Quantitative Analysis of the Human Semen Phosphorometabolome by 31P-NMR.

Phosphorus-containing metabolites occupy a prominent position in cell pathways. The phosphorometabolomic approach in human sperm samples will deliver valuable information as new male fertility biomarkers could emerge. This study analyzed, by 31P-NMR, seminal plasma and whole semen from asthenozoospermic and normozoospermic samples (71% vs. 27% and 45% vs. 17%, total and progressive sperm motility, respectively), and also ejaculates from healthy donors. At least 16 phosphorus-containing metabolites involved in central energy metabolism and phospholipid, nucleotide, and nicotinamide metabolic pathways were assigned and different abundances between the samples with distinct sperm quality was detected. Specifically, higher levels of phosphocholine, glucose-1-phosphate, and to a lesser degree, acetyl phosphate were found in the asthenozoospermic seminal plasma. Notably, the phosphorometabolites implicated in lipid metabolism were highlighted in the seminal plasma, while those associated with carbohydrate metabolism were more abundant in the spermatozoa. Higher levels of phosphocholine, glucose-1-phosphate, and acetyl phosphate in the seminal plasma with poor quality suggest their crucial role in supporting sperm motility through energy metabolic pathways. In the seminal plasma, phosphorometabolites related to lipid metabolism were prominent; however, spermatozoa metabolism is more dependent on carbohydrate-related energy pathways. Understanding the presence and function of sperm phosphorylated metabolites will enhance our knowledge of the metabolic profile of healthy human sperm, improving assessment and differential diagnosis.

Bisphenol S Reduces Pig Spermatozoa Motility through Different Intracellular Pathways and Mechanisms than Its Analog Bisphenol A.

Bisphenol A (BPA: 2,3-bis (4-hydroxyphenyl) propane) is an environmental chemical widely used in the manufacturing of epoxy polymers and many thermoplastic consumer products. Serious concerns about its safety led to the development of analogs, such as BPS (4-hydroxyphenyl sulfone). Very limited studies about BPS's impact on reproduction, specifically in spermatozoa, exist in comparison with BPA. Therefore, this work aims to study the in vitro impact of BPS in pig spermatozoa in comparison with BPA, focusing on sperm motility, intracellular signaling pathways and functional sperm parameters. We have used porcine spermatozoa as an optimal and validated in vitro cell model to investigate sperm toxicity. Pig spermatozoa were exposed to 1 and 100 µM BPS or BPA for 3 and 20 h. Both bisphenol S and A (100 µM) significantly reduce pig sperm motility in a time-dependent manner, although BPS exerts a lower and slower effect than BPA. Moreover, BPS (100 µM, 20 h) causes a significant increase in the mitochondrial reactive species, whereas it does not affect sperm viability, mitochondrial membrane potential, cell reactive oxygen species, GSK3α/ß phosphorylation or phosphorylation of PKA substrates. However, BPA (100 µM, 20 h) leads to a decrease in sperm viability, mitochondrial membrane potential, GSK3ß phosphorylation and PKA phosphorylation, also causing an increase in cell reactive oxygen species and mitochondrial reactive species. These intracellular effects and signaling pathways inhibited might contribute to explaining the BPA-triggered reduction in pig sperm motility. However, the intracellular pathways and mechanisms triggered by BPS are different, and the BPS-caused reduction in motility can be only partially attributed to an increase in mitochondrial oxidant species.

Molecular Mechanisms Involved in the Impairment of Boar Sperm Motility by Peroxynitrite-Induced Nitrosative Stress.

