Foetal origins of adult diseases: just a matter of stem cell number?

Intrauterine growth retardation (IUGR) is associated with insulin resistance, non-insulin-dependent diabetes mellitus (NIDDM) and cardiovascular diseases in adulthood. Postnatal tissues contain stem cells that though quiescent, retain their capacity to self-renew and regenerate tissues to fulfil organ demands. I propose that intrauterine malnutrition reduces the number of tissue stem cells, eventually leading to an early exhaustion of organ function, especially when demands are increased. This hypothesis implies that early prevention of long-term consequences of IUGR should be aimed at inducing proliferation, differentiation and survival of stem cells or reversing the differentiation state of mature cells. (C) 2003 Elsevier Science Ltd. All rights reserved.