Abstract:
BACKGROUND:Early during human development, the trophoblast lineage differentiates to commence placentation. Where the placenta contacts the uterine decidua, extravillous trophoblast (EVT) cells differentiate and invade maternal tissues. EVT cells, identified by expression of HLA-G, invade into uterine blood vessels (endovascular EVT), as well as glands (endoglandular EVT), and open such luminal structures towards the intervillous space of the placenta. Endoglandular invasion diverts the contents of uterine glands to the intervillous space, while glands near the margin of the placenta that also contain endoglandular EVT cells open into the reproductive tract. Cells of the trophoblast lineage have thus been recovered from the uterine cavity and endocervical canal. An emerging non-invasive technology [trophoblast retrieval and isolation from the cervix (TRIC)] isolates and examines EVT cells residing in the cervix to explore their origin, biology and relationship to pregnancy and fetal status. OBJECTIVE AND RATIONALE:This review explores the origins and possible uses of trophoblast cells obtained during ongoing pregnancies (weeks 5-20) by TRIC. We hypothesize that endoglandular EVT cells at the margins of the expanding placenta enter the uterine cavity and are carried together with uterine secretion products to the cervix where they can be retrieved from a Papanicolaou (Pap) smear. The advantages of TRIC for investigation of human placentation and prenatal testing will be considered. Evidence from the literature, and from archived in utero placental histological sections, is presented to support these hypotheses. SEARCH METHODS:We used 52 out of 80 publications that appeared between 1966 and 2017 and were found by searching the PubMed and Google Scholar databases. The studies described trophoblast invasion of uterine vessels and glands, as well as trophoblast cells residing in the reproductive tract. This was supplemented with literature on human placental health and disease. OUTCOMES:The literature describes a variety of invasive routes taken by EVT cells at the fetal-maternal interface that could displace them into the reproductive tract. Since the 1970s, investigators have attempted to recover trophoblast cells from the uterus or cervix for prenatal diagnostics. Trophoblast cells from Pap smears obtained at 5-20 weeks of gestation have been purified (>95% β-hCG positive) by immunomagnetic isolation with nanoparticles linked to anti-HLA-G (TRIC). The isolated cells contain the fetal genome, and have an EVT-like expression profile. Similar EVT-like cells appear in the lumen of uterine glands and can be observed entering the uterine cavity along the margins of the placenta, suggesting that they are the primary source of cervical trophoblast cells. Cells isolated by TRIC can be used to accurately genotype the embryo/fetus by targeted next-generation sequencing. Biomarker protein expression quantified in cervical trophoblast cells after TRIC correlates with subsequent pregnancy loss, pre-eclampsia and fetal growth restriction. A key remaining question is the degree to which EVT cells in the cervix might differ from those in the basal plate and placental bed. WIDER IMPLICATIONS:TRIC could one day provide a method of risk assessment for maternal and fetal disease, and reveal molecular pathways disrupted during the first trimester in EVT cells associated with placental maldevelopment. As perinatal interventions emerge for pregnancy disorders and inherited congenital disorders, TRIC could provide a key diagnostic tool for personalized precision medicine in obstetrics.
journal_name
Hum Reprod Updatejournal_title
Human reproduction updateauthors
Moser G,Drewlo S,Huppertz B,Armant DRdoi
10.1093/humupd/dmy008subject
Has Abstractpub_date
2018-07-01 00:00:00pages
484-496issue
4eissn
1355-4786issn
1460-2369pii
4955872journal_volume
24pub_type
杂志文章,评审abstract:BACKGROUND:Endometriosis is recognized as a steroid-dependent disorder; however, the precise roles of nuclear receptors (NRs) in steroid responsiveness and other signaling pathways are not well understood. OBJECTIVE AND RATIONALE:Over the past several years, a number of paradigm-shifting breakthroughs have occurred in...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/dmz005
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Thyroid hormone disorders and thyroid peroxidase autoantibodies (TPO-Ab) in women are associated with subfertility and early pregnancy loss. Here, we aim to provide a comprehensive overview of the literature on the pathophysiology of these associations. METHODS:A review of the literature in the English lang...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/dmv004
更新日期:2015-05-01 00:00:00
abstract::Homocysteine, a product of the methionine cycle, is known to play an important role in cardiovascular diseases, neurological disorders and embryology, and in very important, fast growing fields concerning obstetrics and gynaecology. Therefore, we attempted an actual overview on possible obstetrical and gynaecological ...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/5.1.64
更新日期:1999-01-01 00:00:00
abstract::The number of cell divisions during embryonic and fetal life makes the embryo/fetus particularly vulnerable to effects resulting from exposure to an adverse intrauterine environment. Exposure to drugs and irradiation at this stage of development are able to cause congenital malformations and various cancers in later l...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/6.6.578
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:IUI for unexplained infertility can be performed in a natural cycle or in combination with ovarian stimulation. A disadvantage of ovarian stimulation is an increased risk of multiple pregnancies with its inherent maternal and neonatal complication risks. Stimulation agents for ovarian stimulation are clomiph...
