Multi-biomarker approach for the (eco)toxicity of UV-filter environmental pollution on the Mediterranean mussel Mytilus galloprovincialis in a multiple stressor context. The case of 4-MBC under salinity shifts

Marine-coastal ecosystems are rapidly transforming because of climate change (CC). At the same time, the impacts of emerging organic contaminants (i.e., organic UV-filters) on these ecosystems are intensifying. In the Mediterranean, the consequences of these disturbances are occurring at a fast pace making this area a potential sentinel site to be investigated. While singular effects of organic UV-filters or CC-related factors on marine biota have been relatively described, their combined impact is still largely unknown. Thus, the objective of this study was to assess the long-term responses of the Mediterranean mussel Mytilus galloprovincialis towards anticipated salinity changes (decreases-S20 or increases-S40) when exposed to environmentally relevant concentrations of the UV-filter 4-methylbenzylidene camphor (4-MBC). An integrated multi-biomarker approach was applied, featuring general and oxidative stress, antioxidant and biotransformation enzyme capacity, energy metabolism, genotoxicity, and neurotoxicity biomarkers. Results showed that both projected salinities, considered separately, exerted non-negligible impacts on mussels' health status, with greater biological impairments found at S 40. Combining both stressors resulted in an evident increase in mussels' susceptibility to the UV-filter, which exacerbated the toxicity of 4-MBC. The dominant influence of salinity in the climate change-contaminant interaction played a crucial role in this outcome. The most severe scenario occurred when S 20 was combined with 4-MBC. In this situation, mussels exhibited a decrease in filtration rate, metabolic capacity and deployment of energy reserves increased, with an upregulation of biotransformation and inhibition of antioxidant enzyme activities. This exposure also led to the observation of cellular and DNA damage, as well as an increase in AChE activity. Furthermore, salinity-dependent bioaccumulation patterns were evaluated revealing that the lowest values in contaminated mussels are found at S 20. Overall, the present findings provide evidence that projected CC/pollutant scenarios may represent high risks for mussels' populations, with global relevant implications for the ecosystem level.

Helminth fauna in roe deer (Capreolus capreolus Linnaeus, 1758) in the province of Grosseto (central Italy)

Helminth infection was analysed at necropsy and coprology in a total of 54 roe deer from the province of Grosseto (central Italy) between 2018 - 2020. Age and sex data were recorded for each deer for a total of 31 adults (23 females, 8 males) and 23 juveniles (11 females, 12 males). The results on the small intestine (51 samples) highlighted that nematodes belonging to the species Trichostrongylus colubriformis were the most prevalent parasite (41.2 %), followed by the cestode Moniezia expansa (7.8 %). The large intestine results (52 samples) showed Trichuris spp. (53.8 %), Oesophagostomum venulosum (50 %) and Chabertia ovina (26.9 %). In the abomasum, only Ostertagia ostertagi (17.9 %) was found. Of the 34 samples analysed by bronchopulmonary, only the lung of an adult female was positive for Dictyocaulus spp. In two livers out of 33 samples analysed, nematodes of the species Setaria tundra were found on the surface. Copropositivity was observed in 45 of the 52 faecal samples analysed. The results of the present study indicate that the roe deer is host to several species of parasites, which are also common in other cervids and domestic ruminants. Statistical testing highlighted a significant difference between mean intensities in males and females.

Posidonia oceanica (L.) (Delile, 1813) extracts as a potential booster biocide in fouling-release coatings

Since the banning of tributyltin, the addition of inorganic (metal oxides) and organic (pesticides, herbicides) biocides in antifouling paint has represented an unavoidable step to counteract biofouling and the resulting biodeterioration of submerged surfaces. Therefore, the development of new methods that balance antifouling efficacy with environmental impact has become a topic of great importance. Among several proposed strategies, natural extracts may represent one of the most suitable alternatives to the widely used toxic biocides. Posidonia oceanica is one of the most representative organisms of the Mediterranean Sea and contains hundreds of bioactive compounds. In this study, we prepared, characterized, and assessed a hydroalcoholic extract of P. oceanica and then compared it to three model species. Together, these four species belong to relevant groups of biofoulers: bacteria (Aliivibrio fischeri), diatoms (Phaeodactylum tricornutum), and serpulid polychaetes (Ficopomatus enigmaticus). We also added the same P. oceanica extract to a PDMS-based coating formula. We tested this coating agent with Navicula salinicola and Ficopomatus enigmaticus to evaluate both its biocidal performance and its antifouling properties. Our results indicate that our P. oceanica extract provides suitable levels of protection against all the tested organisms and significantly reduces adhesion of N. salinicola cells and facilitates their release in low-intensity waterflows.

The influence of salinity on the toxicity of chemical UV-filters to sperms of the free-spawning mussel Mytilus galloprovincialis (Lamark, 1819)

