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Chinese Medical Journal Oct 2022Complete wound regeneration preserves skin structure and physiological functions, including sensation and perception of stimuli, whereas incomplete wound regeneration... (Review)
Review
Complete wound regeneration preserves skin structure and physiological functions, including sensation and perception of stimuli, whereas incomplete wound regeneration results in fibrosis and scarring. Amniotic fluid stem cells (AFSCs) would be a kind of cell population with self-renewing and non-immunogenic ability that have a considerable role in wound generation. They are easy to harvest, culture, and store; moreover, they are non-tumorigenic and not subject to ethical restrictions. They can differentiate into different kinds of cells that replenish the skin, subcutaneous tissues, and accessory organs. Additionally, AFSCs independently produce paracrine effectors and secrete them in exosomes, thereby modulating local immune cell activity. They demonstrate anti-inflammatory and immunomodulatory properties, regulate the physicochemical microenvironment of the wound, and promote full wound regeneration. Thus, AFSCs are potential resources in stem cell therapy, especially in scar-free wound healing. This review describes the biological characteristics and clinical applications of AFSCs in treating wounds and provide new ideas for the treatment of wound healing.
Topics: Humans; Amniotic Fluid; Wound Healing; Regeneration; Skin; Cicatrix; Stem Cells
PubMed: 36535008
DOI: 10.1097/CM9.0000000000002076 -
The Journal of Maternal-fetal &... Jan 2022neurologic injury in myelomeningocele (MMC) occurs via a two-hit process: failed neural tube closure followed by neurodegeneration . Meconium in the amniotic fluid...
BACKGROUND
neurologic injury in myelomeningocele (MMC) occurs via a two-hit process: failed neural tube closure followed by neurodegeneration . Meconium in the amniotic fluid contains pancreatic digestive enzymes and is neurotoxic in rat models of MMC.
OBJECTIVES
The objectives of this study were to demonstrate the neurotoxicity of α-amylase and to compare the enzyme concentration and activity in the amniotic fluid of rats with retinoic acid induced MMC to a healthy control population.
STUDY DESIGN
Timed pregnant Sprague Dawley rats were gavage fed all-trans retinoic acid (60 mg/kg) in olive oil on gestational day E10 to induce a MMC defect. Control rats received olive oil. Amniotic fluid was collected on embryonic days E15, E17, E19, and E21. The amniotic fluid amylase concentration and relative activity were measured at each gestational age, and levels were compared between the MMC and control groups using Wilcoxon Rank Sum and Kruskal-Wallis tests. In a subset of dams sacrificed on E10.5, neuroepithelial cells were isolated from control embryos and exposed to α-amylase in increasing concentrations. Percentage of cell survival was assessed with CellProfiler software.
RESULTS
Amniotic fluid amylase activity for embryonic days E15, E17, E19, and E21 was determined for MMC and control pups. Amylase activity increased significantly from E15 to E21 in both control ( = 3.0 × 10) and MMC ( = 1.5 × 10) groups. Relative amylase activity was significantly increased in MMC pups compared to controls on E19 (247,792.8 versus 106,263.6; = .0019) and E21 (772,645.8 versus 481,975.3; = .021); no difference was detected on E15 (36,646.8 versus 40,179.3; = .645) or E17 (121,617.5 versus 71,750; = 1.000). , amylase demonstrated dose-dependent toxicity to fetal rat neuroepithelial cells.
CONCLUSION
Amylase concentration and activity level were higher in the amniotic fluid of rats with retinoic acid induced MMC compared to controls with advancing gestational age. As amylase is toxic to neural epithelial cells, the higher activity of this digestive enzyme in fetuses with MMC may be a contributor to neural tube damage . Future research should focus on amylase and other digestive enzymes in human MMC, as they may serve as potential targets of therapy.
