Gene-nutrient Etiologies of Neural Tube Defects

描述（由申请人提供）：神经管缺陷（NTDs）是常见的人类先天性异常，其病因在很大程度上仍然未知。关于被忽视热带病病因的最有希望的线索之一是，在怀孕早期使用含有叶酸的维生素的妇女患被忽视热带病的怀孕风险较低。然而，叶酸降低风险的潜在机制尚不清楚。同样不清楚的是，为什么大量服用叶酸的妇女继续受到ntd影响的怀孕。本研究提出了一个广泛的NTD基因和风险因素发现计划，重点是通过以下方式研究NTD的病因：1)研究与叶酸通路相关的新遗传多态性；2)探索饮食中重要营养因子如胆碱、血糖指数的摄入，控制叶酸的摄入；3)测定携带被忽视热带病胎儿/婴儿的妇女与未携带被忽视热带病婴儿的妇女妊娠中期血清中的特定营养素和抗体；4)探索与叶酸转运受损有关的三种独特的小鼠模型，以确定可以应用于人类研究的新靶基因。这个多学科和综合的5年研究项目将使用4个基于人群的流行病学数据集，其中包含1559名患有ntd的婴儿或胎儿和3353名非畸形对照婴儿的数据，结合最先进的人类DNA实验室基因分型方法，并将利用独特的遗传小鼠模型进一步为流行病学方向提供信息。该研究项目有四个合作机构，分别是加州出生缺陷监测项目、德克萨斯农工大学生物科学与技术研究所、奈梅亨大学和奥克兰儿童医院研究所。该研究利用了研究人员在分子和营养流行病学、临床、分子和小鼠遗传学以及致畸学方面的集体专业知识。这项研究计划将加强对被忽视热带病的遗传和营养原因的科学认识。由于被忽视热带病导致大量发病率以及高昂的情绪和经济成本，因此进一步的科学认识导致可能的预防将极大地造福社会。

DESCRIPTION (provided by applicant): Neural tube defects (NTDs) are common human congenital anomalies whose etiologies remain largely unknown. One of the most promising clues to the causes of NTDs is that women who use vitamins containing folic acid in early pregnancy are at reduced risk for NTD-affected pregnancies. However, the underlying mechanisms by which folic acid reduces risks are unknown. Also unknown is why a substantial proportion of women who take folic acid continue to have NTD-affected pregnancies. This research proposes an extensive NTD gene and risk factor discovery program which focus on etiologies of NTDs by: 1) studying new genetic polymorphisms related to the folate pathway; 2) exploring dietary intake of important nutritional factors such as choline and glycemic index, controlling for folate intake; 3) measuring specific nutrients and antibodies in midpregnancy sera from women who deliver fetuses/infants with NTDs compared to those who do not; and 4) exploring three unique mouse models pertaining to impaired folate transport to identify new target genes that can be applied to our human studies. This multidisciplinary and integrated 5- year research program will use four large population-based epidemiologic datasets containing data on 1559 infants or fetuses with NTDs and 3353 nonmalformed control infants in combination with state-of-the-art laboratory genotyping methods of human DNA, and will capitalize on unique genetic mouse models to further inform epidemiologic direction. The research program has four collaborating institutions, the California Birth Defects Monitoring Program, the Institute of Biosciences and Technology at Texas A&M University, University of Nijmegen, and Children's Hospital Oakland Research Institute. The research capitalizes on the investigators' collective expertise in molecular and nutritional epidemiology, clinical, molecular, and murine genetics, and teratology. This research program will enhance scientific understanding of the genetic and nutritional causes of NTDs. Because NTDs result in substantial morbidity as well as high emotional and economic costs, further scientific understanding leading to possible prevention would greatly benefit society.