intrauterine growth restriction

宫内生长受限
  • 文章类型: Journal Article
    宫内生长受限(IUGR),当胎儿没有像预期的那样生长时,与肝功能降低和成年后慢性肝病的风险增加有关。利用早期发育可塑性来逆转不良胎儿编程的结果仍然是一个尚未探索的领域。专注于新生儿的生化概况和先前的转录组发现,选择来自相同胎儿的仔猪作为研究IUGR的模型。通过scRNA-seq创建肝脏的细胞景观,以揭示IUGR诱导的肝损伤中的性别依赖性模式。出生后一周,IUGR仔猪经历低氧应激。IUGR女性表现出成纤维细胞驱动的T细胞转化为免疫适应表型,有效缓解炎症,促进肝再生。相比之下,男性经历更严重的肝损伤。由于脂质代谢中断导致的长时间炎症阻碍了非免疫细胞之间的细胞间通讯,最终损害肝脏再生,甚至到成年。此外,载脂蛋白A4(APOA4)通过减少肝脏甘油三酯沉积作为抗IUGR男性缺氧的保护性反应而被探索作为一种新型生物标志物。PPARα激活可以减轻IUGR男性的肝损伤,同时使过度表达的APOA4恢复正常。这项开创性研究为IUGR期间对肝损伤的性二态反应提供了宝贵的见解。
    Intrauterine growth restriction (IUGR), when a fetus does not grow as expected, is associated with a reduction in hepatic functionality and a higher risk for chronic liver disease in adulthood. Utilizing early developmental plasticity to reverse the outcome of poor fetal programming remains an unexplored area. Focusing on the biochemical profiles of neonates and previous transcriptome findings, piglets from the same fetus are selected as models for studying IUGR. The cellular landscape of the liver is created by scRNA-seq to reveal sex-dependent patterns in IUGR-induced hepatic injury. One week after birth, IUGR piglets experience hypoxic stress. IUGR females exhibit fibroblast-driven T cell conversion into an immune-adapted phenotype, which effectively alleviates inflammation and fosters hepatic regeneration. In contrast, males experience even more severe hepatic injury. Prolonged inflammation due to disrupted lipid metabolism hinders intercellular communication among non-immune cells, which ultimately impairs liver regeneration even into adulthood. Additionally, Apolipoprotein A4 (APOA4) is explored as a novel biomarker by reducing hepatic triglyceride deposition as a protective response against hypoxia in IUGR males. PPARα activation can mitigate hepatic damage and meanwhile restore over-expressed APOA4 to normal in IUGR males. The pioneering study offers valuable insights into the sexually dimorphic responses to hepatic injury during IUGR.
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  • 文章类型: Journal Article
    背景:肠是抵抗各种应激反应的屏障。宫内生长受限(IUGR)可通过破坏肠上皮细胞增殖和凋亡的平衡而引起肠屏障的破坏。已报道枯草芽孢杆菌调节肠上皮细胞的增殖和凋亡。因此,本研究的目的是确定枯草芽孢杆菌是否可以调节宫内生长受限乳猪肠上皮细胞的增殖和凋亡。
    结果:与正常出生体重组相比,IUGR组回肠隐窝中Ki-67阳性细胞的平均光密度值较大(P<0.05)。IUGR导致肠上皮细胞增殖和凋亡能力提高,通过上调富含亮氨酸重复序列的G蛋白偶联受体5,Caspase-3,Caspase-7,β-catenin的mRNA或蛋白质表达,cyclinD1,B细胞淋巴瘤-2相关的细胞死亡激动剂,与BCL2相关的X(P<0.05),B细胞淋巴瘤-2和B细胞淋巴瘤-2样1的mRNA或蛋白表达下调(P<0.05)。然而,补充枯草芽孢杆菌降低了富含亮氨酸重复序列的G蛋白偶联受体5,SPARC相关模块钙结合2,肿瘤坏死因子受体超家族成员19,cyclinD1,Caspase-7,β-catenin的mRNA或蛋白质表达,B细胞淋巴瘤-2相关的细胞死亡激动剂,和Caspase-3(P<0.05),B细胞淋巴瘤-2的mRNA表达增加(P<0.05)。
    结论:IUGR导致肠上皮细胞过度凋亡,诱导代偿性增殖。然而,枯草芽孢杆菌治疗可防止IUGR乳猪肠上皮细胞过度凋亡。本文受版权保护。保留所有权利。
    BACKGROUND: The intestine is a barrier resisting various stress responses. Intrauterine growth restriction (IUGR) can cause damage to the intestinal barrier via destroying the balance of intestinal epithelial cells\' proliferation and apoptosis. Bacillus subtilis has been reported to regulate intestinal epithelial cells\' proliferation and apoptosis. Thus, the purpose of this study was to determine if B. subtilis could regulate intestinal epithelial cells\' proliferation and apoptosis in intrauterine growth restriction suckling piglets.