Topics: Amniotic Fluid; Amylases; Animals; Female; Meningomyelocele; Pregnancy; Rats; Rats, Sprague-Dawley; Tretinoin
PubMed: 31910702
DOI: 10.1080/14767058.2020.1713082 -
Scientific Reports Feb 2023The intra-uterine components of labor, namely, myometrial contractility, cervical ripening, and decidua/membrane activation, have been extensively characterized and...
The intra-uterine components of labor, namely, myometrial contractility, cervical ripening, and decidua/membrane activation, have been extensively characterized and involve a local pro-inflammatory milieu of cellular and soluble immune mediators. Targeted profiling has demonstrated that such processes extend to the intra-amniotic space, yet unbiased analyses of the proteome of human amniotic fluid during labor are lacking. Herein, we utilized an aptamer-based platform to characterize 1,310 amniotic fluid proteins and found that the proteome undergoes substantial changes with term labor (251 proteins with differential abundance, q < 0.1, and fold change > 1.25). Proteins with increased abundance in labor are enriched for immune and inflammatory processes, consistent with prior reports of labor-associated changes in the intra-uterine space. By integrating the amniotic fluid proteome with previously generated placental-derived single-cell RNA-seq data, we demonstrated the labor-driven upregulation of signatures corresponding to stromal-3 and decidual cells. We also determined that changes in amniotic fluid protein abundance are reflected in the maternal plasma proteome. Collectively, these findings provide novel insights into the amniotic fluid proteome in term labor and support its potential use as a source of biomarkers to distinguish between true and false labor by using maternal blood samples.
Topics: Pregnancy; Female; Humans; Amniotic Fluid; Proteome; Obstetric Labor, Premature; Placenta; Biomarkers
PubMed: 36823217
DOI: 10.1038/s41598-023-28157-3 -
Frontiers in Immunology 2022The existence of an amniotic fluid microbiota (i.e., a viable microbial community) in mammals is controversial. Its existence would require a fundamental reconsideration...
The existence of an amniotic fluid microbiota (i.e., a viable microbial community) in mammals is controversial. Its existence would require a fundamental reconsideration of fetal exposure to and colonization by microorganisms and the role of intra-amniotic microorganisms in fetal immune development as well as in pregnancy outcomes. In this study, we determined whether the amniotic fluid of mice harbors a microbiota in late gestation. The profiles of the amniotic fluids of pups located proximally or distally to the cervix were characterized through quantitative real-time PCR, 16S rRNA gene sequencing, and culture (N = 21 dams). These profiles were compared to those of technical controls for bacterial and DNA contamination. The load of 16S rRNA genes in the amniotic fluid exceeded that in controls. Additionally, the 16S rRNA gene profiles of the amniotic fluid differed from those of controls, with being differentially more abundant in amniotic fluid profiles; however, this bacterium was not cultured from amniotic fluid. Of the 42 attempted bacterial cultures of amniotic fluids, only one yielded bacterial growth - . The 16S rRNA gene of this common murine-associated bacterium was not detected in any amniotic fluid sample, suggesting it did not originate from the amniotic fluid. No differences in the 16S rRNA gene load, 16S rRNA gene profile, or bacterial culture were observed between the amniotic fluids located Proximally and distally to the cervix. Collectively, these data indicate that, although there is a modest DNA signal of bacteria in murine amniotic fluid, there is no evidence that this signal represents a viable microbiota. While this means that amniotic fluid is not a source of microorganisms for colonization in mice, it may nevertheless contribute to fetal exposure to microbial components. The developmental consequences of this observation warrant further investigation.
