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Ashley B, Simner C, Manousopoulou A, Jenkinson C, Hey F, Frost JM, Rezwan FI, White CH, Lofthouse EM, Hyde E, Cooke LDF, Barton S, Mahon P, Curtis EM, Moon RJ, Crozier SR, Inskip HM, Godfrey KM, Holloway JW, Cooper C, Jones KS, Lewis RM, Hewison M, Garbis SDD, Branco MR, Harvey NC, Cleal JK. Placental uptake and metabolism of 25(OH)vitamin D determine its activity within the fetoplacental unit. eLife 2022; 11:71094. [PMID: 35256050 PMCID: PMC8903835 DOI: 10.7554/elife.71094] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 01/20/2022] [Indexed: 12/13/2022] Open
Abstract
Pregnancy 25-hydroxyvitamin D [25(OH)D] concentrations are associated with maternal and fetal health outcomes. Using physiological human placental perfusion and villous explants, we investigate the role of the placenta in regulating the relationships between maternal 25(OH)D and fetal physiology. We demonstrate active placental uptake of 25(OH)D3 by endocytosis, placental metabolism of 25(OH)D3 into 24,25-dihydroxyvitamin D3 and active 1,25-dihydroxyvitamin D [1,25(OH)2D3], with subsequent release of these metabolites into both the maternal and fetal circulations. Active placental transport of 25(OH)D3 and synthesis of 1,25(OH)2D3 demonstrate that fetal supply is dependent on placental function rather than simply the availability of maternal 25(OH)D3. We demonstrate that 25(OH)D3 exposure induces rapid effects on the placental transcriptome and proteome. These map to multiple pathways central to placental function and thereby fetal development, independent of vitamin D transfer. Our data suggest that the underlying epigenetic landscape helps dictate the transcriptional response to vitamin D treatment. This is the first quantitative study demonstrating vitamin D transfer and metabolism by the human placenta, with widespread effects on the placenta itself. These data demonstrate a complex interplay between vitamin D and the placenta and will inform future interventions using vitamin D to support fetal development and maternal adaptations to pregnancy.
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Affiliation(s)
- Brogan Ashley
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
| | - Claire Simner
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
| | - Antigoni Manousopoulou
- Beckman Research Institute, City of Hope National Medical CenterDuarteUnited States,Proteas Bioanalytics Inc, BioLabs at the Lundquist InstituteTorranceUnited States
| | - Carl Jenkinson
- Institute of Metabolism and Systems Research, The University of BirminghamBirminghamUnited Kingdom
| | - Felicity Hey
- NIHR Cambridge Biomedical Research Centre, Nutritional Biomarker Laboratory. MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Clifford Allbutt Building, Cambridge Biomedical CampusCambridgeUnited Kingdom,Formerly at MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL l Merck Exploratory Science Center, Merck Research LaboratoriesCambridgeUnited States
| | - Jennifer M Frost
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of LondonLondonUnited Kingdom
| | - Faisal I Rezwan
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom,School of Water, Energy and Environment, Cranfield UniversityCranfieldUnited Kingdom
| | - Cory H White
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom,Merck Exploratory Science Center, Merck Research LaboratoriesCambridgeUnited States
| | - Emma M Lofthouse
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
| | - Emily Hyde
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
| | - Laura DF Cooke
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
| | - Sheila Barton
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom
| | - Pamela Mahon
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom
| | - Elizabeth M Curtis
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom
| | - Rebecca J Moon
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom,NIHR Applied Research Collaboration Wessex, Southampton Science ParkSouthamptonUnited Kingdom
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUnited Kingdom
| | - John W Holloway
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUnited Kingdom,NIHR Oxford Biomedical Research Center, University of OxfordOxfordUnited Kingdom
| | - Kerry S Jones
- NIHR Cambridge Biomedical Research Centre, Nutritional Biomarker Laboratory. MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Clifford Allbutt Building, Cambridge Biomedical CampusCambridgeUnited Kingdom,Formerly at MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL l Merck Exploratory Science Center, Merck Research LaboratoriesCambridgeUnited States
| | - Rohan M Lewis
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
| | - Martin Hewison
- Institute of Metabolism and Systems Research, The University of BirminghamBirminghamUnited Kingdom
| | - Spiros DD Garbis
- Proteas Bioanalytics Inc, BioLabs at the Lundquist InstituteTorranceUnited States
| | - Miguel R Branco
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of LondonLondonUnited Kingdom
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUnited Kingdom
| | - Jane K Cleal
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
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Abstract
We report a case of severe unilateral epistaxis requiring surgical arrest of bleeding, via endoscopic sphenopalatine artery ligation and anterior ethmoidal artery ligation. This followed recreational nasal insertion of St John's wort (Hypericum perforatum). Interactions between this substance and prescribed drugs have been described following oral ingestion. However, this unusual case highlights a further, worrying potential rhinological side effect of this substance.
