Pregnancy and newborns disorders followed by urine metabolomics

Chapter 1 introduces the scope of the work by identifying the clinically relevant prenatal disorders and presently available diagnostic methods. The methodology followed in this work is presented, along with a brief account of the principles of the analytical and statistical tools employed. A thorough description of the state of the art of metabolomics in prenatal research concludes the chapter, highlighting the merit of this novel strategy to identify robust disease biomarkers. The scarce use of maternal and newborn urine in previous reports enlightens the relevance of this work. Chapter 2 presents a description of all the experimental details involved in the work performed, comprising sampling, sample collection and preparation issues, data acquisition protocols and data analysis procedures. The proton Nuclear Magnetic Resonance (NMR) characterization of maternal urine composition in healthy pregnancies is presented in Chapter 3. The urinary metabolic profile characteristic of each pregnancy trimester was defined and a 21-metabolite signature found descriptive of the metabolic adaptations occurring throughout pregnancy. 8 metabolites were found, for the first time to our knowledge, to vary in connection to pregnancy, while known metabolic effects were confirmed. This chapter includes a study of the effects of non-fasting (used in this work) as a possible confounder. Chapter 4 describes the metabolomic study of 2nd trimester maternal urine for the diagnosis of fetal disorders and prediction of later-developing complications. This was achieved by applying a novel variable selection method developed in the context of this work. It was found that fetal malformations (FM) (and, specifically those of the central nervous system, CNS) and chromosomal disorders (CD) (and, specifically, trisomy 21, T21) are accompanied by changes in energy, amino acids, lipids and nucleotides metabolic pathways, with CD causing a further deregulation in sugars metabolism, urea cycle and/or creatinine biosynthesis. Multivariate analysis models´ validation revealed classification rates (CR) of 84% for FM (87%, CNS) and 85% for CD (94%, T21). For later-diagnosed preterm delivery (PTD), preeclampsia (PE) and intrauterine growth restriction (IUGR), it is found that urinary NMR profiles have early predictive value, with CRs ranging from 84% for PTD (11-20 gestational weeks, g.w., prior to diagnosis), 94% for PE (18-24 g.w. pre-diagnosis) and 94% for IUGR (2-22 g.w. pre-diagnosis). This chapter includes results obtained for an ultraperformance liquid chromatography-mass spectrometry (UPLC-MS) study of pre-PTD samples and correlation with NMR data. One possible marker was detected, although its identification was not possible. Chapter 5 relates to the NMR metabolomic study of gestational diabetes mellitus (GDM), establishing a potentially predictive urinary metabolic profile for GDM, 2-21 g.w. prior to diagnosis (CR 83%). Furthermore, the NMR spectrum was shown to carry information on individual phenotypes, able to predict future insulin treatment requirement (CR 94%). Chapter 6 describes results that demonstrate the impact of delivery mode (CR 88%) and gender (CR 76%) on newborn urinary profile. It was also found that newborn prematurity, respiratory depression, large for gestational age growth and malformations induce relevant metabolic perturbations (CR 82-92%), as well as maternal conditions, namely GDM (CR 82%) and maternal psychiatric disorders (CR 91%). Finally, the main conclusions of this thesis are presented in Chapter 7, highlighting the value of maternal or newborn urine metabolomics for pregnancy monitoring and disease prediction, towards the development of new early and non-invasive diagnostic methods.