journal_title:Human reproduction update
pub_type: 杂志文章,meta分析
doi:10.1093/humupd/dmz035
更新日期:2020-01-01 00:00:00
abstract::Polychlorinated dioxins, furans and polychlorinated benzene constitute a family of toxic persistent environmental pollutants. In Europe, environmental concentrations increased slowly throughout this century until the late 1980s. Dioxins have been shown to be carcinogenic in animals and humans. In humans, excess risks ...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/7.3.331
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Zika virus (ZIKV) is an arthropod-borne virus of the family Flaviviridae, genus Flavivirus. ZIKV is currently the focus of an ongoing pandemic and worldwide public health emergency. Although originally isolated in 1947, its pathogenesis was poorly known and very few documented infections were published until...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/dmx024
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Approximately half recurrent miscarriage (RM) cases remain unexplained after standard investigations. Secondary RM (SRM) is, in contrast to primary RM, preceded by a birth, which increases the transfer of fetal cells into the maternal circulation. Mothers of boys are often immunized against male-specific min...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/dmr005
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Hirsutism is the presence of excess body or facial terminal (coarse) hair growth in females in a male-like pattern, affects 5-15% of women, and is an important sign of underlying androgen excess. Different methods are available for the assessment of hair growth in women. METHODS:We conducted a literature se...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/dmp024
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Uterine leiomyomas (fibroids) are highly prevalent benign smooth muscle tumors of the uterus. In the USA, the lifetime risk for women developing uterine leiomyomas is estimated as up to 75%. Except for hysterectomy, most therapies or treatments often provide only partial or temporary relief and are not succe...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/dmv030
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Estrogens are known to orchestrate reproductive events and to regulate the immune system during infections and following tissue damage. Recent findings suggest that, in the absence of any danger signal, estrogens trigger the physiological expansion and functional specialization of macrophages, which are immu...
journal_title:Human reproduction update
pub_type: 杂志文章
doi:10.1093/humupd/dmy026
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:The prevalence of congenital uterine anomalies in high-risk women is unclear, as several different diagnostic approaches have been applied to different groups of patients. This review aims to evaluate the prevalence of such anomalies in unselected populations and in women with infertility, including those un...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/dmr028
更新日期:2011-11-01 00:00:00
abstract::In the male genital tract, reactive oxygen species (ROS) are generated by spermatozoa and leukocytes including neutrophils and macrophages. ROS are involved in the regulation of sperm functions such as capacitation and the acrosome reaction. Infections lead to an excessive ROS production, resulting in an 'oxidative bu...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/5.5.399
更新日期:1999-09-01 00:00:00
abstract::This review presents detailed risk estimates from relevant epidemiological and other studies on the comparative safety of second and third generation oral contraceptives (OC). Written with the intention of presenting a repository of the available information, it also discourses briefly into the symptomatology and diag...
journal_title:Human reproduction update
pub_type: 历史文章,杂志文章,评审
doi:10.1093/humupd/5.6.565
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Androgens, FSH, anti-Müllerian hormone (AMH) and estradiol (E2) are essential in human ovarian folliculogenesis. However, the interactions between these four players is not fully understood. OBJECTIVES AND RATIONALE:The purpose of this review is to highlight the chronological sequence of the appearance and ...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/dmw027
更新日期:2016-11-01 00:00:00
abstract::Ca(2+) is a ubiquitous intracellular messenger which encodes information by temporal and spatial patterns of concentration. In spermatozoa, several key functions, including acrosome reaction and motility, are regulated by cytoplasmic Ca(2+) concentration. Despite the very small size and apparent structural simplicity ...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/dmi050
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Anti-Müllerian hormone (AMH) is an established marker of ovarian reserve and a good predictor of poor or excessive ovarian response after controlled hyperstimulation. However, it is unclear whether it can predict the ultimate outcome of assisted conception, live birth. We undertook a systematic review and me...
