Fetal Alcohol Exposure: an Unexpected Organ on the Scene

A team from Rouen has shown that the placenta constitutes a formidable witness of the neurodevelopmental disorders in children exposed to alcohol during pregnancy. It contains a new biomarker that makes it possible to identify abnormalities in brain angiogenesis.

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While it has been known since the 1960s that the consumption of alcohol by pregnant women can cause fetal malformations, clinical research has not yet made it possible to precisely determine the conditions in which these disorders might occur.

Several factors are under debate, including gestation stage, frequency and quantity of alcohol consumption and the binge drinking phenomenon. What is more, the effects of the exposure vary considerably from one individual to another. An uncertainty which unfortunately encourages families to downplay the risks incurred, even in populations which have already been made aware of them. In addition, the “zero alcohol” slogan is sometimes perceived as exaggerated, guilt-inducing and even infantilizing.

Yet there is no threshold effect for exposure to alcohol. It is toxic from the beginning to end of development,” clarifies Inserm Research Director Bruno Gonzalez*. “The form this toxicity takes depends on the period concerned: we call this the window of vulnerability. But consuming only small amounts doesn’t mean that there won’t be any effects.” Leader of the NeoVasc team in Rouen, the neuroscience researcher is studying the formation of brain lesions in neonates.

Placenta and brain – a link

Examination of human and mouse placentas which had and had not been exposed to alcohol revealed that there is indeed a link between vascular disorders of the placenta and those of the brain. PLGF could therefore be measured to determine brain damage in children. And there is more: animal studies have shown that repressing or amplifying PLGF expression made it possible to mimic the damage caused by alcohol or correct it.

“What we have is not just have a biomarker but a tool which can have an effect on the organs, and this is something that is totally new,” said Gonzalez. “So we filed a therapeutic patent in addition to the initial biomarker patent. At present, in the scope of a third – neurological – patent, we are wondering about the impact of alcohol and placental PLGF on the maturation and positioning of certain nerve cell populations. We will also try to test whether modulating placental PLGF makes it possible to act on behavioral disorders caused by exposure to alcohol in utero.

Once again, the placenta has proven to be a particularly interesting organ because, as it is destroyed at birth, taking samples from it is easy and non-invasive. We can therefore imagine a place for this new generation of biomarkers in systematic neonatal screening strategies. In addition, public health policies aiming to reduce the prevalence of alcohol consumption by pregnant women need to be pursued.

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