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Guan D, Sun W, Gao M, Chen Z, Ma X. Immunologic insights in recurrent spontaneous abortion: Molecular mechanisms and therapeutic interventions. Biomed Pharmacother 2024; 177:117082. [PMID: 38972152 DOI: 10.1016/j.biopha.2024.117082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/20/2024] [Accepted: 07/01/2024] [Indexed: 07/09/2024] Open
Abstract
Recurrent spontaneous abortion refers to the occurrence of two or more spontaneous abortions before or during the early stages of pregnancy. The immune system plays a crucial role in the maintenance of pregnancy and embryo implantation. Various immune cells, cytokines, and immune regulatory pathways are involved in the complex immune balance required for a stable pregnancy. Studies suggest that immune abnormalities may be associated with some recurrent spontaneous abortion cases, particularly those involving the dysregulation of immune cell function, autoimmune responses, and placental immunity. In terms of treatment, interventions targeting immune mechanisms are crucial. Various therapeutic approaches, including immunomodulatory drugs, immunoadsorption therapies, and immunocellular therapies, are continually being researched and developed. These approaches aim to restore the immune balance, enhance the success rate of pregnancies, and provide more effective treatment options for patients with recurrent spontaneous abortion.
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Affiliation(s)
- Defeng Guan
- The First Clinical Medical School of Lanzhou University, Lanzhou, China; The First Hospital of Lanzhou University, Lanzhou, China; Gansu key Laboratory of Reproductive Medicine and Embryology, Lanzhou, China
| | - Wenjie Sun
- The First Clinical Medical School of Lanzhou University, Lanzhou, China
| | - Mingxia Gao
- The First Clinical Medical School of Lanzhou University, Lanzhou, China; The First Hospital of Lanzhou University, Lanzhou, China; Gansu key Laboratory of Reproductive Medicine and Embryology, Lanzhou, China
| | - Zhou Chen
- The First Clinical Medical School of Lanzhou University, Lanzhou, China; The First Hospital of Lanzhou University, Lanzhou, China.
| | - Xiaoling Ma
- The First Clinical Medical School of Lanzhou University, Lanzhou, China; The First Hospital of Lanzhou University, Lanzhou, China; Gansu key Laboratory of Reproductive Medicine and Embryology, Lanzhou, China.
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Agaoglu Z, Tanacan A, Ipek G, Peker A, Ozturk Agaoglu M, Sahin D. Systemic Inflammation Response Index and Systemic Immune-inflammation Index for Prediction of Pregnancy Loss: a Case-control Study. Reprod Sci 2024; 31:1565-1572. [PMID: 38438777 DOI: 10.1007/s43032-024-01506-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 02/25/2024] [Indexed: 03/06/2024]
Abstract
The systemic inflammation response index (SIRI) and systemic immune inflammation index (SII) have recently been investigated as new prognostic markers for obstetric morbidities. However, there are few studies on their predictive role in patients with pregnancy loss. Predicting miscarriages may be useful to support and prevent selected cases.The aim of this study was to investigate the role of SIRI and SII in the prediction of pregnancy loss. A total of 800 patients were included in the retrospective case-control study at a tertiary hospital.Group 1 consisted of 200 patients who had a pregnancy loss for the first time; group 2 consisted of 200 patients with recurrent pregnancy loss; the control group consisted of 400 patients who had a healthy pregnancy. The groups were compared in terms of maternal characteristics, SIRI and SII. Receiver operating characteristic analysis was performed to determine optimal cut-off values for SIRI and SII in predicting pregnancy loss. SIRI and SII were higher in the group with recurrent pregnancy loss than in the control group (p < 0.001).SIRI was higher in the first pregnancy loss group than in the control group (p < 0.001).To predict recurrent pregnancy loss, optimal cut-off values were 1.57 (80% sensitivity, 70% specificity) and 924.12 (74% sensitivity, 57% specificity) for SIRI and SII, respectively. For first pregnancy loss prediction, the optimal cut-off value was 1.38 for SIRI, with 75% sensitivity and 60% specificity. SIRI and SII may be used as inflammatory markers to predict recurrent pregnancy loss. High SIRI values can also help to predict first pregnancy loss.
