imbalance was observed in IUGR fetuses following supplementation. These deviations in AA concentrations prevent the recommendation for use of commercial AA solutions for prenatal treatment of extreme preterm IUGR fetuses.
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22
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Shen G, Li Z, Zhang Y, Wu H, Feng J. 1H NMR-based metabolomics study on the physiological variations during the rat pregnancy process. Mol Cell Endocrinol 2016; 423:40-50. [PMID: 26773731 DOI: 10.1016/j.mce.2016.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 12/22/2015] [Accepted: 01/06/2016] [Indexed: 01/03/2023]
Abstract
In this study, NMR-based metabolomics in combination with multivariate pattern recognition technologies were employed to evaluate the physiological variations in the Wistar rats' plasma that are induced by pregnancy on the gestational days (GDs) 11, 14, 17 and 20. Untargeted metabolomics analysis revealed some possible mechanism of physiological effects for healthy pregnancies and showed a metabolic trajectory during pregnancy process. The levels of 24 metabolites were found to change significantly throughout pregnancy in maternal plasma. These metabolite changes involved in varied kinds of metabolic pathways including synthesis of biological substances, microbial metabolism in diverse environments, protein digestion and absorption, carbohydrate metabolism, digestion and absorption, mineral absorption, and ATP (Adenosine Triphosphate)-binding cassette transporters (ABC transporters). The substantial cores of all the metabolic pathways are promoting fetal growth and development and regulating maternal physiological state. This work showed relevant metabolic pathways perturbation in the maternal plasma due to normal pregnancy and provided the physical basis of time-dependent metabolic trajectory against which disease-related maternal physiological responses may be better understood in future studies.
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Affiliation(s)
- Guiping Shen
- Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, Xiamen University, Xiamen 361005, China; Northwest Metabolomics Research Center, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98109, United States
| | - Zhishui Li
- Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, Xiamen University, Xiamen 361005, China
| | - Yan Zhang
- Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, Xiamen University, Xiamen 361005, China
| | - Huifeng Wu
- Key Laboratory of Coastal Zone Environment Processes, CAS, Shandong Provincial Key Laboratory of Coastal Zone Environment Processes, Yantai Institute of Coastal Zone Research, Chinese Academy of Sciences, Yantai 264003, China
| | - Jianghua Feng
- Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, Xiamen University, Xiamen 361005, China.
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23
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Lindsay KL, Hellmuth C, Uhl O, Buss C, Wadhwa PD, Koletzko B, Entringer S. Longitudinal Metabolomic Profiling of Amino Acids and Lipids across Healthy Pregnancy. PLoS One 2015; 10:e0145794. [PMID: 26716698 PMCID: PMC4699222 DOI: 10.1371/journal.pone.0145794] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 12/08/2015] [Indexed: 01/03/2023] Open
Abstract
Pregnancy is characterized by a complexity of metabolic processes that may impact fetal development and ultimately, infant health outcomes. However, our understanding of whole body maternal and fetal metabolism during this critical life stage remains incomplete. The objective of this study is to utilize metabolomics to profile longitudinal patterns of fasting maternal metabolites among a cohort of non-diabetic, healthy pregnant women in order to advance our understanding of changes in protein and lipid concentrations across gestation, the biochemical pathways by which they are metabolized and to describe variation in maternal metabolites between ethnic groups. Among 160 pregnant women, amino acids, tricarboxylic acid (TCA) cycle intermediates, keto-bodies and non-esterified fatty acids were detected by liquid chromatography coupled with mass spectrometry, while polar lipids were detected through flow-injected mass spectrometry. The maternal plasma concentration of several essential and non-essential amino acids, long-chain polyunsaturated fatty acids, free carnitine, acetylcarnitine, phosphatidylcholines and sphingomyelins significantly decreased across pregnancy. Concentrations of several TCA intermediates increase as pregnancy progresses, as well as the keto-body β-hydroxybutyrate. Ratios of specific acylcarnitines used as indicators of metabolic pathways suggest a decreased beta-oxidation rate and increased carnitine palmitoyltransferase-1 enzyme activity with advancing gestation. Decreasing amino acid concentrations likely reflects placental uptake and tissue biosynthesis. The absence of any increase in plasma non-esterified fatty acids is unexpected in the catabolic phase of later pregnancy and may reflect enhanced placental fatty acid uptake and utilization for fetal tissue growth. While it appears that energy production through the TCA cycle increases as pregnancy progresses, decreasing patterns of free carnitine and acetylcarnitine as well as increased carnitine palmitoyltransferase-1 rate and β-hydroxybutyrate levels suggest a concomitant upregulation of ketogenesis to ensure sufficient energy supply in the fasting state. Several differences in metabolomic profiles between Hispanic and non-Hispanic women demonstrate phenotypic variations in prenatal metabolism which should be considered in future studies.
