The developmental origins of adult disease.
OBJECTIVE
Intrauterine growth restriction (IUGR) is associated with an increased propensity to develop adult-onset disease and is described by the developmental origins of adult disease hypothesis. Sequelae of fetal growth restriction include metabolic disease as well as nonmetabolic disorders. Although it has become clear that the morbidities associated with IUGR are complex and result from disruptions to multiple pathways and multiple organs, the mechanisms driving the long-term effects are only just beginning to be understood.


RESULTS
IUGR affects most organ systems by either interrupting developmental processes such as apoptosis or producing lasting changes to levels of key regulatory factors. Both of these are associated with an often persistent change in gene expression. Epigenetic modulation of transcription is a mechanism that is at least partially responsible for this. IUGR is accompanied by changes in the quantity and activity of enzymes responsible for making modifications to chromatin as well as global and gene-specific modifications of chromatin.


CONCLUSIONS
The subtle adjustments needed to ensure developmental plasticity in IUGR are provided by epigenetic modulation of critical genes. Translating the messages of the epigenetic profile and identifying the players that mediate the effects remains one of the major challenges in the field. An understanding of the mechanisms driving the epigenetic changes will facilitate identification of dietary and pharmaceutical approaches that can be applied in the postnatal period.
Joss-Moore
Lisa A
LA
Division of Neonatology, Department of Pediatrics,University of Utah, 295 Chipeta Way, 2N131 Salt Lake City, UT 84108, USA.
Lane
Robert H
RH
D000328:Adult; D000818:Animals; D017209:Apoptosis / Q000235:genetics; D002908:Chronic Disease; D018450:Disease Progression; D044127:Epigenesis, Genetic; D047109:Fetal Development / Q000235:genetics; D005317:Fetal Growth Retardation; D018507:Gene Expression Regulation, Developmental; D006801:Humans; D008659:Metabolic Diseases / Q000196:embryology* / Q000235:genetics; D009765:Obesity / Q000196:embryology* / Q000235:genetics; D055815:Young Adult