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Affiliation(s)
- Zahid Agaoglu
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Universiteler Mahallesi Cad, Cankaya, Ankara, 06800, Turkey.
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Goksun Ipek
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Universiteler Mahallesi Cad, Cankaya, Ankara, 06800, Turkey
| | - Ayca Peker
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Universiteler Mahallesi Cad, Cankaya, Ankara, 06800, Turkey
| | - Merve Ozturk Agaoglu
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Universiteler Mahallesi Cad, Cankaya, Ankara, 06800, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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Hantoushzadeh S, Gargar OK, Jafarabady K, Rezaei MM, Asadi F, Eshraghi N, Panahi Z, Shirdel S, Mirzamoradi M, Ghaemi M. Diagnostic value of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio to predict recurrent pregnancy loss and abortion; a systematic review and meta-analysis. Immun Inflamm Dis 2024; 12:e1210. [PMID: 38506423 PMCID: PMC10953208 DOI: 10.1002/iid3.1210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 02/05/2024] [Accepted: 02/29/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to evaluate the diagnostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in women with a history of abortion (missed and threatened) and recurrent pregnancy loss (RPL) in comparison with healthy pregnancies. METHODS Electronic databases including MEDLINE, Scopus, Web of Science, Embase, and Cochrane Library were searched for NLR and PLR in women who experienced early pregnancy loss up to January 1, 2023 with a combination of proper keywords. Meta-analysis was done for comparison with three or more studies and summary estimates were measured. RESULTS A total of 390 citations were retrieved initially, and after screening, 16 articles were deemed eligible for the final review. Among these, 14 studies underwent meta-analysis. The meta-analysis revealed that the standard mean of the NLR was significantly higher in abortion cases compared to the control group. However, there was no significant difference in the PLR between the pregnancy loss group and the control group. CONCLUSION NLR was significantly higher among RPL patients compared to the control group, according to these data, NLR may be capable of being used in the diagnosis of RPL as an easy, cheap, and accessible modality. Further studies, which take these variables into account, will need to be undertaken to determine the diagnostic value of NLR and PLR in early pregnancy loss.
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Affiliation(s)
- Sedigheh Hantoushzadeh
- Vali‐E‐Asr Reproductive Health Research Center, Family Health Research InstituteTehran University of Medical SciencesTehranIran
| | | | - Kyana Jafarabady
- Student Research CommitteeAlborz University of Medical SciencesKarajIran
| | | | - Fatemeh Asadi
- Vali‐E‐Asr Reproductive Health Research Center, Family Health Research InstituteTehran University of Medical SciencesTehranIran
| | - Nasim Eshraghi
- Vali‐E‐Asr Reproductive Health Research Center, Family Health Research InstituteTehran University of Medical SciencesTehranIran
| | - Zahra Panahi
- Vali‐E‐Asr Reproductive Health Research Center, Family Health Research InstituteTehran University of Medical SciencesTehranIran
| | - Saeedeh Shirdel
- Vali‐E‐Asr Reproductive Health Research Center, Family Health Research InstituteTehran University of Medical SciencesTehranIran
| | - Masoumeh Mirzamoradi
- Clinical Research Development Center, Mahdiyeh Educational HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Marjan Ghaemi
- Vali‐E‐Asr Reproductive Health Research Center, Family Health Research InstituteTehran University of Medical SciencesTehranIran
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Cai WY, Luo X, Lv HY, Fu KY, Xu J. Insulin resistance in women with recurrent miscarriage: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2022; 22:916. [PMID: 36482358 PMCID: PMC9733104 DOI: 10.1186/s12884-022-05256-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE This review aimed to investigate the association of insulin resistance (IR) in women with recurrent pregnancy loss compared to women with normal pregnancy history. METHODS PubMed, EMBASE, the Web of Science and Google Scholar databases were accessed to collect published observational studies that compared IR of recurrent pregnancy loss women with healthy women until the 6th of October 2022. Outcomes assessed in this review and meta-analysis included fasting blood glucose, fasting plasma insulin, homeostasis model assessment for IR, glucose to insulin ratio. Mean differences, odds ratios with 95% confidence interval were pooled using the fixed or random effect models. Sensitivity analyses were performed to validate the robustness of the results. Review Manager version 5.4.1 and Stata version 8.0 were used. RESULTS A total of nineteen studies involving 4453 individuals were included. Recurrent pregnancy loss patients presented significantly higher fasting blood glucose, fasting plasma insulin, homeostasis model assessment for IR, and lower glucose to insulin ratios. Additionally, recurrent pregnancy loss patients had higher rates of IR as defined by abnormal fasting plasma insulin, homeostasis model assessment for IR, and glucose to insulin ratio. Sensitivity analyses validated the robustness of the results. CONCLUSION In the current review, we show that recurrent pregnancy loss is associated with a higher degree of IR and highlight the importance of screening and treatment of IR.