Excessive levels of reactive nitrogen species (RNS) produce nitrosative stress. Among RNS is peroxynitrite, a highly reactive free radical generated when nitric oxide reacts with superoxide anion. Peroxynitrite effects have been mainly studied in somatic cells, and in spermatozoa the majority of studies are focused in humans. The aim of this study is to investigate the in vitro peroxynitrite effect on boar spermatozoa functions and the molecular mechanisms involved. Spermatozoa were exposed to the donor 3-morpholinosydnonimine (SIN-1) in non-capacitating or capacitating medium, motility was evaluated by CASA, functional parameters by flow cytometry and sperm protein phosphorylation by Western blotting. SIN-1 treatment, that significantly increases peroxynitrite levels in boar spermatozoa, potentiates the capacitating-stimulated phosphorylation of cAMP-dependent protein kinase 1 (PKA) substrates and GSK-3α. SIN-1 induced peroxynitrite does not decrease sperm viability, but significantly reduces sperm motility, progressive motility, velocities and motility coefficients. Concomitantly, peroxynitrite does not affect mitochondrial membrane potential, plasma membrane fluidity, or A23187-induced acrosome reaction. However, peroxynitrite significantly increases sperm lipid peroxidation in both media. In conclusion, peroxynitrite compromises boar sperm motility without affecting mitochondrial activity. Although peroxynitrite potentiates the phosphorylation of pathways leading to sperm motility, it also causes oxidative stress that might explain, at least partially, the motility impairment.

Nucleosomal signatures impose nucleosome positioning in coding and noncoding sequences in the genome.

In the yeast genome, a large proportion of nucleosomes occupy well-defined and stable positions. While the contribution of chromatin remodelers and DNA binding proteins to maintain this organization is well established, the relevance of the DNA sequence to nucleosome positioning in the genome remains controversial. Through quantitative analysis of nucleosome positioning, we show that sequence changes distort the nucleosomal pattern at the level of individual nucleosomes in three species of Schizosaccharomyces and in Saccharomyces cerevisiae This effect is equally detected in transcribed and nontranscribed regions, suggesting the existence of sequence elements that contribute to positioning. To identify such elements, we incorporated information from nucleosomal signatures into artificial synthetic DNA molecules and found that they generated regular nucleosomal arrays indistinguishable from those of endogenous sequences. Strikingly, this information is species-specific and can be combined with coding information through the use of synonymous codons such that genes from one species can be engineered to adopt the nucleosomal organization of another. These findings open the possibility of designing coding and noncoding DNA molecules capable of directing their own nucleosomal organization.

Nucleosomal organization of replication origins and meiotic recombination hotspots in fission yeast.

In Schizosaccharomyces pombe, DNA replication origins (ORIs) and meiotic recombination hotspots lack consensus sequences and show a bias towards mapping to large intergenic regions (IGRs). To explore whether this preference depended on underlying chromatin features, we have generated genome-wide nucleosome profiles during mitosis and meiosis. We have found that meiotic double-strand break sites (DSBs) colocalize with nucleosome-depleted regions (NDRs) and that large IGRs include clusters of NDRs that overlap with almost half of all DSBs. By contrast, ORIs do not colocalize with NDRs and they are regulated independently of DSBs. Physical relocation of NDRs at ectopic loci or modification of their genomic distribution during meiosis was paralleled by the generation of new DSB sites. Over 80% of all meiotic DSBs colocalize with NDRs that are also present during mitosis, indicating that the recombination pattern is largely dependent on constitutive properties of the genome and, to a lesser extent, on the transcriptional profile during meiosis. The organization of ORIs and of DSBs regions in S. pombe reveals similarities and differences relative to Saccharomyces cerevisiae.

Sperm Phosphoproteome: Unraveling Male Infertility.

Infertility affects approximately 15% of couples worldwide of childbearing age, and in many cases the etiology of male infertility is unknown. The current standard evaluation of semen is insufficient to establish an accurate diagnosis. Proteomics techniques, such as phosphoproteomics, applied in this field are a powerful tool to understand the mechanisms that regulate sperm functions such as motility, which is essential for successful fertilization. Among the post-translational modifications of sperm proteins, this review summarizes, from a proteomic perspective, the updated knowledge of protein phosphorylation, in human spermatozoa, as a relevant molecular mechanism involved in the regulation of sperm physiology. Specifically, the role of sperm protein phosphorylation in motility and, consequently, in sperm quality is highlighted. Additionally, through the analysis of published comparative phosphoproteomic studies, some candidate human sperm phosphoproteins associated with low sperm motility are proposed. Despite the remarkable advances in phosphoproteomics technologies, the relatively low number of studies performed in human spermatozoa suggests that phosphoproteomics has not been applied to its full potential in studying male infertility yet. Therefore, further studies will improve the application of this procedure and overcome the limitations, increasing the understanding of regulatory mechanisms underlying protein phosphorylation in sperm motility and, consequently, in male fertility.

