Nanoparticles: Risk for babies in the womb
Impact of pollution on embryonic development
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EMPA-RESEARCHER TINA BÜRKI
view moreCREDIT: EMPA
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Human life begins with a single egg cell that grows into a human being with trillions of cells. To ensure that the highly complex development of tissues and organs is as protected as possible, the placental barrier keeps pathogens and foreign substances out. Tina Bürki and her team from Empa's Particles-Biology Interactions laboratory in St. Gallen are investigating how this protective mechanism copes with nanoparticles.
Nanoparticles are contained in a large number of products, but they are also produced during wear and tear as well as through combustion processes (see box). "We absorb these substances from the environment via our food, cosmetics or the air we breathe," explains Bürki. Some of these nanoparticles are suspected of harming babies in the womb. Low birth weight, autism and respiratory diseases are among the possible consequences for the child.
Mysterious remote effect
It is still unclear how the nanoparticles affect the unborn child. "We already know that the placental barrier retains many nanoparticles or at least delays their transport to the embryo," says Bürki. However, damage to the fetal tissue occurs, even if no particles have been detected in the fetus. The Empa team is now getting to the bottom of this long-range effect of nanoparticles. Together with clinical partners from the Cantonal Hospital of St. Gallen and research partners from the University of Geneva, the Amsterdam University Medical Center and the Leibniz Institute for Environmental Medical Research in Düsseldorf, the team is investigating the consequences of common nanoparticles such as titanium dioxide or diesel soot on the function of the placenta and their indirect damage to embryonic development.
For this purpose, the team used fully functional human placentas that were made available after planned caesarean sections. "Human placental tissue is the only way to obtain meaningful results on the transport and effect of nanoparticles," says the Empa researcher. "The structure, metabolism and interaction of maternal and fetal tissue are unique and species-specific."
The experiments showed that nanoparticles in placental tissue disrupt the production of a large number of messenger substances. And it is these messengers that can trigger serious changes in embryonic development, such as disturbed blood vessel formation.
These effects can be visualized in laboratory models using chicken eggs. The blood vessels in the egg actually grow at an enormous speed and density to enable embryonic development. A dense network of fine blood vessels covers the inside of the eggshell. The situation is strikingly different in eggs treated with the altered messenger substances from the nanoparticle-treated placenta: In the experiments, the blood vessel system was not as dense but rather coarse-meshed. "Nanoparticles apparently have an indirect effect on the child in the womb by inhibiting the formation of blood vessels via messenger substances," says Tina Bürki.
Health consequences
The researchers are currently investigating the entirety of the messenger substances released by a nanoparticle-treated placenta, the so-called secretome. Uncontaminated, the interplay of hormones, inflammatory mediators and signaling substances for the formation of organ systems resembles a perfectly tuned orchestra. It is already clear that the communication between the placenta and the unborn child is disrupted by the presence of nanoparticles and damages the formation of blood vessels. However, initial results show that the development of the nervous system does not appear to be affected. Future analyses will show what other disorders the nanoparticles can trigger indirectly. "As the effects can have an impact on the health of the pregnant woman and the development of her child, these findings should be taken into account in the risk assessment of nanomaterials," says the researcher.
The clinical partner, the Cantonal Hospital of St. Gallen, is also interested. As Thomas Rduch from the Women's Clinic and also a Clinical Research Fellow at Empa puts it: "A healthy placenta is of utmost importance for the development of the child. Correct risk assessments of environmental pollution are therefore crucial for pregnant women."
The placenta
The placenta is an organ that forms exclusively during pregnancy. It supplies the child in the womb with nutrients and also serves as a filter for environmental influences. This so-called placental barrier offers the unborn child a certain degree of protection against pathogens or harmful substances. However, some substances, such as environmental oestrogens (https://www.empa.ch/de/web/s604/schwangerschaft), can pass through the placental barrier and are suspected of being associated with various diseases.
Nanoparticles
Nanoparticles are only a few millionths of a millimeter in size. They include titanium dioxide, for example, which can be found in many foods, cosmetics and medicines. Silicon dioxide is found in paints and printing paper, for example, and is also used as a food additive. Other nanoparticles come from environmental pollution processes such as plastic abrasion (nanoplastics) or industrial soot. They can enter the human body via the respiratory tract, the digestive tract or the skin. As environmental pollution with nanoparticles is increasing, Empa is researching the health risks in various
Human life begins with a single egg cell that grows into a human being with trillions of cells. To ensure that the highly complex development of tissues and organs is as protected as possible, the placental barrier keeps pathogens and foreign substances out. Tina Bürki and her team from Empa's Particles-Biology Interactions laboratory in St. Gallen are investigating how this protective mechanism copes with nanoparticles.
