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Dangat K, Wadhwani N, Randhir K, Poddar A, Gupte S, Wagh G, Lalwani S, Joshi S. Longitudinal profile of high-sensitivity C-reactive protein in women with pre-eclampsia. Am J Reprod Immunol 2023; 90:e13741. [PMID: 37491921 DOI: 10.1111/aji.13741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/26/2023] [Accepted: 06/09/2023] [Indexed: 07/27/2023] Open
Abstract
PROBLEM C-reactive protein (CRP) is a marker for inflammation and its role as a possible biomarker for an early prediction of pre-eclampsia (PE) is unclear. The present study investigates the levels of high-sensitivity CRP (hs-CRP) longitudinally across pregnancy in women with PE and compares them to women without PE (non-PE). METHOD OF STUDY A total of 324 pregnant women [216 non-PE and 108 PE women] were included in this study. Maternal blood was taken at four different intervals (V1 = 11-14 weeks, V2 = 18-22 weeks, V3 = 26-28 weeks, and V4 = at delivery). RESULTS Maternal serum hs-CRP levels were higher at V1, V2, and V3 (p < .05 for all) in the PE group compared to the non-PE group. The hs-CRP levels were associated with maternal blood pressure throughout pregnancy. Maternal hs-CRP levels did not differ among early and late onset PE. Higher maternal hs-CRP levels were associated with the increased risk of PE in unadjusted model in early pregnancy. However, there was no significance after adjusting for confounding factors. CONCLUSIONS Our findings suggest although the levels of hs-CRP were higher in PE in early pregnancy, they are not associated with an increased risk of PE.
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Affiliation(s)
- Kamini Dangat
- Mother and Child Health, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
| | - Nisha Wadhwani
- Mother and Child Health, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
| | - Karuna Randhir
- Mother and Child Health, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
| | - Anupam Poddar
- Mother and Child Health, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
| | - Sanjay Gupte
- Gupte Hospital and Research Centre, Pune, Maharashtra, India
| | - Girija Wagh
- Department of Obstetrics and Gynaecology, Bharati Medical College and Hospital, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
| | - Sanjay Lalwani
- Department of Pediatrics, Bharati Medical College and Hospital, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
| | - Sadhana Joshi
- Mother and Child Health, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
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de Alwis N, Binder NK, Mangwiro YTM, Beard S, Pritchard N, Kadife E, Fato BR, Keenan E, Brownfoot FC, Kaitu’u-Lino TJ, Hannan NJ. Actions of Esomeprazole on the Maternal Vasculature in Lean and Obese Pregnant Mice with Impaired Nitric Oxide Synthesis: A Model of Preeclampsia. Int J Mol Sci 2022; 23:ijms23158185. [PMID: 35897759 PMCID: PMC9330120 DOI: 10.3390/ijms23158185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 01/09/2023] Open
Abstract
Preeclampsia is a devastating, multisystem disorder of pregnancy. It has no cure except delivery, which if premature can impart significant neonatal morbidity. Efforts to repurpose pregnancy-safe therapeutics for the treatment of preeclampsia have led to the assessment of the proton pump inhibitor, esomeprazole. Preclinically, esomeprazole reduced placental secretion of anti-angiogenic sFlt-1, improved endothelial dysfunction, promoted vasorelaxation, and reduced maternal hypertension in a mouse model. Our understanding of the precise mechanisms through which esomeprazole works to reduce endothelial dysfunction and enhance vasoreactivity is limited. Evidence from earlier studies suggested esomeprazole might work via the nitric oxide pathway, upregulating endothelial nitric oxide synthase (eNOS). Here, we investigated the effect of esomeprazole in a mouse model of L-NAME-induced hypertension (decreased eNOS activity). We further antagonised the model by addition of diet-induced obesity, which is relevant to both preeclampsia and the nitric oxide pathway. Esomeprazole did not decrease blood pressure in this model, nor were there any alterations in vasoreactivity or changes in foetal outcomes in lean mice. We observed similar findings in the obese mouse cohort, except esomeprazole treatment enhanced ex vivo acetylcholine-induced vasorelaxation. As acetylcholine induces nitric oxide production, these findings hint at a function for esomeprazole in the nitric oxide pathway.
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Affiliation(s)
- Natasha de Alwis
- Therapeutics Discovery & Vascular Function Group, Department of Obstetrics and Gynaecology, The University of Melbourne, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.d.A.); (N.K.B.); (Y.T.M.M.); (S.B.); (B.R.F.)
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.P.); (E.K.); (E.K.); (F.C.B.); (T.J.K.-L.)
| | - Natalie K. Binder
- Therapeutics Discovery & Vascular Function Group, Department of Obstetrics and Gynaecology, The University of Melbourne, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.d.A.); (N.K.B.); (Y.T.M.M.); (S.B.); (B.R.F.)
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.P.); (E.K.); (E.K.); (F.C.B.); (T.J.K.-L.)
| | - Yeukai T. M. Mangwiro
- Therapeutics Discovery & Vascular Function Group, Department of Obstetrics and Gynaecology, The University of Melbourne, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.d.A.); (N.K.B.); (Y.T.M.M.); (S.B.); (B.R.F.)
| | - Sally Beard
- Therapeutics Discovery & Vascular Function Group, Department of Obstetrics and Gynaecology, The University of Melbourne, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.d.A.); (N.K.B.); (Y.T.M.M.); (S.B.); (B.R.F.)
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.P.); (E.K.); (E.K.); (F.C.B.); (T.J.K.-L.)
| | - Natasha Pritchard
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.P.); (E.K.); (E.K.); (F.C.B.); (T.J.K.-L.)
| | - Elif Kadife
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.P.); (E.K.); (E.K.); (F.C.B.); (T.J.K.-L.)