The adverse impact of herbicide Roundup Ultra Plus in human spermatozoa plasma membrane is caused by its surfactant.

The scarce research about the worldwide used glyphosate-based herbicide Roundup is controversial in human reproduction, especially spermatozoa. This study investigates the in vitro effect in human spermatozoa of Roundup Ultra Plus (RUP), its active ingredient glyphosate and its non-active, surfactant. Human spermatozoa were incubated (1 h, 37 °C) in presence/absence of RUP 0.01%, glyphosate, or equivalent surfactant concentration. Motility and sperm parameters were analyzed by C.A.S.A and flow cytometry, respectively. RUP significantly increases sperm plasma membrane lipid disorganization in a concentration-dependent manner while it decreases plasma membrane integrity. RUP significantly increases the death spermatozoa population after A23187-induced acrosome reaction, without affecting sperm viability, mitochondrial membrane potential, ROS content, acrosome membrane damage, phosphatidylserine exposure, A23187-induced acrosome reaction or GSK3 phosphorylation. RUP also significantly decreases motile and the a + b sperm populations. Interestingly, all sperm effects caused by RUP 0.01% are mimicked by its surfactant POEA at equivalent concentration. However, glyphosate does not affect any sperm parameter, even using 10-times higher concentration than the RUP 0.01% equivalent. RUP disturbs lipid organization and integrity of human sperm plasma membrane and reduces motility, without affecting viability or functional parameters. Importantly, RUP adverse effects in human spermatozoa are caused by the surfactant and no by glyphosate.

Human sperm phosphoproteome reveals differential phosphoprotein signatures that regulate human sperm motility.

Human sperm motility is essential for fertilization and among pathologies underlying male infertility is asthenozoospermia. Nevertheless, mechanisms regulating sperm motility are not completely unraveled. This work investigates phosphoproteins underlying human sperm motility by using differential phosphoproteomic in two human sperm subpopulations: high (HM) and low (LM) motility, obtained by centrifugation in a density gradient. Phosphoproteomics (HPLC-MS/MS triple TOF), comparing human LM and HM phosphoproteomes, identified 210 phosphopeptides with different abundance that correspond with 119 sperm proteins. Analysis showed that 40% of phosphoproteins in LM spermatozoa are involved in metabolism, (catabolism, protein transport, lipid biosynthesis), 25% in spermatogenesis and sperm function, 8% in immune system and 6% in DNA repair. In HM spermatozoa, 48% of phosphoproteins are related to spermatogenesis and sperm function (motility), whereas 8% are associated to metabolism. GSK3α resulted one of the most abundant phosphoproteins in HM spermatozoa. Western blot confirmed that GSK3α phosphorylation is higher in HM spermatozoa. Summarizing, this study i) identified phosphoproteins in two human spermatozoa populations, ii) supports that human spermatozoa rely in protein phosphorylation, such as GSK3 α, to regulate sperm motility, iv) raises the challenge of using some identified human sperm phosphorylated proteins (GSK3α) as targets to develop into clinically relevant biomarkers. SIGNIFICANCE: Human sperm phosphoproteome analyzed by nano HPLC-MS/MS triple TOF identifies the differential abundance of sperm phosphoproteins in two human sperm populations exhibiting high motility (HM) and/or low motility (LM) that were isolated from normozoospermic healthy donors. Majority of human phosphoproteins found in LM spermatozoa are involved in sperm metabolism (40%), whereas those in HM spermatozoa are associated to spermatogenesis and sperm function, as motility (48%), and only 8% are associated to metabolism. One of the most abundant phosphoproteins found in HM spermatozoa is GSK3α, kinase directly involved in the regulation of sperm motility that was also validated by western blot. The biological relevance of this study is based in the fact that supports that mature human sperm cells rely in protein phosphorylation to efficiently regulate sperm motility and allows identifying those regulatory human sperm phosphoproteins. This work will clearly impacts the human reproductive field as it raises the challenge of consider identified human sperm phosphoproteins, such as GSK3α, as potential biological targets to develop into relevant biomarkers for the human clinic or assisted reproductive technology.

Hemoptysis as the first symptom in the diagnosis of metastatic choriocarcinoma in the third trimester of pregnancy: A case report.