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Affiliation(s)
- Karen L. Lindsay
- Development, Health and Disease Research Program, University of California Irvine, School of Medicine, Irvine, California, 92697, United States of America
| | - Christian Hellmuth
- Ludwig-Maximillian-University München, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Lindwurmstrasse 4, D-80337, Munich, Germany
- * E-mail:
| | - Olaf Uhl
- Ludwig-Maximillian-University München, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Lindwurmstrasse 4, D-80337, Munich, Germany
| | - Claudia Buss
- Development, Health and Disease Research Program, University of California Irvine, School of Medicine, Irvine, California, 92697, United States of America
- Institute of Medical Psychology, Charité University Medicine Berlin, Berlin, Germany
| | - Pathik D. Wadhwa
- Development, Health and Disease Research Program, University of California Irvine, School of Medicine, Irvine, California, 92697, United States of America
| | - Berthold Koletzko
- Ludwig-Maximillian-University München, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Lindwurmstrasse 4, D-80337, Munich, Germany
| | - Sonja Entringer
- Development, Health and Disease Research Program, University of California Irvine, School of Medicine, Irvine, California, 92697, United States of America
- Institute of Medical Psychology, Charité University Medicine Berlin, Berlin, Germany
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24
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Malkani N, Jansson T, Gupta MB. IGFBP-1 hyperphosphorylation in response to leucine deprivation is mediated by the AAR pathway. Mol Cell Endocrinol 2015; 412:182-95. [PMID: 25957086 PMCID: PMC5563670 DOI: 10.1016/j.mce.2015.04.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 04/28/2015] [Accepted: 04/30/2015] [Indexed: 02/07/2023]
Abstract
Insulin-like growth factor-1 (IGF-I) is the key regulator of fetal growth. IGF-I bioavailability is markedly diminished by IGF binding protein-1 (IGFBP-1) phosphorylation. Leucine deprivation strongly induces IGFBP-1 hyperphosphorylation, and plays an important role in fetal growth restriction (FGR). FGR is characterized by decreased amino acid availability, which activates the amino acid response (AAR) and inhibits the mechanistic target of rapamycin (mTOR) pathway. We investigated the role of AAR and mTOR in mediating IGFBP-1 secretion and phosphorylation in HepG2 cells in leucine deprivation. mTOR inhibition (rapamycin or raptor + rictor siRNA), or activation (DEPTOR siRNA) demonstrated a role of mTOR in leucine deprivation-induced IGFBP-1 secretion but not phosphorylation. When the AAR was blocked (U0126, or ERK/GCN2 siRNA), both IGFBP-1 secretion and hyperphosphorylation (pSer101/pSer119/pSer169) due to leucine deprivation were prevented. CK2 inhibition by TBB also attenuated IGFBP-1 phosphorylation in leucine deprivation. These results suggest that the AAR and mTOR independently regulate IGFBP-1 secretion and phosphorylation in response to decreased amino acid availability.
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Affiliation(s)
- Niyati Malkani
- Department of Biochemistry, University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Thomas Jansson
- Department of Obstetrics & Gynecology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Madhulika B Gupta
- Department of Biochemistry, University of Western Ontario, London, Ontario N6A 5C1, Canada; Department of Pediatrics, University of Western Ontario, London, Canada; Children's Health Research Institute, University of Western Ontario, London, ON, Canada.
