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Steane SE, Cuffe JSM, Moritz KM. The role of maternal choline, folate and one-carbon metabolism in mediating the impact of prenatal alcohol exposure on placental and fetal development. J Physiol 2023; 601:1061-1075. [PMID: 36755527 PMCID: PMC10952912 DOI: 10.1113/jp283556] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/30/2023] [Indexed: 02/10/2023] Open
Abstract
Prenatal alcohol consumption (PAE) may be associated with a broad spectrum of impacts, ranging from no overt effects, to miscarriage, fetal growth restriction and fetal alcohol spectrum disorder. A major mechanism underlying the effects of PAE is considered to be altered DNA methylation and gene expression. Maternal nutritional status may be an important factor in determining the extent to which PAE impacts pregnancy outcomes, particularly the dietary micronutrients folate and choline because they provide methyl groups for DNA methylation via one carbon metabolism. This review summarises the roles of folate and choline in development of the blastocyst, the placenta and the fetal brain, and examines the evidence that maternal intake of these micronutrients can modify the effects of PAE on development. Studies of folate or choline deficiency have found reduced blastocyst development and implantation, reduced placental invasion, vascularisation and nutrient transport capability, impaired fetal brain development, and abnormal neurodevelopmental outcomes. PAE has been shown to reduce absorption and/or metabolism of folate and choline and to produce similar outcomes to maternal choline/folate deficiency. A few studies have demonstrated that the effects of PAE on brain development can be ameliorated by folate or choline supplementation; however, there is very limited evidence on the effects of supplementation in early pregnancy on the blastocyst and placenta. Further studies are required to support these findings and to determine optimal supplementation parameters.
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Affiliation(s)
- Sarah E. Steane
- School of Biomedical SciencesThe University of QueenslandSt LuciaQLDAustralia
| | - James S. M. Cuffe
- School of Biomedical SciencesThe University of QueenslandSt LuciaQLDAustralia
| | - Karen M. Moritz
- School of Biomedical SciencesThe University of QueenslandSt LuciaQLDAustralia
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2
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van Otterdijk SD, Klett H, Boerries M, Michels KB. The impact of pre-pregnancy folic acid intake on placental DNA methylation in a fortified cohort. FASEB J 2023; 37:e22698. [PMID: 36520012 DOI: 10.1096/fj.202200476rr] [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: 03/29/2022] [Revised: 10/28/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022]
Abstract
Folate plays an important role in the modulation of one-carbon metabolism and DNA methylation through a complex biosynthesis pathway. Folate deficiency during pregnancy has been associated with an increased risk for birth defects. This study investigates the extent to which the availability of folate and S-Adenosylmethionine (SAM) affects placental DNA methylation. We hypothesized that maintaining sufficient levels of folate and SAM is particularly important in individuals carrying the MTHFR C677T polymorphism. Maternal- and cord blood was analyzed to genotype the MTHFR rs1801133 SNP. Red blood cell (RBC) folate, vitamin B12, SAM, and S-Adenosylhomocysteine (SAH) were analyzed in cord blood. Epigenome-wide methylation analyses were performed on 90 placenta tissue samples isolated from the fetal side of the placenta; 45 originating from mother-infant dyads homozygous for the MTHFR C677T variant and 45 originating from mother-infant dyads with the homozygous wild type MTHFR677 genotype. Verification of the results was performed using pyrosequencing assays. Genome-wide placental DNA methylation patterns were relatively stable and not significantly affected by levels of one-carbon metabolites. MTHFR genotype was associated with DNA methylation of several loci, including a locus in the MTHFR region. RBC folate and particularly the SAM:SAH ratio did affect overall CpG DNA methylation in some CpG regions when the loci were split according to their CpG island relation. This was most evident in participants carrying the MTHFR C677T variant suggesting a stronger influence of the biosynthesis pathway on the overall placental DNA methylation in MTHFR TT individuals than in MTHFR CC individuals.
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Affiliation(s)
- Sanne D van Otterdijk
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK), Freiburg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Hagen Klett
- Institute of Medical Bioinformatics and Systems Medicine (IBSM), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Melanie Boerries
- German Cancer Consortium (DKTK), Freiburg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Institute of Medical Bioinformatics and Systems Medicine (IBSM), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Karin B Michels
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.,Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
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3
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Irvine N, England-Mason G, Field CJ, Dewey D, Aghajafari F. Prenatal Folate and Choline Levels and Brain and Cognitive Development in Children: A Critical Narrative Review. Nutrients 2022; 14:nu14020364. [PMID: 35057545 PMCID: PMC8778665 DOI: 10.3390/nu14020364] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 01/13/2023] Open
Abstract
Women’s nutritional status during pregnancy can have long-term effects on children’s brains and cognitive development. Folate and choline are methyl-donor nutrients and are important for closure of the neural tube during fetal development. They have also been associated with brain and cognitive development in children. Animal studies have observed that prenatal folate and choline supplementation is associated with better cognitive outcomes in offspring and that these nutrients may have interactive effects on brain development. Although some human studies have reported associations between maternal folate and choline levels and child cognitive outcomes, results are not consistent, and no human studies have investigated the potential interactive effects of folate and choline. This lack of consistency could be due to differences in the methods used to assess folate and choline levels, the gestational trimester at which they were measured, and lack of consideration of potential confounding variables. This narrative review discusses and critically reviews current research examining the associations between maternal levels of folate and choline during pregnancy and brain and cognitive development in children. Directions for future research that will increase our understanding of the effects of these nutrients on children’s neurodevelopment are discussed.
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Affiliation(s)
- Nathalie Irvine
- O’Brien Centre for the Bachelor of Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada;
| | - Gillian England-Mason
- Owerko Centre, Alberta Children’s Hospital Research Institute, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada; (G.E.-M.); (D.D.)
- Department of Pediatrics, Cumming School of Medicine, Alberta Children’s Hospital, 28 Oki Drive NW, Calgary, AB T3B 6A8, Canada
| | - Catherine J. Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-126C Li Ka Shing Centre for Research, 11203-87th Ave NW, Edmonton, AB T6G 2H5, Canada;
| | - Deborah Dewey
- Owerko Centre, Alberta Children’s Hospital Research Institute, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada; (G.E.-M.); (D.D.)
