Nicholls T, Lacey B, Nitsos I, Smythe G, Walker D W
Department of Physiology, Monash University, Clayton Victoria, Australia.
Am J Obstet Gynecol. 2001 Jan;184(2):203-8. doi: 10.1067/mob.2001.108862.
This study was undertaken to examine the effects of chronic embolization of the umbilical circulation during late gestation on regional concentrations of quinolinic acid and kynurenic acid (neuroactive products of tryptophan catabolism) and of the astrocyte-associated glial fibrillary acidic protein in the fetal brain.
Pregnant ewes bearing fetuses with long-term catheter placement were treated daily with injections of either saline solution (n = 4; control group) or mucopolysaccharide microspheres (n = 5; embolized group) into the umbilical circulation through a femoral artery catheter between 120 and 140 days' gestation. The fetuses in the embolized group received sufficient microspheres each day to reduce and maintain the femoral arterial PO2 at < or =12 mm Hg. Autopsies were performed at 140 days' gestation to obtain the fetal brain for chemical analysis.
Umbilical embolization resulted in nonacidemic hypoxia and hypoglycemia at 140 days' gestation. Quinolinic acid concentrations in the embolized group were significantly increased in the medulla, pons, midbrain, hypothalamus, and hippocampus, whereas kynurenic acid concentrations in the embolized group were reduced in the hippocampus and hypothalamus. There were significant reductions in glial fibrillary acidic protein contents in the occipitoparietal cortex, hippocampus, and pons in the embolized group.
Placental compromise during late pregnancy had effects on kynurenine metabolism and astrocyte function in some regions of the fetal sheep brain. We suggest that these changes increase the vulnerability of the brain to asphyxial injury during late gestation and the perinatal period.
本研究旨在探讨妊娠晚期脐循环慢性栓塞对胎儿脑内喹啉酸和犬尿喹啉酸(色氨酸分解代谢的神经活性产物)区域浓度以及与星形胶质细胞相关的胶质纤维酸性蛋白的影响。
对怀有长期放置导管胎儿的妊娠母羊,在妊娠120至140天期间,通过股动脉导管每日向脐循环注射生理盐水(n = 4;对照组)或粘多糖微球(n = 5;栓塞组)。栓塞组的胎儿每天接受足够数量的微球,以使股动脉血氧分压降低并维持在≤12 mmHg。在妊娠140天时进行尸检,获取胎儿脑进行化学分析。
脐循环栓塞导致妊娠140天时出现非酸血症性缺氧和低血糖。栓塞组延髓、脑桥、中脑、下丘脑和海马中的喹啉酸浓度显著升高,而栓塞组海马和下丘脑中的犬尿喹啉酸浓度降低。栓塞组枕顶叶皮质、海马和脑桥中的胶质纤维酸性蛋白含量显著降低。
妊娠晚期胎盘功能不全对胎羊脑某些区域的犬尿氨酸代谢和星形胶质细胞功能有影响。我们认为这些变化增加了胎儿在妊娠晚期和围生期脑对窒息性损伤的易感性。