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Tinius RA, Cahill AG, Cade WT. Low-intensity Physical Activity is Associated with Lower Maternal Systemic Inflammation during Late Pregnancy. ACTA ACUST UNITED AC 2017; 7. [PMID: 28856070 PMCID: PMC5573245 DOI: 10.4172/2165-7904.1000343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Excessive maternal inflammation during pregnancy increases the risk for maternal and neonatal metabolic complications. Fortunately, maternal physical activity during pregnancy appears to reduce maternal inflammation. The purpose of this study was to examine the relationship between maternal physical activity intensity and maternal inflammation during late pregnancy. Maternal physical activity levels (sedentary, light, lifestyle, and moderate), fitness levels, and systemic inflammation (plasma C-reactive protein (CRP) concentration) were measured between 32–37 weeks gestation. Relationships were examined by Spearman Rank Coefficient Correlation analyses. Maternal plasma CRP was negatively associated with time spent in light and lifestyle physical activities (Light: r=−0.40, p=0.01; Lifestyle: r=−0.31, p=0.03), but not with time spent in moderate physical activity (r=−0.18, p=0.21). Higher maternal plasma CRP tended to correlate with more time spent sedentary (r=0.27, p=0.06). In addition, increases in light and lifestyle activities may elicit a clinically meaningful change in inflammation. In conclusion, pregnant women should be encouraged to incorporate more low-intensity physical activities into their daily routines in order to decrease systemic inflammation and potentially improve maternal and neonatal pregnancy outcomes.
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Affiliation(s)
- R A Tinius
- Program in Physical Therapy, Washington University School of Medicine, USA
| | - A G Cahill
- Department of Obstetrics and Gynecology, Washington University School of Medicine, USA
| | - W T Cade
- Program in Physical Therapy, Washington University School of Medicine, USA
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Graham C, Chooniedass R, Stefura WP, Becker AB, Sears MR, Turvey SE, Mandhane PJ, Subbarao P, HayGlass KT. In vivo immune signatures of healthy human pregnancy: Inherently inflammatory or anti-inflammatory? PLoS One 2017; 12:e0177813. [PMID: 28636613 PMCID: PMC5479559 DOI: 10.1371/journal.pone.0177813] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 05/03/2017] [Indexed: 12/20/2022] Open
Abstract
Changes in maternal innate immunity during healthy human pregnancy are not well understood. Whether basal immune status in vivo is largely unaffected by pregnancy, is constitutively biased towards an inflammatory phenotype (transiently enhancing host defense) or exhibits anti-inflammatory bias (reducing potential responsiveness to the fetus) is unclear. Here, in a longitudinal study of healthy women who gave birth to healthy infants following uncomplicated pregnancies within the Canadian Healthy Infant Longitudinal Development (CHILD) cohort, we test the hypothesis that a progressively altered bias in resting innate immune status develops. Women were examined during pregnancy and again, one and/or three years postpartum. Most pro-inflammatory cytokine expression, including CCL2, CXCL10, IL-18 and TNFα, was reduced in vivo during pregnancy (20-57%, p<0.0001). Anti-inflammatory biomarkers (sTNF-RI, sTNF-RII, and IL-1Ra) were elevated by ~50-100% (p<0.0001). Systemic IL-10 levels were unaltered during vs. post-pregnancy. Kinetic studies demonstrate that while decreased pro-inflammatory biomarker expression (CCL2, CXCL10, IL-18, and TNFα) was constant, anti-inflammatory expression increased progressively with increasing gestational age (p<0.0001). We conclude that healthy resting maternal immune status is characterized by an increasingly pronounced bias towards a systemic anti-inflammatory innate phenotype during the last two trimesters of pregnancy. This is resolved by one year postpartum in the absence of repeat pregnancy. The findings provide enhanced understanding of immunological changes that occur in vivo during healthy human pregnancy.
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Affiliation(s)
- Caroline Graham
- Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rishma Chooniedass
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - William P. Stefura
- Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Allan B. Becker
- Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Malcolm R. Sears
- Department of Medicine, de Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Stuart E. Turvey
- Department of Pediatrics, Child & Family Research Institute and BC Children’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Piush J. Mandhane
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Padmaja Subbarao
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - CHILD Study Investigators
- CHILD (Canadian Healthy Infant Longitudinal Development Study) Investigators, McMaster University, Hamilton, Canada
| | - Kent T. HayGlass
- Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
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153
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Interleukin-1 Receptor Antagonist Polymorphism and Birth Timing: Pathway Analysis Among African American Women. Nurs Res 2017; 66:95-104. [PMID: 28252571 DOI: 10.1097/nnr.0000000000000200] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Timing of birth is a major determinant of newborn health. African American women are at increased risk for early birth, particularly via the inflammatory pathway. Variants of the IL1RN gene, which encode the interleukin-1 receptor antagonist (IL-1Ra) protein, are implicated in early birth. The biological pathways linking these variables remain unclear. Evidence also suggests that inflammatory pathways differ by race; however, studies among African American women are lacking. OBJECTIVES We assessed whether an IL1RN variant was associated with timing of birth among African American women and whether this relationship was mediated by lower anti-inflammatory IL-1Ra production or related to a decrease in inhibition of proinflammatory IL-1β production. METHODS A candidate gene study using a prospective cohort design was used. We collected blood samples at 28-32 weeks of gestation among African American women experiencing an uncomplicated pregnancy (N = 89). IL1RN single-nucleotide polymorphism (SNP) rs2637988 was genotyped, and lipopolysaccharide-stimulated IL-1Ra and IL-1β production was quantified. Medical record review determined timing of birth. RESULTS Women with GG genotype gave birth earlier than women with AA/AG genotypes (b* = .21, p = .04). There was no indirect effect of IL1RN SNP rs2637988 allele status on timing of birth through IL-1Ra production, as evidenced by a nonsignificant product of coefficients in mediational analyses (ab = .006, 95% CI [-0.05, 0.13]). Women with GG genotype showed less inhibition of IL-1β production for a unit positive difference in IL-1Ra production than women with AA/AG genotypes (b* = .93, p = .03). Greater IL-1β production at 28-32 weeks of pregnancy was marginally associated with earlier birth (b* = .21, p = .05). DISCUSSION Women with GG genotype may be at risk for earlier birth because of diminished IL-1β inhibition, allowing for initiation of a robust inflammatory response upon even mild immune challenge. Study of inflammatory contributions to early birth among African American women may be key to identifying potential prognostic markers of risk and targeted preventive interventions.
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154
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Graham C, Thorleifson M, Stefura WP, Funk DJ, HayGlass KT. Class II obese and healthy pregnant controls exhibit indistinguishable pro- and anti-inflammatory immune responses to Caesarian section. IMMUNITY INFLAMMATION AND DISEASE 2017; 5:364-372. [PMID: 28544689 PMCID: PMC5569367 DOI: 10.1002/iid3.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/05/2017] [Accepted: 05/10/2017] [Indexed: 11/15/2022]
Abstract
Introduction Obesity during pregnancy is associated with meta‐inflammation and an increased likelihood of clinical complications. Surgery results in intense, acute inflammatory responses in any individual. Because obese individuals exhibit constitutive inflammatory responses and high rates of Caesarian section, it is important to understand the impact of surgery in such populations. Whether more pronounced pro‐inflammatory cytokine responses and/or counterbalancing changes in anti‐inflammatory immune modulators occurs is unknown. Here we investigated innate immune capacity in vivo and in vitro in non‐obese, term‐pregnant controls versus healthy, term‐pregnant obese women (Class II, BMI 35–40). Methods Systemic in vivo induction of eleven pro‐ and anti‐inflammatory biomarkers and acute phase proteins was assessed in plasma immediately prior to and again following Caesarian section surgery. Independently, innate immune capacity was examined by stimulating freshly isolated PBMC in vitro with a panel of defined PRR‐ligands for TLR4, TLR8, TLR3, and RLR 24 h post‐surgery. Results The kinetics and magnitude of the in vivo inflammatory responses examined were indistinguishable in the two populations across the broad range of biomarkers examined, despite the fact that obese women had higher baseline inflammatory status. Deliberate in vitro stimulation with a range of PRR ligands also elicited pro‐ and anti‐inflammatory cytokine responses that were indistinguishable between control and obese mothers. Conclusions Acute in vivo innate immune responses to C‐section, as well as subsequent in vitro stimulation with a panel of microbial mimics, are not detectably altered in Class II obese women. The data argue that while Class II obesity is undesirable, it has minimal impact on the in vivo inflammatory response, or innate immunomodulatory capacity, in women selecting C‐section.
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Affiliation(s)
- Caroline Graham
- Department of Immunology, University of Manitoba, Winnipeg, Canada
| | - Mullein Thorleifson
- Department of Anesthesia and Perioperative Medicine, University of Manitoba, Winnipeg, Canada
| | | | - Duane J Funk
- Department of Anesthesia and Perioperative Medicine, University of Manitoba, Winnipeg, Canada
| | - Kent T HayGlass
- Department of Immunology, University of Manitoba, Winnipeg, Canada
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Law KP, Zhang H. The pathogenesis and pathophysiology of gestational diabetes mellitus: Deductions from a three-part longitudinal metabolomics study in China. Clin Chim Acta 2017; 468:60-70. [DOI: 10.1016/j.cca.2017.02.008] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 02/06/2017] [Accepted: 02/12/2017] [Indexed: 01/19/2023]
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156
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Sjaarda LA, Radin RG, Silver RM, Mitchell E, Mumford SL, Wilcox B, Galai N, Perkins NJ, Wactawski-Wende J, Stanford JB, Schisterman EF. Preconception Low-Dose Aspirin Restores Diminished Pregnancy and Live Birth Rates in Women With Low-Grade Inflammation: A Secondary Analysis of a Randomized Trial. J Clin Endocrinol Metab 2017; 102:1495-1504. [PMID: 28323989 PMCID: PMC5443323 DOI: 10.1210/jc.2016-2917] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 01/11/2017] [Indexed: 12/19/2022]
Abstract
Context Inflammation is linked to causes of infertility. Low-dose aspirin (LDA) may improve reproductive success in women with chronic, low-grade inflammation. Objective To investigate the effect of preconception-initiated LDA on pregnancy rate, pregnancy loss, live birth rate, and inflammation during pregnancy. Design Stratified secondary analysis of a multicenter, block-randomized, double-blind, placebo-controlled trial. Setting Four US academic medical centers, 2007 to 2012. Participants Healthy women aged 18 to 40 years (N = 1228) with one to two prior pregnancy losses actively attempting to conceive. Intervention Preconception-initiated, daily LDA (81 mg) or matching placebo taken up to six menstrual cycles attempting pregnancy and through 36 weeks' gestation in women who conceived. Main Outcome Measures Confirmed pregnancy, live birth, and pregnancy loss were compared between LDA and placebo, stratified by tertile of preconception, preintervention serum high-sensitivity C-reactive protein (hsCRP) (low, <0.70 mg/L; middle, 0.70 to <1.95 mg/L; high, ≥1.95 mg/L). Results Live birth occurred in 55% of women overall. The lowest pregnancy and live birth rates occurred among the highest hsCRP tertile receiving placebo (44% live birth). LDA increased live birth among high-hsCRP women to 59% (relative risk, 1.35; 95% confidence interval, 1.08 to 1.67), similar to rates in the lower and mid-CRP tertiles. LDA did not affect clinical pregnancy or live birth in the low (live birth: 59% LDA, 54% placebo) or midlevel hsCRP tertiles (live birth: 59% LDA, 59% placebo). Conclusions In women attempting conception with elevated hsCRP and prior pregnancy loss, LDA may increase clinical pregnancy and live birth rates compared with women without inflammation and reduce hsCRP elevation during pregnancy.