- Obstetrics Diagnostics and Therapeutics Group, Department of Obstetrics and Gynaecology, The University of Melbourne, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia
| | - Bianca R. Fato
- Therapeutics Discovery & Vascular Function Group, Department of Obstetrics and Gynaecology, The University of Melbourne, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.d.A.); (N.K.B.); (Y.T.M.M.); (S.B.); (B.R.F.)
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.P.); (E.K.); (E.K.); (F.C.B.); (T.J.K.-L.)
| | - Emerson Keenan
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.P.); (E.K.); (E.K.); (F.C.B.); (T.J.K.-L.)
- Obstetrics Diagnostics and Therapeutics Group, Department of Obstetrics and Gynaecology, The University of Melbourne, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia
| | - Fiona C. Brownfoot
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.P.); (E.K.); (E.K.); (F.C.B.); (T.J.K.-L.)
- Obstetrics Diagnostics and Therapeutics Group, Department of Obstetrics and Gynaecology, The University of Melbourne, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia
| | - Tu’uhevaha J. Kaitu’u-Lino
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.P.); (E.K.); (E.K.); (F.C.B.); (T.J.K.-L.)
- Diagnostics Discovery and Reverse Translation in Pregnancy, The University of Melbourne, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia
| | - Natalie J. Hannan
- Therapeutics Discovery & Vascular Function Group, Department of Obstetrics and Gynaecology, The University of Melbourne, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.d.A.); (N.K.B.); (Y.T.M.M.); (S.B.); (B.R.F.)
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, VIC 3084, Australia; (N.P.); (E.K.); (E.K.); (F.C.B.); (T.J.K.-L.)
- Correspondence: ; Tel.: +61-3-8458-4371; Fax: +61-3-8458-4380
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Joshi K, Acharya N, Acharya S, Joshi S. Maternal Serum High-Sensitivity C-Reactive Protein (hsCRP) as a Prognostic Marker of Fetomaternal Outcome in Hypertensive Disorders of Pregnancy: A Novel Study. Cureus 2022; 14:e24327. [PMID: 35607538 PMCID: PMC9123406 DOI: 10.7759/cureus.24327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction: Hypertensive disorders of pregnancy (HDP) are a group of obstetric disorders causing profound fetomaternal compromise, leading to adverse obstetric outcomes. High-sensitivity c-reactive protein (hsCRP), an inflammatory marker of systemic inflammation, is elevated in HDP and correlates with the severity of the disease. However, prediction and prevention of HDP and its associated fetomaternal complications remain elusive to most obstetricians. The present study aimed to evaluate the use of hsCRP as a prognostic marker of adverse fetomaternal outcome in HDP. Methods: The study included 132 third-trimester pregnancies with HDP who underwent hsCRP quantification at the time of presentation to the out-patient department and followed up till delivery. HsCRP quantification was done using immunoturbidimetry method. Results: Of the 132 cases studied, 72 had normal hsCRP levels while the remaining 60 had raised hsCRP levels. It was observed that patients with raised hsCRP levels had poorer fetomaternal outcomes at delivery as compared to those with normal hsCRP levels. Conclusion: The obstetric outcomes of patients with HDP worsened with increasing levels of hsCRP, as shown in our study, when compared to normotensive patients. Thus, hsCRP delivers promising results as a prognostic marker of adverse fetomaternal outcomes in patients of HDP.
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Sakr HI, Khowailed AA, Al-Fakharany RS, Abdel-Fattah DS, Taha AA. Serum Uric Acid Level as a Predictive Biomarker of Gestational Hypertension Severity; A Prospective Observational Case-Control Study. Rev Recent Clin Trials 2021; 15:227-239. [PMID: 32646363 DOI: 10.2174/1574887115666200709142119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/08/2020] [Accepted: 06/19/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pre-eclampsia poses a significant potential risk of hypertensive disorders during pregnancy, a leading cause of maternal deaths. Hyperuricemia is associated with adverse effects on endothelial function, normal cellular metabolism, and platelet aggregation and adhesion. This study was designed to compare serum urate levels in normotensive pregnant women to those with pregnancy-induced hypertension, and to evaluate its value as a potential predictive marker of hypertension severity during pregnancy. METHODS A prospective, observational, case-control study conducted on 100 pregnant women in their third trimester. Pregnant women were classified into two groups (n=50) according to arterial blood pressure measurements: group I had normal blood pressure, and group II had a blood pressure of ≥ 140/90, which was further subdivided according to hypertension severity into IIa (pregnancy- induced hypertension, IIb (mild pre-eclampsia), and IIc (severe pre-eclampsia). Blood samples were obtained on admission. Serum urate, high sensitive C-reactive protein, and interleukin-1β levels, and lipid profile were compared among the groups. RESULTS A significant increase in the mean values of serum urate, C-reactive protein, and interleukin- 1β levels was detected in gestational hypertensives. In addition, there was a positive correlation between serum urate levels and C-reactive protein and interleukin-1β, as well as between serum urate levels and hypertension severity. CONCLUSION Hyperuricemia and increased C-reactive protein and interleukin-1β serum levels correlate with the severity of pregnancy-induced hypertension, and these biomarkers may play a role in the pathogenesis of pre-eclampsia. Serum urate measurement is sensitive, reliable markers that correlate well with the severity of hypertension in pregnant females with pre-eclampsia.
