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Zaccarelli-Marino MA, Dsouki NA, de Carvalho RP, Maciel RMB. Evaluation of Anti-Thyroperoxidase (A-TPO) and Anti-Thyroglobulin (A-Tg) Antibodies in Women with Previous Hashimoto's Thyroiditis during and after Pregnancy. J Clin Med 2024; 13:4519. [PMID: 39124785 PMCID: PMC11313569 DOI: 10.3390/jcm13154519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 07/26/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024] Open
Abstract
Background/Objective: Autoimmune thyroid diseases (AITD) affect 2 to 5% of the general population. This study aimed to determine changes in activity of A-Tg and A-TPO antibodies before, during, and after pregnancy in women with previous AITD. Methods: This was a single-center study with a retrospective review of the medical records of 30 female patients aged 25-41 years who came to our endocrinology service in the city of Santo André, state of São Paulo, Brazil, to investigate thyroid diseases. The following data were reviewed: total triiodothyronine (totalT3), total thyroxine (totalT4), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and anti-TSH receptor antibodies (anti-TSH receptor or anti-thyrotropin receptor antibodies (TRAb), anti-thyroid peroxidase (A-TPO), and anti-thyroglobulin (A-Tg)). These data were reviewed for 30 patients before and during the three trimesters of pregnancy and during the three months after pregnancy. Results: During gestation, we observed a progressive decrease in the blood values of A-TPO and A-Tg, which reached their lowest values in the third trimester of pregnancy, but after birth, they returned to values statistically equivalent to those before pregnancy. Analyzing the three trimesters and the post-pregnancy period, A-TPO increased 192% between the first trimester and postpartum (p = 0.009); it increased 627% between the second trimester and postpartum (p < 0.001); and it increased >1000% between the third trimester and postpartum (p < 0.001). There was no significant difference in the A-TPO values between the pre- and post-gestational periods (p = 1.00), between the first and second trimesters (p = 0.080), or between the second and third trimesters (p = 0.247). Conclusions: According to the results presented here, we observed changes in the activities of A-Tg and A-TPO antibodies during and after pregnancy in women with previous AITD. In women who intend to become pregnant, are pregnant, or have given birth within three months, it is essential to monitor A-TPO, A-Tg, and thyroid function as well as serum thyroid hormones and TSH to identify thyroid dysfunction in a timely manner and adjust the treatment strategy to avoid the deleterious effects of hypothyroidism on both mother and baby during and after pregnancy.
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Affiliation(s)
- Maria Angela Zaccarelli-Marino
- Internal Medicine Department, University of São Paulo Medical School, São Paulo CEP 01246-000, SP, Brazil
- Internal Medicine Department, ABC Medical School Foundation, Santo André CEP 09060-870, SP, Brazil
| | - Nuha Ahmad Dsouki
- Laboratory of Molecular and Translational Endocrinology, Department of Medicine, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo CEP 04022-001, SP, Brazil;
- Department of Morphology and Physiology, ABC Medical School Foundation, Santo André CEP 09060-870, SP, Brazil;
| | - Rodrigo Pigozzi de Carvalho
- Department of Morphology and Physiology, ABC Medical School Foundation, Santo André CEP 09060-870, SP, Brazil;
| | - Rui M. B. Maciel
- Department of Medicine, Division of Endocrinology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo CEP 04022-001, SP, Brazil;
- Laboratory of Molecular and Translational Endocrinology, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo CEP 04022-001, SP, Brazil
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Wemmert S, Pyrski M, Pillong L, Linxweiler M, Zufall F, Leinders-Zufall T, Schick B. Widespread Distribution of Luteinizing Hormone/Choriogonadotropin Receptor in Human Juvenile Angiofibroma: Implications for a Sex-Specific Nasal Tumor. Cells 2024; 13:1217. [PMID: 39056799 PMCID: PMC11274802 DOI: 10.3390/cells13141217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 07/08/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
Juvenile angiofibroma (JA) is a rare, sex-specific, and highly vascularized nasal tumor that almost exclusively affects male adolescents, but its etiology has been controversial. The G protein-coupled hormone receptor LHCGR [luteinizing hormone (LH)/choriogonadotropin (hCG) receptor] represents a promising new candidate for elucidating the underlying mechanisms of sex specificity, pubertal manifestation, and JA progression. We used highly sensitive RNAscope technology, together with immunohistochemistry, to investigate the cellular expression, localization, and distribution of LHCGR in tissue samples from JA patients. Our results provide evidence for LHCGR expression in subsets of cells throughout JA tissue sections, with the majority of LHCGR+ cells located in close vicinity to blood vessels, rendering them susceptible to endocrine LH/hCG signaling, but LHCGR+ cells were also detected in fibrocollagenous stroma. A majority of LHCGR+ cells located near the vascular lumen co-expressed the neural crest stem cell marker CD271. These results are intriguing as both LH and hCG are produced in a time- and sex-dependent manner, and are known to be capable of inducing cell proliferation and angiogenesis. Our results give rise to a new model that suggests endocrine mechanisms involving LHCGR and its ligands, together with autocrine and paracrine signaling, in JA vascularization and cell proliferation.
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Affiliation(s)
- Silke Wemmert
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, 66424 Homburg, Germany; (S.W.); (L.P.); (M.L.)
| | - Martina Pyrski
- Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University, 66424 Homburg, Germany; (M.P.); (F.Z.)
| | - Lukas Pillong
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, 66424 Homburg, Germany; (S.W.); (L.P.); (M.L.)
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, 66424 Homburg, Germany; (S.W.); (L.P.); (M.L.)
| | - Frank Zufall
- Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University, 66424 Homburg, Germany; (M.P.); (F.Z.)
| | - Trese Leinders-Zufall
- Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University, 66424 Homburg, Germany; (M.P.); (F.Z.)
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, 66424 Homburg, Germany; (S.W.); (L.P.); (M.L.)
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Mey M, Bhatta S, Suresh S, Labrador LM, Piontkivska H, Casadesus G. Therapeutic benefits of central LH receptor agonism in the APP/PS1 AD model involve trophic and immune regulation and are reproductive status dependent. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167165. [PMID: 38653355 DOI: 10.1016/j.bbadis.2024.167165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/02/2024] [Accepted: 04/08/2024] [Indexed: 04/25/2024]
Abstract
The mechanisms that underly reproductive hormone effects on cognition, neuronal plasticity, and AD risk, particularly in relation to gonadotropin LH receptor (LHCGR) signaling, remain poorly understood. To address this gap in knowledge and clarify the impact of circulating steroid hormones on the therapeutic effects of CNS LHCGR activation, we delivered the LHCGR agonist human chorionic gonadotropin (hCG) intracerebroventricularly (ICV) and evaluated functional, structural, plasticity-related signaling cascades, Aβ pathology, and transcriptome differences in reproductively intact and ovariectomized (OVX) APP/PS1 AD female mice. Here we demonstrate that CNS hCG delivery restored function to wild-type levels only in OVX APP/PS1 mice. Spine density was increased in all hCG treated groups independently of reproductive status. Notably, increases in BDNF signaling and cognition, were selectively upregulated only in the OVX hCG-treated group. RNA sequencing analyses identified a significant increase in peripheral myeloid and pro-inflammatory genes within the hippocampi of the OVX group that were completely reversed by hCG treatment, identifying a potential mechanism underlying the selective therapeutic effect of LHCGR activation. Interestingly, in intact mice, hCG administration mimicked the effects of gonadectomy. Together, our findings indicate that CNS LHCGR agonism in the post-menopausal context is beneficial through trophic and immune mechanisms. Our findings also underscore the presence of a steroid-LHCGR mechanistic interaction that is unexplored yet potentially meaningful to fully understand "post-menopausal" brain function and CNS hormone treatment response.
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Affiliation(s)
- Megan Mey
- Kent State University, Kent, OH 44240, United States of America
| | - Sabina Bhatta
- Case Western Reserve University, Cleveland, OH 44106, United States of America
| | - Sneha Suresh
- University of Florida, Gainesville, FL 32606, United States of America
| | | | | | - Gemma Casadesus
- University of Florida, Gainesville, FL 32606, United States of America.
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Kabodmehri R, Ghanami Gashti N, Zahiri Sorouri Z, Sharami SH, Milani F, Hasanpour M, Eslami‐Kenarsari H, Rafiei Sorouri Z. Levels of serum β-human chorionic gonadotropin after embryo transfer and subsequent miscarriage, pre-eclampsia, and intrauterine growth restriction. Health Sci Rep 2024; 7:e2015. [PMID: 38665152 PMCID: PMC11043496 DOI: 10.1002/hsr2.2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 03/09/2024] [Accepted: 03/13/2024] [Indexed: 04/28/2024] Open
Abstract
Background This study aimed to examine maternal serum concentration of β-human chorionic gonadotropin (β-hCG) on Day 16 after embryo transfer and risk of miscarriage, pre-eclampsia, and intrauterine growth restriction (IUGR). Methods In this study, we evaluated 125 pregnancies following in vitro fertilization (IVF). β-hCG concentrations were measured on the morning of Day 16 after embryo transfer. Baseline characteristics of the study participants were also recorded. Results Concentrations of β-hCG on Day 16 after embryo transfer were inversely associated with the higher risk of miscarriage (p < 0.001), but did not with pre-eclampsia and IUGR (p > 0.05). Spearman's correlation coefficient showed a reverse and significant association between β-hCG and higher risk of miscarriage (σ = 0.531 and p < 0.001). There was a significant association between frozen embryo transfer and the risk of IUGR and pre-eclampsia (p = 0.005 and p = 0.023, respectively). Conclusions Maternal serum concentrations of β-hCG on Day 16 after IVF/embryo transfer were associated with the higher risk of miscarriage, but not pre-eclampsia and IUGR.
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Affiliation(s)
- Roya Kabodmehri
- Department of Obstetrics and Gynecology, Reproductive Health Research Center, Al‐Zahra Hospital, School of MedicineGuilan University of Medical SciencesRashtIran
| | - Nasrin Ghanami Gashti
- Department of Obstetrics and Gynecology, Reproductive Health Research Center, Al‐Zahra Hospital, School of MedicineGuilan University of Medical SciencesRashtIran
| | - Ziba Zahiri Sorouri
- Department of Obstetrics and Gynecology, Reproductive Health Research Center, Al‐Zahra Hospital, School of MedicineGuilan University of Medical SciencesRashtIran
- Mehr Fertility Research CenterGuilan University of Medical SciencesRashtIran
| | - Seyedeh Hajar Sharami
- Department of Obstetrics and Gynecology, Reproductive Health Research Center, Al‐Zahra Hospital, School of MedicineGuilan University of Medical SciencesRashtIran
| | - Forozan Milani
- Department of Obstetrics and Gynecology, Reproductive Health Research Center, Al‐Zahra Hospital, School of MedicineGuilan University of Medical SciencesRashtIran
| | - Marziyeh Hasanpour
- Department of Obstetrics and Gynecology, Reproductive Health Research Center, Al‐Zahra Hospital, School of MedicineGuilan University of Medical SciencesRashtIran
| | - Habib Eslami‐Kenarsari
- Vice‐Chancellorship of Research and TechnologyGuilan University of Medical ScienceRashtIran
| | - Zahra Rafiei Sorouri
- Department of Obstetrics and Gynecology, Reproductive Health Research Center, Al‐Zahra Hospital, School of MedicineGuilan University of Medical SciencesRashtIran
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Cambra JM, Gil MA, Cuello C, Gonzalez-Plaza A, Rodriguez-Martinez H, Klymiuk N, Martinez EA, Parrilla I. Cytokine profile in peripheral blood mononuclear cells differs between embryo donor and potential recipient sows. Front Vet Sci 2024; 11:1333941. [PMID: 38601906 PMCID: PMC11006195 DOI: 10.3389/fvets.2024.1333941] [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: 11/06/2023] [Accepted: 03/06/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction Pregnancy success relies on the establishment of a delicate immune balance that requires the early activation of a series of local and systemic immune mechanisms. The changes in the immunological profile that are normally occurring in the pregnant uterus does not take place in cyclic (non-pregnant) uterus, a fact that has been widely explored in pigs at the tissue local level. Such differences would be especially important in the context of embryo transfer (ET), where a growing body of literature indicates that immunological differences at the uterine level between donors and recipients may significantly impact embryonic mortality. However, whether components of peripheral immunity also play a role in this context remains unknown. Accordingly, our hypothesis is that the immune status of donor sows differs from potential recipients, not only at the tissue local level but also at the systemic level. These differences could contribute to the high embryonic mortality rates occurring in ET programs. Methods In this study differences in systemic immunity, based on cytokine gene expression profile in peripheral blood mononuclear cells (PBMCs), between embryo-bearing donor (DO group; N = 10) and potential recipient sows (RE group; N = 10) at Day 6 after the onset of the estrus were explored. Gene expression analysis was conducted for 6 proinflammatory (IL-1α, IL-1β, IL-2, GM-CSF, IFN-γ, and TNF-α) and 6 anti-inflammatory (IL-4, IL-6, IL-10, IL-13, TGF-β1, and LIF) cytokines. Results and discussion All cytokines were overexpressed in the DO group except for IL-4, suggesting that stimuli derived from the insemination and/or the resultant embryos modify the systemic immune profile in DO sows compared to RE (lacking these stimuli). Our results also suggest that certain cytokines (e.g., IL-1α and IL-1β) might have a predictive value for the pregnancy status.
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Affiliation(s)
- Josep M. Cambra
- Department of Medicine and Animal Surgery, Faculty of Veterinary Medicine, International Excellence Campus for Higher Education and Research “Campus Mare Nostrum”, University of Murcia, Murcia, Spain
- Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Campus de Ciencias de la Salud, Murcia, Spain
- Large Animal Models in Cardiovascular Research, Internal Medical Department I, TU Munich, Munich, Germany
| | - Maria A. Gil
- Department of Medicine and Animal Surgery, Faculty of Veterinary Medicine, International Excellence Campus for Higher Education and Research “Campus Mare Nostrum”, University of Murcia, Murcia, Spain
- Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Campus de Ciencias de la Salud, Murcia, Spain
| | - Cristina Cuello
- Department of Medicine and Animal Surgery, Faculty of Veterinary Medicine, International Excellence Campus for Higher Education and Research “Campus Mare Nostrum”, University of Murcia, Murcia, Spain
- Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Campus de Ciencias de la Salud, Murcia, Spain
| | - Alejandro Gonzalez-Plaza
- Department of Medicine and Animal Surgery, Faculty of Veterinary Medicine, International Excellence Campus for Higher Education and Research “Campus Mare Nostrum”, University of Murcia, Murcia, Spain
- Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Campus de Ciencias de la Salud, Murcia, Spain
| | - Heriberto Rodriguez-Martinez
- Department of Biomedical and Clinical Sciences (BKV), BKH/Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Nikolai Klymiuk
- Large Animal Models in Cardiovascular Research, Internal Medical Department I, TU Munich, Munich, Germany
| | - Emilio A. Martinez
- Department of Medicine and Animal Surgery, Faculty of Veterinary Medicine, International Excellence Campus for Higher Education and Research “Campus Mare Nostrum”, University of Murcia, Murcia, Spain
- Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Campus de Ciencias de la Salud, Murcia, Spain
| | - Inmaculada Parrilla
- Department of Medicine and Animal Surgery, Faculty of Veterinary Medicine, International Excellence Campus for Higher Education and Research “Campus Mare Nostrum”, University of Murcia, Murcia, Spain
- Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Campus de Ciencias de la Salud, Murcia, Spain
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Wang X, Wang H, Sun Y, Liu Z, Wang N. Liquid crystal biosensor based on AuNPs signal amplification for detection of human chorionic gonadotropin. Talanta 2024; 266:125025. [PMID: 37586282 DOI: 10.1016/j.talanta.2023.125025] [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: 02/26/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 08/18/2023]
Abstract
The detection of human chorionic gonadotropin (HCG) allows for the determination of pregnancy and is thus crucial during early pregnancy testing. This study introduces a novel liquid crystal (LC) biosensor that employs Au nanoparticles (AuNPs) for signal amplification, thus enabling the detection of the HCG antigen in a micro, efficient, and cost-effective manner. The sensor design capitalizes on the unique properties of LC to facilitate the detection of HCG. In this research, the surface of the base substrate was first modified with material from DMOAP and APTES, and EDC/sulfo-NHS was used to couple AuNPs and β-hCG to form an AuNP-β-hCG conjugate that improves the coupling rate. The carboxyl group of the antibody was reacted with the aldehyde group of glutaraldehyde, which helps to fix the β-hCG antibody to the surface of the substrate. The HCG sample is immobilized on the surface of the substrate via antigen-antibody immunobinding. As signal amplifiers, the AuNPs can have a significant effect on the topology of the interface and the vertical order of the LC molecules, thus reducing the limit of detection. Finally, the limit of detection was calculated using the SPSS system, and the relationship between grey values and concentrations was also obtained. The detection limit for HCG can be as low as 1.916 × 10-3 mIU·mL-1 under ideal conditions. Compared to other detection methods for HCG, this structure provides a detection pathway with excellent sensitivity, low detection limits, and better specificity, thus offering a new idea for HCG or any other target requiring trace detection.
