孕期糖皮质激素暴露所致子代长骨发育异常研究进展

Research progress of long bone dysplasiacaused by glucocorticoid exposure during pregnancy

胎儿长骨发育的主要形式为软骨内成骨。近年来研究表明,孕期母体因不良环境暴露产生的高水平内源性糖皮质激素(glucocorticoid,GC)及因早产而使用的人工合成类GC可通过胎盘进入胎儿体内,引起胎儿血GC水平升高,导致宫内发育迟缓并影响胎儿软骨内成骨。这种影响可进一步延续至出生后甚至老年,导致子代骨质疏松症易感且具有可遗传性。该综述概述了当前孕妇GC暴露现状,总结宫内GC暴露对子代长骨发育的近期影响和远期危害,并阐述可能的宫内内分泌编程机制,为防治孕期GC暴露所致胎源性长骨疾病,探索发育源性疾病未来研究方向奠定理论基础。

The main form of fetal long bone development is endochondral ossification.In recent years,studies have shown that the mother during pregnancy with bad environmental exposure to high levels of endogenous glucocorticoid(GC)and premature use of artificial synthetic GC can go through the placenta into the fetal body,cause fetal blood GC levels,leading to intrauterine retardation,and affect fetal cartilage ossification.This effect can extend beyond birth and even into old age,leading to susceptibility and heritability of osteoporosis in offsprings.This review summarizes the current status of glucocorticoid exposure during pregnancy,summarizes the short-term and long-term effects of intrauterine GC exposure on long bone development in offsprings,and explains the possible mechanism of intrauterine endocrine programming,which lays a theoretical foundation for the prevention and treatment of fetal bone diseases caused by GC exposure during pregnancy and the future research direction of developmental diseases.