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Endocrine regulation of human fetal growth: the role of the mother, placenta, and fetus.

The environment in which the fetus develops is critical for its survival and long-term health. The regulation of normal human fetal growth involves many multidirectional interactions between the mother, placenta, and fetus. The mother supplies nutrients and oxygen to the fetus via the placenta. The fetus influences the provision of maternal nutrients via the placental production of hormones that regulate maternal metabolism. The placenta is the site of exchange between mother and fetus and regulates fetal growth via the production and metabolism of growth-regulating hormones such as IGFs and glucocorticoids. Adequate trophoblast invasion in early pregnancy and increased uteroplacental blood flow ensure sufficient growth of the uterus, placenta, and fetus. The placenta may respond to fetal endocrine signals to increase transport of maternal nutrients by growth of the placenta, by activation of transport systems, and by production of placental hormones to influence maternal physiology and even behavior. There are consequences of poor fetal growth both in the short term and long term, in the form of increased mortality and morbidity. Endocrine regulation of fetal growth involves interactions between the mother, placenta, and fetus, and these effects may program long-term physiology.

11-beta-Hydroxysteroid Dehydrogenases↗

Gestational profiles of rat placental lactogen-II (rPL-II) and growth hormone (GH) in maternal and fetal serum, amniotic fluid, and placental tissue.

Rat placental lactogen-II (rPL-II) and growth hormone (rGH) in maternal and fetal serum, amniotic fluid, and placental tissue were measured by a homologous radioimmunoassay during the last half of pregnancy. rPL-II appeared first in maternal circulation and the placental tissue on day 11 of pregnancy. The maternal serum rPL-II concentration increased progressively and reached the peak value (684 +/- 76 ng/ml) on day 19, and declined thereafter up to term. rPL-II content in the tissue had a similar pattern to the maternal serum profile of rPL-II, while its concentration in the tissue increased dramatically on day 12 and remained high until day 19. Fetal serum rPL-II was detected on days 17 and 18, though its concentration was much lower (ranged between 3-10 ng/ml) than that of maternal serum. rPL-II in amniotic fluid was also detectable only on days 12-14 of pregnancy, and the peak value on day 13 was 22% of the maternal serum rPL-II concentration. The rGH concentration increased gradually as pregnancy advanced with a decline on the day before parturition. Although rGH in fetal serum increased on day 20 with a decline on the following day, it was slightly detectable in amniotic fluid on the last two days of pregnancy. The molecular profile of rPL-II in amniotic fluid and maternal serum of day 13 pregnant rats were examined by Western blotting. Anti-rPL-II serum detected two proteins with molecular weights (mol wt) of 19.5K and 20.5K in amniotic fluid and one protein with a mol wt of 20.5K in maternal serum under nonreducing conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Amniotic Fluid↗

[The endocrinology of the human placenta].

The human placenta performs various, important functions essential for the maintenance of pregnancy and development of the fetus. Its secretory diversity surpasses any of the other endocrine organs. The placenta is provided with precursors of hormones by the mother as well as by the fetus. It synthesizes and secretes steroid and protein hormones, growth factors, cytokines. The paper is the review of the present knowledge of steroid hormones (progesterone, estrogens), in particular their synthesis and functions in fetoplacental unit. The protein hormones (chorionic gonadotropin, placental lactogen) are also discussed. The last findings concerning placental gonadotropin-releasing hormone, corticotropin-releasing hormone, leptin, activin, inhibin, follistatin and urocortin are presented. The endocrinology of the placenta is considered to be a progressive field of science. The performed studies elucidate the role of the newly identified hormones in the placenta. It is believed, that research on endocrinology of the placenta contributes to the development of perinatology and, moreover, they improve the prenatal care.

Activins↗

Capacity for hormone production of cultured trophoblast cells obtained from placentae at term and in early pregnancy.