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Affiliation(s)
- Hader I Sakr
- Department of Medical Physiology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Akef A Khowailed
- Department of Medical Physiology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Reham S Al-Fakharany
- Department of Medical Physiology, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Dina S Abdel-Fattah
- Department of Biochemistry, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed A Taha
- Department of Obstetrics and Gynecology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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Chen T, He P, Tan Y, Xu D. Biomarker identification and pathway analysis of preeclampsia based on serum metabolomics. Biochem Biophys Res Commun 2017; 485:119-125. [DOI: 10.1016/j.bbrc.2017.02.032] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 02/06/2017] [Indexed: 01/03/2023]
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Dickinson E, Arnold JRP, Fisher J. Determination of glucose exchange rates and permeability of erythrocyte membrane in preeclampsia and subsequent oxidative stress-related protein damage using dynamic- 19F-NMR. JOURNAL OF BIOMOLECULAR NMR 2017; 67:145-156. [PMID: 28224261 PMCID: PMC5346149 DOI: 10.1007/s10858-017-0092-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 01/27/2017] [Indexed: 06/06/2023]
Abstract
The cause of the pregnancy condition preeclampsia (PE) is thought to be endothelial dysfunction caused by oxidative stress. As abnormal glucose tolerance has also been associated with PE, we use a fluorinated-mimic of this metabolite to establish whether any oxidative damage to lipids and proteins in the erythrocyte membrane has increased cell membrane permeability. Data were acquired using 19F Dynamic-NMR (DNMR) to measure exchange of 3-fluoro-3-deoxyglucose (3-FDG) across the membrane of erythrocytes from 10 pregnant women (5 healthy control women, and 5 from women suffering from PE). Magnetisation transfer was measured using the 1D selective inversion and 2D EXSY pulse sequences, over a range of time delays. Integrated intensities from these experiments were used in matrix diagonalisation to estimate the values of the rate constants of exchange and membrane permeability. No significant differences were observed for the rate of exchange of 3-FDG and membrane permeability between healthy pregnant women and those suffering from PE, leading us to conclude that no oxidative damage had occurred at this carrier-protein site in the membrane.
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Affiliation(s)
| | - John R P Arnold
- Selby College, Abbot's Road, Selby, North Yorkshire, YO8 8AT, UK
| | - Julie Fisher
- School of Chemistry, University of Leeds, Leeds, UK
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Sen-yu W, Chao X. Assessment of the relationship between red blood cell distribution width and preganecy hypertension disease. J Obstet Gynaecol Res 2016; 42:1258-1262. [PMID: 27436585 DOI: 10.1111/jog.13067] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/02/2016] [Accepted: 05/02/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Wang Sen-yu
- The Nuclear Medicine Departement; The Second Affiliated Hospital of Xinjiang Medical University; Urumqi China
| | - Xu Chao
- The Clinical Laboratory Department; The 98th Hospital of Chinese PLA; Urumqi China
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Mihu D, Razvan C, Malutan A, Mihaela C. Evaluation of maternal systemic inflammatory response in preeclampsia. Taiwan J Obstet Gynecol 2016; 54:160-6. [PMID: 25951721 DOI: 10.1016/j.tjog.2014.03.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To evaluate the systemic inflammatory response in preeclampsia compared to normal pregnancy. MATERIALS AND METHODS The following serum parameters were determined in three groups of patients: leukocytes, neutrophils, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), and certain markers of oxidative stress. Fetal status was assessed based on the gestational age at which birth occurred, on the Apgar score, and on fetal weight. RESULTS In preeclampsia, a higher systemic inflammatory status was found compared to normal pregnancy. Gestational age at birth, fetal weight, and Apgar score were significantly lower in the group with preeclampsia compared to normal pregnancy. CONCLUSION In preeclampsia, there is an increased systemic inflammatory response compared to normal pregnancy, which can influence fetal status at birth.
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Affiliation(s)
- Dan Mihu
- 2nd Department of Obstetrics and Gynecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012, Cluj-Napoca, Romania
| | - Ciortea Razvan
- 2nd Department of Obstetrics and Gynecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012, Cluj-Napoca, Romania
| | - Andrei Malutan
- 2nd Department of Obstetrics and Gynecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012, Cluj-Napoca, Romania.
| | - Carmen Mihaela
- Department of Histology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012, Cluj-Napoca, Romania
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Cheng PJ, Huang SY, Su SY, Hsiao CH, Peng HH, Duan T. Prognostic Value of Cardiovascular Disease Risk Factors Measured in the First-Trimester on the Severity of Preeclampsia. Medicine (Baltimore) 2016; 95:e2653. [PMID: 26844488 PMCID: PMC4748905 DOI: 10.1097/md.0000000000002653] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Recent studies have suggested that preeclampsia and cardiovascular disease may share common mechanisms. The purpose of this prospective nested case-controlled study was to characterize a variety of cardiovascular disease risk factors measured during the first trimester of pregnancy in predicting subsequent outcomes and the severity of preeclampsia.We ascertained the severity of preeclampsia at the onset of the disease, and the presence of intrauterine growth restriction (IUGR). We compared first trimester maternal serum cardiovascular disease risk factors in preeclampsia subjects versus normal pregnancies, early-onset versus late-onset preeclampsia, and preeclampsia with IUGR versus without IUGR. To identify the prognostic value of independent predictors on the severity of preeclampsia, we calculated the area under the receiver operating characteristics curve (AUC) using logistic regression analysis.There were 134 cases of preeclampsia and 150 uncomplicated pregnancies, and preeclampsia cases were classified as early-onset (53 cases) or late-onset (81 cases), or as with IUGR (44 cases) or without IUGR (90 cases). Among the cardiovascular disease risk factors, maternal serum high-sensitive C-reactive protein (hsCRP) and homocysteine were predictors of both early-onset preeclampsia and preeclampsia with IUGR. For the detection of early onset preeclampsia or preeclampsia with IUGR, the AUC for the combination model (0.943 and 0.952, respectively) was significantly higher than with serum hsCRP or serum homocysteine only.Patients with preeclampsia can be subdivided into different severities according to time of onset and fetal weight. Cardiovascular risk factors distinguish a subgroup of these patients.