Interactions of cetaceans with Spanish and Portuguese fisheries in Atlantic waters : costs, benefits and implications for management

With the aim to provide new insights into operational cetacean-fishery interactions in Atlantic waters, this thesis assesses interactions of cetaceans with Spanish and Portuguese fishing vessels operating in Iberian and South West Atlantic waters. Different opportunistic research methodologies were applied, including an interview survey with fishers (mainly skippers) and onboard observations by fisheries observers and skippers, to describe different types of interactions and to identify potential hotspots for cetacean-fishery interactions and the cetacean species most involved, and to quantify the extent and the consequences of these interactions in terms of benefits and costs for cetaceans and fisheries. In addition, the suitability of different mitigation strategies was evaluated and discussed. The results of this work indicate that cetaceans interact frequently with Spanish and Portuguese fishing vessels, sometimes in a beneficial way (e.g. cetaceans indicate fish schools in purse seine fisheries), but mostly with negative consequences (depredation on catch, gear damage and cetacean bycatch). Significant economic loss and high bycatch rates are, however, only reported for certain fisheries and associated with particular cetacean species. In Galician fisheries, substantial economic loss was reported as a result of bottlenose dolphins damaging artisanal coastal gillnets, while high catch loss may arise from common dolphins scattering fish in purse seine fisheries. High cetacean bycatch mortality arises in trawl fisheries, mainly of common dolphin and particularly during trawling in water depths below 350 m, and in coastal set gillnet fisheries (mainly common and bottlenose dolphins). In large-scale bottom-set longline fisheries in South West Atlantic waters, sperm whales may significantly reduce catch rates through depredation on catch. The high diversity of cetacean-fishery interactions observed in the study area indicates that case-specific management strategies are needed to reduce negative impacts on fisheries and cetaceans. Acoustic deterrent devices (pingers) may be used to prevent small cetaceans from approaching and getting entangled in purse seines and set gillnets, although possible problems include cetacean habituation to the pinger sounds, as well as negative side effects on non-target cetaceans (habitat exclusion) and fisheries target species (reduced catch rates). For sardine and horse mackerel, target species of Iberian Atlantic fisheries, no aversive reaction to pinger sounds was detected during tank experiments conducted in the scope of this thesis. Bycatch in trawls may be reduced by the implementation of time/area restrictions of fishing activity. In addition, the avoidance of fishing areas with high cetacean abundance combined with the minimization of fishery-specific sound cues that possibly attract cetaceans, may also help to decrease interactions. In large-scale bottom-set longline fisheries, cetacean depredation on catch may be reduced by covering hooked fish with net sleeves ("umbrellas") provided that catch rates are not negatively affected by this gear modification. Trap fishing, as an alternative fishing method to bottom-set gillnetting and longlining, also has the potential to reduce cetacean bycatch and depredation, given that fish catch rates are similar to the rates obtained by bottom-set gillnets and longlines, whereas cetacean by-catch is unlikely. Economic incentives, such as the eco-certification of dolphin-safe fishing methods, should be promoted in order to create an additional source of income for fishers negatively affected by interactions with cetaceans, which, in turn, may also increase fishers’ willingness to accept and adopt mitigation measures. Although the opportunistic sampling methods applied in this work have certain restrictions concerning their reliability and precision, the results are consistent with previous studies in the same area. Moreover, they allow for the active participation of fishers that can provide important complementary ecological and technical knowledge required for cetacean management and conservation.