PROBLEM: There is an increased doubt about the identity of isolated cytotrophoblast cells at term. Therefore, we compared pregnancy serum levels of three hormones [human placental lactogen (hPL), human chorionic gonadotropin (hCG), and leptin] with the capacity for hormone production of early placentae [EP; 8-13 weeks of gestation (WG)] and term placentae (TP; 38-42 WG). METHODS: Serum levels of these hormones were determined in 15 paired maternal (7-41 WG) and fetal (37-41 WG) samples. Cytotrophoblast cells were isolated from term (TP; 38-42 weeks) and early (EP; 8-13 weeks) placentae by enzymatic digestion and subsequent purification on a Percoll gradient. These cells were cultured for 6 days. The production of the hormones hPL, hCG, and leptin was determined as release during culture + cell content after culture - cell content before culture. RESULTS: Serum levels (mean +/- SD; n = 15) at 7-12 and 37-41 WG were 89,652 +/- 21,431 and 13,620 +/- 5854 mIU/ml for hCG, 400 +/- 182 and 7088 +/- 2030 ng/ml for hPL, and 12,675 +/- 4266 and 32,236 +/- 10,961 pg/ml for leptin, respectively. For cultured cells from EP and TP, hCG and hPL showed different patterns of release during the first 2-3 days. While the release of these two hormones by EP cytotrophoblast cells continued during 6 days in culture, their concentrations reached a plateau for TP cytotrophoblasts between 4 and 6 days. Leptin was undetectable (< 15 pg/ml) in TP cell cultured media, while for EP all three hormones showed the same release profiles. Production calculated for 30,000 TP trophoblast cells cultured for 6 days (n = 8) was 2-31 mIU for hCG and 0.5-2 ng for hPL. For EP (n = 11), it was 50-1070 mIU for hCG, 15-323 ng for hPL, and 137-580 pg for leptin. Net synthesis of hCG and hPL for TP was > 10-fold and < 1-fold, respectively. In contrast, the production of all three hormones for EP was at least 100 times the initial cell content. CONCLUSIONS: These results demonstrate that trophoblasts from early pregnancy show much higher production rates of hCG, hPL, and leptin than at term. However, the in vitro findings are difficult to be reconciled with the different serum concentrations of the two hormones hPL and leptin observed during the course of pregnancy.

Cells, Cultured↗

Placental 5-deiodinase activity and fetal thyroid hormone economy are unaffected by selenium deficiency in the rat.

In adult male rats, selenium deficiency results in a near complete loss in the selenoprotein 5'-deiodinase in the liver, resulting in decreased peripheral deiodination of thyroxine (T4) and increased serum T4 concentrations. Serum 3,5,3'-triiodothyronine concentrations are normal or slightly decreased, and serum 3,3',5'-triiodothyronine concentrations are normal or slightly increased in selenium-deficient rats. We now report the effects of selenium deficiency on maternal and fetal thyroid hormone economy and on placental 5-deiodinase activity in the rat. Weanling female rats were fed either a selenium-deficient or selenium-supplemented diet for 4 wk before mating and then throughout gestation. Rats were killed at 21 d of gestation. Selenium deficiency was confirmed by a 95 and 94% decrease in glutathione peroxidase and a 84 and 56% decrease in liver type I outer ring 5' deiodinase activity in the mother and the fetus, respectively. In contrast to the increase in circulating T4 observed in selenium-deficient male and nonpregnant female adult rats, serum T4 was not affected by selenium deficiency in pregnant rats, but there was a 3-fold increase in serum 3,3',5'-triiodothyronine concentrations associated with a 70% decrease in maternal brain type II outer ring 5' deiodinase activity. Maternal serum 3,5,3'-triiodothyronine concentrations were decreased by 21%. Placental 5-deiodinase activity was unaffected by selenium deficiency. In the fetus, serum T4, 3,3',5'-triiodothyronine, and TSH concentrations were not affected by selenium deficiency.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Influence of bromocriptine on plasma prolactin, human placental lactogen, beta-HCG and steroid hormones in early human pregnancy.

To study the role of prolactin in the regulation of the production of 17 beta-oestradiol, HPL, beta-HCG, progesterone, testosterone, delta 4-androstenedione and 5 alpha-dihydrotestosterone, 20 healthy women were given 5 mg of bromocriptine daily for two weeks between 7-9 weeks of normal pregnancy. Plasma HPRL, HPL, HCG, oestradiol, progesterone, testosterone, delta 4-androstenedione and 5 alpha-dihydrotestosterone levels were measured before and one and two weeks after the start of bromocriptine-application, and they were compared with those examined in control groups (18 women). Bromocriptine induced a significant HPRL depression at one week and two weeks. Other hormones, except progesterone, showed no significant differences between two groups. These data suggest that neither maternal hypoprolactinemia nor bromocriptine during normal early human pregnancy interfere with the normal synthesis of sex steroids.

