Altered Amniotic Fluid Levels of Hyaluronic Acid in Fetal Rats with Myelomeningocele: Understanding Spinal Cord Injury

JOURNAL OF NEUROTRAUMA, 2019 · DOI: 10.1089/neu.2018.5894 · Published: June 15, 2019

Simple Explanation

Myelomeningocele (MMC) is a birth defect where the spinal cord is exposed to the intrauterine environment, leading to spinal cord injury. The study investigates whether the concentration of hyaluronic acid (HA) in amniotic fluid (AF) differs between fetuses with MMC and normal controls, and if these differences affect AF viscosity. The researchers found that at embryonic days 18 and 20, HA concentrations in AF were similar in both MMC and normal fetuses. However, by embryonic day 21, normal fetuses showed a significant increase in HA concentration, while MMC fetuses did not. This resulted in significantly lower HA concentrations and viscosity in the AF of MMC fetuses at E21. The study suggests that a deficiency in HA levels and reduced viscosity in the amniotic fluid of fetal rats with MMC could exacerbate spinal cord damage due to mechanical trauma at the lesion site.

Study Duration

Not specified

Participants

168 MMC fetal rats and 122 normal fetal rats

Evidence Level

Not specified

Key Findings

1
No significant difference in HA concentration was observed between MMC-AF and Norm-AF at E18 and E20.
2
The HA concentration significantly increased in Norm-AF samples from E20 to E21, but not in MMC-AF samples.
3
The concentration of HA in MMC-AF and the viscosity of MMC-AF were significantly lower at E21 compared with Norm-AF.

Research Summary

This study investigates hyaluronic acid (HA) levels in the amniotic fluid (AF) of fetal rats with myelomeningocele (MMC). It compares HA concentrations in MMC-AF to normal control AF (Norm-AF) at different embryonic stages to determine if differences exist and affect AF viscosity. The findings reveal that while HA levels are similar in both groups at early stages (E18, E20), Norm-AF shows a significant increase in HA by E21, which is not observed in MMC-AF. This results in lower HA concentration and viscosity in MMC-AF compared to Norm-AF at E21. The study concludes that a deficiency in HA and reduced AF viscosity in MMC fetuses may contribute to the exacerbation of spinal cord damage due to mechanical trauma, providing a basis for future research into MMC pathogenesis and potential therapeutic strategies involving HA supplementation.

Practical Implications

Therapeutic Potential of HA Supplementation

Supplementing amniotic fluid with HA could mitigate secondary spinal cord injury in MMC fetuses by increasing AF viscosity and reducing mechanical trauma.

Improved Prenatal Strategies

Understanding the role of HA in MMC pathogenesis can aid the development of improved prenatal strategies for enhancing regeneration and protecting the spinal cord.

Targeted Therapies

Focusing on HA levels and the extracellular matrix in the fetal environment may lead to targeted therapies for MMC repair.

Study Limitations

1
The study is based on a retinoic acid-induced rat model of MMC, which may not fully replicate the complexities of human MMC.
2
The exact mechanisms by which reduced HA levels contribute to spinal cord damage are not fully elucidated.
3
The study focuses primarily on HA and viscosity, without fully exploring other potential contributing factors in the amniotic fluid.

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