Pathophysiological and molecular considerations of viral and bacterial infections during maternal-fetal and –neonatal interactions of SARS-CoV-2, Zika,and Mycoplasma infectious diseases

During pregnancy, a series of physiological changes are determined at the molecular, cellular and macroscopic level that make the mother and fetus more susceptible to certain viral and bacterial infections, especially the infections in this and the companion review. Particular situations increase susceptibility to infection in neonates. The enhanced susceptibility to certain infections increases the risk of developing particular diseases that can progress to become morbidly severe. For example, during the current pandemic caused by the SARS-CoV-2 virus, epidemiological studies have established that pregnant women with COVID-19 disease are more likely to be hospitalized. However, the risk for intensive care unit admission and mechanical ventilation is not increased compared with nonpregnant women. Although much remains unknown with this particular infection, the elevated risk of progression during pregnancy towards more severe manifestations of COVID-19 disease is not associated with an increased risk of death. In addition, the epidemiological data available in neonates suggest that their risk of acquiring COVID-19 is low compared with infants (<12 months of age). However, they might be at higher risk for progression to severe COVID-19 disease compared with older children. The data on clinical presentation and disease severity among neonates are limited and based on case reports and small case series. It is well documented the importance of the Zika virus infection as the main cause of several congenital anomalies and birth defects such as microcephaly, and also adverse pregnancy outcomes. Mycoplasma infections also increase adverse pregnancy outcomes. This review will focus on the molecular, pathophysiological and biophysical characteristics of the mother/placental-fetal/neonatal interactions and the possible mechanisms of these pathogens (SARS-CoV-2, ZIKV, and Mycoplasmas) for promoting disease at this level.     

Expression of estrogen receptor (ER) -α and -βtranscripts in the neonatal and adult rat cerebral cortex, cerebellum, and olfactory bulb

INTRODUCTIONEstrogen has been known to exert extensive effects via estrogen receptor (ER) on diverse physio-logical and develoPmental functions of the brain[1,2]. It has been observed that the distribution ofthe classical ER subtype-a (ERa) and the recentlycharacterized novel ER subtype--fi (ERg), and theirexpression patterns (ERcr/ERfi) vary greatly amongvarious brain regions[1, 3]. These evidences suggestthat each ER subtype may play a different role inestrogen's effects on the br…     

Lethal,neonatal, short-limbed platyspondylic dwarfism. A further variant?

Summary A stillborn short-limbed platyspondylic dwarf is described. Detailed analysis of the X-ray and histological characteristics of bone and cartilage suggest that this infant represents a previously unreported variant of short-limbed platyspondylic dwarfism. The designation Luton variant is suggested.     

Does neonatal androgen modulate uptake and retention of 3H-estradiol in gonadotrophs and lactotrophs?

Summary Castrated adult male and female and androgenized female rats (AS rats) were injected i.v. with ³H-estradiol (E₂). Nuclear uptake and retention of the ³H-steroid was examined in pituitary luteinizing hormone (LH) and prolactin (PRL) cells by the combined techniques of autoradiography and immunocytochemistry. About 80% of PRL cells were found to concentrate the radioactive steroid compound in all experimental groups, while 89%, 82% and 68% of LH cells were found to be labeled in AS rats, normal female and male rats, respectively. This suggests that there are subpopulations of LH or PRL cells that contain no or, if any, small numbers of E₂ receptor. Statistical analysis revealed that PRL cells take up more radioactivity than LH cells in male rats, while there is no significant difference between female and AS rats. Variations in E₂ uptake (coefficient of variation) was higher in LH cells than in PRL cells in male rats and in AS rats. In females, on the contrary, coefficient of variation was larger in PRL cells. Thus the characteristics of nuclear uptake and retention of estradiol in LH and PRL cells appear to be modulated in part by neonatal androgen since the pattern found in AS rats is different than that found in normal male and female rats.     

Deletion 3q27→3qter in an infant with mild dysmorphism,parietal meningocele,and neonatal miliaria rubra-like lesions

Summary Deletion 3q273qter in an infant is described. A chromosomal abnormality was suspected because of minor facial dysmorphism and closed parietal meningocele. On the first day of life, a large exudative inflammation appeared on the skin of her back, which completely resolved after 1 week. Biopsy showed dilated sweat gland openings resembling miliaria rubra, which has not been previously reported in this age group. It is unclear if the skin change was due to the chromosomal abnormality. The meningocele was repaired at age 8 months. At age 20 months, slight neurodevelopmental delay was evident, the main features being hypertonicity and inability to walk without support. The patient has two healthy sisters, and prometaphase chromosome studies in both parents were normal. This infant represents the first example of del3q273qter and the first reported association of meningocele with an abnormality of chromosome 3.     

