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Published on: June 29, 2013
Phosphodiesterase Inhibitors in Fetal Growth Restriction: Do Not Forget to Consider Fetal Sex and Subcellular
Anne-Christine Peyter1, David Baud2, Jean-François Tolsa3
1Neonatal Research Laboratory, Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.
Insights
Fetal growth restriction (FGR) management requires considering fetal sex and umbilical vessel differences. This approach may improve phosphodiesterase (PDE) inhibitor effectiveness for better fetal circulation.
Area of Science:
- Perinatal medicine
- Developmental biology
- Pharmacology
Background:
- Fetal growth restriction (FGR) is a significant pregnancy complication with long-term health risks.
- Current treatments for FGR are ineffective, necessitating novel therapeutic strategies.
- Phosphodiesterase (PDE) inhibitors show potential for FGR management but yield inconsistent results.
Purpose of the Study:
- To highlight the importance of biological sex and umbilical vessel characteristics in FGR.
- To propose a refined approach for using PDE inhibitors in FGR therapy.
- To address the variability in PDE inhibitor efficacy for improving fetal circulation.
Main Methods:
- Review of existing literature on FGR and PDE inhibitors.
- Analysis of factors influencing human umbilical circulation.
- Consideration of subcellular mechanisms in therapeutic response.
Main Results:
- Fetal sex and umbilical vessel (vein vs. artery) reactivity are critical factors.
- Subcellular compartmentation may be influenced by sex, vessel type, and FGR.
- These factors can impact the efficacy of PDE inhibitors.
Conclusions:
- Therapeutic strategies for FGR must account for biological sex and umbilical vessel differences.
- Optimizing PDE inhibitor use requires understanding these biological variations.
- Further research is needed to personalize FGR treatment for improved outcomes.
Abstract:
Fetal growth restriction (FGR) is a common complication of pregnancy, associated with major perinatal mortality and morbidity, and with an increased risk to develop cardiometabolic diseases later in life. There is currently no effective approach to prevent or treat FGR, despite numerous animal and human studies assessing substances likely to improve fetal growth. Phosphodiesterase (PDE) inhibitors appeared as promising drugs to improve FGR management. However, to date, studies have led to somewhat disappointing or controversial results. In this Opinion article, we would like to draw attention to the need to consider the biological sex and the relative reactivity of human umbilical vein and arteries when developing therapeutic interventions to improve human umbilical circulation using PDE inhibitors. Indeed, we suspect that fetal sex, vessel type and the presence of FGR may influence subcellular compartmentation, which could jeopardize beneficial effects of PDE inhibitors.
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