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25
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Pinto J, Barros AS, Domingues MRM, Goodfellow BJ, Galhano E, Pita C, Almeida MDC, Carreira IM, Gil AM. Following Healthy Pregnancy by NMR Metabolomics of Plasma and Correlation to Urine. J Proteome Res 2015; 14:1263-74. [DOI: 10.1021/pr5011982] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Joana Pinto
- CICECO−Department
of Chemistry, Campus Universitário de Santiago, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - António S. Barros
- QOPNA
Research Unit, Department of Chemistry, Campus Universitário
de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Maria Rosário M. Domingues
- QOPNA
Research Unit, Department of Chemistry, Campus Universitário
de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Brian J. Goodfellow
- CICECO−Department
of Chemistry, Campus Universitário de Santiago, Universidade de Aveiro, 3810-193 Aveiro, Portugal
- Institute
for Research in Biomedicine−iBiMED, Health Sciences Program, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Eulália Galhano
- Maternidade
Bissaya Barreto, Centro Hospitalar e Universitário de Coimbra (CHUC), 3000 Coimbra, Portugal
| | - Cristina Pita
- Maternidade
Bissaya Barreto, Centro Hospitalar e Universitário de Coimbra (CHUC), 3000 Coimbra, Portugal
| | - Maria do Céu Almeida
- Maternidade
Bissaya Barreto, Centro Hospitalar e Universitário de Coimbra (CHUC), 3000 Coimbra, Portugal
| | - Isabel M. Carreira
- Cytogenetics
and Genomics Laboratory, Faculty of Medicine, University of Coimbra, Portugal and CIMAGO Center for Research in Environment, Genetics and Oncobiology, 3004-504 Coimbra, Portugal
| | - Ana M. Gil
- CICECO−Department
of Chemistry, Campus Universitário de Santiago, Universidade de Aveiro, 3810-193 Aveiro, Portugal
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26
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Sulek K, Han TL, Villas-Boas SG, Wishart DS, Soh SE, Kwek K, Gluckman PD, Chong YS, Kenny LC, Baker PN. Hair metabolomics: identification of fetal compromise provides proof of concept for biomarker discovery. Am J Cancer Res 2014; 4:953-9. [PMID: 25057319 PMCID: PMC4107295 DOI: 10.7150/thno.9265] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 06/12/2014] [Indexed: 12/25/2022] Open
Abstract
Analysis of the human metabolome has yielded valuable insights into health, disease and toxicity. However, the metabolic profile of complex biological fluids such as blood is highly dynamic and this has limited the discovery of robust biomarkers. Hair grows relatively slowly, and both endogenous compounds and environmental exposures are incorporated from blood into hair during growth, which reflects the average chemical composition over several months. We used hair samples to study the metabolite profiles of women with pregnancies complicated by fetal growth restriction (FGR) and healthy matched controls. We report the use of GC-MS metabolite profiling of hair samples for biomarker discovery. Unsupervised statistical analysis showed complete discrimination of FGR from controls based on hair composition alone. A predictive model combining 5 metabolites produced an area under the receiver-operating curve of 0.998. This is the first study of the metabolome of human hair and demonstrates that this biological material contains robust biomarkers, which may lead to the development of a sensitive diagnostic tool for FGR, and perhaps more importantly, to stable biomarkers for a range of other diseases.