- Department of Pediatrics, Cumming School of Medicine, Alberta Children’s Hospital, 28 Oki Drive NW, Calgary, AB T3B 6A8, Canada
- Hotchkiss Brain Institute, Health Research Innovation Centre, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada
| | - Fariba Aghajafari
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, G012, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
- Correspondence:
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4
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Affiliation(s)
- Vishal D Naik
- Department of Obstetrics & Gynecology, C.S. Mott Center for Human Growth and Development, School of Medicine, Wayne State University, Detroit, Michigan, USA
| | - Jehoon Lee
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Guoyao Wu
- Department of Animal Science, Texas A&M University, College Station, Texas, USA
| | - Shannon Washburn
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Jayanth Ramadoss
- J. Ramadoss, Department of Obstetrics & Gynecology and Department of Physiology, 275 E Hancock St, C.S. Mott Center for Human Growth and Development, Rm 195, School of Medicine, Wayne State University, Detroit, MI 48201, USA. E-mail:
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5
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Moen GH, Beaumont RN, Grarup N, Sommer C, Shields BM, Lawlor DA, Freathy RM, Evans DM, Warrington NM. Investigating the causal effect of maternal vitamin B12 and folate levels on offspring birthweight. Int J Epidemiol 2021; 50:179-189. [PMID: 33347560 PMCID: PMC7938507 DOI: 10.1093/ije/dyaa256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 11/29/2022] Open
Abstract
Background Lower maternal serum vitamin B12 (B12) and folate levels have been associated with lower offspring birthweight, in observational studies. The aim of this study was to investigate whether this relationship is causal. Methods We performed two-sample Mendelian randomization (MR) using summary data on associations between genotype-B12 (10 genetic variants) or genotype-folate (four genetic variants) levels from: a genome-wide association study of 45 576 individuals (sample 1); and both maternal- and fetal-specific genetic effects on offspring birthweight from the latest Early Growth Genetics consortium meta-analysis with 297 356 individuals reporting their own birthweight and 210 248 women reporting their offspring's birthweight (sample 2). We used the inverse variance weighted method, and sensitivity analyses to account for pleiotropy, in addition to excluding a potentially pleiotropic variant in the FUT2 gene for B12 levels. Results We did not find evidence for a causal effect of maternal or fetal B12 levels on offspring birthweight. The results were consistent across the different methods. We found a positive causal effect of maternal folate levels on offspring birthweight [0.146 (0.065, 0.227), which corresponds to an increase in birthweight of 71 g per 1 standard deviation higher folate]. We found some evidence for a small inverse effect of fetal folate levels on their own birthweight [−0.051 (−0.100, −0.003)]. Conclusions Our results are consistent with evidence from randomized controlled trials that higher maternal folate levels increase offspring birthweight. We did not find evidence for a causal effect of B12 levels on offspring birthweight, suggesting previous observational studies may have been confounded.
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Affiliation(s)
- Gunn-Helen Moen
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,University of Queensland Diamantina Institute, University of Queensland, Woolloongabba, QLD, Australia.,K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Robin N Beaumont
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Royal Devon and Exeter Hospital, Exeter, UK
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christine Sommer
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Beverley M Shields
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Royal Devon and Exeter Hospital, Exeter, UK
| | - Deborah A Lawlor
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Bristol National Institute of Health Research Biomedical Research Centre, Bristol, UK
| | - Rachel M Freathy
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Royal Devon and Exeter Hospital, Exeter, UK.,Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - David M Evans
- University of Queensland Diamantina Institute, University of Queensland, Woolloongabba, QLD, Australia.,Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Nicole M Warrington
- University of Queensland Diamantina Institute, University of Queensland, Woolloongabba, QLD, Australia.,K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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6
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Maternal folic acid supplementation reduces the severity of cleft palate in Tgf-β 3 null mutant mice. Pediatr Res 2019; 85:566-573. [PMID: 30683931 DOI: 10.1038/s41390-018-0267-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 11/28/2018] [Accepted: 12/12/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Cleft palate (CP) constitutes the most frequently seen orofacial cleft and is often associated with low folate status. Folate plays an essential role in the human body as a major coenzyme in one-carbon metabolism, including DNA synthesis, repair, and methylation. Whether the administration of isolated folic acid (FA) supplements prevents the CP caused by genetic mutations is unknown, as is its effect on the mechanisms leading to palate fusion. METHODS FA was administered to females from two different strains of transforming growth factor β3 heterozygous mice. Null mutant progeny of these mice exhibit CP in 100% of cases of varying severity. We measured cleft length, height of palatal shelf adhesion, and the number of proliferating mesenchymal cells. Immunohistochemistry was also carried for collagen IV, laminin, fibronectin, cytokeratin-17, and EGF. RESULTS FA supplementation significantly reduced CP severity and improved palatal shelf adhesion in both strains both in vivo and in vitro. Medial edge epithelium proliferation increased, and its differentiation was normalized as indicated by the presence and disposition of collagen IV, laminin, fibronectin, and cytokeratin-17. CONCLUSIONS A maternal FA supplementation reduces the CP appearance by improving the mechanisms leading to palatal shelf adhesion.