Nanoparticles are contained in a large number of products, but they are also produced during wear and tear as well as through combustion processes (see box). "We absorb these substances from the environment via our food, cosmetics or the air we breathe," explains Bürki. Some of these nanoparticles are suspected of harming babies in the womb. Low birth weight, autism and respiratory diseases are among the possible consequences for the child.
Mysterious remote effect
It is still unclear how the nanoparticles affect the unborn child. "We already know that the placental barrier retains many nanoparticles or at least delays their transport to the embryo," says Bürki. However, damage to the fetal tissue occurs, even if no particles have been detected in the fetus. The Empa team is now getting to the bottom of this long-range effect of nanoparticles. Together with clinical partners from the Cantonal Hospital of St. Gallen and research partners from the University of Geneva, the Amsterdam University Medical Center and the Leibniz Institute for Environmental Medical Research in Düsseldorf, the team is investigating the consequences of common nanoparticles such as titanium dioxide or diesel soot on the function of the placenta and their indirect damage to embryonic development.
For this purpose, the team used fully functional human placentas that were made available after planned caesarean sections. "Human placental tissue is the only way to obtain meaningful results on the transport and effect of nanoparticles," says the Empa researcher. "The structure, metabolism and interaction of maternal and fetal tissue are unique and species-specific."
The experiments showed that nanoparticles in placental tissue disrupt the production of a large number of messenger substances. And it is these messengers that can trigger serious changes in embryonic development, such as disturbed blood vessel formation.
These effects can be visualized in laboratory models using chicken eggs. The blood vessels in the egg actually grow at an enormous speed and density to enable embryonic development. A dense network of fine blood vessels covers the inside of the eggshell. The situation is strikingly different in eggs treated with the altered messenger substances from the nanoparticle-treated placenta: In the experiments, the blood vessel system was not as dense but rather coarse-meshed. "Nanoparticles apparently have an indirect effect on the child in the womb by inhibiting the formation of blood vessels via messenger substances," says Tina Bürki.
Health consequences
The researchers are currently investigating the entirety of the messenger substances released by a nanoparticle-treated placenta, the so-called secretome. Uncontaminated, the interplay of hormones, inflammatory mediators and signaling substances for the formation of organ systems resembles a perfectly tuned orchestra. It is already clear that the communication between the placenta and the unborn child is disrupted by the presence of nanoparticles and damages the formation of blood vessels. However, initial results show that the development of the nervous system does not appear to be affected. Future analyses will show what other disorders the nanoparticles can trigger indirectly. "As the effects can have an impact on the health of the pregnant woman and the development of her child, these findings should be taken into account in the risk assessment of nanomaterials," says the researcher.
The clinical partner, the Cantonal Hospital of St. Gallen, is also interested. As Thomas Rduch from the Women's Clinic and also a Clinical Research Fellow at Empa puts it: "A healthy placenta is of utmost importance for the development of the child. Correct risk assessments of environmental pollution are therefore crucial for pregnant women."
If nanoparticles enter the placenta during pregnancy, the formation of blood vessels is suppressed. Fluorescence microscopy visualizes the consequences in the chicken egg model: The veins (green) only form a perforated, coarse-meshed network when they are treated with messenger substances from a nanoparticle-contaminated placenta (bottom). In comparison, a control chicken egg (top) displays a dense network of very fine blood vessels.
CREDIT
Empa
The placenta
The placenta is an organ that forms exclusively during pregnancy. It supplies the child in the womb with nutrients and also serves as a filter for environmental influences. This so-called placental barrier offers the unborn child a certain degree of protection against pathogens or harmful substances. However, some substances, such as environmental oestrogens (https://www.empa.ch/de/web/s604/schwangerschaft), can pass through the placental barrier and are suspected of being associated with various diseases.