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Affiliation(s)
- Xue Wang
- Institute of Land Engineering and Technology, Shaanxi Provincial Land Engineering Construction Group Co., Ltd., Xi'an, Shaanxi, 710075, China; Shaanxi Provincial Land Engineering Construction Group Co., Ltd., Xi'an, Shaanxi, 710021, China; The Key Laboratory of Degeneration and Unutilized Land Improvement of the Ministry of Land and Resources, Xi'an, Shaanxi, 710075, China; Shaanxi Engineering Research Center of Land Consolidation, Xi'an, Shaanxi, 710075, China; Land Engineering Technology Innovation Center, Ministry of Natural Resources, Xi'an, Shaanxi, 710075, China.
| | - Huanyuan Wang
- Institute of Land Engineering and Technology, Shaanxi Provincial Land Engineering Construction Group Co., Ltd., Xi'an, Shaanxi, 710075, China; Shaanxi Provincial Land Engineering Construction Group Co., Ltd., Xi'an, Shaanxi, 710021, China; The Key Laboratory of Degeneration and Unutilized Land Improvement of the Ministry of Land and Resources, Xi'an, Shaanxi, 710075, China; Shaanxi Engineering Research Center of Land Consolidation, Xi'an, Shaanxi, 710075, China; Land Engineering Technology Innovation Center, Ministry of Natural Resources, Xi'an, Shaanxi, 710075, China.
| | - Yingying Sun
- Institute of Land Engineering and Technology, Shaanxi Provincial Land Engineering Construction Group Co., Ltd., Xi'an, Shaanxi, 710075, China; Shaanxi Provincial Land Engineering Construction Group Co., Ltd., Xi'an, Shaanxi, 710021, China; The Key Laboratory of Degeneration and Unutilized Land Improvement of the Ministry of Land and Resources, Xi'an, Shaanxi, 710075, China; Shaanxi Engineering Research Center of Land Consolidation, Xi'an, Shaanxi, 710075, China; Land Engineering Technology Innovation Center, Ministry of Natural Resources, Xi'an, Shaanxi, 710075, China
| | - Zhe Liu
- Institute of Land Engineering and Technology, Shaanxi Provincial Land Engineering Construction Group Co., Ltd., Xi'an, Shaanxi, 710075, China; Shaanxi Provincial Land Engineering Construction Group Co., Ltd., Xi'an, Shaanxi, 710021, China; The Key Laboratory of Degeneration and Unutilized Land Improvement of the Ministry of Land and Resources, Xi'an, Shaanxi, 710075, China; Shaanxi Engineering Research Center of Land Consolidation, Xi'an, Shaanxi, 710075, China; Land Engineering Technology Innovation Center, Ministry of Natural Resources, Xi'an, Shaanxi, 710075, China
| | - Na Wang
- Institute of Land Engineering and Technology, Shaanxi Provincial Land Engineering Construction Group Co., Ltd., Xi'an, Shaanxi, 710075, China; Shaanxi Provincial Land Engineering Construction Group Co., Ltd., Xi'an, Shaanxi, 710021, China; The Key Laboratory of Degeneration and Unutilized Land Improvement of the Ministry of Land and Resources, Xi'an, Shaanxi, 710075, China; Shaanxi Engineering Research Center of Land Consolidation, Xi'an, Shaanxi, 710075, China; Land Engineering Technology Innovation Center, Ministry of Natural Resources, Xi'an, Shaanxi, 710075, China
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Xin X, Dong L, Guan L, Wang Y, Li J, Lian F. Effect of human chorionic gonadotropin injection before frozen-thawed embryo transfer: A retrospective cohort study. Medicine (Baltimore) 2023; 102:e35658. [PMID: 38050223 PMCID: PMC10695501 DOI: 10.1097/md.0000000000035658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/25/2023] [Indexed: 12/06/2023] Open
Abstract
The aim of this study is to investigate the effect of human chorionic gonadotropin (hCG) in hormone replacement regimen for frozen-thawed embryos. We performed a retrospective cohort study and included patients who underwent frozen embryo transfer (FET) between January 1, 2020 and May 31, 2022. According to the protocols for the FET cycle, the patients were divided into control (n = 238) and hCG groups (n = 216). The clinical pregnancy rate, live birth rate, early abortion rate, late abortion rate, and ectopic pregnancy rate were compared between the 2 groups. There was a significant difference in clinical pregnancy rate between the hCG and control groups (55.1% vs 45.8%, P = .048). The ectopic pregnancy rate decreased (5.0% vs 6.4%, P = .654), while the live birth rate increased (36.1% vs 29.0%, P = .105) in the hCG group. However, these differences were not statistically significant. The administration of hCG injection in HRT-FET cycles alone was also found to be associated with clinical pregnancy by logistic regressive analysis. HCG injection in the hormone replacement regimen for FET increased the clinical pregnancy rate.
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Affiliation(s)
- Xin Xin
- Shandong University of Traditional Chinese Medicine, Jinan City, Shandong Province, China
| | - Li Dong
- Shandong University of Traditional Chinese Medicine, Jinan City, Shandong Province, China
| | - Lu Guan
- Shandong University of Traditional Chinese Medicine, Jinan City, Shandong Province, China
| | - Yixuan Wang
- Shandong University of Traditional Chinese Medicine, Jinan City, Shandong Province, China
| | - Jiaxi Li
- Shandong University of Traditional Chinese Medicine, Jinan City, Shandong Province, China
| | - Fang Lian
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan City, Shandong Province, China
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Lédée N, Petitbarat M, Prat-Ellenberg L, Dray G, Vaucoret V, Kazhalawi A, Rodriguez-Pozo A, Habeichi N, Ruoso L, Cassuto NG, Rahmati M. The Next Frontier in ART: Harnessing the Uterine Immune Profile for Improved Performance. Int J Mol Sci 2023; 24:11322. [PMID: 37511080 PMCID: PMC10379072 DOI: 10.3390/ijms241411322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/23/2023] [Accepted: 06/24/2023] [Indexed: 07/30/2023] Open
Abstract
Assisted reproduction techniques have improved considerably in recent decades, but despite these advances, success rates remain relatively low. Endometrial immune profiling involves the analysis of cytokine biomarkers in the endometrium during the mid-luteal phase. This profiling aims to provide insights into the immune environment of the uterus. The aim is to identify immune disturbances and thus guide the development of personalized therapeutic approaches. The first part of the review looks back at the emergence of innovative concepts, highlighting the specificity of the human uterine environment at the time of implantation. Based on this new knowledge, biomarkers have been selected for endometrial immune profiling. The second part details the results of clinical studies conducted over the last ten years. These clinical results suggest that this approach can increase the rate of live births in patients suffering from repeated implantation failures or repeated pregnancy loss. Uterine immune profiling represents a clinical innovation that can significantly improve the performance of medically assisted reproduction treatments through personalized strategies tailored to the local immune profile. Innovation in personalized medicine for assisted reproduction is crucial to improving the success rates of fertility treatments, while reducing the risks and costs associated with ineffective or unnecessary interventions.
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Affiliation(s)
- Nathalie Lédée
- MatriceLab Innove Laboratory, Immeuble Les Gemeaux, 2 Rue Antoine Etex, 94000 Creteil, France
- Centre d'Assistance Médicale à la Procréation, Hôpital des Bluets, 4 Rue Lasson, 75012 Paris, France
| | - Marie Petitbarat
- MatriceLab Innove Laboratory, Immeuble Les Gemeaux, 2 Rue Antoine Etex, 94000 Creteil, France
| | - Laura Prat-Ellenberg
- Centre d'Assistance Médicale à la Procréation, Hôpital des Bluets, 4 Rue Lasson, 75012 Paris, France
| | - Géraldine Dray
- Centre d'Assistance Médicale à la Procréation, Hôpital des Bluets, 4 Rue Lasson, 75012 Paris, France
| | - Virginie Vaucoret
- Centre d'Assistance Médicale à la Procréation, Hôpital des Bluets, 4 Rue Lasson, 75012 Paris, France
| | - Alaa Kazhalawi
- MatriceLab Innove Laboratory, Immeuble Les Gemeaux, 2 Rue Antoine Etex, 94000 Creteil, France
| | - André Rodriguez-Pozo
- MatriceLab Innove Laboratory, Immeuble Les Gemeaux, 2 Rue Antoine Etex, 94000 Creteil, France
| | - Nada Habeichi
- MatriceLab Innove Laboratory, Immeuble Les Gemeaux, 2 Rue Antoine Etex, 94000 Creteil, France
| | - Lea Ruoso
- Laboratoire Drouot, 21 Rue Drouot, 75010 Paris, France
| | | | - Mona Rahmati
- London Women's Clinic, 113-115 Harley Street, London W1G 6AP, UK
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Guibourdenche J, Leguy MC, Pidoux G, Hebert-Schuster M, Laguillier C, Anselem O, Grangé G, Bonnet F, Tsatsaris V. Biochemical Screening for Fetal Trisomy 21: Pathophysiology of Maternal Serum Markers and Involvement of the Placenta. Int J Mol Sci 2023; 24:ijms24087669. [PMID: 37108840 PMCID: PMC10146970 DOI: 10.3390/ijms24087669] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 04/29/2023] Open
Abstract
It is now well established that maternal serum markers are often abnormal in fetal trisomy 21. Their determination is recommended for prenatal screening and pregnancy follow-up. However, mechanisms leading to abnormal maternal serum levels of such markers are still debated. Our objective was to help clinicians and scientists unravel the pathophysiology of these markers via a review of the main studies published in this field, both in vivo and in vitro, focusing on the six most widely used markers (hCG, its free subunit hCGβ, PAPP-A, AFP, uE3, and inhibin A) as well as cell-free feto-placental DNA. Analysis of the literature shows that mechanisms underlying each marker's regulation are multiple and not necessarily directly linked with the supernumerary chromosome 21. The crucial involvement of the placenta is also highlighted, which could be defective in one or several of its functions (turnover and apoptosis, endocrine production, and feto-maternal exchanges and transfer). These defects were neither constant nor specific for trisomy 21, and might be more or less pronounced, reflecting a high variability in placental immaturity and alteration. This explains why maternal serum markers can lack both specificity and sensitivity, and are thus restricted to screening.
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Affiliation(s)
- Jean Guibourdenche
- Hormonologie CHU Cochin AP-HP, 75014 Paris, France
- Faculté de Santé, Université Paris Cité, 75014 Paris, France
- FHU Préma, 75014 Paris, France
| | | | | | | | - Christelle Laguillier
- Hormonologie CHU Cochin AP-HP, 75014 Paris, France
- Faculté de Santé, Université Paris Cité, 75014 Paris, France
- UMR-S1139, 75014 Paris, France
| | - Olivia Anselem
- FHU Préma, 75014 Paris, France
- Maternité Port Royal CHU Cochin AP-HP, 75014 Paris, France
| | - Gilles Grangé
- FHU Préma, 75014 Paris, France
- Maternité Port Royal CHU Cochin AP-HP, 75014 Paris, France
| | - Fidéline Bonnet
- Hormonologie CHU Cochin AP-HP, 75014 Paris, France
- Faculté de Santé, Université Paris Cité, 75014 Paris, France
| | - Vassilis Tsatsaris
- Faculté de Santé, Université Paris Cité, 75014 Paris, France
- FHU Préma, 75014 Paris, France
- Maternité Port Royal CHU Cochin AP-HP, 75014 Paris, France
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10
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Kong X, Tang G, Liu Y, Zheng Z, Li Y, Yan F. Efficacy of intrauterine infusion therapy before embryo transfer in recurrent implantation failure: A systematic review and network meta-analysis. J Reprod Immunol 2023; 156:103819. [PMID: 36774717 DOI: 10.1016/j.jri.2023.103819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023]
Abstract
Previous studies of intrauterine infusion therapy in recurrent implantation failure (RIF) patients have shown conflicting results, and there is a lack of head-to-head horizontal comparisons between different drugs. This study aimed to assess the effectiveness of four intrauterine infusion drugs, including human chorionic gonadotropin (HCG), granulocyte colony-stimulating factor (G-CSF), peripheral blood mononuclear cells (PBMCs) and autologous platelet-rich plasma (PRP), in improving pregnancy outcomes in RIF patients through the network meta-analysis. Randomized controlled trials (RCTs) of preimplantation intrauterine infusion for RIF were searched in the Cochrane Library, Embase, Medline and CINAHL. Meanwhile, relevant data were extracted and Stata 15.0 software was applied to statistical analysis. A total of 21 studies with a sample size of 2917 cases were included in this study. Clinical pregnancy rate network meta-analysis showed that, intrauterine infusion of all four drugs is significantly better than the blank and placebo groups, while only PRP could significantly increase live birth rate compared with the blank and placebo groups. The SUCRA plots of clinical pregnancy and live birth rates showed a higher ranking of PRP and PBMCs. Early abortion intervention analysis found that only G-CSF is significantly better than the blank and placebo groups, and the SUCRA plot of G-CSF showed the highest ranking. All these findings confirmed that all four intrauterine infusion drugs can improve pregnancy outcomes in RIF patients to varying degrees, with PRP being the most effective. Further prospective, large-scale and high-quality RCTs are still necessary to determine the exact subgroups of benefit for the different drugs.
