Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
Manchester Academic Health Science Centre, St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
J Physiol. 2019 Oct;597(19):4975-4990. doi: 10.1113/JP278226. Epub 2019 Aug 27.
Fetal growth restriction (FGR) is a major risk factor for stillbirth and has significant impact upon lifelong health. A small, poorly functioning placenta, as evidenced by reduced transport of nutrients to the baby, underpins FGR. It remains unclear how a small but normal placenta differs from the small FGR placenta in terms of ability to transfer nutrients to the fetus. Placental transport of glutamine and glutamate, key amino acids for fetal growth, was assessed in normal mice and those with FGR. Glutamine and glutamate transport was greater in the lightest versus heaviest placenta in a litter of normally grown mice. Placentas of mice with FGR had increased transport capacity in mid-pregnancy, but this adaptation was insufficient in late pregnancy. Placental adaptations, in terms of increased nutrient transport (per gram) to compensate for small size, appear to achieve appropriate fetal growth in normal pregnancy. Failure of this adaptation might contribute to FGR.
Fetal growth restriction (FGR), a major risk factor for stillbirth, and neonatal and adulthood morbidity, is associated with reduced placental size and decreased placental nutrient transport. In mice, a small, normal placenta increases its nutrient transport, thus compensating for its reduced size and maintaining normal fetal growth. Whether this adaptation occurs for glutamine and glutamate, two key amino acids for placental metabolism and fetal growth, is unknown. Additionally, an assessment of placental transport of glutamine and glutamate between FGR and normal pregnancy is currently lacking. We thus tested the hypothesis that the transport of glutamine and glutamate would be increased (per gram of tissue) in a small normal placenta [C57BL6/J (wild-type, WT) mice], but that this adaptation fails in the small dysfunctional placenta in FGR [insulin-like growth factor 2 knockout (P0) mouse model of FGR]. In WT mice, comparing the lightest versus heaviest placenta in a litter, unidirectional maternofetal clearance (K ) of C-glutamine and C-glutamate ( K and K ) was significantly higher at embryonic day (E) 18.5, in line with increased expression of LAT1, a glutamine transporter protein. In P0 mice, K and K were higher (P0 versus wild-type littermates, WTL) at E15.5. At E18.5, K remained elevated whereas K was similar between groups. In summary, we provide evidence that K and K adapt according to placental size in WT mice. The placenta of the growth-restricted P0 fetus also elevates transport capacity to compensate for size at E15.5, but this adaptation is insufficient at E18.5; this may contribute to decreased fetal growth.
胎儿生长受限(FGR)是死产的主要危险因素,对终身健康有重大影响。胎盘功能不良,表现为向胎儿输送的营养物质减少,是导致 FGR 的主要原因。目前尚不清楚正常胎盘和 FGR 胎盘在向胎儿输送营养物质的能力方面有何不同,尽管胎盘较小但功能正常。我们评估了正常小鼠和 FGR 小鼠中胎盘对谷氨酰胺和谷氨酸这两种胎儿生长关键氨基酸的转运情况。在正常生长的小鼠中,胎盘中最轻和最重的胎盘相比,谷氨酰胺和谷氨酸的转运能力更强。FGR 小鼠的胎盘在妊娠中期的转运能力增加,但在妊娠晚期这种适应能力不足。就增加营养物质转运(每克)以补偿较小的尺寸而言,胎盘的适应性似乎在正常妊娠中实现了适当的胎儿生长。这种适应的失败可能是导致 FGR 的原因。
胎儿生长受限(FGR)是死产和新生儿及成年发病率的主要危险因素,与胎盘体积减小和胎盘营养物质转运减少有关。在小鼠中,较小的正常胎盘增加其营养物质转运,从而补偿其较小的尺寸并维持正常的胎儿生长。目前尚不清楚这种适应是否适用于谷氨酰胺和谷氨酸,这两种是胎盘代谢和胎儿生长的关键氨基酸。此外,目前还缺乏 FGR 与正常妊娠之间谷氨酰胺和谷氨酸胎盘转运的评估。因此,我们假设在较小的正常胎盘(C57BL6/J(野生型,WT)小鼠)中,谷氨酰胺和谷氨酸的转运(每克组织)会增加,但在 FGR 中较小的功能失调胎盘中这种适应会失败[胰岛素样生长因子 2 敲除(P0)小鼠的 FGR 模型]。在 WT 小鼠中,比较一窝中最轻和最重的胎盘,胚胎第 18.5 天时,C-谷氨酰胺和 C-谷氨酸的单向母体-胎儿清除率(K)显著升高,这与谷氨酰胺转运蛋白 LAT1 的表达增加一致。在 P0 小鼠中,E15.5 时 K 和 K 较高(P0 与野生型同窝仔鼠,WTL)。在 E18.5 时,K 仍然升高,而 K 两组间相似。总之,我们提供的证据表明,在 WT 小鼠中,K 和 K 根据胎盘大小进行适应。生长受限的 P0 胎儿的胎盘也会在 E15.5 时提高转运能力以补偿大小,但在 E18.5 时这种适应不足;这可能导致胎儿生长受限。