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Affiliation(s)
- Wang-Yu Cai
- grid.13402.340000 0004 1759 700XFourth Affiliated Hospital, Zhejiang University, School of Medicine, No. 1 Shang Cheng Avenue, Yiwu, 322000 Zhejiang China
| | - Xi Luo
- grid.268505.c0000 0000 8744 8924Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Hou-Yi Lv
- grid.13402.340000 0004 1759 700XInternational Institutes of Medicine, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, Zhejiang China
| | - Kai-You Fu
- grid.452661.20000 0004 1803 6319The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang China
| | - Jian Xu
- grid.13402.340000 0004 1759 700XFourth Affiliated Hospital, Zhejiang University, School of Medicine, No. 1 Shang Cheng Avenue, Yiwu, 322000 Zhejiang China ,grid.13402.340000 0004 1759 700XWomen’s Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang China
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Yucel Cicek OS, Doger E. Neutrophil-to-lymphocyte ratio is a predictor of biochemical miscarriage following artificial frozen embryo transfer cycles. J OBSTET GYNAECOL 2022; 42:3349-3355. [PMID: 36135375 DOI: 10.1080/01443615.2022.2125296] [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: 01/06/2023]
Abstract
The aim of this study is to examine the relationship between complete blood count (CBC) inflammatory markers and pregnancy outcome following artificial frozen embryo transfer cycles (AC-FET). This was a retrospective cohort study including 183 patients undergoing an AC-FET. The inflammatory markers including white blood cell count (WCC), neutrophil and lymphocyte count, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were compared between cycles with and without clinical pregnancies. Furthermore, these markers were compared between pregnancies with and without biochemical and clinical miscarriages. NLR was significantly higher in cycles with biochemical miscarriages (p = 0.009). Receiver operating curve analysis was performed to assess the role of NLR in predicting biochemical pregnancy. The area under the curve was 0.714 (95% confidence interval; 0.578-0.850, p = 0.009). The optimal cut-off value for NLR that was associated with biochemical miscarriage was 2.48 with 63% sensitivity and 75% specificity. A logistic regression analysis was performed with biochemical miscarriage as the dependent variable. An NLR value below 2.48 was an independent variable to affect biochemical miscarriage (OR: 0.2, 95% CI 0.05-0.92, p = 0.030). NLR emerged as a reliable predictor of biochemical miscarriage in AC-FET.Impact StatementWhat is already known on this subject? NLR and PLR are novel markers of inflammation. They are related to various gynecological and obstetric conditions including spontaneous abortion, preeclampsia. These markers are also associated with assisted reproductive technology success in fresh cycles.What the results of this study add? This is the first study to investigate the association of these markers with FET cycles. Our results have shown that cycles that ended in biochemical miscarriage had a significantly higher NLR compared with cycles continuing as a clinical pregnancy. An NLR value above 2.48 was predictive of biochemical miscarriage following AC-FET.What the implications are of these findings for clinical practice and/or further research? A high NLR level might have a significant value for the identification of patients at risk of biochemical miscarriage. Future research should assess the impact of anti-inflammatory agents on pregnancy outcomes in patient populations where systemic inflammation is documented by CBC inflammatory markers.
