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Human Reproduction Update Sep 2020Haem oxygenases (HO) catabolise haem, which is the prosthetic group of numerous haemoproteins. Thus, multiple primary cellular pathways and functions rely on haem... (Review)
Review
BACKGROUND
Haem oxygenases (HO) catabolise haem, which is the prosthetic group of numerous haemoproteins. Thus, multiple primary cellular pathways and functions rely on haem availability. HO exists in two isoforms, both expressed in the placenta, namely HO-1 and HO-2, the first being inducible. Haem oxygenases, particularly HO-1, have garnered specific interest in the field of physiological and pathological placental function. These enzymes mediate haem degradation by cleaving the alpha methene bridge to produce biliverdin, which is subsequently converted to bilirubin, carbon monoxide and iron. HO-1 has anti-inflammatory and antioxidant activities.
SEARCH METHODS
An initial literature analysis was performed using PubMed on 3 October 2018 using key terms such as 'haem oxygenase and pregnancy', 'haem oxygenase and placenta', 'HO-1 and pregnancy', 'HO-1 and placenta', 'HO and placenta', 'HO and pregnancy', 'genetic variant and HO', 'CO and pregnancy', 'CO and placenta', 'Bilirubin and pregnancy', 'Iron and pregnancy' and 'PPAR and Haem', selecting consensus conferences, recommendations, meta-analyses, practical recommendations and reviews. A second literature analysis was performed, including notable miscarriages, foetal loss and diabetes mellitus, on 20 December 2019. The three authors studied the publications independently to decipher whether they should be included in the manuscript.
OBJECTIVE AND RATIONALE
This review aimed to summarise current pieces of knowledge of haem oxygenase location, function and regulation in the placenta, either in healthy pregnancies or those associated with miscarriages and foetal loss, pre-eclampsia, foetal growth restriction and diabetes mellitus.
OUTCOMES
HO-1 exerts some protective effects on the placentation, probably by a combination of factors, including its interrelation with the PGC-1α/PPAR pathway and the sFlt1/PlGF balance, and through its primary metabolites, notably carbon monoxide and bilirubin. Its protective role has been highlighted in numerous pregnancy conditions, including pre-eclampsia, foetal growth restriction, gestational diabetes mellitus and miscarriages.
WIDER IMPLICATIONS
HO-1 is a crucial enzyme in physiological and pathological placentation. This protective enzyme is currently considered a potential therapeutic target in various pregnancy diseases.
Topics: Animals; Female; Heme Oxygenase (Decyclizing); Humans; Placenta; Placenta Diseases; Placentation; Pregnancy; Pregnancy Complications
PubMed: 32347305
DOI: 10.1093/humupd/dmaa014 -
Theriogenology Jan 2021Risk factors for retained placenta (RP), as a common and economically important disorder, have been widely investigated. However, comprehensive studies are rare....
Risk factors for retained placenta (RP), as a common and economically important disorder, have been widely investigated. However, comprehensive studies are rare. Therefore, this study sought to identify herd-cow factors and their interactions on the risk of RP in Iranian dairy herds. The data were collected from nine Holstein dairy herds in Isfahan province, Iran. The final dataset included 154,048 records for 59,610 cows which calved between March 2011 and December 2018. A logistic regression model was used to separately analyze the risk factors and their interactions for RP in primiparous and multiparous cows. The average rate of RP was 12.3% (9.0-15.4%) at the herd level. The highest rate of RP was recorded in spring compared with other seasons. Regardless of calving season, occurrence of dystocia, stillbirth and twinning increased the odds ratio (OR) of RP. In primiparous cows, occurrence of dystocia and stillbirth increased OR of RP 4.30 and 3.33 times, respectively. In multiparous cows, dystocia, twinning and stillbirth increased OR of RP 4.36, 3.94 and 1.29 times, respectively. Cows with an age at first calving of >28 months had the highest rate of RP compared with other cows. Multiparous and primiparous cows with a short (less than 271 d) and long (more than 281 d) pregnancy, respectively, had the highest risk of RP compared to cows in other groups. Furthermore, multiparous cows with an extended dry period length (more than 75 d) and produced milk yield more than 13,000 kg/lactation were at higher risk of RP with an average of 13.5%. With an interaction analysis, although the potential effect of each factors depends on the effect of other factors, but in general dystocia, stillbirth, an extended age at first calving (>28 months), and calving during the spring increased risk of RP for both groups. In conclusion, identification of risk factors for RP with an interaction analysis can help farm managers to employ the best strategies to reduce the occurrence of this reproductive disorder.
Topics: Animals; Cattle; Cattle Diseases; Farms; Female; Incidence; Iran; Lactation; Milk; Parity; Placenta, Retained; Pregnancy
PubMed: 33113449
DOI: 10.1016/j.theriogenology.2020.10.007 -
Acta Radiologica (Stockholm, Sweden :... May 2020
Review
Topics: Female; Humans; Magnetic Resonance Imaging; Placenta; Placenta Diseases; Pregnancy; Prenatal Diagnosis; Ultrasonography, Doppler, Color; Ultrasonography, Prenatal; Umbilical Cord
PubMed: 31550171
DOI: 10.1177/0284185119875644 -
Acta Obstetricia Et Gynecologica... Aug 2020Low-lying placentas, placenta previa and abnormally invasive placentas are the most frequently occurring placental abnormalities in location and anatomy. These...