Marine-coastal systems have been increasingly exposed to multiple stressors, including anthropogenic pollution and variations of Climate Change (CC) related factors, whose coexistence could create associated environmental and ecotoxicological risks. Among emergent stressors, 4-methylbenzylidenecamphor (4-MBC) and benzophenone-3 (BP-3) UV-filters are compounds widely used in increasing consumer products, resulting in their ubiquity in aquatic environments and possible pressing challenges on gamete susceptibility. Since most marine invertebrates reproduce by external fertilization, after spawning, gametes may be exposed to several pressures, affecting reproductive success and outcome. The present study focuses on the spermiotoxicity of the environmentally relevant UV-filters 4-MBC and BP-3 combined with salinity shifts, as potential modulators of their harmful effects. For this, Mytilus galloprovincialis male gametes were exposed in vitro to environmentally relevant and slightly higher concentrations (1, 10 and 100 µg/L) of 4-MBC or BP-3 under three different salinities (S 20, 30 and 40). Sperm quality endpoints associated with oxidative status, viability, motility, kinetics, and genotoxicity were evaluated. Similarities and differences in sperm responses among all conditions were highlighted by principal coordinates analysis (PCO). Results showed that salinity acting alone posed greater sperms impairments at the lowest (20) and highest (40) tested levels. When salinity acts as a co-varying stressor, salinity-dominant interactive effects resulted evident, especially for 4-MBC at S 40 and BP-3 at S 20. These findings were pointed out as the worst exposure conditions for M. galloprovincialis sperms, since caused major toxicological effects in terms of: (I) oxidative stress, sperm structural impairments, motility and kinetic alterations in 4-MBC-exposed sperms; (II) DNA damage, compromised mitochondrial activity and hyperactivation in BP-3-exposed ones. Overall, it stands out that salinity influences UV-filter toxicological pathways and, thereby, the potential environmental risk of these contaminants on M. galloprovincialis male gametes, especially in an expected salinity stress scenario.

A multi-bioassay integrated approach to assess antifouling potential of extracts from the Mediterranean sponge Ircinia oros

The phylum Porifera and their symbionts produce a wide variety of bioactive compounds, playing a central role in their ecology and evolution. In this study, four different extracts (obtained by non-polar and semi-polar extraction methodologies) of the Mediterranean sponge Ircinia oros were tested through a multi-bioassay integrated approach to assess their antifouling potential. Tests were performed using three common species, associated with three different endpoints: the marine bacterium Aliivibrio fischeri (inhibition of bioluminescence), the marine diatom Phaeodactylum tricornutum (inhibition of growth), and different development stages of the brackish water serpulid Ficopomatus enigmaticus (gametes: sperm motion, vitality inhibition and cellular damage; larvae: development; adults: AChE (acetylcholinesterase)-inhibitory activity). The effects of extracts were species specific and did not vary among different extraction methodologies. In particular, no significant reduction of bioluminescence of A. fischeri was observed for all tested samples. By contrast, extracts inhibited P. tricornutum growth and had toxic effects on different F. enigmaticus' developmental stages. Our results suggest that the proposed test battery can be considered a suitable tool as bioactivity screening of marine natural products.

Amphiphilic Polyphosphonate Copolymers as New Additives for PDMS-Based Antifouling Coatings

Poly(ethyl ethylene phosphonate)-based methacrylic copolymers containing polysiloxane methacrylate (SiMA) co-units are proposed as surface-active additives as alternative solutions to the more investigated polyzwitterionic and polyethylene glycol counterparts for the fabrication of novel PDMS-based coatings for marine antifouling applications. In particular, the same hydrophobic SiMA macromonomer was copolymerized with a methacrylate carrying a poly(ethyl ethylene phosphonate) (PEtEPMA), a phosphorylcholine (MPC), and a poly(ethylene glycol) (PEGMA) side chain to obtain non-water soluble copolymers with similar mole content of the different hydrophilic units. The hydrolysis of poly(ethyl ethylene phosphonate)-based polymers was also studied in conditions similar to those of the marine environment to investigate their potential as erodible films. Copolymers of the three classes were blended into a condensation cure PDMS matrix in two different loadings (10 and 20 wt%) to prepare the top-coat of three-layer films to be subjected to wettability analysis and bioassays with marine model organisms. Water contact angle measurements showed that all of the films underwent surface reconstruction upon prolonged immersion in water, becoming much more hydrophilic. Interestingly, the extent of surface modification appeared to be affected by the type of hydrophilic units, showing a tendency to increase according to the order PEGMA < MPC < PEtEPMA. Biological tests showed that Ficopomatus enigmaticus release was maximized on the most hydrophilic film containing 10 wt% of the PEtEP-based copolymer. Moreover, coatings with a 10 wt% loading of the copolymer performed better than those containing 20 wt% for the removal of both Ficopomatus and Navicula, independent from the copolymer nature.

Sperm quality assessment in Ficopomatus enigmaticus (Fauvel, 1923): Effects of selected organic and inorganic chemicals across salinity levels

Contamination by organic and inorganic compounds remains one of the most complex problems in both brackish and marine environments, causing potential implications for the reproductive success and survival of several broadcast spawners. Ficopomatus enigmaticus is a tubeworm polychaete that has previously been used as a model organism for ecotoxicological analysis, due to its sensitivity and ecological relevance. In the present study, the effects of five trace elements (zinc, copper, cadmium, arsenic and lead), one surfactant (sodium dodecyl sulfate, SDS) and one polycyclic aromatic hydrocarbon (benzo(a)pyrene, B(a)P) on the sperm quality of F. enigmaticus were investigated. Sperm suspensions were exposed in vitro to different concentrations of each selected contaminant under four salinity conditions (10, 20, 30, 35). Possible adverse effects on sperm function were assessed by measuring oxidative stress, membrane integrity, viability and DNA damage. Sperm quality impairments induced by organic contaminants were more evident than those induced by inorganic compounds. SDS exerted the largest effect on sperm. In addition, F. enigmaticus sperm showed high tolerance to salinity variation, supporting the wide use of this species as a promising model organism for ecotoxicological assays. Easy and rapid methods on polychaete spermatozoids were shown to be effective as integrated sperm quality parameters or as an alternative analysis for early assessment of marine and brackish water pollution.

