Moderate maternal folic acid supplementation ameliorates adverse embryonic and epigenetic outcomes associated with assisted reproduction in a mouse model

STUDY QUESTION

Could clinically-relevant moderate and/or high dose maternal folic acid supplementation prevent aberrant developmental and epigenetic outcomes associated with assisted reproductive technologies (ART)?

SUMMARY ANSWER

Our results demonstrate dose-dependent and sex-specific effects of folic acid supplementation in ART and provide evidence that moderate dose supplements may be optimal for both sexes.

WHAT IS KNOWN ALREADY

Children conceived using ART are at an increased risk for growth and genomic imprinting disorders, often associated with DNA methylation defects. Folic acid supplementation is recommended during pregnancy to prevent adverse offspring outcomes; however, the effects of folic acid supplementation in ART remain unclear.

STUDY DESIGN, SIZE, DURATION

Outbred female mice were fed three folic acid-supplemented diets, control (rodent daily recommended intake or DRI; CD), moderate (4-fold DRI; 4FASD) or high (10-fold DRI; 10FASD) dose, for six weeks prior to ART and throughout gestation. Mouse ART involved a combination of superovulation, in vitro fertilisation, embryo culture and embryo transfer.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Midgestation embryos and placentas (n = 74-99/group) were collected; embryos were assessed for developmental delay and gross morphological abnormalities and embryos and placentas were examined for epigenetic defects. We assessed methylation at four imprinted genes (Snrpn, Kcnq1ot1, Peg1 and H19) in matched midgestation embryos and placentas (n = 31-32/group) using bisulfite pyrosequencing. In addition, we examined genome-wide DNA methylation patterns in placentas (n = 6 normal placentas per sex/group) and embryos (n = 6 normal female embryos/group; n = 3 delayed female embryos/group) using reduced representation bisulfite sequencing (RRBS).

MAIN RESULTS AND THE ROLE OF CHANCE

Moderate, but not high dose supplementation, was associated with a decrease in the proportion of developmentally delayed embryos. Although moderate dose folic acid supplementation reduced DNA methylation variance at certain imprinted genes in embryonic and placental tissues, high dose supplementation exacerbated the negative effects of ART at imprinted loci. Furthermore, folic acid supplements resolved female-biased aberrant imprinted gene methylation. Supplementation was more effective at correcting ART-induced genome-wide methylation defects in male versus female placentas; however, folic acid supplementation also led to additional methylation perturbations which were more pronounced in males.

LARGE-SCALE DATA

The RRBS data from this study have been submitted to the NCBI Gene Expression Omnibus under the accession number GSE123143.

LIMITATIONS REASONS FOR CAUTION

Although the combination of mouse ART utilised in this study consisted of techniques commonly used in human fertility clinics, there may be species differences. Therefore, human studies, designed to determine the optimal levels of folic acid supplementation for ART pregnancies, and taking into account foetal sex, are warranted.

WIDER IMPLICATIONS OF THE FINDINGS

Taken together, our findings support moderation in the dose of folic acid supplements taken during ART.

STUDY FUNDING/COMPETING INTEREST(S)

This work was funded by the Canadian Institutes of Health Research (FDN-148425). The authors declare no conflict of interest.

Impact of mothers' early life exposure to low or high folate on progeny outcome and DNA methylation patterns

The dynamic patterning of DNA and histone methylation during oocyte development presents a potentially susceptible time for epigenetic disruption due to early life environmental exposure of future mothers. We investigated whether maternal exposure to folic acid deficient and supplemented diets starting in utero could affect oocytes and cause adverse developmental and epigenetic effects in next generation progeny. Female BALB/c mice (F0) were placed on one of four amino acid defined diets for 4 weeks before pregnancy and throughout gestation and lactation: folic acid control (rodent recommended daily intake; Ctrl), 7-fold folic acid deficient, 10-fold folic acid supplemented or 20-fold folic acid supplemented diets. F1 female pups were weaned onto Ctrl diets, mated to produce the F2 generation and the F2 offspring were examined at E18.5 for developmental and epigenetic abnormalities. Resorption rates were increased and litter sizes decreased amongst F2 E18.5-day litters in the 20-fold folic acid supplemented group. Increases in abnormal embryo outcomes were observed in all three folic acid deficient and supplemented groups. Subtle genome-wide DNA methylation alterations were found in the placentas and brains of F2 offspring in the 7-fold folic acid deficient , 10-fold folic acid supplemented and 20-fold folic acid supplemented groups; in contrast, global and imprinted gene methylation were not affected. The findings show that early life female environmental exposures to both low and high folate prior to oocyte maturation can compromise oocyte quality, adversely affecting offspring of the next generation, in part by altering DNA methylation patterns.