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Affiliation(s)
- Xinliang Kong
- Beijing University of Chinese Medicine, Beijing, China
| | - Guodong Tang
- Hebei Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Hebei, China
| | - Yanfeng Liu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
| | - Zhibo Zheng
- Beijing University of Chinese Medicine, Beijing, China
| | - Ying Li
- Beijing University of Chinese Medicine, Beijing, China
| | - Fei Yan
- Beijing University of Chinese Medicine, Beijing, China
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11
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Decreased ratio of FOXP3 +/FOXP3 -CD45RA +CD4 + T cells in peripheral blood is associated with unexplained infertility and ART failure. J Reprod Immunol 2023; 155:103793. [PMID: 36603467 DOI: 10.1016/j.jri.2022.103793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/17/2022] [Accepted: 12/29/2022] [Indexed: 01/01/2023]
Abstract
Unexplained infertility has a huge social impact and is a significant challenge for both clinicians and researchers. Previous studies have shown the involvement of multiple factors in infertility. Among these, the subset of regulatory T cells is of particular interest for the maternal tolerance towards the semi-allogenic fetus. We investigated circulating CD45RA+ regulatory and non-regulatory CD4+ T cells in healthy women and patients with unexplained infertility in the context of thymic output and peripheral proliferation. The proportion of FOXP3+ and FOXP3-CD45RA+CD4+ T cells in peripheral blood was studied in control groups of healthy parous and nulliparous (never-pregnant) women and in patients with unexplained infertility. In the same groups thymic output and peripheral proliferation were defined by the sj/βTREC ratio, and signal joint T-cell receptor excision circles (sjTREC) and Ki67 expression, respectively. In parous women a decrease in sjTREC/105 cells and CD45RA+ T lymphocytes, compared to nulliparous group was found. At the same time, the proportion of FOXP3-CD45RA+CD4+ cells, but not FOXP3+CD45RA+ Tregs was reduced. In contrast, in patients with unsuccessful pregnancy, proportions of both regulatory and non-regulatory T cell counterparts were lower. Taken together, our results provide evidence for group-specific properties in the CD45RA+ T cell compartment between healthy parous, nulliparous and women with unexplained infertility.
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12
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Granulocyte colony stimulating factor versus human chorionic gonadotropin for recurrent implantation failure in intra cytoplasmic sperm injection: a randomized clinical trial. BMC Pregnancy Childbirth 2022; 22:881. [PMID: 36447142 PMCID: PMC9706918 DOI: 10.1186/s12884-022-05098-9] [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: 05/01/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Repeated implantation failure (RIF) is defined as the case whereby the transferred embryos fail to implant after several attempts of In vitro fertilization (IVF) which causes a profound impact on the quality of life and financial burden. Some clinical studies have confirmed that Granulocyte colony-stimulating factor (G-CSF) and human chorionic gonadotropin (HCG) can improve pregnancy outcomes and implantation rates. Hence, our study aims to compare the efficacy of G-CSF and HCG on pregnancy outcomes in RIF women who undergo intra-cytoplasmic sperm injection (ICSI). METHODS This randomized, single-blinded study was conducted et al.-Azhar University Hospitals, Cairo, Egypt, between 10th October 2020 and 20th December 2020. The study included 100 women aged 20-43 years old undergoing ICSI cycles, with a history of RIF. Patients were divided randomly into two groups: group (1): included 50 patients injected with 500 IU of intrauterine HCG on embryo transfer day, and group (2): Included 50 patients injected with G-CSF on the embryo transfer day. RESULTS In 100 RIF women, we found a significant improvement in pregnancy outcomes favoring G-CSF over HCG including implantation rate, chemical pregnancy, and clinical pregnancy (P < 0.0001, P = 0.0003, and P = 0.0006, respectively). CONCLUSION For the first time, we demonstrated a significant improvement in pregnancy outcomes favoring G-CSF over HCG in terms of implantation rate, chemical pregnancy, and clinical pregnancy. TRIAL REGISTRATION The study was registered on Pan African Clinical Trials Registry with the following number: PACTR202010482774275 and was approved on 2nd October 2020.
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13
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Effects of intrauterine human chorionic gonadotropin administration on endometrial receptivity and embryo implantation. Life Sci 2022; 311:121154. [DOI: 10.1016/j.lfs.2022.121154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/26/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022]
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14
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Conforti A, Longobardi S, Carbone L, Iorio GG, Cariati F, Campitiello MR, Strina I, Palese M, D’Hooghe T, Alviggi C. Does Intrauterine Injection of hCG Improve IVF Outcome? A Systematic Review and a Meta-Analysis. Int J Mol Sci 2022; 23:12193. [PMID: 36293052 PMCID: PMC9603006 DOI: 10.3390/ijms232012193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/24/2022] [Accepted: 10/04/2022] [Indexed: 11/16/2022] Open
Abstract
Various interventions have been proposed to improve embryo implantation in IVF. Among these, intrauterine injections of human chorionic gonadotropin seem to have promising results. Consequently, we conducted a review and meta-analysis to assess IVF outcomes by comparing couples who underwent intrauterine hCG injection transfer versus those who underwent embryo transfer with intrauterine injection of placebo, or without any additional intervention. The primary outcome was the clinical pregnancy rate. Secondary outcomes were the implantation rate, miscarriage rate, and live birth rate. A meta-analysis was conducted using the random effects model, while bias within studies was detected using the Cochrane risk of bias tool. Ectopic pregnancies and stillbirths were also assessed. The clinical pregnancy (RR 1.38, 95% CI 1.17−1.62, p < 0.0001) and implantation rate (RR 1.40, 95% CI 1.12−1.75, p = 0.003) were significantly higher in women who underwent hCG injection than in the control group. These significant effects persisted only in women who underwent cleavage-stage embryo transfer. No significant differences between groups were observed in the other secondary outcomes. In conclusion, our systematic review and meta-analysis demonstrate that intrauterine injection of hCG could be a valuable approach in women who undergo cleavage-stage embryo transfer. Given the lack of data about the live birth rate, caution should be exercised in interpreting these data.
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Affiliation(s)
- Alessandro Conforti
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | | | - Luigi Carbone
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Giuseppe Gabriele Iorio
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Federica Cariati
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Maria Rosaria Campitiello
- Department of Obstetrics and Gynecology and Physiopathology of Human Reproduction, ASL Salerno, 84124 Salerno, Italy
| | - Ida Strina
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Michela Palese
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Thomas D’Hooghe
- Department of Development and Regeneration, Biomedical Sciences Group, KU Leuven (University of Leuven), 3000 Leuven, Belgium
- KGaA, 64293 Darmstadt, Germany
| | - Carlo Alviggi
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
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15
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Pradhan A, Mishra P, Tiwari S, Choure K, Gupta A. Prediction of Low Birth Weight by Quadruple Parameters in High-Risk Pregnancies. Int J Appl Basic Med Res 2022; 12:277-283. [PMID: 36726653 PMCID: PMC9886151 DOI: 10.4103/ijabmr.ijabmr_155_22] [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: 02/17/2022] [Revised: 08/16/2022] [Accepted: 11/03/2022] [Indexed: 12/24/2022] Open
Abstract
Context Aneuploidy screening is done in the early second trimester of pregnancy among all pregnant women as compulsory, with a special focus on those who had abnormal ultrasound parameters, higher dual marker risk, or other comorbidities. Recently, all individual quad markers of conventional trisomy screening have been suggested as useful in predicting adverse pregnancy outcomes (APO) such as preeclampsia, preterm labor, small for gestational age, and placental abruptions. However, similar studies on Indian pregnant women are limited. Hence, this study was intended to find the relation of quadruple markers with any other APO than aneuploidy. Materials and Methods A retrospective study was conducted in a Tertiary Care multi-specialty hospital in North India. Data from 252 pregnant women's quadruple test was analyzed. The association of abnormal value of quadruple markers (human chorionic gonadotropin [HCG]/alpha-fetoprotein/uE3/Inhibin A) with adverse outcomes was evaluated. Multiple logistic regression analysis and classification and regression tree were used to predict the significant risk factor in high-risk pregnancies. Results In the study, a total (n = 252) of pregnant women, 190 were screened as high-risk pregnancies, whereas the remaining 62 were reported as low-risk using trisomy screening in the quadruple test. Baby birth weight was observed to be significantly associated with Inhibin-A, and HCG (P < 0.001), whereas Corrected (Corr)-multiple of median (MoM)-HCG (>1.415) and Inhibin-A Corr-MoM (>364.175) were the suitable predictor for the LBW. Both parameters were significantly higher in the high-risk group as compared to the low-risk group (each P < 0.05). Conclusion Abnormal deviation of biochemical markers from aneuploidy screening assessment could help predict other perinatal adverse outcomes such as low birth weight babies.
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Affiliation(s)
- Avani Pradhan
- Department of Molecular Medicine and Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
- Department of Biotechnology, AKS University, Satna, Madhya Pradesh, India
| | - Prabhakar Mishra
- Department of Biostatics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Swasti Tiwari
- Department of Molecular Medicine and Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kamlesh Choure
- Department of Biotechnology, AKS University, Satna, Madhya Pradesh, India
| | - Amrit Gupta
- Department of Maternal Health and Reproduction, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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16
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Lentz LS, Stutz AJ, Meyer N, Schubert K, Karkossa I, von Bergen M, Zenclussen AC, Schumacher A. Human chorionic gonadotropin promotes murine Treg cells and restricts pregnancy-harmful proinflammatory Th17 responses. Front Immunol 2022; 13:989247. [PMID: 36203576 PMCID: PMC9531259 DOI: 10.3389/fimmu.2022.989247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/25/2022] [Indexed: 11/15/2022] Open
Abstract
An equilibrium between proinflammatory and anti-inflammatory immune responses is essential for maternal tolerance of the fetus throughout gestation. To study the participation of fetal tissue-derived factors in this delicate immune balance, we analyzed the effects of human chorionic gonadotropin (hCG) on murine Treg cells and Th17 cells in vitro, and on pregnancy outcomes, fetal and placental growth, blood flow velocities and remodeling of the uterine vascular bed in vivo. Compared with untreated CD4+CD25+ T cells, hCG increased the frequency of Treg cells upon activation of the LH/CG receptor. hCG, with the involvement of IL-2, also interfered with induced differentiation of CD4+ T cells into proinflammatory Th17 cells. In already differentiated Th17 cells, hCG induced an anti-inflammatory profile. Transfer of proinflammatory Th17 cells into healthy pregnant mice promoted fetal rejection, impaired fetal growth and resulted in insufficient remodeling of uterine spiral arteries, and abnormal flow velocities. Our works show that proinflammatory Th17 cells have a negative influence on pregnancy that can be partly avoided by in vitro re-programming of proinflammatory Th17 cells with hCG.
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Affiliation(s)
- Lea S. Lentz
- Experimental Obstetrics and Gynecology, Medical Faculty, Health Campus Immunology, Infectilogy and Inflammation (GC-I), Otto-von-Guericke University, Magdeburg, Germany
| | - Annika J. Stutz
- Experimental Obstetrics and Gynecology, Medical Faculty, Health Campus Immunology, Infectilogy and Inflammation (GC-I), Otto-von-Guericke University, Magdeburg, Germany
| | - Nicole Meyer
- Experimental Obstetrics and Gynecology, Medical Faculty, Health Campus Immunology, Infectilogy and Inflammation (GC-I), Otto-von-Guericke University, Magdeburg, Germany
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research, Leipzig, Germany
| | - Kristin Schubert
- Department of Molecular Systems Biology, Helmholtz Centre for Environmental Research, Leipzig, Germany
| | - Isabel Karkossa
- Department of Molecular Systems Biology, Helmholtz Centre for Environmental Research, Leipzig, Germany
| | - Martin von Bergen
- Department of Molecular Systems Biology, Helmholtz Centre for Environmental Research, Leipzig, Germany
- Faculty of Life Sciences, Institute of Biochemistry, University of Leipzig, Leipzig, Germany
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Leipzig, Germany
| | - Ana C. Zenclussen
- Experimental Obstetrics and Gynecology, Medical Faculty, Health Campus Immunology, Infectilogy and Inflammation (GC-I), Otto-von-Guericke University, Magdeburg, Germany
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research, Leipzig, Germany
| | - Anne Schumacher
- Experimental Obstetrics and Gynecology, Medical Faculty, Health Campus Immunology, Infectilogy and Inflammation (GC-I), Otto-von-Guericke University, Magdeburg, Germany
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research, Leipzig, Germany
- *Correspondence: Anne Schumacher,
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Hernandez-Nieto C, Lee J, Alkon-Meadows T, Briton-Jones C, Sandler B, Copperman A, Mukherjee T. Biological relevance of trophectoderm morphology: initial β-hCG measurements correlate with trophectoderm grading on euploid frozen embryo transfers. J Assist Reprod Genet 2022; 39:2051-2059. [PMID: 35751829 PMCID: PMC9475011 DOI: 10.1007/s10815-022-02553-6] [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: 04/07/2022] [Accepted: 06/07/2022] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE To analyze the correlation between TE grading and initial β-hCG serum level after single euploid embryo transfer. Secondarily, to explore the association between TE grading with subsequent IVF outcomes. DESIGN Retrospective cohort analysis. SETTING Single, academic, private infertility and assisted reproductive care institute. PATIENTS OR OTHER PARTICIPANTS Infertility patients who underwent a single euploid embryo transfer that resulted in a positive pregnancy test. INTERVENTION(S) β-hCG measurements. MAIN OUTCOME MEASURE(S) Correlation between TE grade with first β-hCG measurement. Second outcome measurements included ongoing pregnancy, biochemical pregnancy loss, and clinical pregnancy loss rates. RESULTS 2,798 cases were analyzed. A significant difference in initial β-hCG measurement among groups (TE A: median 143.4 mIU/mL IQR 79.2-211.2; TE B: 119 mIU/mL IQR 57.1-177.8; TE C: 82.4 mIU/mL IQR 36.3-136.4, p ≤ 0.0001) was observed. There was a significant correlation found between the TE grade and β-hCG measurements (p ≤ 0.0001, r2 = 0.10). TE grade was not associated with higher odds of biochemical pregnancy loss (TE A vs. TE B: aOR 1.01 CI95% 0.97-1.05; TE A vs. TE C: aOR 1.03 CI95% 0.98-1.08), or higher odds of clinical pregnancy loss (TE A vs. TE B: aOR 1.02 CI95% 0.98-1.05; TE A vs. TE C: aOR 1.03 CI95% 0.98-1.07). CONCLUSIONS In patients with euploid embryos, TE grade correlates with the first pregnancy test measurement of β-hCG. We propose this finding helps to appoint a relevant link between morphology assessment and early embryo development in vivo.
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Affiliation(s)
- Carlos Hernandez-Nieto
- Reproductive Medicine Associates of New York, 635 Madison Ave, Floor 10th, New York City, NY, 10022, USA.
