High molecular mass multimer complexes and vascular expression contribute to high adiponectin in the fetus.

CONTEXT: High plasma adiponectin concentrations in human fetuses and neonates are unique features of early developmental stages. Yet, the origins of the high adiponectin concentrations in the perinatal period remain elusive. OBJECTIVE: This study was undertaken to identify the sources and functional properties of adiponectin in utero. DESIGN AND METHODS: Tissue specimens were obtained at autopsy from 21- to 39-wk-old stillborn human fetuses. Adipose tissue and placenta were obtained at term elective cesarean section. Adiponectin complexes and expression were measured by immunodetection and real-time PCR. RESULTS: Adiponectin mRNA transcripts were detected in fetal sc and omental adipose depots at lower concentrations than in maternal adipose tissue. Immunoreactive adiponectin was also observed in vascular endothelial cells of fetal organs, including skeletal muscle, kidney, and brain. The absence of adiponectin in all placental cell types and lack of correlation between maternal and umbilical adiponectin indicate that umbilical adiponectin reflects its exclusive production by fetal tissues. The most prominent forms of adiponectin in fetal plasma were high and low molecular mass (HMW and LMW) multimers of 340 and 160 kDa, respectively. The proportion of the HMW complexes was 5-fold (P < 0.001) higher in umbilical plasma than in adult. The high HMW and total adiponectin levels were associated with lower insulin concentration and lower homeostasis model of assessment of insulin resistance indices in umbilical plasma, reflecting higher insulin sensitivity of the fetus compared with adult. CONCLUSIONS: The abundance of HMW adiponectin and its vascular expression are characteristics of human fetal adiponectin. Combined with high insulin sensitivity, fetal adiponectin may be a critical determinant of in utero growth.

Obesity in pregnancy stimulates macrophage accumulation and inflammation in the placenta.

Obesity and pregnancy are associated with a combination of insulin resistance and inflammatory changes which exacerbate in combination. Based on the similarity between the inflammatory transcriptomes of adipose tissue and placenta, we hypothesized that the placenta develops exaggerated inflammation in response to obesity. The aim of this study was to characterize placental inflammatory mediators and macrophage accumulation in relation to peripheral inflammation in obesity. Placental macrophages and maternal peripheral blood mononuclear cells (PBMC) from 20 obese and 15 lean women were functionally and phenotypically characterized using immunohistochemistry, flow cytometry and expression for macrophage markers and inflammatory cytokines. The number of resident CD68+ and CD14+ cells was increased 2-3 fold in the placenta of obese as compared to lean women. The macrophage population was characterized by a marked phenotypic heterogeneity with complex subsets of CD14+, CD68+ and CD11b+ (mac-1) cells and by an increased expression of the pro-inflammatory cytokines IL-1, TNF-alpha, IL-6. Placental inflammation was associated with an activation of PBMC gene expression with an increase in the monocyte differentiation and maturation markers CD14 and CD68 in maternal but not fetal PBMC. The inflammatory changes were associated with higher plasma concentrations of C-reactive protein and IL-6 in obese compared to lean women. In conclusion, the chronic inflammation state of pre-gravid obesity is extending to in utero life with accumulation of a heterogeneous macrophage population and pro-inflammatory mediators in the placenta. The resulting inflammatory milieu in which the fetus develops may have critical consequences for short and long term programming of obesity.

Differential expression of the duffy antigen receptor for chemokines according to RBC age and FY genotype.

BACKGROUND: The Duffy (Fy) blood group (also known as Duffy antigen receptor for chemokines, or DARC) may be involved in regulation of the level of circulating proinflammatory chemokines, and it is an obligatory receptor on RBCs for the human malaria parasite Plasmodium vivax. STUDY DESIGN AND METHODS: Because quantification of Fy expression by using RBCs of various ages will not detect acute changes associated with inflammatory states, and because P. vivax exclusively invades reticulocytes, a flow cytometric method was developed to measure the level of surface expression of Fy. Reticulocytes and mature RBCs from persons with different genotypes (GATA-1 T-->C promoter mutation at nt -46; FY*A and FY*B in the ORF) were used. RESULTS: Expression of the Fy6 epitope, which is required for P. vivax invasion, was 49 +/- 19 percent higher on reticulocytes than on mature RBCs, regardless of donor genotype (p<0.0001). Fy6 levels were approximately 50 percent lower in persons who were heterozygous for the GATA-1 promoter mutation and were significantly lower on reticulocytes and mature RBCs of the FY*B/FY*B genotype than on those of the FY*A/FY*A or FY*A/FY*B genotype. CONCLUSION: Fy has greater expression on reticulocytes than on mature RBCs in flow cytometry. This method may be useful in further studies of this antigen, such as characterization of reticulocytes and RBC phenotypes across populations, in response to chemokine regulation, and in the context of susceptibility to P. vivax and other parasites.

Baroreflex responses to the stress of severe hemorrhage in the rat.

In two groups of anesthetized (sodium pentobarbital), mature Sprague-Dawley rats, 1) aged 2 years and weighing 300-400 grams, 2) aged 6 months weighing 200-300 grams, baroreflex-induced circulatory responses to pressor (graded doses phenylephrine) and depressor (graded doses nitroglycerine) agents were compared to those occurring during progressive hemorrhage in the same animals. Graded withdrawals of blood from the femoral artery elicited progressive hypotension accompanied by bradycardia rather than expected tachycardia. Graded doses of phenylephrine (2.5 ug to 40 ug bolus, via femoral vein) regularly induced elevations in arterial blood pressure with associated reflex bradycardia. Similarly graded doses of nitroglycerine induced a marked decline in arterial blood pressure, without expected tachycardia. As hypotension became more severe (during hemorrhage), atrioventricular conduction slowed and A-V block developed, resulting in statistically greater slowing in ventricular than in atrial excitation and contractile cycles. Heart failure during hemorrhage in the rat is characterized sequentially by severe bradycardia, depressed atrial contractile force, impaired conduction and A-V block, terminating in ventricular, atrial, and finally, in pacemaker failure. Baroreceptor reflexes were blunted or even absent in both young and old animals during induced hypotension.

Gross and microscopic anatomy of the vagal innervation of the rat heart.

Intrinsic cardiac ganglia and their vagal innervation are described from gross and microscopic dissections and functional studies in the anesthetized, open-chest, adult rat. Dissecting microscope sketches of the ventral and dorsal aspects of the rat heart provide gross descriptions of the anatomical course of the vagal cardiac nerves. Histological sectioning of adipose tissue packets surrounding the terminal endings of vagal branches distributed to the roots of the great cardiac vessels (aorta, pulmonary artery, precaval veins) revealed clusters of autonomic ganglia. These packets or "fat pads" were located: (1) along the dorsal surface of the right precava and extending medially toward the aortic root, (2) deep to the aortic arch, (3) in the angle between the root of the left precava and the pulmonary artery on the superior-dorsal surface of the left atrium, and (4) in the rostro-dorsal interatrial septum. Vagal distributions of small terminal branches were traced to each of these pads, which contained numerous autonomic ganglia. Electrical excitation of right or left cervical vagus elicited varying degrees of sinus slowing, slowing of A-V conduction, and suppression in atrial contractile force. Very small quantities (0.5 mg in 10 microliters saline) of the ganglionic blocking agent, hexamethonium (C6) were injected selectively into a single fat pad, followed by repetition of right or left vagal stimulation, with careful analysis of changes in heart rate (paced and unpaced), A-V conduction, and contractile force.