Lead consumption of 18- to 36-month-old children as determined from duplicate diet collections: nutrient intakes, blood lead levels, and effects on growth

OBJECTIVE

To determine the amount of lead ingested in food by means of duplicate diet collections, nutrient intakes, and anthropometric measurements of young children.

DESIGN

Once a month for a year, data were collected from 24-hour duplicate diets, hand wipes, a dust index, and anthropometric measurements. Quarterly, venous blood samples were obtained. Thermal ionization spectrometry by means of a lead-205 tracer was used to determine lead present in food, blood, and the hand wipes. A dust index was determined on the basis of observation of dust on surfaces in the home. Anthropometric measurements obtained were height, weight, head circumference, and mid-upper arm circumference.

SUBJECTS/SETTING

Subjects were 21 children, aged 18 to 36 months, who resided in homes located in an urban area with potentially high lead levels.

MAIN OUTCOMES MEASURED

Lead contamination in food and on hands, and blood lead values, were determined.

STATISTICAL ANALYSIS PERFORMED

Pearson correlation coefficients were used to determine relationships between lead content in food, blood, and hand wipes and growth. Multiple regression analyses examined the effect of food types and dust lead on lead levels in food, and the effect of these variables on head circumference.

RESULTS

Mean blood levels were 0.3089 +/- 0.1496 micromol/L; 12 samples contained more than 0.4826 micromol/L. Total intake of lead from food was 4.95 microg/day and ranged from 1.10 to -22.10 microg/day. More than a fourth of the diets collected exceeded 6.00 microg/day. Foods considered home prepared were moderately related to blood lead level, and the dust index and hand wipe lead levels were related to total food lead. Home-handled foods, canned foods, and hand-wipe lead were significant predictors of the lead content in food. A negative relationship was found between head circumference and blood lead level.

APPLICATIONS

Level of lead in food was directly related to hand-wipe lead. This finding underscores the need for dietitians and other health professionals to stress the importance of cleanliness in environments that are potentially lead contaminated. Appropriate hand washing and surface cleaning should be emphasized when preparing and consuming food. The inverse relationship between head circumference and blood lead levels points to the need for additional studies to validate this finding while controlling for other extraneous variables.

Manganese encephalopathy: utility of early magnetic resonance imaging

The use of magnetic resonance imaging (MRI) provides visual evidence of cerebral deposits of paramagnetic metals. The usefulness of MRI is described in connection with the manganese poisoning of a 44 year old arc welder who had been engaged in the repair and recycling of railroad track made of manganese steel alloy.

Erythrocyte pyrimidine 5'-nucleotidase and deoxynucleotidase isozymes: metallosensitivity and kinetics