Post-fire vegetation regeneration in Portugal : implications for management

This thesis aims at improving the knowledge on the post-fire vegetation regeneration. For that, forests and shrublands were studied, after forest fires and experimental fires. Maritime Pine (Pinus pinaster) recruitment after fire was studied. Fire severity was evidenced as a major effect on this process. High crown fire severity can combust the pines, destroying the seed bank and impeding post fire pine recruitment. However, crown combustion also influences the post-fire conditions on the soil surface, since high crown combustion (HCC) will decrease the postfire needle cast. After low crown combustion (LCC) (scorched rather than torched crowns), a considerable needle cover was observed, along with a higher density of pine seedlings. The overall trends of post-fire recruitment among LCC and HCC areas could be significantly attributed to cover by needles, as well by the estimation of fire severity using the diameters of the burned twigs (TSI). Fire increased the germination from the soil seed bank of a Pinus pinaster forest, and the effects were also related with fire severity. The densities of seedlings of the dominant taxa (genus Erica and Calluna vulgaris) were contrastingly affected in relation to the unburned situation, depending on fire severity, as estimated from the degree of fire-induced crown damage (LCC/HCC), as well as using a severity index based on the diameters of remaining twigs (TSI). Low severity patches had an increase in germination density relatively to the control, while high severity patches suffered a reduction. After an experimental fire in a heathland dominated by Pterospartum tridentatum, Erica australis and E. umbellata, no net differences in seedling emergence were observed, in relation to the pre-fire situation. However, rather than having no effect, the heterogeneity of temperatures caused by fire promoted caused divergent effects over the burned plot in terms of Erica australis germination – a progressive increased was observed in the plots were maximum temperature recorded ranged from 29 to 42.5ºC and decreased in plots with maximum temperature ranging from 51.5 to 74.5ºC. In this heathland, the seed density of two of the main species (E. australis and E. umbellata) was higher under their canopies, but the same was not true for P. tridentatum. The understory regeneration in pine and eucalypt stands, 5 to 6 years post fire, has been strongly associated with post-fire management practices. The effect of forest type was, comparatively, insignificant. Soil tilling, tree harvesting and shrub clearance, were linked to lower soil cover percentages. However, while all these management operations negatively affected the cover of resprouters, seeders were not affected by soil tilling. A strong influence of biogeographic region was identified, suggesting that more vulnerable regions may suffer higher effects of management, even under comparatively lower management pressure than more productive regions. This emphasizes the need to adequate post-fire management techniques to the target regions.

The effects of chemicals in isopods : a multi-organizational evaluation

The global aim of this thesis was to evaluate and assess the effects of a pesticide (dimethoate) and a metal (nickel), as model chemicals, within different organization levels, starting at the detoxification pathways (enzymatic biomarkers) and energy costs associated (energy content quantification, energy consumption and CEA) along with the physiological alterations at the individual and population level (mortality), leading to a metabolomic analysis (using liquid 1H-NMR) and finally a gene expression analysis (transcriptome and RT-qPCR analysis). To better understand potential variations in response to stressors, abiotic factors were also assessed in terrestrial isopods such as temperature, soil moisture and UV radiation. The evaluation performed using biochemical biomarkers and energy related parameters showed that increases in temperature might negatively affect the organisms by generating oxidative stress. It also showed that this species is acclimated to environments with low soil moisture, and that in high moisture scenarios there was a short gap between the optimal and adverse conditions that led to increased mortality. As for UV-R, doses nowadays present have shown to induce significant negative impact on these organisms. The long-term exposure to dimethoate showed that besides the neurotoxicity resulting from acetylcholinesterase inhibition, this stressor also caused oxidative stress. This effect was observed for both concentrations used (recommended field dose application and a below EC50 value) and that its combination with different temperatures (20ºC and 25ºC) showed different response patterns. It was also observed that dimethoate’s degradation rate in soils was higher in the presence of isopods. In a similar study performed with nickel, oxidative stress was also observed. But, in the case of this stressor exposure, organisms showed a strategy where the energetic costs necessary for detoxification (biomarkers) seemed to be compensated by positive alterations in the energy related parameters. In this work we presented for the first time a metabolomic profile of terrestrial isopods exposed to stressors (dimethoate and niquel), since until the moment only a previous study was performed on a metabolomic evaluation in nonexposed isopods. In the first part of the study we identify 24 new metabolites that had not been described previously. On the second part of the study a metabolomic profile variation of abstract non-exposed organism throughout the exposure was presented and finally the metabolomic profile of organisms exposed to dimethoate and nickel. The exposure to nickel suggested alteration in growth, moult, haemocyanin and glutathione synthesis, energy pathways and in osmoregulation. As for the exposure to dimethoate alterations in osmoregulation, energy pathways, moult and neurotransmission were also suggested. In this work it was also presented the first full body transcriptome of a terrestrial isopod from the species Porcellionides pruinosus, which will complement the scarce information available for this group of organisms. This transcriptome also served as base for a RNA-Seq and a RT-qPCR analysis. The results of the RNA-Seq analysis performed in organisms exposed to nickel showed that this stressor negatively impacted at the genetic and epigenetic levels, in the trafficking, storage and elimination of metals, generates oxidative stress, inducing neurotoxicity and also affecting reproduction. These results were confirmed through RT-qPCR. As for the impact of dimethoate on these organisms it was only accessed through RT-qPCR and showed oxidative stress, an impact in neurotransmission, in epigenetic markers, DNA repair and cell cycle impairment. This study allowed the design of an Adverse Outcome Pathway draft that can be used further on for legislative purposes.