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Joseph Lee
- Reproductive Medicine Associates of New York, 635 Madison Ave, Floor 10th, New York City, NY, 10022, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tamar Alkon-Meadows
- Reproductive Medicine Associates of New York, 635 Madison Ave, Floor 10th, New York City, NY, 10022, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christine Briton-Jones
- Reproductive Medicine Associates of New York, 635 Madison Ave, Floor 10th, New York City, NY, 10022, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Benjamin Sandler
- Reproductive Medicine Associates of New York, 635 Madison Ave, Floor 10th, New York City, NY, 10022, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alan Copperman
- Reproductive Medicine Associates of New York, 635 Madison Ave, Floor 10th, New York City, NY, 10022, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tanmoy Mukherjee
- Reproductive Medicine Associates of New York, 635 Madison Ave, Floor 10th, New York City, NY, 10022, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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18
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Jahanshahi M, Aleyasin A, Aghahosseini M, Najafian A, Shabani Nashtaei M, Hosseinimousa S. The effect of intrauterine hCG injection before embryo transfer on pregnancy rate in frozen embryo transfer cycles. Ann Med Surg (Lond) 2022; 79:104091. [PMID: 35860168 PMCID: PMC9289495 DOI: 10.1016/j.amsu.2022.104091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/25/2022] Open
Abstract
Objective HCG (human chorionic gonadotropin), which is secreted by cytotrophoblast cells, plays an important role in improving pregnancy outcomes among patients with infertility or related problems. In this study, we evaluate the effect of intrauterine hCG injection prior to frozen embryo transfer on pregnancy outcomes. Methods In this clinical trial study, among women with infertility problems referred to (XXX) and those with frozen embryos were included in the study. 155 patients in the intervention group received 500 units of hCG while 157 in control group received saline prior to embryo transfer. Along with demographic data, successful in vitro fertilization and clinical pregnancy, loss of pregnancy, successful transplantation, and biochemical parameters were compared among the two groups. Results The mean age of the patients included in the study was 32.97 ± 3.31 years. The level of anti-Mullerian hormone, follicle stimulating hormone and the grade of frozen embryos were not significantly different between the two groups (P > 0.05). The rate of laboratory pregnancy in the intervention group was significantly higher than in the control group (51% vs 35%), p = 0.006. The rate of successful implantation and clinical pregnancy in the intervention group was also significantly higher, p = 0.01 and p = 0.006, respectively. Overall loss of pregnancy in intervention group was 78.1% and 86.0% in control group which was not significantly different, p = 0.068. Conclusion The outcomes of our study showed that 500 IU of hCG prior to embryo transfer improves the rate of clinical and laboratory pregnancy. However, it does not reduce the rate of loss of pregnancy. Further studies are therefore required in this area.
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Affiliation(s)
- Moghadaseh Jahanshahi
- Clinical Research Developmental Center (CRDC), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ashraf Aleyasin
- Department of Obstetrics and Gynecology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Aghahosseini
- Department of Obstetrics and Gynecology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Aida Najafian
- Department of Obstetrics and Gynecology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Shabani Nashtaei
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sedigheh Hosseinimousa
- Department of Obstetrics and Gynecology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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19
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A Risk Model of Eight Immune-Related Genes Predicting Prognostic Response to Immune Therapies for Gastric Cancer. Genes (Basel) 2022; 13:genes13050720. [PMID: 35627105 PMCID: PMC9141964 DOI: 10.3390/genes13050720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/17/2022] [Accepted: 04/18/2022] [Indexed: 12/11/2022] Open
Abstract
Immune checkpoint inhibitor (ICI) treatment is considered as an innovative approach for cancers. Since not every patient responded well to ICI therapy, it is imperative to screen out novel signatures to predict prognosis. Based on 407 gastric cancer (GC) samples retrieved from The Cancer Genome Atlas (TCGA), 36 immune-related hub genes were identified by weighted gene co-expression network analysis (WGCNA), and eight of them (RNASE2, CGB5, INHBE, DUSP1, APOA1, CD36, PTGER3, CTLA4) were used to formulate the Cox regression model. The obtained risk score was proven to be significantly correlated with overall survival (OS), consistent with the consequence of the Gene Expression Omnibus (GEO) cohort (n = 433). Then, the relationship between the risk score and clinical, molecular and immune characteristics was further investigated. Results showed that the low-risk subgroup exhibited higher mutation rate, more M1 macrophages, CD8+ and CD4+ T cells infiltrating, more active MHC-I, and bias to “IFN-γ Dominant” immune type, which is consistent with our current understanding of tumor prognostic risk. Furthermore, it is suggested that our model can accurately predict 1-, 2-, and 3-year OS of GC patients, and that it was superior to other canonical models, such as TIDE and TIS. Thus, these eight genes are probably considered as potential signatures to predict prognosis and to distinguish patient benefit from ICI, serving as a guiding individualized immunotherapy.
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20
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Human Chorionic Gonadotropin and Early Embryogenesis: Review. Int J Mol Sci 2022; 23:ijms23031380. [PMID: 35163303 PMCID: PMC8835849 DOI: 10.3390/ijms23031380] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/20/2022] [Accepted: 01/23/2022] [Indexed: 12/27/2022] Open
Abstract
Human chorionic gonadotropin (hCG) has four major isoforms: classical hCG, hyperglycosylated hCG, free β subunit, and sulphated hCG. Classical hCG is the first molecule synthesized by the embryo. Its RNA is transcribed as early as the eight-cell stage and the blastocyst produces the protein before its implantation. This review synthetizes everything currently known on this multi-effect hormone: hCG levels, angiogenetic activity, immunological actions, and effects on miscarriages and thyroid function.
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Li N, Guan Y, Ren B, Zhang Y, Du Y, Kong H, Zhang Y, Lou H. Effect of Blastocyst Morphology and Developmental Rate on Euploidy and Live Birth Rates in Preimplantation Genetic Testing for Aneuploidy Cycles With Single-Embryo Transfer. Front Endocrinol (Lausanne) 2022; 13:858042. [PMID: 35498424 PMCID: PMC9044033 DOI: 10.3389/fendo.2022.858042] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/14/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate whether blastocyst morphology and developmental rate are associated with euploidy and live birth rates (LBRs) in single euploid frozen-thawed embryo transfer (FET) cycles. DESIGN Retrospective cohort study. METHODS This study included 431 preimplantation genetic testing for aneuploidy (PGT-A) cycles followed by 393 FET cycles performed at our center from June 2017 to March 2021. All cycles were analyzed for euploidy based on blastocyst morphology (good, average and poor), developmental stage (day 5 and 6) and maternal age (< 35 and ≥ 35 years old). Multivariate logistic analysis models were used to identify the independent effects of conventional blastocyst morphology, developmental rate and morphological parameters (degree of blastocoele expansion, and grade of inner cell mass and trophectoderm (TE)) on LBRs. RESULTS In the group of women aged < 35 years, compared with poor-quality blastocysts, good-quality blastocysts (62.90% vs. 32.46%; odds ratio (OR) 3.163, 95% confidence interval (CI) 2.247-4.451; P < 0.001) and average-quality blastocysts (46.70% vs. 32.46%; OR 1.665, 95% CI 1.287-2.154; P < 0.001) had significantly higher euploidy rates. Additionally, day 5 blastocysts were associated with higher euploidy rates than day 6 blastocysts (49.28% vs. 35.02%; OR 1.506, 95% CI 1.191-1.903; P= 0.001). In the group of women aged ≥ 35 years, euploidy rates were also associated with blastocyst morphology, with 41.86%, 45.65% and 24.39% of good, average and poor-quality embryos, respectively, exhibiting euploidy. However, no relationship was seen between euploidy and blastocyst developmental rate. Multiple logistic regression analysis show that overall blastocyst morphology of euploid embryos was not associated with LBR, only embryos with A-grade TE had significantly higher LBRs than those with C-grade TE (62.71% vs. 45.40%; OR 2.189, 95% CI 1.166-4.109; P=0.015). Similarly, LBRs were significantly higher when day 5 blastocysts were transferred than when day 6 blastocysts were transferred (57.75% vs. 41.67%; OR 2.132, 95% CI 1.370-3.318; P = 0.001). CONCLUSION Poor-quality embryos have reduced rates of euploidy. However, blastocyst developmental rate only significantly associates with euploidy rates in women aged younger than 35. Furthermore, only TE grade and blastocyst developmental rate are significantly associated with LBRs following FET cycles.
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22
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Lebede M, Di Marco F, Esser-Skala W, Hennig R, Wohlschlager T, Huber CG. Exploring the Chemical Space of Protein Glycosylation in Noncovalent Protein Complexes: An Expedition along Different Structural Levels of Human Chorionic Gonadotropin by Employing Mass Spectrometry. Anal Chem 2021; 93:10424-10434. [PMID: 34288669 PMCID: PMC8340079 DOI: 10.1021/acs.analchem.1c02199] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
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Modern analytical
approaches employing high-resolution mass spectrometry
(MS) facilitate the generation of a vast amount of structural data
of highly complex glycoproteins. Nevertheless, systematic interpretation
of this data at different structural levels remains an analytical
challenge. The glycoprotein utilized as a model system in this study,
human chorionic gonadotropin (hCG), exists as a heterodimer composed
of two heavily glycosylated subunits. In order to unravel the multitude
of glycoforms of recombinant hCG (drug product Ovitrelle), we combine
established techniques, such as released glycan and glycopeptide analysis,
with novel approaches employing high-performance liquid chromatography-mass
spectrometry (HPLC-MS) to characterize protein subunits and native
MS to analyze the noncovalent hCG complex. Starting from the deconvoluted
mass spectrum of dimeric hCG comprising about 50 signals, it was possible
to explore the chemical space of hCG glycoforms and elucidate the
complexity that hides behind just 50 signals. Systematic, stepwise
integration of data obtained at the levels of released glycans, glycopeptides,
and subunits using a computational annotation tool allowed us to reveal
1031 underlying glycoforms. Additionally, critical quality attributes
such as sialylation and core fucosylation were compared for two batches
of Ovitrelle to assess the potential product variability.
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Affiliation(s)
- Maximilian Lebede
- Department of Biosciences, Bioanalytical Research Labs, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria.,Christian Doppler Laboratory for Innovative Tools for Biosimilar Characterization, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria
| | - Fiammetta Di Marco
- Department of Biosciences, Bioanalytical Research Labs, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria.,Christian Doppler Laboratory for Innovative Tools for Biosimilar Characterization, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria
| | - Wolfgang Esser-Skala
- Department of Biosciences, Bioanalytical Research Labs, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria.,Christian Doppler Laboratory for Innovative Tools for Biosimilar Characterization, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria.,Department of Biosciences, Computational Systems Biology Group, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria
| | - René Hennig
- glyXera GmbH, Brenneckestraße 20 - ZENIT, 39120 Magdeburg, Germany.,Max Planck Institute for Dynamics of Complex Technical Systems, Sandtorstraße 1, 39106 Magdeburg, Germany
| | - Therese Wohlschlager
- Department of Biosciences, Bioanalytical Research Labs, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria.,Christian Doppler Laboratory for Innovative Tools for Biosimilar Characterization, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria
| | - Christian G Huber
- Department of Biosciences, Bioanalytical Research Labs, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria.,Christian Doppler Laboratory for Innovative Tools for Biosimilar Characterization, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria
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23
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Graham JJ, Longhi MS, Heneghan MA. T helper cell immunity in pregnancy and influence on autoimmune disease progression. J Autoimmun 2021; 121:102651. [PMID: 34020252 PMCID: PMC8221281 DOI: 10.1016/j.jaut.2021.102651] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/30/2021] [Accepted: 05/02/2021] [Indexed: 02/07/2023]
Abstract
Pregnancy presents the maternal immune system with a unique immunological challenge since it has to defend against pathogens while tolerating paternal allo-antigens expressed by fetal tissues. T helper (Th) cells play a central role in modulating immune responses and recent advances have defined distinct contributions of various Th cell subsets throughout each phase of human pregnancy, while dysregulation in Th responses show association with multiple obstetrical complications. In addition to localized decidual mechanisms, modulation of Th cell immunity during gestation is mediated largely by oscillations in sex hormone concentrations. Aberrant Th cell responses also underlie several autoimmune disorders while pregnancy-induced changes in the balance of Th cell immunity has been shown to exert favorable outcomes in the progression Th1 and Th17 driven autoimmune conditions only to be followed by post-partal exacerbations in disease.
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Affiliation(s)
- Jonathon J Graham
- Institute of Liver Studies, King's College Hospital, London, SE5 9RS, United Kingdom
| | - Maria Serena Longhi
- Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Michael A Heneghan
- Institute of Liver Studies, King's College Hospital, London, SE5 9RS, United Kingdom.
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24
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CHORIONIC GONADOTROPINE: STRUCTURAL HETEROGENEITY, METABOLIC PATHWAY, FUNCTIONS, OBTAINING AND POSSIBILITIES OF CLINICAL APPLICATION. BIOTECHNOLOGIA ACTA 2021. [DOI: 10.15407/biotech14.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Human chorionic gonadotropin (hCG) is one of the key hormones needed for pregnancy sustaining. At the same time, it performs many other biological functions, which is due to the effect on the immune cells’ activity, the ability to bind to at least three types of receptors and activate various signaling cascades. Several structural forms of hCG and their combinations have been identified. This structural heterogeneity is the cause of variations not only in the degree and direction of the hormone functional activity, but in the mechanisms of its action, the degree of binding to other molecules and the conditions of dissociation as well. Aim. To review the current understanding of the role and mechanisms of the biological activity of hCG and its isoforms, as well as the identification of physicochemical factors that affect the completeness of hCG release from biological raw materials and the stability of the isolated drug during further storage. Methods. A computerized literature search was performed using three electronic databases from 1980 to 2020. Descriptive and comparative analyzes were performed for discovered studies in molecular biology, biochemistry and clinical practice. Results. A detailed biochemical and physiological analysis of hCG and its related molecules are provided in this review. The features of measuring its content in tissues, isolation and purification methods, difficulties associated with low-temperature storage, as well as the spectrum of hCG preparations clinical use of and their proposed new therapeutic possibilities are considered. Conclusions. HCG is characterized by a wide range of versatile functions, and its field of application in laboratory diagnostics and clinical practice is still expanding. At the same time, to elucidate the mechanisms of its multiple therapeutic effects, including antitumor action, as well as the mechanisms of dissociation under conditions of low-temperature storage, which can solve the problem of maintaining the stability of this hormone, it remains relevant.
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Cheloufi M, Kazhalawi A, Pinton A, Rahmati M, Chevrier L, Prat-ellenberg L, Michel AS, Dray G, Mekinian A, Kayem G, Lédée N. The Endometrial Immune Profiling May Positively Affect the Management of Recurrent Pregnancy Loss. Front Immunol 2021; 12:656701. [PMID: 33841443 PMCID: PMC8024694 DOI: 10.3389/fimmu.2021.656701] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/04/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction The endometrial immune profiling is an innovative approach based on the analysis of the local immune reaction occurring in the endometrium at the time of the embryo implantation. By documenting the local immune activation during the period of uterine receptivity, we aim to detect and correct potential imbalances before and at the very beginning of placentation. The main objective of the study was to analyze in women with a history of repeated pregnancy loss (RPL) the association of personalized strategies based on immune dysregulations with live birth rates. The secondary objective was to highlight the main prognostic factors for live births. Methods This is an observational retrospective analysis of 104 patients with RPL, included between January 2012 and December 2019. Inclusion criteria included a spontaneous fertility with at least three miscarriages, an assessment including a three-dimension ultrasound scan, an endometrial biopsy for uterine immune profiling and a follow-up over at least 6 months with personalized care if indicated after the complete assessment. We defined as a success if the patients had a live birth after the suggested plan, as a failure if the patient either did not get pregnant or experienced a new miscarriage after the targeted therapies. Results Uterine immune profiling was the only exploration to be significantly associated with a higher live birth rate (LBR) if a dysregulation was identified and treated accordingly (55% vs 45%, p=0.01). On the contrary, an absence of local dysregulation (resulting in an apparently balanced immune environment) was associated with a higher risk of a new miscarriage, suggesting that the cause inducing RPL still needed to be identified. Independently of age and AMH level, dysregulated immune profile is significatively associated with 3 times higher LBR than a non-deregulated profile (OR=3.4 CI 95%1.27-9.84) or five times in case of an overactive profile treated by immunotherapy (OR=5 CI 95% 1.65-16.5). The usage of ART was significantly associated with lower LBR regardless of the presence of a subfertility factor (p=0.012). Personalization of medical care using natural cycle or simple hormonal stimulation is associated with a significantly higher LBR than personalization including ART treatments regardless of maternal age and AMH level (OR= 2.9 CI 95% 1.03-8.88). Conclusion Our study suggests that some endometrial immune profiles with targeted management of RPL are associated with a higher rate of LBR. ART may be negatively associated with LBR.
