Early Pregnancy Loss (EPL) is the
medical term for miscarriage or abortion within the sixth week of conception.
Although chromosomal abnormality in the embryo, endocrine diseases in the
mother, immunologic factors or even environmental influences may cause EPL,
scientists are not sure of the molecular mechanism except for the fact that DNA
methylation is involved in the process.
DNA methylation is a biochemical
process which involves the addition of a methyl group to cytosine of the DNA. This
process is critical to fertilization of the embryo and the normal development
of the fetus.
DNA methylation is
initiated by a group of enzymes called the DNA methyltransferase (DNMT)
most importantly DNMT1, DNMT2, and DNMT3. Earlier researches showed that if the
DNMTs do not function properly, they could jeopardize embryonic development and
subsequent gestation in experimental animals.
So, to find out whether dysfunction of DNMTs is associated
with EPL in humans, Li-Jun Yin from the School of Medicine, Zhejiang University,
China, and colleagues, conducted a study to evaluate the role of DNA
methylation in early pregnancy loss.
They collected tissues, villous (which is of fetal origin
and eventually forms the placenta) and decidual (which is the lining of the
uterus which is shed following delivery), from the uterus of the patients with
EPL and from the women who were terminating pregnancy in the first-trimester for
non-medical reasons. Tissues were snap-frozen in liquid nitrogen and stored at
-80 degree C for Western blot analysis or fixed in paraformaldehyde for
immunohistochemistry (to diagnose abnormal cells by detecting antigens in
tissue section through right antibodies).
They also obtained embryos and tissues from 6 to 7
week-old female mice by breeding them and then collecting the samples on day 4
by flushing mouse uteri.
EPL was diagnosed based on the presence of vaginal bleeding and
/or lower abdominal pain, together with the findings of pelvic and ultrasonic
Results showed that -
DNMT1 was significantly down-regulated in the villous of women
with EPL, but not in the decidua.
DNMT3A expression was not significantly changed in the EPL group
compared to the control group.
inhibitor disturbed methylation resulting in a decreased global DNA methylation
level and impaired embryonic development in the mice. It also inhibited embryo
attachment to the uterus.
So, the researchers inferred that 'insufficient embryonic
maintenance methylation is associated with abnormal embryonic development in
human early pregnancy loss.'
During embryo implantation and development, DNA methylation
undergoes dramatic reprogramming that is crucial for the development of the
embryo as well as the development of endometrium or the inner lining of the
uterus. So, inhibited maintenance methylation could be the cause of unexplained
abnormal fetal development in early pregnancy loss.
The researchers concluded - 'Defects in DNA methylation
maintenance were demonstrated in the villous of human EPL tissues. Inhibition
of DNA methylation maintenance led to a decreased implantation rate of embryos,
increased fetal absorption, and poor fetal and placental development'.
Yin LJ, Zhang Y, Lv PP, He WH, Wu YT, Liu AX, Ding
GL, Qu F, Xu CM, Dong MY, Zhu XM, Huang HF. Insufficient maintenance DNA
methylation is associated with abnormal embryonic development. BMC Med. 2012
Mar 13;10(1):26. http://www.biomedcentral.com/content/pdf/1741-7015-10-26.pdf