Effects of copper on larvae of the marbled crab Pachygrapsus marmoratus (Decapoda, Grapsidae): Toxicity test and biochemical marker responses

The importance of trace elements in ecotoxicological investigations is a well-known issue when monitoring polluted areas such as commercial harbors. Copper represents one of the most common metal contaminants, often detected in these areas as it is widely employed in various fields and has many sources of inflow in the marine environment. Pachygrapsus marmoratus is a widespread intertidal crab species that has been extensively studied in ecology, ethology and population genetics. Ecotoxicological studies have also been performed, exclusively on the adult stage. In the present study we investigated the mortality and biochemical (oxidative stress and neurotoxicity) responses of P. marmoratus larvae exposure to environmental relevant concentration of copper. Results showed dose-dependent responses in terms of larval mortality, with a calculated LC₅₀ value of 0.5 mg/L of Cu²⁺. The LC₅₀ concentration was used as the starting point for subsequent biochemical response evaluation. Results also demonstrated dose-dependent activation of antioxidant systems assuming a compensatory antioxidant activity to prevent higher cellular damage when larvae were exposed to the highest concentrations of copper. Moreover, a significant enhancement of neurotransmitter activities was observed, assuming a possible direct interaction of copper with the enzymes or an increase of free copper ion aliquot into the cells.

Soluble esterases as biomarkers of neurotoxic compounds in the widespread serpulid Ficopomatus enigmaticus (Fauvel, 1923)

The characterization of soluble cholinesterases (ChEs) together with carboxylesterases (CEs) in Ficopomatus enigmaticus as suitable biomarkers of neurotoxicity was the main aim of this study. ChEs of F. enigmaticus were characterized considering enzymatic activity, substrate affinity (acetyl-, butyryl-, propionylthiocholine), kinetic parameters (K_m and V_max) and in vitro response to model inhibitors (eserine hemisulfate, iso-OMPA, BW284C51), and carbamates (carbofuran, methomyl, aldicarb, and carbaryl). CEs were characterized based on enzymatic activity, kinetic parameters and in vitro response to carbamates (carbofuran, methomyl, aldicarb, and carbaryl). Results showed that cholinesterases from F. enigmaticus showed a substrate preference for acetylthiocholine followed by propionylthiocholine; butyrylthioline was not hydrolyzed differently from other Annelida species. CE activity was in the same range of cholinesterase activity with acetylthiocholine as substrate; the enzyme activity showed high affinity for the substrate p-nytrophenyl butyrate. Carbamates inhibited ChE activity with propionylthiocholine as substrate to a higher extent than with acetylthiocoline. Also CE activity was inhibited by all tested carbamates except carbaryl. In vitro data highlighted the presence of active forms of ChEs and CEs in F. enigmaticus that could potentially be inhibited by pesticides at environmentally relevant concentration.

Insights into the levulinate-based ionic liquid class: synthesis, cellulose dissolution evaluation and ecotoxicity assessment

New levulinate ionic liquids (ILs) were able to dissolve cellulose in high amounts. The ecotoxicity profiles of these new ILs were also assessed.

The serpulid Ficopomatus enigmaticus () as candidate organisms for ecotoxicological assays in brackish and marine waters

Ficopomatus enigmaticus is an ubiquitous fouling reef-forming species, easy to sample and recognize, diecious with gamete spawning along different seasons in different salinity conditions. Due to its characteristics it could become a good candidate for the monitoring of both marine and brackish waters. The suitability of F. enigmaticus as a promising model organism in ecotoxicological bioassays was evaluated by a sperm toxicity and a larval development assay. The fertilization rate in different salinity conditions (range 5-35‰) was first assessed in order to detect the salinity threshold within which profitably perform the assays. Afterward copper (Cu²⁺), cadmium (Cd²⁺), sodium dodecyl sulfate (SDS) and 4-n-nonylphenol (NP) were used as reference toxicants in exposure experiments with spermatozoids (sperm toxicity assay) and zygotes (larval development assay). A dose-response effect was obtained for all tested toxicants along all salinity conditions except for 5‰ salinity condition where a too low (<30%) fertilization rate was observed. NP showed the highest degree of toxicity both in sperm toxicity and larval development assay. In some cases the results, expressed as EC₅₀ values at 35‰ salinity condition, were similar to those observed in the literature for marine organisms such as the sea urchin (Paracentrotus lividus) and the marine serpulid Hydroides elegans, while the exposure of F. enigmaticus spermatozoids' to Cd²⁺ and NP resulted in toxicity effects several orders of magnitude higher than observed in P. lividus. Spermatozoids resulted to be slightly more sensitive then zygotes to all different toxicants.

Ecotoxicological properties of ketoprofen and the S(+)-enantiomer (dexketoprofen): Bioassays in freshwater model species and biomarkers in fish PLHC-1 cell line

