Conference on 'Transforming the nutrition landscape in Africa' Plenary Session 2: Reproductive health and fetal origins Iron deficiency during pregnancy: the consequences for placental function and fetal outcome
Conference on 'Transforming the nutrition landscape in Africa' Plenary Session 2: Reproductive health and fetal origins Iron deficiency during pregnancy: the consequences for placental function and fetal outcome
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DOI：
10.1017/s0029665113003637
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发表时间：
2014-02-01
影响因子：
7
通讯作者：
Kennedy, Christine
中科院分区：
文献类型：
--
作者：
McArdle, Harry J.;Gambling, Lorraine;Kennedy, Christine
本文综述了胎盘在发育过程中铁代谢的重要性以及铁缺乏对母体和胎儿生理的影响。铁是一种必需的微量营养素，是多种生物过程所必需的。在怀孕期间，母亲必须消耗她的铁储存，以提供足够的婴儿。经胎盘铁转移涉及将转铁蛋白（Tf）结合的铁结合到Tf受体，摄取到内体中，酸化，通过二价金属转运蛋白1释放铁，通过膜铁转运蛋白流出基底外侧膜，并通过zyklopen氧化Fe（II）。一个额外的血红素运输系统已经被假设，这可能解释为什么某些基因敲除对发育中的胎儿不致命。铁缺乏是怀孕期间的常见现象，胎盘通过上调其转移系统来适应，以母亲为代价维持铁。尽管有这些适应性，但缺乏症不能完全预防，后代会遭受短期和长期的后果。至少其中一些可能是由于参与细胞周期的基因表达减少和转录因子（如c-myc）表达改变引起的，这反过来又会产生肾单位数量减少的肾脏。诱导这些变化的机制尚不确定，但可能仅仅是由于铁的可用性降低导致酶活性降低。由于这些变化如此显着，而且其中一些变化是不可逆转的，我们认为所有怀孕期间都应考虑铁预防。
This review examines the importance of the placenta in iron metabolism during development and the effect of iron deficiency on maternal and fetal physiology. Iron is an essential micronutrient, required for a wide variety of biological processes. During pregnancy, the mother has to deplete her iron stores in order to provide the baby with adequate amounts. Trans-placental iron transfer involves binding transferrin (Tf)-bound iron to the Tf receptor, uptake into an endosome, acidification, release of iron through divalent metal transporter 1, efflux across the basolateral membrane through ferroportin and oxidation of Fe(II) by zyklopen. An additional haem transport system has been hypothesised, which may explain why certain gene knockouts are not lethal for the developing fetus. Iron deficiency is a common phenomenon during pregnancy, and the placenta adapts by up-regulating its transfer systems, maintaining iron at the expense of the mother. Despite these adaptations, deficiency cannot be completely prevented, and the offspring suffers both short- and long-term consequences. Some of these, at least, may arise from decreased expression of genes involved in the cell cycle and altered expression of transcription factors, such as c-myc, which in turn can produce, for example, kidneys with reduced numbers of nephrons. The mechanism whereby these changes are induced is not certain, but may simply be as a result of the reduced availability of iron resulting in decreased enzyme activity. Since these changes are so significant, and because some of the changes are irreversible, we believe that iron prophylaxis should be considered in all pregnancies.