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Affiliation(s)
- Po-Jen Cheng
- From the Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan (PJC, SYH, SYS, HHP); Department of Obstetrics and Gynecology, Taipei City Hospital, Taipei, Taiwan, R.O.C. (CHH); and Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, P.R. China (TD)
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Pourghassem Gargari B, Pourteymour Fard Tabrizi F, Sadien B, Asghari Jafarabadi M, Farzadi L. Vitamin D Status Is Related to Oxidative Stress But Not High-Sensitive C-Reactive Protein in Women with Pre-Eclampsia. Gynecol Obstet Invest 2015; 81:308-14. [DOI: 10.1159/000441781] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 10/15/2015] [Indexed: 11/19/2022]
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Kwiatkowski S, Kwiatkowska E, Rzepka R, Torbe A, Dolegowska B. Ischemic placental syndrome--prediction and new disease monitoring. J Matern Fetal Neonatal Med 2015; 29:2033-9. [PMID: 26444581 DOI: 10.3109/14767058.2015.1072165] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The last decade has seen an improved understanding of the cause of the development of pathologies such as gestational hypertension, preeclampsia, intrauterine growth restriction, intrauterine fetal death or placental abruption. Nowadays, we know that most conditions within this group share the same pathogenesis, the cause of which is placental ischemia. The following review is an attempt to propose a new method for prediction, diagnosis and--above all--appropriate monitoring of pregnant women and fetuses developing the ischemic placental syndrome with the use of tests that are new but yet widely available in clinical diagnosis. They are closely related to the condition's pathogenesis, therefore their elevated levels may predate clinical symptoms, and--most importantly--they correlate with syndrome aggravation and the occurrence of complications. Perhaps, the new look will allow us to improve perinatal results by reducing mortality and severe complications in pregnant women and fetal deaths resulting from sudden intrauterine fetal death or placental abruption.
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Affiliation(s)
| | - Ewa Kwiatkowska
- b Department of Nephrology , Transplantology and Internal Medicine , and
| | | | | | - Barbara Dolegowska
- c Department of Laboratory Diagnostics , Pomeranian University of Medicine , Szczecin , Poland
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Xu QL, Zhu M, Jin Y, Wang N, Xu HX, Quan LM, Wang SS, Li SS. The predictive value of the first-trimester maternal serum chemerin level for pre-eclampsia. Peptides 2014; 62:150-4. [PMID: 25445606 DOI: 10.1016/j.peptides.2014.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 10/03/2014] [Accepted: 10/03/2014] [Indexed: 01/06/2023]
Abstract
Chemerin is a novel adipokine linked to inflammation. The cross-sectional studies have reported that maternal chemerin serum concentrations are significantly increased in pre-eclampsia. However, limited data are available regarding the cause-effect relationship between chemerin and pre-eclampsia. The aim of this prospective observational study was to evaluate predictive significance of the first-trimester maternal serum chemerin levels for pre-eclampsia and to further confirm the hypothesis that chemerin is an important causative factor in the pathogenesis of pre-eclampsia. 518 pregnancy women were recruited. The first-trimester maternal serum chemerin levels were determined using enzyme-linked immunosorbent assay. The first-trimester maternal serum chemerin levels were statistically significantly elevated in women with pre-eclampsia compared with those without pre-eclampsia and in severe pre-eclampsia women compared with mild pre-eclampsia women. Serum chemerin levels remained positively associated with plasma C-reactive protein levels using a linear regression model. A logistic-regression analysis demonstrated that body mass index and serum chemerin levels appeared to be the independent predictors of pre-eclampsia. A receiver–operating characteristic curve analysis identified that serum chemerin levels predicted pre-eclampsia with high predictive value. The predictive value of the chemerin concentrations was similar to that of body mass index. Chemerin improved the predictive value of body mass index statistically significantly. Thus, our results suggest that high serum chemerin levels are associated with inflammation and pre-eclampsia independently, as well as chemerin may play a role as predictive biomarker for pre-eclampsia and be an important causative factor in the pathogenesis of pre-eclampsia.