Topics: Amniotic Fluid; Animals; Bacteria; Female; Mammals; Mice; Microbiota; Pregnancy; RNA, Ribosomal, 16S; Real-Time Polymerase Chain Reaction
PubMed: 35296083
DOI: 10.3389/fimmu.2022.820366 -
BMC Pregnancy and Childbirth Sep 2021Amniotic fluid (AF) provides vital information on fetal development, which is also valuable in identifying fetal abnormalities during pregnancy. However, the... (Comparative Study)
Comparative Study
BACKGROUND
Amniotic fluid (AF) provides vital information on fetal development, which is also valuable in identifying fetal abnormalities during pregnancy. However, the relationship between the metabolic profile of AF in the second trimester of a normal pregnancy with several maternal-fetal parameters remains poorly understood, which therefore limits its application in clinical practice. The aim of this study was to explore the association between the metabolic profile of AF with fetal gender, maternal age, and gestational week using an untargeted metabolomics method.
METHODS
A total of 114 AF samples were analyzed in this study. Clinical data on fetal gender, maternal age, and gestational week of these samples were collected. Samples were analyzed by gas chromatography/time-of-flight-mass spectrometry (GC-TOF/MS). Principal component analysis(PCA), orthogonal partial least square discrimination analysis(OPLS-DA) or partial least square discrimination analysis (PLS-DA) were conducted to compare metabolic profiles, and differential metabolites were obtained by univariate analysis.
RESULTS
Both PCA and OPLS-DA demonstrated no significant separation trend between the metabolic profiles of male and female fetuses, and there were only 7 differential metabolites. When the association between the maternal age on AF metabolic profile was explored, both PCA and PLS-DA revealed that the maternal age in the range of 21 to 40 years had no significant effect on the metabolic profile of AF, and only four different metabolites were found. There was no significant difference in the metabolic profiles of AF from fetuses of 17-22 weeks, and 23 differential metabolites were found.
CONCLUSIONS
In the scope of our study, there was no significant correlation between the AF metabolic profile and the fetal gender, maternal age and gestational week of a small range. Nevertheless, few metabolites appeared differentially expressed.
Topics: Adult; Amniotic Fluid; China; Female; Gas Chromatography-Mass Spectrometry; Gestational Age; Humans; Male; Maternal Age; Metabolomics; Pregnancy; Sex Determination Processes; Young Adult
PubMed: 34537001
DOI: 10.1186/s12884-021-04116-6 -
Journal of Mother and Child Dec 2020Prolonged labour can lead to postpartum complications and adverse outcomes for both mother and baby. Measurable parameters can help in the active management of labour,... (Review)
Review
Prolonged labour can lead to postpartum complications and adverse outcomes for both mother and baby. Measurable parameters can help in the active management of labour, timely diagnosis of dystocia and in the choice of the method of delivery. Progressive uterine contractions are necessary to complete labour successfully. Myometrial fatigue during prolonged labour causes a change from aerobic to anaerobic metabolism, resulting in an accumulation of intramuscular lactic acid and probably a subsequent increase in amniotic fluid lactate concentration. High amniotic fluid lactate level has been associated with ineffective uterine contractions leading to labour arrest. A considerable number of studies conducted so far indicate that the level of lactate in amniotic fluid may be a new non-invasive diagnostic tool for early prediction of prolonged labour and the need for immediate obstetric intervention. Low amniotic fluid lactate level may facilitate a decision to continue vaginal labour by oxytocin augmentation. A high level of amniotic fluid lactate is associated with surgical obstetric procedures. Measuring amniotic fluid lactate level might simplify the patient's allocation to a group, which will benefit from the administration of oxytocin and to a group that will not benefit from further prolongation of labour. This study aimed to briefly review current knowledge on amniotic fluid lactate concentrations measured using standard biochemical methods during the first stage of labour following normal pregnancy, as a possible diagnostic tool for prolonged labour. For this purpose, PubMed, EMBASE, Medline (1990 to July 2020) trials register and reference lists of relevant articles were searched.
Topics: Amniotic Fluid; Female; Humans; Lactic Acid; Obstetric Labor Complications; Oxytocics; Pregnancy; Pregnancy Outcome; Time Factors
PubMed: 33470958
DOI: 10.34763/jmotherandchild.20202403.2027.d-20-00011 -
Nature Communications Nov 2023Fetal biometry and amniotic fluid volume assessments are two essential yet repetitive tasks in fetal ultrasound screening scans, aiding in the detection of potentially...