Low-lying placentas, placenta previa and abnormally invasive placentas are the most frequently occurring placental abnormalities in location and anatomy. These conditions can have serious consequences for mother and fetus mainly due to excessive blood loss before, during or after delivery. The incidence of such abnormalities is increasing, but treatment options and preventive strategies are limited. Therefore, it is crucial to understand the etiology of placental abnormalities in location and anatomy. Placental formation already starts at implantation and therefore disorders during implantation may cause these abnormalities. Understanding of the normal placental structure and development is essential to comprehend the etiology of placental abnormalities in location and anatomy, to diagnose the affected women and to guide future research for treatment and preventive strategies. We reviewed the literature on the structure and development of the normal placenta and the placental development resulting in low-lying placentas, placenta previa and abnormally invasive placentas.
Topics: Adult; Female; Humans; Placenta Diseases; Pregnancy
PubMed: 32108320
DOI: 10.1111/aogs.13834 -
Frontiers in Endocrinology 2022The placenta plays a fundamental role during pregnancy for fetal growth and development. A suboptimal placental function may result in severe consequences during the... (Review)
Review
The placenta plays a fundamental role during pregnancy for fetal growth and development. A suboptimal placental function may result in severe consequences during the infant's first years of life. In recent years, a new field known as neuroplacentology has emerged and it focuses on the role of the placenta in fetal and neonatal brain development. Because of the limited data, our aim was to provide a narrative review of the most recent knowledge about the relation between placental lesions and fetal and newborn neurological development. Papers published online from 2000 until February 2022 were taken into consideration and particular attention was given to articles in which placental lesions were related to neonatal morbidity and short-term and long-term neurological outcome. Most research regarding the role of placental lesions in neurodevelopment has been conducted on fetal growth restriction and preterm infants. Principal neurological outcomes investigated were periventricular leukomalacia, intraventricular hemorrhages, neonatal encephalopathy and autism spectrum disorder. No consequences in motor development were found. All the considered studies agree about the crucial role played by placenta in fetal and neonatal neurological development and outcome. However, the causal mechanisms remain largely unknown. Knowledge on the pathophysiological mechanisms and on placenta-related risks for neurological problems may provide clues for early interventions aiming to improve neurological outcomes, especially among pediatricians and child psychiatrists.
Topics: Autism Spectrum Disorder; Female; Fetal Growth Retardation; Humans; Infant; Infant, Newborn; Infant, Premature; Placenta; Placenta Diseases; Pregnancy
PubMed: 36060976
DOI: 10.3389/fendo.2022.936171 -
Best Practice & Research. Clinical... Apr 2021The purpose of this review is to describe the panorama of placenta accreta spectrum (PAS) disorder management in low- and middle-income countries, providing information... (Review)
Review
The purpose of this review is to describe the panorama of placenta accreta spectrum (PAS) disorder management in low- and middle-income countries, providing information that allows for the improvement of maternal and perinatal outcomes in the management of this pathology. This spectrum of disorders is associated with implications of high morbidity and mortality, both maternal and perinatal, which is why clinical practice guidelines based on management are produced in settings where there is a wide range of available resources. This situation often contrasts with what the reality is in low-resource countries. Prenatal diagnosis of placental accreta is essential to carry out adequate surgical planning in centres where multidisciplinary teams are in place, which improve results and reduce complications. These ideal scenarios should be developed in countries with more significant difficulties in the availability of human and technological resources, through teamwork in the different hospital centres and the adequate transfer of patients at higher risk to centres with the best interdisciplinary management skills.
Topics: Female; Humans; Placenta; Placenta Accreta; Placenta Previa; Pregnancy; Prenatal Diagnosis
PubMed: 32900599
DOI: 10.1016/j.bpobgyn.2020.08.004 -
Ultrasound Quarterly Sep 2020Routine second trimester ultrasound (US) examinations include an assessment of the umbilical cord given its vital role as a vascular conduit between the maternal... (Review)
Review
Routine second trimester ultrasound (US) examinations include an assessment of the umbilical cord given its vital role as a vascular conduit between the maternal placenta and fetus during fetal development. Placental cord insertion abnormalities can be identified during prenatal US screening and are increasingly recognized as independent risk factors for various complications during pregnancy and delivery. The purpose of this pictorial review is to illustrate examples of velamentous and marginal placental cord insertion with an emphasis on how to differentiate their morphology using color Doppler US.