Adolescent↗

The effects of GnRH analogue (buserelin) or hCG (Chorulon) on Day 12 of pregnancy on ovarian function, plasma hormone concentrations, conceptus growth and placentation in ewes and ewe lambs.

The objectives of this study were to determine the effect of GnRH analogue (buserelin) or human chorionic gonadotrophin (hCG, Chorulon) treatment on Day 12 of pregnancy on ovarian function, plasma hormone concentrations, conceptus growth and placentation in ewes and ewe lambs. After oestrus synchronization with progestagen sponges and eCG, all the animals were mated with fertile rams. Both ewes and ewe lambs (20 per treatment group) were given either normal saline or 4 microg GnRH or 200 IU hCG on Day 12 post-mating. Pre- and post-treatment plasma hormone concentrations were determined in seven pregnant animals per treatment group in samples collected 1h before and 0, 2, 4, 6, 8, 24, 48 and 72 h after treatment. Overall mean progesterone concentrations were higher (P<0.001) in ewes as compared with ewe lambs in saline-treated controls. GnRH or hCG treatment increased (P<0.001) mean plasma progesterone concentrations in both age groups, however, post-treatment concentrations were significantly (P<0.05) higher in ewes than in ewe lambs. Oestradiol concentrations were similar in the two control groups. In ewes, but not in ewe lambs, both GnRH and hCG treatments significantly (P<0.05) increased the mean oestradiol concentrations above pre-treatment levels. Moreover, post-treatment oestradiol concentrations in GnRH- and hCG-treated animals were significantly (P<0.05) higher than those in the saline-treated controls. LH release in response to GnRH treatment was greater (P<0.05) in ewes than in ewe lambs, whereas FSH release in ewes was less (P<0.05) than that of ewe lambs. The effects of GnRH or hCG on conceptus growth and placentation was determined at slaughter on Day 25. In ewes, GnRH treatment increased (P<0.05) luteal weight, amniotic sac width and length, and crown-rump length compared with controls, but had no effect on these parameters in ewe lambs. In ewes, hCG treatment also enhanced (P<0.05) luteal weight, amniotic sac width and length, crown-rump length, embryo weight and number of placentomes as compared with controls. In ewe lambs, there was no difference (P<0.05) between hCG and control groups in luteal weight, embryo weight and amniotic sac width but crown-rump length, amniotic sac length and the number of placentomes forming the placenta were greater (P<0.05). In conclusion, GnRH or hCG treatment on Day 12 of pregnancy can increase ovarian function, conceptus growth and placental attachment in ewes. However, these treatments were less effective in ewe lambs.

Animals↗

The importance of prolactin for initiation of lactation in the pregnant ewe.

A single injection of ergocryptine (0.5 mg/kg liveweight) given to ewes 0.5-20 days prepartum or two injections (0.5 mg/kg liveweight per injection) given c. 30 and 10 days prepartum reduced concentrations of plasma prolactin to negligible (less than 5 ng/ml) values for 4 weeks after parturition, but did not affect concentrations of growth hormone and placental lactogen. Milking of treated ewes had no effect on concentrations of plasma prolactin during the first 4 weeks of lactation, but concentrations of growth hormone were increased during the 10-20 min period after milking. The half-life of prolactin in plasma was estimated as 21 min. In spite of the dramatic effect of ergocryptine on plasma prolactin all treated ewes secreted copious quantities of milk of normal composition. Mean daily yields of ewes treated with ergocryptine were not significantly different (P greater than 0.05) from those of untreated control ewes, but the mean +/- s.e.m. of total milk production over the first 3 weeks of lactation for ergocryptine-treated ewes was significantly lower (P less than 0.05) than that of control ewes (9.5 +/- 1.11 v. 14.1 +/- 1.20 kg milk). The results suggest that prolactin is not an essential component of the lactogenic and galactopoietic complexes of hormones in the ewe.