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7
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Barzilay E, Moon A, Plumptre L, Masih SP, Sohn KJ, Visentin CE, Ly A, Malysheva O, Croxford R, Caudill MA, O'Connor DL, Kim YI, Berger H. Fetal one-carbon nutrient concentrations may be affected by gestational diabetes. Nutr Res 2018; 55:57-64. [PMID: 29914628 DOI: 10.1016/j.nutres.2018.04.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 01/19/2018] [Accepted: 04/15/2018] [Indexed: 01/21/2023]
Abstract
Both insufficiency and excess of one-carbon nutrients (folate, choline, vitamins B6 and B12) during pregnancy have been associated with gestational diabetes mellitus (GDM). However, the precise nature of this association has not been clearly established. We hypothesized that GDM may affect one-carbon nutrients concentrations in the fetus, thus possibly participating in epigenetic programing of the offspring. Maternal blood was collected at recruitment (12-16 weeks). At delivery (28-42 weeks), both maternal and cord blood were collected. Blood concentrations of one-carbon nutrients and their metabolites were compared between the two groups. A total of 368 women were included in the study, of whom 19 (5.6%) were later diagnosed with GDM. No significant differences were found in maternal blood concentrations of one-carbon nutrients and their metabolites between the GDM and control groups at recruitment or at delivery. In cord blood, however, serum folate (87.7 [IQR 70.4-103.9] vs 66.6 [IQR 45.5-80.3] nmol/L, P = .025) and plasma TMAO (2.82 [IQR 1.3-3.2] vs 1.35 [IQR 1.0-2.0] μmol/L, P = .017) concentrations were higher, while plasma betaine concentrations were lower (17.5 [IQR 16.3-19.4] vs 21.1 [IQR 18.0-24.1] μmol/L, P = .019) in infants born to mothers with GDM compared with control. Our data suggest that while maternal blood concentrations of one-carbon nutrients and their metabolites may not affect the risk of GDM, GDM may alter concentrations of serum folate, plasma betaine and TMAO in cord blood. These alterations in one-carbon nutrient concentrations in fetal circulation may impact epigenetic programing, thereby contributing to physiologic changes and disease susceptibility in adulthood associated with GDM offspring.
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Affiliation(s)
- Eran Barzilay
- Department of Obstetrics & Gynecology, St. Michael's Hospital & University of Toronto, Toronto, ON, Canada; Department of Obstetrics and Gynecology, Assuta Ashdod University Hospital, Ashdod, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Ashley Moon
- The Keenan Research Center for Biomedical Science of St. Michael's Hospital, Toronto, Ontario, Canada
| | - Lesley Plumptre
- The Keenan Research Center for Biomedical Science of St. Michael's Hospital, Toronto, Ontario, Canada; Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Shannon P Masih
- The Keenan Research Center for Biomedical Science of St. Michael's Hospital, Toronto, Ontario, Canada; Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Kyoung-Jin Sohn
- The Keenan Research Center for Biomedical Science of St. Michael's Hospital, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Carly E Visentin
- The Keenan Research Center for Biomedical Science of St. Michael's Hospital, Toronto, Ontario, Canada; Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Anna Ly
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Olga Malysheva
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY
| | - Ruth Croxford
- Freelance statistics consultant, Toronto, Ontario, Canada
| | - Marie A Caudill
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY
| | - Deborah L O'Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Research Institute, the Hospital for Sick Children
| | - Young-In Kim
- The Keenan Research Center for Biomedical Science of St. Michael's Hospital, Toronto, Ontario, Canada; Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; The Division of Gastroenterology, Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Howard Berger
- Department of Obstetrics & Gynecology, St. Michael's Hospital & University of Toronto, Toronto, ON, Canada
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8
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Louis-Jacques AF, Salihu HM, King LM, Paothong A, Sinkey RG, Pradhan A, Riggs BM, Siegel EM, Salemi JL, Whiteman VE. A positive association between umbilical cord RBC folate and fetal TL at birth supports a potential for fetal reprogramming. Nutr Res 2016; 36:703-9. [DOI: 10.1016/j.nutres.2016.01.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 01/11/2016] [Accepted: 01/28/2016] [Indexed: 01/06/2023]
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Ahmed T, Fellus I, Gaudet J, MacFarlane AJ, Fontaine-Bisson B, Bainbridge SA. Effect of folic acid on human trophoblast health and function in vitro. Placenta 2015; 37:7-15. [PMID: 26748157 DOI: 10.1016/j.placenta.2015.11.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 11/11/2015] [Accepted: 11/24/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The combined intake of folic acid (FA) from prenatal multivitamin supplements and fortified foods can result in FA intake values that exceed the tolerable upper intake level (UL). It is unclear what impact FA intake above the UL may have on the feto-placental unit. Our objective was to determine the effects of increasing concentrations of FA on trophoblast health and function in vitro. METHODS Two human placental cell lines [HTR-8/SVneo (n = 5 experiments) and BeWo (n = 5 experiments)] and human placenta tissue explants (n = 6 experiments) were exposed to increasing concentrations of FA (2-2000 ng/mL) for 48-h. Intracellular total folate concentration, trophoblast proliferation, viability, apoptosis, placenta cell invasion and β-hCG hormone release were assessed. RESULTS Exposure to increasing FA concentrations resulted in higher intracellular total folate in placental cell lines and tissue explants (p < 0.05); yet, only minimal effects of excess folic acid were observed on the primary indicators of placental health and function studied. Specifically, treatment with excess folic acid (2000 ng/mL) resulted in reduced cellular viability in the villous trophoblast BeWo cell line and increased rates of proliferation in the HT8-8/SVneo extravillous trophoblast cell line (p < 0.05). Further, deficient concentrations of folic acid (2 ng/mL) resulted in decreased cell viability and invasive capabilities of the HTR-8/SVneo extravillous trophoblast cell line (p < 0.05). DISCUSSION Our results demonstrate that placental health and function may be compromised in conditions of folate deficiency, and not necessarily in conditions of excess FA. This finding supports the recommendation of prenatal folic acid supplementation in the North American population. Further work aimed at clarifying the therapeutic window of FA intake in the obstetrical population is warranted.
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Affiliation(s)
- Tasfia Ahmed
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, K1N 6N5, Canada.
| | - Ilan Fellus
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, K1N 6N5, Canada.
| | - Jeremiah Gaudet
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, K1N 6N5, Canada.
| | - Amanda J MacFarlane
- Nutrition Research Division, Health Canada, 251 Sir Frederick Banting Driveway, AL2203E, Ottawa, K1A 0K9, Canada.
| | | | - Shannon A Bainbridge
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, K1N 6N5, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, K1H 8M5, Canada; Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, K1Y 4E9, Canada.