Topics: Female; Humans; Placenta; Placenta Diseases; Pregnancy; Ultrasonography, Prenatal
PubMed: 30870317
DOI: 10.1097/RUQ.0000000000000437 -
Journal of Magnetic Resonance Imaging :... Dec 2019Even though the placenta has been known for millennia, it is still considered one of the most complex and least understood human organs. Imaging of the placenta is... (Review)
Review
Even though the placenta has been known for millennia, it is still considered one of the most complex and least understood human organs. Imaging of the placenta is gaining attention due to its impact on fetal and maternal outcomes. MRI plays a vital role in evaluation of inconclusive cases by ultrasonography. It enables precise mapping of placental abnormalities for proper multidisciplinary planning and management. In this article we provide a comprehensive in-depth review of the role of antenatal MR in evaluating "The Placenta." We will describe the protocols and techniques used for MRI of the placenta, review anatomy of the placenta, describe MRI features of major placental abnormalities including those related to position, depth of implantation, hemorrhage, gestational trophoblastic neoplasia, and retained products of conception and discuss the added value of MRI in the management and preoperative planning of such abnormalities. Level of Evidence: 3 Technical Efficacy Stage: 5 J. Magn. Reson. Imaging 2019;50:1702-1717.
Topics: Female; Gestational Trophoblastic Disease; Humans; Magnetic Resonance Imaging; Placenta; Placenta Diseases; Pregnancy
PubMed: 31102327
DOI: 10.1002/jmri.26764 -
Advances in Protein Chemistry and... 2021Autophagy and apoptosis are catabolic pathways essential for homeostasis. They play a crucial role for normal placental and fetal development. These cell death... (Review)
Review
Autophagy and apoptosis are catabolic pathways essential for homeostasis. They play a crucial role for normal placental and fetal development. These cell death mechanisms are exaggerated in placental disorders such as preeclampsia, intrauterine growth restriction (IUGR) and gestational diabetes mellitus (GDM). Apoptosis is widely studied, highly controlled and regulated whereas; autophagy is an orderly degradation and recycling of the cellular components. Cellular senescence may be initiated by a variety of stimuli, including hypoxia, oxidative stress, reduction in survival signals and nutrition deprivation. Apoptosis is regulated by two types of pathways intrinsic and extrinsic. Extrinsic pathway is initiated by apoptosis inducing cells such as macrophages, natural killer cells whereas; intrinsic pathway is initiated in response to DNA damage, cell injury and lack of oxygen. In autophagy, the cell or organelles undergo lysosomal degradation. Placental apoptosis increases as the gestation progresses while autophagy plays a role in trophoblast differentiation and invasion. In pregnancy disorders like preeclampsia and IUGR, proapoptotic markers such as caspase 3, 8, BAX are higher and antiapoptotic markers like Bcl-2 are lower. In GDM, apoptotic markers are reduced resulting in increased placental mass and fetal macrosomia. Apoptosis in the pathological pregnancies is also influenced by the reduced levels of micronutrients and long chain polyunsaturated fatty acids resulting in disturbed placental biology. This chapter describes the role of various key molecular events involved in cellular senescence and the various factors influencing them. This will help identify future therapeutic strategies for better management of these processes.
Topics: Apoptosis; Apoptosis Regulatory Proteins; Cell Hypoxia; Cellular Senescence; DNA Damage; Female; Humans; Oxidative Stress; Placenta Diseases; Pregnancy; Trophoblasts
PubMed: 34090615
DOI: 10.1016/bs.apcsb.2021.01.006 -
International Journal of Molecular... Sep 2023Global health efforts have increased against infectious diseases, but issues persist with pathogens like Group B Streptococcus (GBS). Preclinical studies have elaborated... (Review)
Review
Global health efforts have increased against infectious diseases, but issues persist with pathogens like Group B Streptococcus (GBS). Preclinical studies have elaborated on the mechanistic process of GBS-induced chorioamnionitis and its impact on the fetal programming of chronic neuropsychiatric diseases. GBS inoculation in rodents demonstrated the following: (i) silent and self-limited placental infection, similar to human chorioamnionitis; (ii) placental expression of chemokines attracting polymorphonuclear (PMN) cells; (iii) in vitro cytokine production; (iv) PMN infiltration in the placenta (histologic hallmark of human chorioamnionitis), linked to neurobehavioral impairments like cerebral palsy and autism spectrum disorders (ASD); (v) upregulation of interleukin-1β (IL-1β) in the placenta and fetal blood, associated with higher ASD risk in humans; (vi) sex-specific effects, with higher IL-1β release and PMN recruitment in male placenta; (vii) male offspring exhibiting ASD-like traits, while female offspring displayed attention deficit and hyperactivity disorder (ADHD)-like traits; (viii) IL-1 and/or NF-kB blockade alleviate placental and fetal inflammation, as well as subsequent neurobehavioral impairments. These findings offer potential therapeutic avenues, including sex-adapted anti-inflammatory treatment (e.g., blocking IL-1; repurposing of FDA-approved IL-1 receptor antagonist (IL-1Ra) treatment). Blocking the IL-1 pathway offers therapeutic potential to alleviate chorioamnionitis-related disabilities, presenting an opportunity for a human phase II RCT that uses IL-1 blockade added to the classic antibiotic treatment of chorioamnionitis.
Topics: Pregnancy; Humans; Female; Male; Chorioamnionitis; Placenta; Autism Spectrum Disorder; Brain Injuries; Streptococcus; Interleukin-1
PubMed: 37762401
DOI: 10.3390/ijms241814090