Gaccioli F, Lager S, Powell T L, Jansson T
Department of Obstetrics and Gynecology, Center for Pregnancy and Newborn Research, University of Texas Health Science Center, San Antonio, TX, USA.
J Dev Orig Health Dis. 2013 Apr;4(2):101-15. doi: 10.1017/S2040174412000529.
The mechanisms linking maternal nutrition to fetal growth and programming of adult disease remain to be fully established. We review data on changes in placental transport in response to altered maternal nutrition, including compromized utero-placental blood flow. In human intrauterine growth restriction and in most animal models involving maternal undernutrition or restricted placental blood flow, the activity of placental transporters, in particular for amino acids, is decreased in late pregnancy. The effect of maternal overnutrition on placental transport remains largely unexplored. However, some, but not all, studies in women with diabetes giving birth to large babies indicate an upregulation of placental transporters for amino acids, glucose and fatty acids. These data support the concept that the placenta responds to maternal nutritional cues by altering placental function to match fetal growth to the ability of the maternal supply line to allocate resources to the fetus. On the other hand, some findings in humans and mice suggest that placental transporters are regulated in response to fetal demand signals. These observations are consistent with the idea that fetal signals regulate placental function to compensate for changes in nutrient availability. We propose that the placenta integrates maternal and fetal nutritional cues with information from intrinsic nutrient sensors. Together, these signals regulate placental growth and nutrient transport to balance fetal demand with the ability of the mother to support pregnancy. Thus, the placenta plays a critical role in modulating maternal-fetal resource allocation, thereby affecting fetal growth and the long-term health of the offspring.
母体营养与胎儿生长以及成人疾病编程之间的联系机制仍有待全面确立。我们回顾了关于胎盘转运变化的数据,这些变化是对母体营养改变的反应,包括子宫 - 胎盘血流受损。在人类宫内生长受限以及大多数涉及母体营养不良或胎盘血流受限的动物模型中,胎盘转运蛋白的活性,尤其是氨基酸转运蛋白的活性,在妊娠晚期会降低。母体营养过剩对胎盘转运的影响在很大程度上仍未得到探索。然而,一些(但并非全部)对分娩巨大儿的糖尿病女性的研究表明,氨基酸、葡萄糖和脂肪酸的胎盘转运蛋白上调。这些数据支持这样一种概念,即胎盘通过改变胎盘功能来响应母体营养信号,以使胎儿生长与母体供应线向胎儿分配资源的能力相匹配。另一方面,人类和小鼠的一些研究结果表明,胎盘转运蛋白是根据胎儿需求信号进行调节的。这些观察结果与胎儿信号调节胎盘功能以补偿营养可利用性变化的观点一致。我们提出,胎盘将母体和胎儿营养信号与来自内在营养传感器的信息整合在一起。这些信号共同调节胎盘生长和营养转运,以平衡胎儿需求与母亲支持妊娠的能力。因此,胎盘在调节母胎资源分配中起着关键作用,从而影响胎儿生长和后代的长期健康。