Nanoparticles
Nanoparticles are only a few millionths of a millimeter in size. They include titanium dioxide, for example, which can be found in many foods, cosmetics and medicines. Silicon dioxide is found in paints and printing paper, for example, and is also used as a food additive. Other nanoparticles come from environmental pollution processes such as plastic abrasion (nanoplastics) or industrial soot. They can enter the human body via the respiratory tract, the digestive tract or the skin. As environmental pollution with nanoparticles is increasing, Empa is researching the health risks in various
Human life begins with a single egg cell that grows into a human being with trillions of cells. To ensure that the highly complex development of tissues and organs is as protected as possible, the placental barrier keeps pathogens and foreign substances out. Tina Bürki and her team from Empa's Particles-Biology Interactions laboratory in St. Gallen are investigating how this protective mechanism copes with nanoparticles.
Nanoparticles are contained in a large number of products, but they are also produced during wear and tear as well as through combustion processes (see box). "We absorb these substances from the environment via our food, cosmetics or the air we breathe," explains Bürki. Some of these nanoparticles are suspected of harming babies in the womb. Low birth weight, autism and respiratory diseases are among the possible consequences for the child.
Mysterious remote effect
It is still unclear how the nanoparticles affect the unborn child. "We already know that the placental barrier retains many nanoparticles or at least delays their transport to the embryo," says Bürki. However, damage to the fetal tissue occurs, even if no particles have been detected in the fetus. The Empa team is now getting to the bottom of this long-range effect of nanoparticles. Together with clinical partners from the Cantonal Hospital of St. Gallen and research partners from the University of Geneva, the Amsterdam University Medical Center and the Leibniz Institute for Environmental Medical Research in Düsseldorf, the team is investigating the consequences of common nanoparticles such as titanium dioxide or diesel soot on the function of the placenta and their indirect damage to embryonic development.
For this purpose, the team used fully functional human placentas that were made available after planned caesarean sections. "Human placental tissue is the only way to obtain meaningful results on the transport and effect of nanoparticles," says the Empa researcher. "The structure, metabolism and interaction of maternal and fetal tissue are unique and species-specific."
The experiments showed that nanoparticles in placental tissue disrupt the production of a large number of messenger substances. And it is these messengers that can trigger serious changes in embryonic development, such as disturbed blood vessel formation.
These effects can be visualized in laboratory models using chicken eggs. The blood vessels in the egg actually grow at an enormous speed and density to enable embryonic development. A dense network of fine blood vessels covers the inside of the eggshell. The situation is strikingly different in eggs treated with the altered messenger substances from the nanoparticle-treated placenta: In the experiments, the blood vessel system was not as dense but rather coarse-meshed. "Nanoparticles apparently have an indirect effect on the child in the womb by inhibiting the formation of blood vessels via messenger substances," says Tina Bürki.
Health consequences
The researchers are currently investigating the entirety of the messenger substances released by a nanoparticle-treated placenta, the so-called secretome. Uncontaminated, the interplay of hormones, inflammatory mediators and signaling substances for the formation of organ systems resembles a perfectly tuned orchestra. It is already clear that the communication between the placenta and the unborn child is disrupted by the presence of nanoparticles and damages the formation of blood vessels. However, initial results show that the development of the nervous system does not appear to be affected. Future analyses will show what other disorders the nanoparticles can trigger indirectly. "As the effects can have an impact on the health of the pregnant woman and the development of her child, these findings should be taken into account in the risk assessment of nanomaterials," says the researcher.
The clinical partner, the Cantonal Hospital of St. Gallen, is also interested. As Thomas Rduch from the Women's Clinic and also a Clinical Research Fellow at Empa puts it: "A healthy placenta is of utmost importance for the development of the child. Correct risk assessments of environmental pollution are therefore crucial for pregnant women."
The placenta
The placenta is an organ that forms exclusively during pregnancy. It supplies the child in the womb with nutrients and also serves as a filter for environmental influences. This so-called placental barrier offers the unborn child a certain degree of protection against pathogens or harmful substances. However, some substances, such as environmental oestrogens (https://www.empa.ch/de/web/s604/schwangerschaft), can pass through the placental barrier and are suspected of being associated with various diseases.
