Williams Monica, Zhang Zhi, Nance Elizabeth, Drewes Julia L, Lesniak Wojciech G, Singh Sarabdeep, Chugani Diane C, Rangaramanujam Kannan, Graham David R, Kannan Sujatha
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University SOM, Baltimore, MD, USA.
Dev Neurosci. 2017;39(5):399-412. doi: 10.1159/000471509. Epub 2017 May 11.
Maternal inflammation has been linked to neurodevelopmental and neuropsychiatric disorders such as cerebral palsy, schizophrenia, and autism. We had previously shown that intrauterine inflammation resulted in a decrease in serotonin, one of the tryptophan metabolites, and a decrease in serotonin fibers in the sensory cortex of newborns in a rabbit model of cerebral palsy. In this study, we hypothesized that maternal inflammation results in alterations in tryptophan pathway enzymes and metabolites in the placenta and fetal brain. We found that intrauterine endotoxin administration at gestational day 28 (G28) resulted in a significant upregulation of indoleamine 2,3-dioxygenase (IDO) in both the placenta and fetal brain at G29 (24 h after treatment). This endotoxin-mediated IDO induction was also associated with intense microglial activation, an increase in interferon gamma expression, and increases in kynurenine and the kynurenine pathway metabolites kynurenine acid and quinolinic acid, as well as a significant decrease in 5-hydroxyindole acetic acid (a precursor of serotonin) levels in the periventricular region of the fetal brain. These results indicate that maternal inflammation shunts tryptophan metabolism away from the serotonin to the kynurenine pathway, which may lead to excitotoxic injury along with impaired development of serotonin-mediated thalamocortical fibers in the newborn brain. These findings provide new targets for prevention and treatment of maternal inflammation-induced fetal and neonatal brain injury leading to neurodevelopmental disorders such as cerebral palsy and autism.
母体炎症与神经发育和神经精神疾病有关,如脑瘫、精神分裂症和自闭症。我们之前已经表明,在脑瘫兔模型中,宫内炎症导致新生儿感觉皮层中色氨酸代谢产物之一血清素减少,以及血清素纤维减少。在本研究中,我们假设母体炎症会导致胎盘和胎儿大脑中色氨酸途径酶和代谢产物的改变。我们发现,在妊娠第28天(G28)给予宫内内毒素会导致在G29(治疗后24小时)时胎盘和胎儿大脑中吲哚胺2,3-双加氧酶(IDO)显著上调。这种内毒素介导的IDO诱导还与强烈的小胶质细胞激活、干扰素γ表达增加、犬尿氨酸以及犬尿氨酸途径代谢产物犬尿氨酸酸和喹啉酸增加有关,以及胎儿脑室周围区域5-羟吲哚乙酸(血清素的前体)水平显著降低。这些结果表明,母体炎症使色氨酸代谢从血清素途径转向犬尿氨酸途径,这可能导致兴奋性毒性损伤以及新生大脑中血清素介导的丘脑皮质纤维发育受损。这些发现为预防和治疗母体炎症引起的胎儿和新生儿脑损伤导致的神经发育障碍(如脑瘫和自闭症)提供了新的靶点。