Identification de dérèglements épigénétiques embryonnaires associés à une exposition prénatale à l’alcool pendant la période préimplantatoire

Il est connu qu’une exposition prénatale à l’alcool (EPA) peut entrainer des dérégulations épigénétiques dans les cellules du cerveau en développement et être responsable de certains phénotypes du Trouble du Spectre de l’Alcoolémie Fœtale (TSAF) comme les troubles neurodéveloppementaux (TND). Les conséquences d’une EPA très tôt dans le développement sur le paysage épigénétique embryonnaire et extra-embryonnaire sont toutefois peu connues. Notre hypothèse est qu’une EPA durant la période préimplantatoire va initier des dérèglements des profils de méthylation d’ADN qui seront amplifiés et perpétués au cours du développement. Ces dérèglements seront visibles dans le cerveau et le placenta des embryons plus tard dans la gestation. Nous avons développé un modèle murin d’EPA en injectant avec de l’éthanol (EtOH) ou de la saline (Ctrl) des femelles souris gestantes au jour embryonnaire 2.5 (E2.5) soit au stade 8-cellules. Des embryons et placentas furent récoltés aux jours E10.5 et E18.5. Un système d’évaluation morphologique a permis de montrer une augmentation significative des anomalies visibles des embryons EtOH. Les profils de méthylation d’ADN ont par la suite été établis par Reduced Representation Bisulfite Sequencing sur 8 échantillons contrôles et 12 échantillons EtOH de cerveaux antérieurs et de placentas au stade E10.5. Des analyses bio-informatiques ont démontré 686 et 2942 régions différentiellement méthylées (DMTs) respectivement dans le cerveau antérieur et le placenta. Nous avons aussi trouvé 21 DMTs communément affectés dans chacun des tissus. Étonnamment, nous avons aussi observé des différences spécifiques aux sexes dans la dérégulation de profils de méthylation en réponse à l’EPA. Notre étude montre, pour la première fois, qu’une EPA très tôt dans le développement embryonnaire entraine des dérégulations de la méthylation d’ADN perceptibles plus tard dans le développement. Ces résultats nous en apprennent davantage sur comment les perturbations épigénétiques peuvent altérer le fonctionnement normal du cerveau et mener à des TNDs chez les enfants atteints du TSAF.Prenatal alcohol exposure (PAE) is known to altered epigenetic profiles in cells during brain development and be part of the molecular basis underpinning Fetal Alcohol Spectrum Disorders (FASD) etiology. However, the consequences of a PAE during very early embryonic life on the future epigenetic landscape of embryonic and extraembryonic tissues remain unknown. Our research hypothesis is that a PAE during preimplantation will initiate DNA methylation dysregulation that will later be observable in the developing conceptus. We believe that these original epigenetic alterations will be perpetuated and amplified in the developing brain as well as in the placental tissue. To test this, we instigated FASD in mouse 8-cell embryos by injecting ethanol at 2.5 days of pregnancy (E2.5). We collected FASD (ethanol) and control (saline) E10.5 and E18.5 embryos and placentas. Dissection scoring showed an increase in morphological abnormalities in EtOH embryos of both stages. We then established genome-wide quantitative DNA methylation profiles of forebrains and placentas of E10.5 embryos by Reduced Representation Bisulfite Sequencing. Bioinformatic analyses of FASD samples (n=12) vs controls samples (n=8) revealed 686 and 2942 differentially methylated tiles (DMTs) in forebrain and placenta samples respectively. Unexpectedly, we highlighted sex-specific DNA methylation perturbations and gene expression pattern in response to ethanol exposure. Interestingly, we also uncovered 21 specific regions abnormally methylated in both FASD forebrain and placenta samples. Our study establishes for the first time that early embryonic PAE can cause epigenetic dysregulations that leads to permanent alteration in the future epigenetic program of brain and placenta cells and that some of these dysregulations are sex-specific. Altogether, our results allow us to have a better understanding of how epigenetic perturbations can alter the normal function of the brain and lead to neurodevelopmental disorders present in children with FASD

Exposition à l'alcool pendant la période préimplantatoire : conséquences sur l'épigénome et le développement embryonnaire