Nanoparticles
Nanoparticles are only a few millionths of a millimeter in size. They include titanium dioxide, for example, which can be found in many foods, cosmetics and medicines. Silicon dioxide is found in paints and printing paper, for example, and is also used as a food additive. Other nanoparticles come from environmental pollution processes such as plastic abrasion (nanoplastics) or industrial soot. They can enter the human body via the respiratory tract, the digestive tract or the skin. As environmental pollution with nanoparticles is increasing, Empa is researching the health risks in various
JOURNAL
Advanced Science
METHOD OF RESEARCH
Experimental study
SUBJECT OF RESEARCH
Cells
ARTICLE TITLE
Nanoparticles dysregulate the human placental secretome with consequences on angiogenesis and vascularization
Lifesaving childbirth blood loss intervention is highly cost-effective
Additional cost to achieve the improved outcome could be as little as 30 US cents extra - on average, compared to usual care
A lifesaving package including early detection and bundled treatment for women who have heavy bleeding during childbirth has been found to incur minimal additional cost according to new analysis from 78 hospitals around the world.
In a paper published in Nature Medicine today, a team of researchers working on the E-MOTIVE trial conducted an economic analysis to establish whether a package of interventions to objectively identify and treat post-partum haemorrhage (PPH) was cost effective.
Over 200,000 women from hospitals across four countries in Africa were included in the economic analysis of E-MOTIVE, with hospitals being randomly assigned to either the intervention or usual care groups. The intervention resulted in more than 1000 fewer PPH cases compared to the usual care group. The additional cost for E-MOTIVE was estimated to be, on average, an extra $0.30 per patient after adjustments for clinical factors including the proportion of patients with a clinical primary outcome event at each hospital, as well as for cluster and time-period considerations. .
The economic analysis explored a range of costs for a key component of the E-MOTIVE package which is a calibrated blood collection drape, used for all women in the intervention group used to objectively measure blood loss. The analysis found that when the cost of the drape is around 1 USD, the average cost per patient could be comparable to usual care.
Tracy Roberts, Professor of Health Economics at the University of Birmingham and corresponding author of the study said:
“E-MOTIVE is clearly a cost-effective intervention for what is a lifesaving treatment for thousands of women around the world who may experience severe bleeding in childbirth. Our analysis of the E-MOTIVE trial shows that the costs incurred in delivering the package of treatments and the drape are on average minimal and represent really good value for money”.
“The drape forms a key part of the E-MOTIVE package, and should E-MOTIVE be widely adopted and the cost of drapes reduced to below $1, the economic benefits could be even more apparent. The cost of delivering the E-MOTIVE intervention could then be, on average, equivalent to usual care, which would represent a significant health benefit for women around the world.”
60% reduction in heavy bleeding
E-MOTIVE being found cost-effective comes after the publication of a landmark study published that found a 60% reduction in heavy bleeding for women experiencing PPH.
Postpartum haemorrhage (PPH) - defined as the loss of more than 500 mL of blood within 24 hours after birth - is the leading cause of maternal mortality worldwide. It affects an estimated 14 million women each year and results in around 70 000 deaths – mostly in low and middle-income countries - equivalent to 1 death every 6 minutes.
The study found that objectively measuring blood loss using a simple, low-cost collection device called a ‘drape’ and bundling together WHO-recommended treatments - rather than offering them sequentially - resulted in dramatic improvements in outcomes for women. Severe bleeding – when a woman loses more than a litre of blood after birth - was reduced by 60%, and they were less likely to lose their life.
There was also a substantial reduction in the rate of blood transfusions for bleeding, which is of particular importance in low-income countries where blood is a scarce and expensive resource.
Professor Arri Coomarasamy, who led the E-MOTIVE trial and is the Co-Director of the WHO Collaborating Centre on Global Women’s Health at the University of Birmingham said:
“This new approach to treating postpartum haemorrhage could radically improve women’s chances of surviving childbirth globally, helping them get the treatment they need when they need it.
“Time is of the essence when responding to postpartum bleeding, so interventions that eliminate delays in diagnosis or treatment should be gamechangers for maternal health. With this latest study showing that E-MOTIVE is extremely cost effective, and following WHO recommending the treatment bundle we hope that the intervention can quickly become the standard of care that will save many lives around the world.
JOURNAL
Nature Medicine
METHOD OF RESEARCH
Data/statistical analysis
SUBJECT OF RESEARCH
Not applicable
ARTICLE TITLE
A cost-effectiveness analysis of early detection and bundled treatment of postpartum hemorrhage alongside the E-MOTIVE trial
ARTICLE PUBLICATION DATE
6-Jun-2024
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