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      The placenta and neurodevelopment: sex differences in prenatal vulnerability Translated title: La placenta y el neurodesarrollo: diferencias por sexo en la vulnerabilidad prenatal Translated title: Placenta et neurodéveloppement : les différences selon le sexe dans la vulnérabilité prénatale

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          Abstract

          Prenatal insults, such as maternal stress, are associated with an increased neurodevelopmental disease risk and impact males significantly more than females, including increased rates of autism, mental retardation, stuttering, dyslexia, and attention deficit/hyperactivity disorder (ADHD). Sex differences in the placenta, which begin with sex chromosomes, are likely to produce sex-specific transplacental signals to the developing brain. Our studies and others have identified X-linked genes that are expressed at higher levels in the female placenta. Through a genome-wide screen after maternal stress in mice, we identified the X-linked gene O-linked N-acetylglucosamine transferase (OGT) and demonstrated its causality in neurodevelopmental programming producing a male-specific stress phenotype. Elucidating the sex-specific molecular mechanisms involved in transplacental signals that impact brain development is key to understanding the sex bias in neurodevelopmental disorders and is expected to yield novel insight into disease risk and resilience.

          Translated abstract

          Las agresiones prenatales, como el estrés materno, están asociadas con un aumento del riesgo de enfermedades del neurodesarrollo y el impacto en los hombres es significativamente mayor que en las mujeres, incluyendo el aumento de las frecuencias de autismo, retardo mental, tartamudez, dislexia y trastorno por déficit de atención e hiperactividad (TDAH). Las diferencias por sexo en la placenta, que parten ya con los cromosomas sexuales, es probable que produzcan señales transplacentarias sexo-específicas para el cerebro en desarrollo. Los estudios nuestros y los de otros han identificado genes ligados al cromosoma X que tienen una mayor expresión en la placenta de las hembras. Mediante una evaluación en ratones del genoma completo después de estrés materno, identificamos el gen de la transferasa N-acetilglucosamina O unida (OGT), ligado al cromosoma X y demostramos su causalidad en la programación del neurodesarrollo que da origen a un fenotipo de estrés específico en los machos. La clarificación de los mecanismos moleculares sexo-específicos involucrados en las señales transplacentarias que afectan el desarrollo cerebral es clave para comprender el sesgo del sexo en los trastornos del neurodesarrollo y se espera que conduzcan a una nueva visión acerca de los riesgos y de la resiliencia en las enfermedades.

          Translated abstract

          Les atteintes prénatales, comme le stress maternel, sont associées à un risque accru de maladies neurodéveloppementales et affectent significativement davantage les garçons que les filles, avec une augmentation des taux d'autisme, de retard mental, de bégaiement, de dyslexie et de troubles du déficit de l'attention avec ou sans hyperactivité (TDAH). Les différences de sexe au niveau du placenta, qui commencent avec les chromosomes sexuels, semblent transmettre des signaux transplacentaires spécifiques du sexe au cerveau en développement. Nos études, et d'autres, ont identifié des gènes liés à l'X, exprimés à des niveaux plus élevés dans le placenta des filles. Après un stress maternel chez les souris, nous avons identifié, grâce à une analyse systématique du génome, le gène de la N-acétylglucosamine transférase (OGT), qui est lié à l'X, et démontré sa causalité dans la programmation neurodéveloppementale produisant un phénotype de stress spécifique chez l'homme. L'élucidation des mécanismes moléculaires spécifiques du sexe impliqués dans les signaux transplacentaires qui impactent le développement cérébral est la clé de la compréhension du biais lié au sexe dans les troubles neurodéveloppementaux et améliorera notre connaissance des risques et de la résilience des maladies.

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          Review: Sex and the human placenta: mediating differential strategies of fetal growth and survival.

