Emerging Progress in Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum: Challenges and Opportunities

Resolving the molecular details of proteome variation in the different tissues and organs of the human body will greatly increase our knowledge of human biology and disease. Here, we present a map of the human tissue proteome based on an integrated omics approach that involves quantitative transcriptomics at the tissue and organ level, combined with tissue microarray-based immunohistochemistry, to achieve spatial localization of proteins down to the single-cell level. Our tissue-based analysis detected more than 90% of the putative protein-coding genes. We used this approach to explore the human secretome, the membrane proteome, the druggable proteome, the cancer proteome, and the metabolic functions in 32 different tissues and organs. All the data are integrated in an interactive Web-based database that allows exploration of individual proteins, as well as navigation of global expression patterns, in all major tissues and organs in the human body. Copyright © 2015, American Association for the Advancement of Science.

The placenta is the extraembryonic organ that supports the fetus during intrauterine life. Although placental dysfunction results in major disorders of pregnancy with immediate and lifelong consequences for both mother and child, our knowledge of the human placenta is limited due to lack of functional experimental models1. Upon implantation, the trophectoderm of the blastocyst rapidly proliferates and generates the trophoblast, the unique cell type of the placenta. In vivo, the proliferative villous cytotrophoblast cells (VCT) differentiate into two main sub-populations: syncytiotrophoblast (SCT), the multinucleated epithelium of the villi responsible for nutrient exchange and hormone production, and extravillous trophoblast (EVT) that anchor the placenta to the maternal decidua and transform the maternal spiral arteries2. Here, we describe the generation of long-term, genetically-stable organoid cultures of trophoblast cells that can differentiate to SCT and EVT. We used HLA-typing to confirm the organoids are fetally-derived, and verified their identity against four trophoblast-specific criteria3. The cultures organise into villous-like structures, and we detected secretion of placental-specific peptides and hormones, including hCG, GDF15, PSGs and PAPPA, by mass spectrometry. The organoids also differentiate to HLA-G+ EVT that vigorously invade in 3D. Analysis of the methylome reveals the organoids closely resemble normal first-trimester placentas. This organoid model will be transformative for studying human placental development and for investigating trophoblast interactions with the local and systemic maternal environment.

Summary GDF15 is an established biomarker of cellular stress. The fact that it signals via a specific hindbrain receptor, GFRAL, and that mice lacking GDF15 manifest diet-induced obesity suggest that GDF15 may play a physiological role in energy balance. We performed experiments in humans, mice, and cells to determine if and how nutritional perturbations modify GDF15 expression. Circulating GDF15 levels manifest very modest changes in response to moderate caloric surpluses or deficits in mice or humans, differentiating it from classical intestinally derived satiety hormones and leptin. However, GDF15 levels do increase following sustained high-fat feeding or dietary amino acid imbalance in mice. We demonstrate that GDF15 expression is regulated by the integrated stress response and is induced in selected tissues in mice in these settings. Finally, we show that pharmacological GDF15 administration to mice can trigger conditioned taste aversion, suggesting that GDF15 may induce an aversive response to nutritional stress.