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Affiliation(s)
- Meryam Cheloufi
- Department of Obstetrics and Gynecology, Trousseau Hospital, APHP, Sorbonne Université, FHU PREMA, Paris, France
| | - Alaa Kazhalawi
- MatriceLAB Innove SARL, Pépinière Paris Santé Cochin, Paris, France
| | - Anne Pinton
- Department of Obstetrics and Gynecology, Trousseau Hospital, APHP, Sorbonne Université, FHU PREMA, Paris, France
| | | | - Lucie Chevrier
- MatriceLAB Innove SARL, Pépinière Paris Santé Cochin, Paris, France
| | - Laura Prat-ellenberg
- Centre d’Assistance Médical á la Procréation Bluets-Drouot, Hôpital Les Bluets, Paris, France
| | - Anne-Sophie Michel
- Department of Obstetrics and Gynecology, Trousseau Hospital, APHP, Sorbonne Université, FHU PREMA, Paris, France
- Centre d’Assistance Médical á la Procréation Bluets-Drouot, Hôpital Les Bluets, Paris, France
| | - Geraldine Dray
- Centre d’Assistance Médical á la Procréation Bluets-Drouot, Hôpital Les Bluets, Paris, France
| | - Arsène Mekinian
- Hôpital Saint-Antoine Groupe Hospitalier AP-HP, Sorbonne Université (Paris), Paris, France
| | - Gilles Kayem
- Department of Obstetrics and Gynecology, Trousseau Hospital, APHP, Sorbonne Université, FHU PREMA, Paris, France
| | - Nathalie Lédée
- MatriceLAB Innove SARL, Pépinière Paris Santé Cochin, Paris, France
- Centre d’Assistance Médical á la Procréation Bluets-Drouot, Hôpital Les Bluets, Paris, France
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26
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Motomura K, Romero R, Galaz J, Miller D, Done B, Arenas-Hernandez M, Garcia-Flores V, Tao L, Tarca AL, Gomez-Lopez N. Human Chorionic Gonadotropin Modulates the Transcriptome of the Myometrium and Cervix in Late Gestation. Reprod Sci 2021; 28:2246-2260. [PMID: 33650091 DOI: 10.1007/s43032-020-00454-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/29/2020] [Indexed: 10/22/2022]
Abstract
Human chorionic gonadotropin (hCG) is a critical hormone for the establishment and maintenance of pregnancy. hCG administration prevents the onset of preterm labor in mice; yet, the transcriptomic changes associated with this tocolytic effect that take place in the myometrium and cervix have not been elucidated. Herein, we implemented both discovery and targeted approaches to investigate the transcriptome of the myometrium and cervix after hCG administration. Pregnant mice were intraperitoneally injected with 10 IU of hCG on 13.0, 15.0, and 17.0 days post coitum, and the myometrium and cervix were collected. RNA sequencing was performed to determine differentially expressed genes, enriched biological processes, and impacted KEGG pathways. Multiplex qRT-PCR was performed to investigate the expression of targeted contractility- and inflammation-associated transcripts. hCG administration caused the differential expression of 720 genes in the myometrium. Among the downregulated genes, enriched biological processes were primarily associated with regulation of transcription. hCG administration downregulated key contractility genes, Gja1 and Oxtr, but upregulated the prostaglandin-related genes Ptgfr and Ptgs2 and altered the expression of inflammation-related genes in the myometrium. In the cervix, hCG administration caused differential expression of 3348 genes that were related to inflammation and host defense, among others. The downregulation of key contractility genes and upregulation of prostaglandin-related genes were also observed in the cervix. Thus, hCG exerts tocolytic and immunomodulatory effects in late gestation by altering biological processes in the myometrium and cervix, which should be taken into account when considering hCG as a potential treatment to prevent the premature onset of labor.
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Affiliation(s)
- Kenichiro Motomura
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Roberto Romero
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, USA.,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.,Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.,Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA.,Detroit Medical Center, Detroit, MI, USA.,Department of Obstetrics and Gynecology, Florida International University, Miami, FL, USA
| | - Jose Galaz
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Derek Miller
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Bogdan Done
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Marcia Arenas-Hernandez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Valeria Garcia-Flores
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Li Tao
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Adi L Tarca
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, USA. .,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA. .,Department of Computer Science, Wayne State University College of Engineering, Detroit, MI, USA.
| | - Nardhy Gomez-Lopez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, USA. .,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA. .,Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, MI, USA.
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Coello A, Nohales M, Meseguer M, de Los Santos MJ, Remohí J, Cobo A. Prediction of embryo survival and live birth rates after cryotransfers of vitrified blastocysts. Reprod Biomed Online 2021; 42:881-891. [PMID: 33785304 DOI: 10.1016/j.rbmo.2021.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 01/17/2021] [Accepted: 02/22/2021] [Indexed: 10/22/2022]
Abstract
RESEARCH QUESTION Which pre-vitrification parameters are the most predictive of survival and live birth in vitrified-warmed blastocyst transfer cycles? DESIGN A retrospective study including 11,936 warmed blastocysts. Pre-vitrification morphological parameters analysed for blastocysts included day of vitrification; blastocyst expansion degree; trophoectoderm grade (A, B and C); and inner cell mass grade (A, B and C). Univariate and multivariate generalized estimating equations models were used to analyse survival, clinical pregnancy and live birth rate. A stepwise regression analysis was conducted to select and classify by order which outcomes were the most predictive. RESULTS The odds of survival increased almost twice for blastocysts with lower expansion degree (OR 1.92; 95% CI 1.37 to 2.69; P < 0.001) and by about 50% for blastocysts vitrified on day 5 (OR 1.56; 95% CI 1.27 to 1.89; P < 0.001). Multivariate generalized estimating equations model showed that trophectoderm grade followed by the day of vitrification were the most significant predictors of live birth. The odds of live birth increased nearly three times for blastocysts with trophectoderm graded as A compared with those with trophectoderm graded as C (OR 2.85; 95% CI 2.48 to 3.27; P < 0.001), and double for blastocysts vitrified on day 5 compared with those vitrified on day 6 (OR 2.22; 95% CI 1.97 to 2.49; P < 0.001). The odds of live birth also increased in higher expansion degree blastocysts. CONCLUSIONS Blastocysts vitrified on day 5 and those with higher trophoectoderm grade should be given priority when warming.
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Affiliation(s)
- Aila Coello
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain.
| | - Mar Nohales
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - Marcos Meseguer
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - M José de Los Santos
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - José Remohí
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - Ana Cobo
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
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28
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Sciorio R, Thong D, Thong KJ, Pickering SJ. Clinical pregnancy is significantly associated with the blastocyst width and area: a time-lapse study. J Assist Reprod Genet 2021; 38:847-855. [PMID: 33471232 DOI: 10.1007/s10815-021-02071-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 01/11/2021] [Indexed: 10/22/2022] Open
Abstract
In order to maintain pregnancy rates following single embryo transfer, optimisation of embryo culture and selection is vital. Time-lapse monitoring (TLM) has the potential to play a crucial role by providing sequential images of embryo development and minimal disturbance. Therefore, in this study morphometric assessment of blastocyst area and maximum width was performed in order to evaluate if these parameters are associated with pregnancy outcomes in IVF/ICSI cycles. This is a retrospective study of 664 patients who had elective single blastocyst transfer (eSBT). The EmbryoScope drawing tools were used to measure specific variables such as the maximum blastocyst width and blastocyst area. Our results show that women who were pregnant had significantly (P < 0.01) larger blastocyst width [median (range) μm] 184 (125-239) versus non-pregnant, 160 (120-230)] and area [median (range) μm2] 26099 (12101-45,280) versus non-pregnant women, 22,251 (10992-37,931)]. A univariate logistic regression performed showed that blastocyst width [(OR = 1.026, 95% CI = (1.019, 1.033)] was significant (P < 0.01) and for every μm increase of blastocyst width, the odds of clinical pregnancy increase by 2.6%. A univariate logistic regression performed showed that blastocyst area [(OR = 1.00008, 95% CI = (1.00006, 1.00011)] was significant with P < 0.01. For every μm2 increase of blastocyst area, our data showed the odds of clinical pregnancy increase by 0.008%. Hosmer-Lemeshow tests of calibrations were performed to verify calibration. Although our findings show a clear correlation between blastocyst dimensions and the clinical pregnancy rate, further studies are necessary to confirm these observations.
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Affiliation(s)
- Romualdo Sciorio
- Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, Scotland, EH16 4SA, UK.
| | - D Thong
- Independent Statistician, Edinburgh, Scotland, UK
| | - K J Thong
- Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, Scotland, EH16 4SA, UK
| | - Susan J Pickering
- Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, Scotland, EH16 4SA, UK
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Bozward AG, Wootton GE, Podstawka O, Oo YH. Autoimmune Hepatitis: Tolerogenic Immunological State During Pregnancy and Immune Escape in Post-partum. Front Immunol 2020; 11:591380. [PMID: 33072138 PMCID: PMC7541906 DOI: 10.3389/fimmu.2020.591380] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 09/07/2020] [Indexed: 12/12/2022] Open
Abstract
The maternal immune system engages in a fine balancing act during pregnancy by simultaneously maintaining immune tolerance to the fetus and immune responses to protect against invading organisms. Pregnancy is an intricately orchestrated process where effector immune cells with fetal specificity are selectively silenced. This requires a sustained immune suppressive state not only by expansion of maternal Foxp3+ regulatory T cells (Tregs) but also by leaning the immune clock toward a Th2 dominant arm. The fetus, known as a semi-allograft or temporary-self, leads to remission of autoimmune hepatitis during pregnancy. However, this tolerogenic immune state reverts back to a Th1 dominant arm, resulting in post-partum flare of AIH. Various hormones play a significant role in endocrine-immune axis during pregnancy. The placenta functions as a barrier between the maternal immune system and the fetus also plays a pivotal role in creating a tolerogenic environment during pregnancy. We review the evidence of immune tolerance during pregnancy and immune escape at post-partum period, focusing on patients with autoimmune hepatitis.
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Affiliation(s)
- Amber G Bozward
- Centre for Liver and Gastroenterology Research, NIHR Birmingham Biomedical Research Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom.,Centre for Rare Diseases, European Reference Network ERN Rare-Liver, Birmingham, United Kingdom
| | - Grace E Wootton
- Centre for Liver and Gastroenterology Research, NIHR Birmingham Biomedical Research Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom.,Centre for Rare Diseases, European Reference Network ERN Rare-Liver, Birmingham, United Kingdom
| | - Oskar Podstawka
- Centre for Liver and Gastroenterology Research, NIHR Birmingham Biomedical Research Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | - Ye H Oo
- Centre for Liver and Gastroenterology Research, NIHR Birmingham Biomedical Research Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom.,Centre for Rare Diseases, European Reference Network ERN Rare-Liver, Birmingham, United Kingdom.,Liver Transplant and Hepatology Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
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Biskup K, Blanchard V, Castillo-Binder P, Alexander H, Engeland K, Schug S. N- and O-glycosylation patterns and functional testing of CGB7 versus CGB3/5/8 variants of the human chorionic gonadotropin (hCG) beta subunit. Glycoconj J 2020; 37:599-610. [PMID: 32767150 PMCID: PMC7501100 DOI: 10.1007/s10719-020-09936-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/26/2020] [Accepted: 07/23/2020] [Indexed: 12/28/2022]
Abstract
The classical function of human chorionic gonadotropin (hCG) is its role in supporting pregnancy. hCG is a dimer consisting of two highly glycosylated subunits, alpha (CGA) and beta (CGB). The beta-hCG protein is encoded by CGB3, CGB5, CGB7 and CGB8 genes. CGB3, 5 and 8 code for an identical protein, CGB3/5/8, whereas CGB7 differs in three amino acids from CGB3/5/8. We had observed earlier that CGB7 and CGB3/5/8 display very distinct tissue expression patterns and that the tumor suppressor and transcription factor p53 can activate expression of CGB7 but not of CGB3/5/8 genes. Here, we investigate the glycan structures and possible functional differences of the two CGB variants. To this end, we established a system to produce and isolate recombinant CGA, CGB7 and CGB3/5/8 proteins. We found that N- and O-glycosylation patterns of CGB7 and CGB3/5/8 are quite similar. Functional assays were performed by testing activation of the ERK1/2 pathway and demonstrated that CGB7 and CGB5/5/8 appear to be functionally redundant isoforms, although a slight difference in the kinetics of ERK1/2 pathway activation was observed. This is the first time that biological activity of CGB7 is shown. In summary, the results lead to the hypothesis that CGB7 and CGB3/5/8 do not hold significant functional differences but that timing and cell type of their expression is the key for understanding their divergent evolution.
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Affiliation(s)
- Karina Biskup
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Véronique Blanchard
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Paola Castillo-Binder
- Division of Molecular Oncology and Division of Human Reproduction and Endocrinology, Department of Obstetrics and Gynecology, Medical School, University of Leipzig, Semmelweisstr. 14, 04103, Leipzig, Germany
| | - Henry Alexander
- Division of Molecular Oncology and Division of Human Reproduction and Endocrinology, Department of Obstetrics and Gynecology, Medical School, University of Leipzig, Semmelweisstr. 14, 04103, Leipzig, Germany
| | - Kurt Engeland
- Division of Molecular Oncology and Division of Human Reproduction and Endocrinology, Department of Obstetrics and Gynecology, Medical School, University of Leipzig, Semmelweisstr. 14, 04103, Leipzig, Germany.
| | - Sindy Schug
- Division of Molecular Oncology and Division of Human Reproduction and Endocrinology, Department of Obstetrics and Gynecology, Medical School, University of Leipzig, Semmelweisstr. 14, 04103, Leipzig, Germany
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Peterson LS, Stelzer IA, Tsai AS, Ghaemi MS, Han X, Ando K, Winn VD, Martinez NR, Contrepois K, Moufarrej MN, Quake S, Relman DA, Snyder MP, Shaw GM, Stevenson DK, Wong RJ, Arck P, Angst MS, Aghaeepour N, Gaudilliere B. Multiomic immune clockworks of pregnancy. Semin Immunopathol 2020; 42:397-412. [PMID: 32020337 PMCID: PMC7508753 DOI: 10.1007/s00281-019-00772-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/31/2019] [Indexed: 12/15/2022]
Abstract
Preterm birth is the leading cause of mortality in children under the age of five worldwide. Despite major efforts, we still lack the ability to accurately predict and effectively prevent preterm birth. While multiple factors contribute to preterm labor, dysregulations of immunological adaptations required for the maintenance of a healthy pregnancy is at its pathophysiological core. Consequently, a precise understanding of these chronologically paced immune adaptations and of the biological pacemakers that synchronize the pregnancy "immune clock" is a critical first step towards identifying deviations that are hallmarks of peterm birth. Here, we will review key elements of the fetal, placental, and maternal pacemakers that program the immune clock of pregnancy. We will then emphasize multiomic studies that enable a more integrated view of pregnancy-related immune adaptations. Such multiomic assessments can strengthen the biological plausibility of immunological findings and increase the power of biological signatures predictive of preterm birth.