Single and joint effects of natural and chemical stressors to the terrestrial isopod Porcellionides pruinosus

Environmental contamination and climate changes constitute two of the most serious problems affecting soil ecosystems in agricultural fields. Agriculture is nowadays a highly optimized process that strongly relies on the application of multiple pesticides to reduce losses and increase yield production. Although constituting, per se, a serious problem to soil biota, pesticide mixtures can assume an even higher relevance in a context of unfavourable environmental conditions. Surprisingly, frameworks currently established for environmental risk assessments keep not considering environmental stressors, such as temperature, soil moisture or UV radiation, as factors liable to influence the susceptibility of organisms to pesticides, or pesticide mixtures, which is raising increasing apprehension regarding their adequacy to actually estimate the risks posed by these compounds to the environment. Albeit the higher attention received on the last few years, the influence of environmental stressors on the behaviour and toxicity of chemical mixtures remains still poorly understood. Aiming to contribute for this discussion, the main goal of the present thesis was to evaluate the single and joint effects of natural stressors and pesticides to the terrestrial isopod Porcellionides pruinosus. The first approach consisted on evaluating the effects of several abiotic factors (temperature, soil moisture and UV radiation) on the performance of P. pruinosus using several endpoints: survival, feeding parameters, locomotor activity and avoidance behaviour. Results showed that these stressors might indeed affect P. pruinosus at relevant environmental conditions, thus suggesting the relevance of their consideration in ecotoxicological assays. At next, a multiple biomarker approach was used to have a closer insight into the pathways of damage of UV radiation and a broad spectrum of processes showed to be involved (i.e. oxidative stress, neurotoxicity, energy). Furthermore, UV effects showed to vary with the environment medium and growth-stage. A similar biomarker approach was employed to assess the single and joint effects of the pesticides chlorpyrifos and mancozeb to P. pruinosus. Energy-related biomarkers showed to be the most differentiating parameters since age-classes seemed to respond differently to contamination stress and to have different metabolic costs associated. Finally, the influence of temperature and soil moisture on the toxicity of pesticide mixtures was evaluated using survival and feeding parameters as endpoints. Pesticide-induced mortality was found to be oppositely affected by temperature, either in single or mixture treatments. Whereas chlorpyrifos acute toxicity was raised under higher temperatures the toxicity of mancozeb was more prominent at lower temperatures. By the opposite, soil moisture showed no effects on the pesticide-induced mortality of isopods. Contrary to survival, both temperature and soil moisture showed to interact with pesticides to influence isopods’ feeding parameters. Nonetheless, was however the most common pattern. In brief, findings reported on this thesis demonstrated why the negligence of natural stressors, or multiple stressors in general, is not a good solution for risk assessment frameworks.