The expression of collagen mRNAs in normally developing neonatal rabbit long bones and after treatment of neonatal and adult rabbit tibiae with transforming growth factor-β2

Summary Normal transverse growth of long bones is by periosteal appositional bone formation, balanced by endosteal resorption. Changes in the distribution of cells that are expressing collagen mRNAs during growth were determined using digoxigeninlabelled riboprobes. In neonatal rabbit tibiae osteoblasts expressing type I collagen mRNA are found on periosteal, and at early stages on endosteal, bone surfaces and lining peripheral cavities. Occasional osteocytes express type I collagen mRNA very weakly. The pattern is disrupted when transforming growth factor-2 (TGF-2) is injected daily into the periosteum of neonatal animals; there is increased bone, and later cartilage, formation. Three injections of 20 ng TGF-2 onto the tibia of 3-day-old rabbits led to an increase of periosteal osteoblasts that express the mRNA for type I collagen. Some endosteal osteoblasts and osteocytes in newly-formed peripheral woven bone also express the mRNA. After five injections chondrocytes expressing type II collagen mRNA are found around the injection site. Similar injections of TGF-2 in old rabbits induce only fibrous tissue within which some cells express type I collagen mRNA. This precise localization of mRNAs shows that the expression of type I or II collagen mRNA is here restricted to osteoblasts and chondrocytes, respectively.     

Cell-specific expression and immunolocalization of nitric oxide synthase isoforms and soluble guanylyl cyclase α1 and β1 subunits in the ovary of fetal, neonatal and immature pigs

The present study is designed to investigate the cellular expression and immunolocalization of three different nitric oxide synthase (NOS) isoforms and soluble guanylyl cyclase (sGC) subunits in the porcine ovary. Our results showed that in the fetal and neonatal pigs, all three isoforms of NOS were mainly localized in the oocyte and showed the expression of gradual increase in the granulosa cell and theca cell with the growing follicle. In addition, subunits of the sGC, sGC α1 and β1 were mainly expressed in the granulosa cell in precious studies. The bioactivity of total NOS, eNOS, iNOS and nNOS was detected in the ovary and were higher at prenatal stages compared to postnatal stages. However, the activities of nNOS were no different between prenatal stages and postnatal stages. Taken together, our findings suggested that the NOS/sGC pathway may be involved in the follicular formation and development in the porcine ovary.     

Prostaglandin 15-hydroxy dehydrogenase and Δ13 reductase levels in the lungs of maternal,fetal and neonatal rabbits

The levels of prostaglandin 15-hydroxy dehydrogenase and reductase have been studied in the lungs of maternal, fetal and neonatal rabbits. Fetal lungs obtained at gestational age of 28–30 days (full term 31 days) had the same levels of prostaglandin dehydrogenase as the adults, while the reductase levels in the fetal lungs were only one fourth that in the adults. The lungs of maternal rabbits at near term possessed very high levels of prostaglandin dehydrogenase — approximately twenty-fold higher than in the adult non-pregnant female controls. The Δ¹³ reductase appeared slightly elevated during pregnancy. Neonatal animals at different ages showed the same levels of both enzymes as the near term fetus and/or the non-pregnant adults, which suggests that the development of the ability for prostaglandin metabolism is completed at least several days before birth. The high dehydrogenase levels in the near term maternal lungs indicated the requirement for extra protection against prostaglandin release during late pregnancy.     

Localization of α1,2,3-subunit isoforms of Na,K-ATPase in cultured neonatal and adult rat myocardium: The immunofluorescence and immunocytochemical study

By indirect immunofluorescence and preembedding peroxidase-diaminobenzidine technique the localization of polyclonal and monoclonal antibodies against 1, 2 and 3 isoforms of the Na,K-ATPase were studied in rat myocardium.The 1-subunit was identified predominantly on sarcolemma of cultured myocytes, neonatal, as well as adult cardiocytes. The 2 signal was localized around nuclei of cultured cardiocytes, very weak signals were seen in neonatal and more intense signal, were dispersed throughout the adult myocytes. The 3-subunit immunoreactivity was weak and localized in cell processes connecting individual cultured cells, on sarcolemma and intercalated discs of neonatal cells and very weak in adult working myocytes. Cytochemically demonstrated ouabain resistant Na,K-ATPase localized in junctional sarcoplasmic reticulum may represent 1 isoenzyme which is directly involved in modulation of action potential fluxes.     