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Affiliation(s)
- Lindsey A. Sjaarda
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20892
| | - Rose G. Radin
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20892
| | - Robert M. Silver
- Department of Obstetrics and Gynecology, University of Utah and Intermountain Healthcare, Salt Lake City, Utah 84132-2209
| | - Emily Mitchell
- Centers for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland 20857
| | - Sunni L. Mumford
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20892
| | - Brian Wilcox
- Department of Clinical Sciences, Obstetrics and Gynecology, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania 18509
| | - Noya Galai
- Department of Statistics, University of Haifa, Haifa 3498838, Israel
| | - Neil J. Perkins
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20892
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York 14214-8001
| | - Joseph B. Stanford
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah 84108
| | - Enrique F. Schisterman
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20892
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Abstract
OBJECTIVE Elevated levels of C-reactive protein (CRP) are associated with increased risk of cardiovascular and metabolic disease. The current study tested associations between psychosocial stress and CRP in a large sample of women during the first postpartum year. METHODS We analyzed data collected by the five-site Community Child Health Network study, which studied a predominately poor population. Participants (n = 1206 women; 54% African American, 23% white, 23% Hispanic/Latina) were recruited shortly after the birth of a child. Multiple linear regression analyses tested associations of psychosocial stress in several life domains (financial, neighborhood, family, coparenting, partner relationship, discrimination, and interpersonal violence) with log-transformed CRP concentrations at 6-month and 1-year postpartum. RESULTS Forty-eight percent of participants showed evidence of elevated CRP (≥3 mg/L) at 6-month postpartum, and 46% had elevated CRP at 12-month postpartum. Chronic financial stress at 1-month postpartum predicted higher levels of CRP at 6- (b = .15, SE = .05, p = .006) and 12-month postpartum (b = .15, SE = .06, p = .007) adjusting for race/ethnicity, income, education, parity, health behaviors, and chronic health conditions, though associations became nonsignificant when adjusted for body mass index. CONCLUSIONS In this low-income and ethnic/racially diverse sample of women, higher financial stress at 1-month postbirth predicted higher CRP. Study findings suggest that perceived financial stress stemming from socioeconomic disadvantage may be a particular deleterious form of stress affecting maternal biology during the year after the birth of a child.
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Mokkala K, Pellonperä O, Röytiö H, Pussinen P, Rönnemaa T, Laitinen K. Increased intestinal permeability, measured by serum zonulin, is associated with metabolic risk markers in overweight pregnant women. Metabolism 2017; 69:43-50. [PMID: 28285651 DOI: 10.1016/j.metabol.2016.12.015] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 11/23/2016] [Accepted: 12/28/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Increased intestinal permeability with subsequent metabolic endotoxemia, i.e., elevated circulating levels of bacterial lipopolysaccharide, LPS, has been introduced as a novel initiator of obesity related metabolic disturbances in non-pregnant individuals. The objective was to investigate the extent to which intestinal permeability, measured by serum zonulin concentration, is related to metabolic endotoxemia and metabolic risk markers in overweight pregnant women. METHODS This was a cross-sectional study including 100 pregnant overweight women in early pregnancy. Serum zonulin was analyzed using ELISA, and markers for metabolic endotoxemia (LPS), inflammation (high-sensitive C-reactive protein and glycoprotein acetylation GlyA), glucose metabolism (fasting glucose and insulin), and lipid metabolism were measured. RESULTS Higher serum zonulin concentration associated positively with LPS (P=0.02), inflammatory markers (P<0.001), insulin (P<0.001), insulin resistance (P<0.001), and triglycerides (P=0.001), and negatively with insulin sensitivity (P=0.001) (ANOVA with Tukey's corrections or Kruskal-Wallis nonparametric test with Bonferroni correction for zonulin quartiles). All the observed associations were confirmed (P<0.015) in a linear regression model adjusted with potential confounding factors. Both LPS and GlycA showed positive relationship with insulin resistance, serum insulin, triglycerides, total and LDL-cholesterol and negative relationship with insulin sensitivity (P≤0.03) in the univariate linear regression. Positive relationship was also found between LPS and HDL-cholesterol (P=0.03). CONCLUSIONS Our findings suggest that increased serum zonulin concentration, i.e., increased intestinal permeability, contributes to metabolic endotoxemia, systemic inflammation, and insulin resistance in overweight pregnant women. By reinforcing intestinal barrier, it may be possible to manipulate maternal metabolism during pregnancy with subsequent health benefits.
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Affiliation(s)
- Kati Mokkala
- Institute of Biomedicine, University of Turku, Finland; Functional Foods Forum, University of Turku, Finland.
| | - Outi Pellonperä
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Finland
| | - Henna Röytiö
- Institute of Biomedicine, University of Turku, Finland; Functional Foods Forum, University of Turku, Finland
| | - Pirkko Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and University Hospital of Helsinki, Finland
| | - Tapani Rönnemaa
- Department of Medicine, Institute of Clinical Medicine, University of Turku and Turku University Hospital, Finland
| | - Kirsi Laitinen
- Institute of Biomedicine, University of Turku, Finland; Functional Foods Forum, University of Turku, Finland
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159
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Pendeloski KPT, Ono E, Torloni MR, Mattar R, Daher S. Maternal obesity and inflammatory mediators: A controversial association. Am J Reprod Immunol 2017; 77. [PMID: 28328066 DOI: 10.1111/aji.12674] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 02/22/2017] [Indexed: 12/11/2022] Open
Abstract
The link between maternal obesity and inflammatory mediators is still unclear. Our aim was to summarize the main findings of recently published studies on this topic. We performed a search in Medline for studies published in the last years on obesity, human pregnancy, and inflammatory mediators. We report the findings of 30 studies. The characteristics and number of participants, study design, gestational age at sample collection, and type of sample varied widely. Approximately two-thirds of them investigated more than one mediator, and 50% included participants in only one trimester of pregnancy. The most frequently investigated mediators were leptin, tumour necrosis factor-alpha (TNF-α), and interleukin (IL)-6. Almost all studies reported an association between maternal obesity, leptin, and C-reactive protein (CRP) serum levels but not with IL-1β and IL-10. The association of IL-6, TNF-α, monocyte chemo-attractant protein-1 (MCP-1), adiponectin, and resistin with maternal obesity is still controversial. To clarify the physiopathological link between maternal obesity and inflammation, more high-quality studies are needed.
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Affiliation(s)
| | - Erika Ono
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
| | - Maria Regina Torloni
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
| | - Rosiane Mattar
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
| | - Silvia Daher
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
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160
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Close relationship qualities and maternal peripheral inflammation during pregnancy. Psychoneuroendocrinology 2017; 77:252-260. [PMID: 28129559 DOI: 10.1016/j.psyneuen.2017.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 11/16/2016] [Accepted: 01/04/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Close relationships are associated with pregnancy outcomes, but little is known about the mechanisms involved. This paper examines whether quality of women's close relationships, specifically with romantic partner (RP) and closest friend or family member (CF), is associated with inflammatory biomarkers during the third trimester of pregnancy. METHODS 90 pregnant women were assessed during the second and third trimester. At both visits they completed self-reports describing the positive and negative aspects of their RP and CF relationships. Peripheral blood was collected during these visits, and used to measure systemic levels of cytokines, including IFNγ, IL10, IL6, IL8 and IL13. An index of inflammatory regulation, as reflected by the ratio of IL6:IL10, was also computed. RESULTS Positive (e.g. support, intimacy) and negative (e.g. conflict) aspects of the RP relationship interacted to predict third trimester cytokine values. Specifically, RP relationships relatively low in both positive and negative aspects were associated with lower third trimester anti-inflammatory (IL10, IL13) and anti-viral (IFNγ) cytokines, and a higher IL6:IL10 ratio, controlling for second trimester levels. These associations were independent of demographics, gestational age, weeks between assessment, parity, pre-pregnancy body mass index, maternal stress, distress, depressed mood and RP cohabitation. CF relationship aspects were not associated with inflammatory markers. CONCLUSIONS RP relationships relatively low in both positive, e.g. support and intimacy, and negative, e.g. conflict, aspects were associated with a less anti- and more pro-inflammatory cytokine profile during the third trimester. These findings have implications for understanding the associations amongst close relationships, inflammation, and potentially pregnancy outcomes.
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161
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Romero R, Chaemsaithong P, Tarca AL, Korzeniewski SJ, Maymon E, Pacora P, Panaitescu B, Chaiyasit N, Dong Z, Erez O, Hassan SS, Chaiworapongsa T. Maternal plasma-soluble ST2 concentrations are elevated prior to the development of early and late onset preeclampsia - a longitudinal study. J Matern Fetal Neonatal Med 2017; 31:418-432. [PMID: 28114842 DOI: 10.1080/14767058.2017.1286319] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The objectives of this study were to determine (1) the longitudinal profile of plasma soluble ST2 (sST2) concentrations in patients with preeclampsia and those with uncomplicated pregnancies; (2) whether the changes in sST2 occur prior to the diagnosis of preeclampsia; and (3) the longitudinal sST2 profile of women with early or late preeclampsia. MATERIALS AND METHODS This longitudinal nested case-control study included singleton pregnancies in the following groups: (1) uncomplicated pregnancies (n = 160); and (2) those complicated by early (<34 weeks, n = 9) and late (≥34 weeks, n = 31) preeclampsia. sST2 concentrations were determined by enzyme-linked immunosorbent assays. Mixed-effects models were used for the longitudinal analysis. RESULTS (1) Plasma sST2 concentration profiles across gestation differed significantly among cases and controls (p < 0.0001); (2) women with early preeclampsia had higher mean sST2 concentrations than controls at >22 weeks of gestation; cases with late preeclampsia had higher mean concentrations at >33 weeks of gestation (both p < 0.05); and (3) these changes started approximately 6 weeks prior to clinical diagnosis. CONCLUSIONS Maternal plasma sST2 concentrations are elevated 6 weeks prior to the clinical diagnosis of preeclampsia. An increase in the maternal plasma concentration of sST2 may contribute to an exaggerated intravascular inflammatory response and/or the Th1/Th2 imbalance in some cases.