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Affiliation(s)
- Laura S Peterson
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Ina A Stelzer
- Department of Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Amy S Tsai
- Department of Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Mohammad S Ghaemi
- Department of Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Xiaoyuan Han
- Department of Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Kazuo Ando
- Department of Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Virginia D Winn
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Nadine R Martinez
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Kevin Contrepois
- Stanford Metabolic Health Center, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Center for Genomics and Personalized Medicine, Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Mira N Moufarrej
- Department of Bioengineering, Stanford University School of Engineering, Stanford, CA, USA
| | - Stephen Quake
- Department of Bioengineering, Stanford University School of Engineering, Stanford, CA, USA
| | - David A Relman
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Infectious Diseases Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Michael P Snyder
- Stanford Center for Genomics and Personalized Medicine, Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Gary M Shaw
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - David K Stevenson
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Ronald J Wong
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Petra Arck
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin S Angst
- Department of Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Nima Aghaeepour
- Department of Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Brice Gaudilliere
- Department of Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
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Chen H, Cai J, Liu L, Sun X. Roles of estradiol levels on the day of human chorionic gonadotrophin administration in the live birth of patients with frozen embryo transfer. J Clin Lab Anal 2020; 34:e23422. [PMID: 32715506 PMCID: PMC7521236 DOI: 10.1002/jcla.23422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 04/08/2020] [Accepted: 05/08/2020] [Indexed: 11/25/2022] Open
Abstract
Background Estradiol (E2) is an important hormone in women. Changes of serum E2 levels may affect the endometrial receptivity for embryo implantation and thus affect pregnancy outcomes. This study was to assess the association between serum E2 levels on the day of human chorionic gonadotrophin (HCG) administration and live‐birth rates in patients with frozen embryo transfer (FET). Methods Totally 2071 women receiving long protocols of long‐acting gonadotropin‐releasing hormone (GnRH) agonists were enrolled. According to the E2 levels on the day of HCG administration, these patients were divided into four groups: 676 cases of E2 ≤ 3051 pg/mL in Q1 group, 676 cases of 3051 pg/mL < E2 ≤ 4558 pg/mL in Q2 group, 675 cases of 4558 pg/mL < E2 ≤ 6718 pg/mL in Q3 group, and 674 cases of E2 > 6718 pg/mL in Q4 group. The clinical indicators including female age, body mass index (BMI), duration of infertility, infertility styles, treatment protocols, hormone levels, total antral follicle count, endometrial thickness, top‐level embryos, and live‐birth rates were analyzed, and multivariable logistic model was conducted to select significant variables. Results Significant differences were observed for the female age (OR = 0.965, 95% CI: 0.946‐0.985, P < .001), total antral follicle counts (OR = 1.025, 95% CI: 1.008‐1.043, P = .004), transferring what day of embryos (OR = 1.242, 95% CI: 1.137‐1.356, P < .001), endometrial thickness (OR = 1.058, 95% CI: 1.004‐1.115, P = .035), top‐level embryos (OR = 1.416, 95% CI: 1.157‐1.731, P = .001), and E2 levels on HCG day >6781 pg/mL (OR = 1.344, 95% CI: 1.069‐1.690, P = .011) between live‐birth and non‐live‐birth groups. The area under the curve (AUC) for E2 levels on HCG day was 0.558, the sensitivity was 54.75%, and the specificity was 55.10%. Conclusion Serum E2 level on HCG day was an independent predictor of live‐birth achievement in patients with FET.
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Affiliation(s)
- Haixiao Chen
- Reproductive Medicine Center, Chenggong Hospital Affiliated to Xiamen University, Xiamen, China
| | - Jiali Cai
- Reproductive Medicine Center, Chenggong Hospital Affiliated to Xiamen University, Xiamen, China
| | - Lanlan Liu
- Reproductive Medicine Center, Chenggong Hospital Affiliated to Xiamen University, Xiamen, China
| | - Xiaohua Sun
- Reproductive Medicine Center, Chenggong Hospital Affiliated to Xiamen University, Xiamen, China
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Lédée N, Petitbarat M, Prat-Ellenberg L, Dray G, Cassuto GN, Chevrier L, Kazhalawi A, Vezmar K, Chaouat G. Endometrial Immune Profiling: A Method to Design Personalized Care in Assisted Reproductive Medicine. Front Immunol 2020; 11:1032. [PMID: 32582163 PMCID: PMC7287127 DOI: 10.3389/fimmu.2020.01032] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 04/29/2020] [Indexed: 11/20/2022] Open
Abstract
Objective: To assess the efficiency of the endometrial immune profiling as a method to design personalized care to enhance the pregnancy rate in a large heterogeneous infertile population. We hypothesized that some reproductive failures could be induced by a uterine immune dysregulation which could be identified and corrected with a targeted plan. Design: Prospective cohort study. Setting: Multicentric study. Intervention(s) and Main outcome measure(s): One thousand and seven hundred thirty-eight infertile patients had an immune profiling on a timed endometrial biopsy between 2012 and 2018. This test documented the absence or the presence of an endometrial immune dysregulation and identified its type. In case of dysregulation, a targeted personalized plan was suggested to the treating clinician aiming to supply the anomaly. One year after the test, the clinician was contacted to provide the outcome of the subsequent embryo transfer with the applied suggested plan. Result(s): After testing, 16.5% of the patients showed no endometrial immune dysregulation, 28% had a local immune under-activation, 45% had a local immune over-activation, and 10.5% had a mixed endometrial immune profile. In patients with a history of repeated implantation failures (RIF) or recurrent miscarriages (RM), the pregnancy rate was significantly higher if an endometrial dysregulation was found and the personalized plan applied, compared to the patients with an apparent balanced immune profile (respectively 37.7 and 56% vs. 26.9 and 24%, p < 0.001). In contrast, in good prognosis IVF (in vitro fertilization) subgroup and patients using donor eggs, this difference was not significant between dysregulated and balanced subgroups, but higher pregnancy rates were observed in absence of dysregulation. For patients with immune over-activation, pregnancy rates were significantly higher for patients who had a test of sensitivity, regarding the type of immunotherapy introduced, when compared to the ones who did not (51 vs. 39.9%, p = 0.012). Conclusion(s): Local endometrial immunity appears to be a new and important parameter able to influence the prognosis of pregnancy. Targeted medical care in case of local immune dysregulation resulted in significantly higher pregnancy rates in RIF and RM patients.
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Affiliation(s)
- Nathalie Lédée
- MatriceLAB Innove, Pépinière Paris Santé Cochin, Hôpital Cochin, Paris, France
- Centre d'Assistance Médicale à la Procréation, Hôpital des Bluets, Paris, France
| | - Marie Petitbarat
- MatriceLAB Innove, Pépinière Paris Santé Cochin, Hôpital Cochin, Paris, France
| | - Laura Prat-Ellenberg
- Centre d'Assistance Médicale à la Procréation, Hôpital des Bluets, Paris, France
| | - Géraldine Dray
- Centre d'Assistance Médicale à la Procréation, Hôpital des Bluets, Paris, France
| | - Guy N. Cassuto
- Centre d'Assistance Médicale à la Procréation, Hôpital des Bluets, Paris, France
- Laboratoire Drouot, Paris, France
| | - Lucie Chevrier
- MatriceLAB Innove, Pépinière Paris Santé Cochin, Hôpital Cochin, Paris, France
| | - Alaa Kazhalawi
- MatriceLAB Innove, Pépinière Paris Santé Cochin, Hôpital Cochin, Paris, France
| | - Katia Vezmar
- MatriceLAB Innove, Pépinière Paris Santé Cochin, Hôpital Cochin, Paris, France
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Time of morulation and trophectoderm quality are predictors of a live birth after euploid blastocyst transfer: a multicenter study. Fertil Steril 2020; 112:1080-1093.e1. [PMID: 31843084 DOI: 10.1016/j.fertnstert.2019.07.1322] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/11/2019] [Accepted: 07/22/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To investigate whether the morphodynamic characterization of a euploid blastocyst's development allows a higher prediction of a live birth after single-embryo-transfer (SET). DESIGN Observational cohort study conducted in two phases: training and validation. SETTING Private in vitro fertilization centers. PATIENT(S) Euploid blastocysts: 511 and 319 first vitrified-warmed SETs from 868 and 546 patients undergoing preimplantation genetic testing for aneuploidies (PGT-A) in the training and validation phase, respectively. INTERVENTION(S) Data collected from time of polar body extrusion to time of starting blastulation, and trophectoderm and inner-cell-mass static morphology in all embryos cultured in a specific time-lapse incubator with a continuous medium. Logistic regressions conducted to outline the variables showing a statistically significant association with live birth. In the validation phase, these variables were tested in an independent data set. MAIN OUTCOME MEASURE(S) Live births per SET. RESULT(S) The average live birth rate (LBR) in the training set was 40% (N = 207/511). Only time of morulation (tM) and trophectoderm quality were outlined as putative predictors of live birth at two IVF centers. In the validation set, the euploid blastocysts characterized by tM <80 hours and high-quality trophectoderm resulted in a LBR of 55.2% (n = 37/67), while those with tM ≥ 80 hours and a low-quality trophectoderm resulted in a LBR of 25.5% (N = 13/51). CONCLUSION(S) Time of morulation and trophectoderm quality are better predictors of a euploid blastocyst's reproductive competence. Our evidence was reproducible across different centers under specific culture conditions. These data support the crucial role of morulation for embryo development, a stage that involves massive morphologic, cellular, and molecular changes and deserves more investigation.
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van Groenendael R, Beunders R, Kox M, van Eijk LT, Pickkers P. The Human Chorionic Gonadotropin Derivate EA-230 Modulates the Immune Response and Exerts Renal Protective Properties: Therapeutic Potential in Humans. Semin Nephrol 2020; 39:496-504. [PMID: 31514913 DOI: 10.1016/j.semnephrol.2019.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The extent of the systemic inflammatory response following infectious or noninfectious insults is related to impaired patient outcome. Pregnancy is associated with immunotolerance and an increased glomerular filtration rate. EA-230 is a newly developed synthetic linear tetrapeptide derived from the "pregnancy hormone" human chorionic gonadotropin. In this review, we describe the immunomodulatory and renoprotective properties of EA-230 in preclinical animal models, phase 1 studies in humans and phase 2a studies performed during human experimental endotoxemia. In addition, details pertaining to the design of a recently completed phase 2b study in 180 patients who underwent cardiac surgery to investigate the safety and immunomodulatory and renoprotective properties of EA-230 are discussed.
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Affiliation(s)
- Roger van Groenendael
- Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Institute for Molecular Life Sciences, Radboud Center for Infectious Diseases (RCI), Nijmegen, the Netherlands; Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Institute of Molecular Life Sciences (RIMLS), Nijmegen, the Netherlands
| | - Remi Beunders
- Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Institute for Molecular Life Sciences, Radboud Center for Infectious Diseases (RCI), Nijmegen, the Netherlands
| | - Matthijs Kox
- Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Institute for Molecular Life Sciences, Radboud Center for Infectious Diseases (RCI), Nijmegen, the Netherlands
| | - Lucas T van Eijk
- Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Institute for Molecular Life Sciences, Radboud Center for Infectious Diseases (RCI), Nijmegen, the Netherlands; Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Institute of Molecular Life Sciences (RIMLS), Nijmegen, the Netherlands
| | - Peter Pickkers
- Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Institute for Molecular Life Sciences, Radboud Center for Infectious Diseases (RCI), Nijmegen, the Netherlands.
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Huo X, Huang R, Gan Y, Luo K, Aimuzi R, Nian M, Ao J, Feng L, Tian Y, Wang W, Ye W, Zhang J. Perfluoroalkyl substances in early pregnancy and risk of hypertensive disorders of pregnancy: A prospective cohort study. ENVIRONMENT INTERNATIONAL 2020; 138:105656. [PMID: 32222612 DOI: 10.1016/j.envint.2020.105656] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/04/2020] [Accepted: 03/09/2020] [Indexed: 05/20/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFASs) were reported to be associated with hypertensive disorders of pregnancy (HDP) but the results were inconsistent and prospective data are scarce. We aimed to examine these associations in a large prospective birth cohort study in Shanghai, China. METHODS A total of 10 PFASs were measured by high-performance liquid chromatography/tandem mass spectrometry (HPLC/MS-MS) in the plasma samples from 3220 women who were enrolled during early pregnancy and gave birth to a singleton live birth between 2013 and 2016. The outcomes included gestational hypertension (GH), preeclampsia (PE) and overall HDP. Associations of these outcomes with each PFASs were estimated by multivariable logistic regression and expressed as odd ratios (ORs) and 95% confidence intervals (95% CIs). Potential non-linear association between PFASs and HDP was examined with restricted cubic spline model. To handle the potential confounding by correlated PFASs, we applied elastic net regression (ENR) to identify independent PFASs components of outcomes. RESULTS Among all singleton live births, the incidence rates of GH and PE were 2.0% and 2.2%, respectively. Overall, PFASs did not show a significant and consistent pattern of the associations with GH, PE or overall HDP, both before and after controlling for potential confounders. ENR model confirmed the results that there was no independently predictive role of PFASs on GH, PE or overall HDP. CONCLUSIONS In this large prospective cohort study, maternal plasma concentration of PFASs in early pregnancy were not associated with GH, PE or overall HDP in singleton livebirths.
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Affiliation(s)
- Xiaona Huo
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. 1665 Kong Jiang Road, Shanghai 200092, China.
| | - Rong Huang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. 1665 Kong Jiang Road, Shanghai 200092, China.
| | - Yuexin Gan
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. 1665 Kong Jiang Road, Shanghai 200092, China.
| | - Kai Luo
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. 1665 Kong Jiang Road, Shanghai 200092, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai 200052, China.
| | - Ruxianguli Aimuzi
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. 1665 Kong Jiang Road, Shanghai 200092, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai 200052, China.
| | - Min Nian
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. 1665 Kong Jiang Road, Shanghai 200092, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai 200052, China.
| | - Junjie Ao
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. 1665 Kong Jiang Road, Shanghai 200092, China.
| | - Liping Feng
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. 1665 Kong Jiang Road, Shanghai 200092, China.
| | - Ying Tian
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. 1665 Kong Jiang Road, Shanghai 200092, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai 200052, China.
| | - Weiye Wang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. 1665 Kong Jiang Road, Shanghai 200092, China.
| | - Weiping Ye
- Department of Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China.
| | - Jun Zhang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. 1665 Kong Jiang Road, Shanghai 200092, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai 200052, China.