INTRODUCTION: Choriocarcinoma is a rare neoplasm (1/40000 pregnancies). In the context of a viable pregnancy, the incidence is even lower (1/160000). CASE REPORT: A woman in her second pregnancy was admitted at 31 + 6 weeks of gestation with hemoptysis and abnormal vaginal bleeding. Numerous placental venous lakes, bilateral pulmonary nodules and a pleural effusion were found. Pleural fluid ß-HCG levels were elevated and a brain-chest-abdominal-pelvic CT scan led to the diagnosis of a high-risk gestational trophoblastic neoplasm. A caesarean section at 32 + 1 weeks of gestation was performed. Six cycles of an EMA-CO chemotherapy regime were administered. ß-HCG levels normalized after 3 cycles. Placental histopathology confirmed the presence of a gestational choriocarcinoma. CONCLUSION: Choriocarcinoma is a highly aggressive tumor. In high-risk tumors, combination chemotherapy is the first-line treatment, offering high remission rates. Treatment response is evaluated by monitoring blood ß-HCG levels, which should be long-term.

Delayed-interval delivery in twin pregnancies: report of three cases and literature review.

INTRODUCTION: Delayed delivery is sometimes performed in selected multifetal pregnancies when the first twin birth occurs inevitably. The aim of this procedure is to improve the prognosis and decrease the morbidity and mortality of the second twin. We report three cases of delayed-interval delivery of dichorionic-diamniotic twin pregnancies assisted in our center between 2015 and 2017. After the first twin delivery, the second twin was left in utero and the patient received tocolytic therapy and antibiotics. Cervical cerclage was not performed. RESULTS: Our patients were admitted between 21 + 3 and 23 + 6 weeks of gestation. We achieved an average interval delivery of 6.33 d. Four out of six twins did not survive the delayed interval procedure. The average stay of the first and second twins that were admitted to the neonatal intensive care unit (NICU) was of 72 d (28-116) and 39.5 d (12-67), respectively. The first twin birth was vaginal in all cases, while the second twin delivery was performed by cesarean section in two out of our three patients. Our neonatal results are not favorable, probably due to the extreme prematurity. CONCLUSIONS: Delayed delivery of the second twin before 28 weeks of gestation can be an alternative for the obstetrician since it could prolong the pregnancy until a gestational age which confers a better prognosis and a better perinatal outcome for the second twin.

Urgencias ginecológicas y obstétricas en la pandemia por COVID-19, ¿qué fue lo que dejamos de ver? / Gynecological and obstetric emergencies in the COVID-19 pandemic, what did we stop attending?

Resumen OBJETIVO: Determinar si disminuyeron las urgencias ginecológicas y obstétricas atendidas en un hospital de tercer nivel durante el periodo de confinamiento domiciliario ocasionado por la pandemia de SARS CoV-2 y analizar a expensas de qué tipo de urgencias se produjo la disminución. MATERIALES Y MÉTODOS: Estudio retrospectivo y observacional efectuado en el Hospital Maternal del Hospital Universitario Miguel Servet del 15 de marzo al 15 de abril de 2019, 2020 y 2021. Se incluyeron todas las pacientes atendidas y se determinó el número absoluto de urgencias entre los diferentes periodos. Además, se analizaron las características de las pacientes atendidas con una comparación entre los tres periodos con χ2 de Pearson. RESULTADOS: Se atendieron menos de la mitad de las urgencias ginecoobstétricas que en el mismo periodo de los años anteriores y posteriores. La disminución fue, sobre todo, a expensas de pacientes mayores de 40 años, embarazadas y no embarazadas, con niveles de prioridad bajos según la priorización efectuada y que tuvieron como destino el alta a su domicilio. CONCLUSIONES: La situación de pandemia ocasionada por el SARS CoV-2 y las medidas de confinamiento domiciliario provocaron una disminución en la demanda de atención por parte de las pacientes obstétricas y ginecológicas.