    RESULTS: Compared with the normal birth weight group, the IUGR group showed greater mean optical density values of Ki-67-positive cells in the ileal crypt (P < 0.05). IUGR resulted in higher ability of proliferation and apoptosis of intestinal epithelial cells, by upregulation of the messenger RNA (mRNA) or proteins expression of leucine rich repeat containing G protein coupled receptor 5, Caspase-3, Caspase-7, β-catenin, cyclinD1, B-cell lymphoma-2 associated agonist of cell death, and BCL2 associated X (P < 0.05), and downregulation of the mRNA or protein expression of B-cell lymphoma-2 and B-cell lymphoma-2-like 1 (P < 0.05). However, B. subtilis supplementation decreased the mRNA or proteins expression of leucine rich repeat containing G protein coupled receptor 5, SPARC related modular calcium binding 2, tumor necrosis factor receptor superfamily member 19, cyclinD1, Caspase-7, β-catenin, B-cell lymphoma-2 associated agonist of cell death, and Caspase-3 (P < 0.05), and increased the mRNA expression of B-cell lymphoma-2 (P < 0.05).
    CONCLUSIONS: IUGR led to excessive apoptosis of intestinal epithelial cells, which induced compensatory proliferation. However, B. subtilis treatment prevented intestinal epithelial cells of IUGR suckling piglets from excessive apoptosis. © 2024 Society of Chemical Industry.
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  • 文章类型: English Abstract
    OBJECTIVE: To explore the value of functional magnetic resonance imaging (MRI) techniques, including intravoxel incoherent motion (IVIM), T1 mapping, and T2 mapping, in assessing the microstructural and perfusion changes in the kidneys of rats with intrauterine growth restriction (IUGR).
    METHODS: An IUGR rat model was established through a low-protein diet during pregnancy. Offspring from pregnant rats on a low-protein diet were randomly divided into an IUGR 8-week group and an IUGR 12-week group, while offspring from pregnant rats on a normal diet were divided into a normal 8-week group and a normal 12-week group (n=8 for each group). The apparent diffusion coefficient (ADC), true diffusion coefficient (Dt), pseudo-diffusion coefficient (D*), perfusion fraction (f), T1 value, and T2 value of the renal cortex and medulla were compared, along with serum creatinine and blood urea nitrogen levels among the groups.
    RESULTS: The Dt value in the renal medulla was higher in the IUGR 12-week group than in the IUGR 8-week group, and the D* value in the renal medulla was lower in the IUGR 12-week group than in both the normal 12-week group and the IUGR 8-week group (P<0.05). The T1 value in the renal medulla was higher than in the cortex in the IUGR 8-week group, and the T1 value in the renal medulla was higher in the IUGR 12-week group than in both the IUGR 8-week group and the normal 12-week group, with the cortical T1 value in the IUGR 12-week group also being higher than that in the normal 12-week group (P<0.05). The T2 values in the renal medulla were higher than those in the cortex across all groups (P<0.05). There were no significant differences in the T2 values of either the cortex or medulla among the groups (P>0.05). There were no significant differences in serum creatinine and blood urea nitrogen levels among the groups (P>0.05). Glomerular hyperplasia and hypertrophy without significant fibrotic changes were observed in the IUGR 8-week group, whereas glomerular atrophy, cystic stenosis, and interstitial inflammatory infiltration and fibrosis were seen in the IUGR 12-week group.
    CONCLUSIONS: IVIM MRI can be used to assess and dynamically observe the microstructural and perfusion damage in the kidneys of IUGR rats. MRI T1 mapping can be used to evaluate kidney damage in IUGR rats, and the combination of MRI T1 mapping and T2 mapping can further differentiate renal fibrosis in IUGR rats.