Animals↗

Characterization of a single strong tissue-specific enhancer downstream from the three human genes encoding placental lactogen.

The human genes coding for growth hormone (hGH) and placental lactogen (choriosomatomammotropic hormone [hCS]) are clustered on chromosome 17 in the following order: 5' hGH-N hCS-L hCS-A hGH-V hCS-B 3'. So far, a single placenta-specific enhancer has been identified in the locus, 2 kb downstream from the hCS-B gene, and shown to comprise one in vitro binding site for a nuclear protein. We here provide evidence that the hCS-B enhancer is more complex: (i) protection against DNase I digestion in the 3' flanking region of the hCS-B gene reveals four binding sites (DF-1, DF-2, DF-3, and DF-4) for nuclear proteins from either placental or HeLa cells, and (ii) placenta-specific enhancer activity can be fully exerted in transient expression experiments by a 126-bp fragment comprising the DF-3 and DF-4 protein-binding sites. By dissecting this region, we show that enhancer activity is mediated by a synergy between DF-3 and DF-4. Competitions with various oligonucleotides in footprinting and gel retardation experiments indicate that the same protein or set of proteins, different in HeLa and placenta cell nuclei, interacts with sites DF-2, DF-3, and DF-4. We also studied the regions of the hCS-L and hCS-A genes which are highly similar to the hCS-B enhancer. Although they each present the same four protein-binding sites, they exhibit only minor enhancer activity.

Base Sequence↗

[Uterine perforation revealing a rare placental tumor: trophoblastic tumor of the implantation site. Review of the literature. Apropos of a case].

The trophoblastic tumor of the implantation site (TTIS), recently discovered, is a peculiar and rare choriocarcinoma; the authors are reporting the 36th case in the world. Clinically, it is different from the typical choriocarcinoma by amenorrhea, frequent uterine perforations and negative pregnancy tests. The diagnosis is made histologically; most important are the monomorphic tumor cells, and especially, the immunocytochemical labelling for human chorionic gonadotropic hormone and lactogenic placental hormone permitting the differentiation of TTIS in choriocarcinoma from TTIS in non-trophoblastic tumors. Its course is highly malignant in 25 p. cent of the cases without any absolute prognostic factor at this time. The treatment is not codified; it seems that, unlike in the typical choriocarcinoma, a place of choice should be given to surgery, since the usual chemotherapy of trophoblastic tumors has not proved to be effective in this indication. On the contrary, monitoring will be supported by serum hCG assays.

Adult↗

Current topic: the placental corticotrophin-releasing hormone-adrenocorticotrophin axis.

In this review the factors regulating production of corticotrophin-releasing hormone (CRH) in intrauterine tissues are discussed and interactions of placental CRH with placental pro-opiomelanocortin (POMC)/adrenocorticotrophin (ACTH) and prostaglandins (PG) are examined. Discrepant results concerning localization of immunoreactive (IR-) CRH and its binding protein (CRH-BP) and their mRNAs in intrauterine tissues are described, and these issues require further resolution. It is suggested that the CRH-ACTH-PG axis in the placenta and choriodecidua may be important in relation to paracrine/autocrine regulation of uteroplacental blood flow, and in term and preterm labour. During the initial stages of preterm labour in the setting of infection, intrauterine cytokines and other factors may stimulate CRH output, implying a role for the immune-neuroendocrine axes in this process. With loss of chronic trophoblasts in advanced infection leading to preterm labour, a major intrauterine site of CRH production may be lost and the influence of this pathway becomes minimal. At this time increased intrauterine prostaglandin synthesis, together with loss of prostaglandin dehydrogenase activity in the fetal membranes, may become the primary route leading to myometrial activity and delivery.

Adrenocorticotropic Hormone↗

Growth hormone binding proteins and various forms of growth hormone: implications for measurements.

GH measurements are complicated by numerous physiologically occurring GH forms, by the lack of availability of completely specific reagents for the various GH isoforms, and by interference of the circulating BP in some assays. The discrepancies between assay results are partly due to these factors, with monoclonal immunoassays or RRAs being more affected than polyclonal immunoassays.

Biological Assay↗