Love cells: the affective role of the fetal cells migration into the maternal limbic system

Love cells: the affective role of the fetal cells migration into the maternal limbic system

Mario Valerio Tartagni1 Orcid, Alessandra Graziottin2,3 Orcid

1 – “Fontana” Department of Gynecology and Obstetrics, Kantonsspital Graubünden, Chur, Switzerland.

2 – Graziottin Foundation for the treatment of pain in women, Onlus

3 – Center of Gynecology and Medical Sexology, H. San Raffaele Resnati Milan

Corresponding Author: Mario Valerio Tartagni

DOI: 10.53146/lriog1202142


Why do foetal cells migrate in mother’s limbic system? During pregnancy the mother’s brain undergoes both microscopic and macroscopic changes. The foetus, throughout the whole pregnancy, sends its own cells (Pregnancy Associated Progenitor Cells, PAPCs) to colonize many maternal organs, inclu- ding the brain and the limbic system. This phenomenon is known as “micro- chimerism”. The migration of PAPCs has both an evolutionary and affective meaning because the limbic system is the department of the brain dedicated to the regulation of emotions and memory. Here, the PAPCs will differen- tiate into neurons and glial cells, forming new synapses and therefore new connections with and among maternal neurons. This process is accompanied by structural alterations (documented by magnetic resonance imaging and orchestrated by the hormonal changes characteristic of gestation) invol- ving the limbic system and the other brain structures closely connected to it, which are the very same areas colonized by the migration of the foetal cells. Instrumental diagnostics and specific tests showed that greater volumetric losses of grey matter during pregnancy were strongly related to the quality of mother-child attachment and absence of hostility towards the newborn in the postpartum period. Greater brain alterations during gestation were asso- ciated to a higher degree of maternal attachment to her child after birth. For the first time in literature. In this review we have integrated the studies on the migration of PAPCs in the maternal brain with those, very recent, on the morphological and functional alterations that the maternal brain undergoes during pregnancy, indicating a possible synergistic effect of these two com- ponents. Part of the biologic base of the maternal-child attachment takes place during this migration suggesting that the foetus could play a surprising active role in modulating the mother’s ability to love him, right from its life in uterus.

Keywords: limbic system; pregnancy associated progenitor cells (PAPCs); pregnancy; microchimerism; stem-cell migration.

Available in LRIOG Nr.4 – 2021

e-ISSN: 1824-0283

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Bicuspid aortic valve and aortic bulb dilatation in pregnancy: a case report

Bicuspid aortic valve and aortic bulb dilatation in pregnancy: a case report
Alessia SalaOrcid, Stefano RestainoOrcid , Luigi VetrugnoOrcid, Martina BertoniOrcid, Emiliano Bacchetti
Orcid, Francesco VenturelliOrcid, Lorenza Driul1,2 – Orcid

1 – Department of Medicine, Clinic of Obstetrics and Gynecology, University of Udine

2 – Maternal and Child Department, Clinic of Obstetrics and Gynecology, Friuli Centrale University Health Authority

3 -Department of anesthesia and resuscitation, Clinic of anesthesia and resuscitation, Friuli Centrale University Healthcare Company

4 – Department of Medicine, University of Udine

Corresponding Author: Lorenza Driul

DOI: 10.53146/lriog1202145


BACKGROUND: the number of women with cardiovascular diseases is increa- sing, especially in Western countries, where maternal heart disease is the le- ading cause of maternal death during pregnancy. The progressive increasing of maternal age is associated with a high risk in developing a cardiovascular risk factors and consequently cardiovascular disorders.
CASE REPORT: we present the case of a 39 years old pregnant patient with a bicuspid aortic valve and severe dilatation of the aortic root (50 mm). The patient was referred to the high-risk pregnancy service. A multidisciplina- ry team, composed by gynaecologist, cardiologist, cardiothoracic surgeon, anaesthetist and neonatologist, followed every phase of patient’s pregnancy. During the third trimester, an elective caesarean section was programmed in the cardiothoracic surgery operating room, with the aim to reduce the possi- ble risk both for the mother and for the foetus. However, she presented at 34 week and 4 days with uterine contractions, and an urgent caesareans section was performed: a male of 2980gr was born. DISCUSSION: pregnancy is responsible of physiological cardiovascular altera- tions during pregnancy, which may be responsible for serious consequences on the mother, especially if concomitant cardiovascular diseases are present. Considering bicuspid aortic valve, pregnancy should be avoided when aorta diameter is more than 50 mm. This case shows that a multidisciplinary team and adequate monitoring and a good clinical practice may be fundamental in reducing maternal and foetal risks.

Keywords: valvola aortica bicuspide; VAB; gravidanza; dilatazione bulbo aortico.