The increased use of nonsteroidal anti-inflammatory drugs (NSAIDs) has resulted in their ubiquitous presence in the environment. The toxicological properties of these 2 widely prescribed NSAIDs, namely racemic ketoprofen and its enantiomer S(+)-ketoprofen (dexketoprofen), were evaluated, firstly, by acute and chronic toxicity tests using 3 representative model organisms (Vibrio fischeri, Pseudokirchneriella subcapitata, and Ceriodaphnia dubia) and, secondly, by evaluating the responses of biotransformation systems and multidrug resistance-associated proteins (MRP1/MRP2) using the Poeciliopsis lucida hepatocellular carcinoma 1 (PLHC-1) fish hepatic cell line. Toxicity data from both acute and chronic dexketoprofen exposure indicated higher sensitivity through inhibition of bioluminescence and algal growth and through increased mortality/immobilization compared to racemic ketoprofen exposure. The growth inhibition test showed that racemic ketoprofen and dexketoprofen exhibited different effect concentration values (240.2 and 65.6 μg/L, respectively). Furthermore, racemic ketoprofen and dexketoprofen did not exert cytotoxic effects in PLHC-1 cells and produced compound-, time-, and concentration-specific differential effects on cytochrome P450 1A (CYP1A) and glutathione S-transferase levels. For CYP1A, the effects of racemic ketoprofen and dexketoprofen differed at the transcriptional and catalytic levels. Exposure to racemic ketoprofen and dexketoprofen modulated MRP1 and MRP2 mRNA levels, and these effects were also dependent on compound, exposure time, and concentration of the individual drug. The present study revealed for the first time the interactions between these NSAIDs and key detoxification systems and different sensitivity to the racemic mixture compared to its enantiomer. Environ Toxicol Chem 2018;37:201-212. © 2017 SETAC.

Ecotoxicity of pristine graphene to marine organisms

The ecotoxicity of pristine graphene nanoparticles (GNC1, PGMF) in model marine organisms was investigated. PGMF resulted more toxic than GNC1 to the bioluminescent bacterium Vibrio fischeri and the unicellular alga Dunaliella tertiolecta on the basis of EC50 values (end-points: inhibition of bioluminescence and growth, respectively). No acute toxicity was demonstrated with respect to the crustacean Artemia salina although light microscope images showed the presence of PGMF and GNC1 aggregates into the gut; a 48-h exposure experiment revealed an altered pattern of oxidative stress biomarkers, resulting in a significant increase of catalase activities in both PGMF and GNC1 1mg/L treated A. salina and a significant increase of glutathione peroxidase activities in PGMF (0.1 and 1mg/L) treated A. salina. Increased levels of lipid peroxidation of membranes was also observed in PGMF 1mg/L exposed A. salina.

Acute toxicity and biodegradability of N-alkyl-N-methylmorpholinium and N-alkyl-DABCO based ionic liquids

N-alkyl-N-methylmorpholinium and N-alkyl substituted 1,4-diazabicyclo[2.2.2]octane (DABCO) based ionic liquids (ILs), N-alkyl-DABCO, bearing short alkyl chains are characterised by a low toxicity to Vibrio fischeri, although toxicity significantly increases on increasing the alkyl chain length. Alkyl chain length affects also biodegradability in the 28 days tests; the higher level of biodegradation was found in both the series in the case of the ethyl (C2) derivatives. In the case of N-ethyl DABCO based IL, although biodegradability is still around 40%, and consequently this IL cannot be classified as "readily biodegradable", this value is similar to the more biodegradable functionalized imidazolium based ILs.

Acute toxicity of ionic liquids for three freshwater organisms: Pseudokirchneriella subcapitata, Daphnia magna and Danio rerio

The static acute toxicities of 18 ionic liquids (ILs) were determined for three representative freshwater organisms, the cladoceran Daphnia magna, the green alga Pseudokirchneriella subcapitata (formerly known as Selenastrum capricornutum), and the fish Danio rerio (formerly known as zebrafish). The test kit compounds contained three widely used ILs (1-butyl-3-methylimidazolium bis(triflimide), [bmim][Tf(2)N], butylpyridinium bis(triflimide), [bpy][Tf(2)N], and N,N-methylbutylpyrrolidinium bis(triflimide), [bmpyrr][Tf(2)N]) and 15 less common salts. These latter comprised a range of five anions, four positively charged head groups (ammonium, morpholinium, thiophenium, and sulfonium), five 1-methyl-3-alkyl imidazolium derivatives bearing a specific functional group on the longer alkyl chain (Cl, OH, or (CH(3))(3)Si) and three imidazolium derivatives characterized by the presence of a hydrogen atom on the imidazolium nitrogen ("Brønsted acidic imidazolium"-based ILs). Generally, long-chain ammonium salts showed higher toxicity to algae, cladocerans, and fish, whereas very low toxicities characterized sulfonium- and morpholinium-based ILs. In imidazolium-based ILs, the substitution of one or two carbon atoms of the longer alkyl chain with a more electronegative atom (chlorine or oxygen) reduced the acute toxicity for algae and cladocerans. Low toxicity also characterized the "Brønsted acidic imidazolium"-based ILs. Structural information for a rational designer of safer ILs can be obtained from these studies.

Tolerance of benzalkonium chloride, formalin, malachite green, and potassium permanganate in goldfish and zebrafish

OBJECTIVE

To determine tolerance of goldfish and zebrafish to benzalkonium chloride, formalin, malachite green, and potassium permanganate.

DESIGN

Tolerance study.

ANIMALS

Adult goldfish (Carassius auratus) and zebrafish (Danio rerio).

PROCEDURES

Groups of fish (n = 10/group) were exposed to each disinfectant at the therapeutic dosage; at 0.25, 0.5, 3, and 5 times the concentration used for the therapeutic dosage; and at the concentration used for the therapeutic dosage but for 3 or 5 times the recommended exposure time.

RESULTS

In both species, exposure to malachite green at the therapeutic dosage resulted in toxic effects, including death. Exposure to formalin at the therapeutic dosage resulted in toxic effects in goldfish, but not zebrafish, and exposure to potassium permanganate resulted in toxic effects in zebrafish, but not goldfish. On the basis of the ratio of therapeutic dosage to median lethal dosage, in goldfish, formalin was more toxic than benzalkonium chloride, which was more toxic than malachite green, which was more toxic than potassium permanganate. In zebrafish, potassium permanganate was more toxic than formalin and benzalkonium chloride, which were approximately equally toxic and more toxic than malachite green. Extending treatment time increased the toxicity of potassium permanganate in zebrafish and the toxicity of formalin and malachite green in goldfish, but did not alter the toxicity of the other disinfectants.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that there was no consistency between zebrafish and goldfish in their tolerance to disinfectants, and that therapeutic dosages reported in the literature for these disinfectants were not always safe.

