Department of Obstetrics and Gynecology, Institute for Clinical Science, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden.
Hum Reprod. 2010 Mar;25(3):697-704. doi: 10.1093/humrep/dep470. Epub 2010 Jan 18.
Pregnancies after organ transplantation and under immunosuppressive treatment are associated with slightly elevated risks for obstetric and post-natal complications but can usually be managed well. However, little is known about the effects of intrauterine exposure (IUE) to immunosuppressants in the growing and adult offspring. One major issue is the potentially negative effects of immunosuppressive medication on reproduction. This study investigates the effect of exposure during pregnancy to the most commonly used immunosuppressant in organ transplantation, cyclosporine A (CsA), on the reproductive outcome in mothers and offspring.
Female C57CBA-F1 mice received 0, 10, 20 or 30 mg/kg bodyweight of CsA daily by subcutaneous mini-osmotic pumps during mating and pregnancy. Blood concentrations of CsA, implantation rates, resorption rates and fetal weights were analysed. In addition, female and male mice exposed to CsA in utero were mated to unexposed partners and pregnancy outcomes were analysed.
Direct maternal exposure to CsA at high doses reduced implantation rates and fetal survival. IUE to CsA reduced adolescent growth but did not affect fertility, although a reduction in birthweight was seen in offspring of females exposed to CsA in utero.
CsA exposure during pregnancy correlates with impaired reproductive outcome, but offspring fertility is not affected. The cause of reduction in adolescent weight gain and low birthweight in offspring of females exposed to CsA in utero need further investigation.
器官移植后和免疫抑制治疗下的妊娠与产科和产后并发症的风险略有升高有关,但通常可以得到很好的管理。然而,对于宫内暴露(IUE)于免疫抑制剂对生长和成年后代的影响知之甚少。一个主要问题是免疫抑制药物对生殖的潜在负面影响。本研究调查了在器官移植中最常用的免疫抑制剂环孢素 A(CsA)在怀孕期间暴露对母亲和后代生殖结果的影响。
雌性 C57CBA-F1 小鼠在交配和妊娠期间通过皮下迷你渗透泵每天接受 0、10、20 或 30mg/kg 体重的 CsA。分析 CsA 的血药浓度、着床率、吸收率和胎儿体重。此外,对宫内暴露于 CsA 的雌性和雄性小鼠进行交配,并与未暴露的伴侣进行妊娠结局分析。
直接母体暴露于高剂量 CsA 会降低着床率和胎儿存活率。CsA 的宫内暴露会导致青春期生长迟缓,但不会影响生育能力,尽管暴露于 CsA 的雌性后代的出生体重降低。
怀孕期间 CsA 的暴露与生殖结局受损相关,但后代的生育能力不受影响。需要进一步研究宫内暴露于 CsA 的雌性后代青春期体重减轻和低出生体重的原因。