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e-ISSN: 1824-0283

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Sexual abuse: how to recognize symptoms and signs in a child and in an adolescent

Sexual abuse: how to recognize symptoms and signs in a child and in an adolescent
Vincenzina BruniOrcid, Metella DeiOrcid , Pina MertinoOrcid

1 – University of Florence

2 – Endocrinologist gynecologist. l. p. Florence

3 – Childhood and Adolescent Gynecology Operational Structure, University Hospital, Careggi Florence

Corresponding Author: Vincenzina Bruni

DOI: 10.53146/lriog1202144


Sexual abuse toward children and adolescents, i.e. the involvement of a child in sexual acts that she or he does not comprehend and cannot give consent to, is a common occurrence. The intervention in suspected sexual abuse is complex and requires an expert multidisciplinary team. A medical exami- nation is also mandatory, ideally by a professional who specialized in child sexual abuse evaluation, even if in chronic abuse clinical evidence is scanty. Sometimes a gynaecologist must suddenly face a disclosure of abuse or a suspect arising by a genital examination or by the unexpected finding of a sexually transmitted infection in a child. So it is important to know what to do and what to avoid.
The article is a systematic description of the procedures validated by the in- ternational guidelines for performing a clinical examination in a child or in an adolescent when sexual abuse is suspected. We start with the documenta- tion of parents’ information and the registration of eventual child’s disclosu- re, with complete medical history and a thorough physical examination. The anogenital region examination is necessary to rule out injuries in cases of re- cent abuse and should be completed with tests for sexually transmitted infec- tions and the collection of forensic evidences. An adequate documentation of the findings, filling in a specific medical record and using photographs, is of paramount importance.

Keywords: sexual abuse; methodology of consultation for abuse; sexually transmitted infections in children.

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e-ISSN: 1824-0283

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Metabolic syndrome in menopause

Metabolic syndrome in menopause

Roberta Scairati1 Orcid, Renata Simona AuriemmaOrcid, Annamaria Colao1,2 Orcid, Alessandra Graziottin3,4 – Orcid

1 – Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy

2 – United Nations Educational, Scientific and Cultural Organization (UNESCO), Chair for Health Education and Sustainable Development, University Federico II, Naples, Italy

3 – Director of the Center for Gynecology and Medical Sexology, H. San Raffaele Resnati, Milan

4 – President of the Graziottin Foundation for the treatment of pain in women – Non profit organization

Corresponding Author: Roberta Scairati

DOI: 10.53146/lriog1202149


Background: Menopause is associated with a high risk for cardiometabolic diseases, including metabolic syndrome (MetS), cardiovascular disease (CVD) and type 2 diabetes (DMT2).
Insulin resistance, abdominal obesity, dyslipidemia and hypertension are in- terdependent factors associated with menopause. The increase in the syste- mic inflammation is the common denominator of MetS. The purposes of this review are i) to clarify how the natural cessation of ovarian function, which is characterized by the decline of female sexual hormones and the relative in- crease of androgens, could explain the relationship between MetS, increase of the inflammatory indexes and menopause; ii) to understand how surgical menopause could influence the onset of MetS; iii) to highlight the role of hormone replacement therapy.
Methods: We revised the published literature in english language on PubMed database, from year 1992 to year 2021, by searching the following keywords, including 1) a refined definition of metabolic syndrome 2) relationship betwe- en metabolic syndrome and systemic inflammation 3) relationship between metabolic syndrome and obesity, insulin resistance, hypertension, osteoporo- sis and hypothyroidism, 4) surgical menopause and metabolic syndrome, 5) effects of HRT on the components of the MetS in post-menopausal women. Results: Derived evidences suggest an increased incidence of metabolic syn- drome in menopause, probably due to woman aging and hormonal chan- ges in menopause, worsened by hypothyroidism, inappropriate lifestyles and lack of timely initiated HRT.
Conclusions: Menopause plays a crucial role in the development of MetS and surgical menopause; sudden cessation of ovarian function can lead to a hi- gher incidence of MetS and systemic inflammation than physiological me- nopause. Hormone replacement therapy (HRT) and a healthy lifestyle may positively influence some aspects of Mets. Our observations can help in the clinical management of menopause-related MetS.

Keywords: menopause; surgical menopause; metabolic syndrome; inflammation; hormone replacement therapy.

Available in LRIOG Nr.4 – 2021

e-ISSN: 1824-0283

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LRIOG 2021-4

In this issue:

Original articles

Love cells: the affective role of the fetal cells migration into the maternal limbic system

Maria Valerio Tartagni, Alessandra Graziottin

PDF DOI:10.53146/lriog1202142 Abstract

The role of enviromental pollutant in the pathogenesis of endometriosis: a systematic review of literature

Alessandro Conforti, Silvia Picarelli, Giuseppe Gabriele Iorio, Luigi Carbone, Ida Strina, Carlo Alviggi

PDF DOI:10.53146/lriog1202143 Abstract

Sexual abuse: how to recognize symptoms and signs in a child and in an adolescent

Vincenzina Bruni, Metella Dei, Pina Mertino

PDF DOI:10.53146/lriog1202144 Abstract

Bicuspid aortic valve and aortic bulb dilation in pregnancy: a case report

Alessia Sala, Stefano Restaino, Luigi Vetrugno, Martina Bertoni, Emiliano Bacchetti, Francesco Venturelli, Lorenza Driul