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Affiliation(s)
- Roberto Romero
- a Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,b Department of Obstetrics and Gynecology , University of Michigan , Ann Arbor , MI , USA.,c Department of Epidemiology and Biostatistics , Michigan State University , East Lansing , MI , USA.,d Center for Molecular Medicine and Genetics , Wayne State University , Detroit , MI , USA
| | - Piya Chaemsaithong
- a Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,e Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Adi L Tarca
- a Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,e Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Steven J Korzeniewski
- a Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,c Department of Epidemiology and Biostatistics , Michigan State University , East Lansing , MI , USA.,e Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Eli Maymon
- a Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,e Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Percy Pacora
- a Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,e Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Bogdan Panaitescu
- a Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,e Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Noppadol Chaiyasit
- a Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,e Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Zhong Dong
- a Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,e Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Offer Erez
- a Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,e Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Sonia S Hassan
- a Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,e Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Tinnakorn Chaiworapongsa
- a Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,e Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
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Rusconi F, Popovic M. Maternal obesity and childhood wheezing and asthma. Paediatr Respir Rev 2017; 22:66-71. [PMID: 27743958 DOI: 10.1016/j.prrv.2016.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 08/11/2016] [Indexed: 10/21/2022]
Abstract
Obesity represents one of the major public health problems worldwide, with an increased prevalence also among women of reproductive age. Maternal pre-pregnancy overweight and obesity are important risk factors for a number of maternal and foetal/neonatal complications. The objective of this review is to provide an overview of the most recent evidence regarding the associations between pre-pregnancy overweight/obesity and wheezing and asthma in childhood. Potential mechanisms, mediators and confounding factors involved in these associations are also discussed. Despite the relatively large body of studies examining these associations and taking into account main confounders and potential mediators, the causal relationship between maternal obesity and wheezing and asthma in childhood is still uncertain. This uncertainty is not trivial, as any prevention strategy aimed at reducing the burden of these conditions would necessarily imply better understanding of the factors that are in the causal chain.
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Affiliation(s)
- Franca Rusconi
- Unit of Epidemiology, 'Anna Meyer' Children's University Hospital, Florence, Italy.
| | - Maja Popovic
- Department of Medical Sciences, University of Turin, Turin, Italy
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163
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Mitchell AM, Palettas M, Christian LM. Fetal sex is associated with maternal stimulated cytokine production, but not serum cytokine levels, in human pregnancy. Brain Behav Immun 2017; 60:32-37. [PMID: 27375004 PMCID: PMC5558889 DOI: 10.1016/j.bbi.2016.06.015] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/28/2016] [Accepted: 06/28/2016] [Indexed: 02/07/2023] Open
Abstract
Some studies suggest that fetal sex plays a role in maternal physiological processes during pregnancy including glycemic control, blood pressure, and cortisol regulation. However, data examining fetal sex-specific differences in maternal immune parameters is lacking. In the current study, serum levels of interleukin(IL)-6, IL-8, and tumor necrosis factor(TNF)-α as well as LPS-stimulated production of IL-6, IL-8, TNF-α, and IL-1β by PBMCs incubated for 24h were assessed in early, mid, and late pregnancy among 80 women (46 with male and 34 with female fetuses). Linear mixed models showed that women carrying females versus males exhibited greater stimulated production of IL-6 at each timepoint (ps⩽0.03), TNF-α in early pregnancy (p=0.04), and IL-1β in mid- and late pregnancy (ps⩽0.05). Despite changes in serum levels of IL-8 (p=0.002) and TNF-α (p<0.0001) across pregnancy, no differences in any serum cytokines were observed in relation to fetal sex (ps>0.85). In conclusion, in pregnant women, those carrying female versus male fetuses exhibited greater stimulated cytokine production across pregnancy. Differential inflammatory responses could affect maternal health and fetal development. Fetal sex should be considered as a factor in studies of maternal inflammation. These findings have relevance both clinically and conceptually. For example, maternal asthma is exacerbated among women carrying female versus male fetuses. In addition, data on associations between fetal sex and maternal immune function among women with health conditions (e.g., preeclampsia) and adverse pregnancy outcomes (e.g., preterm birth) would be informative.
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Affiliation(s)
- Amanda M Mitchell
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, United States; Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Marilly Palettas
- Center for Biostatistics, The Ohio State University, Columbus, OH, United States
| | - Lisa M Christian
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, United States; Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, United States; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States; Department of Psychology, The Ohio State University, United States.
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164
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Zembala-Szczerba M, Jaworowski A, Huras H, Babczyk D, Jach R. Low-Grade Metabolically-Induced Inflammation Mediators Interleukin-6, Adiponectin, and TNF-α Serum Levels in Obese Pregnant Patients in the Perinatal Period. Med Sci Monit Basic Res 2017; 23:1-7. [PMID: 28077838 PMCID: PMC5248566 DOI: 10.12659/msmbr.902273] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Obesity is a major clinical problem. The number of obese pregnant women is rising rapidly. The consequences of obesity are significant and affect every aspect of perinatal care for both the mother and the developing fetus. Adipose tissue may be responsible for chronic subclinical inflammation in obesity, being a source of inflammatory mediators. The study was designed to evaluate the analysis of the serum concentration of inflammatory mediators, including interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and adiponectin, in obese pregnant women at full-term pregnancies. Material/Methods The study included 40 women with body mass index (BMI) less than 30 and 24 pregnant women with BMI equal to or greater than 30, admitted to the Perinatology and Obstetrics Department of the University Hospital in Cracow in the first stage of labor. Blood samples were taken from patients to detect the serum concentration of cytokines. Ultrasound was used to evaluate the development of the fetus, including estimated fetal weight, Doppler flows, and the amount of amniotic fluid. We also included the history of chronic diseases and other complications of the pregnancy. A p-value <0.05 was considered significant. Results The level of adiponectin in obese patients as compared to controls was significantly lower. There was no statistically significant difference in either group when TNF-α and IL-6 were measured. The results of the survey are consistent with previous reports. Conclusions The exact role of inflammation in pregnancy is not well understood. Determining the exact functions of the different cytokines in physiological pregnancy and pregnancy complicated by obesity requires further study.
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Affiliation(s)
| | - Andrzej Jaworowski
- Clinical Department of Obstetrics and Perinatology, University Hospital, Cracow, Poland
| | - Hubert Huras
- Clinical Department of Obstetrics and Perinatology, University Hospital, Cracow, Poland
| | - Dorota Babczyk
- Clinical Department of Obstetrics and Perinatology, University Hospital, Cracow, Poland
| | - Robert Jach
- Clinical Department of Obstetrics and Perinatology, University Hospital, Cracow, Poland
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165
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Elfeky O, Longo S, Lai A, Rice GE, Salomon C. Influence of maternal BMI on the exosomal profile during gestation and their role on maternal systemic inflammation. Placenta 2016; 50:60-69. [PMID: 28161063 DOI: 10.1016/j.placenta.2016.12.020] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/15/2016] [Accepted: 12/18/2016] [Indexed: 12/23/2022]
Abstract
Recent studies report that 35% of women are either overweight or obese at reproductive age. The placenta continuously releases exosomes across gestation and their concentration is higher in pregnancy complications. While there is considerable interest in elucidating the role of exosomes during gestation, important questions remain to be answered: i) Does maternal BMI affect the exosomal profile across gestation? and ii) What is the contribution of placenta-derived exosomes to the total number of exosomes present in maternal plasma across gestation? Plasma samples were classified according to the maternal BMI into three groups (n = 15 per group): Lean, overweight, and obese. Total exosomes and specific placenta-derived exosomes were determined by Nanoparticle Tracking Analysis (NanoSight™) using quantum dots coupled with CD63 or PLAP antibodies. The effect of exosomes on cytokine (IL-6, IL-8, IL-10 and TNF-α) release from endothelial cells was established by cytokine array analysis (Bioplex-200). The total number of exosomes present in maternal circulation was strongly correlated with maternal BMI. Between ∼12% and ∼25% of circulating exosomes in maternal blood are of placental origin during gestation, and the contribution of placental exosomes to the total exosomal population decreases with higher maternal BMI across gestation. Exosomes increase IL-6, IL-8 and TNF-α release from endothelial cells, an effect even higher when exosomes were isolated from obese women compared to lean and overweight. This study established that maternal BMI is a factor that explains a significant component of the variation in the exosomes data. Exosomes may contribute to the maternal systemic inflammation during pregnancy.
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Affiliation(s)
- Omar Elfeky
- Exosome Biology Laboratory, Centre for Clinical Diagnostics, UQ Centre for Clinical Research, Royal Brisbane and Women's Hospital, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Australia
| | - Sherri Longo
- Department of Obstetrics and Gynecology, Ochsner Baptist Hospital, New Orleans, LA, USA
| | - Andrew Lai
- Exosome Biology Laboratory, Centre for Clinical Diagnostics, UQ Centre for Clinical Research, Royal Brisbane and Women's Hospital, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Australia
| | - Gregory E Rice
- Exosome Biology Laboratory, Centre for Clinical Diagnostics, UQ Centre for Clinical Research, Royal Brisbane and Women's Hospital, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Australia; Department of Obstetrics and Gynecology, Ochsner Baptist Hospital, New Orleans, LA, USA
| | - Carlos Salomon
- Exosome Biology Laboratory, Centre for Clinical Diagnostics, UQ Centre for Clinical Research, Royal Brisbane and Women's Hospital, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Australia; Department of Obstetrics and Gynecology, Ochsner Baptist Hospital, New Orleans, LA, USA.
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166
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Howell KR, Powell TL. Effects of maternal obesity on placental function and fetal development. Reproduction 2016; 153:R97-R108. [PMID: 27864335 DOI: 10.1530/rep-16-0495] [Citation(s) in RCA: 209] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/10/2016] [Accepted: 11/18/2016] [Indexed: 12/11/2022]
Abstract
Obesity has reached epidemic proportions, and pregnancies in obese mothers have increased risk for complications including gestational diabetes, hypertensive disorders, pre-term birth and caesarian section. Children born to obese mothers are at increased risk of obesity and metabolic disease and are susceptible to develop neuropsychiatric and cognitive disorders. Changes in placental function not only play a critical role in the development of pregnancy complications but may also be involved in linking maternal obesity to long-term health risks in the infant. Maternal adipokines, i.e., interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), leptin and adiponectin link maternal nutritional status and adipose tissue metabolism to placental function. Adipokines and metabolic hormones have direct impact on placental function by modulating placental nutrient transport. Nutrient delivery to the fetus is regulated by a complex interaction including insulin signaling, cytokine profile and insulin responsiveness, which is modulated by adiponectin and IL-1β. In addition, obese pregnant women are at risk for hypertension and preeclampsia with reduced placental vascularity and blood flow, which would restrict placental nutrient delivery to the developing fetus. These sometimes opposing signals regulating placental function may contribute to the diversity of short and long-term outcomes observed in pregnant obese women. This review focuses on the changes in adipokines and obesity-related metabolic hormones, how these factors influence placental function and fetal development to contribute to long-term metabolic and behavioral consequences of children born to obese mothers.