Intracardiac Doppler assessment of left valve inflow in first-trimester fetuses with increased nuchal translucency: preliminary observations in trisomy 21

OBJECTIVES

To perform a qualitative assessment of the pulsed Doppler waveform profile at the level of left atrioventricular valve inflow in first-trimester fetuses with increased nuchal translucency thickness (NT), in order to compare those with trisomy 21 and those with normal karyotype.

METHODS

This was a review of 285 consecutive fetuses with increased NT. Pulsed Doppler velocity waveforms of left atrioventricular valve inflow were recorded. The E-wave, A-wave and velocity profile in the aorta were displayed. Cases were classified into two patterns: Pattern A included those in which the E-wave velocity crossed the A-wave before the baseline in all waveforms; Pattern B included those in which the lowest E-wave velocity crossed the baseline but not the A-wave in at least one of the profiles. The karyotype was determined and the frequency of occurrence of Patterns A or B in fetuses with normal karyotype and those with trisomy 21 were compared.

RESULTS

Of the 285 cases, 230 were assigned to Pattern A and 55 to Pattern B. There were 47 cases of trisomy 21, 22 had other chromosomal abnormalities, and 212 had a normal karyotype; in four cases the karyotype was unknown. Among the 212 karyotypically normal fetuses, five had heart defects, five had other structural defects, three suffered spontaneous intrauterine death and one was terminated. Pattern A was found in 200/212 (94.3%) cases with normal karyotype, in 12/47 (25.5%) cases with trisomy 21, and in 17/22 (77.3%) cases with other chromosomal abnormalities. Pattern B was found in 12/212 (5.7%) cases with normal karyotype, in 35/47 (74.5%) cases with trisomy 21 (chi-square test, P < 0.001), and in 5/22 (22.7%) cases with other chromosomal abnormalities.

CONCLUSIONS

Intracardiac Doppler qualitative assessment of left valve inflow in first-trimester fetuses with increased NT shows differences between normal and trisomy 21 fetuses, probably reflecting differences in myocardial function.

Fetal cells in maternal blood: a six-fold increase in women who have undergone amniocentesis and carry a fetus with Down syndrome: a multicenter study

Fetal nucleated red blood cells (FNRBCs) circulate in the maternal blood throughout pregnancy. Even if the frequency of fetal cells in the maternal circulation remains to be ascertained, complications of pregnancy such as fetal cells aneuploidies, preeclampsia, abnormal Doppler of the uterine artery without symptoms of preeclampsia, fetal growth restriction and polyhydramnios are associated with an increased feto-maternal trafficking. Based on these observations, previous studies have suggested that determination of the fetal nucleated red blood cell count (FNRBCC) might be a useful non-invasive screening test, either alone or in combination with existing maternal tests, for the non-invasive assessment of aneuploidies, in particular Down syndrome (DS). In this paper we have evaluated the distribution of FNRBCC in a set of 18 normal pregnancies and 18 pregnancies with a trisomy 21-affected fetus, matching for gestational age, maternal age, and, when possible, fetal gender, in order to quantify the difference in the number of fetal cells between the two populations. Maternal blood was collected from each pregnant woman two to three weeks after amniocentesis after knowing the cytogenetic results. Correlation of FNRBCC with the gestational week and clinical status (affected vs. non affected) by multiple regression analysis provided significant results (p < 0.001). Adjusted values of FNRBCC were 48 +/- 10.2 in controls and 301 +/- 17.01 in DS cases, corresponding to a 6.27 fold increase. These retrospective results prompt a prospective evaluation of the use of FNRBCC for screening purposes.

Safety of azamethiphos in eel, seabass and trout

The safety of azamethiphos (AZA), an organophosphorous insecticide and the active ingredient of Salmosan, was evaluated in the European eel, seabass and rainbow trout. Fish were bathed in 0.1 ppm AZA for a period of 60, 120 or 240 min. After termination of each treatment fish were transferred to clean aquaria and randomly sampled over 21 days. Compared to controls, brain acetylcholinesterase (AChE) was inhibited up to 44, 56 and 62% in eels, seabass and trout, respectively, with the inhibition being significant for up to 4 days in eels and seabass and 7 days in trout. As result of the AChE depression, fish displayed motor hyperactivity and erratic jumping at the onset of treatment. Mortality was observed only in trout following exposure for 240 min. A variable correlation observed among species between the level of exposure, the reduced activity of brain AChE and the signs of toxicity suggest that brain AChE should be considered as an indicator of exposure rather than as an index of toxicity of AZA. The present data indicate that at the therapeutic dosage of 0.1 ppm AZA for 1h can be safely used in eels, seabass and trout. The extended treatment times up to 240 min were equally safe for eels and seabass but not for trout.

Antigenicity of Pseudodactylogyrus anguillae and P. bini (Monogenea) in the European eel (Anguilla anguilla, L.) under different oxygenation conditions

The antibody response of European eels (Anguilla anguilla, L.) to the branchial parasites Pseudodactylogyrus anguillae and P. bini under hyperoxygenation conditions was studied. The antigenic fractions of parasites were detected by means of electrophoretic techniques (SDS-PAGE) and by Western blot analysis. The results obtained demonstrate that under hyperoxygenation conditions, the eels responded to a greater number of proteins, and this was correlated with a decrease in the level of infestation.