Effects of environmental factors on the toxicity of pesticides to zebrafish embryos

During the last century mean global temperatures have been increasing. According to the predictions, the temperature change is expected to exceed 1.5ºC in this century and the warming is likely to continue. Freshwater ecosystems are among the most sensitive mainly due to changes in the hydrologic cycle and consequently changes in several physico-chemical parameters (e.g. pH, dissolved oxygen). Alterations in environmental parameters of freshwater systems are likely to affect distribution, morphology, physiology and richness of a wide range of species leading to important changes in ecosystem biodiversity and function. Moreover, they can also work as co-stressors in environments where organisms have already to cope with chemical contamination (such as pesticides), increasing the environmental risk due to potential interactions. Therefore, the objective of this work was to evaluate the effects of climate change related environmental parameters on the toxicity of pesticides to zebrafish embryos. The following environmental factors were studied: pH (3.0-12.0), dissolved oxygen level (0-8 mg/L) and UV radiation (0-500 mW/m2). The pesticides studied were the carbamate insecticide carbaryl and the benzimidazole fungicide carbendazim. Stressors were firstly tested separately in order to derive concentration- or intensity-response curves to further study the effects of binary combinations (environmental factors x pesticides) by applying mixture models. Characterization of zebrafish embryos response to environmental stress revealed that pH effects were fully established after 24 h of exposure and survival was only affected at pH values below 5 and above 10. Low oxygen levels also affected embryos development at concentrations below 4 mg/L (delay, heart rate decrease and edema), and at concentrations below 0.5 mg/L the survival was drastically reduced. Continuous exposure to UV radiation showed a strong time-dependent impact on embryos survival leading to 100% of mortality after 72 hours of exposure. The toxicity of pesticides carbaryl and carbendazim was characterized at several levels of biological organization including developmental, biochemical and behavioural allowing a mechanistic understanding of the effects and highlighting the usefulness of behavioural responses (locomotion) as a sensitive endpoint in ecotoxicology. Once the individual concentration response relationship of each stressor was established, a combined toxicity study was conducted to evaluate the effects of pH on the toxicity of carbaryl. We have shown that pH can modify the toxicity of the pesticide carbaryl. The conceptual model concentration addition allowed a precise prediction of the toxicity of the jointeffects of acid pH and carbaryl. Nevertheless, for alkaline condition both concepts failed in predicting the effects. Deviations to the model were however easy to explain as high pH values favour the hydrolysis of carbaryl with the consequent formation of the more toxic degradation product 1- naphtol. Although in the present study such explanatory process was easy to establish, for many other combinations the “interactive” nature is not so evident. In the context of the climate change few scenarios predict such increase in the pH of aquatic systems, however this was a first approach focused in the lethal effects only. In a second tier assessment effects at sublethal level would be sought and it is expectable that more subtle pH changes (more realistic in terms of climate changes scenarios) may have an effect at physiological and biochemical levels with possible long term consequences for the population fitness.

Concentration of tumor biomarkers using aqueous biphasic systems

According to the World Health Organization, around 8.2 million people die each year with cancer. Most patients do not perform routine diagnoses and the symptoms, in most situations, occur when the patient is already at an advanced stage of the disease, consequently resulting in a high cancer mortality. Currently, prostate cancer is the second leading cause of death among males worldwide. In Portugal, this is the most diagnosed type of cancer and the third that causes more deaths. Taking into account that there is no cure for advanced stages of prostate cancer, the main strategy comprises an early diagnosis to increase the successful rate of the treatment. The prostate specific antigen (PSA) is an important biomarker of prostate cancer that can be detected in biological fluids, including blood, urine and semen. However, the commercial kits available are addressed for blood samples and the commonly used analytical methods for their detection and quantification requires specialized staff, specific equipment and extensive sample processing, resulting in an expensive process. Thus, the aim of this MSc thesis consisted on the development of a simple, efficient and less expensive method for the extraction and concentration of PSA from urine samples using aqueous biphasic systems (ABS) composed of ionic liquids. Initially, the phase diagrams of a set of aqueous biphasic systems composed of an organic salt and ionic liquids were determined. Then, their ability to extract PSA was ascertained. The obtained results reveal that in the tested systems the prostate specific antigen is completely extracted to the ionic-liquid-rich phase in a single step. Subsequently, the applicability of the investigated ABS for the concentration of PSA was addressed, either from aqueous solutions or urine samples. The low concentration of this biomarker in urine (clinically significant below 150 ng/mL) usually hinders its detection by conventional analytical techniques. The obtained results showed that it is possible to extract and concentrate PSA, up to 250 times in a single-step, so that it can be identified and quantified using less expensive techniques.