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10
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Plumptre L, Masih SP, Ly A, Aufreiter S, Sohn KJ, Croxford R, Lausman AY, Berger H, O'Connor DL, Kim YI. High concentrations of folate and unmetabolized folic acid in a cohort of pregnant Canadian women and umbilical cord blood. Am J Clin Nutr 2015; 102:848-57. [PMID: 26269367 DOI: 10.3945/ajcn.115.110783] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 07/14/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Mandatory fortification, prevalent supplement use, and public health guidelines recommending periconceptional supplementation have increased folic acid intakes in North American pregnant women. However, the effects of increased folic acid intakes during pregnancy on maternal and cord blood folate concentrations have not been well established. OBJECTIVES In this prospective study, we determined maternal and cord blood concentrations of folate and unmetabolized folic acid (UMFA) in a cohort of pregnant Canadian women and their newborns and examined the effect of maternal intakes of folate and folic acid and fetal genetic variants in folate metabolism on folate status. DESIGN Folate and folic acid intakes of 368 Canadian pregnant women were assessed in early (0-16 wk) and late (23-37 wk) pregnancy. Blood concentrations of folate and UMFA were measured with the use of immunoassays and liquid chromatography-mass spectrometry, respectively, in maternal samples in early pregnancy (12-16 wk), at delivery (28-42 wk), and in cord blood. Four fetal genetic variants of the 5,10-methylenetetrahydrofolate reductase (MTHFR) and dihydrofolate reductase (DHFR) genes were assessed for their association with cord blood concentrations of folate and UMFA. RESULTS Geometric mean (95% CI) maternal red blood cell (RBC) folate concentrations were 2417 nmol/L (2362, 2472 nmol/L ) and 2793 nmol/L (2721, 2867 nmol/L ) in early pregnancy and at delivery, respectively. The mean (95% CI) cord RBC folate concentration was 2689 nmol/L (2614, 2765 nmol/L). UMFA was detectable in >90% of maternal and cord plasma samples. Although 3 fetal MTHFR and DHFR genetic variants had no effect, the fetal MTHFR 677TT genotype was associated with significantly lower cord serum (P = 0.03) and higher cord RBC (P = 0.02) folate concentrations than those of the wild type. CONCLUSIONS Notwithstanding differences in assays, maternal and cord RBC folate and plasma UMFA concentrations were higher than previously reported values. Functional ramifications of high folate and UMFA concentrations in maternal and fetal circulation warrant additional investigation because an excess folate status may affect long-term health outcomes of the offspring. This study was registered at www.clinicaltrials.gov as NCT02244684.
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Affiliation(s)
- Lesley Plumptre
- Departments of Nutritional Sciences and Keenan Research Center for Biomedical Science and
| | - Shannon P Masih
- Departments of Nutritional Sciences and Keenan Research Center for Biomedical Science and
| | - Anna Ly
- Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Susanne Aufreiter
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kyoung-Jin Sohn
- Medicine, University of Toronto, Toronto, Ontario, Canada; Keenan Research Center for Biomedical Science and
| | - Ruth Croxford
- Freelance statistics consultant, Toronto, Ontario, Canada; and
| | - Andrea Y Lausman
- Department of Obstetrics and Gynecology, St. Michael's Hospital and University of Toronto, Toronto, Canada
| | - Howard Berger
- Department of Obstetrics and Gynecology, St. Michael's Hospital and University of Toronto, Toronto, Canada
| | - Deborah L O'Connor
- Departments of Nutritional Sciences and Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Young-In Kim
- Departments of Nutritional Sciences and Medicine, University of Toronto, Toronto, Ontario, Canada; Keenan Research Center for Biomedical Science and Division of Gastroenterology, Department of Medicine, St. Michael's Hospital, Toronto, Canada;
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11
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Araújo JR, Keating E, Martel F. Impact of gestational diabetes mellitus in the maternal-to-fetal transport of nutrients. Curr Diab Rep 2015; 15:569. [PMID: 25620402 DOI: 10.1007/s11892-014-0569-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Gestational diabetes mellitus (GDM) is a metabolic disorder prevalent among pregnant women. This disease increases the risk of adverse perinatal outcomes and diseases in the offspring later in life. The human placenta, the main interface between the maternal and fetal blood circulations, is responsible for the maternal-to-fetal transfer of nutrients essential for fetal growth and development. In this context, the aim of this article is to review the latest advances in the placental transport of macro and micronutrients and how they are affected by GDM and its associated conditions, such as elevated levels of glucose, insulin, leptin, inflammation, and oxidative stress. Data analyzed in this article suggest that GDM and its associated conditions, particularly high levels of glucose, leptin, and oxidative stress, disturb placental nutrient transport and, consequently, fetal nutrient supply. As a consequence, this disturbance may contribute to the fetal and postnatal adverse health outcomes associated with GDM.
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Affiliation(s)
- João Ricardo Araújo
- Department of Biochemistry, Faculty of Medicine of Porto, University of Porto, 4200-319, Porto, Portugal,
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12
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Hutson JR, Stade B, Lehotay DC, Collier CP, Kapur BM. Folic acid transport to the human fetus is decreased in pregnancies with chronic alcohol exposure. PLoS One 2012; 7:e38057. [PMID: 22666445 PMCID: PMC3362577 DOI: 10.1371/journal.pone.0038057] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 05/02/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND During pregnancy, the demand for folic acid increases since the fetus requires this nutrient for its rapid growth and cell proliferation. The placenta concentrates folic acid into the fetal circulation; as a result the fetal levels are 2 to 4 times higher than the maternal level. Animal and in vitro studies have suggested that alcohol may impair transport of folic acid across the placenta by decreasing expression of transport proteins. We aim to determine if folate transfer to the fetus is altered in human pregnancies with chronic alcohol consumption. METHODOLOGY/PRINCIPAL FINDINGS Serum folate was measured in maternal blood and umbilical cord blood at the time of delivery in pregnancies with chronic and heavy alcohol exposure (n = 23) and in non-drinking controls (n = 24). In the alcohol-exposed pairs, the fetal:maternal serum folate ratio was ≤ 1.0 in over half (n = 14), whereas all but one of the controls were >1.0. Mean folate in cord samples was lower in the alcohol-exposed group than in the controls (33.15 ± 19.89 vs 45.91 ± 20.73, p = 0.04). CONCLUSIONS/SIGNIFICANCE Our results demonstrate that chronic and heavy alcohol use in pregnancy impairs folate transport to the fetus. Altered folate concentrations within the placenta and in the fetus may in part contribute to the deficits observed in the fetal alcohol spectrum disorders.