Fetal biometry and amniotic fluid volume assessments are two essential yet repetitive tasks in fetal ultrasound screening scans, aiding in the detection of potentially life-threatening conditions. However, these assessment methods can occasionally yield unreliable results. Advances in deep learning have opened up new avenues for automated measurements in fetal ultrasound, demonstrating human-level performance in various fetal ultrasound tasks. Nevertheless, the majority of these studies are retrospective in silico studies, with a limited number including African patients in their datasets. In this study we developed and prospectively assessed the performance of deep learning models for end-to-end automation of fetal biometry and amniotic fluid volume measurements. These models were trained using a newly constructed database of 172,293 de-identified Moroccan fetal ultrasound images, supplemented with publicly available datasets. the models were then tested on prospectively acquired video clips from 172 pregnant people forming a consecutive series gathered at four healthcare centers in Morocco. Our results demonstrate that the 95% limits of agreement between the models and practitioners for the studied measurements were narrower than the reported intra- and inter-observer variability among expert human sonographers for all the parameters under study. This means that these models could be deployed in clinical conditions, to alleviate time-consuming, repetitive tasks, and make fetal ultrasound more accessible in limited-resource environments.
Topics: Pregnancy; Female; Humans; Amniotic Fluid; Retrospective Studies; Deep Learning; Automation; Biometry
PubMed: 37923713
DOI: 10.1038/s41467-023-42438-5 -
The Journal of Maternal-fetal &... Dec 2022Estimation of amniotic fluid volume (AFV) is part of routine obstetric sonography which reflects maternal-fetal circulation efficiency, fetal hemodynamic status, and a...
INTRODUCTION
Estimation of amniotic fluid volume (AFV) is part of routine obstetric sonography which reflects maternal-fetal circulation efficiency, fetal hemodynamic status, and a parameter for predicting adverse neonatal outcome. Fetal weight is positively correlated with AFV. Therefore, our objective is to provide a new nomogram of AFV indices and to evaluate the relation between AFV and fetal biometric parameters.
MATERIALS AND METHODS
Retrospective cohort study between 2011 and 2018, at a large tertiary medical center. Data were collected from medical charts of prenatal sonographic evaluation of normal pregnancies, including routine estimation of AFV by using amniotic fluid index (AFI). Generalized estimating equations model was used to study the association between AFI, gestational age and fetal biometric parameters. Centiles were calculated using the Generalized Additive Models for Location, Scale, and Shape model. Box-Cox-t distribution and smoothing splines were used.
RESULTS
Analysis included 28,650 pregnancies. From 25 to 41 weeks gestation, the median and fifth percentile AFI gradually decreased from 174 (IQR 157-193) to 138 mm (IQR 107-173) and from 125 to 68 mm, respectively. The change in the 95th percentile was less significant, ranging around 230 mm throughout pregnancy. Multivariate regression analysis demonstrated a significant correlation between AFI and maternal body mass index ( = -0.147; CI = -0.27 to -0.02), gestational age ( = -11.8; CI = -12.5 to -11.4), estimated fetal weight (EFW) ( = 0.05; CI = 0.049-0.053) and abdominal circumference (AC) ( = 0.94; CI = 0.95-1). There was no correlation between AFI and other fetal biometric parameters.
CONCLUSIONS
We suggest new AFI indices of singleton pregnancies. We found a positive correlation between AFI and EFW and AC.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Pregnancy Trimester, Third; Amniotic Fluid; Fetal Weight; Retrospective Studies; Gestational Age; Ultrasonography, Prenatal; Body Mass Index
PubMed: 34470112
DOI: 10.1080/14767058.2021.1965981 -
JCI Insight Feb 2020Adequate iron supply during pregnancy is essential for fetal development. However, how fetal or amniotic fluid iron levels are regulated during healthy pregnancy, or...
