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Phoswa WN, Khaliq OP, Eche S. A Review on Inflammasomes and Immune Checkpoints in Pre-Eclampsia Complicated with Tuberculosis and Human Immune Deficiency Virus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6627. [PMID: 37681767 PMCID: PMC10487055 DOI: 10.3390/ijerph20176627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/09/2023]
Abstract
The current review evaluates how inflammasomes and immune checkpoints are regulated in pre-eclampsia (PE) associated with tuberculosis (TB) and Human Immune Deficiency Virus (HIV). Studies indicate that inflammasomes such as (NRLP3, NEK7, and AIM2) and immune checkpoints such as (CLT4, PD-1, TIM3, and LAG-3) are dysregulated in TB- and HIV-infected individuals, and also in pre-eclamptic pregnancies, which explains why pregnant women who are either infected with TB or HIV have an increased risk of developing PE. Evidence suggests that inhibition of inflammasomes and immune checkpoints may assist in the development of novel anti-inflammatory drugs for the prevention and management of PE in patients with or without TB and HIV infection.
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Affiliation(s)
- Wendy N. Phoswa
- Department of Life and Consumer Sciences, Science Campus, University of South Africa (UNISA), Private Bag X 6, Florida, Roodepoort 1710, South Africa
| | - Olive P. Khaliq
- Department of Paediatrics and Child Health, University of the Free State, Bloemfontein 9300, South Africa;
| | - Simeon Eche
- School of Medicine, Yale University, 333 Cedar Street, New Haven, CO 06510, USA;
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Nobrega GM, Guida JP, Novaes JM, Solda LM, Pietro L, Luz AG, Lajos GJ, Ribeiro-do-Valle CC, Souza RT, Cecatti JG, Mysorekar IU, Dias TZ, Laura Costa M. Role of biomarkers (sFlt-1/PlGF) in cases of COVID-19 for distinguishing preeclampsia and guiding clinical management. Pregnancy Hypertens 2023; 31:32-37. [PMID: 36525933 PMCID: PMC9719935 DOI: 10.1016/j.preghy.2022.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 10/11/2022] [Accepted: 11/28/2022] [Indexed: 12/07/2022]
Abstract
OBJECTIVES To analyze soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factors (PlGF) concentrations and their ratio in pregnant and postpartum women with suspected COVID-19, and further investigate conditions associated with an increased ratio (sFlt-1/PlGF > 38), including preeclampsia (PE) and severe acute respiratory syndrome (SARS). STUDY DESIGN The present study is a secondary analysis of a prospective cohort. Blood samples were collected at time of COVID-19 investigation and the serum measurements of sFlt-1 and PlGF were performed. Clinical background, SARS-CoV-2 infection characteristics, maternal and perinatal outcomes were further analyzed. MAIN OUTCOME MEASURES Serum measurements of sFlt-1 and PlGF; obstetrics and clinical outcomes. RESULTS A total of 97 SARS-CoV-2 unvaccinated women with suspected infection were considered, 76 were COVID-19 positive cases and 21 COVID-19 negative. Among COVID-19 positive cases, 09 presented with SARS and 11 were diagnosed with PE, of which 6 had SARS-CoV-2 infection in first and second trimester (04 with sFlt-1/PlGF ≥ 38) and 05 with PE and COVID-19 diagnosed at the same time, during third trimester (03 with sFlt-1/PlGF ≥ 38). Five presented with PE with severe features. sFlt-1/PlGF ratio was significantly higher in the COVID-19 positive/PE positive group compared to COVID-19 positive/PE negative group (p-value = 0.005), with no increase in cases complicated by SARS. CONCLUSIONS sFlt-1/PlGF ratio could be a useful tool for differential diagnosis and adequate counseling among cases of COVID-19 and PE, especially if severe disease. COVID-19 early in pregnancy could potentially be a risk factor for PE later during gestation.
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Affiliation(s)
- Guilherme M. Nobrega
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Jose P. Guida
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Juliana M. Novaes
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Larissa M. Solda
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Luciana Pietro
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil,Institute of Health Sciences, Paulista University, Brazil
| | - Adriana G. Luz
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Giuliane J. Lajos
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Carolina C. Ribeiro-do-Valle
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Renato T Souza
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Jose G. Cecatti
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Indira U. Mysorekar
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX 77030, USA,Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Tabata Z. Dias
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Maria Laura Costa
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
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Lumbanraja SN, Effendi IH, Siahaan A, Bancin BEP, Sinurat T. Morbidity and mortality of newborn from preeclampsia mother with SARS-CoV-2 infection. J Neonatal Perinatal Med 2023; 16:517-525. [PMID: 37718857 DOI: 10.3233/npm-220002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND Preeclampsia is a major cause of maternal and infant mortality in Indonesia. Several studies have investigated the association between SARS-CoV-2 infection and adverse maternal, fetal, and neonatal outcomes. The studies found that SARS-CoV-2 infection during pregnancy is associated with an increased risk of maternal morbidity and mortality related to hypertensive disorders, including preeclampsia. However, the studies did not provide specific information on the morbidity and mortality of newborns from mothers diagnosed with preeclampsia with conjunction SARS-CoV-2 infection. METHODS This hospital-based case-control study was conducted on 28 mother-infant pairs using a systematic sampling method from February 2021 to December 2021. Data were analyzed using SPSS software (version 26), and statistical tests including chi-square analysis, Fisher's exact test, Mann-Whitney U-test and independent t-test were performed to identify factors associated with study variables in a 95% confidence interval (CI). RESULTS We conducted a prospective study involving the enrollment of 28 pregnant women with confirmed SARS-CoV-2 infection through RT-PCR tests. Within this cohort, a subset of 4 mothers (14.8%) were diagnosed with preeclampsia. Four preeclamptic patients (100%) experienced fatal outcomes. Furthermore, among the infants born to preeclamptic mothers with SARS-CoV-2 infections, two (50%) newborns not survive. One infant passed away shortly after birth at 30 weeks of gestation, while the other had intrauterine demise at 28 weeks of gestation. CONCLUSIONS SARS-CoV-2 infection during pregnancy is associated with an increased risk of maternal morbidity and mortality related preeclampsia.
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Affiliation(s)
- S N Lumbanraja
- Department of Obstertrics and Gyenecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - I H Effendi
- Department of Obstertrics and Gyenecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - A Siahaan
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - B E P Bancin
- Department of Obstertrics and Gyenecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - T Sinurat
- Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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