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Affiliation(s)
- D P Crampsey
- Department of Otolaryngology, Head and Neck Surgery, North Glasgow University Hospitals, Gartnavel General Hospital, Glasgow, Scotland, UK.
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Abstract
Injury to the vagus nerve or one of its branches during carotid endarterectomy (CEA) can result in vocal fold paralysis (VFP). This study assessed prospectively 73 patients undergoing CEA. A total of 76 procedures were performed in these patients over a one-year period. All patients underwent pre-operative and post-operative assessment of vocal fold mobility by indirect laryngoscopy and/or flexible nasendoscopy. All patients had normal vocal fold mobility pre-operatively. Eight patients (10 per cent) complained of hoarseness after surgery and in three patients (four per cent) examination confirmed an ipsilateral VFP. This persists in all three patients at six-month follow-up. Vocal fold assessment is important in patients undergoing CEA, particularly when performing second side surgery. We recommend that patients should be informed of the risk of VFP following CEA when obtaining consent.
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Affiliation(s)
- F I Espinoza
- Department of Otolaryngology-Head and Neck Surgery, Gartnavel General Hospital, West Glasgow Hospitals University NHS Trust, UK
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Jones AS, Roland NJ, Caslin AW, Cooke TG, Cooke LD, Forster G. A comparison of cellular proliferation markers in squamous cell carcinoma of the head and neck. J Laryngol Otol 1994; 108:859-64. [PMID: 7989834 DOI: 10.1017/s0022215100128336] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Head and neck squamous cell carcinoma has a relatively good prognosis but treatment may be at the expense of function and quality of life. Various host and tumour parameters have been studied in an attempt to predict the course of the disease but without success. It has been hoped that laboratory based methods, particularly those based on molecular biology, may prove more useful. Cell kinetic parameters are studied in this paper. The present study includes 75 patients with a proven squamous cell carcinoma of the head and neck at various sites and undergoing various forms of treatment. The patient's mean age was 62 years and the median survival rate 45 months. Immunohistochemical techniques using Ki67 and PCNA were compared with flow cytometric analysis which included the BRDU labelling index, the duration of S phase, ploidy and potential doubling time. The median PCNA index was 560 and the Ki67 index 298. These indices varied between 980 and 150 for PCNA and 808 and 110 for Ki67. The BRDU labelling index measured by flow cytometry was 8.9 with a range from 25 to 1.6 and the duration of S phase was 14.8 hours. The PCNA index failed to correlate with any host or tumour factors and this failure was also seen in Ki67 indices and also in the flow cytometric parameters. There was a strong correlation between PCNA and Ki67 expression (p < 0.0001). Neither PCNA nor Ki67 values were significantly different between irradiated and nonirradiated tissues nor in sites or in patients who later developed lymph node metastases.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A S Jones
- Department of Otolaryngology/Head and Neck Surgery, University of Liverpool
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Cooke LD, Cooke TG, Forster G, MacDonald DG, Robertson AG, Soutar DS. Flow cytometric analysis of DNA content in squamous carcinoma of the tongue: the relationship to host and tumour factors and survival. Clin Otolaryngol 1994; 19:131-4. [PMID: 8026090 DOI: 10.1111/j.1365-2273.1994.tb01196.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Cellular DNA content has been found to be an important prognostic factor in many human tumours, yet within the head and neck region few studies have examined its effect on survival and in those that have, findings differ. Eighty-one consecutive patients with squamous carcinoma of the tongue mainly treated by surgery and post-operative radiotherapy were studied. The DNA content of archival paraffin embedded tumours was measured by flow cytometry. Fifty-seven tumours were diploid and 24 were aneuploid. There was no association between ploidy status and age, sex, tumour size or nodal status. Ploidy status was not related to survival. These findings indicate that analysis of tumour DNA content in squamous carcinoma of the tongue does not provide any additional prognostic information for the individual patient.