Twin pregnancy achieved through TESE in an adult male exstrophy

Bladder exstrophy is a rare anomaly, it compromises bladder functions, and in males it occurs with an impairment of reproductive functions, because of erectile and ejaculatory deficit. Advancements in the surgical treatment of bladder exstrophy have allowed an improvement of the bladder functions while spontaneous conception is still impaired. This is a case report of a pregnancy and subsequent birth of twins following testicular sperm extraction, on a man born with classical bladder exstrophy with infertility due to an ejaculation.

Fetal nuchal translucency screening in 12495 pregnancies in Sardinia

OBJECTIVE

To examine the distribution of fetal nuchal translucency thickness in normal and chromosomally abnormal fetuses in Sardinia and to determine the effectiveness of screening by a combination of fetal nuchal translucency and maternal age.

METHODS

Fetal nuchal translucency thickness and crown-rump length were measured at 10-14 weeks of gestation in 12 495 pregnancies. A reference range of fetal nuchal translucency thickness for crown-rump length was determined from the 10 001 singleton pregnancies with known normal pregnancy outcome. The median nuchal translucency thickness for crown-rump length was determined by regression analysis of the calculated median values of nuchal translucency thickness for each 0.1 mm interval in crown-rump length. The proportions of unaffected fetuses and those with trisomy 21 or other chromosomal defects with nuchal translucency thickness > 1.5 and 2.0 multiples of the regressed normal median for crown-rump length were calculated. The distribution of estimated risks based on maternal age and fetal nuchal translucency thickness according to The Fetal Medicine Foundation software were also determined and the sensitivity and false-positive rates were calculated.

RESULTS

In the 10 001 normal pregnancies, the median fetal nuchal translucency thickness increased with crown-rump length (median nuchal translucency thickness = 0.3496 + 0.018 x crown-rump length) (r2 = 0.4411). In the singleton pregnancies, there were 64 fetuses with trisomy 21 and 46 with other chromosomal defects. The fetal nuchal translucency thickness was > 1.5 multiples of the median in 510 (5%) of the normal fetuses, in 52 (81%) of the trisomy 21 fetuses and in 33 (72%) of those with other chromosomal defects. The respective values for nuchal translucency thickness > 2.0 multiples of the median were 195 (2%), 41 (64%) and 32 (70%). In 184 multiple pregnancies, there were four fetuses with chromosomal abnormalities and in three of these the nuchal translucency thickness was > 1.5 multiples of the median. Screening by a combination of maternal age and fetal nuchal translucency thickness with a risk cut-off of 1 in 300 identified 90% of trisomy 21 pregnancies and 85% of all other chromosomal defects for a false-positive rate of 9%.

CONCLUSION

Screening for chromosomal defects by measurement of nuchal translucency thickness identifies 80% of fetuses with trisomy 21 for a false-positive rate of 5%. In our population with a median maternal age of 33 years, screening by a combination of maternal age and fetal nuchal translucency thickness with a risk cut-off of 1 in 300 identified 90% of trisomy 21 pregnancies for a false-positive rate of 9%.

Prenatal sonographic diagnosis of Klippel-Trénaunay-Weber syndrome with cardiac failure

This report describes the prenatal sonographic diagnosis of a case of Klippel-Trénaunay-Weber syndrome. The sonographic appearance of this disorder was characterized by the presence of multiple distorted cystic areas involving the right leg and abdomen and cardiomegaly with early fetal heart failure. Despite the prenatal detection of the extensive cutaneous and visceral involvement, the infant died soon after birth of high-output cardiac failure and Kasabach-Merritt syndrome.

Nuchal translucency and the acceptance of invasive prenatal chromosomal diagnosis in women aged 35 and older

OBJECTIVE

To investigate the effect of nuchal translucency screening on use of prenatal diagnosis for chromosomal abnormalities in women aged 35 and older.

METHODS

Two groups of women, referred to our center for prenatal karyotype diagnosis because of maternal age, were compared: one in 1995 and the other in 1999 after the introduction of nuchal translucency measurement. Each woman received nondirective genetic counseling, and for the 1999 group, nuchal translucency results were also discussed. Risks of transabdominal chorionic villi sampling (CVS) and amniocentesis, laboratory techniques, genetic results, and local experiences were discussed. Patient's decision to undergo prenatal diagnosis, acceptance of the nuchal translucency test (in the 1999 group), and the rate of chromosomal abnormalities diagnosed by transabdominal CVS and amniocentesis, were considered.

RESULTS

Two hundred twenty-one of 982 (22%) women in the 1995 group and 421 of 1386 (30%) in the 1999 group, after nondirective genetic counseling declined invasive diagnosis (P <.05). In the 1999 cohort, 1088 of 1089 (99.9%) women of appropriate gestational age had nuchal translucency measurement. Among women seen in 1995, 214 opted for transabdominal CVS (31%) and 476 (69%) for amniocentesis. Nineteen abnormal karyotypes were detected, six by transabdominal CVS and 13 (68.5%) by amniocentesis. In 1999, 266 women (29%) opted for transabdominal CVS and 650 (71%) for amniocentesis. Twenty abnormal karyotypes were detected, 13 (65%) by transabdominal CVS and seven (35%) by amniocentesis (P <.05).

CONCLUSION

Knowledge of nuchal translucency could lead to a decrease in the demand for invasive diagnosis and to a more frequent diagnosis by first-trimester transabdominal CVS.