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Cohen Y, Ascher-Landsberg J, Cohen A, Lessing JB, Grisaru D. The role of C-reactive protein measurement as a diagnostic aid in early pregnancy. Eur J Obstet Gynecol Reprod Biol 2014; 176:64-7. [DOI: 10.1016/j.ejogrb.2014.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 02/19/2014] [Accepted: 03/03/2014] [Indexed: 11/25/2022]
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Kashanian M, Aghbali F, Mahali N. Evaluation of the diagnostic value of the first-trimester maternal serum high-sensitivity C-reactive protein level for prediction of pre-eclampsia. J Obstet Gynaecol Res 2013; 39:1549-54. [DOI: 10.1111/jog.12105] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 12/12/2012] [Indexed: 12/31/2022]
Affiliation(s)
- Maryam Kashanian
- Department of Obstetrics & Gynecology; Tehran University of Medical Sciences; Tehran Iran
| | - Farnaz Aghbali
- Department of Obstetrics & Gynecology; Tehran University of Medical Sciences; Tehran Iran
| | - Neda Mahali
- Department of Obstetrics & Gynecology; Tehran University of Medical Sciences; Tehran Iran
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Verit FF, Erel O, Celik H. Paraoxonase-1 activity in patients with hyperemesis gravidarum. Redox Rep 2013; 13:134-8. [DOI: 10.1179/135100008x259259] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Inflammatory disturbances in preeclampsia: relationship between maternal and umbilical cord blood. J Pregnancy 2012; 2012:684384. [PMID: 22685662 PMCID: PMC3366239 DOI: 10.1155/2012/684384] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 03/02/2012] [Accepted: 03/21/2012] [Indexed: 01/25/2023] Open
Abstract
Preeclampsia (PE) is one of the main causes of maternal and fetal mortality and morbidity. PE is associated with an inflammatory state and with oxidative stress, in maternal circulation. Our aim was to evaluate and compare the levels of oxidative stress and inflammatory markers in maternal and umbilical cord blood (UCB), in normal and PE pregnancies. We measured acute-phase proteins (CRP and α1-antitrypsin), proinflammatory cytokines (IL-6 and TNF-α), leukocyte activation (elastase, lactoferrin, sL-selectin, sVCAM, sPECAM), total antioxidant status (TAS), thiobarbituric acid reactive substances (TBARS), and uric acid levels. We studied 42 healthy pregnant women, 46 PE women, and their neonates. The concentrations of IL-6, TNF-α, α1-antitrypsin, CRP, sVCAM, uric acid, and TBARS were significantly higher, and sL-selectin was significantly lower in PE pregnant women as compared with normotensive pregnant women. In newborns uric acid, α1-antitrypsin, and CRP values were significantly higher in PE; leukocyte count, sL-selectin, lactoferrin, and the ratio elastase/α1-antitrypsin were significantly lower. Our data suggest that PE pregnancy is associated with an enhanced maternal inflammatory condition, which is reflected in fetal circulation. This enhanced inflammatory state seems to be related to endothelial dysfunction and increased cytokine synthesis, rather than with neutrophil activation.
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Novakov Mikic A, Cabarkapa V, Nikolic A, Maric D, Brkic S, Mitic G, Ristic M, Stosic Z. Cystatin C in pre-eclampsia. J Matern Fetal Neonatal Med 2012; 25:961-5. [DOI: 10.3109/14767058.2011.601366] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Adali E, Kurdoglu M, Adali F, Cim N, Yildizhan R, Kolusari A. The relationship between brachial artery flow-mediated dilatation, high sensitivity C-reactive protein, and uterine artery doppler velocimetry in women with pre-eclampsia. JOURNAL OF CLINICAL ULTRASOUND : JCU 2011; 39:191-197. [PMID: 21480285 DOI: 10.1002/jcu.20781] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2010] [Accepted: 10/15/2010] [Indexed: 05/30/2023]
Abstract
PURPOSE To investigate serum high sensitivity C-reactive protein (hs-CRP) levels and endothelial function in pregnancies complicated by pre-eclampsia and to clarify their relationship with uterine artery Doppler velocimetry. METHODS A cross-sectional study was carried out in 70 pregnant women (35 patients with pre-eclampsia and 35 age-matched normotensive healthy pregnant women) during the third trimester of pregnancy. The maternal levels of serum hs-CRP were determined in all cases by immunonephelometry. Uterine artery Doppler velocimetry was performed. Flow-mediated dilatation was measured by sonography of the brachial artery for the assessment of endothelial function. RESULTS Serum hs-CRP levels were higher in the pre-eclamptic group than in the normotensive group. hs-CRP levels were positively correlated with mean arterial pressure. Eleven patients with pre-eclampsia had abnormal uterine artery Doppler velocimetry. hs-CRP levels were significantly higher in pre-eclamptic patients with than without abnormal uterine artery Doppler velocimetry. Endothelial function was inversely correlated with hs-CRP levels and mean arterial pressure. CONCLUSIONS These findings suggest that maternal serum hs-CRP levels increase with the severity of pre-eclampsia, reflecting endothelial dysfunction and constituting a potential marker of pathological utero-placental perfusion, with a high risk for fetal growth restriction.
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Affiliation(s)
- Ertan Adali
- Department of Obstetrics and Gynaecology, Yuzuncu Yil University, Van, Turkey
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Kuklina EV, Bateman BT. Pregnancy Complications and Prevention of Cardiovascular Disease in Women: Stay Tuned. J Womens Health (Larchmt) 2011; 20:657-9. [DOI: 10.1089/jwh.2011.2827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Elena V. Kuklina
- Division of Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian T. Bateman
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Seong WJ, Chong GO, Hong DG, Lee TH, Lee YS, Cho YL, Chun SS, Park IS. Clinical significance of serum albumin level in pregnancy-related hypertension. J Obstet Gynaecol Res 2010; 36:1165-73. [DOI: 10.1111/j.1447-0756.2010.01296.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Ertas IE, Kahyaoglu S, Yilmaz B, Ozel M, Sut N, Guven MA, Danisman N. Association of maternal serum high sensitive C-reactive protein level with body mass index and severity of pre-eclampsia at third trimester. J Obstet Gynaecol Res 2010; 36:970-7. [DOI: 10.1111/j.1447-0756.2010.01279.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Valério EG, Müller ALL, Martins-Costa SH, Lopes Ramos JG, Rodini G. Are insulin resistance index, IGF-1 and metabolic syndrome components correlates with severe preeclampsia? Hypertens Pregnancy 2010; 30:302-10. [PMID: 20701471 DOI: 10.3109/10641950903214609] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Analyse the relation between insulin resistance and severe preeclampsia (SPE). METHODS Case control study paired by body mass index and gestational age; including 16 patients with severe SPE and 16 normotensive controls. Insulin resistance was assessed through the HOMA-IR and QUICKI-IS indexes. RESULTS There was no significant difference between the groups regarding the HOMA-IR and QUICKI-IS indexes and HDL cholesterol. Triglyceride levels were higher and the IGF-1 was lower in the SPE group than in the control group. CONCLUSIONS There were no differences in the insulin resitance indexes between the group with SPE and normal controls.