          There are known sex specific differences in fetal and neonatal morbidity and mortality. There are also known differences in birthweight centile with males generally being larger than females at birth. These differences are generally ignored when studying obstetric complications of pregnancy and the mechanisms that confer these differences between the sexes are unknown. Current evidence suggests sex specific adaptation of the placenta may be central to the differences in fetal growth and survival. Our research examining pregnancies complicated by asthma has reported sexually dimorphic differences in fetal growth and survival with males adapting placental function to allow for continued growth in an adverse maternal environment while females reduce growth in an attempt to survive further maternal insults. We have reported sex differences in placental cytokine expression, insulin-like growth factor pathways and the placental response to cortisol in relation to the complication of asthma during pregnancy. More recently we have identified sex specific alterations in placental function in pregnancies complicated by preterm delivery which were associated with neonatal outcome and survival. We propose the sexually dimorphic differences in growth and survival of the fetus are mediated by the sex specific function of the human placenta. This review will present evidence supporting this hypothesis and will argue that to ignore the sex of the placenta is no longer sound scientific practice. Crown Copyright 2010. Published by Elsevier Ltd. All rights reserved.
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            Prenatal Stress, Glucocorticoids and the Programming of Adult Disease

            Numerous clinical studies associate an adverse prenatal environment with the development of cardio-metabolic disorders and neuroendocrine dysfunction, as well as an increased risk of psychiatric diseases in later life. Experimentally, prenatal exposure to stress or excess glucocorticoids in a variety of animal models can malprogram offspring physiology, resulting in a reduction in birth weight and subsequently increasing the likelihood of disorders of cardiovascular function, glucose homeostasis, hypothalamic–pituitary–adrenal (HPA) axis activity and anxiety-related behaviours in adulthood. During fetal development, placental 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) provides a barrier to maternal glucocorticoids. Reduced placental 11β-HSD2 in human pregnancy correlates with lower birth weight and higher blood pressure in later life. Similarly, in animal models, inhibition or knockout of placental 11β-HSD2 lowers offspring birth weight, in part by reducing glucose delivery to the developing fetus in late gestation. Molecular mechanisms thought to underlie the programming effects of early life stress and glucocorticoids include epigenetic changes in target chromatin, notably affecting tissue-specific expression of the intracellular glucocorticoid receptor (GR). As such, excess glucocorticoids in early life can permanently alter tissue glucocorticoid signalling, effects which may have short-term adaptive benefits but increase the risk of later disease.
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              Mechanisms of disease: glucocorticoids, their placental metabolism and fetal 'programming' of adult pathophysiology.

              Epidemiological evidence suggests that an adverse prenatal environment permanently 'programs' physiology and increases the risk of cardiovascular, metabolic, neuroendocrine and psychiatric disorders in adulthood. Prenatal stress or exposure to excess glucocorticoids might provide the link between fetal maturation and adult pathophysiology. In a variety of animal models, prenatal stress, glucocorticoid exposure and inhibition (or knockout of) 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2)--the fetoplacental barrier to maternal glucocorticoids--reduce birth weight and cause increases in adult blood pressure, glucose levels, hypothalamic-pituitary-adrenal (HPA) axis activity and anxiety-related behaviors. In humans, mutations in the gene that encodes 11beta- hydroxysteroid dehydrogenase type 2 are associated with low birth weight. Babies with low birth weight have higher plasma cortisol levels throughout life, which indicates HPA-axis programming. In human pregnancy, severe maternal stress affects the offspring's HPA axis and is associated with neuropsychiatric disorders; moreover, maternal glucocorticoid therapy alters offspring brain function. The molecular mechanisms that underlie prenatal programming might reflect permanent changes in the expression of specific transcription factors, including the glucocorticoid receptor; tissue specific effects reflect modification of one or more of the multiple alternative first exons or promoters of the glucocorticoid receptor gene. Intriguingly, some of these effects seem to be inherited by subsequent generations that are unexposed to exogenous glucocorticoids at any point in their lifespan from fertilization, which implies that these epigenetic effects persist.
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                Author and article information

                Contributors
                Journal
                Dialogues Clin Neurosci
                Dialogues Clin Neurosci
                Dialogues Clin Neurosci
                Dialogues in Clinical Neuroscience
                Les Laboratoires Servier (France )
                1294-8322
                1958-5969
                December 2016
                December 2016
                : 18
                : 4
                : 459-464
                Affiliations
                Department of Biomedical Sciences, School of Veterinary Medicine and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
                Author notes
                Article
                10.31887/DCNS.2016.18.4/tbale
                5286731
                28179817
                30b10134-d6aa-4a07-b6a5-a8d063b9857b
                Copyright: © 2016 Institut la Conference Hippocrate - Servier Research Group

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Brief Report

                Neurosciences
                early prenatal stress,o-linked n-acetylgluosamine transferase,maternal stress,neurodevelopmental disorder,transplacental signal

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