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Affiliation(s)
- Kristy R Howell
- Departments of PsychiatryObstetrics/Gynecology and Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Theresa L Powell
- Departments of PsychiatryObstetrics/Gynecology and Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
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167
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Taylor BD, Ness RB, Klebanoff MA, Zoh R, Bass D, Hougaard DM, Skogstrand K, Haggerty CL. First and second trimester immune biomarkers in preeclamptic and normotensive women. Pregnancy Hypertens 2016; 6:388-393. [PMID: 27939488 DOI: 10.1016/j.preghy.2016.09.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/14/2016] [Accepted: 09/16/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Circulating immune markers may be associated with preeclampsia but further investigations in early pregnancy and among preeclampsia subtypes are warranted. We examined immune markers in 208 preeclamptic women and 411 normotensive controls. METHODS Our study was nested within the Collaborative Perinatal Project. A total of 242 women had first trimester serum samples and 392 had second trimester serum samples. Preeclampsia was defined as hypertension >20weeks of gestation with proteinuria or pulmonary edema, oliguria, or convulsions. Preterm preeclampsia was defined as preeclampsia with delivery less than 37weeks of gestation. Associations between immune markers RANTES, interleukin (IL)-6, IL4, IL5, IL12, IL10, IL8, IL1-beta, interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha and beta, transforming growth factor (TGF)-beta and preeclampsia were explored using a modified version of cox regression developed to address data with non-detectable levels. Models were adjusted for body mass index, gestational age of blood sampling, fetal sex, smoking, socioeconomic status and maternal age. RESULTS In first trimester samples, IL-12 was associated with preeclampsia (p=0.0255). IFN-gamma (p=0.0063), IL1-beta (p=0.0006), IL5 (p=0.0422) and TNFr (p=0.0460) were associated with preterm preeclampsia only. In second trimester samples, IL1-beta was associated with preeclampsia (p=0.0180) and term preeclampsia (p=0.0454). After correction for multiple comparisons, only IL1-beta remained associated with preterm preeclampsia in the first trimester (p=0.0288). DISCUSSION Elevated first trimester IL1-beta appears to be associated with preterm preeclampsia. However, few associations were observed in the second trimester. Systemic immune markers alone may not be useful for preeclampsia prediction.
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Affiliation(s)
- Brandie D Taylor
- Department of Epidemiology and Biostatistics, Texas A&M University, School of Public Health, College Station, TX, United States; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.
| | - Roberta B Ness
- University of Texas School of Public Health, Houston, TX, United States
| | - Mark A Klebanoff
- The Research Institute at Nationwide Children's Hospital, United States
| | - Roger Zoh
- Department of Epidemiology and Biostatistics, Texas A&M University, School of Public Health, College Station, TX, United States
| | - Debra Bass
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - David M Hougaard
- Danish Centre for Neonatal Screening, Department of Clinical Biochemistry, Immunology and Genetics, Statens Serum Institut, Copenhagen, Denmark
| | - Kristin Skogstrand
- Danish Centre for Neonatal Screening, Department of Clinical Biochemistry, Immunology and Genetics, Statens Serum Institut, Copenhagen, Denmark
| | - Catherine L Haggerty
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
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168
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Ross KM, Miller G, Culhane J, Grobman W, Simhan HN, Wadhwa PD, Williamson D, McDade T, Buss C, Entringer S, Adam E, Qadir S, Keenan-Devlin L, Leigh AKK, Borders A. Patterns of peripheral cytokine expression during pregnancy in two cohorts and associations with inflammatory markers in cord blood. Am J Reprod Immunol 2016; 76:406-414. [PMID: 27615067 DOI: 10.1111/aji.12563] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 08/15/2016] [Indexed: 01/02/2023] Open
Abstract
PROBLEM Maternal inflammation undergoes adaptations during pregnancy, and excessive inflammation has been associated with adverse outcomes. One mechanism may be maternal inflammation transmission to the fetal compartment. Links between maternal pregnancy inflammation and fetal inflammation are poorly characterized. METHOD Principal components analysis was used to extract underlying inflammation components across cytokines (IFN-γ, IL-10, IL-13, IL-6, IL-8, TNF-α) in two pregnancy cohorts (SPAH N=87, MOMS N=539) assessed during the second and third trimesters. Links between maternal inflammation over pregnancy and fetal (cord blood) inflammation were assessed. RESULTS Substantial cytokine rank-order stability was observed in both cohorts, β's range .47-.96, P's <.001. Two consistent inflammatory components were extracted: a pro-inflammatory (IL-10, IL-6, IL-8, TNF-α, IFN-γ) component and anti-inflammatory (IL-13) component. Higher maternal pro-inflammatory and lower anti-inflammatory indices during pregnancy were associated with higher cord blood inflammation, P's>.04. CONCLUSION Maternal inflammation indices over pregnancy were associated with inflammation in cord blood at birth. Results have implications for understanding pregnancy inflammatory processes and how maternal inflammation may be transmitted to fetal circulation.
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Affiliation(s)
- Kharah MacKenzie Ross
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA.
| | - Gregory Miller
- Department of Psychology, Northwestern University, Evanston, IL, USA.,Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Jennifer Culhane
- Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - William Grobman
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Healthcare Studies, Institute for Public Health and Medicine, Chicago, IL, USA
| | - Hyagriv N Simhan
- Division of Maternal-Fetal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Division of Obstetrical Services, Magee Women's Hospital, Pittsburgh, PA, USA
| | - Pathik D Wadhwa
- UCI Development, Health and Disease Research Program, University of California Irvine, Irvine, CA, USA
| | - Douglas Williamson
- Department of Psychiatry and Behavioral Services, Duke University, Durham, NC, USA
| | - Thomas McDade
- Institute for Policy Research, Northwestern University, Evanston, IL, USA.,Department of Anthropology, Northwestern University, Evanston, IL, USA
| | - Claudia Buss
- UCI Development, Health and Disease Research Program, University of California Irvine, Irvine, CA, USA.,Charite Universitätsmedizin Berlin, Berlin, Germany
| | - Sonja Entringer
- UCI Development, Health and Disease Research Program, University of California Irvine, Irvine, CA, USA.,Charite Universitätsmedizin Berlin, Berlin, Germany
| | - Emma Adam
- Institute for Policy Research, Northwestern University, Evanston, IL, USA.,School of Education and Social Policy, Northwestern University, Evanston, IL, USA
| | - Sameen Qadir
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA
| | - Lauren Keenan-Devlin
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, NorthShore University Health System, Evanston, IL, USA
| | - Adam K K Leigh
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Ann Borders
- Center for Healthcare Studies, Institute for Public Health and Medicine, Chicago, IL, USA.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Obsetrics and Gynecology, Division of Maternal Fetal Medicine, NorthShore University Health System, University of Chicago Pritzker School of Medicine, Evanston, IL, USA
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169
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Boeck C, Koenig AM, Schury K, Geiger ML, Karabatsiakis A, Wilker S, Waller C, Gündel H, Fegert JM, Calzia E, Kolassa IT. Inflammation in adult women with a history of child maltreatment: The involvement of mitochondrial alterations and oxidative stress. Mitochondrion 2016; 30:197-207. [DOI: 10.1016/j.mito.2016.08.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 07/15/2016] [Accepted: 08/12/2016] [Indexed: 12/24/2022]
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170
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Gillespie SL, Christian LM. Body Mass Index as a Measure of Obesity: Racial Differences in Predictive Value for Health Parameters During Pregnancy. J Womens Health (Larchmt) 2016; 25:1210-1218. [PMID: 27487272 DOI: 10.1089/jwh.2016.5761] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND As a measure of obesity, body mass index (BMI; kg/m2) is an imperfect predictor of health outcomes, particularly among African Americans. However, BMI is used to guide prenatal care. We examined racial differences in the predictive value of maternal BMI for physiologic correlates of obesity, serum interleukin (IL)-6 and C-reactive protein (CRP), as well as cesarean section and infant birth weight. METHODS One hundred five pregnant women (40 European American, 65 African American) were assessed during the second trimester. BMI was defined as per prepregnancy weight. Electrochemiluminescence and enzyme-linked immunosorbent assays were used to quantify IL-6 and CRP, respectively. Birth outcomes were determined by medical record review. RESULTS Women of both races classified as obese had higher serum IL-6 and CRP than their normal-weight counterparts (ps ≤ 0.01). However, among women with overweight, elevations in IL-6 (p < 0.01) and CRP (p = 0.06) were observed among European Americans, but not African Americans (ps ≥ 0.61). Maternal obesity was a significantly better predictor of cesarean section among European Americans versus African Americans (p = 0.03) and BMI was associated with infant birth weight among European Americans (p < 0.01), but not African Americans (p = 0.94). Effects remained after controlling for gestational age at delivery, gestational diabetes, and gestational weight gain as appropriate. CONCLUSIONS BMI may be a less valid predictor of correlates of overweight/obesity among African Americans versus European Americans during pregnancy. This should be considered in epidemiological studies of maternal-child health. In addition, studies examining the comparative validity of alternative/complementary measures to define obesity in pregnancy are warranted to inform clinical care.
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Affiliation(s)
| | - Lisa M Christian
- 2 Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center , Columbus, Ohio.,3 Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center , Columbus, Ohio.,4 The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center , Columbus, Ohio.,5 Department of Psychology, The Ohio State University , Columbus, Ohio
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171
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Racial discrimination predicts greater systemic inflammation in pregnant African American women. Appl Nurs Res 2016; 32:98-103. [PMID: 27969060 DOI: 10.1016/j.apnr.2016.06.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 06/18/2016] [Indexed: 11/21/2022]
Abstract
PURPOSE Chronic exposure to racial discrimination by pregnant African American women may lead to allostatic overload; thereby, predisposing women to systemic inflammation. Thus, the goal of this study was to examine if experiences of racial discrimination are related to systemic inflammation in pregnant African Americans. METHODS A sample of 96 African American women from Chicago completed questionnaires and had blood drawn during the second trimester of pregnancy (19.7±2.5 weeks). RESULTS Experiences of racial discrimination were associated with higher cytokine levels of interleukin (IL)-4 (B=2.161, 95% CI = 1.02-3.30, p<.001) and IL-6 (B=1.859, 95% CI=.61-3.11, p=.004) when controlling for covariates. CONCLUSION These findings suggest that experiences of racial discrimination may cause physiological wear and tear on the body leading to alteration of immune functions. Nurses should inquire about women's experiences of racial discrimination and make referrals for community or church support groups for women who report racial discrimination.