Une exposition prénatale à l’alcool peut altérer le développement embryonnaire et causer le Trouble du Spectre de l’Alcoolisation Fœtale (TSAF). Les mécanismes moléculaires menant aux symptômes observés chez les enfants atteints sont toutefois méconnus. Plus encore, bien que les taux de consommation excessive d’alcool (binge-drinking) et de grossesses non-planifiées soient en hausse à travers le monde, les impacts d’une exposition prénatale à l’alcool pendant la préimplantation de l’embryon, sont inconnus et peu étudiés. Dans cette thèse, je souhaitais caractériser les impacts morphologiques d’une exposition à l’alcool pendant la préimplantation sur l’embryon en développement. De plus, je voulais définir les mécanismes moléculaires impliqués dans le cerveau antérieur ainsi que dans le placenta embryonnaire, en plus d’évaluer l’effet d’une exposition à l’alcool pendant la préimplantation sur certaines fonctions cognitives au stade post-natal. Notre hypothèse de recherche est qu’une exposition à l’alcool de type aigu pendant la préimplantation entrainera des erreurs dans l’établissement du programme épigénétique embryonnaire, causant des altérations dans les profils de méthylation d’ADN et d’expression des gènes chez l’embryon et son placenta qui persisteront tout au long de la gestation. Plus encore, nous croyons que ces dérégulations moléculaires altèreront les fonctions cognitives à long terme chez les souriceaux exposés. Pour répondre à ces questions, nous avons établi un modèle murin d’exposition à l’alcool de type aigu pendant la préimplantation en injectant des femelles gestantes au jour embryonnaire 2.5 (E2.5), correspondant au stade 8-cellules, avec deux doses de 2.5g/kg d’alcool séparées par 2 heures d’intervalle. Nous avons récolté des embryons à mi-gestation (E10.5), évaluer la morphologie puis nous avons isolé le cerveau antérieur pour étudier la méthylation d’ADN et l’expression génique. Nous avons aussi récolté des embryons en fin de gestation (E18.5) et leur placenta pour procéder à des analyses de méthylation d’ADN et de l’expression génique, en plus d’effectuer des analyses histologiques des placentas. Finalement, nous avons aussi laissé naître des souris issues de notre modèle d’exposition à l’alcool pendant la préimplantation pour évaluer certaines fonctions cognitives, notamment l’anxiété, la sociabilité et la mémoire, en procédant à des tests de comportement. Nous avons d’abord observé une augmentation des anomalies morphologiques chez l’embryon à mi-gestation à la suite de l’exposition prénatale à l’alcool. Nous avons aussi découvert que l’exposition prénatale, pendant la préimplantation, engendrait des différences de méthylation d’ADN dans le cerveau antérieur à mi-gestation et en fin de gestation, dans plusieurs voies biologiques reliées au développement embryonnaire et au fonctionnement du système nerveux. La plupart des régions différentiellement méthylées (DMRs) et des gènes différentiellement exprimés (DEGs) étaient spécifiques à chaque sexe, avec peu de régions partagées entre les mâles et les femelles. Nous avons aussi identifié des DMRs et DEGs spécifiques à chaque sexe ou partagés entre les deux sexes, dans les placentas en fin de gestation en plus de démontrer une baisse du poids fœtal chez les embryons mâles exposés à l’alcool. Enfin, nous avons démontré que l’exposition prénatale pendant la préimplantation causait une baisse de la sociabilité et de la mémoire à court-terme, sans avoir d’effet sur le niveau d’anxiété des souris En conclusion, nous avons démontré qu’une exposition prénatale à l’alcool en tout début de grossesse affecte le développement embryonnaire, via l’épigénome et le transcriptome du cerveau antérieur et du placenta, et entraine des conséquences à plus long terme sur les fonctions cognitives. En perspective, nous souhaitons établir les profils de méthylation d’ADN et d’expression génique précisément dans certains sous-types cellulaires du cerveau, dont les interneurones GABAergiques afin de mieux définir les mécanismes moléculaires derrière les altérations observées.Prenatal alcohol exposure can alter embryonic development and lead to Fetal Alcohol Spectrum Disorder (FASD). However, the molecular mechanisms underlying the symptoms in affected children remain poorly understood. Furthermore, despite the increasing rates of binge drinking and unplanned pregnancies worldwide, the impacts of prenatal alcohol exposure during the preimplantation stage of embryonic development are largely unknown and understudied. In this thesis I aimed to characterize the morphological effects of alcohol exposure during preimplantation on developing embryos. Additionally, we sought to define the extent of DNA methylation defects and gene expression in the anterior brain and embryonic placenta. Furthermore, we aimed to evaluate the effects of our preimplantation alcohol exposure on certain cognitive functions in the postnatal stage. Our research hypothesis is that acute alcohol exposure during preimplantation will lead to errors in establishing the embryonic epigenetic program, causing alterations in DNA methylation profiles and gene expression in both the embryo and its placenta, persisting throughout gestation. We also believed that these molecular dysregulations would result in long-term cognitive impairments in exposed pups. To address these questions, we established a preclinical mouse model of acute alcohol exposure during preimplantation by injecting pregnant females on embryonic day 2.5 (E2.5), corresponding to the 8-cell stage, with two doses of 2.5g/kg of alcohol, separated by a 2-hour interval. We collected embryos at mid-gestation (E10.5), assessed for morphological defects and isolated the forebrain for DNA methylation and gene expression studies. We also collected embryos at late gestation (E18.5) along with their placenta for DNA methylation and gene expression analyses, as well as histological examinations of fixed placentas. Finally, we allowed mice from our preimplantation alcohol exposure model to be born and assessed specific cognitive functions such as anxiety, sociability, and memory through behavioral tests. First, we observed an increase in morphological anomalies in mid-gestation embryos following prenatal alcohol exposure and discovered that prenatal exposure during preimplantation led to DNA methylation differences in the forebrain at mid-gestation and late gestation, affecting various biological pathways related to embryonic development and nervous system function. Most of the differentially methylated regions (DMRs) and differentially expressed genes (DEGs) were sex-specific, with only few regions shared between males and females. We also identified sex-specific and shared DMRs and DEGs in late gestational placentas. Additionally, we demonstrated a decrease in fetal weight in male embryos and showed that preimplantation alcohol exposure caused reduced sociability and short-term memory without affecting the anxiety levels of the mice. In conclusion, we have shown that early preimplantation alcohol exposure affects embryonic development through the epigenome and transcriptome of the anterior brain and placenta, leading to long-term cognitive consequences. Moving forward, we intend to establish DNA methylation and gene expression profiles specifically in certain brain cell subtypes, including GABAergic interneurons, to better define the molecular mechanisms underlying the observed alterations

Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19

Introduction: Cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is a severe disease with high mortality. There are few data on sex differences in CVST-VITT. The aim of our study was to investigate the differences in presentation, treatment, clinical course, complications, and outcome of CVST-VITT between women and men. Patients and methods: We used data from an ongoing international registry on CVST-VITT. VITT was diagnosed according to the Pavord criteria. We compared the characteristics of CVST-VITT in women and men. Results: Of 133 patients with possible, probable, or definite CVST-VITT, 102 (77%) were women. Women were slightly younger [median age 42 (IQR 28–54) vs 45 (28–56)], presented more often with coma (26% vs 10%) and had a lower platelet count at presentation [median (IQR) 50x109/L (28–79) vs 68 (30–125)] than men. The nadir platelet count was lower in women [median (IQR) 34 (19–62) vs 53 (20–92)]. More women received endovascular treatment than men (15% vs 6%). Rates of treatment with intravenous immunoglobulins were similar (63% vs 66%), as were new venous thromboembolic events (14% vs 14%) and major bleeding complications (30% vs 20%). Rates of good functional outcome (modified Rankin Scale 0-2, 42% vs 45%) and in-hospital death (39% vs 41%) did not differ. Discussion and conclusions: Three quarters of CVST-VITT patients in this study were women. Women were more severely affected at presentation, but clinical course and outcome did not differ between women and men. VITT-specific treatments were overall similar, but more women received endovascular treatment.</p

Preimplantation alcohol exposure and developmental programming of FASD: An epigenetic perspective.