    目的: 探讨体素内不相干运动(intravoxel incoherent motion, IVIM)、纵向弛豫时间定量成像(T1 mapping)、横向弛豫时间定量成像(T2 mapping)等功能磁共振成像技术评估宫内发育迟缓(intrauterine growth restriction, IUGR)仔鼠的肾脏微观结构及灌注改变的价值。方法: 通过孕期低蛋白饮食法建立IUGR仔鼠模型。低蛋白饮食孕鼠所产仔鼠随机分为IUGR 8周组、IUGR 12周组,正常饮食孕鼠所产仔鼠随机分为正常8周组、正常12周组,各组n=8。比较各组仔鼠肾脏皮质、髓质的表观弥散系数(apparent diffusion coefficient, ADC)、真实扩散系数(Dt)、伪扩散系数(D*)、灌注分数(f)、T1值、T2值,以及血肌酐、血尿素氮水平。结果: IUGR 12周组肾脏髓质Dt值高于IUGR 8周组,IUGR 12周组肾脏髓质D*值低于正常12周组与IUGR 8周组(P<0.05);IUGR 8周组肾脏髓质T1值高于皮质,IUGR 12周组肾脏髓质T1值高于IUGR 8周组与正常12周组,IUGR 12周组肾脏皮质T1值高于正常12周组(P<0.05);各组内肾脏髓质T2值均高于皮质(P<0.05),各组间肾脏皮质及髓质的T2值比较差异均无统计学意义(P>0.05)。各组血肌酐及血尿素氮含量比较差异无统计学意义(P>0.05)。IUGR 8周组仔鼠肾脏可见肾小球增生肥大,未见明显纤维化改变;IUGR 12周组仔鼠肾脏可见肾小球萎缩,囊腔狭窄,间质出现炎性细胞浸润及纤维化。结论: IVIM磁共振成像可用于评估及动态观察IUGR仔鼠肾脏微观结构及灌注损伤,T1 mapping磁共振成像可用于评估IUGR仔鼠肾脏损伤,T1 mapping联合T2 mapping磁共振成像可进一步分辨IUGR仔鼠的肾脏纤维化。.
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  • 文章类型: Journal Article
    宫内生长受限(IUGR)猪的特征是长期生长障碍,代谢紊乱,和肠道微生物群失衡。IUGR在猪不同生长阶段的负效应特征尚不清楚。因此,这项研究通过多组学分析探讨了IUGR是否会损害肠道屏障功能并改变生长育肥猪结肠微生物群的定植和代谢谱。本试验分配72只仔猪(36只IUGR和36只NBW)进行生理和血浆生化指标分析,以及结肠的氧化损伤和炎症反应。此外,我们使用16srRNA测序和代谢组学技术检测了结肠微生物群落和代谢组,以揭示不同生长阶段(25,50和100kg)IUGR猪的肠道特征.IUGR改变了血浆葡萄糖的浓度,总蛋白质,甘油三酯,和胆固醇。结肠紧密连接蛋白被IUGR显著抑制。IUGR降低血浆T-AOC,SOD,GSH水平和结肠SOD-1、SOD-2和GPX-4的表达通过抑制Nrf2/Keap1信号通路。此外,IUGR可能通过激活TLR4-NF-κB/ERK途径增加结肠IL-1β和TNF-α水平,同时降低IL-10。值得注意的是,IUGR猪在25kgBW阶段具有较低的结肠链球菌丰度和厚壁菌与拟杆菌比率,而在100kgBW阶段具有较高的厚壁菌丰度;此外,IUGR猪具有较低的SCFA浓度。代谢组学分析显示IUGR增加结肠脂质和类脂分子,有机酸及其衍生物,和有机杂环化合物的浓度和丰富的三个差异代谢途径,包括亚油酸,鞘脂,以及整个试验中的嘌呤代谢。总的来说,IUGR改变了营养代谢,氧化还原状态,和猪的结肠微生物群落和代谢物谱,并在生长结束阶段通过Nrf2/Keap1途径降低抗氧化能力并通过TLR4-NF-κB/ERK途径激活炎症,继续破坏结肠屏障功能。此外,结肠Firmicutes和链球菌可能是调节IUGR猪代谢和健康的潜在调节靶标。
    Intrauterine growth restriction (IUGR) pigs are characterized by long-term growth failure, metabolic disorders, and intestinal microbiota imbalance. The characteristics of the negative effects of IUGR at different growth stages of pigs are still unclear. Therefore, this study explored through multi-omics analyses whether the IUGR damages the intestinal barrier function and alters the colonization and metabolic profiles of the colonic microbiota in growing-finishing pigs. Seventy-two piglets (36 IUGR and 36 NBW) were allocated for this trial to analyze physiological and plasma biochemical parameters, as well as oxidative damage and inflammatory response in the colon. Moreover, the colonic microbiota communities and metabolome were examined using 16s rRNA sequencing and metabolomics technologies to reveal the intestinal characteristics of IUGR pigs at different growth stages (25, 50, and 100 kg). IUGR altered the concentrations of plasma glucose, total protein, triglycerides, and cholesterol. Colonic tight junction proteins were markedly inhibited by IUGR. IUGR decreased plasma T-AOC, SOD, and GSH levels and colonic SOD-1, SOD-2, and GPX-4 expressions by restraining the Nrf2/Keap1 signaling pathway. Moreover, IUGR increased colonic IL-1β and TNF-α levels while reducing IL-10, possibly through activating the TLR4-NF-κB/ERK pathway. Notably, IUGR pigs had lower colonic Streptococcus abundance and Firmicutes-to-Bacteroidetes ratio at the 25 kg BW stage while having higher Firmicutes abundance at the 100 kg BW stage; moreover, IUGR pigs had lower SCFA concentrations. Metabolomics analysis showed that IUGR increased colonic lipids