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172
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Sargın MA, Yassa M, Taymur BD, Celik A, Ergun E, Tug N. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios: are they useful for predicting gestational diabetes mellitus during pregnancy? Ther Clin Risk Manag 2016; 12:657-65. [PMID: 27217758 PMCID: PMC4853164 DOI: 10.2147/tcrm.s104247] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE We aimed to investigate whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) could be utilized to screen for gestational diabetes mellitus (GDM). SUBJECTS AND METHODS NLR and PLR were assessed by retrospective analysis of 762 healthy and pregnant women with GDM. The patients were stratified into four groups, as follows: GDM (n=144), impaired glucose tolerance (n=76), only screen positive (n=238), and control (n=304). RESULTS The leukocyte, neutrophil, and lymphocyte counts were significantly higher in the study groups compared with the control group (P=0.001; P<0.01). There were no statistically significant differences between the groups with respect to the NLR and PLR (P>0.05). CONCLUSION We do not recommend that blood NLR and PLR can be used to screen for GDM. However, increase in the leukocyte count is an important marker for GDM as it provides evidence of subclinical inflammation.
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Affiliation(s)
- Mehmet Akif Sargın
- Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Murat Yassa
- Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Bilge Dogan Taymur
- Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Ayhan Celik
- Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Emrah Ergun
- Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Niyazi Tug
- Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
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173
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Lower prenatal vitamin D status and postpartum depressive symptomatology in African American women: Preliminary evidence for moderation by inflammatory cytokines. Arch Womens Ment Health 2016; 19:373-83. [PMID: 26407996 PMCID: PMC4801760 DOI: 10.1007/s00737-015-0585-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 09/14/2015] [Indexed: 02/06/2023]
Abstract
Vitamin D deficiency and elevated pro-inflammatory cytokines have each been associated individually with postpartum depression (PPD). African American women are at increased risk for prenatal vitamin D deficiency, inflammation, and prenatal and postpartum depressive symptoms, but biological risk factors for PPD in this population have rarely been tested. This prospective study tested whether low prenatal vitamin D status (serum 25-hydroxyvitamin D, 25[OH]D) predicted PPD symptomatology in pregnant African American women and whether high levels of prenatal inflammatory cytokines interacted with low 25(OH)D in effects on PPD symptoms. Vitamin D status was measured in the first trimester in a sample of 91 African American pregnant women who had a second trimester blood sample assayed for inflammatory markers. Depressive symptoms were assessed at a postpartum visit. An inverse association between prenatal log 25(OH)D and PPD symptomatology approached significance (β = -0.209, p = 0.058), and interleukin-6 and IL-6/IL-10 ratio significantly moderated the effect. Among women with higher levels of inflammatory markers, lower prenatal log 25(OH)D was associated with significantly higher PPD symptoms (p < 0.05). These preliminary results are intriguing because, if replicable, easy translational opportunities, such as increasing vitamin D status in pregnant women with elevated pro-inflammatory cytokines, may reduce PPD symptoms.
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174
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Siwetz M, Blaschitz A, El-Heliebi A, Hiden U, Desoye G, Huppertz B, Gauster M. TNF-α alters the inflammatory secretion profile of human first trimester placenta. J Transl Med 2016; 96:428-38. [PMID: 26752743 DOI: 10.1038/labinvest.2015.159] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 09/23/2015] [Accepted: 10/12/2015] [Indexed: 12/22/2022] Open
Abstract
Implantation and subsequent placental development depend on a well-orchestrated interaction between fetal and maternal tissues, involving a fine balanced synergistic cross-talk of inflammatory and immune-modulating factors. Tumor necrosis factor (TNF)-α has been increasingly recognized as pivotal factor for successful pregnancy, although high maternal TNF-α levels are associated with a number of adverse pregnancy conditions including gestational hypertension and gestational diabetes mellitus. This study describes effects of exogenously applied TNF-α, mimicking increased maternal TNF-α levels, on the secretion profile of inflammation associated factors in human first trimester villous placenta. Conditioned culture media from first trimester villous placental explants were analyzed by inflammation antibody arrays and ELISA after 48 h culture in the presence or absence of TNF-α. Inflammation antibody arrays identified interleukin (IL)-6, IL-8, chemokine (C-C motif) ligand 2 (CCL2), CCL4, and granulocyte-macrophage colony-stimulating factor (GM-CSF) as the most abundantly secreted inflammation-associated factors under basal culture conditions. In the presence of TNF-α, secretion of GM-CSF, CCL5, and IL-10 increased, whereas IL-4 and macrophage CSF levels decreased compared with controls. ELISA analysis verified antibody arrays by showing significantly increased synthesis and release of GM-CSF and CCL5 by placental explants in response to TNF-α. Immunohistochemistry localized GM-CSF in the villous trophoblast compartment, whereas CCL5 was detected in maternal platelets adhering to perivillous fibrin deposits on the villous surface. mRNA-based in situ padlock probe approach localized GM-CSF and CCL5 transcripts in the villous trophoblast layer and the villous stroma. Results from this study suggest that the inflammatory secretion profile of human first trimester placenta shifts towards increased levels of GM-CSF, CCL5, and IL10 in response to elevated maternal TNF-α levels, whereas IL-6 and IL-8 remain unaffected. This shift may represent a protective mechanism by human first trimester villous placenta to sustain trophoblast function and dampen inflammatory processes in the intervillous space.
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Affiliation(s)
- Monika Siwetz
- Institute of Cell Biology, Histology and Embryology, Medical University Graz, Graz, Austria
| | - Astrid Blaschitz
- Institute of Cell Biology, Histology and Embryology, Medical University Graz, Graz, Austria
| | - Amin El-Heliebi
- Institute of Cell Biology, Histology and Embryology, Medical University Graz, Graz, Austria
| | - Ursula Hiden
- Department of Obstetrics and Gynaecology, Medical University Graz, Graz, Austria
| | - Gernot Desoye
- Department of Obstetrics and Gynaecology, Medical University Graz, Graz, Austria
| | - Berthold Huppertz
- Institute of Cell Biology, Histology and Embryology, Medical University Graz, Graz, Austria
| | - Martin Gauster
- Institute of Cell Biology, Histology and Embryology, Medical University Graz, Graz, Austria
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175
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Lekva T, Norwitz ER, Aukrust P, Ueland T. Impact of Systemic Inflammation on the Progression of Gestational Diabetes Mellitus. Curr Diab Rep 2016; 16:26. [PMID: 26879309 DOI: 10.1007/s11892-016-0715-9] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
With increasing rates of obesity and new diagnostic criteria for gestational diabetes mellitus (GDM), the overall prevalence of GDM is increasing worldwide. Women with GDM have an increased risk of maternal and fetal complications during pregnancy as well as long-term risks including higher prevalence of type 2 diabetes mellitus and cardiovascular disease. In recent years, the role of immune activation and inflammation in the pathogenesis of GDM has gained increasing attention. This monograph explores the current state of the literature as regards the expression of markers of inflammation in the maternal circulation, placenta, and adipose tissue of women with GDM.
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Affiliation(s)
- Tove Lekva
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0027, Oslo, Norway.
- Mother Infant Research Institute, Tufts Medical Center, 800 Washington Street, Boston, MA, 02116, USA.
| | - Errol R Norwitz
- Mother Infant Research Institute, Tufts Medical Center, 800 Washington Street, Boston, MA, 02116, USA.
- Department of Obstetrics & Gynecology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA.
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0027, Oslo, Norway.
- Faculty of Medicine, University of Oslo, Oslo, Norway.
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0027, Oslo, Norway.
- Faculty of Medicine, University of Oslo, Oslo, Norway.
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176
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Stepan M, Cobo T, Musilova I, Hornychova H, Jacobsson B, Kacerovsky M. Maternal Serum C-Reactive Protein in Women with Preterm Prelabor Rupture of Membranes. PLoS One 2016; 11:e0150217. [PMID: 26942752 PMCID: PMC4778871 DOI: 10.1371/journal.pone.0150217] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 02/10/2016] [Indexed: 11/18/2022] Open
Abstract
Objective This study evaluated maternal C-reactive protein (CRP) as a predictor of microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA) in women with preterm prelabor rupture of the membranes (PPROM) before and after 32 weeks of gestation. Methods This study was a prospective observational cohort study of 386 women. Maternal serum CRP concentrations were evaluated, and amniotic fluid samples were obtained via transabdominal amniocentesis at the time of admission. Placentas underwent histopathological examination after delivery. MIAC was defined based on a positive PCR for Ureaplasma species, Mycoplasma hominis and Chlamydia trachomatis and/or positive 16S rRNA gene amplification. HCA was defined based on the Salafia classification. Results Maternal CRP was significantly higher in women with MIAC and HCA (median 9.0 mg/l) than in women with HCA alone (median 6.9 mg/l), MIAC alone (median 7.4 mg/l) and without MIAC or HCA (median 4.5 mg/l) (p<0.0001). CRP was a weak predictor of the occurrence of MIAC and HCA before and after 32 weeks of gestation. Only the 95th percentile of CRP and PPROM before 32 weeks exhibited a false-positive rate of 1%, a positive predictive value of 90% and a positive likelihood ratio of 13.2 to predict MIAC and HCA. However, the low sensitivity of 15% limits the clinical utility of this detection. Conclusion CRP is a poor predictor of the occurrence of MIAC and HCA, even at early gestational ages.
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Affiliation(s)
- Martin Stepan
- Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, Hradec Kralove, Czech Republic
- * E-mail:
| | - Teresa Cobo
- Department of Obstetrics and Gynecology, Sahlgrenska academy, Sahlgrenska University Hospital, Gothenburg, Sweden
- BCNatal—Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clinic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, IDIBAPS, University of Barcelona, Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - Ivana Musilova
- Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, Hradec Kralove, Czech Republic
| | - Helena Hornychova
- Fingerland´s Department of Pathology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska academy, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo University, Oslo, Norway
| | - Marian Kacerovsky
- Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, Hradec Kralove, Czech Republic
- Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
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177
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Christian LM, Blair LM, Porter K, Lower M, Cole RM, Belury MA. Polyunsaturated Fatty Acid (PUFA) Status in Pregnant Women: Associations with Sleep Quality, Inflammation, and Length of Gestation. PLoS One 2016; 11:e0148752. [PMID: 26859301 PMCID: PMC4747600 DOI: 10.1371/journal.pone.0148752] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/22/2016] [Indexed: 02/03/2023] Open
Abstract
Mechanistic pathways linking maternal polyunsaturated fatty acid (PUFA) status with gestational length are poorly delineated. This study examined whether inflammation and sleep quality serve as mediators, focusing on the antiinflammatory ω-3 docosahexaenoic acid (DHA; 22:6n3) and proinflammatory ω-6 arachidonic acid (AA; 20:4n6). Pregnant women (n = 135) provided a blood sample and completed the Pittsburgh Sleep Quality Index (PSQI) at 20–27 weeks gestation. Red blood cell (RBC) fatty acid levels were determined by gas chromatography and serum inflammatory markers [interleukin (IL)-6, IL-8, tumor necrosis factor-α, IL-1β, and C-reactive protein] by electrochemiluminescence using high sensitivity kits. Both higher serum IL-8 (95% CI = 0.10,3.84) and poor sleep (95% CI = 0.03,0.28) served as significant mediators linking lower DHA:AA ratios with shorter gestation. Further, a serial mediation model moving from the DHA:AA ratio → sleep → IL-8 → length of gestation was statistically significant (95% CI = 0.02, 0.79). These relationships remained after adjusting for depressive symptoms, age, BMI, income, race, and smoking. No interactions with race were observed in relation to length of gestation as a continuous variable. However, a significant interaction between race and the DHA:AA ratio in predicting preterm birth was observed (p = 0.049); among African Americans only, odds of preterm birth decreased as DHA:AA increased (p = 0.048). These data support a role for both inflammatory pathways and sleep quality in linking less optimal RBC PUFA status with shorter gestation in African American and European American women and suggest that African-Americans have greater risk for preterm birth in the context of a low DHA:AA ratio.
