Perinatal Endocrinology: Common Endocrine Disorders in the Sick and Premature Newborn

Hyman, Sharon J.; Novoa, Yeray; Holzman, Ian R.

doi:10.1016/j.ecl.2009.06.005

Cited by 10 publications

(5 citation statements)

References 78 publications

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“…A high degree of mismatch between the adaptive trait and the future environment, which includes aging, changes in lifestyle, or the introduction of new chemicals, pathogens, and pollutants, may increase the risk of developing disease. Prime examples are the strong correlations observed between hyponutrition and/or low birth weight with many endocrine disorders related to thyroid function, calcium balance, utilization of glucose, insulin sensitivity, and adrenal gland function (Vaag & Poulsen 2007, Hyman et al . 2009, Latini et al .…”

Section: Phenotype Plasticity and Developmental Plasticity: Bases Of mentioning

confidence: 99%

Epigenetics meets endocrinology

Zhang¹,

Ho²

2010

Journal of Molecular Endocrinology

229

123

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Although genetics determines endocrine phenotypes, it cannot fully explain the great variability and reversibility of the system in response to environmental changes. Evidence now suggests that epigenetics, i.e. heritable but reversible changes in gene function without changes in nucleotide sequence, links genetics and environment in shaping endocrine function. Epigenetic mechanisms, including DNA methylation, histone modification, and microRNA, partition the genome into active and inactive domains based on endogenous and exogenous environmental changes and developmental stages, creating phenotype plasticity that can explain interindividual and population endocrine variability. We will review the current understanding of epigenetics in endocrinology, specifically, the regulation by epigenetics of the three levels of hormone action (synthesis and release, circulating and target tissue levels, and target-organ responsiveness) and the epigenetic action of endocrine disruptors. We will also discuss the impacts of hormones on epigenetics. We propose a three-dimensional model (genetics, environment, and developmental stage) to explain the phenomena related to progressive changes in endocrine functions with age, the early origin of endocrine disorders, phenotype discordance between monozygotic twins, rapid shifts in disease patterns among populations experiencing major lifestyle changes such as immigration, and the many endocrine disruptions in contemporary life. We emphasize that the key for understanding epigenetics in endocrinology is the identification, through advanced high-throughput screening technologies, of plasticity genes or loci that respond directly to a specific environmental stimulus. Investigations to determine whether epigenetic changes induced by today's lifestyles or environmental `exposures' can be inherited and are reversible should open doors for applying epigenetics to the prevention and treatment of endocrine disorders.

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Section: Phenotype Plasticity and Developmental Plasticity: Bases Of mentioning

confidence: 99%

Epigenetics meets endocrinology

Zhang¹,

Ho²

2010

Journal of Molecular Endocrinology

229

123

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“…Calcium homeostasis is a complex mechanism often dysregulated in critically ill neonates and children. [ 11 12 13 ] Hypocalcemia is well-described but partially unexplained in critically ill neonates. [ 14 15 ] Unlike these reports, our patients had a normal or high serum calcium level before ECMO implantation.…”

Section: Discussionmentioning

confidence: 99%

Calcium homeostasis disorder during and after neonatal extracorporeal membrane oxygenation

Rambaud¹,

Guellec²,

Guilbert³

et al. 2015

Indian Journal of Critical Care Medicine

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Background and Aims:Extracorporeal membrane oxygenation (ECMO) is used during pediatric resuscitation in case of refractory hypoxemia or septic shock under maximum therapy. Previous studies describe calcium homeostasis dysregulation. The aim of this study was to confirmed of calcium homeostasis dysregulation in neonates under ECMO and supposed news explanation.Subjects and Methods:From November 2012 to July 2013, we performed a prospective single center observational study. Eleven neonatal patients were included. Blood was obtained before and during ECMO (day 7, 14 and 21) for parathyroid hormone (PTH), protein adjusted serum calcium, ionized calcium, magnesium, and calcitriol levels. All surviving patients underwent a consultation up to 6 months after ECMO weaning.Results:During ECMO PTH was inadequately high with normal serum calcium on day 7 (PTH: 73.54 ± 40 ng/l; calcemia: 2.33 ± 0.21 mmol/l), day 14 (PTH: 57.63 ± 29.57 ng/l; calcemia: 2.44 ± 0.43 mmol/l) and day 21 (PTH: 54.93 ± 8.43 ng/l; calcemia: 2.13 ± 0.09 mmol/l). The absence of correlation between serum calcium and PTH levels seem to confirm the dysregulation of PTH - serum calcium metabolism during ECMO. Six months after ECMO weaning, we noticed hypercalcemia with normal PTH.Conclusions:We confirmed the existence of severe disturbances of calcium homeostasis in neonates on ECMO and supposed the possible damage of calcium regulation. We did not succeed in finding clear explanations of these disturbances.

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“…Late neonatal hypocalcemia occurring from the fifth day of life may result from dietary phosphate overload, hypomagnesemia, and vitamin D deficiency associated with maternal vitamin D deficiency. Congenital hypoparathyroidism can be isolated or a component of the DiGeorge syndrome [Hyman et al, ]. In infants born with the DiGeorge syndrome, maldevelopment of the third and fourth branchial arches is frequently associated with the congenital absence or dygenesis of the parathyroid gland.…”

Section: Maternal Factorsmentioning

confidence: 99%

Perinatal and Early Postnatal Factors Underlying Developmental Delay and Disabilities

Ergaz¹,

Ornoy²

2011

Dev Disabil Res Revs

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A delay in meeting developmental milestones may be secondary to perinatal events, involving complicated interactions between mother and fetus during delivery. Maternal factors including weight, diet, and morbidities can affect neonatal adaptation and later development. Prematurity, low birth weight, and previous intrauterine insults as well as complications during delivery of a previously normal fetus increase the risk for perinatal stress. In this article, the literature on perinatal and early postnatal factors that underlie risks for developmental delay and disabilities is reviewed. Studies that concern neuroprotective therapies and prediction of long-term neurologic outcome by clinical examination, neuroimaging techniques, and electroencephalographic studies are reviewed as well.

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Perinatal Endocrinology: Common Endocrine Disorders in the Sick and Premature Newborn

Cited by 10 publications

References 78 publications

Epigenetics meets endocrinology

Epigenetics meets endocrinology

Calcium homeostasis disorder during and after neonatal extracorporeal membrane oxygenation

Perinatal and Early Postnatal Factors Underlying Developmental Delay and Disabilities

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