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.

Contributo e caracterização de PM da ressuspensão rodoviária

Nos últimos anos, tem-se assistido a um crescimento no interesse do estudo da ressuspensão de pó de estrada, dado o reconhecimento da importância que esta fração representa para os níveis de partículas atmosféricas em ambiente urbano. Dada a prematuridade deste tema e, de forma a compreender e conhecer a sua contribuição e caracterização, realizou-se um estudo sobre a ressuspensão de pó de estrada urbano para as cidades do Porto e Braga. No âmbito do projeto AIRUSE e URBE, realizaram-se amostragens de PM10 no terreno com um dispositivo de amostragem móvel e em ambiente laboratorial com uma câmara de ressuspensão, sendo posteriormente analisado o seu conteúdo carbonoso por um sistema de análise termo-ótico de transmitância e, os elementos por ICP-MS e ICP-AES. Da campanha in situ resultaram cargas de PM10 compreendidas entre 0.190 e 49.5 mg.m-2 para a cidade do Porto e 0.577 mg.m-2 para o túnel rodoviário em Braga. As amostras caracterizam-se por serem dominadas pelos elementos Al, Fe, K, e Ca e conterem enriquecimentos de Sb, Fe, Cu, Sn e Zn, fruto da contaminação antropogénica da atividade rodoviária. No que respeita às amostragens em laboratório, utilizou-se uma câmara de ressuspensão e o dispositivo móvel aplicado na campanha anteriormente descrita para estudar e caracterizar a fração PM10 do pó de estrada urbano proveniente do Túnel Avenida da Liberdade (Braga). Os resultados obtidos para as duas metodologias foram de um modo geral similares, com o carbono total a representar cerca de 6% da massa total de PM10. Esta última é composta maioritariamente por Al, Fe, Ca e K, elementos característicos da crosta terrestre. Quanto ao fatores de enriquecimento calculados, denotou-se a presença de Sb, Zn, Cu e Sn, tendo-se associando ao desgaste dos travões e pneus.