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Affiliation(s)
- Lisa M. Christian
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- Department of Psychology, The Ohio State University, Columbus, Ohio, United States of America
- * E-mail:
| | - Lisa M. Blair
- College of Nursing, The Ohio State University, Columbus, Ohio, United States of America
| | - Kyle Porter
- Center for Biostatistics, The Ohio State University, Columbus, Ohio, United States of America
| | - Mary Lower
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
| | - Rachel M. Cole
- Program of Nutrition in the Department of Human Sciences, The Ohio State University, Columbus, Ohio, United States of America
| | - Martha A. Belury
- Program of Nutrition in the Department of Human Sciences, The Ohio State University, Columbus, Ohio, United States of America
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178
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McDade TW, Borja JB, Largado F, Adair LS, Kuzawa CW. Adiposity and Chronic Inflammation in Young Women Predict Inflammation during Normal Pregnancy in the Philippines. J Nutr 2016; 146:353-7. [PMID: 26764318 PMCID: PMC4725437 DOI: 10.3945/jn.115.224279] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 12/08/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Rates of overweight and obesity are on the rise globally, and excess adipose tissue may contribute to elevations in inflammation during pregnancy, leading to pregnancy complications and adverse birth outcomes. OBJECTIVE The purpose of this study was to evaluate adiposity and inflammation in young women as predictors of inflammation in the third trimester of pregnancy in a community-based sample of healthy women. METHODS Female participants (24-30 y) in a prospective observational cohort study (Cebu Longitudinal Health and Nutrition Survey) were contacted between 2009 and 2014 to identify new pregnancies. A total of 309 women provided data from 409 pregnancies. An in-home interview was scheduled for the third trimester to collect pregnancy information, anthropometric measurements, and a blood sample. Circulating C-reactive protein (CRP) was measured with a high-sensitivity immunoassay. Data collected from assessments in 2005 and 2009 were used to assess body mass index (BMI) and CRP in young adulthood, before pregnancy. Robust regression models were implemented to evaluate BMI and CRP in young adulthood as predictors of pregnancy CRP. RESULTS Pre-pregnancy BMI was a stronger predictor of third-trimester circulating CRP than BMI in the third trimester. No association was found between pregnancy weight gain and CRP. Pre-pregnancy CRP was a significant predictor of CRP in pregnancy, independent of BMI. CONCLUSIONS Levels of overweight/obesity and inflammation in young adulthood, before pregnancy, are important predictors of inflammation in the third trimester of pregnancy. These results may have implications for addressing the growing concern about the contribution of obesity to adverse birth outcomes, and they suggest that factors that influence the regulation of inflammation, before pregnancy and independent of adiposity, may be important in shaping the inflammatory response to pregnancy.
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Affiliation(s)
- Thomas W McDade
- Department of Anthropology and Institute for Policy Research, Northwestern University, Evanston, IL; Child and Brain Development Program, Canadian Institute for Advanced Research, Toronto, Canada;
| | - Judith B Borja
- University of San Carlos Office of Population Studies Foundation, Inc., and,Department of Nutrition and Dietetics, University of San Carlos, Cebu City, Philippines; and
| | - Fe Largado
- University of San Carlos Office of Population Studies Foundation, Inc., and
| | - Linda S Adair
- Carolina Population Center and Department of Nutrition, University of North Carolina, Chapel Hill, Chapel Hill, NC
| | - Christopher W Kuzawa
- Department of Anthropology and Institute for Policy Research, Northwestern University, Evanston, IL
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179
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Gonzalez-Espinosa LO, Montiel-Cervantes LA, Guerra-Márquez A, Peñaflor-Juárez K, Reyes-Maldonado E, Vela-Ojeda J. Maternal obesity associated with increase in natural killer T cells and CD8+ regulatory T cells in cord blood units. Transfusion 2016; 56:1075-81. [PMID: 26815139 DOI: 10.1111/trf.13481] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 12/01/2015] [Accepted: 12/08/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND One of the major limitations of umbilical cord blood (UCB) as hematopoietic stem cell source is its restricted cell number. In mothers who are candidates for stem cell donation, there are variables that affect the quantity and quality of UCB units. The aim of this study was to determine if obstetric, maternal, and fetal factors modify the number of lymphocyte subsets in UCB units. STUDY DESIGN AND METHODS This was a prospective, observational study. In UCB units, the numbers of CD34, NK, NKT, iNKT, Type 1 dendritic cells (DCs), Type 2 DCs, T γδ, T CD4+, T CD8+ lymphocytes, CD4+CD25+FoxP3+, and CD8+CD25+FoxP3+ T regulatory (Treg) cells were quantified by flow cytometry. RESULTS Fifty-four UCB units were included; the donors' mean weight was 75 kg (range, 52 to 102 kg) and they had a mean body mass index (BMI) of 30 kg/m(2) (range 22 to 40 kg/m(2) ), of which 12 (22%) had a normal BMI, 14 (26%) were overweight, and 28 (52%) were obese. The mean number of CD34+ cells was 4.45 × 10(6) (range, 0.7 × 10(6) to 20.5 × 10(6) ). The number of NKT, CD3+, CD4+, CD8+, and CD8+CD25+FoxP3+ Treg cells was significantly higher in overweight or obese mothers; CD34+ cells were decreased in the same group. The number of iNKT and CD34+ cells was decreased in newborns weighing above the average. CONCLUSIONS Maternal factors such as BMI, and fetal factors such as weight at birth, should be added to the selection criteria of UCB donors.
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Affiliation(s)
| | - Laura Arcelia Montiel-Cervantes
- Hematopathology Laboratory, National School of Biological Sciences, Instituto Politécnico Nacional, México City.,Hematology Department, Unidad Médica de Alta Especialidad, Hospital de Especialidades Centro Médico Nacional La Raza, IMSS, México, DF, México
| | - Angel Guerra-Márquez
- Umbilical Cord Blood Bank, La Raza Medical Center, Mexican Institute of Social Security, México City
| | - Karina Peñaflor-Juárez
- Umbilical Cord Blood Bank, La Raza Medical Center, Mexican Institute of Social Security, México City
| | - Elba Reyes-Maldonado
- Hematopathology Laboratory, National School of Biological Sciences, Instituto Politécnico Nacional, México City
| | - Jorge Vela-Ojeda
- Hematopathology Laboratory, National School of Biological Sciences, Instituto Politécnico Nacional, México City.,Hematology Department, Unidad Médica de Alta Especialidad, Hospital de Especialidades Centro Médico Nacional La Raza, IMSS, México, DF, México
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180
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Tinius RA, Cahill AG, Strand EA, Cade WT. Altered maternal lipid metabolism is associated with higher inflammation in obese women during late pregnancy. ACTA ACUST UNITED AC 2015; 2:168-175. [PMID: 27239331 DOI: 10.15761/iod.1000137] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Inflammation is elevated in obese pregnant women and is associated with adverse maternal and neonatal outcomes. Maternal lipid metabolism and its relationships with maternal inflammation, insulin resistance and neonatal metabolic health are poorly understood in obese pregnant women. 18 lean (age: 26.1 ± 5.0 years, pre-pregnancy BMI: 21.5 ± 1.9 kg/m2) and 16 obese (age: 25.0 ± 4.8 years, pre-pregnancy BMI: 36.3 ± 4.3 kg/m2) women participated in this case-control study during the third trimester of pregnancy. Maternal plasma markers of insulin resistance (HOMA-IR) and inflammation (C-reactive protein (CRP)) were measured at rest, and lipid concentration and kinetics (lipid oxidation rate and lipolysis) were measured at rest, during a 30-minute bout of low-intensity (40% VO2peak) exercise, and during a recovery period. Umbilical cord blood was collected for measurement of neonatal plasma insulin sensitivity, inflammation, and lipid concentration. Neonatal body composition was measured via air displacement plethysmography. Pregnant obese women had higher plasma CRP (9.1 ± 4.0 mg/L versus 2.3 ± 1.8 mg/L, p<0.001) and higher HOMA-IR (3.8 ± 1.9 versus 2.3 ± 1.5, p=0.009) compared to pregnant lean women. Obese women had higher lipid oxidation rates during recovery from low-intensity exercise (0.13 ± 0.03 g/min versus 0.11 ±0.04 g/min, p=0.02) that was associated with higher maternal CRP (r=0.55, p=0.001). Maternal CRP was positively associated with maternal HOMA-IR (r=0.40, p<0.02) and systolic blood pressure (r=0.40, p<0.02). Maternal lipid metabolism-associated inflammation may contribute to insulin resistance and higher blood pressure in obese women during pregnancy.
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Affiliation(s)
- Rachel A Tinius
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Alison G Cahill
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Eric A Strand
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - W Todd Cade
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
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181
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Nuttall JR. The plausibility of maternal toxicant exposure and nutritional status as contributing factors to the risk of autism spectrum disorders. Nutr Neurosci 2015; 20:209-218. [DOI: 10.1080/1028415x.2015.1103437] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Johnathan R. Nuttall
- Departments of Nutrition and Environmental Toxicology, University of California Davis, Davis, CA, USA
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182
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Garfield L, Mathews HL, Janusek LW. Inflammatory and Epigenetic Pathways for Perinatal Depression. Biol Res Nurs 2015; 18:331-43. [DOI: 10.1177/1099800415614892] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Depression during the perinatal period is common and can have adverse consequences for women and their children. Yet, the biobehavioral mechanisms underlying perinatal depression are not known. Adverse early life experiences increase the risk for adult depression. One potential mechanism by which this increased risk occurs is epigenetic embedding of inflammatory pathways. The purpose of this article is to propose a conceptual model that explicates the linkage between early life adversity and the risk for maternal depression. The model posits that early life adversity embeds a proinflammatory epigenetic signature (altered DNA methylation) that predisposes vulnerable women to depression during pregnancy and the postpartum period. As proposed, women with a history of early life adversity are more likely to exhibit higher levels of proinflammatory cytokines and lower levels of oxytocin in response to the demands of pregnancy and new motherhood, both of which are associated with the risk for perinatal depression. The model is designed to guide investigations into the biobehavioral basis for perinatal depression, with emphasis upon the impact of early life adversity. Testing this model will provide a better understanding of maternal depressive risk and improve identification of vulnerable women who would benefit from targeted interventions that can reduce the impact of perinatal depression on maternal–infant health.