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Ott TL. Immunological detection of pregnancy: Evidence for systemic immune modulation during early pregnancy in ruminants. Theriogenology 2020; 150:498-503. [PMID: 32331860 DOI: 10.1016/j.theriogenology.2020.04.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/08/2020] [Indexed: 12/28/2022]
Abstract
Mammalian pregnancy creates unique challenges for immune systems highly evolved to detect and eliminate invading pathogens. Recognition of the challenges created by gestating a semi-allogeneic fetus evolved from the discipline of transplantation biology and were informed by studies on the unique natural parabiosis that occurs when female calves are gestated with twin male fetuses. These pregnancies typically result in an intersex female termed a freemartin, which revealed insights into development of the male and female reproductive tracts. However, they also uncovered important clues on immune tolerance with wide-ranging implications to reproductive biology, transplantation biology and autoimmune disease. Many studies focused on identifying mechanisms through which the fetus evades maternal immune detection and elimination. These included studies characterizing immune interactions between the fetus and mother at the nourishing interface of the placenta and uterine endometrium. This immunological forbearance only occurs under high concentrations of circulating progesterone. Beyond the requirement for progesterone, there has been considerable progress towards understanding the effects of conceptus signals on maternal immune function. One common theme is that pregnancy induces a T helper 2 immune bias as shown in several mammalian species, including domestic ruminants. However, a growing body of evidence shows that the fetus not only evades, but also provokes immune responses locally in the uterus and in peripheral tissues. This is perhaps most dramatically illustrated by domestic ruminants where the conceptus secretes a unique interferon in the opening salvo of hormonal communication with the maternal immune system. The role of interferon tau in regulating expression of genes of the innate immune system in the uterus has been extensively studied. More recently, it was determined that these same genes are also induced in peripheral immune cells and other tissues throughout the body. In addition to interferon tau and progesterone, pregnancy associate glycoproteins and chaperonin 10 (aka Early Pregnancy Factor) are implicated in altering immune function both locally and systemically during pregnancy. While it is tempting to speculate that this activation of innate immunity is designed to counteract selective immunosuppression, knowledge of the importance of local and systemic immune activation to the success of pregnancy remains incomplete. This area remains fertile ground for developing better approaches to diagnose and treat infertility in domestic farm species and humans alike.
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Affiliation(s)
- Troy L Ott
- Department of Animal Science, Center for Reproductive Biology and Health, Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, PA, 16802, USA.
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Silasi M, You Y, Simpson S, Kaislasuo J, Pal L, Guller S, Peng G, Ramhorst R, Grasso E, Etemad S, Durosier S, Aldo P, Mor G. Human Chorionic Gonadotropin modulates CXCL10 Expression through Histone Methylation in human decidua. Sci Rep 2020; 10:5785. [PMID: 32238853 PMCID: PMC7113245 DOI: 10.1038/s41598-020-62593-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 03/12/2020] [Indexed: 12/20/2022] Open
Abstract
The process of implantation, trophoblast invasion and placentation demand continuous adaptation and modifications between the trophoblast (embryonic) and the decidua (maternal). Within the decidua, the maternal immune system undergoes continued changes, as the pregnancy progress, in terms of the cell population, phenotype and production of immune factors, cytokines and chemokines. Human chorionic gonadotropin (hCG) is one of the earliest hormones produced by the blastocyst and has potent immune modulatory effects, especially in relation to T cells. We hypothesized that trophoblast-derived hCG modulates the immune population present at the maternal fetal interface by modifying the cytokine profile produced by the stromal/decidual cells. Using in vitro models from decidual samples we demonstrate that hCG inhibits CXCL10 expression by inducing H3K27me3 histone methylation, which binds to Region 4 of the CXCL10 promoter, thereby suppressing its expression. hCG-induced histone methylation is mediated through EZH2, a functional member of the PRC2 complex. Regulation of CXCL10 expression has a major impact on the capacity of endometrial stromal cells to recruit CD8 cells. We demonstrate the existence of a cross talk between the placenta (hCG) and the decidua (CXCL10) in the control of immune cell recruitment. Alterations in this immune regulatory function, such as during infection, will have detrimental effects on the success of the pregnancy.
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Affiliation(s)
- Michelle Silasi
- Yale University School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, New Haven, CT, USA
| | - Yuan You
- Yale University School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, New Haven, CT, USA
- C.S. Mott Center for Human Growth and Development, Department of Obstetrics, Gynecology, Wayne State University, Detroit, MI, USA
| | - Samantha Simpson
- Yale University School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, New Haven, CT, USA
| | - Janina Kaislasuo
- Yale University School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, New Haven, CT, USA
- Department of Obstetrics and Gynecology, University of Helsinki and the Helsinki University Hospital, Helsinki, Finland
| | - Lubna Pal
- Yale University School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, New Haven, CT, USA
| | - Seth Guller
- Yale University School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, New Haven, CT, USA
| | - Gang Peng
- Department of Biostatistics, School of Public Health, Yale University, New Haven, CT, USA
| | - Rosanna Ramhorst
- Laboratory of Immunopharmacology, University of Buenos Aires School of Sciences, IQUIBICEN-CONICET (National Research Council), Buenos Aires, Argentina
| | - Esteban Grasso
- Laboratory of Immunopharmacology, University of Buenos Aires School of Sciences, IQUIBICEN-CONICET (National Research Council), Buenos Aires, Argentina
| | - Shervin Etemad
- Yale University School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, New Haven, CT, USA
| | - Sandy Durosier
- Yale University School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, New Haven, CT, USA
| | - Paulomi Aldo
- Yale University School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, New Haven, CT, USA
| | - Gil Mor
- Yale University School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, New Haven, CT, USA.
- C.S. Mott Center for Human Growth and Development, Department of Obstetrics, Gynecology, Wayne State University, Detroit, MI, USA.
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Chen J, Zhao X, Ao L, Yin T, Yang J. Transcriptomic changes and potential regulatory mechanism of intrauterine human chorionic gonadotropin co-cultured with peripheral blood mononuclear cells infusion in mice with embryonic implantation dysfunction. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:99. [PMID: 32175392 DOI: 10.21037/atm.2019.12.109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background This study aimed to explore whether intrauterine infusion of peripheral blood mononuclear cells (PBMCs) could induce favorable transcriptomic changes in the endometrium for embryo implantation and the potential mechanism. Methods Twenty-one mice were randomly divided to five groups, including a normal pregnancy (NP) group, an embryo implantation dysfunction (EID) group, an EID with human chorionic gonadotropin (hCG) group, an EID with PBMCs group, and an EID with hCG co-cultured with PBMCs group. The endometrium in the implantation window from mice were collected and determined by RNA sequencing (RNA-Seq), and the expression of significantly different genes with high degree of coincidence was recommended and validated by quantitative real-time polymerase chain reaction (qRT-PCR). Results There were totally 1,366 up-regulated and 1,374 down-regulated genes in the EID mice compared with the normal pregnant mice. We selected (fold change ≥2, P<0.05) and verified the candidate genes associated with embryo implantation, immune response and other reproductive processes in previous reports by qRT-PCR. Leukemia inhibitory factor (LIF), solute carrier family 15 member 2 (SLC15A2), retinoic acid receptor responder 1 (RARRES1), vascular cell adhesion molecule 1 (VCAM1) were down-regulated and musculin (MSC), chemokine (C-X-C motif) ligand 14 (CXCL14) were up-regulated significantly in EID group (P<0.05), and the synergistic effects of hCG were seen. In addition, the expression of glucocorticoid receptor (GR)-β in PBMCs of NP mice was higher than that of EID mice, and up-regulated GR-β in EID mice could significantly increase the expression of LIF, SLC15A2, RARRES1 and VCAM1, and decrease the expression of CXCL14 and MSC, which indicated GR-β might be a transcriptional factor of the six genes above. Conclusions Intrauterine PBMCs perfusion might improve the performance of impaired endometrial receptivity by regulating LIF, SLC15A2, RARRES1, VCAM1, MSC as well as CXCL14, and hCG could enhance the effect of PBMCs. In addition, GR-β, as a transcriptional factor, could regulate the six genes in PBMCs.
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Affiliation(s)
- Jiao Chen
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Hubei Clinical Research Center for Assisted Reproductive and Embryonic Development, Wuhan 430060, China
| | - Xuehan Zhao
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Hubei Clinical Research Center for Assisted Reproductive and Embryonic Development, Wuhan 430060, China
| | - Liangfei Ao
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Hubei Clinical Research Center for Assisted Reproductive and Embryonic Development, Wuhan 430060, China
| | - Tailang Yin
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Hubei Clinical Research Center for Assisted Reproductive and Embryonic Development, Wuhan 430060, China
| | - Jing Yang
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Hubei Clinical Research Center for Assisted Reproductive and Embryonic Development, Wuhan 430060, China
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Gridelet V, Perrier d'Hauterive S, Polese B, Foidart JM, Nisolle M, Geenen V. Human Chorionic Gonadotrophin: New Pleiotropic Functions for an "Old" Hormone During Pregnancy. Front Immunol 2020; 11:343. [PMID: 32231662 PMCID: PMC7083149 DOI: 10.3389/fimmu.2020.00343] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 02/12/2020] [Indexed: 12/11/2022] Open
Abstract
Human chorionic gonadotrophin (hCG) is the first specific molecule synthesized by the embryo. hCG RNA is transcribed as early as the eight-cell stage, and the blastocyst produces the protein before its implantation. hCG in the uterine microenvironment binds with its cognate receptor, luteinizing hormone/choriogonadotropin receptor (LHCGR), on the endometrial surface. This binding stimulates leukemia inhibitory factor (LIF) production and inhibits interleukin-6 (IL-6) production by epithelial cells of the endometrium. These effects ensure essential help in the preparation of the endometrium for initial embryo implantation. hCG also effects angiogenic and immunomodulatory actions as reported in many articles by our laboratories and other ones. By stimulating angiogenesis and vasculogenesis, hCG provides the placenta with an adequate maternal blood supply and optimal embryo nutrition during the invasion of the uterine endometrium. The immunomodulatory properties of hCG are numerous and important for programming maternal immune tolerance toward the embryo. The reported effects of hCG on uterine NK, Treg, and B cells, three major cell populations for the maintenance of pregnancy, demonstrate the role of this embryonic signal as a crucial immune regulator in the course of pregnancy. Human embryo rejection for hCG-related immunological reasons has been studied in different ways, and a sufficient dose of hCG seems to be necessary to maintain maternal tolerance. Different teams have studied the addition of hCG in patients suffering from recurrent miscarriages or implantation failures. hCG could also have a beneficial or a negative impact on autoimmune diseases during pregnancy. In this review, we will discuss the immunological impacts of hCG during pregnancy and if this hormone might be used therapeutically.
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Affiliation(s)
- Virginie Gridelet
- GIGA-I3 Center of Immunoendocrinology GIGA Research Institute, University of Liege, Liege, Belgium
- Center for Assisted Medical Procreation, University of Liège, CHR Citadelle, Liège, Belgium
| | - Sophie Perrier d'Hauterive
- GIGA-I3 Center of Immunoendocrinology GIGA Research Institute, University of Liege, Liege, Belgium
- Center for Assisted Medical Procreation, University of Liège, CHR Citadelle, Liège, Belgium
| | - Barbara Polese
- GIGA-I3 Center of Immunoendocrinology GIGA Research Institute, University of Liege, Liege, Belgium
| | - Jean-Michel Foidart
- Laboratory of Tumor and Development Biology, University of Liège, Liège, Belgium
| | - Michelle Nisolle
- Center for Assisted Medical Procreation, University of Liège, CHR Citadelle, Liège, Belgium
- Department of Obstetrics and Gynecology, CHR Citadelle, University of Liège, Liège, Belgium
| | - Vincent Geenen
- GIGA-I3 Center of Immunoendocrinology GIGA Research Institute, University of Liege, Liege, Belgium
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Movsas TZ, Paneth N, Gewolb IH, Lu Q, Cavey G, Muthusamy A. The postnatal presence of human chorionic gonadotropin in preterm infants and its potential inverse association with retinopathy of prematurity. Pediatr Res 2020; 87:558-563. [PMID: 31537012 PMCID: PMC7035966 DOI: 10.1038/s41390-019-0580-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/31/2019] [Accepted: 08/29/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Human chorionic gonadotropin (hCG) and luteinizing hormone (LH) are pro-angiogenic gonadotropic hormones, which classically target the reproductive organs. However, hCG, LH, and their shared CG/LH receptor are also present in the human eye. The possibility that a deficiency of these hormones may be involved in the pathogenesis of retinopathy of prematurity (ROP) during its early non-proliferative phase has not been explored. METHODS We conducted a cross-sectional study of Michigan-born preterm infants utilizing dried blood spots. We analyzed hCG and LH blood levels at 1 week and 4 weeks of age from 113 study participants (60 without ROP; 53 with non-proliferative ROP). We utilized electrochemiluminescence assays on the Mesoscale Discovery platform. RESULTS Similar levels of hCG are found in preterm infants at both 1 week and 4 weeks after birth. Preterm infants with non-proliferative ROP, after adjusting for sex and gestational age, have 2.42 [95% CI: 1.08-5.40] times the odds of having low hCG at fourth week of age. CONCLUSIONS We found that hCG is present postnatally in preterm infants and that a deficiency of hCG at 4 weeks of age is potentially associated with non-proliferative ROP. This provides novel evidence to suggest that hCG may participate in human retinal angiogenesis.
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Affiliation(s)
- Tammy Z Movsas
- Zietchick Research Institute, Plymouth, MI, USA.
- Department of Pediatrics & Human Development, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
| | - Nigel Paneth
- Department of Pediatrics & Human Development, College of Human Medicine, Michigan State University, East Lansing, MI, USA
- Department of Epidemiology & Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Ira H Gewolb
- Department of Pediatrics & Human Development, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Qing Lu
- Department of Epidemiology & Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Gregory Cavey
- Biomedical Sciences, Western Michigan University-Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
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Gallardo V, González M, Toledo F, Sobrevia L. Role of heme oxygenase 1 and human chorionic gonadotropin in pregnancy associated diseases. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165522. [DOI: 10.1016/j.bbadis.2019.07.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 07/25/2019] [Accepted: 07/27/2019] [Indexed: 01/13/2023]
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Schumacher A, Zenclussen AC. Human Chorionic Gonadotropin-Mediated Immune Responses That Facilitate Embryo Implantation and Placentation. Front Immunol 2019; 10:2896. [PMID: 31921157 PMCID: PMC6914810 DOI: 10.3389/fimmu.2019.02896] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 11/26/2019] [Indexed: 12/13/2022] Open
Abstract
Human chorionic gonadotropin (hCG) serves as one of the first signals provided by the embryo to the mother. Exactly at the time when the first step of the implantation process is initiated and the blastocyst adheres to the maternal endometrium, the embryonic tissue starts to actively secrete hCG. Shortly thereafter, the hormone can be detected in the maternal circulation where its concentration steadily increases throughout early pregnancy as it is continuously released by the forming placenta. Accumulating evidence underlines the critical function of hCG for embryo implantation and placentation. hCG not only regulates biological aspects of these early pregnancy events but also supports maternal immune cells in their function as helpers in the establishment of an adequate embryo-endometrial relationship. In view of its early presence in the maternal circulation, hCG has the potential to influence both local uterine immune cell populations as well as peripheral ones. The current review aims to summarize recent literature on the participation of innate and adaptive immune cells in embryo implantation and placentation with a specific focus on their regulation by hCG.
