pregnancy Complications gut.docx

pregnancy Complications gut.docx

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pregnancyComplicationsgut

pregnancyComplicationsgut

PediatrRes. 2015Jan;77（1-2）:

196-204.doi:

10.1038/pr.2014.169.Epub2014Oct14.

Ofthebugsthatshapeus:

maternalobesity,the gut microbiome,andlong-termdiseaserisk.

GohirW1, RatcliffeEM2, SlobodaDM3.

Authorinformation

Abstract

Chronicdiseaseriskisinextricablylinkedtoourearly-lifeenvironment,wherematernal,fetal,andchildhoodfactorspredictdiseaserisklaterinlife.Currently,maternalobesityisakeypredictorofchildhoodobesityandmetabolic complications inadulthood.Althoughthemechanismsareunclear,newandemergingevidencepointstoourmicrobiome,wherethebacterialcompositionofthe gut modulatestheweightgainandalteredmetabolismthatdrivesobesity.Overthecourseof pregnancy,maternalbacterialloadincreases,and gut bacterialdiversitychangesandisinfluencedbypre-pregnancy-and pregnancy-relatedobesity.Alterationsinthebacterialcompositionofthemotherhavebeenshowntoaffectthedevelopmentandfunctionofthegastrointestinaltractofheroffspring.Howthesemicrobialshiftsinfluencethematernal-fetal-infantrelationshipisatopicofhotdebate.Thispaperwillreviewtheevidencelinkingnutrition,maternalobesity,thematernal gut microbiome,andfetal gut development,bringingtogetherclinicalobservationsinhumansandexperimentaldatafromtargetedanimalmodels.

JNutrBiochem. 2014Jul;25（7）:

785-95.doi:

10.1016/j.jnutbio.2014.03.008.Epub2014Apr2.

Temporalproteomicanalysisrevealsdefectsinsmall-intestinaldevelopmentofporcinefetuseswithintrauterinegrowthrestriction.

WangX1, LinG1, LiuC1, FengC2, ZhouH3, WangT1, LiD1, WuG4, WangJ5.

Authorinformation

Abstract

Thefetus/neonatewithintrauterinegrowthrestriction（IUGR）hasahighperinatalmortalityandmorbidityrate,aswellasreducedefficiencyfornutrientsutilization.OurpreviousstudiesshowedalterationsofintestinalproteomeinIUGRpigletsbothatbirthandduringthenursingperiod.Consideringthepotentiallong-termimpactsoffetalprogrammingandsubstantialincreasesinamountsofamnioticfluidnutrientsfrommid-gestationinpigs,thepresentstudyinvolvedIUGRporcinefetusesfromdays60to110ofgestation（midtolategestation）.Weidentified59differentiallyexpressedproteinsinthefetalsmallintestinethatarerelatedtointestinalgrowth,developmentandreprogramming.Ourresultsfurtherindicatedincreasedabundancesofproteinsandenzymesassociatedwithoxidativestress,apoptosisandproteindegradation,aswellasdecreasedabundancesofproteinsthatarerequiredformaintenanceofcellstructureandmotility,absorptionandtransportofnutrients,energymetabolism,andproteinsynthesisinthefetal gut.Moreover,IUGRfrommiddletolategestationwasassociatedwithreducedexpressionofintestinalproteinsthatparticipateinregulationofgeneexpressionandsignaltransduction.Collectively,thesefindingsprovidethefirstevidenceforalteredproteomesinthesmallintestineofIUGRfetuses,therebypredisposingthe gut tometabolicdefectsduringgestationandneonatalperiods.

AmJObstetGynecol. 2014Jul;211

（1）:

79.e1-2.doi:

10.1016/j.ajog.2014.03.006.Epub2014Mar5.

A gut-wrenchingfeeling:

 pregnancy complicatedbymassiveventralherniawithbowelobstruction.

SerraAE1, FongA1, ChungJH1.

Authorinformation

Abstract

A44yearoldG4P3presentswithmassiveherniarecurrenceandbowelobstruction.Hersymptomsresolvewithconservativemanagement,andsheisdeliveredbycesareansectionattermwithherniorrhaphyperformed10weekspostpartum.

AdvNeonatalCare. 2014Feb;14

（1）:

44-51.doi:

10.1097/ANC.0000000000000052.

Colostrumasoralimmunetherapytopromoteneonatalhealth.

GephartSM1, WellerM.

Authorinformation

Abstract

Itiswellknownthattheimmuneresponseisbluntedandunderdevelopedintheprematureinfant,buthumanmilksupportstheinfant'sgrowth,function,andeffectiveness.Thus,ownmother'scolostrum（OMC）administeredoropharyngeallyhaspotentialtodeliveroralimmunetherapy（C-OIT）evenbeforeenteralfeedingshavebegun.Colostruminteractswithlymphoidtissueintheoropharynxand gut.Colostrumasoralimmunetherapyisdeliveredbyswabbingthecheeksinthefirstdaysoflife.Littleformalstudyhasevaluateditseffectiveness.However,smallstudiesdemonstratethatitisapracticethatissafe,feasible,andwelltoleratedevenbythesmallestprematureinfants.EncouragingpreliminaryevidencesupportstheeffectofC-OITtoreducethetimetofullenteralfeedings.Effectsonotheroutcomesisunclear,inpartbecauseexistingstudiesareunderpoweredtodetectsignificantdifferencesonoutcomeslikenecrotizingenterocolitis,sepsis,anddeath.Anotherlimitationintheevidencebaseisthatadherencetotheinterventionandthenumberofdosesofcolostruminfantsreceivedinthestudiesisnotconsistentlymadeclear.Morewell-designedstudiesareneededtodemonstratetheimpactonneonatal complications andhowC-OITsupportstheinfant'simmunedevelopment.Qualityimprovementandtimeseriesreportsofdifferencespre-andpostimplementationofOMCgivenorallyshouldminimallyincludestatisticsforadherencetotheinterventionand/orthenumberofdosesaninfantreceivedasacovariate.Evenso,OMCisanimmunetherapythatposeslittleriskyetofferslikelycost-effectivebenefitforvulnerableinfants.

