Reduced 11β-hydroxysteroid dehydrogenase type 2 activity is associated with decreased birth weight centile in pregnancies complicated by asthma
Reduced 11β-hydroxysteroid dehydrogenase type 2 activity is associated with decreased birth weight centile in pregnancies complicated by asthma
复制标题
DOI：
10.1210/jc.87.4.1660
复制
发表时间：
2002-04-01
影响因子：
5.8
通讯作者：
Clifton, VL
中科院分区：
文献类型：
--
作者：
Murphy, VE;Zakar, T;Clifton, VL
妊娠合并哮喘与低出生体重的风险增加有关。目前，导致这一结果的机制尚不清楚。为了研究胎盘功能受损是否可能是一个决定因素，我们检测了胎盘11β-羟基类固醇脱氢酶2(11β-HSD2)活性、蛋白质和mRNA、胎盘CRH mRNA、胎儿皮质醇和胎儿雌三醇浓度。哮喘患者根据孕期吸入糖皮质激素的摄入量进行分类，并与对照组非哮喘组进行比较。没有使用吸入性糖皮质激素治疗的哮喘妇女新生儿出生体重百分位数减少了25%。伴随着胎盘11β-HSD2活性的显著降低，胎儿皮质醇的显著增加，以及胎盘CRH mRNA的增加和胎儿雌三醇浓度的降低。吸入糖皮质激素的使用与出生体重百分位数、11β-HSD2活性、CRH mRNA、胎儿皮质醇和雌三醇浓度与对照组水平相似。这些研究表明，吸入糖皮质激素治疗哮喘与改善胎盘功能和胎儿结局有关，提示与哮喘相关的炎症因子可能对这些妊娠的胎儿生长和发育不利。
Pregnancies complicated by asthma are associated with an increased risk of low birth weight. Currently, the mechanisms causing this outcome are unknown. To investigate whether impaired placental function may be a determinant, we measured placental 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) activity, protein and mRNA, placental CRH mRNA, fetal cortisol, and fetal estriol concentrations at delivery.Asthmatic subjects were classified according to inhaled glucocorticoid intake during pregnancy and compared with a control nonasthmatic group. There was a 25% reduction in neonatal birth weight centile in asthmatic women who did not use inhaled glucocorticoid treatment. This was accompanied by significantly reduced placental 11beta-HSD2 activity, significantly increased fetal cortisol, and a trend toward increased placental CRH mRNA and reduced fetal estriol concentrations. The use of inhaled glucocorticoids for treatment was associated with birth weight centile, 11beta-HSD2 activity, CRH mRNA, fetal cortisol, and estriol concentrations similar to control levels. There was a significant inverse correlation between fetal cortisol and fetal estriol concentrations across all groups.These studies demonstrate that inhaled glucocorticoid intake for the treatment of asthma is associated with improved placental function and fetal outcome, suggesting that inflammatory factors associated with asthma may be detrimental to fetal growth and development in these pregnancies.