Scientists have shed new light on the
relationship between hypoxia during pregnancy and congenital birth defects.
An
international team of scientists has made a landmark discovery that could help
women minimize their risk of having a baby born with congenital birth defects.
The
team, led by scientists from Sydney’s Victor Chang Cardiac Research Institute
(VCCRI), show for the first time in the journal Cell how ‘nature’ and ‘nurture’
interact to increase the severity and likelihood of developing birth defects,
including abnormalities in the heart, kidneys, brain, limbs, and cranio-facial
regions (ie. cleft palate).
They
demonstrated how hypoxia, or insufficient oxygen during pregnancy, when
combined with a genetic risk factor of having only one functioning copy of the
MESP2 and HES7 genes, dramatically increases the chances of a baby being born
with congenital scoliosis, a malformation of the spine that affects around one
in 1000.
Hypoxia
during pregnancy can be caused by a variety of circumstances including poorly
controlled sugar levels in diabetics, smoking, high altitude, prescription and
recreational drug-use, anemia, or a poorly functioning placenta.
“We’ve
long suspected that it is genes or our environment that cause birth defects,
but up until now, the majority of these have been largely unknown,” said senior
author Professor Sally Dunwoodie, Head of the Embryology Laboratory at the
VCCRI.
Apart
from studying individuals with congenital scoliosis, the team also tested the
genetic risk factor in a mouse model combined with the presence of hypoxia.
They found a marked increase in spinal abnormalities in the offspring, when the
mothers were exposed to just eight hours of low oxygen during an entire 21-day
pregnancy.
“We
found that the combination of the genetic risk as well as exposure to low
oxygen, resulted in our subjects being up to ten times more likely to develop
congenital scoliosis, than those that only had the genetic risk factor,” said
Dunwoodie.
“What
this brief period of low oxygen essentially did was disrupt the pathway
responsible for development of the spine, and we know that the same pathway is
used in the development of limbs and many organs, including the heart, kidneys,
brain and cranio-facial region,” she added.
According
to Professor Bob Graham, Executive Director of the VCCRI, around a quarter of
patients with congenital scoliosis also have some form of congenital heart
defect, indicating that a single environmental insult, such as hypoxia, can
potentially affect the development of more than one organ in the body.
“It may
not necessarily be a lack of oxygen that allows the underlying gene defect to
be revealed, it could be a lot of other environmental factors, such as anemia
or lack of folate. But the message is, if you have family history of disease or
you know you have a defective gene, mums need to be extra careful during
pregnancy,” added Graham.
The
team has begun working on similar studies in congenital heart defects, which
affect around one in every 100 babies born in Australia every year.
The
article can be found at: Sparrow DB et al. (2012) A Mechanism for
Gene-Environment Interaction in the Etiology of Congenital Scoliosis.
AsianScientist
Source: VCCRI
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