PLoSOne. 2014Jan22;9

（1）:

e87072.doi:

10.1371/journal.pone.0087072.eCollection2014.

Pre-andneonatalexposuretolipopolysaccharideortheentericmetabolite,propionicacid,altersdevelopmentandbehaviorinadolescentratsinasexuallydimorphicmanner.

FoleyKA1, OssenkoppKP2, KavaliersM2, MacfabeDF3.

Authorinformation

Abstract

Alterationsinthecompositionofthe gut microbiomeand/orimmunesystemfunctionmayhavearoleinthedevelopmentofautismspectrumdisorders（ASD）.Thecurrentstudyexaminedtheeffectsofprenatalandearlylifeadministrationoflipopolysaccharide（LPS）,abacterialmimetic,andtheshortchainfattyacid,propionicacid（PPA）,ametabolicfermentationproductofentericbacteria,ondevelopmentalmilestones,locomotoractivity,andanxiety-likebehaviorinadolescentmaleandfemaleoffspring.PregnantLong-EvansratsweresubcutaneouslyinjectedonceadaywithPPA（500mg/kg）ongestationdaysG12-16,LPS（50µg/kg）onG15-16,orvehiclecontrolonG12-16orG15-16.MaleandfemaleoffspringwereinjectedwithPPA（500mg/kg）orvehicletwiceaday,everyseconddayfrompostnataldays（P）10-18.PhysicalmilestonesandreflexesweremonitoredinearlylifewithprenatalPPAandLPSinducingdelaysineyeopening.Locomotoractivityandanxietywereassessedinadolescence（P40-42）intheelevatedplusmaze（EPM）andopen-field.Prenatalandpostnataltreatmentsalteredbehaviorinasex-specificmanner.PrenatalPPAdecreasedtimespentinthecentreoftheopen-fieldinmalesandfemaleswhileprenatalandpostnatalPPAincreasedanxietybehaviorontheEPMinfemalerats.PrenatalLPSdidnotsignificantlyinfluencethosebehaviors.EvidenceforthedoublehithypothesiswasseenasfemalesreceivingadoublehitofPPA（prenatalandpostnatal）displayedincreasedrepetitivebehaviorintheopen-field.Theseresultsprovideevidenceforthehypothesisthatby-productsofentericbacteriametabolismsuchasPPAmaycontributetoASD,alteringdevelopmentandbehaviorinadolescentratssimilartothatobservedinASDandotherneurodevelopmentaldisorders.

Gut. 2014Jun;63（6）:

1014-23.doi:

10.1136/gutjnl-2013-305418.Epub2014Jan15.

Managementofgastrointestinalandliverdiseasesduring pregnancy.

vanderWoudeCJ1, MetselaarHJ, DaneseS.

Authorinformation

Abstract

Inthemajorityofpatientswithchronicgastrointestinalandliverdiseases,maintenancetherapyisrequiredduring pregnancy tocontrolthedisease,anddiseasefollow-upordiseasecontrolmightnecessitateendoscopy.Evidenceonthesafetyofdrugsandimagingtechniquesduring pregnancy isscarceandsometimesdifficulttointerpret.Inthisreviewwesummariseexistingliteraturewiththeaimofoptimisingcounsellingofpatientswithcommonchronicgastrointestinalandliverdiseaseswhowanttoconceive.

JAnimSci. 2014May;92（5）:

1840-9.doi:

10.2527/jas.2013-7106.Epub2013Nov15.

CELLBIOLOGYSYMPOSIUM:

Impactsofmaternalobesityonplacentaland gut inflammationandhealth.

ZhuMJ1, DuM, FordSP.

Authorinformation

Abstract

Obesityinpregnantwomenisagrowingpublichealthconcernthatnegativelyaffectsfetaldevelopmentandhaslong-termimpactsonoffspringhealth.Theplacentaplaysanessentialroleinnutrienttransporttothefetusandsupportsfetalgrowthanddevelopment.Maternalobesity（MO）inducesanexacerbatedproinflammatorymilieuintheplacentaprovidinganinflammatoryenvironmentforfetuses.The gut isoneofthelargestimmuneorgansandmainlydevelopsduringthefetalstage.Maternalobesityandthecorrespondinginflammatoryuteroplacentalenvironmentaffect gut development,incurringinflammatoryresponsesinthefetalintestinethatfurtherprimeorprogramtheoffspring gut toenhanceinflammationandimpairintestinalbarrierintegrity.ThisreviewsummarizestheimpactofMOoninflammatoryresponsesinplacentaandfetalintestineandthelong-termeffectsonoffspringintestinalhealth.Because"leaky gut"isoneofthemainetiologicalfactorsforanumberofcommondiseases,includinginflammatoryboweldiseases,typeIdiabetes,andrelatedautoimmunediseases,theadverseeffectofMOontheoverallhealthofprogenyisfurtherdiscussed.

PediatrAllergyImmunol. 2014May;25（3）:

218-26.doi:

10.1111/pai.12149.Epub2013Nov17.

Foodallergyandfood-basedtherapies