Erythrocytes from a subject with classical pyrimidine 5'-nucleotidase (P5N) deficiency (PND) possessed typically low nucleotidase activity with uridine 5'-monophosphate (UMP) and cytidine 5'-monophosphate (CMP) as the substrates with subnormal dephosphorylation of 2'-deoxy thymidine 5'-monophosphate (dTMP) and 2'-deoxyuridine 5'-monophosphate (dUMP) and intermediate activity with 2'-deoxycytidine 5'-monophosphate (dCMP). Contrary to previously reported data, there was enzyme activity with all five substrates. The metallosensitivities of the P5N isozymes using UMP, dUMP, dCMP and dTMP as the substrates were defined. Nucleotidase (P5N) is slightly more sensitive than 2'-deoxy-pyrimidine 5'-nucleotidase (dP5N) to inhibition by lead, copper and mercury. Chromium stimulated more enzyme activity with dCMP than other substrates. Apparent Michaelis constants (Km) were calculated for UMP, CMP, dUMP, dCMP, and dTMP for PND and control subjects. Optimal activity was at pH 7.0-7.8 when using UMP and CMP as the substrates but at pH 5.5-6.5 with dUMP, dCMP and dTMP as the substrates. The Km, pH optima and metallosensitivities were, however, consistent with electrophoretic evidence for two and probably three isozymes: P5N with maximal affinity for UMP and CMP; dP5N with maximal affinity for dUMP and dTMP; and a closely related dCMPase. The relative activity with representative substrates can be used to distinguish homozygotes and heterozygotes for P5N deficiency and subjects with heavy metal exposure.

Relationship between childhood blood lead levels and stature

The second National Health and Nutrition Examination Survey, 1976 to 1980, incorporated medical history, physical examination, anthropometric measurements, dietary information (24-hour recall and food frequency), laboratory tests, and radiographs. In linear regressions of adjusted data from 2,695 children aged 7 years and younger, 91% of the variance in height, 72% of the variance in weight, and 58% of the variance in chest circumference were explained by six variables: age, race, sex, blood lead level, total calories or protein, and hematocrit or transferrin saturation level. Variables that did not significantly improve the models predicting growth included family income, degree of urbanization, serum albumin, copper, iron, and zinc levels, dietary carbohydrate, fat, calcium, potassium, phosphorus, vitamin A, vitamin C, niacin, riboflavin, and thiamine. The highly significant correlation of blood lead level with growth does not contradict the established association of childhood deprivation with increased lead exposure and with nutritional deficiences known to enhance lead absorption. Blood lead level may also represent a composite marker for unidentified genetic, ethnic, environmental, and sociocultural variables, other than race, sex, and nutrition, that affect growth. However, the correlation of stature, particularly height, with blood lead levels in the range of 5 to 35 micrograms/dL is so statistically significant that it merits investigation in other surveys and consideration of the multiple biologic mechanisms by which low-level lead exposure could impair the growth of children.

Assay of human erythrocyte pyrimidine and deoxypyrimidine 5'-nucleotidase by isocratic reversed-phase high-performance liquid chromatography

We report a rapid and reproducible assay for activity of human erythrocyte pyrimidine 5'-nucleotidase and deoxypyrimidine 5'-nucleotidase. The nucleotides CMP, UMP, dUMP, dCMP or dTMP are individually incubated 30 min at 37 degrees C with erythrocyte hemolysate and 4 mM magnesium chloride in Tris, pH 7.5. Data are provided for standardization of the reaction with each substrate. Individual nucleoside products are assayed in less than 10 min by reversed-phase high-performance liquid chromatography at 280 nm with 0-14% methanol in 0.01 M potassium dihydrogen phosphate. This is the first report of a high-performance liquid chromatographic assay system which allows quantitation of the activity of pyrimidine 5'-nucleotidase isozymes using five individual pyrimidine and deoxypyrimidine nucleotides as the substrates.

Syndrome of amelogenesis imperfecta, nephrocalcinosis, impaired renal concentration, and possible abnormality of calcium metabolism

We describe a brother and sister with amelogenesis imperfecta, nephrocalcinosis and impaired renal concentrating ability. This is the second sibship reported, further substantiating autosomal recessive inheritance of this condition. There is lack of enamel, lifelong nocturnal enuresis, progressive punctate nephrocalcinosis, and decreased calcium and phosphate excretion over 24 hours and after an acute load. Increased serum osteocalcin and decreased urine delta-carboxyglutamic acid suggest involvement of vitamin K-dependent calcium binding proteins, although this may represent a secondary finding. No other evidence of abnormal calcium metabolism was found. Renal function is stable in the early teens, but the previously reported patients went on to renal failure.