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Affiliation(s)
- Janine R Hutson
- Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, Toronto, Ontario, Canada
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Mislanova C, Martsenyuk O, Huppertz B, Obolenskaya M. Placental markers of folate-related metabolism in preeclampsia. Reproduction 2011; 142:467-76. [DOI: 10.1530/rep-10-0484] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The etiology and degree of clinical symptoms of preeclampsia depend on genotypic and phenotypic maternal and trophoblast factors, and elevated levels of plasma homocysteine (Hcy) are one of the pathogenetic factors of preeclampsia. To assess the impact of the folate-related metabolism, we characterized the indices of this metabolism in 40 samples from uncomplicated term placentas and 28 samples from preeclamptic pregnancies by quantifying the total content of folate, methionine (Met), Hcy and related cysteine, and glutathione (GSH) in compliance with the 677 C/T genotype of methylene tetrahydrofolate reductase (MTHFR). The prevalence ofMTHFRgenotypes was not significantly different between the two groups. The polymorphism ofMTHFRwas not unambiguously connected with the content of total placental Met, Hcy and related cysteine, and GSH either in uncomplicated or in complicated pregnancies. By contrast, the combination of the heterozygousMTHFRgenotype with folate deficiency in the samples from preeclamptic pregnancies was characterized by a statistically significant decrease in the Met content, a trend toward increased Hcy levels and a tight association between metabolically directly and indirectly related compounds, e.g. positive relation between Hcy versus cysteine and folate versus GSH and negative relation between folate versus Hcy and both Hcy and cysteine versus GSH. We demonstrated the expression of cystathionine-β-synthase (CBS) in human placenta at term by RT-PCR and western blot analysis, for the first time, and confirmed its catalytic activity and the accumulation of cysteine and CBS in placental explants cultivated in the presence of elevated Hcy concentrations. We suggest that disturbance in placental folate-related metabolism may be one of the pathogenetic factors in preeclampsia.
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Obeid R, Kasoha M, Kirsch SH, Munz W, Herrmann W. Concentrations of unmetabolized folic acid and primary folate forms in pregnant women at delivery and in umbilical cord blood. Am J Clin Nutr 2010; 92:1416-22. [PMID: 20844072 DOI: 10.3945/ajcn.2010.29361] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The importance of unmetabolized folic acid in maternal and fetal blood is not known. OBJECTIVE We investigated total folate, tetrahydrofolate (THF), 5-methyltetrahydrofolate (5-MTHF), formyl-THF, 5,10-methenylTHF, and folic acid concentrations in women and in umbilical cord blood at delivery. DESIGN The study included 87 pregnant women and 29 cord blood samples, including 24 mother-infant pairs. We measured serum concentrations of folate forms by using ultraperformance liquid chromatography-tandem mass spectrometry. RESULTS Pregnant women who received 400 μg folic acid daily (n = 25) had higher total folate (P = 0.041), 5-MTHF (P = 0.049), and formyl-THF (P < 0.001) concentrations and slightly higher THF (P = 0.093) concentrations than did nonsupplemented pregnant women (n = 61). We measured folic acid concentrations >0.20 nmol/L in 38 (44%) pregnant women and in 55% of the cord serum samples, but these measurements were not explained by maternal supplement use. Concentrations of folic acid were nonsignificantly higher in cord blood from supplemented women than in cord blood from nonsupplemented women (P = 0.154). Proportions of folic acid to total folate in cord serum did not differ according to maternal supplement usage (0.54% compared with 0.43% in supplemented and nonsupplemented women, respectively). Concentrations of folic acid did not differ between maternal and cord serum. However, folic acid constituted a significantly lower proportion of total folate in cord serum than in maternal serum. CONCLUSIONS We detected unmetabolized folic acid in more than one-half of cord blood samples. Folic acid (400 μg/d) supplied during pregnancy is not likely to accumulate in the fetus, in contrast to 5-MTHF and THF, which accumulate in the fetus.
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Affiliation(s)
- Rima Obeid
- Department of Clinical Chemistry and Laboratory Medicine and Gynecology, University Hospital of Saarland, Homburg, Germany.
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15
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de Barros Duarte L, Moisés ECD, Carvalho Cavalli R, Lanchote VL, Duarte G, da Cunha SP. Distribution of fentanyl in the placental intervillous space and in the different maternal and fetal compartments in term pregnant women. Eur J Clin Pharmacol 2009; 65:803-8. [PMID: 19330322 DOI: 10.1007/s00228-009-0645-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2008] [Accepted: 03/06/2009] [Indexed: 10/21/2022]
Abstract
BACKGROUND Fentanyl is used in obstetrical practice to promote analgesia and anesthesia during labor and in cesarean delivery, with rapid and short-term effects. OBJECTIVE To determine fentanyl concentrations in maternal plasma, in the placental intervillous space, and in the umbilical artery and vein in term pregnant women. PATIENTS AND METHODS Ten healthy pregnant women underwent epidural anesthesia with fentanyl plus bupivacaine and lidocaine, and fentanyl concentrations were determined in the various maternal and fetal compartments, including the placental intervillous space, which has not been previously studied in the literature. RESULTS The ratios of fentanyl concentrations in the various maternal and fetal compartments revealed an 86% rate of placental fentanyl transfer. The highest fentanyl concentrations were detected in the placental intervillous space, being 2.19 times higher than in maternal plasma, 2.8 times higher than in the umbilical vein and 3.6 times higher than in the umbilical artery, with no significant differences between the umbilical vein and artery, demonstrating that there was no drug uptake by fetal tissues nor metabolism of the drug by the fetus despite the high rates of placental transfer. CONCLUSION The present study demonstrated that the placental intervillous space acted as a site of fentanyl deposit, a fact that may be explained by two hypotheses: (1) the blood collected from the placental intervillous space is arterial and, according to some investigators, the arterial plasma concentrations of the drugs administered to patients undergoing epidural anesthesia are higher than the venous concentrations, and (2) a possible role of P-glycoprotein (P-gp).