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27
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Luan H, Meng N, Liu P, Feng Q, Lin S, Fu J, Davidson R, Chen X, Rao W, Chen F, Jiang H, Xu X, Cai Z, Wang J. Pregnancy-induced metabolic phenotype variations in maternal plasma. J Proteome Res 2014; 13:1527-36. [PMID: 24450375 DOI: 10.1021/pr401068k] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Metabolic variations occur during normal pregnancy to provide the growing fetus with a supply of nutrients required for its development and to ensure the health of the woman during gestation. Mass spectrometry-based metabolomics was employed to study the metabolic phenotype variations in the maternal plasma that are induced by pregnancy in each of its three trimesters. Nontargeted metabolomics analysis showed that pregnancy significantly altered the profile of metabolites in maternal plasma. The levels of six metabolites were found to change significantly throughout pregnancy, with related metabolic pathway variations observed in biopterin metabolism, phospholipid metabolism, amino acid derivatives, and fatty acid oxidation. In particular, there was a pronounced elevation of dihydrobiopterin (BH₂), a compound produced in the synthesis of dopa, dopamine, norepinephrine, and epinephrine, in the second trimester, whereas it was markedly decreased in the third trimester. The turnover of BH₂ and tryptophan catabolites indicated that the fluctuations of neurotransmitters throughout pregnancy might reveal the metabolic adaption in the maternal body for the growth of the fetus. Furthermore, 11 lipid classes and 41 carnitine species were also determined and this showed variations in the presence of long-chain acylcarnitines and lysophospholipids in later pregnancy, suggesting changes of acylcarnitines and lysophospholipids to meet the energy demands in pregnant women. To our knowledge, this work is the first report of dynamic metabolic signatures and proposed related metabolic pathways in the maternal plasma for normal pregnancies and provided the basis for time-dependent metabolic trajectory against which disease-related disorders may be contrasted.
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Affiliation(s)
- Hemi Luan
- BGI-Shenzhen , Building No.11, Beishan Industrial Zone, Yantian District, Shenzhen, China
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28
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Desforges M, Ditchfield A, Hirst CR, Pegorie C, Martyn-Smith K, Sibley CP, Greenwood SL. Reduced placental taurine transporter (TauT) activity in pregnancies complicated by pre-eclampsia and maternal obesity. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013; 776:81-91. [PMID: 23392873 PMCID: PMC5159744 DOI: 10.1007/978-1-4614-6093-0_9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Taurine is an important nutrient in intrauterine life, being required for fetal organ development and cellular renewal of syncytiotrophoblast (STB), the nutrient transport epithelium of the placenta. As taurine is conditionally essential in human pregnancy, the fetal and placental demand for taurine is met by uptake from maternal blood into STB through the activity of TauT. Pre-eclampsia (PE) and maternal obesity are serious complications of pregnancy, associated with fetal growth restriction (FGR) and abnormal renewal of STB, and maternal obesity is a major risk factor for PE. Here we test the hypothesis that STB TauT activity is reduced in maternal obesity and PE compared to normal pregnancy.STB TauT activity, measured in fragments of placental tissue, was negatively related to maternal BMI over the range 18-46 kg/m(2) in both the first trimester (7-12 weeks gestation) and at term (p < 0.01; linear regression). Neither TauT activity nor expression in the first trimester differed to normal pregnancy at term. STB TauT activity was significantly lower in PE than normal pregnancy (p < 0.01). Neuropeptide Y (NPY), a protein kinase C (PKC) activator which is elevated in PE and obesity, reduced STB TauT activity by 20% (50 pM-50 nM: 2 h) (p < 0.03). Activation of PKC by phorbol 12-myristate-13-acetate (1 μM) reduced TauT activity by 18% (p < 0.05). As TauT activity is inhibited by phosphorylation, we propose that NPY activates PKC in the STB which phosphorylates TauT in PE and maternal obesity.Reduced TauT activity could contribute to dysregulated renewal of STB and FGR that are common to PE and maternal obesity.
