Impact of the Environment on Lifelong Health Flashcards

1
Q

What impacts on a fetus in utero can have a lasting impact?

A
  • fetal infection
  • maternal nutrition
  • maternal illness
  • maternal stress
  • maternal medication
  • environmental factors/exposures
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2
Q

What are the possible biological (nature) influences on long term health?

A
  • genetics
  • epigenetics
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3
Q

What are the possible social/environmental (nurture) influences on long term health?

A
  • environment
  • family/neighbourhood, school
  • nutrition
  • social (behaviours observed, substance use, care-giver behaviour)
  • health provisions
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4
Q

What are the conclusions of the Barker hypothesis?

A
  • adults that had a coronary event had been small at birth -> 2 yrs
  • thereafter gained weight rapidly
  • the risk of coronary events was more strongly related to the rate of change of childhood BMI, rather than BMI at a specific time.
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5
Q

What is the Barker/DOHaD hypothesis?

A

Undernutrition in utero and over nutrition as a child leads to an increased risk of ‘metabolic syndrome’ and therefore increased risk of CV events

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6
Q

What are the three major mechanisms for fetal reprogramming?

A
  • hormonal effects (glucocorticoid exposure)
  • epigentic modifications
  • irreversible developmental changes in organ size/structure
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7
Q

What does DOHaD stand for?

A

Developmental Origins of Health and Disease

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8
Q

What is epigenetics?

A

heritable changes in DNA that do not change the nucleotide sequence but influence gene expression.

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9
Q

What are some epigenetic changes in the DNA?

A
  • DNA methylation
  • modification of histones post-translation
  • non-coding RNA
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10
Q

What are the fetal epigenomic changes caused by maternal stress?

A
  • fetal growth restriction
  • obesity (increased energy storage)
  • diabetes mellitus (altered metabolism)
  • hypertension/cardiovascular disease (changes in number of cardio/vascular myocytes and nephrons)
  • stroke, schizophrenia, cognitive dysfunction, depression and behavioural disorders (altered neurons and brain cells)
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11
Q

What are the three key windows of epigenetic reprogramming in a fetus?

A
  • gametogenesis
  • early development
  • organogenesis and fetal growth
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12
Q

What can influence fetal gene expression?

A
  • maternal health and environment
  • fetal nutrient demand:supply
  • endocrine mileu
  • placental vascular supply
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13
Q

What are some fetal developmental responses to its altered gene expression?

A
  • altered endocrinology and metabolism
  • changes in fetal bone and lean and fat mass
  • altered blood flow
  • altered immune response
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14
Q

What is the mechanism of the developmental origin of health and disease?

A
  • ‘programming’ in utero
  • leads to epigenetic changes that influence development and physiology
  • changes ay include predictive adaptive responses (PARS)
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15
Q

What are PARs?

A
  • developmental adaptations taken to prepare the ftus for its future environment after birth
  • don’t benefit the fetus immediately
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16
Q

What diseases are associated with early environmental exposures?

A
  • CVD
  • DMT2
  • lung disease
  • cancer risk
  • allergic and autoimmune diseases
  • neurological, special sense and intellectual development
17
Q

What can cause increased fetal glucocorticoid exposure?

A
  • increased maternal stress releasing more glucocorticoids
  • decreased 11BHSD2 enzyme expression in placental
18
Q

What is the effect of increased fetal glucocorticoid exposure?

A
  • reprogramming of fetal growth, development and metabolism
  • HPA axis dysregulation
  • changes in GC receptor expression
  • leads to adult disease
19
Q

What are the effects of fetal hypoxia?

A
  • reduced nephron numbers
  • increased risk of hypertension and renal disease in adulthood
20
Q

What are the effects of fetal undernutrition?

A
  • reduced beta cell mass
  • altered muscle insulin sensitivity
  • impaired glucose control in adulthood
21
Q

What are primordial germ cells?

A

Embryonic precursor cells of oocytes and spermatozoa

22
Q

What happens to PGCs in embryogenesis?

A
  • undergo epigenetic reprogramming
  • gives rise to sperm and egg which transmit these epigenetic markers to the next generation
  • sensitive to environmental impacts