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Affiliation(s)
- Luciana de Barros Duarte
- Deparment of Gynecology and Obstetrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
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Camelo JS, Martinez FE, Gonçalves AL, Monteiro JP, Jorge SM. Plasma amino acids in pregnancy, placental intervillous space and preterm newborn infants. ACTA ACUST UNITED AC 2008; 40:971-7. [PMID: 17653451 DOI: 10.1590/s0100-879x2006005000103] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2006] [Accepted: 03/06/2007] [Indexed: 11/21/2022]
Abstract
Plasma amino acid levels have never been studied in the placental intervillous space of preterm gestations. Our objective was to determine the possible relationship between plasma amino acids of maternal venous blood (M), of the placental intervillous space (PIVS) and of the umbilical vein (UV) of preterm newborn infants. Plasma amino acid levels were analyzed by ion-exchange chromatography in M from 14 parturients and in the PIVS and UV of their preterm newborn infants. Mean gestational age was 34 +/- 2 weeks, weight = 1827 +/- 510 g, and all newborns were considered adequate for gestational age. The mean Apgar score was 8 and 9 at the first and fifth minutes. Plasma amino acid values were significantly lower in M than in PIVS (166%), except for aminobutyric acid. On average, plasma amino acid levels were significantly higher in UV than in M (107%) and were closer to PIVS than to M values, except for cystine and aminobutyric acid (P < 0.05). Comparison of the mean plasma amino acid concentrations in the UV of preterm to those of term newborn infants previously studied by our group showed no significant difference, except for proline (P < 0.05), preterm > term. These data suggest that the mechanisms of active amino acid transport are centralized in the syncytiotrophoblast, with their passage to the fetus being an active bidirectional process with asymmetric efflux. PIVS could be a reserve amino acid space for the protection of the fetal compartment from inadequate maternal amino acid variations.
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Affiliation(s)
- J S Camelo
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São PauloRibeirão Preto, SP, Brasil.
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Xiao S, Hansen DK, Horsley ETM, Tang YS, Khan RA, Stabler SP, Jayaram HN, Antony AC. Maternal folate deficiency results in selective upregulation of folate receptors and heterogeneous nuclear ribonucleoprotein-E1 associated with multiple subtle aberrations in fetal tissues. ACTA ACUST UNITED AC 2005; 73:6-28. [PMID: 15641086 DOI: 10.1002/bdra.20105] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Homocysteine, which increases in folate deficiency, can upregulate folate receptors (FR) at the translational level by increasing the interaction between a short cis-element in the 5'-untranslated region of FR-alpha mRNA and heterogeneous nuclear ribonucleoprotein-E1 (hnRNP-E1). Perturbation of this RNA-protein interaction on GD8.5 induces neural tube defects and neurocristopathies in mice. FR upregulation can also reduce cell proliferation independently of folate deficiency in some human cells. Accordingly, we tested the hypothesis that sustained murine maternal folate deficiency would negatively impact pregnancy outcomes, upregulate FR, and selectively reduce fetal cell proliferation. METHODS Dams were fed chow with various levels of folic acid added for eight weeks before and throughout pregnancy. Following sacrifice on GD17, dams were compared for folate and homocysteine status as well as pregnancy outcomes. Fetuses from some groups were evaluated by specific biochemical, molecular, and immunohistochemical studies for FR, hnRNP-E1, and apoptosis. RESULTS When compared to dams fed a folate-replete diet, those dams on a folate-depleted diet developed reduced red cell folates and hyperhomocysteinemia and an inverse dose-dependent upregulation of FR and hnRNP-E1 on GD17 without alterations in cell number in the majority of tissues. However, FR overexpression was accompanied by a significant reduction in the net number of cells in the midgut, lung, pons, tongue, and olfactory epithelium, and with premature differentiation in dorsal root ganglion cells and dysplasia of taste buds. By contrast, in the brain, spinal cord, diaphragm, and primordium of follicles of vibrissae, there was less FR expression, which accompanied a net reduction in number of cells and architectural anomalies. Subtle "immunohistochemical footprints" of apoptosis on GD17 fetuses corresponded with net cell loss in the lung and olfactory epithelium. Upregulation of FR could be explained by a homocysteine-induced RNA-protein interaction in folate-depleted fetuses that led to a proportionate increase in murine FR biosynthesis. CONCLUSIONS Maternal folate deficiency results in selective upregulation of FR and hnRNP-E1 associated with multiple aberrations in fetal tissues that include increased cell loss, architectural anomalies, and premature differentiation. The potential significance of these findings to explain the wide spectrum of folate-responsive birth defects in humans is discussed.
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Affiliation(s)
- Suhong Xiao
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202-5254, USA
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Obeid R, Munz W, Jäger M, Schmidt W, Herrmann W. Biochemical indexes of the B vitamins in cord serum are predicted by maternal B vitamin status. Am J Clin Nutr 2005. [DOI: 10.1093/ajcn/82.1.133] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rima Obeid
- From the Departments of Clinical Chemistry (RO and WH) and Obstetrics and Gynaecology (WM, MJ, and WS), Faculty of Medicine, University Hospital of Saarland, Homburg/Saar, Germany
| | - Winfried Munz
- From the Departments of Clinical Chemistry (RO and WH) and Obstetrics and Gynaecology (WM, MJ, and WS), Faculty of Medicine, University Hospital of Saarland, Homburg/Saar, Germany
| | - Monika Jäger
- From the Departments of Clinical Chemistry (RO and WH) and Obstetrics and Gynaecology (WM, MJ, and WS), Faculty of Medicine, University Hospital of Saarland, Homburg/Saar, Germany
| | - Werner Schmidt
- From the Departments of Clinical Chemistry (RO and WH) and Obstetrics and Gynaecology (WM, MJ, and WS), Faculty of Medicine, University Hospital of Saarland, Homburg/Saar, Germany
| | - Wolfgang Herrmann
- From the Departments of Clinical Chemistry (RO and WH) and Obstetrics and Gynaecology (WM, MJ, and WS), Faculty of Medicine, University Hospital of Saarland, Homburg/Saar, Germany
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Refsum H, Grindflek AW, Ueland PM, Fredriksen A, Meyer K, Ulvik A, Guttormsen AB, Iversen OE, Schneede J, Kase BF. Screening for Serum Total Homocysteine in Newborn Children. Clin Chem 2004; 50:1769-84. [PMID: 15319318 DOI: 10.1373/clinchem.2004.036194] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Background: Newborn screening for total homocysteine (tHcy) in blood may identify babies with vitamin B12 (B12) deficiency or homocystinuria, but data on the causes of increased tHcy in screening samples are sparse.