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Affiliation(s)
- Michelle Desforges
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester, M13 9WL, UK
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29
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Van den Akker CH, Van Goudoever JB. Recent advances in our understanding of protein and amino acid metabolism in the human fetus. Curr Opin Clin Nutr Metab Care 2010; 13:75-80. [PMID: 19904202 DOI: 10.1097/mco.0b013e328333aa4f] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE OF REVIEW Premature infants often suffer from suboptimal outcome, at least partially due to suboptimal nutrition. Gaining insight into human fetal amino acid metabolism might ultimately lead to an improved nutritional strategy for prematurely born infants. Our aim was, therefore, to discuss recent findings with regard to human fetal amino acid metabolism. RECENT FINDINGS Human fetal protein and amino acid metabolism can be studied in vivo using stable isotope techniques. To date, however, only a few studies employing these techniques have been performed. For one, it was shown in vivo that essential amino acids are transported at different rates across the human placenta. In addition, tyrosine appears not to be a conditionally essential amino acid in the fetus at term, as phenylalanine is hydroxylated into tyrosine at considerable rates. Furthermore, albumin is synthesized at very high rates at two-thirds of gestation; higher than prematurely born infants do at a neonatal intensive care unit. This could indicate that postnatal nutrition of very immature infants can be improved. SUMMARY Although technically challenging, more studies regarding human fetal amino acid metabolism should be performed. Premature infants could then benefit from this knowledge from new nutritional strategies.
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Affiliation(s)
- Chris Hp Van den Akker
- Erasmus MC - Sophia Children's Hospital, Division of Neonatology, Department of Pediatrics, Rotterdam, The Netherlands
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30
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de Boo HA, Harding JE. Protein metabolism in preterm infants with particular reference to intrauterine growth restriction. Arch Dis Child Fetal Neonatal Ed 2007; 92:F315-9. [PMID: 17585098 PMCID: PMC2675441 DOI: 10.1136/adc.2006.099697] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2006] [Indexed: 11/03/2022]
Abstract
There is growing evidence that neonatal and long-term morbidity in preterm infants, particularly those born before 32 weeks' gestation, can be modified by attained growth rate in the neonatal period. Guidelines for optimal growth and the nutritional intakes, particular of protein, required to achieve this are not well defined. Due to delays in postnatal feeding and a lack of energy stores developed in the last trimester of pregnancy, preterm infants often suffer early postnatal catabolism until feeding is established. There are indications that infants born with intrauterine growth restriction have perturbations in protein metabolism. Therefore, they may have different protein requirements than appropriate for gestational age infants. This review summarises what is known about protein requirements and metabolism in the fetus and preterm infant, with particular emphasis on the distinct requirements of the growth-restricted infant.
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Affiliation(s)
- H A de Boo
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand.
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31
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de Boo HA, Harding JE. Taurine as a marker for foetal wellbeing? Neonatology 2007; 91:145-54. [PMID: 17377398 DOI: 10.1159/000097445] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2005] [Accepted: 05/09/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND After placental embolisation in pregnant sheep, we found elevated plasma taurine concentrations in several foetuses. These animals also had higher morbidity and mortality than foetuses with normal taurine concentrations. We therefore re-analysed our foetal growth and metabolism data with embolised animals divided into subgroups with high taurine concentrations (EH) and low taurine concentrations (EL). OBJECTIVE To investigate the hypothesis that foetal plasma taurine concentrations may be used as a marker for foetal wellbeing. METHODS Growth, metabolic and endocrine parameters were measured in normally grown foetal sheep and in those who had EH or EL after placental embolisation. RESULTS EH animals were more compromised than the EL animals, as shown by reductions in foetal weight and hind limb length and a failure to increase growth rate (chest girth increment) after embolisation. EH foetuses were hypoxaemic, hypoglycaemic and had increased lactate concentrations. Kidney, liver and adrenal weights were increased and thymus weight was decreased in EH animals. Maternal amino acid concentrations were elevated in EL animals. Foetal amino acid concentrations were more reduced in EH animals than in EL animals. Maternal IGF-1 concentrations were increased in EL, but not EH animals. CONCLUSIONS Animals with EH were less able to compensate for the effects of embolisation than animals with EL. Taurine may have been released by the tissues as a protective mechanism against hypoxia-induced inflammation, or in an attempt to maintain osmotic balance. The connection between taurine and foetal wellbeing deserves further investigation.
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Affiliation(s)
- Hendrina A de Boo
- The Liggins Institute, University of Auckland, Auckland, New Zealand.
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