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Affiliation(s)
- Anne Schumacher
- Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Ana C Zenclussen
- Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
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Alonso MA, Silva LA, Affonso FJ, Lemes KM, Celeghini ECC, Lançoni R, Carvalho HF, de Arruda RP. Effect of hCG application at different moments of the estrous cycle on corpus luteum and uterine vascularization and serum progesterone concentration in mares. Anim Reprod 2019; 16:317-327. [PMID: 33224293 PMCID: PMC7673598 DOI: 10.21451/1984-3143-ar2018-0103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Establishment of pregnancy after embryo transfer is the ultimate goal of an embryo transfer program and increasing pregnancy rates and reducing pregnancy loss are mandatory. The utilization of treatments to improve conception rates in recipient mares has been the focus of several research groups over the last years and the results are controversial. Some studies using human chorionic gonadotrophin (hCG) found promising results. Our hypothesis was that hCG administration would cause an additional stimulation on luteal function, uterine and luteal vascularization and progesterone concentration, and the mares would have increased uterine and cervix tone. Therefore, in the present study the effects of hCG administration to induce ovulation, on day 0 (day of ovulation) or day 5 postovulation were evaluated on corpus luteum characteristics, reproductive tract vascularization, and serum progesterone concentration from ovulation until day 15 postovulation. Groups were: G1: (control) - no hCG; G2: 2500 IU of hCG to induce ovulation when a follicle greater than 35mm and uterine edema were detected; G3: 2500 IU hCG on day 0; G4: 2500 IU hCG on day 5 postovulation. Twelve mares were randomly assigned to each group, during consecutive cycles, in a Latin Square experimental design, in a total of 48 cycles. Doppler ultrasound evaluations were performed daily from day 0 until day 15 postovulation, including mesometrial vascularity, endometrial vascularity and corpus luteum vascularity. Blood samples were collected for serum progesterone concentration. Data was analyzed using the Proc Glimmix SAS Procedure for nonparametric variables and Proc Mixed for parametric parameters. There was no treatment effect for all variables studied (P > 0.05). Characteristics were only affected by day (P < 0.05). It can be concluded that hCG administration at the time points suggested in the current study did not alter the characteristics evaluated.
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Affiliation(s)
- Maria Augusta Alonso
- Laboratory of Semen Biotechnology and Andrology, Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of Sao Paulo (USP), Pirassununga, São Paulo, Brazil
| | - Luciano Andrade Silva
- Laboratory of Theriogenology Dr. O.J. Ginther, Department of Veterinary Medicine, School of Animal Sciences and Food Engineering, University of Sao Paulo, Pirassununga, São Paulo, Brazil
| | - Fernanda Jordão Affonso
- Laboratory of Semen Biotechnology and Andrology, Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of Sao Paulo (USP), Pirassununga, São Paulo, Brazil
| | - Kleber Menegon Lemes
- Laboratory of Semen Biotechnology and Andrology, Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of Sao Paulo (USP), Pirassununga, São Paulo, Brazil
| | - Eneiva Carla Carvalho Celeghini
- Laboratory of Semen Biotechnology and Andrology, Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of Sao Paulo (USP), Pirassununga, São Paulo, Brazil
| | - Renata Lançoni
- Laboratory of Semen Biotechnology and Andrology, Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of Sao Paulo (USP), Pirassununga, São Paulo, Brazil
| | - Henrique Fulanetti Carvalho
- Laboratory of Semen Biotechnology and Andrology, Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of Sao Paulo (USP), Pirassununga, São Paulo, Brazil
| | - Rubens Paes de Arruda
- Laboratory of Semen Biotechnology and Andrology, Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of Sao Paulo (USP), Pirassununga, São Paulo, Brazil
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Abstract
Pregnancy, a challenging physiological state, requires shuffling of conventional immune work-sets. Strategies to tolerate the semi-allogenic fetus in normal human pregnancy are multivariate with perfect modulation of the immune cells. Pregnancy is marked by B cell lymphocytopenia accompanied by reduced responsiveness to infectious agents. Besides this old age concept, plenty of research confirms that B cells have other crucial roles in pregnancy and undergo a wide range of modifications in terms of its proliferation, switching between its subtypes, variation in antibody productions, shifting the tides of cytokines as well as regulating other immune cells. B cells establish tolerant environment in pregnancy by producing protective antibodies to encounter the foreign paternal antigens. Regulatory B cells (Bregs) have adopted anti-inflammatory characteristics to sustain normal pregnancy. Moreover, the colossal physiological alterations during human pregnancy also include synchronized changes in the cross-talks between the pregnancy hormones and B cells. These aspects of pregnancy from the view point of B cell functions have so far appeared individually in discrete reports. This review finds its novelty in concisely presenting every facet of association of B cell with human pregnancy.
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Affiliation(s)
- Sulagna Dutta
- Department of Oral Biology and Biomedical Sciences, Faculty of Dentistry, MAHSA University, Jenjarom, Malaysia
| | - Pallav Sengupta
- Department of Physiology, Faculty of Medicine, MAHSA University, Jenjarom, Malaysia
| | - Nazmul Haque
- Department of Oral Biology and Biomedical Sciences, Faculty of Dentistry, MAHSA University, Jenjarom, Malaysia
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Barjaktarovic M, Korevaar TIM, Jaddoe VWV, de Rijke YB, Peeters RP, Steegers EAP. Human chorionic gonadotropin and risk of pre-eclampsia: prospective population-based cohort study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 54:477-483. [PMID: 30834627 PMCID: PMC6856821 DOI: 10.1002/uog.20256] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/20/2019] [Accepted: 02/27/2019] [Indexed: 05/13/2023]
Abstract
OBJECTIVES Abnormal placentation in early pregnancy may play a role in the pathogenesis of pre-eclampsia. Human chorionic gonadotropin (hCG) regulates placental development and angiogenesis and may affect the ratio of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) in the serum. The aims of this study were to investigate the association of total hCG with the risk of pre-eclampsia and to examine the potential effect of pro- and anti-angiogenic factors on this association. METHODS This was a population-based prospective cohort study of 7754 women with a singleton pregnancy. Total hCG was measured in the first available sample (median gestational age, 14.4 weeks; 95% range, 10.1-26.1 weeks) and sFlt-1 and PlGF concentrations in early (< 18 weeks; median, 13.2 weeks; 95% range, 9.6-17.6 weeks) and in mid- (18-25 weeks; median, 20.4 weeks; 95% range, 18.5-23.5 weeks) pregnancy. We tested the association of hCG concentration and risk of pre-eclampsia using regression analysis, adjusting for maternal age, ethnicity, body mass index, parity, education level, smoking status and fetal sex. Additionally, we assessed whether this association was affected by the sFlt-1/PlGF ratio. RESULTS High hCG concentration was associated with a 1.5-2.7-fold increased risk of pre-eclampsia (P = 0.0001), depending on the cut-off used, and with increased sFlt-1/PlGF ratio during early pregnancy (P < 0.0001). The association between high hCG and pre-eclampsia attenuated by roughly 40% after adjustment for early-pregnancy sFlt-1/PlGF ratio (β-estimate change from 0.19 ± 0.10 (P = 0.052) to 0.12 ± 0.10 (P = 0.22)). CONCLUSIONS High total hCG concentration in early pregnancy is associated with an increased risk of pre-eclampsia. The effect of high hCG concentration on the balance between pro- and anti-angiogenic factors during pregnancy may have a role in the pathophysiology of pre-eclampsia. © 2019 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M. Barjaktarovic
- The Generation R Study GroupErasmus Medical Center, Sophia Children's HospitalRotterdamThe Netherlands
- Department of Internal Medicine, Academic Center for Thyroid DiseasesErasmus Medical Center, Sophia Diseases, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - T. I. M. Korevaar
- The Generation R Study GroupErasmus Medical Center, Sophia Children's HospitalRotterdamThe Netherlands
- Department of Internal Medicine, Academic Center for Thyroid DiseasesErasmus Medical Center, Sophia Diseases, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - V. W. V. Jaddoe
- The Generation R Study GroupErasmus Medical Center, Sophia Children's HospitalRotterdamThe Netherlands
- Department of Epidemiology and PediatricsErasmus Medical Center, Sophia Children's HospitalRotterdamThe Netherlands
| | - Y. B. de Rijke
- Department of Internal Medicine, Academic Center for Thyroid DiseasesErasmus Medical Center, Sophia Diseases, Sophia Children's Hospital, Rotterdam, The Netherlands
- Department of Clinical ChemistryErasmus Medical Center, Sophia Children's HospitalRotterdamThe Netherlands
| | - R. P. Peeters
- The Generation R Study GroupErasmus Medical Center, Sophia Children's HospitalRotterdamThe Netherlands
- Department of Internal Medicine, Academic Center for Thyroid DiseasesErasmus Medical Center, Sophia Diseases, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - E. A. P. Steegers
- The Generation R Study GroupErasmus Medical Center, Sophia Children's HospitalRotterdamThe Netherlands
- Department of Obstetrics and GynecologyErasmus Medical Center, Sophia Children's HospitalRotterdamThe Netherlands
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Wu B. Introductory Chapter: New Theory and Technology in Early Clinical Embryogenesis. EMBRYOLOGY - THEORY AND PRACTICE 2019. [DOI: 10.5772/intechopen.88331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Ortega-Hrepich C, Drakopoulos P, Bourgain C, Van Vaerenbergh I, Guzman L, Tournaye H, Smitz J, De Vos M. Aberrant endometrial steroid receptor expression in in-vitro maturation cycles despite hormonal luteal support: A pilot study. Reprod Biol 2019; 19:210-217. [PMID: 31262644 DOI: 10.1016/j.repbio.2019.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/08/2019] [Accepted: 06/11/2019] [Indexed: 01/12/2023]
Abstract
Clinical outcomes of fresh embryo transfer in non-hCG triggered in vitro maturation (IVM) cycles are inferior compared to vitrified-warmed embryo transfer. This is a prospective observational pilot study in a consecutive cohort of 31 polycystic ovary syndrome (PCOS) patients and 37 normo-ovulatory egg donors who underwent IVM without fresh embryo transfer between July 2009 and June 2014. All subjects received 150 IU of highly purified menotropin (HP-hMG) daily for three days. On cycle day 6, all patients started transdermal oestradiol (E2) at a daily dose of 9 mg. There was no human chorionic gonadotropin (hCG) trigger before oocyte retrieval (OR). Vaginal micronized progesterone was commenced on the evening after OR, at a daily dose of 600 mg. Additional luteal phase support (LPS) was administered as follows: Group A: no additional LPS; Group B: 1500 IU of hCG administered 4 h after OR and Group C: 5000 IU of hCG administered 4 h after OR + an additional injection of 5000 IU of hCG 1 day before endometrial biopsy. Endometrial biopsy for histology and immunohistochemistry (IHC) was performed on day 5 or 6 after OR. Instead of being downregulated, both PR-B and ERα in endometrial glands and stroma were moderately to strongly expressed in all three protocols, suggesting that the mid-luteal histological signature of endometrial receptivity is deficient in a non-hCG-triggered IVM cycle. Poor clinical outcomes after fresh embryo transfer following IVM are probably related to inappropriate endometrial development which may be linked to the short follicular phase of IVM cycles.
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Affiliation(s)
- Carolina Ortega-Hrepich
- Centre for Reproductive Medicine, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium; Clinica Monteblanco, Santiago, Chile
| | | | - Claire Bourgain
- Research Group Reproductive Immunology and Implantation, Vrije Universiteit Brussel, Laarbeeklaan 103,1090 Brussels, Belgium; AZ Imelda, Bonheiden, Belgium
| | - Inge Van Vaerenbergh
- Laboratory of Follicular Biology (FOBI), UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | | | - Herman Tournaye
- Centre for Reproductive Medicine, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Johan Smitz
- Laboratory of Follicular Biology (FOBI), UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Michel De Vos
- Centre for Reproductive Medicine, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
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Xu Z, Chen W, Chen C, Xiao Y, Chen X. Effect of intrauterine injection of human chorionic gonadotropin before frozen-thawed embryo transfer on pregnancy outcomes in women with endometriosis. J Int Med Res 2019; 47:2873-2880. [PMID: 31119991 PMCID: PMC6683888 DOI: 10.1177/0300060519848928] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective To investigate the effect of human chorionic gonadotropin (hCG) intrauterine injection before frozen–thawed embryo transfer (FET) in women with endometriosis. Methods This retrospective cohort study included 45 women with endometriosis who underwent hCG intrauterine injection before FET; each woman was matched with three patients with endometriosis who did not receive hCG intrauterine injection (controls). Data on pregnancy and prenatal outcomes were extracted from medical records and compared. Results Patients in the hCG intrauterine injection group had significantly higher rates of pregnancy and clinical pregnancy (64.4% and 57.8%, respectively) than controls (47.4% and 39.3%, respectively). Neonatal birth weight for both singletons and twins was significantly higher in the hCG group (3486 ± 458 g and 2710 ± 437 g, respectively) than in the control group (3195 ± 401 g and 2419 ± 370 g, respectively). Conclusion Pregnancy rate, clinical pregnancy rate, and birth weight were improved in women with endometriosis who underwent intrauterine hCG injection compared with those who did not receive hCG before FET.
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Affiliation(s)
- Zhihui Xu
- 1 Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Wenming Chen
- 2 Department of Obstetrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Chune Chen
- 3 School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Yikang Xiao
- 3 School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Xia Chen
- 1 Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
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Schug S, Baunacke A, Goeckenjan M, Horn LC, Pretzsch G, Zimmermann G, Alexander H. Endometrial human chorionic gonadotropin (hCG) expression is a marker for adequate secretory transformation of the endometrium. Arch Gynecol Obstet 2019; 299:1727-1736. [PMID: 30955059 DOI: 10.1007/s00404-019-05130-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 03/25/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE Successful embryo implantation into the endometrium depends on embryonic characteristics and proper endometrial development. Reproductive medicine often focuses on embryo quality, whereas reliable diagnostic tests for endometrial receptivity are still needed. We previously found that human chorionic gonadotropin (hCG), one of the earliest proteins secreted by the embryo, was also expressed by the luteal phase endometrium around the implantation window. Here, we tested our hypothesis of endometrial hCG as an implantation marker. METHODS Endometrial biopsies and serum samples were taken from patients undergoing routine infertility diagnostics. Correlations of immunohistochemically detected endometrial hCG expression with adequate endometrial secretory transformation, the infiltration of CD45-positive leukocytes, clinical diagnostic parameters, and endometrial thickness were analyzed. RESULTS A highly significant correlation between the endometrial score, as a measurement for regular secretory transformation, and the intensity of hCG staining was found. The invasion of CD45-positive leukocytes increased with progressing endometrial secretory transformation and rising endometrial hCG expression. In addition, serum progesterone concentrations correlated with hCG expression by the endometrial glands. CONCLUSIONS Our results suggest endometrial hCG as a possible diagnostic parameter characterizing the endometrial secretory transformation and, thus, possibly also its implantation capability.
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Affiliation(s)
- Sindy Schug
- Research Laboratory of the Department of Obstetrics and Gynecology, Division of Human Reproduction and Endocrinology, Medical School, University of Leipzig, Semmelweisstr. 14, 04103, Leipzig, Germany.
| | - Anja Baunacke
- Research Laboratory of the Department of Obstetrics and Gynecology, Division of Human Reproduction and Endocrinology, Medical School, University of Leipzig, Semmelweisstr. 14, 04103, Leipzig, Germany
| | - Maren Goeckenjan
- Department of Gynecology and Obstetrics, University of Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Lars-Christian Horn
- Institute of Pathology, Department of Breast, Gynecological and Perinatal Pathology, University Hospital of Leipzig, Liebigstr. 24, 04103, Leipzig, Germany
| | - Gabriele Pretzsch
- Women's Hospital, University Hospital of Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Gerolf Zimmermann
- Research Laboratory of the Department of Obstetrics and Gynecology, Division of Human Reproduction and Endocrinology, Medical School, University of Leipzig, Semmelweisstr. 14, 04103, Leipzig, Germany
| | - Henry Alexander
- Research Laboratory of the Department of Obstetrics and Gynecology, Division of Human Reproduction and Endocrinology, Medical School, University of Leipzig, Semmelweisstr. 14, 04103, Leipzig, Germany.
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