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Affiliation(s)
- Edimárlei Gonsales Valério
- Programa de Pós-Graduação em Medicina: Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, RS, Brazil.
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Gammill HS, Powers RW, Clifton RG, Van Dorsten JP, Klebanoff MA, Lindheimer MD, Sibai B, Landon MB, Miodovnik M, Dombrowski M. Does C-reactive protein predict recurrent preeclampsia? Hypertens Pregnancy 2010; 29:399-409. [PMID: 20701468 PMCID: PMC3339658 DOI: 10.3109/10641950903214633] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Evaluate association of the inflammatory marker C-reactive protein with recurrent preeclampsia. METHODS Serum samples collected longitudinally in women with previous preeclampsia from the Maternal-Fetal Medicine Units Network trial of aspirin to prevent preeclampsia were assayed for CRP. RESULTS Of 255 women studied, 50 developed recurrence. Baseline C-reactive protein concentration was similar between women who did and did not recur. After adjusting for confounders, neither elevated baseline C-reactive protein nor its change over gestation was associated with recurrence. CONCLUSION In this group of women with previous preeclampsia, neither baseline C-reactive protein concentration nor change in concentration over gestation was associated with recurrent preeclampsia.
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Affiliation(s)
- Hilary S Gammill
- Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA, USA.
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Guven MA, Coskun A, Ertas IE, Aral M, Zencirci B, Oksuz H. Association of maternal serum CRP, IL-6, TNF-alpha, homocysteine, folic acid and vitamin B12 levels with the severity of preeclampsia and fetal birth weight. Hypertens Pregnancy 2009; 28:190-200. [PMID: 19437229 DOI: 10.1080/10641950802601179] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To assess the levels and clinical significance of high sensitive(hs)-CRP (C-reactive protein), IL-6(interleukin-6), TNF-alpha(tumor necrosis factor-alpha), homocysteine, folic acid and vitamin B12 in normotensive healthy pregnant women, mild and severe preeclamptic patients, and to evaluate the correlations between these markers and the severity of preeclampsia and fetal birth weight. STUDY DESIGN Using a cross-sectional study design, hs-CRP, IL-6, TNF-alpha, homocysteine and vitamin B12 were measured in the third trimester of pregnancy from normotensive healthy women with uncomplicated pregnancies (n = 62), mild (n = 61) and severe (n = 60) preeclamptic patients. RESULTS There were statistically significant differences between three groups for hs-CRP (p = 0.012), TNF- alpha (p = 0.046), IL-6 (p = 0.015), homocysteine (p < 0.001) and fetal birth weight (p < 0.001). Fetal birth weights in mild (2477 +/- 746) and severe (2435 +/- 768) preeclamptic patients were significantly lower than controls (3485 +/- 365) (p < 0.001). No significant difference was found between the three groups for folic acid (p = 0.066) and vitamin B12 (p = 0.286). Bonferroni adjusted multiple comparison test showed that the statistical differences with respect to TNF-alpha, IL-6 and homocysteine were mainly created by control and severe preeclampsia groups. Hs-CRP levels still remained higher in severe preeclampsia patients than mild preeclampsia and normotensive patients except for overweight patients in the previous two groups after Bonferroni post hoc adjustment test. CONCLUSION Elevated maternal serum levels of hs-CRP, TNF- alpha, IL-6 and homocysteine in preeclamptic women correlate with fetal birth weight in the early third trimester.
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Affiliation(s)
- Melih A Guven
- Department of Obstetrics and Gynecology, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey.
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Turner E, Brewster JA, Simpson NAB, Walker JJ, Fisher J. Imidazole-Based Erythrocyte Markers of Oxidative Stress in Preeclampsia—An NMR Investigation. Reprod Sci 2009; 16:1040-51. [DOI: 10.1177/1933719109340928] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Elizabeth Turner
- School of Chemistry, University of Leeds, Leeds, United Kingdom (ET, JF)
| | - Jennifer A. Brewster
- Academic Unit of Paediatrics, Obstetrics and Gynaecology, University of Leeds, Leeds, United Kingdom
| | - Nigel A. B. Simpson
- Academic Unit of Paediatrics, Obstetrics and Gynaecology University of Leeds, Leeds, United Kingdom
| | - James J. Walker
- Leeds Institute of Molecular Medicine, Leeds, United Kingdom
| | - Julie Fisher
- School of Chemistry, University of Leeds, Leeds, United Kingdom, (ET, JF)
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Sersam LW. Inflammatory markers in pre-eclampsia and related conditions. Int J Gynaecol Obstet 2008; 105:69-70. [DOI: 10.1016/j.ijgo.2008.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Revised: 11/16/2008] [Accepted: 11/19/2008] [Indexed: 11/28/2022]
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Turner E, Brewster JA, Simpson NAB, Walker JJ, Fisher J. Aromatic amino acid biomarkers of preeclampsia--a nuclear magnetic resonance investigation. Hypertens Pregnancy 2008; 27:225-35. [PMID: 18696351 DOI: 10.1080/10641950801955725] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES There is conflicting literature regarding the correlation between aromatic amino acid concentrations and the occurrence of preeclampsia (PE). The object of this study was to test whether these molecules could enable discrimination between healthy and preeclamptic pregnancies when detected using (1)H nuclear magnetic resonance spectroscopy. METHODS Plasma samples from 11 normotensive and 11 preeclamptic pregnant women were analyzed using (1)H-NMR. The the aromatic region of the spectrum was divided into regions of uniform size. The area of each region was subjected to principal component analysis. RESULTS A distinction was made between normal and preeclamptic pregnancies on the basis of histidine, tyrosine, and phenylalanine concentrations. The concentration of histidine was significantly higher in the plasma of patients with PE than in that of normotensive women (p = 0.003). CONCLUSION (1)H-NMR-based analysis of biofluids is capable of differentiating between patients with and without preeclampsia.