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Affiliation(s)
- Ozge Senem Yucel Cicek
- Kocaeli University, Faculty of Medicine, Department of Obstetrics and Gynecology, Assisted Reproductive Technology Clinic, İzmit, Kocaeli, Turkey
| | - Emek Doger
- Kocaeli University, Faculty of Medicine, Department of Obstetrics and Gynecology, Assisted Reproductive Technology Clinic, İzmit, Kocaeli, Turkey
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Qin D, Xu H, Chen Z, Deng X, Jiang S, Zhang X, Bao S. The peripheral and decidual immune cell profiles in women with recurrent pregnancy loss. Front Immunol 2022; 13:994240. [PMID: 36177021 PMCID: PMC9513186 DOI: 10.3389/fimmu.2022.994240] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
Abstract
Recurrent pregnancy loss (RPL) affects 1-2% of couples of reproductive age. Immunological analysis of the immune status in RPL patients might contribute to the diagnosis and treatment of RPL. However, the exact immune cell composition in RPL patients is still unclear. Here, we used flow cytometry to investigate the immune cell profiles of peripheral blood and decidual tissue of women who experienced RPL. We divided peripheral immune cells into 14 major subgroups, and the percentages of T, natural killer T (NKT)-like and B cells in peripheral blood were increased in RPL patients. The decidual immune cells were classified into 14 major subpopulations and the percentages of decidual T, NKT-like cells and CD11chi Mφ were increased, while those of CD56hi decidual NK cells and CD11clo Mφ were decreased in RPL patients. The spearmen correlation analysis showed that the proportion of peripheral and decidual immune cells did not show significant correlations with occurrences of previous miscarriages. By using flow cytometry, we depicted the global peripheral and decidual immune landscape in RPL patients. The abnormalities of peripheral and decidual immune cells may be involved in RPL, but the correlations with the number of previous miscarriages need further verification.
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Affiliation(s)
- Dengke Qin
- Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Huihui Xu
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences/University of Chinese Academy of Sciences, Shanghai, China
| | - Zechuan Chen
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences/University of Chinese Academy of Sciences, Shanghai, China
| | - Xujing Deng
- Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shan Jiang
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences/University of Chinese Academy of Sciences, Shanghai, China
| | - Xiaoming Zhang
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences/University of Chinese Academy of Sciences, Shanghai, China
- *Correspondence: Shihua Bao, ; Xiaoming Zhang,
| | - Shihua Bao
- Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Shihua Bao, ; Xiaoming Zhang,
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Zhang L, Jiang X, Wang G, Kanda T, Yokosuka O, Zhai C, Zhang L, Liu P, Zhao Z, Li Z. Effects of Let-7c on the processing of hepatitis B virus associated liver diseases. Infect Agent Cancer 2022; 17:46. [PMID: 36057607 PMCID: PMC9440497 DOI: 10.1186/s13027-022-00458-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/22/2022] [Indexed: 11/24/2022] Open
Abstract
Background The most common type of cancer of the digestive system is hepatocellular carcinoma. In China, many patients harbour HBV. The lin28B/Let-7c/MYC axis is associated with the occurrence of many cancers. Therefore, we aimed to illuminate the function of the lin28B/Let-7c/MYC axis in hepatocellular carcinoma. We aimed to evaluate the critical involvement of lin28B and Let-7c in the carcinogenesis of human hepatocellular carcinoma (B-HCC). Methods Data from the GEO database were used to analyse differentially expressed genes and IRGs. A protein − protein interaction (PPI) network and Venn diagram were generated to analyse relationships. Real-time RT-PCR, Western blotting, and cell counting kit-8 assays were used to examine the association of lin28B, Let-7c, and MYC with cell proliferation. Results A total of 2552 functionally annotated differentially expressed RNAs were analysed in HBV patients from the GSE135860 database. In addition, 46 let-7c target genes were screened in HBV patients, and the interactions were analysed through PPI network analysis. The results confirmed that Let-7c and its target genes play a key role in HBV-related diseases. Next, we discovered a gradual decrease in Let-7c expression during the progression from HBV-associated chronic hepatitis (B-CH) and HBV-associated liver cirrhosis (B-LC) to B-HCC. We found evidence for a negative association between lin28B expression and Let-7c expression. The expression of MYC was obviously upregulated when Let-7c was inhibited. Conclusion Our results highlight that Let-7c and lin28B participate in the carcinogenesis of HBV-associated diseases through the lin28B/Let-7c/MYC axis. Supplementary Information The online version contains supplementary material available at 10.1186/s13027-022-00458-8.