Alcohol exposure during in utero development can permanently change the developmental programming of physiological responses, thereby increasing the risk of childhood neurological illnesses and later adverse health outcomes associated with fetal alcohol spectrum disorders (FASD). There is an increasing body of evidence indicating that alcohol exposure during gestation triggers lasting epigenetic alterations in offspring long after the initial insult; together, these studies support the role of epigenetics in FASD etiology. However, we still have little information about how ethanol interferes with the fundamental epigenetic reprogramming wave (e.g., erasure and re-establishment of DNA methylation marks) that characterizes preimplantation embryo development. This article will review key epigenetic processes occurring during preimplantation development and especially focus on the current knowledge regarding how a prenatal alcohol exposure during this period could affect the developmental programming of the early stage preimplantation embryo. We will also outline current limitations of studies examining the in vivo and in vitro effects of alcohol exposure on embryos as well as underline the next critical steps to be taken if we want to better understand the implicated mechanisms in order to strengthen the translational potential for non-invasive epigenetic diagnosis markers and the treatment of newborns that have higher risks of developing FASD.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Molecular Signature of CAID Syndrome: Noncanonical Roles of SGO1 in Regulation of TGF-β Signaling and EpigenomicsSummary

Background & Aims: A generalized human pacemaking syndrome, chronic atrial and intestinal dysrhythmia (CAID) (OMIM 616201), is caused by a homozygous SGO1 mutation (K23E), leading to chronic intestinal pseudo-obstruction and arrhythmias. Because CAID patients do not show phenotypes consistent with perturbation of known roles of SGO1, we hypothesized that noncanonical roles of SGO1 drive the clinical manifestations observed. Methods: To identify a molecular signature for CAID syndrome, we achieved unbiased screens in cell lines and gut tissues from CAID patients vs wild-type controls. We performed RNA sequencing along with stable isotope labeling with amino acids in cell culture. In addition, we determined the genome-wide DNA methylation and chromatin accessibility signatures using reduced representative bisulfite sequencing and assay for transposase-accessible chromatin with high-throughput sequencing. Functional studies included patch-clamp, quantitation of transforming growth factor-β (TGF-β) signaling, and immunohistochemistry in CAID patient gut biopsy specimens. Results: Proteome and transcriptome studies converge on cell-cycle regulation, cardiac conduction, and smooth muscle regulation as drivers of CAID syndrome. Specifically, the inward rectifier current, an important regulator of cellular function, was disrupted. Immunohistochemistry confirmed overexpression of Budding Uninhibited By Benzimidazoles 1 (BUB1) in patients, implicating the TGF-β pathway in CAID pathogenesis. Canonical TGF-β signaling was up-regulated and uncoupled from noncanonical signaling in CAID patients. Reduced representative bisulfite sequencing and assay for transposase-accessible chromatin with high-throughput sequencing experiments showed significant changes of chromatin states in CAID, pointing to epigenetic regulation as a possible pathologic mechanism. Conclusions: Our findings point to impaired inward rectifier potassium current, dysregulation of canonical TGF-β signaling, and epigenetic regulation as potential drivers of intestinal and cardiac manifestations of CAID syndrome. Transcript profiling and genomics data are as follows: repository URL: https://www.ncbi.nlm.nih.gov/geo; SuperSeries GSE110612 was composed of the following subseries: GSE110309, GSE110576, and GSE110601. Keywords: CAID Syndrome (Chronic Atrial and Intestinal Dysrhythmia), Chronic Intestinal Pseudo-obstruction, TGF-β Signaling, Epigenetic

Characteristics and Outcomes of Patients with Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia

Importance: Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). Objective: To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. Design, Setting, and Participants: This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. Exposures: Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. Main Outcomes and Measures: Clinical characteristics and mortality rate. Results: Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI, 2.0-7.4), respectively. The mortality rate was 61% (14 of 23) among patients in the TTS group diagnosed before the condition garnered attention in the scientific community and 42% (22 of 53) among patients diagnosed later. Conclusions and Relevance: In this cohort study of patients with CVST, a distinct clinical profile and high mortality rate was observed in patients meeting criteria for TTS after SARS-CoV-2 vaccination