Concentration of tumor biomarkers using aqueous biphasic systems

According to the World Health Organization, around 8.2 million people die each year with cancer. Most patients do not perform routine diagnoses and the symptoms, in most situations, occur when the patient is already at an advanced stage of the disease, consequently resulting in a high cancer mortality. Currently, prostate cancer is the second leading cause of death among males worldwide. In Portugal, this is the most diagnosed type of cancer and the third that causes more deaths. Taking into account that there is no cure for advanced stages of prostate cancer, the main strategy comprises an early diagnosis to increase the successful rate of the treatment. The prostate specific antigen (PSA) is an important biomarker of prostate cancer that can be detected in biological fluids, including blood, urine and semen. However, the commercial kits available are addressed for blood samples and the commonly used analytical methods for their detection and quantification requires specialized staff, specific equipment and extensive sample processing, resulting in an expensive process. Thus, the aim of this MSc thesis consisted on the development of a simple, efficient and less expensive method for the extraction and concentration of PSA from urine samples using aqueous biphasic systems (ABS) composed of ionic liquids. Initially, the phase diagrams of a set of aqueous biphasic systems composed of an organic salt and ionic liquids were determined. Then, their ability to extract PSA was ascertained. The obtained results reveal that in the tested systems the prostate specific antigen is completely extracted to the ionic-liquid-rich phase in a single step. Subsequently, the applicability of the investigated ABS for the concentration of PSA was addressed, either from aqueous solutions or urine samples. The low concentration of this biomarker in urine (clinically significant below 150 ng/mL) usually hinders its detection by conventional analytical techniques. The obtained results showed that it is possible to extract and concentrate PSA, up to 250 times in a single-step, so that it can be identified and quantified using less expensive techniques.

Ajustamento psicossocial e adesão terapêutica em doentes oncológicos: estudo em doentes com cancro colorectal

O cancro do cólon e reto (CCR) representa uma das neoplasias malignas mais relevantes, não só pela morbilidade mas também pelas altas taxas de mortalidade. Paralelamente, esta neoplasia representa uma elevada sobrecarga psicossocial, para o indivíduo, que se reflete na existência de sintomatologia depressiva e ansiosa e de uma qualidade de vida deficitária e que se estima influenciar o processo de adesão terapêutica. Assim, o presente estudo tem como objetivo estudar a associação das variáveis sóciodemográficas, clínicas e de ajustamento psicossocial, com a adesão terapêutica em doentes com cancro colo-rectal. Trinta e cinco pacientes com cancro colo-rectal, acompanhados na Liga Portuguesa Contra o Cancro, foram selecionados de acordo com o método de amostragem de conveniência. Os instrumentos de avaliação psicossocial utilizados consistiram nos seguintes: questionário de variáveis sociodemográficas e clínicas; na Escala de Ansiedade e Depressão Hospitalar (EADH); no questionário de Qualidade de Vida da Organização Europeia de Investigação e Tratamento de Cancro (QLQC30) e na Escala de Adesão Geral (EAG). Os resultados obtidos revelam a existência de relações significativas entre sintomatologia psicopatológica, qualidade de vida e adesão ao tratamento em pacientes com CCR, mais espeficamente, encontrou-se que: a sintomatologia psicopatológica correlacionou-se negativamente com adesão ao tratamento e com a qualidade de vida, e a adesão ao tratamento associou-se positivamente com a qualidade de vida. Concluimos que o presente estudo contribui com a clarificação do sofrimento psicossocial do paciente com CCR e da interação das variáveis demográficas, clínicas e de ajustamento psicossocial com a adesão terapeutica destes doentes. Implicações clinicas e de investigação são apontadas neste contexto.