Manzon Lauren, Altarescu Gheona, Tevet Aharon, Schimmel Michael S, Elstein Deborah, Samueloff Arnon, Grisaru-Granovsky Sorina
Department of Obstetrics and Gynecology, 12 Bayit Street, Shaare Zedek Medical Center, Jerusalem 91031, Israel.
Department of Genetics Unit, Shaare Zedek Medical Center, Jerusalem Israel.
Eur J Obstet Gynecol Reprod Biol. 2014 Jun;177:84-8. doi: 10.1016/j.ejogrb.2014.03.008. Epub 2014 Mar 15.
The active form of vitamin D (1,25[OH]2D3) has been established to have potent anti-proliferative, immuno-modulatory, and anti-microbial action in addition to its effects on bone. The nuclear vitamin D receptor (VDR) is expressed in the placenta-decidua, regulating genes associated with implantation and implantation immuno-tolerance. If VDR polymorphisms regulate VDR functionality at the placenta-decidua interface, VDR genotypes may be involved in idiopathic preterm birth (PTB).
Maternal and fetal (umbilical cord) blood samples from 33 Jewish and Arab mothers with PTB of a singleton neonate were compared to 98 samples from Jewish and Arab maternal and fetal blood samples from full-term, uncomplicated singleton births. Maternal age and ethnicity were comparable between groups. PCR amplification/digestion identified the VDR SNPs: FokI, ApaI, TaqI, and BsmI.
Allele frequency for the FokI VDR in maternal blood samples from preterm births (but not umbilical cord samples) was significantly different (p=0.01) from that in maternal and umbilical cord blood samples from full-term singleton births, with an odds ratio for FokI carriers of 3.317 (95% CI, 1.143, 9.627) for preterm birth. The FokI VDR variant may therefore be a maternal risk trait for PTB among these women.
This study may support a future platform for the study of vitamin D during pregnancy and treatment of selective target populations with vitamin D and/or VDR "tissue-specific therapeutic intervention" for prevention of PTB.
维生素D的活性形式(1,25[OH]2D3)除了对骨骼有影响外,还具有强大的抗增殖、免疫调节和抗菌作用。核维生素D受体(VDR)在胎盘-蜕膜中表达,调节与着床和着床免疫耐受相关的基因。如果VDR多态性在胎盘-蜕膜界面调节VDR功能,VDR基因型可能与特发性早产(PTB)有关。
将33例单胎新生儿特发性早产的犹太和阿拉伯母亲的母血和胎儿(脐带)血样本与98例足月、无并发症单胎分娩的犹太和阿拉伯母亲及胎儿血样本进行比较。两组间母亲年龄和种族具有可比性。通过聚合酶链反应扩增/酶切鉴定VDR单核苷酸多态性(SNP):FokI、ApaI、TaqI和BsmI。
早产母亲血样本(而非脐带样本)中FokI VDR的等位基因频率与足月单胎分娩的母亲和脐带血样本中的等位基因频率有显著差异(p = 0.01),早产时FokI携带者的优势比为3.317(95%可信区间,1.143, 9.627)。因此,FokI VDR变异可能是这些女性特发性早产的母亲风险特征。
本研究可能为孕期维生素D研究以及用维生素D和/或VDR“组织特异性治疗干预”治疗选择性目标人群以预防特发性早产提供未来的研究平台。