and lipid-like molecules, organic acids and derivatives, and organoheterocyclic compounds concentrations and enriched three differential metabolic pathways, including linoleic acid, sphingolipid, and purine metabolisms throughout the trial. Collectively, IUGR altered the nutrient metabolism, redox status, and colonic microbiota community and metabolite profiles of pigs and continued to disrupt colonic barrier function by reducing antioxidant capacity via the Nrf2/Keap1 pathway and activating inflammation via the TLR4-NF-κB/ERK pathway during the growing-finishing stage. Moreover, colonic Firmicutes and Streptococcus could be potential regulatory targets for modulating the metabolism and health of IUGR pigs.
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  • 文章类型: Journal Article
    宫内生长受限(IUGR)与产后快速追赶生长与成年期的肺血管功能障碍密切相关。而出生后早期生长延迟的IUGR会导致长期的脑损伤。在本研究中,据推测,早期中度追赶性生长的IUGR可缓解成年期肺血管重塑,而不影响记忆功能.通过限制孕妇在怀孕期间的营养来建立IUGR模型。通过调整泌乳期间每组的产仔数来实现不同的生长模式。在三个时间点(3、9和13周)选择满足断奶时体重要求的大鼠用于后续研究。使用Y迷宫评估认知功能。进行有创血流动力学测量以测量平均肺动脉压(mPAP)。此外,培养原代肺动脉平滑肌细胞(PASMC)和肺血管内皮细胞(PVEC),以研究它们在快速追赶生长后mPAP增加中的作用。结果表明,延迟生长组大鼠的记忆功能缺陷与海马颗粒下区域神经干细胞增殖减少有关。此外,在三个时间点的适度追赶增长改善了记忆功能,同时保持了正常的mPAP。在经历快速追赶生长的成年IUGR大鼠中,虽然记忆功能有所改善,观察到mPAP升高和肺小动脉内侧增厚。此外,PASMC表现出过度增殖,在快速追赶组中的迁移和抗凋亡活性,PVECs也表现出过度增殖。这些结果表明,与快速追赶增长或延迟增长相比,IUGR后的适度追赶增长是成年期最佳认知和心血管健康的更好策略。
    Intrauterine growth restriction (IUGR) with rapid postnatal catch-up growth is strongly associated with pulmonary vascular dysfunction in adulthood, whereas IUGR with delayed growth in early postnatal life results in long-term brain deficits. In the present study, it was hypothesized that IUGR with early moderate catch-up growth may alleviate pulmonary vascular remodeling in adulthood without affecting memory function. An IUGR model was established by restricting maternal nutrition during pregnancy. Different growth patterns were achieved by adjusting the litter size in each group during lactation. Rats meeting the weight requirement at weaning were selected for subsequent studies at three time points (3, 9 and 13 weeks). Cognitive function was evaluated using a Y-maze. Invasive hemodynamic measurements were conducted to measure the mean pulmonary arterial pressure (mPAP). In addition, primary pulmonary artery smooth muscle cells (PASMCs) and pulmonary vascular endothelial cells (PVECs) were cultured to investigate their role in the increase in mPAP following rapid catch-up growth. The results showed that memory function deficits in the rats in the delayed growth group were associated with reduced proliferation of neural stem cells in the subgranular zone of the hippocampus. Furthermore, moderate catch-up growth at the three time points improved memory function while maintaining a normal mPAP. In adult IUGR rats experiencing rapid catch-up growth, although memory function improved, elevated mPAP and medial thickening of pulmonary arterioles were observed. Additionally, PASMCs exhibited excessive proliferation, migration and anti-apoptotic activity in the rapid catch-up group, and PVECs also displayed excessive proliferation. These results suggested that moderate catch-up growth after IUGR is a better strategy for optimal cognition and cardiovascular health in adulthood compared with rapid catch-up growth or delayed growth.