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Affiliation(s)
- Like Zhang
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, No.89 Donggang Road, Shijiazhuang, 050031, Hebei, China
| | - Xia Jiang
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, No.89 Donggang Road, Shijiazhuang, 050031, Hebei, China.
| | - Guiqi Wang
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, No.89 Donggang Road, Shijiazhuang, 050031, Hebei, China
| | - Tatsuo Kanda
- Department of Gastroenterology and Nephrology, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Japan.,Division of Gastroenterology and Hepatology Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Osamu Yokosuka
- Department of Gastroenterology and Nephrology, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Japan
| | - Congjie Zhai
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, No.89 Donggang Road, Shijiazhuang, 050031, Hebei, China
| | - Lei Zhang
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, No.89 Donggang Road, Shijiazhuang, 050031, Hebei, China
| | - Peng Liu
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, No.89 Donggang Road, Shijiazhuang, 050031, Hebei, China
| | - Zengren Zhao
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, No.89 Donggang Road, Shijiazhuang, 050031, Hebei, China.
| | - Zhongxin Li
- Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, No.89 Donggang Road, Shijiazhuang, 050031, Hebei, China
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Association of subclinical markers of inflammation with preterm premature rupture of membranes and adverse neonatal results: a case control study. Arch Gynecol Obstet 2022; 306:2063-2068. [PMID: 36031665 DOI: 10.1007/s00404-022-06756-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/14/2022] [Indexed: 11/02/2022]
Abstract
AIM The study aims to investigate the relationship between subclinical inflammatory factors, which are known to be closely related to inflammation, with preterm premature rupture of membranes (PPROM) and adverse postpartum outcomes. MATERIALS AND METHODS The case control type study was conducted between January 1, 2021, and January 2022. 525 pregnant women, including 272 PPROM and 253 normal patients, were added to the study. RESULTS There was a positive relationship between PPROM and PCT (platelet crit), MPV (mean platelet volume), NLR (neutrophil-to-lymphocyte ratio), and MLR (monocytes to lymphocyte ratio) values. ROC analysis, PCT > 0.19, MPV > 8.78, NLR > 2.82, and MLR > 0.24 were significantly related to improved risk of PPROM (P < 0.05). In logistic regression analysis, a one-unit rise in PCT resulted in a 3.9-fold rise in RDS risk and a one-unit increase in NLR resulted in a 1.6-fold significant rise in sepsis risk (p < 0.05). CONCLUSION NLR and PCT parameters were found to be related to adverse neonatal outcomes.
