Fung Camille M
Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States.
Front Neurosci. 2023 Mar 16;17:1092357. doi: 10.3389/fnins.2023.1092357. eCollection 2023.
Intrauterine growth restriction (IUGR) complicates up to 10% of human pregnancies and is the second leading cause of perinatal morbidity and mortality after prematurity. The most common etiology of IUGR in developed countries is uteroplacental insufficiency (UPI). For survivors of IUGR pregnancies, long-term studies consistently show a fivefold increased risk for impaired cognition including learning and memory deficits. Among these, only a few human studies have highlighted sex differences with males and females having differing susceptibilities to different impairments. Moreover, it is well established from brain magnetic resonance imaging that IUGR affects both white and gray matter. The hippocampus, composed of the dentate gyrus (DG) and cornu ammonis (CA) subregions, is an important gray matter structure critical to learning and memory, and is particularly vulnerable to the chronic hypoxic-ischemic effects of UPI. Decreased hippocampal volume is a strong predictor for learning and memory deficits. Decreased neuron number and attenuated dendritic and axonal morphologies in both the DG and CA are additionally seen in animal models. What is largely unexplored is the prenatal changes that predispose an IUGR offspring to postnatal learning and memory deficits. This lack of knowledge will continue to hinder the design of future therapy to improve learning and memory. In this review, we will first present the clinical susceptibilities and human epidemiology data regarding the neurological sequelae after IUGR. We will follow with data generated using our laboratory's mouse model of IUGR, that mimics the human IUGR phenotype, to dissect at the cellular and molecular alterations in embryonic hippocampal DG neurogenesis. We will lastly present a newer topic of postnatal neuron development, namely the critical period of synaptic plasticity that is crucial in achieving an excitatory/inhibitory balance in the developing brain. To our knowledge, these findings are the first to describe the prenatal changes that lead to an alteration in postnatal hippocampal excitatory/inhibitory imbalance, a mechanism that is now recognized to be a cause of neurocognitive/neuropsychiatric disorders in at-risk individuals. Studies are ongoing in our laboratory to elucidate additional mechanisms that underlie IUGR-induced learning and memory impairment and to design therapy aimed at ameliorating such impairment.
宫内生长受限(IUGR)在高达10%的人类妊娠中出现并发症,是仅次于早产的围产期发病和死亡的第二大原因。在发达国家,IUGR最常见的病因是子宫胎盘功能不全(UPI)。对于IUGR妊娠的幸存者,长期研究一致表明,包括学习和记忆缺陷在内的认知障碍风险增加了五倍。其中,只有少数人体研究强调了性别差异,即男性和女性对不同损伤的易感性不同。此外,脑磁共振成像已充分证实IUGR会影响白质和灰质。海马体由齿状回(DG)和海马角(CA)亚区域组成,是对学习和记忆至关重要的重要灰质结构,特别容易受到UPI慢性缺氧缺血效应的影响。海马体体积减小是学习和记忆缺陷的有力预测指标。在动物模型中还额外观察到DG和CA中神经元数量减少以及树突和轴突形态减弱。很大程度上尚未探索的是使IUGR后代易患出生后学习和记忆缺陷的产前变化。这种知识的缺乏将继续阻碍未来改善学习和记忆的治疗方案的设计。在本综述中,我们将首先介绍关于IUGR后神经后遗症的临床易感性和人类流行病学数据。接下来,我们将展示使用我们实验室的IUGR小鼠模型生成的数据,该模型模拟人类IUGR表型,以剖析胚胎海马体DG神经发生中的细胞和分子变化。我们最后将介绍出生后神经元发育的一个新主题,即突触可塑性的关键期,这对于在发育中的大脑中实现兴奋/抑制平衡至关重要。据我们所知,这些发现首次描述了导致出生后海马体兴奋/抑制失衡改变的产前变化,这种机制现在被认为是高危个体神经认知/神经精神障碍的一个原因。我们实验室正在进行研究,以阐明IUGR诱导的学习和记忆障碍的其他潜在机制,并设计旨在改善此类障碍的治疗方法。