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  • 文章类型: Case Reports
    目标:Kleefstra综合征(KS),以前称为9q亚端粒缺失综合征,具有多重结构异常的特点。然而,大多数胎儿没有明显的异常表型。在这项研究中,患有KS的胎儿表现出多个系统结构异常,我们旨在探讨KS胎儿的基因型-表型相关性。
    方法:多个系统结构异常,包括严重的宫内生长受限(IUGR)和心脏缺陷,在妊娠33+5周时通过超声检测到胎儿。这些异常可能是由9q34.3的致病性缺失片段引起的,包括原色组蛋白甲基转移酶1(EHMT1)和V型胶原α1链(COL5A1)基因,通过拷贝数变异测序(CNV-seq)检测。
    结论:临床医生必须对疑似KS胎儿进行CNV-seq结合多学科咨询,尤其是那些有多重系统结构异常的人。
    OBJECTIVE: Kleefstra syndrome (KS), formerly known as 9q subtelomeric deletion syndrome, is characterized by multiple structural abnormalities. However, most fetuses do not have obvious abnormal phenotypes. In this study, the fetus with KS presented with multiple system structural anomalies, and we aimed to explore the genotype-phenotype correlations of KS fetuses.
    METHODS: Multiple systematic structural anomalies, including severe intrauterine growth restriction (IUGR) and cardiac defects, were detected by ultrasound in the fetus at 33 + 5 weeks\' gestation. These abnormalities may be caused by the pathogenic deleted fragment at 9q34.3, including the euchromatic histone methyltransferase 1 (EHMT1) and collagen type V alpha 1 chain (COL5A1) genes, detected by copy number variation sequencing (CNV-seq).
    CONCLUSIONS: It is essential for clinicians to perform CNV-seq combined with multidisciplinary consultation for suspected KS fetuses, especially those with multiple systematic structural anomalies.