Adequate iron supply during pregnancy is essential for fetal development. However, how fetal or amniotic fluid iron levels are regulated during healthy pregnancy, or pregnancies complicated by intraamniotic infection or inflammation (IAI), is unknown. We evaluated amniotic fluid and fetal iron homeostasis in normal and complicated murine, macaque, and human pregnancy. In mice, fetal iron endowment was affected by maternal iron status, but amniotic fluid iron concentrations changed little during maternal iron deficiency or excess. In murine and macaque models of inflamed pregnancy, the fetus responded to maternal systemic inflammation or IAI by rapidly upregulating hepcidin and lowering iron in fetal blood, without altering amniotic fluid iron. In humans, elevated cord blood hepcidin with accompanying hypoferremia was observed in pregnancies with antenatal exposure to IAI compared with those that were nonexposed. Hepcidin was also elevated in human amniotic fluid from pregnancies with IAI compared with those without IAI, but amniotic fluid iron levels did not differ between the groups. Our studies in mice, macaques, and humans demonstrate that amniotic fluid iron is largely unregulated but that the rapid induction of fetal hepcidin by inflammation and consequent fetal hypoferremia are conserved mechanisms that may be important in fetal host defense.
Topics: Amniotic Fluid; Animals; Case-Control Studies; Female; Fetal Blood; Fetus; Homeostasis; Humans; Iron; Macaca mulatta; Mice; Mice, Inbred C57BL; Pregnancy; Pregnancy Complications
PubMed: 31990688
DOI: 10.1172/jci.insight.135321 -
The Journal of Obstetrics and... Aug 2021To analyze the effectiveness of amniotic fluid neutrophil gelatinase-associated lipocalin and L-type fatty acid-binding protein as predictive factors for fetal...
AIM
To analyze the effectiveness of amniotic fluid neutrophil gelatinase-associated lipocalin and L-type fatty acid-binding protein as predictive factors for fetal inflammatory response syndrome.
METHODS
We classified single pregnancy cases into the fetal inflammatory response syndrome and nonfetal inflammatory response syndrome groups. We collected amniotic fluid at vaginal delivery and cesarean section and compared the patient characteristics, maternal white blood cell count, C-reactive protein level, and amniotic fluid interleukin-6; neutrophil gelatinase-associated lipocalin; and L-type fatty acid-binding protein levels between the groups. We further analyzed the relationship between L-type fatty acid-binding protein levels and neonatal clinical outcomes.
RESULTS
We analyzed 129 pregnancies, of which 36 and 93 (27.9% and 72.1%, respectively) were classified into the fetal inflammatory response syndrome and nonfetal inflammatory response syndrome groups, respectively. We observed significant differences in the maternal white blood cell counts and amniotic fluid interleukin-6 and neutrophil gelatinase-associated lipocalin levels. On the multivariate analysis, the useful predictive factors were maternal white blood cell count and amniotic fluid interleukin-6 and neutrophil gelatinase-associated lipocalin levels. Furthermore, the level of L-type fatty acid-binding protein was significantly higher in the transient tachypnea of the newborn and postnatal respiratory support group than in the control group.
CONCLUSIONS
The maternal white blood cell count and amniotic interleukin-6 and neutrophil gelatinase-associated lipocalin levels were effective predictors of fetal inflammatory response syndrome. Amniotic fluid L-type fatty acid-binding protein level was an effective predictor of neonatal respiratory support.
Topics: Amniotic Fluid; Biomarkers; Cesarean Section; Fatty Acid-Binding Proteins; Female; Fetal Diseases; Humans; Infant, Newborn; Interleukin-6; Lipocalin-2; Pregnancy; Prenatal Diagnosis; Systemic Inflammatory Response Syndrome
PubMed: 34056815
DOI: 10.1111/jog.14873