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Affiliation(s)
- Lindsey Garfield
- Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL, USA
| | - Herbert L. Mathews
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA
| | - Linda Witek Janusek
- Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL, USA
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183
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Tinius RA, Cahill AG, Strand EA, Cade WT. Maternal inflammation during late pregnancy is lower in physically active compared with inactive obese women. Appl Physiol Nutr Metab 2015; 41:191-8. [PMID: 26799789 DOI: 10.1139/apnm-2015-0316] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The primary purpose of this study was to compare maternal plasma inflammation between physically active and inactive obese women during late pregnancy. The secondary purpose was to examine the relationships between maternal plasma inflammation and lipid metabolism and maternal and neonatal metabolic health in these women. A cross-sectional, observational study design was performed in 16 obese-inactive (OBI; means ± SD; age, 25.0 ± 4.8 years; prepregnancy body mass index (BMI), 36.3 ± 4.3 kg/m(2); body fat percentage in late gestation, 37.7% ± 3.5%) and 16 obese-active (OBA; age, 28.9 ± 4.8 years; prepregnancy BMI, 34.0 ± 3.7 kg/m(2); body fat in late gestation, 36.6% ± 3.8%) women during the third trimester of pregnancy. Maternal plasma inflammation (C -reactive protein (CRP)) and insulin resistance (Homeostatic Model Assessment-Insulin Resistance) were measured at rest. Plasma lipid concentration and metabolism (lipid oxidation and lipolysis) were measured at rest, during a 30-min bout of low-intensity (40% peak oxygen uptake) exercise, and during a resting recovery period using indirect calorimetry. Umbilical cord blood was collected for measurement of neonatal plasma insulin resistance, inflammation, and lipid concentration. Neonatal body composition was measured via air displacement plethysmography. Maternal plasma CRP concentration was significantly higher in OBI compared with OBA women (9.1 ± 4.0 mg/L vs. 6.3 ± 2.5 mg/L, p = 0.02). Maternal plasma CRP concentration was significantly associated with maternal lipolysis (r = 0.43, p = 0.02), baseline lipid oxidation rate (r = 0.39, p = 0.03), and baseline plasma free fatty acid concentration (r = 0.36, p = 0.04). In conclusion, maternal physical activity may reduce inflammation during pregnancy in obese women. Maternal lipid metabolism is related to systemic inflammation.
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Affiliation(s)
- Rachel A Tinius
- a Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63139, USA
| | - Alison G Cahill
- b Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Eric A Strand
- b Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - W Todd Cade
- a Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63139, USA
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184
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Corwin EJ, Pajer K, Paul S, Lowe N, Weber M, McCarthy DO. Bidirectional psychoneuroimmune interactions in the early postpartum period influence risk of postpartum depression. Brain Behav Immun 2015; 49:86-93. [PMID: 25937051 PMCID: PMC4567438 DOI: 10.1016/j.bbi.2015.04.012] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 04/17/2015] [Accepted: 04/21/2015] [Indexed: 12/15/2022] Open
Abstract
More than 500,000 U.S. women develop postpartum depression (PPD) annually. Although psychosocial risks are known, the underlying biology remains unclear. Dysregulation of the immune inflammatory response and the hypothalamic-pituitary-adrenal (HPA) axis are associated with depression in other populations. While significant research on the contribution of these systems to the development of PPD has been conducted, results have been inconclusive. This is partly because few studies have focused on whether disruption in the bidirectional and dynamic interaction between the inflammatory response and the HPA axis together influence PPD. In this study, we tested the hypothesis that disruption in the inflammatory-HPA axis bidirectional relationship would increase the risk of PPD. Plasma pro- and anti-inflammatory cytokines were measured in women during the 3rd trimester of pregnancy and on Days 7 and 14, and Months 1, 2, 3, and 6 after childbirth. Saliva was collected 5 times the day preceding blood draws for determination of cortisol area under the curve (AUC) and depressive symptoms were measured using the Edinburgh Postpartum Depression Survey (EPDS). Of the 152 women who completed the EPDS, 18% were depressed according to EDPS criteria within the 6months postpartum. Cortisol AUC was higher in symptomatic women on Day 14 (p=.017). To consider the combined effects of cytokines and cortisol on predicting symptoms of PPD, a multiple logistic regression model was developed that included predictors identified in bivariate analyses to have an effect on depressive symptoms. Results indicated that family history of depression, day 14 cortisol AUC, and the day 14 IL8/IL10 ratio were significant predictors of PPD symptoms. One unit increase each in the IL8/IL10 ratio and cortisol AUC resulted in 1.50 (p=0.06) and 2.16 (p=0.02) fold increases respectively in the development of PPD. Overall, this model correctly classified 84.2% of individuals in their respective groups. Findings suggest that variability in the complex interaction between the inflammatory response and the HPA axis influence the risk of PPD.
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Affiliation(s)
- Elizabeth J. Corwin
- School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, GA 30322,To whom correspondence should be addressed: Elizabeth J. Corwin, 1520 Clifton Road NE, Atlanta, GA, Tel: 404-712-9805,
| | - Kathleen Pajer
- School of Medicine, University of Ottawa Faculty of Medicine, 451 Smyth Road, Ottawa, ON K1H 8M5 Canada
| | - Sudeshna Paul
- School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, GA 30322
| | - Nancy Lowe
- College of Nursing, University of Colorado, 13120 E. 19 Avenue, Aurora, CO 80045
| | - Mary Weber
- College of Nursing, University of Colorado, 13120 E. 19 Avenue, Aurora, CO 80045
| | - Donna O. McCarthy
- College of Nursing, Marquette University, 1250 W. Wisconsin Ave, Milwaukee, WI 53233
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Barrera D, Díaz L, Noyola-Martínez N, Halhali A. Vitamin D and Inflammatory Cytokines in Healthy and Preeclamptic Pregnancies. Nutrients 2015; 7:6465-90. [PMID: 26247971 PMCID: PMC4555132 DOI: 10.3390/nu7085293] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 04/28/2015] [Accepted: 07/29/2015] [Indexed: 01/08/2023] Open
Abstract
Preeclampsia is a pregnancy disease characterized by hypertension and proteinuria. Among several disorders, the imbalance of inflammatory cytokines and the alteration of vitamin D metabolism have been reported in preeclampsia. The effects of calcitriol upon inflammatory cytokines has been demonstrated. In healthy pregnant women there is a shift toward a Th2 cytokine profile, which is necessary for an adequate pregnancy outcome. As compared with normal pregnancy, high pro-inflammatory and low anti-inflammatory cytokine levels have been observed in preeclamptic women. Preeclampsia has been associated with low calcitriol levels and vitamin D deficiency is correlated with a higher risk of the development of this disease. It has been demonstrated that placenta is a source as well as the target of calcitriol and cytokines and placental dysfunction has been associated with preeclampsia. Therefore, the present manuscript includes a review about serum calcitriol levels in non-pregnant, pregnant, and preeclamptic women as well as a review on the fetoplacental vitamin D metabolism in healthy and preeclamptic pregnancies. In addition, circulating and fetoplacental inflammatory cytokines in healthy and preeclamptic pregnancies are reviewed. Finally, the effects of calcitriol upon placental pro-inflammatory cytokines are also explored. In conclusion, maternal and placental calcitriol levels are low in preeclampsia which may explain, at least in part, high pro-inflammatory cytokine levels in this disease.
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Affiliation(s)
- David Barrera
- Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Tlalpan, México D.F. 14000, México.
| | - Lorenza Díaz
- Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Tlalpan, México D.F. 14000, México.
| | - Nancy Noyola-Martínez
- Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Tlalpan, México D.F. 14000, México.
| | - Ali Halhali
- Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Tlalpan, México D.F. 14000, México.
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186
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Blair LM, Porter K, Leblebicioglu B, Christian LM. Poor Sleep Quality and Associated Inflammation Predict Preterm Birth: Heightened Risk among African Americans. Sleep 2015; 38:1259-67. [PMID: 25845693 DOI: 10.5665/sleep.4904] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 03/07/2015] [Indexed: 12/18/2022] Open
Abstract
STUDY OBJECTIVES Poor sleep promotes inflammation. In turn, inflammation is a causal mechanism in term as well as preterm parturition. In the United States, a persistent racial disparity in preterm birth exists, with African Americans showing ∼1.5 times greater risk. This study examined associations among sleep quality, serum proinflammatory cytokines, and length of gestation in a racially diverse sample of 138 pregnant women. DESIGN Observational. MEASUREMENTS Women completed the Pittsburgh Sleep Quality Index (PSQI) and other psychosocial and behavioral measures during midpregnancy. Serum levels of interleukin (IL)-6, IL-8, IL-1β, and tumor necrosis factor (TNF)-α were determined by high-sensitivity assays. Birth outcomes were determined via medical record review. RESULTS Among African American women (n = 79), shorter gestation was predicted by poorer overall sleep (rs = -0.35, P = 0.002) as well the following PSQI subscales: subjective sleep quality (rs = -0.34, P = 0.002), sleep latency (rs = -0.27, P = 0.02), and sleep efficiency (rs = -0.27, P = 0.02). African American women with poor sleep quality (PSQI > 5) had 10.2 times the odds of preterm birth compared to those with good sleep quality. In contrast, among European American women (n = 53), gestational length was not significantly predicted by sleep quality (Ps > 0.12). Bootstrapping analyses showed that, among African Americans, IL-8 significantly mediated the association between sleep quality and length of gestation (indirect effect estimate -0.029; 95% confidence interval -0.06, -0.002). CONCLUSIONS The data provide novel evidence that African American women exhibit greater inflammation in response to sleep disturbance than European American women and these effects correspond with length of gestation. Racial differences in susceptibility to sleep induced immune dysregulation may contribute to marked racial disparities in preterm birth.
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Affiliation(s)
- Lisa M Blair
- College of Nursing, The Ohio State University, Columbus, OH
| | - Kyle Porter
- Center for Biostatistics, The Ohio State University, Columbus, OH
| | | | - Lisa M Christian
- Department of Psychiatry, The Institute for Behavioral Medicine Research, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Psychology, The Ohio State University, Columbus, OH
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187
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Pantham P, Aye ILMH, Powell TL. Inflammation in maternal obesity and gestational diabetes mellitus. Placenta 2015; 36:709-15. [PMID: 25972077 DOI: 10.1016/j.placenta.2015.04.006] [Citation(s) in RCA: 372] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 04/08/2015] [Accepted: 04/13/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND The prevalence of maternal obesity is rising rapidly worldwide and constitutes a major obstetric problem, increasing mortality and morbidity in both mother and offspring. Obese women are predisposed to pregnancy complications such as gestational diabetes mellitus (GDM), and children of obese mothers are more likely to develop cardiovascular and metabolic disease in later life. Maternal obesity and GDM may be associated with a state of chronic, low-grade inflammation termed "metainflammation", as opposed to an acute inflammatory response. This inflammatory environment may be one mechanism by which offspring of obese women are programmed to develop adult disorders. METHODS Herein we review the evidence that maternal obesity and GDM are associated with changes in the maternal, fetal and placental inflammatory profile. RESULTS Maternal inflammation in obesity and GDM may not always be associated with fetal inflammation. CONCLUSION We propose that the placenta 'senses' and adapts to the maternal inflammatory environment, and plays a central role as both a target and producer of inflammatory mediators. In this manner, maternal obesity and GDM may indirectly program the fetus for later disease by influencing placental function.