Do malnutrition and fluoxetine neonatal treatment program alterations in heart morphology?

Growth and development events are observed in all organisms and can be modified by exogenous factors such as nutritional changes. Drastic morphological and functional alterations may occur during a vulnerable stage of development. The aim of this study was to investigate if malnutrition and/or fluoxetine neonatal treatment program alterations in heart morphology during the postnatal period. The sample consisted of 48 albino Wistar male rats. The rats were divided into two groups: nourished and malnourished. Pharmacologic manipulation was performed during the suckling period. The animals of each group were divided into two subgroups: saline-nourished and saline-malnourished, treated with sodium chloride solution, and fluoxetine-nourished and fluoxetine-malnourished, treated with fluoxetine. Half of the individuals in each subgroup were weighed and sacrificed on day 30 and the other half on day 71. Myocardial perfusion was performed and the heart subsequently weighed. The ventricles were cross-sectioned into two parts, which were fixed, dehydrated and sectioned. There were differences in body weight, heart weight, cross-sectional area and perimeter of the heart and in the cross-sectional area and perimeter of the cardiac cells among the groups at the different ages. Malnutrition appears to program alterations in heart morphology. However, malnourished animals that had undergone drug treatment did not exhibit the same changes.     

Modulation of β-receptors as adult and neonatal cardiac myocytes progress into culture

Summary Modulation of β-adrenergic receptors and their ability to respond to β-receptor stimulation was studied in cultures of adult and neonatal rat cardiac myocytes. The radioligand iodocyanopindolol (¹²⁵I-CYP) was used to identify β-adrenoceptors on the intact cells.¹²⁵I-CYP was found to bind to the receptors in a stereospecific and saturable manner. Freshly isolated neonatal and adult myocytes both had a receptor density of approximately 50 fmol/mg protein. The number of β-receptors per milligram protein was similar during a 10-d culture period for adult myocytes but increased after a 5-d culture period for neonatal myocytes. Both cell types responded to β-receptor stimulation with isoproterenol by a twofold increase in the concentration of cAMP and this response increased with time in culture. The number of receptors as well as the response to isoproterenol was similar for neonatal myocytes cultured on laminin, collagen type I, or on uncoated culture dishes. From these data we conclude that cultured cardiac myocytes maintain functional β-receptors as they progress into culture, and the expression of β-receptors is not influenced by culture substrates. This investigation was supported by grants HL 24935 and HL 33656 from the National Institutes of Health, Bethesda, MD, and Swedish Medical Research Council grant 07466.     

Are developing beta-adrenoceptors able to desensitize? Acute and chronic effects of beta-agonists in neonatal heart and liver

During fetal and neonatal development, beta-adrenergic receptors (beta-ARs) appear to be resistant to desensitization by beta-agonist drugs. To determine the mechanisms underlying the regulatory differences between adults and neonates, we administered isoproterenol, a mixed beta(1)/beta(2)-AR agonist, and terbutaline, a beta(2)-selective agonist. Effects were examined in the ensuing 4 h after a single injection, or after the last of four daily injections. We prepared cell membranes from heart (predominantly beta(1)-ARs) and liver (predominantly beta(2)-ARs) and assessed signal transduction in the adenylyl cyclase (AC) pathway. In the first few hours after a single administration of isoproterenol to adult rats, cardiac beta-ARs showed activation of G proteins (elevated AC response to forskolin) and desensitization of beta-AR-mediated responses; after the fourth injection, heterologous desensitization emerged, characterized by a loss of signaling mediated either through beta-ARs or glucagon receptors. Terbutaline evoked an increase in the forskolin response but no desensitization of receptor-mediated responses. When we gave the same treatments to neonatal rats, we observed cardiac G protein activation, but there was neither homologous nor heterologous desensitization of beta-ARs or glucagon receptors. In the adult liver, isoproterenol and terbutaline both failed to evoke desensitization, regardless of whether the drugs were given once or for 4 days. In neonates, however, acute or chronic treatment elicited homologous desensitization of beta-AR-mediated AC signaling, while sensitizing the response to glucagon. These results show that neonatal beta-ARs are inherently capable of desensitization in some, but not all, cell types; cellular responses can be maintained through heterologous sensitization of signaling proteins downstream from the receptor. Differences from adult patterns of response are highly tissue selective and are likely to depend on ontogenetic differences in subtypes of beta-ARs and AC.     