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  • 文章类型: Journal Article
    胎盘的血管对胎儿的生长至关重要。这里,在妊娠第75天,低出生体重胎儿的胎盘血管密度和鸟氨酸(Orn)含量低于正常出生体重胎儿。此外,胎盘中的Orn含量从妊娠的第75天下降到第110天。探讨Orn在胎盘血管生成中的作用,将48只小母猪(巴马猪)分为四组。对照组母猪饲喂基础饲粮(CON组),而实验组中的那些人饲喂添加0.05%Orn的基础饮食(0.05%Orn组),0.10%Orn(0.10%Orn组),和0.15%Orn(0.15%Orn组),分别。结果表明,与CON组相比,0.15%Orn和0.10%Orn组的仔猪出生体重增加。此外,0.15%Orn组胎盘血管密度高于CON组。机械上,Orn通过调节血管内皮生长因子-A(VEGF-A)促进胎盘血管生成。此外,孕妇在妊娠期间补充0.15%Orn可增加乳猪空肠和回肠绒毛高度以及结肠丙酸盐和丁酸盐的浓度。总的来说,这些结果表明,母亲补充Orn可以促进胎盘血管生成,并改善哺乳仔猪的肠道发育。
    The blood vessels of the placenta are crucial for fetal growth. Here, lower vessel density and ornithine (Orn) content were observed in placentae for low-birth-weight fetuses versus normal-birth-weight fetuses at day 75 of gestation. Furthermore, the Orn content in placentae decreased from day 75 to 110 of gestation. To investigate the role of Orn in placental angiogenesis, 48 gilts (Bama pig) were allocated into four groups. The gilts in the control group were fed a basal diet (CON group), while those in the experimental groups were fed a basal diet supplemented with 0.05% Orn (0.05% Orn group), 0.10% Orn (0.10% Orn group), and 0.15% Orn (0.15% Orn group), respectively. The results showed that 0.15% Orn and 0.10% Orn groups exhibited increased birth weight of piglets compared with the CON group. Moreover, the 0.15% Orn group was higher than the CON group in the blood vessel densities of placenta. Mechanistically, Orn facilitated placental angiogenesis by regulating vascular endothelial growth factor-A (VEGF-A). Furthermore, maternal supplementation with 0.15% Orn during gestation increased the jejunal and ileal villi height and the concentrations of colonic propionate and butyrate in suckling piglets. Collectively, these results showed that maternal supplementation with Orn promotes placental angiogenesis and improves intestinal development of suckling piglets.
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  • 文章类型: Journal Article
    胎盘的生理或病理性灌注不足是宫内生长受限(IUGR)的主要原因之一,对胎儿和新生儿的健康构成重大风险。他达拉非,一种5型磷酸二酯酶抑制剂,先前已在各种临床研究中发现改善IUGR的症状。不幸的是,其有限的水溶性阻碍了其临床应用,快速新陈代谢,在靶组织中缺乏特异性分布,使他达拉非无法维持长期胎盘灌注。在这项研究中,iRGD修饰的他达拉非脂质体(iRGD-lipo@Tad)的大小约为480nm,旨在纠正他达拉非的缺点。制备的iRGD-lipo@Tad表现出优越的稳定性,持续药物释放能力,和低细胞毒性。荧光研究,组织切片研究,和药物生物分布研究共同证明了iRGD修饰的脂质体的胎盘锚定能力。这是通过由iRGD介导的胎盘靶向作用和特殊粒径介导的胎盘驻留作用组成的双重方法实现的。药代动力学研究表明,通过iRGD修饰的脂质体封装的他达拉非的体内过程显着改善。与他达拉非溶液相比,iRGD-lipo@Tad的峰值血浆浓度显着增加,曲线下面积增加约7.88倍。在药效学研究中,iRGD-lipo@Tad实现了胎盘血液灌注的持续有效改善。这是通过降低血浆可溶性fms样酪氨酸激酶与胎盘生长因子的比例并增加环磷酸鸟苷和一氧化氮的水平来实现的。因此,iRGD-lipo@Tad导致N-硝基-L-精氨酸甲酯诱导的IUGR妊娠小鼠的胚胎重量显着增加,流产率降低,而无可检测的毒性。总之,本文提出的纳米技术辅助治疗策略不仅克服了他达拉非在IUGR临床治疗中的局限性,而且为解决其他胎盘源性疾病的治疗提供了新的途径.