Abstract OBJECTIVE: To determine whether there was a decrease in gynecological and obstetric emergencies attended in a tertiary hospital during the period of home confinement caused by the SARS CoV-2 pandemic and to analyze what type of emergencies caused the decrease. MATERIALS AND METHODS: Retrospective and observational study performed at the Maternal Hospital of the Miguel Servet University Hospital from March 15 to April 15, 2019, 2020 and 2021. All patients attended were included and the absolute number of emergencies between the different periods was determined. In addition, the characteristics of the patients attended were analyzed with a comparison between the three periods with Pearson& s χ2. RESULTS: Fewer than half as many obstetric and gynecological emergencies were attended as in the same period of the previous and subsequent years. The decrease was mainly at the expense of patients older than 40 years, pregnant and non-pregnant, with low priority levels according to the prioritization performed and who had discharge home as their destination. CONCLUSIONS: The pandemic situation caused by SARS CoV-2 and home confinement measures led to a decrease in demand for care by obstetric and gynecologic patients.

Síndrome de Ballantyne: segundo episodio en una embarazada. Reporte de caso y revisión de la bibliografía / Ballantyne syndrome: Second episode in a pregnant woman. Case report and literature review

Resumen ANTECEDENTES: El síndrome de Ballantyne es un cuadro poco frecuente asociado con hidrops fetal, en el que la madre refleja los síntomas fetales. Es decisivo diferenciarlo de la preeclampsia porque comparten signos de hipertensión y proteinuria. Su etiopatogenia se desconoce pero se han propuesto teorías asociadas con el desequilibrio entre factores angiogénicos y antiangiogénicos. CASO CLÍNICO: Paciente de 29 años, controlada en la consulta de Medicina Materno-Fetal debido al antecedente de síndrome de Ballantyne en el embarazo previo. En la ecografía de control a las 26 semanas se detectaron placentomegalia, ascitis fetal e incremento del líquido amniótico. Las ecografías posteriores demostraron polihidramnios e hidrops a las 28 semanas. Enseguida de la aparición del edema se estableció el diagnóstico de síndrome del espejo recidivante e hidrops no inmunitario. Se hospitalizó para drenaje del líquido. La amniorrexis se produjo a las 29 + 6 semanas. Una semana después se inició la dinámica uterina y el embarazo finalizó a las 31 semanas, después de la ruptura prematura de membranas. El neonato fue un varón de 3200 g, Apgar 2-6-8 al minuto, 5 y 10 minutos, respectivamente. Después del estudio postnatal se estableció el diagnóstico de perforación ileal múltiple. El recién nacido requirió 5 intervenciones quirúrgicas, con posoperatorio tórpido y se dio de alta a los 3 meses de vida. CONCLUSIONES: El síndrome del espejo es infradiagnosticado, a pesar de su potencial para complicar gravemente el embarazo asociado con hidrops. La recuperación de la madre suele ser favorable a los pocos días de posparto aunque la morbilidad y la mortalidad fetal son elevadas.

Abstract BACKGROUND: Ballantyne syndrome is characterized by the triad: fetal, placental and maternal edema. It is an uncommon condition associated with fetal hydrops, in which mother reflects fetal symptoms. It is essential to differentiate from preeclampsia, since there are common signs such as hypertension and proteinuria. Etiopathogenesis is unknown, although theories associated with an imbalance between angiogenic and antiangiogenic factors have been postulated. Treatment consists of ending the pregnancy or improving the fetal situation. CLINICAL CASE: We present the case of a 29-years pregnant woman controlled in the Maternal-Fetal Medicine Unit due to the history of Ballantyne Syndrome in the previous gestation. In the follow-up ultrasound performed at 26-weeks, placentomegaly, fetal ascites and increased amniotic fluid were detected. Subsequent ultrasounds showed polyhydramnios and fetal hydrops at 28-weeks. After maternal edema began, she was diagnosed with recurrent Mirror Syndrome and non-immune hydrops. Admission was indicated and amniodrainage was performed due to symptomatic polyhydramnios. Finally, premature rupture of membranes occurred at 29+6-weeks. She started uterine dynamic after one week, ending in a preterm delivery at 31-weeks after premature rupture of membranes. A 3200gr male was born with Apgar Scores 2-6-8 at 1, 5 and 10min respectively and, after postnatal study, he was diagnosed with multiple ileal perforation. Five surgical interventions were necessary, with a complicated postoperative period and could be discharged at 3 months of age. CONCLUSIONS: Mirror syndrome is an underdiagnosed pathology of unknown incidence that can seriously complicate gestation associated with fetal hydrops. Maternal recovery is favorable few days after delivery, but it leads to high fetal morbi-mortality.