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Affiliation(s)
- L D Cooke
- Department of Surgery, Glasgow Royal Infirmary, UK
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Cooke LD, Cooke TG, Forster G, Jones AS, Stell PM. Prospective evaluation of cell kinetics in head and neck squamous carcinoma: the relationship to tumour factors and survival. Br J Cancer 1994; 69:717-20. [PMID: 8142259 PMCID: PMC1968830 DOI: 10.1038/bjc.1994.135] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Tumour growth rates were measured in 105 patients using in vivo incorporation of bromodeoxyuridine (BrdU) and investigated for any relationship to tumour factors or survival. The median labelling index (LI) was 8.7%, the duration of S-phase (Ts) was 14 h and the potential doubling time (Tpot) was 5.9 days. The labelling index in aneuploid tumours was significantly higher than that in diploid tumours. However the total labelling index (TLI) did not differ significantly between aneuploid and diploid tumours, and so it would seem likely that the difference in LI is due to the dilutional effect of benign tissue upon the calculation of LI in diploid tumours. The total labelling index, duration of S-phase and potential doubling time were not related to the tumour factors examined (site, T stage, N stage, stage grouping). Interim survival analysis was carried out and there was no difference in survival between those patients with high values for TLI, Ts, and Tpot and those with low values.
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Affiliation(s)
- L D Cooke
- Department of Surgery, Glasgow Royal Infirmary, UK
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Forster G, Cooke TG, Cooke LD, Stanton PD, Bowie G, Stell PM. Tumour growth rates in squamous carcinoma of the head and neck measured by in vivo bromodeoxyuridine incorporation and flow cytometry. Br J Cancer 1992; 65:698-702. [PMID: 1586597 PMCID: PMC1977390 DOI: 10.1038/bjc.1992.147] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The cell kinetics of 82 squamous cell carcinomas of the head and neck were studied by in vivo administration of the thymidine analogue, bromodeoxyuridine (BrdUrd). Ploidy, BrdUrd labelling index (LI), duration of S-phase (Ts), potential doubling time (Tpot) and S-phase fraction (SPF) were measured by flow cytometry on 50 microns paraffin embedded sections. The range of values obtained compared well with other in vivo cell kinetic studies of head and neck cancer. Aneuploid tumours had a significantly higher BrdUrd labelling index and SPF, and a short Tpot than diploid tumours. To validate the use of 50 microns sections for measuring cell kinetic parameters by flow cytometry a comparison of values obtained by 50 microns sections and small blocks of tissue was made. No significant difference was found between the two methods. Reproducibility of values between two consecutive thick sections was also good. We conclude that reproducible cell kinetic measurements can be made in tumour samples using 50 microns sections of BrdUrd labelled tissue.
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Affiliation(s)
- G Forster
- University Department of Surgery, Glasgow Royal Infirmary, UK
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Cooke LD, Cooke TG, Bootz F, Forster G, Helliwell TR, Spiller D, Stell PM. Ploidy as a prognostic indicator in end stage squamous cell carcinoma of the head and neck region treated with cisplatinum. Br J Cancer 1990; 61:759-62. [PMID: 2337512 PMCID: PMC1971589 DOI: 10.1038/bjc.1990.169] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
We measured tumour cellular DNA in 102 patients entered into two phase III trials of chemotherapy for end stage squamous carcinoma of the head and neck. The median survival of untreated patients with aneuploid tumours was 55 days compared with 224 days for patients treated with cisplatinum. This difference was highly significant. In contrast the median survival of untreated patients with diploid tumours was 74 days compared with 118 days for treated patients. Although this difference is statistically significant, the increased survival of 6 weeks is of no clinical benefit compared with the prolongation of survival of 6 months in patients with aneuploid tumours. Multivariate analysis showed that the significant predictors of survival were Karnofsky status, response to chemotherapy and ploidy.
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Affiliation(s)
- L D Cooke
- Department of Otorhinolaryngology, University of Liverpool, UK
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Abstract
The histopathology of 54 squamous carcinomas of the head and neck was evaluated by qualitative grading and morphometry in order to identify those features which predicted a good response to cisplatinum chemotherapy. The histopathology of 66 cases was correlated with tumour ploidy, determined by flow cytometry of paraffin-embedded material, since a separate study has shown that aneuploid carcinomas respond better to chemotherapy. The degree of differentiation was a poor predictor of ploidy, although diploid carcinomas did show more keratin and less nuclear pleomorphism than aneuploid carcinomas. The prominence of nucleoli in tumour cells and the surface area to volume (s/v) ratio of the tumour islands were the variables most strongly correlated with ploidy, with diploid carcinomas having prominent nucleoli and a low s/v ratio. A good response to chemotherapy was related partly to the architecture of the carcinoma (pushing border and low s/v ratio), and partly to the tumour cells (well differentiated) and the percentage of necrotic tumour. A lack of inflammatory reaction or desmoplasia was associated with a poor response. The results indicate that both subjective and objective histopathological criteria may be used to predict ploidy and the response to cisplatinum chemotherapy of squamous carcinoma of the head and neck. A combination of s/v ratio and the percentage of necrotic tumour can be used to identify a group of patients with a relatively good survival.
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Affiliation(s)
- T R Helliwell
- Department of Pathology, Otorhinolaryngology University of Liverpool, England
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