journal_title:Human reproduction update
pub_type: 杂志文章,meta分析,评审
doi:10.1093/humupd/dmu003
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:First-trimester miscarriage affects up to a quarter of women worldwide. With many competing treatment options available, there is a need for a comprehensive evidence synthesis. OBJECTIVES AND RATIONALE:We conducted a systematic review and network meta-analysis to assess the effectiveness and safety of treat...
journal_title:Human reproduction update
pub_type: 杂志文章,meta分析
doi:10.1093/humupd/dmz002
更新日期:2019-05-01 00:00:00
abstract::Apoptosis is a selective process for deletion of cells in various biological systems. This event, similar to proliferation, is tightly regulated, with both processes playing essential roles in the homeostasis of renewable tissues. In human endometrium, proliferation and apoptosis occur at opposing poles of the menstru...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/1.4.303
更新日期:1995-07-01 00:00:00
abstract::During the elongating spermatid stage of spermiogenesis, human sperm chromatin undergoes a complex transition in which histones are extensively replaced by protamines in a carefully regulated transition including histone modifications and intermediate and temporary replacement of the histones by sperm-specific transit...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/dml057
更新日期:2007-05-01 00:00:00
abstract::The clinical significance of micro-organisms in semen samples of asymptomatic subfertile patients is a matter of constant debate. Usually little attention is paid to anaerobic bacteria as they are sensitive to transportation and culturing, and differentiation is difficult, costly and time-consuming. In the present stu...
journal_title:Human reproduction update
pub_type: 杂志文章
doi:10.1093/humupd/1.5.462
更新日期:1995-09-01 00:00:00
abstract::Mammals are generally held to be exceptions to the rule that organization of the egg plays a role in specifying the differentiation of cells, axes, or other aspects of patterning in the early embryo. However, there are several grounds for questioning this conclusion. Not only do certain experimental findings remain un...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/2.1.3
更新日期:1996-01-01 00:00:00
abstract::Operative hysteroscopy is a relatively new technique that has significantly improved the diagnosis and therapy of abnormal uterine bleeding. At first, the success of operative hysteroscopy in controlling this bleeding seemed extremely high but, with long-term follow-up, a significant failure rate became evident requir...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/4.4.350
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:Threatened miscarriage affects one in five women and is associated with significant emotional distress. The uncertainty around the prognosis of threatened miscarriage makes it equally challenging to the healthcare professionals. Various biochemical markers have been investigated in the past to predict the ou...
journal_title:Human reproduction update
pub_type: 杂志文章,meta分析,评审
doi:10.1093/humupd/dmv054
更新日期:2016-03-01 00:00:00
abstract::Androgen levels are measured in today's clinical practice almost exclusively by immunoassays. The androgen that is most frequently determined is testosterone (T), but sometimes also the levels of other testicular, ovarian and adrenal androgens such as 5alpha-dihydrotestosterone, androstenedione, dehydroepiandrosterone...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/dmm038
更新日期:2008-01-01 00:00:00
abstract::BACKGROUND Angiogenesis, i.e. the development of new blood vessels from pre-existing ones, represents an integral part in the pathogenesis of endometriosis. During the last decade, an increasing number of studies have therefore focused on the anti-angiogenic treatment of the disease. The present review provides a syst...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/dms026
更新日期:2012-11-01 00:00:00
abstract::Women suffer a higher incidence of osteoporosis than men, in part due to oestrogen deficiency after menopause. In fact, the administration of oestrogen to post-menopausal women is associated with a decrease of bone resorption. Tamoxifen is a widely used selective oestrogen receptor modulator in women with breast cance...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/6.3.255
更新日期:2000-05-01 00:00:00
abstract::Nitric oxide (NO) is an important mediator of paracrine interactions, especially within the vascular system. It is a powerful inhibitor of platelet aggregation and a potent vasodilator. NO is also a neurotransmitter and it plays a role in cell-mediated cytotoxicity. NO-generating enzymes (nitric oxide synthases, NOS) ...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/4.5.565
更新日期:1998-09-01 00:00:00
abstract::Hormonal contraception has become more effective and more widely used, while the world population has grown from 3000 million in 1960 to 6000 million in 2000. There is a need for improved contraception, because legal abortion is used in a high proportion of pregnancies and illegal abortion continues to be common in so...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/8.4.359
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:High-density lipoprotein (HDL) appears to be the dominant lipoprotein particle in human follicular fluid (FF). The reported anti-atherogenic properties of HDL have been attributed in part to reverse cholesterol transport. The discoveries of the scavenger receptor class B type I (SR-BI) and the ATP-binding ca...
journal_title:Human reproduction update
pub_type: 杂志文章,评审
doi:10.1093/humupd/dmp029
更新日期:2010-01-01 00:00:00