    Physiological or pathological hypoperfusion of the placenta is one of the main causes of intrauterine growth restriction (IUGR) which poses a significant risk to the health of the fetus and newborn. Tadalafil, a 5-type phosphodiesterase inhibitor, has previously been found to improve the symptoms of IUGR in various clinical studies. Unfortunately, its clinical utility is hindered by its limited water solubility, rapid metabolism, and lack of specific distribution in target tissues rendering tadalafil unable to maintain long-term placental perfusion. In this study, iRGD-modified tadalafil-loaded liposomes (iRGD-lipo@Tad) featuring a size of approximately 480 nm were designed to rectify the shortcomings of tadalafil. The prepared iRGD-lipo@Tad exhibited superior stability, sustained drug release capacity, and low cytotoxicity. The fluorescence study, tissue slice study, and drug biodistribution study together demonstrated the placenta-anchored ability of iRGD-modified liposomes. This was achieved by a dual approach consisting of the iRGD-mediated placenta-targeting effect and special particle size-mediated placenta resident effect. The pharmacokinetic study revealed a significant improvement in the in vivo process of tadalafil encapsulated by the iRGD-modified liposomes. In comparison to the tadalafil solution, the peak plasma concentration of iRGD-lipo@Tad was significantly increased, and the area under the curve was increased by about 7.88 times. In the pharmacodynamic study, iRGD-lipo@Tad achieved a continuous and efficient improvement of placental blood perfusion. This was achieved by decreasing the ratio of plasma soluble fms-like tyrosine kinase to placental growth factor and increasing the levels of cyclic guanosine monophosphate and nitric oxide. Consequently, iRGD-lipo@Tad resulted in a significant increase in embryo weight and a reduction in the miscarriage rate of N-Nitro-L-arginine methyl ester-induced IUGR pregnant mice without detectable toxicity. In summary, the nanotechnology-assisted therapy strategy presented here not only overcomes the limitations of tadalafil in the clinical treatment of IUGR but also offers new avenues to address the treatment of other placenta-originated diseases.
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  • 文章类型: Journal Article
    评估三维(3D)能量多普勒联合二维(2D)多普勒超声检查在检测胎儿生长受限(FGR)中的预测准确性。
    这项研究是在妊娠20至40周之间进行生长超声检查的单胎妊娠。纳入63例FGR患者,胎龄与正常胎儿匹配1:1.8。两组进一步分为亚组,以32周为阈值-早发性和晚发性FGR组,和相应的对照组。胎盘的常规2D多普勒参数和标准化3D功率多普勒测量,包括血管化指数(VI),流量指数(FI),获得每位患者的血管化-血流指数(VFI)。
    (1)早发型和晚发型FGR病例组新生儿的平均分娩孕周和出生体重均低于对照组,而前置胎盘发生率及不良妊娠结局均高于对照组。(2)双顶直径,头围,腹围,股骨长度,估计胎儿体重,大脑中动脉收缩/舒张速度比(S/D),搏动指数(PI),阻力指数(RI),和胎盘血液灌注指数的血管指数(VI),流量指数(FI),血管血流指数(VFI),早发性和晚发性FGR病例组的脑胎盘比率(CPR)均低于对照组。此外,S/D,PI,脐动脉和子宫动脉的RI高于相应的对照组。(3)对于早发性FGR,脐动脉PI曲线下面积(AUC)最大(0.861),表现出最高的预测值。当结合胎盘血液灌注指数,AUC为0.789。对于迟发性FGR,CPR的AUC为0.861.整合胎盘血液灌注指数后,AUC增加到0.877。在早发性FGR组中,组合2D多普勒指数的正似然比(PLR)(21.938)和VFI的负似然比(NLR)(0.565)最高。晚发性FGR组组合3D多普勒指数的PLR(8.536)和VFI的NLR(0.557)最高。
    与其他常规指标相比,3D多普勒指数与2D多普勒超声检查的组合在诊断迟发性FGR方面显示出更好的预测价值。3DDower索引,VFI,对早期和晚期FGR都有很好的真阴性预测值。
    UNASSIGNED: To assess the predictive accuracy of three-dimensional (3D) power Doppler combined with two-dimensional (2D) Doppler ultrasonography in detecting fetal growth restriction (FGR).
    UNASSIGNED: The study was conducted on singleton pregnancies presenting for growth ultrasound examinations between 20 and 40 weeks of gestation. 63 patients with FGR were enrolled and matched 1:1.8 for gestational age with normal fetuses. Both groups were further divided into subgroups, with 32 weeks as the threshold-early-onset and late-onset FGR groups, and corresponding control groups. Conventional 2D Doppler parameters and standardized 3D power Doppler measurements of the placenta, including vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) were obtained for each patient.