PDF DOI:10.53146/lriog1202145 Abstract

The vagina: therapeutic role of estrogen

Vincenza Di Stasi, Irene Scavello, Elisa Maseroli, Sarah Cipriani, Linda Vignozzi

PDF DOI:10.53146/lriog1202146 Abstract

Caesarean section for maternal choice: boundaries between self-determination and risk

Lorenzo Agoni, Paola Delbon

PDF DOI:10.53146/lriog1202147 Abstract

Vitamin d and anti-covid-19 vaccination

Marco Infante, Tsvetelina Velikova, Andrea Fabbri

PDF DOI:10.53146/lriog1202148 Abstract

Metabolic syndrome in menopause

Roberta Scairati, Renata Simona Auriemma, Annamaria Colao, Alessandra Graziottin

PDF DOI:10.53146/lriog1202149 Abstract

Endocrine – metabolic syndrome and nutritional aspects: polycystic ovary syndrome

Luigi Barrea, Ludovica Verde, Giovanna Muscogiuri

PDF DOI:10.53146/lriog1202150 Abstract

Weight excess and inflammation in menopause: pathophysiology of a dangerous liaison and role of lifestyles

Gabriella Pugliese, Annamaria Colao, Alessandra Graziottin

PDF DOI:10.53146/lriog1202151 Abstract

Thyroid diseases and female infertility

Chiara Graziadio, Emanuele Filice, Rosa Pirchio, Renata Simona Auriemma, Alessandra Graziottin, Anmmaria Colao

PDF DOI:10.53146/lriog1202152 Abstract

Parathyroid disease: boe health and metabolic syndrome

Roberta Modica, Roberto Minotta, Giuseppe Cannavale, Alessia Liccardi, Renata Simona Auriemma, Annamaria Colao

PDF DOI:10.53146/lriog1202153 Abstract

Quaterly magazine: Nr.4 – 2021

e – ISSN: 1824 – 0283

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Vitamin D and anti-covid-19 vaccination

Vitamin D and anti-covid-19 vaccination

Marco Infante1,2,3 Orcid, Tsvetelina VelikovaOrcid, Andrea FabbriOrcid

1 – Transmural Complex Operative Unit of Endocrinology & Diabetes Research Institute Federation (DRIF), Department of Systems Medicine, CTO A. Alesini & S.Eugenio Hospitals, ASL Roma 2, University of Rome Tor Vergata, Rome, Italy

2 – UniCamillus, Saint Camillus International University of Health Sciences, Roma, Italia

3 – Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Rome, Italy

4 – Department of Clinical Immunology, Lozenetz University Hospital, Sofia University “S. Clement of Ohrid ”, Sofia, Bulgaria

Corresponding Author: Marco Infante

DOI: 10.53146/lriog1202148


Since March 2020, the coronavirus disease 2019 (COVID-19) pandemic cau- sed by the novel coronavirus SARS-CoV-2 (severe acute respiratory syndro- me coronavirus 2) has been posing a serious threat to global public health. Significant efforts have been made by the scientific community to develop different types of vaccines against SARS-CoV-2, such as inactivated whole- virion vaccines, viral vector-based vaccines, mRNA vaccines, DNA vaccines and protein subunit vaccines. To date, nationwide and global vaccination cam- paigns represent critical tools to reach the so-called “herd imunity” aimed at controlling and eventually ending the COVID-19 pandemic. Due to the continuous emergence and spread of novel SARS-CoV-2 viral variants, com- plementary strategies aimed at improving the immunity of the general po- pulation and frail individuals may contribute to increase the effectiveness of COVID-19 vaccines. Therefore, the scientific community is also focused on fac- tors able to determine an effective immune response against the virus after vaccination against COVID-19. Currently, vitamin D deficiency also represents a global pandemic afflicting more than one billion individuals across all age groups. Several observational studies have demonstrated that serum levels of vitamin D are significantly and inversely correlated with the incidence and se- verity of COVID-19. In addition, intervention studies have shown that vitamin D supplementation may have a role in mitigating the clinical progression of COVID-19 in light of the anti-infective, anti-inflammatory and immunomo- dulatory properties exerted by this vitamin. Nevertheless, it remains unclear whether vitamin D supplementation (particularly in subjects with vitamin D deficiency) plays a relevant role in enhancing the effectiveness of different COVID-19 vaccines. Thus, future prospective studies are needed to address this unanswered question. In this Report article, we discuss the relationship between hypovitaminosis D and COVID-19 pathophysiology, as well as the potential mechanisms behind the role of vitamin D as as an immunologic adjuvant for COVID-19 vaccines.

Keywords: COVID-19 vaccines; SARS-CoV-2 vaccines; vitamin D; vaccine adjuvant; immunity.

Available in LRIOG Nr.4 – 2021

e-ISSN: 1824-0283

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