Methods: Serum concentrations of tHcy, cystathionine, methionine, folate, and B12 and the methylenetetrahydrofolate reductase (MTHFR) 677C>T polymorphism were determined in 4992 capillary blood samples collected as part of the routine screening program in newborn children. Methylmalonic acid (MMA), gender (SRY genotyping), and the frequency of six cystathionine β-synthase (CBS) mutations were determined in 20–27% of the samples, including all samples with tHcy >15 μmol/L (n = 127), B12 <100 pmol/L (n = 159), or methionine >40 μmol/L (n = 154).
Results: The median (5th–95th percentile) tHcy concentration was 6.8 (4.2–12.8) μmol/L. B12 status, as determined by serum concentrations of B12, tHcy, and MMA, was moderately better in boys than in girls. tHcy concentrations between 10 and 20 μmol/L were often associated with low B12, whereas tHcy >20 μmol/L (n = 43) was nearly always explained by increased methionine. tHcy did not differ according to folate concentrations or MTHFR 677C>T genotypes. None of the babies had definite CBS deficiencies, but heterozygosity led to low cystathionine, increased methionine, but normal tHcy concentrations.
Conclusion: Increased tHcy is a common but not specific finding in newborns. The metabolite and vitamin profiles will point to the cause of hyperhomocysteinemia. Screening for tHcy and related factors should be further evaluated in regions with high prevalence of homocystinuria and in babies at high risk of B12 deficiency.
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Affiliation(s)
- Helga Refsum
- Department of Pharmacology, University of Oxford, UK.
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20
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Camelo JS, Jorge SM, Martinez FE. Amino acid composition of parturient plasma, the intervillous space of the placenta and the umbilical vein of term newborn infants. Braz J Med Biol Res 2004; 37:711-7. [PMID: 15107934 DOI: 10.1590/s0100-879x2004000500013] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The objective of the present study was to determine the levels of amino acids in maternal plasma, placental intervillous space and fetal umbilical vein in order to identify the similarities and differences in amino acid levels in these compartments of 15 term newborns from normal pregnancies and deliveries. All amino acids, except tryptophan, were present in at least 186% higher concentrations in the intervillous space than in maternal venous blood, with the difference being statistically significant. This result contradicted the initial hypothesis of the study that the plasma amino acid levels in the placental intervillous space should be similar to those of maternal plasma. When the maternal venous compartment was compared with the umbilical vein, we observed values 103% higher on the fetal side which is compatible with currently accepted mechanisms of active amino acid transport. Amino acid levels of the placental intervillous space were similar to the values of the umbilical vein except for proline, glycine and aspartic acid, whose levels were significantly higher than fetal umbilical vein levels (average 107% higher). The elevated levels of the intervillous space are compatible with syncytiotrophoblast activity, which maintain high concentrations of free amino acids inside syncytiotrophoblast cells, permitting asymmetric efflux or active transport from the trophoblast cells to the blood in the intervillous space. The plasma amino acid levels in the umbilical vein of term newborns probably may be used as a standard of local normality for clinical studies of amino acid profiles.
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Affiliation(s)
- J S Camelo
- Departamento de Puericultura e Pediatria, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirao Preto, SP, Brazil.
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Takahashi T, Utoguchi N, Takara A, Yamamoto N, Nakanishi T, Tanaka K, Audus KL, Watanabe Y. Carrier-mediated transport of folic acid in BeWo cell monolayers as a model of the human trophoblast. Placenta 2001; 22:863-9. [PMID: 11718574 DOI: 10.1053/plac.2001.0742] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Using cultured BeWo cells as a model of human trophoblast, we investigated whether carrier-mediated transport of folic acid occurs. BeWo cells, which were derived from human choriocarcinoma, were cultured on a tissue culture plate or in a permeation chamber. When the cells reached confluence, drug uptake or transport experiments were performed. The uptake of [(3)H]folic acid by BeWo cells occurred at a much lower rate at 4 degrees C than at 37 degrees C. The uptake of [(3)H]folic acid was saturable at higher concentrations and inhibited by typical metabolic inhibitors, sodium azide and 2,4-dinitrophenol. The uptake of [(3)H]folic acid was significantly increased with decreasing pH of the incubation buffer and markedly inhibited by 4,4'-diidothiocyanostilbene-2,2'-disulfonic acid (DIDS). Analogs of folic acid, methotrexate and 5-methyltetrahydrofolate, inhibited the uptake of [(3)H]folic acid by BeWo cells. Kinetic analysis using Lineweaver-Burk plots revealed that methotrexate competitively inhibited the uptake of [(3)H]folic acid and folic acid competitively inhibited the uptake of [(3)H]methotrexate. In transport experiments, the permeation of [(3)H]folic acid from the apical-to-basal side was greater than that from the basal-to-apical side, and the transport of [(3)H]folic acid from the apical-to-basal side was inhibited by an excess of folic acid. The findings obtained in the present study confirm the existence of an asymmetric, carrier-mediated transport system for folic acid and its analog, methotrexate, across BeWo cells, a representative of the human trophoblast.
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Affiliation(s)
- T Takahashi
- Department of Pharmaceutics and Biopharmaceutics, Showa Pharmaceutical University, Machida, Tokyo 194-8543, Japan
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Abstract
Folic acid is an essential nutrient from the B complex group of vitamins. Folate, as a cofactor, is involved in numerous intracellular reactions, and this is reflected in the various derivatives that have been isolated from biological sources. Folic acid is involved in single carbon transfer reactions and serves as a source of single carbon units in different oxidative states. The processes involved in the absorption, transport, and intracellular metabolism of this cofactor are complex. Much of folate is bound tightly to enzymes, indicating that there is not excess of this cofactor and that its cellular availability is protected as well as being strictly regulated. In animals, the liver controls the supply of folate through first pass metabolism, biliary secretion, enterohepatic recirculation, as well as through senescent erythrocyte recycling. Deficiencies of folate can occur for many reasons, including reduced intake, increased metabolism, and/or increased requirements as well as through genetic defects. The effects of folate deficiency include hyperhomocysteinemia, megaloblastic anemia, and mood disorders. Folate deficiency has also been implicated in disorders associated with neural tube defects. Supplementation of grain products such as cereals has been undertaken in several countries as a cost-effective means of reducing the prevelance of neural tube defects. Recently, common polymorphisms have been discovered in several genes associated with folate pathways that may play a role in diseases associated with folate deficiency, particularly mild folate deficiency.