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Facteurs de risque de la prééclampsie en cas de grossesse unique. ACTA ACUST UNITED AC 2008; 37:477-82. [DOI: 10.1016/j.jgyn.2008.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2007] [Revised: 04/26/2007] [Accepted: 04/08/2008] [Indexed: 11/21/2022]
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Coskun S, Kasirga E, Yilmaz O, Bayindir P, Akil I, Yuksel H, Polat M, Sanlidag T. Is Helicobacter pylori related to endothelial dysfunction during childhood? Pediatr Int 2008; 50:150-3. [PMID: 18353048 DOI: 10.1111/j.1442-200x.2008.02542.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Helicobacter pylori infection has been proposed to have a role in the development of atherosclerosis preceded by endothelial dysfunction. The aim of the present study was to determine if a relationship exists between H. pylori infection in childhood and endothelial dysfunction and level of high-sensitivity C-reactive protein (hsCRP). METHODS Between October 2003 and November 2004, 28 subjects who were anti-H. pylori IgG-positive and 25 who were anti-H. pylori IgG-negative were included in the study. Mean ages of the H. pylori-positive and negative groups were not significantly different. Endothelial functions were evaluated on Doppler ultrasonography of the brachial artery. Percent ratio of the change in systolic diameter during hyperemic phase to the basal diameter was evaluated. Each subject's serum was tested for hsCRP, homocysteine and lipids. RESULTS Percent ratio of the change in systolic diameters during hyperemic phase to the basal diameter was not significantly different between the H. pylori-negative and -positive groups (P > 0.29). Mean levels of hsCRP were also not significantly different (1.48 +/- 1.8 g/dL vs 2.35 +/- 3.33 g/dL; P > 0.24). Similarly, serum levels of lipids and homocysteine were not significantly different (P > 0.05 for all lipids). CONCLUSIONS Non-invasive techniques used in the present study were not indicative of early findings of atherosclerosis in H. pylori infection during childhood. Further studies are required to evaluate the relationship between early endothelial dysfunction and H. pylori infection in children with cardiovascular risk factors.
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Affiliation(s)
- Senol Coskun
- Department of Pediatric Cardiology, Celal Bayar University, Manisa, Turkey
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Turner E, Brewster JA, Simpson NAB, Walker JJ, Fisher J. Plasma from women with preeclampsia has a low lipid and ketone body content--a nuclear magnetic resonance study. Hypertens Pregnancy 2007; 26:329-42. [PMID: 17710581 DOI: 10.1080/10641950701436073] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Using (1)H-nuclear magnetic resonance spectroscopy and chemometrics, we sought to establish the metabolic profile for preeclampsia and to identify biomarkers that would permit a distinction between women with a normal pregnancy and those suffering from preeclampsia. METHODS Plasma samples from 11 normotensive pregnant women and 11 women with preeclampsia were analyzed. Principal component analysis was applied to differentiate between the two groups of patients. RESULTS Lipid concentrations were found to be significantly lower in the plasma of patients suffering from preeclampsia than those in normotensive pregnant women (p = 0.031). There is also evidence to suggest that ketone body constituents may contribute to the discrimination. CONCLUSION (1)H-nuclear magnetic resonance-based metabolic profiling can detect patients with preeclampsia.
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Coussons-Read ME, Okun ML, Nettles CD. Psychosocial stress increases inflammatory markers and alters cytokine production across pregnancy. Brain Behav Immun 2007; 21:343-50. [PMID: 17029703 DOI: 10.1016/j.bbi.2006.08.006] [Citation(s) in RCA: 295] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2006] [Revised: 08/22/2006] [Accepted: 08/23/2006] [Indexed: 11/28/2022] Open
Abstract
Previous work has shown that psychosocial stress is related to increases in serum levels of pro-inflammatory cytokines late in pregnancy, and a growing body of research suggests that increased inflammatory activity during pregnancy, generally, may have a negative impact on outcome. The present study further addressed these issues by assessing relationships between psychosocial stress, social support and serum cytokines in early, mid, and late pregnancy, and the effects of stress and social support on the production of cytokines by stimulated lymphocytes in late pregnancy. In addition, we examined relationships between stress, support, and serum C-reactive protein (CRP) during pregnancy. Elevated stress was not only related to higher serum IL-6 late in pregnancy as in our prior work, but this relationship was also evident during early pregnancy and elevated stress was also associated with lower IL-10 in early pregnancy. No relationships between stress and cytokines were apparent during the 2nd trimester of pregnancy. Elevated stress during the 2nd trimesters and low social support during the 3rd trimester were related to increased serum levels of CRP, further suggesting that psychosocial factors can contribute increased inflammation during pregnancy. Importantly, elevated stress levels across pregnancy were predictive of elevated production of the pro-inflammatory cytokines IL-1B and IL-6 by stimulated lymphocytes in the 3rd trimester, suggesting that stress during pregnancy affects the function of immune system cells. These findings further support the notion that prenatal stress alters maternal physiology and immune function in a manner consistent with increased risk of pregnancy complications such as preeclampsia and premature labor.