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Aslan MM, Yeler MT, Bıyık İ, Yuvacı HU, Cevrioğlu AS, Özden S. Hematological Parameters to Predict the Severity of Hyperemesis Gravidarum and Ketonuria. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:458-466. [PMID: 35405756 PMCID: PMC9948287 DOI: 10.1055/s-0042-1743101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Hyperemesis gravidarum (HG) is a pregnancy complication that can progress with persistent nausea and vomiting. The aim of the present study is to evaluate the relationship between hematological parameters and HG. METHOD A total of 532 pregnant women with HG who were admitted to the Department of Obstetrics and Gynecology between March 2019 and February 2021, and 534 healthy pregnant women with characteristics similar to those of the case group were included in the study. The hematological parameters of both groups were compared. In addition, the hematological parametersof patients with HG according to the severity of ketonuria were compared. RESULTS The mean age of the HG group (n = 532) was 26.3 ± 4.1 years, and that of the control group (n = 534) was 25.9 ± 4.8 years. Among patients with HG, 46% (n = 249) had ketone (+), 33% (n = 174), ketone (++), and 21% (n = 109), ketone (++ + ). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were higher in the HG group than in the control group: 3.8 (2.8-5.8)/3.2 (2.6-4.0); p < 0.001; and 135.2 ± 30.4/108.9 ± 62.2; p < 0.001 respectively. The neutrophil count, NLR, and PLR were higher in the group with ketone (++ + ) than in the groups with ketone (+) or ketone (++): 7.6 ± 1.9/5.5 ± 2.4; p < 0.001; 3.8(2.8-4.6)/2.9(2.3-3.6); p < 0.001; and 149.9 ± 48.0/135.9 ± 65.7; p < 0.001 respectively. The mean corpuscular hemoglobin (MCH) level, the NLR, and the PLR were identified as independent predictors of the presence of HG and the level of ketone positivity in HG patients. CONCLUSION The NLR and PLR were high in patients with HG, suggesting the its inflammatory activity. They may be important markers associated with the presence and severity of HG.
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Affiliation(s)
- Mehmet Musa Aslan
- Department of Obstetrics and Gynecology, Sakarya Training and Research Hospital, School of Medicine, Sakarya University, Sakarya, Turkey
| | | | - İsmail Bıyık
- Department of Obstetrics and Gynecology, Kütahya Health Sciences University, Kütahya, Turkey
| | - Hilal Uslu Yuvacı
- Sakarya University, School of Medicine, Sakarya Training and Research Hospital, Department of Obstetrics and Gynecology, Sakarya, Turkey
| | - Arif Serhan Cevrioğlu
- Sakarya University, School of Medicine, Sakarya Training and Research Hospital, Department of Obstetrics and Gynecology, Sakarya, Turkey
| | - Selcuk Özden
- Sakarya University, School of Medicine, Sakarya Training and Research Hospital, Department of Obstetrics and Gynecology, Sakarya, Turkey
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Gao R, Kong L, Qing P, Cheng K, Chen H, Zhang S, Hu X, Hu Z, Yu F, Qin L. Interleukin-1β as clinically predictive risk marker for recurrent pregnancy loss in women positive for antinuclear antibody. Int J Clin Pract 2021; 75:e14887. [PMID: 34538020 DOI: 10.1111/ijcp.14887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/16/2021] [Indexed: 02/05/2023] Open
Abstract
AIMS Antinuclear antibody (ANA) was found to be associated with recurrent pregnancy loss (RPL). This study was designed to explore the immunological predictive indicators of RPL in women with positive ANA. METHODS A retrospective case-control study in a university hospital from March 2020 to January 2021 was performed, including 56 cases of women with RPL and 56 controls matched for age, all of which were positive for ANA. Levels of cytokines, lymphocyte subsets, immune globulin and complement in peripheral blood among two groups were compared. Statistical analyses in this study were performed using SPSS 25.0. RESULTS The level of IL-1β was higher in RPL women compared with controls according to univariable analysis and multivariable regression logistic analysis (7.67 [5.86-11.35] vs 5.00 [5.00-5.00], P = .000). After the cut-off value of IL-1β was set as 5.66 pg/mL, the prevalence of RPL was significantly elevated in the high IL-1β group as compared with the low IL-1β group (P < .05). The sensitivity and specificity of IL-1β predicting RPL in ANA-positive women were 76.8% and 91.1%, respectively. CONCLUSION Increased IL-1β may play roles in the occurrence of RPL among women with positive ANA. The level of the IL-1β has the potential to be a predictive indicator of RPL in women with positive ANA.
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Affiliation(s)
- Rui Gao
- The Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Linglingli Kong
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Pingying Qing
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Kemin Cheng
- Department of Outpatients, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Hanxiao Chen
- The Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Sirui Zhang
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Xiao Hu
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Zhengyan Hu
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Fan Yu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Lang Qin
- The Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
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