First trimester umbilical artery pulsatility index in fetuses presenting enlarged nuchal translucency

The aim of this prospective study was to evaluate an umbilical artery pulsatility index (UAPI) in first trimester fetuses who present enlarged nuchal translucency (NT) measurements. UAPI was measured in 121 single fetuses with NT > or =95th centile, from 10+3 to 13+6 weeks (crown-rump length (CRL) > or =38 mm - < or =84 mm). In these fetuses there were 20 trisomy 21, and six other chromosomal abnormalities (three trisomy 18 and three monosomy X). Eighty-nine cases had normal karyotype and delivered a baby without evidence of congenital malformations. Five fetuses with normal karyotype assessed antenatally were excluded from the comparison, because of evidence of congenital malformation. A fetus with normal karyotype that was spontaneously miscarried at 14 weeks' after chorionic villus sampling was also excluded. UAPI of fetuses with enlarged NT was compared with those of 65 singleton fetuses with normal NT and normal karyotype, which were used to establish our terms of reference (5th centile, median and 95th centile). UAPI of 7/20 (35%) Down syndrome and 42/89 (47%) normal karyotype fetuses presenting enlarged NT were above the median, and respectively 2/20 (10%) and 14/89 (15.7%) were above 95th centile of normal NT and normal karyotype fetuses. No significant differences were demonstrated in the UAPI values amongst normal karyotype fetuses with normal NT or normal karyotype fetuses with an enlarged NT or trisomy 21 fetuses with an enlarged NT.

Nuchal translucency in multiple pregnancies

AIM

To evaluate the prevalence of increased nuchal translucency (NT) in multiple pregnancies and its relation to fetal karyotype and pregnancy outcome.

METHODS

We measured fetal nuchal translucency (NT) in 6,338 women pregnant from 10+3 to 13+6 weeks by ultrasound and evaluated the prevalence of NT=95th centile in 115 multiple pregnancies, including 100 pairs of twins (70 dichorionic and 30 monochorionic placentas), 9 triplets, 5 quadruplets, and one quintuplet. Chorionicity, fetal karyotype, and pregnancy outcome were also evaluated in 400 singleton pregnancies.

RESULTS

NT=95th centile in a single fetus was found in 10/70 cases of dichorionic twin pregnancies (14%), in two quadruplets, in 7/30 monochorionic twin pregnancies (23.3%), and in both fetuses in one dichorionic twin pregnancy. In the control group, NT=95th centile was found in 17/400 (4.2%) cases. In multiple pregnancies, two cases of trisomy 21 and one of 47, XXY were found. NT=95th centile was found in 2/2 fetuses with trisomy 21 (one dichorionic twin pregnancy and one tetrachorionic pregnancy), but not in the 47, XXY trisomy (trichorionic triplet pregnancy). A skeletal dysplasia and a Goldenhar syndrome were found among the 10 dichorionic pregnancies with increased NT. Three intrauterine deaths of both fetuses, one congenital heart disease, and a case of twin-to-twin transfusion occurred in 7 monochorionic pregnancies with increased NT.

CONCLUSION

Increased NT in multiple pregnancies indicates fetuses at risk of chromosomal abnormalities and fetal malformation, and monochorionic twin pregnancies at higher risk of adverse outcome.

Transient hyperechogenicity of the fetal pericardium: a case report

An unusually echogenic fetal pericardium was visualized using ultrasound at 21 weeks' gestation. Serial prenatal examinations revealed its progressive, spontaneous resolution. Follow-up examinations of the newborn and infant failed to demonstrate any clinical or echocardiographic abnormality. The occurrence of this unusual pericardial abnormality and its transient nature should be considered during sonographic examination of the fetus.

Prenatal ultrasound diagnosis of congenital cystic adenomatoid malformation of the lung: a report of 26 cases and review of the literature

OBJECTIVES

To evaluate the sonographic appearances and prenatal natural history of congenital cystic adenomatoid malformation of the lung.

METHODS

In each case a detailed examination of the thoracic lesion and a complete fetal survey was performed. The pregnancies that elected to continue were followed to term.

RESULTS

A total of 26 cases were identified. The pregnancy was electively terminated in nine cases (35%). All the remaining 17 pregnancies ended in liveborn infants (100%). The lesion disappeared completely in three fetuses (18%). Of the 14 infants in whom the lesion was confirmed at birth nine required surgery in the neonatal or post-natal period. Five children did not undergo surgery.

CONCLUSIONS

Conservative management appears to be an adequate medical practice in cases of isolated congenital unilateral cystic adenomatoid malformation of the lung, in the absence of hydrops and/or acute polyhydramnios.

Assessment of risk for chromosomal abnormalities at 10-14 weeks of gestation by nuchal translucency and maternal age in 5,210 fetuses at a single centre

OBJECTIVE

To evaluate the screening of chromosomal abnormalities by nuchal translucency (NT) measurement.

METHODS

Assessment of risk for chromosomal abnormalities by NT and maternal age in 5,210 single fetuses with karyotype and outcome already known.

RESULTS

Risk was > or =1 in 300 in 640 (12.2%) of all fetuses, in 575 (11.1%) of the normal fetuses, in 38 (80.8%) of the fetuses affected by trisomy 21, and in 65 (89%) of the fetuses affected by chromosomal abnormalities. Risk was > or =1 in 200 in 477 (9.1%) of all fetuses, in 418 (8.1%) of the normal fetuses, in 35 (74.4%) of the fetuses affected by trisomy 21, and in 59 (80.8%) of the fetuses affected by chromosomal abnormalities. Risk was > or =1 in 100 in 270 (5.1%) of all fetuses, in 216 (4.2%) of the normal fetuses, in 33 (70.2%) of the fetuses affected by trisomy 21, and in 54 (73.9%) of the fetuses affected by chromosomal abnormalities.