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Affiliation(s)
- P Pantham
- Department of Pediatrics, Section of Neonatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - I L M H Aye
- Department of Obstetrics & Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - T L Powell
- Department of Pediatrics, Section of Neonatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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188
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Seo H, Jeon BD, Ryu S. Persimmon vinegar ripening with the mountain-cultivated ginseng ingestion reduces blood lipids and lowers inflammatory cytokines in obese adolescents. J Exerc Nutrition Biochem 2015; 19:1-10. [PMID: 25960949 PMCID: PMC4424440 DOI: 10.5717/jenb.2015.19.1.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/02/2015] [Accepted: 03/11/2015] [Indexed: 11/17/2022] Open
Abstract
[Purpose] This study investigated the effect of the vinegar, which is made of 4-year-old mountain-cultivated ginseng ripened into 4-year-matured persimmon vinegar, on the blood lipids level and inflammatory cytokines concentration in obese female adolescents. [Methods] Subjects ingested the vinegar, so-called 'mountain-cultivated ginseng persimmon vinegar (MPV)', without meals every day for 6 weeks with activities control. Subjects were grouped into control (CON), persimmon vinegar (PV), and MPV with 10 people in each group. Blood lipids, triglyceride (TG), total-cholesterol (TC), and high density lipoprotein-cholesterol (HDL-C) were analyzed. Also, glutamic oxaloacetic transaminase (GOT) and glutamate pyruvate transaminase (GPT) were analyzed for the hepatotoxicity. Blood cytokines, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB) were analyzed. [Results] Subjects showed a high reduction in body weight and body fat. Their blood lipid level was effectively improved, and the secretion of inflammatory cytokine was suppressed as well, except for TNF-α. However, the change ratio of the cytokines was high in PV and MPV. Such results were similar to those from research subjects who took persimmon vinegar only (PV), but the effect of the vinegar (MPV) was more remarkable. Besides, this mixture was found to have no effect on the hepatotoxicity. [Conclusion] The significance of this study is that all the experiments were conducted without controlling research subjects' daily lives, and it is suggested that the vinegar may be recommended as a kind of health supplement food to suppress obesity. Especially, since these two products are traditional foods of Korean people, which have been taken for ages, it is expected that the fusing of two foods may be better applied to ordinary people who are concerned about obesity.
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Affiliation(s)
- Hyobin Seo
- Department of Leisure Sports, Kyungpook National University, Sangju, Korea
| | - Byung-Duk Jeon
- Department of Physical Education Leisure, Suseong College, Daegu, Korea
| | - Sungpil Ryu
- Department of Leisure Sports, Kyungpook National University, Sangju, Korea
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189
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Christian LM. Stress and Immune Function during Pregnancy: An Emerging Focus in Mind-Body Medicine. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2015; 24:3-9. [PMID: 25745279 DOI: 10.1177/0963721414550704] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Maternal psychosocial stress during pregnancy is associated with risks to maternal health, birth outcomes, as well as adverse health and behavioral outcomes in offspring. Maternal immune dysregulation, particularly disruption of inflammatory processes, is also implicated in adverse perinatal health outcomes, with the greatest evidence in relation to preterm birth. Increasingly, the extent to which psychosocial stress induces dysregulation of inflammatory processes during pregnancy is being considered. In this article, I describe studies linking stress to immune function during pregnancy, with an emphasis on studies from our group on inflammation. As will be reviewed, research utilizing psychoneuroimmunology models in pregnancy is a rapidly developing area with abundant opportunities to address questions of clinical relevance for both maternal and child health.
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Affiliation(s)
- Lisa M Christian
- Department of Psychiatry, The Ohio State University Wexner Medical Center, Columbus, Ohio, 43210, USA ; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center ; Department of Psychology, The Ohio State University, Columbus, Ohio, 43210, USA ; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio, 43210, USA
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190
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Parchim NF, Wang W, Iriyama T, Ashimi OA, Siddiqui AH, Blackwell S, Sibai B, Kellems RE, Xia Y. Neurokinin 3 receptor and phosphocholine transferase: missing factors for pathogenesis of C-reactive protein in preeclampsia. Hypertension 2014; 65:430-9. [PMID: 25452470 DOI: 10.1161/hypertensionaha.114.04439] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
C-reactive protein (CRP), an innate immune mediator, is elevated in the circulation before symptoms in patients with preeclampsia, a severe hypertensive pregnancy disorder with high mortality and morbidity. However, the specific sources underlying increased CRP and the role of elevated CRP in preeclampsia are undefined. Here, we report that circulating CRP levels are significantly increased in a large cohort of normotensive pregnant individuals when compared with nulligravid women and is further increased in patients with preeclampsia. These findings led us to discover further that placental syncytiotrophoblasts are previously unrecognized cellular sources of CRP and underlie elevated CRP in normotensive pregnant women and the additional increase in patients with preeclampsia. Next, we demonstrated that injection of CRP induces preeclampsia features, including hypertension (157 mm Hg CRP treated versus 119 mm Hg control), proteinuria (35.0 mg/μg CRP treated versus 14.1 mg/μg control), kidney, and placental damage and increased levels of sFlt-1 in pregnant mice but not in nonpregnant mice. Our study implicates that phosphocholine transferase, a placental-specific enzyme post-translationally modifying neurokinin B, is essential for the pathogenic role of CRP in preeclampsia through activation of the neurokinin 3 receptor. Overall, our studies have provided significant new insight on the pathogenic role of CRP in preeclampsia and highlighted innovative therapeutic strategies.
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Affiliation(s)
- Nicholas F Parchim
- From the Departments of Biochemistry and Molecular Biology (N.F.P., W.W. T.I., A.H.S., R.E.K., Y.X.), Obstetrics, Gynecology, and Reproductive Sciences (O.A.A., S.B., B.S.), Graduate School of Biomedical Science (N.F.P., R.E.K. Y.X.), University of Texas, Houston; Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China (W.W., Y.X.); Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan (T.I.); and School of Medical Sciences, University of Hyderabad, Gachibowli, Hyderabad, India (A.H.S.)
| | - Wei Wang
- From the Departments of Biochemistry and Molecular Biology (N.F.P., W.W. T.I., A.H.S., R.E.K., Y.X.), Obstetrics, Gynecology, and Reproductive Sciences (O.A.A., S.B., B.S.), Graduate School of Biomedical Science (N.F.P., R.E.K. Y.X.), University of Texas, Houston; Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China (W.W., Y.X.); Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan (T.I.); and School of Medical Sciences, University of Hyderabad, Gachibowli, Hyderabad, India (A.H.S.)
| | - Takayuki Iriyama
- From the Departments of Biochemistry and Molecular Biology (N.F.P., W.W. T.I., A.H.S., R.E.K., Y.X.), Obstetrics, Gynecology, and Reproductive Sciences (O.A.A., S.B., B.S.), Graduate School of Biomedical Science (N.F.P., R.E.K. Y.X.), University of Texas, Houston; Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China (W.W., Y.X.); Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan (T.I.); and School of Medical Sciences, University of Hyderabad, Gachibowli, Hyderabad, India (A.H.S.)
| | - Olaide A Ashimi
- From the Departments of Biochemistry and Molecular Biology (N.F.P., W.W. T.I., A.H.S., R.E.K., Y.X.), Obstetrics, Gynecology, and Reproductive Sciences (O.A.A., S.B., B.S.), Graduate School of Biomedical Science (N.F.P., R.E.K. Y.X.), University of Texas, Houston; Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China (W.W., Y.X.); Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan (T.I.); and School of Medical Sciences, University of Hyderabad, Gachibowli, Hyderabad, India (A.H.S.)
| | - Athar H Siddiqui
- From the Departments of Biochemistry and Molecular Biology (N.F.P., W.W. T.I., A.H.S., R.E.K., Y.X.), Obstetrics, Gynecology, and Reproductive Sciences (O.A.A., S.B., B.S.), Graduate School of Biomedical Science (N.F.P., R.E.K. Y.X.), University of Texas, Houston; Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China (W.W., Y.X.); Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan (T.I.); and School of Medical Sciences, University of Hyderabad, Gachibowli, Hyderabad, India (A.H.S.)
| | - Sean Blackwell
- From the Departments of Biochemistry and Molecular Biology (N.F.P., W.W. T.I., A.H.S., R.E.K., Y.X.), Obstetrics, Gynecology, and Reproductive Sciences (O.A.A., S.B., B.S.), Graduate School of Biomedical Science (N.F.P., R.E.K. Y.X.), University of Texas, Houston; Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China (W.W., Y.X.); Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan (T.I.); and School of Medical Sciences, University of Hyderabad, Gachibowli, Hyderabad, India (A.H.S.)
| | - Baha Sibai
- From the Departments of Biochemistry and Molecular Biology (N.F.P., W.W. T.I., A.H.S., R.E.K., Y.X.), Obstetrics, Gynecology, and Reproductive Sciences (O.A.A., S.B., B.S.), Graduate School of Biomedical Science (N.F.P., R.E.K. Y.X.), University of Texas, Houston; Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China (W.W., Y.X.); Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan (T.I.); and School of Medical Sciences, University of Hyderabad, Gachibowli, Hyderabad, India (A.H.S.)
| | - Rodney E Kellems
- From the Departments of Biochemistry and Molecular Biology (N.F.P., W.W. T.I., A.H.S., R.E.K., Y.X.), Obstetrics, Gynecology, and Reproductive Sciences (O.A.A., S.B., B.S.), Graduate School of Biomedical Science (N.F.P., R.E.K. Y.X.), University of Texas, Houston; Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China (W.W., Y.X.); Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan (T.I.); and School of Medical Sciences, University of Hyderabad, Gachibowli, Hyderabad, India (A.H.S.)
| | - Yang Xia
- From the Departments of Biochemistry and Molecular Biology (N.F.P., W.W. T.I., A.H.S., R.E.K., Y.X.), Obstetrics, Gynecology, and Reproductive Sciences (O.A.A., S.B., B.S.), Graduate School of Biomedical Science (N.F.P., R.E.K. Y.X.), University of Texas, Houston; Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China (W.W., Y.X.); Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan (T.I.); and School of Medical Sciences, University of Hyderabad, Gachibowli, Hyderabad, India (A.H.S.).
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