Molecular, Cellular and Integrative Physiology Graduate Program, Graduate Programs in Bioscience.
Center for Iron Disorders, and.
JCI Insight. 2020 Feb 27;5(4):135321. doi: 10.1172/jci.insight.135321.
Adequate iron supply during pregnancy is essential for fetal development. However, how fetal or amniotic fluid iron levels are regulated during healthy pregnancy, or pregnancies complicated by intraamniotic infection or inflammation (IAI), is unknown. We evaluated amniotic fluid and fetal iron homeostasis in normal and complicated murine, macaque, and human pregnancy. In mice, fetal iron endowment was affected by maternal iron status, but amniotic fluid iron concentrations changed little during maternal iron deficiency or excess. In murine and macaque models of inflamed pregnancy, the fetus responded to maternal systemic inflammation or IAI by rapidly upregulating hepcidin and lowering iron in fetal blood, without altering amniotic fluid iron. In humans, elevated cord blood hepcidin with accompanying hypoferremia was observed in pregnancies with antenatal exposure to IAI compared with those that were nonexposed. Hepcidin was also elevated in human amniotic fluid from pregnancies with IAI compared with those without IAI, but amniotic fluid iron levels did not differ between the groups. Our studies in mice, macaques, and humans demonstrate that amniotic fluid iron is largely unregulated but that the rapid induction of fetal hepcidin by inflammation and consequent fetal hypoferremia are conserved mechanisms that may be important in fetal host defense.
怀孕期间充足的铁供应对胎儿发育至关重要。然而,在健康妊娠或伴有羊膜腔内感染或炎症(IAI)的妊娠中,胎儿或羊水铁水平如何调节尚不清楚。我们评估了正常和复杂的鼠、猕猴和人类妊娠中的羊水和胎儿铁稳态。在小鼠中,胎儿铁的赋予受母体铁状态的影响,但在母体缺铁或铁过量时,羊水铁浓度变化不大。在妊娠炎症的鼠和猕猴模型中,胎儿通过快速上调铁调素并降低胎儿血液中的铁来应对母体全身炎症或 IAI,而不改变羊水铁。在人类中,与未暴露于 IAI 的妊娠相比,产前暴露于 IAI 的妊娠中脐带血铁调素升高伴随着低血症。与没有 IAI 的妊娠相比,IAI 妊娠的人羊水中的铁调素也升高,但两组之间的羊水铁水平没有差异。我们在小鼠、猕猴和人类中的研究表明,羊水铁的调节作用很大程度上不受控制,但炎症快速诱导胎儿铁调素并导致胎儿低血症是保守的机制,这在胎儿宿主防御中可能很重要。