CONCLUSIONS

Risk generated by NT and maternal age is effective in screening for chromosomal abnormalities.

[Fertilization in vitro and microinsemination. 6 years of experience in the Ospedale Microcitemico of Cagliari]

BACKGROUND

In this study the results of six years experience (1993-1998) in IVF, ICSI and assisted hatching on 442 sterile couples for a total of 868 cycles are reported. Since 1997 ICSI has also been carried out in cases of azoospermia extracting mobile spermatozoa from the epididymal (MESA) or from the testicle (TESE).

METHODS

Ages ranged from 20 to 48 and mean years sterility was 5.868 cycles were carried out of which 153 (17.62%) were for IVF, 705 (81.22%) for ICSI and 10 (1.15%) for MESA and TESE. Assisted hatching was performed through "partial zona dissection" in 329 cases on a total of 987 embryos.

RESULTS

The pregnancy rates per embryo transfer in IVF and ICSI cycles were 22.4 and 19.96% respectively. Results considering patients age were: 33.87% below 35, 29.55% between 35 and 38 and 6.60% above 38. In the group of 189 assisted hatching patients the evolutive pregnancy rate rose from 15.78 to 26.40% and multiple pregnancies from 28.63 to 42%.

CONCLUSIONS

ICSI has offered high rates of fertilization and pregnancy even in extreme cases of oligoasthenospermia or cases of azoospermia adopting MESA or TESE techniques. A decisive factor on pregnancy rates is age, very low over 38 years. Assisted Hatching further increased the pregnancy rates.

Fetal nuchal translucency and prenatal diagnosis of beta-thalassaemia

In Sardinia, fetal karyotyping for couples at risk for beta-thalassaemia is offered only to women >/=35 years and for specific risk of chromosomopathies. This policy is not easily accepted by the couples who incessantly request additional karyotyping. In order to select those at highest risk of chromosomal abnormalities among young women, fetal nuchal translucency (NT) thickness measurement was performed in 510 fetuses to assess the chromosomal risk before chorionic villus sampling. A risk >/=1/100 was judged positive and worthy of additional karyotyping. 126 cases interrupted the pregnancy after a result of homozygous beta-thalassaemia, hence 384 pregnancies were included in the study. 22 (5.7 per cent) fetuses were found NT positive. A total of three chromosomal abnormalities were detected. The NT test was positive in all three cases of chromosomopathies detected (100 per cent) and in 19 of 381 (4.98 per cent) normal karyotype fetuses. No features of major chromosomal abnormalities were reported among the newborns whose NT had resulted normal. These preliminary results have confirmed the efficacy of NT testing to assess the risk of trisomy 21 and other chromosomopathies and enhanced its utility in pregnancies already suited to sampling in the first-trimester for Mendelian disorders.

Can fetal iliac bone measurement be used as a marker for Down's syndrome screening?

OBJECTIVE

The aim of this study was to assess the application of iliac bone length measurement in screening for Down's syndrome.

DESIGN

Measurement of fetal iliac bone length was prospectively carried out in 609 pregnant women at the time of amniocentesis, and correlated with the results of karyotype analysis.

SUBJECTS

Following exclusion of cases with chromosomal abnormalities other than trisomy 21, cases with intrauterine growth impairment or structural abnormalities and cases with incomplete follow-up, 466 karyotypically normal fetuses and 14 fetuses with trisomy 21 were included in the analysis.

METHODS

Centiles, standard deviations, expected values by means of linear regression analysis of the iliac bone, in relation to the biparietal diameter, were calculated in the normal fetuses. In order to identify pregnancies at risk for trisomy 21, where a 'longer' than normal iliac bone was expected, three cut-offs previously proposed by other authors and three new criteria were employed. Sensitivity, false-positive rate and likelihood ratio were calculated to assay the different cut-off criteria.

RESULTS

Eleven of the 14 (79%) fetuses affected by trisomy 21 had an iliac bone length greater than the 50th centile of normal values. The most useful threshold was an iliac bone length > or = 2 SD of the normal (29% sensitivity and 2% false-positive rate).

CONCLUSIONS

This study confirms that fetuses with Down's syndrome tend to have a longer iliac bone length measurement than those with normal karyotype. However, due to the different methods used in different centers, the application of this measurement does not offer sufficiently convincing results for it to be used when screening for Down's syndrome.

In utero stem cell transplantation

AIM

To investigate feasibility, safety, and efficacy of in utero transplantation of hemopoietic stem cells.

METHODS

A 10-week fetus was found to have b-thalassemia major after prenatal diagnosis by chorionic villus sampling and DNA analysis. The couple asked for prenatal treatment and, after extensive genetic counseling and local Ethical Committee approval, CD34+ hematopoietic progenitor cells purified from paternal bone marrow were injected to the fetus intraperitoneally, under ultrasound guidance.

RESULTS

A healthy 3.5 kg fetus was spontaneously delivered with no clinical or laboratory signs of graft-versus-host-disease. Analysis of the cord blood by high-pressure liquid chromatography revealed the absence of adult HbA, typical of b-thalassemic patients. Analysis of the Hb chain synthesis showed no clear signs of b-chain presence.

CONCLUSIONS

In utero transplantation of hematopoietic progenitor cells was not successful for b-thalassemia. Caution should be taken when considering other applications than immunodeficiency diseases.