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Affiliation(s)
- Mary E Coussons-Read
- Department of Psychology, The University of Colorado at Denver and Health Sciences Center, CB 173, P.O. Box 173364, Denver, CO 80217, USA.
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Bibliography. Current world literature. Women's health. Curr Opin Obstet Gynecol 2006; 18:666-74. [PMID: 17099340 DOI: 10.1097/gco.0b013e328011ef42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Molvarec A, Prohászka Z, Nagy B, Kalabay L, Szalay J, Füst G, Karádi I, Rigó J. Association of increased serum heat shock protein 70 and C-reactive protein concentrations and decreased serum alpha(2)-HS glycoprotein concentration with the syndrome of hemolysis, elevated liver enzymes, and low platelet count. J Reprod Immunol 2006; 73:172-179. [PMID: 17023052 DOI: 10.1016/j.jri.2006.07.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2006] [Revised: 07/19/2006] [Accepted: 07/24/2006] [Indexed: 11/23/2022]
Abstract
The primary aim of this study was to determine serum Hsp70 concentrations in HELLP syndrome. We measured also the serum concentrations of three acute phase proteins: C-reactive protein (CRP), alpha(2)-macroglobulin (AMG) and alpha(2)-HS glycoprotein (AHSG). Ten severe preeclamptic patients with HELLP syndrome, 20 severe preeclamptic patients without HELLP syndrome and 20 normotensive, healthy pregnant women were included in this case-control study. Serum concentrations of Hsp70, CRP, AMG and AHSG were measured using an enzyme-linked immunosorbent assay (Hsp70), particle-enhanced immunoturbidimetric assay (CRP) and radial immunodiffusion (AMG, AHSG). The serum Hsp70 and CRP concentrations were significantly higher, whereas the serum AHSG concentration was significantly lower in the HELLP group (H) than the severe preeclamptic (P) and control (C) groups (median (25-75 percentile); Hsp70: 2.02 ng/ml (0.76-2.23) (H) versus 0.54 ng/ml (0.47-0.79) (P), p<0.01, and 0.30 ng/ml (0.27-0.33) (C), p<0.001; CRP: 43.9 mg/l (27.1-84.5) (H) versus 6.5 mg/l (2.7-10.7) (P), p<0.001, and 2.5 mg/l (1.1-6.7) (C), p<0.001; AHSG: 588 microg/ml (492-660) (H) versus 654 microg/ml (576-768) (P), p<0.05, and 738 microg/ml (666-804) (C), p<0.01, respectively). The serum AMG concentration did not differ between the study groups. In the HELLP group, there was a statistically significant negative correlation between serum Hsp70 concentration and platelet count (Spearman R=-0.69, p=0.026). In conclusion, serum Hsp70 and CRP concentrations are increased, whereas serum AHSG concentration is decreased, in HELLP syndrome. The maternal systemic inflammation seems to be more pronounced in HELLP syndrome than preeclampsia without HELLP syndrome, as suggested by the alterations in serum CRP and AHSG levels. However, it requires further investigation to determine whether these changes are causes or consequences of the disease.
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Affiliation(s)
- Attila Molvarec
- Department of Obstetrics and Gynecology, Kútvölgyi Clinical Center, Semmelweis University, Budapest, Hungary.
| | - Zoltán Prohászka
- 3rd Department of Internal Medicine, Semmelweis University and Research Group on Metabolism and Atherosclerosis, Hungarian Academy of Sciences, Budapest, Hungary
| | - Bálint Nagy
- 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - László Kalabay
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - János Szalay
- Department of Obstetrics and Gynecology, Kútvölgyi Clinical Center, Semmelweis University, Budapest, Hungary
| | - Georg Füst
- 3rd Department of Internal Medicine, Semmelweis University and Research Group on Metabolism and Atherosclerosis, Hungarian Academy of Sciences, Budapest, Hungary
| | - István Karádi
- 3rd Department of Internal Medicine, Semmelweis University and Research Group on Metabolism and Atherosclerosis, Hungarian Academy of Sciences, Budapest, Hungary
| | - János Rigó
- 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
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Engin-Ustün Y, Ustün Y, Karabulut AB, Ozkaplan E, Meydanli MM, Kafkasli A. Serum Amyloid A Levels Are Increased in Pre-Eclampsia. Gynecol Obstet Invest 2006; 64:117-20. [PMID: 17339772 DOI: 10.1159/000100329] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AIM The purpose of this study was to examine serum amyloid A (SAA) levels in normal pregnant and pre-eclamptic women. METHODS SAA levels were measured in 25 normotensive and 25 pre-eclamptic pregnant women by enzyme linked immuno-sorbent assay. RESULTS In pre-eclampsia, SAA level and C-reactive protein (CRP) averaged 28.2 (7.2-135) ng/l and 21 (6.13-91) mg/l, respectively, which were significantly higher than those of normal pregnancy (7.8 [4.65-24.6] ng/l and 6.05 [0.3-19] mg/l, respectively) (p < 0.05). In addition, SAA level was positively correlated to CRP (r = 0.468, p < 0.05). CONCLUSION Marked increases of both SAA level and CRP in pre-eclampsia, and their inter-relation, may at least in part contribute to the pathogenesis of pre-eclampsia.
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Affiliation(s)
- Yaprak Engin-Ustün
- Department of Obstetrics and Gynecology, School of Medicine, Inonu University, Malatya, Turkey.
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