Abstract. The objective of this study was to investigate the hypothesis that the altered epigenetic mechanisms that regulate IGF2 imprinting in placentas from fetal growth restricted (FGR) pregnancies affect IGF2 expression leading to impaired fetal growth. We investigated gene transcription, genotyping and the methylation patterns of IGF2 from 31 and 17 placentas from FGR-complicated and normal pregnancies, respectively. A statistically significant decrease in IGF2 mRNA levels was observed in the placentas from the FGR pregnancies. Loss of imprinting (LOI) was only detected in the abnormal placentas. The evaluation of the percentage of the methylated reference (PMR) of two different potentially differentially methylated regions (DMR) demonstrated significant PMR values in both sites for the normal and FGR pregnancies with no significant differences. Our results suggest the involvement of the IGF2 imprinted gene in placental function and fetal growth and the possible association of epigenetic alterations with the pathophysiology of fetal growth restriction.
IntroductionIt is well known that fetal growth restriction (FGR) is not a single disorder, but instead has various causes (1). Placental dysfunction ranks high among the most common causes of FGR. Although numerous placental histopathological changes have been described, little is known about the precise etiology and the contribution of placental genes in this disorder (2,3).Imprinted genes are known to be involved in regulating placental growth and function and are therefore considered to be suitable candidates for a role in FGR development (4,5). Genomic imprinting is the preferential silencing of one copy of an autosomal gene while the other copy is expressed (6). This parent-of-origin-specific expression is regulated by epigenetic modifications, such as DNA methylation. Imprinted genes that are paternally expressed (maternally imprinted) promote growth of the fetus, while maternally expressed (paternally imprinted) genes act as growth suppressors to ensure the appropriate allocation of limited maternal resources to each offspring (7). Insulin-like growth factor 2 (IGF2) and H19 represent two oppositely expressed genes located adjacent to each other at 11p15.5 that share the same transcription regulatory epigenetic mechanisms (8). IGF2 is highly expressed in mouse and human placenta and affects both the functional capacity of the placenta to transfer nutrients to the fetus and placental size (9,10). It is expressed in most tissues only from the paternal allele, with the maternal allele being transcriptionally silent.Imprinting occurs primarily by allelic-specific methylation of cytosines in areas of DNA that are rich in CpG dinucleotides (11). In most human tissues the imprinting of IGF2 depends on a differentially methylated region (DMR) which is located upstream of H19 promoters (12). This region functions as a methylation-sensitive insulator that binds to a CCCTC factor (CTCF) on the unmethylated maternal allele preventing the interaction of IGF2 with t...