Metabolomics of the amniotic fluid: Is it a feasible approach to evaluate the safety of Chinese medicine during pregnancy?

Abstract

The use of Chinese medicines (CMs) during pregnancy has long been a major public health concern. Although CMs have been shown to be effective in treating infertility and preventing miscarriage, their use has been restricted, mainly because of limited knowledge of their potential toxicity. Accurate toxicology data are urgently required to assess whether these CMs are safe for maternal health and fetal development. Amniotic fluid (AF) contains carbohydrates, lipids and phospholipids, urea and proteins, all of which aid in the growth of the fetus and reflect the mother's health status as well. The changes in metabolomic patterns of AF are related to pathophysiological occurrences during the course of pregnancy. In this review, we provide a summary of the research performed in recent years on metabolomic AF samples, and use our previous study as an example to explore the feasibility of metabolomics of AF to evaluate the safety of CMs during pregnancy. We believe that metabolomics of AF play a far more important role than traditional morphology methods in the safety evaluation of CMs for pregnancy, with a higher sensitivity and correlation.

Amniotic fluid cell-free transcriptome: a glimpse into fetal development and placental cellular dynamics during normal pregnancy

“…Among the omics platforms used to study AF (see Kamath-Rayne et al [88] for a review), the analysis of cell-free mRNA (cfRNA) has the advantage of being easier to profile than its proteomics [45,89,90] and metabolomics [91][92][93][94][95][96] counterparts. The AF cfRNAs are thought to be contributed directly by the fetus and by apoptotic amniocytes [97] and have been shown to be altered by physiologic and pathologic factors such as gestational age [83,85,98], fetal sex [83], maternal obesity [99], genetic syndromes [100][101][102], and neonatal comorbidities [85] (see Zwemer and Bianchi for a review [97]).…”

Maternal Rat Metabolomics: Amniotic Fluid and Placental Metabolic Profiling Workflows

“…The AF metabolome has been frequently studied using NMR in clinical and preclinical studies, 11,34 but for the past few years, the use of LC−MS is quickly increasing. 35 Several studies already report the use of different solvents such as MeOH or ACN to deproteinize and extract metabolites 12,17,36 but without a rationale for their choice. Therefore, we have assessed three extraction methods using MeOH, ACN, or a mixture of both solvents on rat AF samples.…”

Efficacy of Fluid-Increasing Decoction, Low Molecular Heparin Sodium and Aspirin in the Treatment of Patients with Oligohydramnios in Pregnancy

“…The combination of low molecular heparin sodium and aspirin has been effective in the treatment of pregnant women with oligohydramnios in recent years, but shortcomings in this treatment included the necessity to individualise the dose [6] and the fact that some studies [7] concluded that high doses of low molecular heparin sodium and aspirin can affect the coagulation function of the pregnant body, which resulted in a limited acceptance of this method in some patients. According to Chinese medicine, oligohydramnios in pregnant women belongs to the category of "hypoplasticity" and its occurrence is strongly related to the maternal kidney and spleen [8]. Based on this, some clinical scholars have proposed to treat pregnant women with herbal regimens such as benefiting the kidneys and strengthening the spleen from TCM theory [9].…”