Effect of experimental hyperphenylalaninemia induced by dietary phenylalanine plus α-methylphenylalanine administration on amino acid concentration in neonatal chick brain,plasma, and liver

Supplementation of 5% phenylalanine plus 0.4% -methylphenylalanine to the standard diet or 1% phenylalanine plus 0.08% -methylphenylalanine to the drinking water produced phenylketonuria-like conditions in 5-day-old chicks. An increase of 10 to 15-fold in the phenylalanine content was observed in plasma or brain of animals after 9 days of both types of treatment. A smaller but significant increase was also observed in liver. However, practically no changes were found in the levels of tyrosine in the same conditions. Thus, the high values of plasma and brain phenylalanine/tyrosine ratio obtained by these treatments were mainly due to an increase in the phenylalanine levels, without increasing those of tyrosine. Chronic hyperphenylalaninemia induced a nonsignificant decrease in the most of amino acid contents in brain, especially after 9 days of treatment, although the levels of glycine and serine were significantly increased. A similar decrease was found in the plasma and liver concentration of various amino acids, although the variations observed in the liver were smaller than those found in plasma and brain.     

Loss of βarrestin1 and βarrestin2 contributes to pulmonary hypoplasia and neonatal lethality in mice

Less is known about the connection between the malfunction of βarrestins and developmental defects as the mice with either of two βarrestin isoforms knockout appear normal. In order to address the biological function of βarrestins during developmental process, we generate βarrestin1/2 double knockout mice. We found that βarrestin1/2 dual-null mice developed respiratory distress and atelectasis that subsequently caused neonatal death. Morphological examination revealed type II pneumocyte immaturity. Our results indicate that not only βarrestin1/2 double knockout lung tissue show disturbances in cell proliferation but βarrestin1 and βarrestin2 contribute to pulmonary surfactant complex generation during pulmonary maturation. Intra-amniotic delivery of recombinant adenovirus expressing βarrestin1 or βarrestin2 enhances surfactant-associated proteins synthesis in vivo. Our mRNA microarray data further reveal that βarrestin1/2 double knockout results in downregulation of a significant proportion of genes involved in several lung morphogenesis processes. Together, our study demonstrates that βarrestin1 and βarrestin2 collaborate in embryonic development processes for epithelial pneumocyte differentiation and lung maturation.     

Does Streptococcus mitis,a neonatal oropharyngeal bacterium,influence the pathogenicity of Pseudomonas aeruginosa?

Microorganisms in a biofilm might promote or suppress each other. We previously found that Pseudomonas aeruginosa (P. aeruginosa) and the normal colonized bacteria in the oropharynx, Streptococcus mitis (S. mitis), were the most common bacteria in the biofilm found on newborns' endotracheal tubes. Here, we found that S. mitis enhanced the adhesion and biofilm formation of P. aeruginosa. Furthermore, it alleviated the immune response induced by P. aeruginosa. These findings remind us that we should not ignore the role of traditionally viewed non-pathogenic bacteria in biofilms and provide new insights into exploring bacterial interaction mechanisms in biofilm related infections.     

Hexokinase–mitochondrial interactions regulate glucose metabolism differentially in adult and neonatal cardiac myocytes

In mammalian tumor cell lines, localization of hexokinase (HK) isoforms to the cytoplasm or mitochondria has been shown to control their anabolic (glycogen synthesis) and catabolic (glycolysis) activities. In this study, we examined whether HK isoform differences could explain the markedly different metabolic profiles between normal adult and neonatal cardiac tissue. We used a set of novel genetically encoded optical imaging tools to track, in real-time in isolated adult (ARVM) and neonatal (NRVM) rat ventricular myocytes, the subcellular distributions of HKI and HKII, and the functional consequences on glucose utilization. We show that HKII, the predominant isoform in ARVM, dynamically translocates from mitochondria and cytoplasm in response to removal of extracellular glucose or addition of iodoacetate (IAA). In contrast, HKI, the predominant isoform in NRVM, is only bound to mitochondria and is not displaced by the above interventions. In ARVM, overexpression of HKI, but not HKII, increased glycolytic activity. In neonatal rat ventricular myocytes (NVRM), knockdown of HKI, but not HKII, decreased glycolytic activity. In conclusion, differential interactions of HKI and HKII with mitochondria underlie the different metabolic profiles of ARVM and NRVM, accounting for the markedly increased glycolytic activity of NRVM.