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Affiliation(s)
- J G Donnelly
- Department of Pathology, the Ottawa Hospital and the University of Ottawa, Ontario, Canada
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Stefanidis K, Stefos T, Vekris A, Sotiriadis A, Dalkalitsis N, Lolis D. Folate status during labor: relationship with pregnancy outcome. THE JOURNAL OF MATERNAL-FETAL MEDICINE 1999; 8:61-3. [PMID: 10090493 DOI: 10.1002/(sici)1520-6661(199903/04)8:2<61::aid-mfm6>3.0.co;2-p] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The purpose of our study was to determine the folate status of pregnant women at labor, and to detect probable relationships with the gestational age at delivery, the birth weight of the newborns, as well as the mode of the delivery, taking into account any changes in the fetal heart rate (FHR) at labor and, subsequently, operative delivery. METHODS Maternal serum folate levels were determined using automated fluorometric enzyme-linked assays. Gestational age was determined by ultrasound in the first trimester followed by serial fetal biometry. RESULTS The results of our study in 101 consecutive pregnant women revealed that the mean (+/-SD) maternal serum concentration of the folate during labor was 12.01 (+/-4.16) ng/ml (range 2.50-23). The mean (+/-SD) gestational age at labor was 38.5 (+/-1.2) weeks (range 35-41 wks) as also the mean (+/-SD) birth weight of the newborns was 3.217 (+/-403) g (range 2,000-4,250 g). CONCLUSIONS No significant correlation (p>0.05) between folate levels of the maternal serum and gestational age at delivery or birth weight was found. The mode of delivery as a result of probable relationship between operative delivery and maternal serum folate levels was also not found.
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Affiliation(s)
- K Stefanidis
- Department of Obstetrics and Gynecology, Ioannina University Hospital, Greece.
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Abstract
Pregnant women are prone to becoming folate deficient because there is a significant increase in folate requirement during pregnancy and folate intakes of pregnant women are often insufficient. Reduced folate levels in blood and neutrophilic hypersegmentation reflect a negative folate balance. Possible consequences of a low maternal folate status may be pregnancy complications such as abortion, abortus imminens, abruptio placentae, and congenital malformations. The role of folic acid in the etiology of neural tube defects has been discussed for decades. The importance of an adequate maternal folate status in the prevention of neural tube defects has been demonstrated by observational and controlled intervention trials. However, the mechanism of the protective effect of periconceptional folate supplementation is not completely understood. Metabolic disorders are probably involved in the pathogenesis of neural tube defects so that a relative folate shortage rather than folate deficiency seems to be responsible for the disturbed neural tube development, which can be compensated for by a higher folate intake.
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Affiliation(s)
- K F Pietrzik
- Institute of Nutritional Science, University of Bonn, Germany
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25
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Economides DL, Ferguson J, Mackenzie IZ, Darley J, Ware II, Holmes-Siedle M. Folate and vitamin B12 concentrations in maternal and fetal blood, and amniotic fluid in second trimester pregnancies complicated by neural tube defects. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1992; 99:23-5. [PMID: 1547166 DOI: 10.1111/j.1471-0528.1992.tb14386.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To investigate maternal and fetal folate and vitamin B12 concentrations in pregnancies affected by neural tube defects (NTD). DESIGN Measurement of folate and vitamin B12 concentrations in amniotic fluid, fetal blood and maternal blood samples in midgestation. SUBJECTS 32 women undergoing termination of pregnancy at 14-21 weeks gestation for social reasons (n = 24) or for fetuses with neural tube defects (n = 8). INTERVENTIONS Fetoscopy before intra-amniotic injection of prostaglandins. RESULTS In normal pregnancies there was a positive correlation between maternal and fetal serum folate, and the fetal serum and red blood cell folate concentrations were higher than the maternal. There were no differences in amniotic fluid, maternal blood or fetal blood folate concentrations between pregnancies with NTD and normal pregnancies. Although amniotic fluid vitamin B12 was lower in pregnancies with NTD, maternal serum vitamin B12 concentration was not reduced. CONCLUSION In this small group of pregnancies with NTD at mid-gestation there is no evidence to suggest folate or vitamin B12 deficiency.
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Affiliation(s)
- D L Economides
- Nuffield Department of Obstetrics and Gynaecology, Churchill Hospital, Headington, Oxford
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26
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Holm J, Hansen SI, Høier-Madsen M. A high-affinity folate binding protein in human amniotic fluid. Radioligand binding characteristics, immunological properties and molecular size. Biosci Rep 1990; 10:79-85. [PMID: 2340351 DOI: 10.1007/bf01116855] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The presence of a folate binding protein of high-affinity type (affinity constant 5.10(9) M-1, maximum folate binding 3 nM) in human amniotic fluid was demonstrated in equilibrium dialysis experiments (37 degrees C, pH 7.4) with the radioligand 3H-folate. Dissociation of 3H-folate from the binding protein was slow at pH 7.4 but rapid at pH 3.5. By use of rabbit antibodies against low molecular weight folate binding protein from human milk we determined the concentration of folate binding protein in 5 amniotic fluids (range 1.5-2.3 nM) in an Enzyme-Linked Immunosorbent Assay (ELISA). Ultrogel AcA 44 chromatography of amniotic fluid showed that immunoreactive and radioligand bound folate binding protein coeluted in two peaks: a major one (Mr approximately 25,000) and a minor one (Mr approximately 100,000).
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Affiliation(s)
- J Holm
- Department of Clinical Chemistry, University of Tromsø, Norway
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