    UNASSIGNED: (1) The average gestational weeks of delivery and birth weight of newborns in early-onset and late-onset FGR case groups were lower than those in control groups, while the incidence of placenta previa and adverse pregnancy outcomes were higher than those in control groups. (2) The biparietal diameter, head circumference, abdominal circumference, femur length, estimated fetal weight, middle cerebral artery systolic/diastolic velocity ratio (S/D), pulsatility index (PI), resistance index (RI), and placental blood perfusion indices of vascular index (VI), flow index (FI), vascular flow index (VFI), and cerebro-placental ratio (CPR) of the early-onset and late-onset FGR case groups were all lower than those of the control group. Moreover, the S/D, PI, and RI of the umbilical and uterine arteries were higher than those of the corresponding control group. (3) For early-onset FGR, the area under the curve (AUC) of the umbilical artery PI was the largest (0.861), exhibiting the highest predictive value. When combined with the placental blood perfusion index, the AUC was 0.789. For late-onset FGR, the AUC of the CPR was 0.861. After integrating the placental blood perfusion index, the AUC increased to 0.877. The positive likelihood ratio (PLR) of combined 2D Doppler indexes (21.938) and negative likelihood ratio (NLR) of VFI (0.565) were the highest in the early-onset FGR group. The PLR of combined 3D Doppler indexes (8.536) and NLR of VFI (0.557) were the highest in the late-onset FGR group.
    UNASSIGNED: The combination of 3D Doppler indices with 2D Doppler ultrasonography demonstrated superior predictive value in diagnosing late-onset FGR compared to other conventional indicators. The 3D Dower index, VFI, has a good true-negative predictive value for both early- and late-onset FGR.
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  • 文章类型: Journal Article
    中国新生儿中邻苯二甲酸酯(PAEs)的产前暴露普遍存在。进入体内的PAEs将转化为各种水解和氧化的PAE代谢物(mPAEs)。PAEs和mPAEs暴露可能通过破坏多种激素信号通路导致不良出生结局。氧化应激的诱导,和细胞内信号传导过程的改变。在这项研究中,采用HPLC-ESI-MS对济南地区318例新生儿脐带血清中11种mPAEs的浓度进行了定量。多元线性回归,贝叶斯核机回归,和分位数g计算模型用于研究个体mPAE和mPAE混合物对出生结局的影响。进行分层分析以探索这些影响是否具有性别特异性。mPAE混合物与出生身长(BL)z评分呈负相关,出生体重(BW)z评分,头围(HC)z值,和体重指数(PI)。邻苯二甲酸单(2-乙基己基)酯(MEHP)与BL(z评分)呈负相关,BW(z-score),HC(z-score),和PI,而邻苯二甲酸单(2-羧甲基己基)酯(MCMHP)与mPAE混合物中的BW(z评分)和PI呈负相关。分层分析显示,mPAE混合物与四种出生结局之间的负相关在女婴中减弱,而邻苯二甲酸单(2-乙基-5-羧基戊基)酯(MECPP)对BL(z评分)和BW(z评分)的积极影响只能在女性中检测到。总之,我们的研究结果表明,产前接触邻苯二甲酸盐可能与宫内生长受限有关,这些影响因婴儿的性别而异。
    Prenatal exposure to phthalates (PAEs) is ubiquitous among Chinese neonates. PAEs entering the body will be transformed to various hydrolyzed and oxidated PAE metabolites (mPAEs). PAEs and mPAEs exposure may lead to adverse birth outcomes through disruption of multiple hormone signaling pathways, induction of oxidative stress, and alterations in intracellular signaling processes. In this study, the concentrations of 11 mPAEs in 318 umbilical cord serum samples from neonates in Jinan were quantified with HPLC-ESI-MS. Multiple linear regression, Bayesian kernel machine regression, and quantile g-computation models were utilized to investigate the effects of both individual mPAE and mPAE mixture on birth outcomes. Stratified analysis was performed to explore whether these effects were gender-specific. mPAE mixture was negatively associated with birth length (BL) z-score, birth weight (BW) z-score, head circumference (HC) z-score, and ponderal index (PI). Mono(2-ethylhexyl) phthalate (MEHP) manifested negative associations with BL(z-score), BW(z-score), HC(z-score), and PI, whereas mono(2-carboxymethylhexyl) phthalate (MCMHP) was negatively associated with BW(z-score) and PI within the mPAE mixture. Stratified analysis revealed that the negative associations between mPAE mixture and four birth outcomes were attenuated in female infants, while the positive impact of mono(2-ethyl-5carboxypentyl) phthalate (MECPP) on BL(z-score) and BW(z-score) could be detected only in females. In summary, our findings suggest that prenatal exposure to phthalates may be associated with intrauterine growth restriction, and these effects vary according to the gender of the infant.
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