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Bautista-Bautista G, Salguero-Zacarias S, Villeda-Gabriel G, García-López G, Osorio-Caballero M, Palafox-Vargas ML, Acuña-González RJ, Lara-Pereyra I, Díaz-Ruíz O, Flores-Herrera H. Escherichia coli induced matrix metalloproteinase-9 activity and type IV collagen degradation is regulated by progesterone in human maternal decidual. BMC Pregnancy Childbirth 2024; 24:645. [PMID: 39367340 PMCID: PMC11451097 DOI: 10.1186/s12884-024-06847-8] [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: 06/22/2024] [Accepted: 09/20/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND Escherichia coli (E. coli) is one of the main bacteria associated with preterm premature rupture of membranes by increasing pro-matrix metalloproteinase 9 (proMMP-9) and degradation of type IV collagen in human feto-maternal interface (HFMi). proMMP-9 is regulated by progesterone (P4) but it is unclear whether P4 inhibits proMMP in human maternal decidual (MDec). This study aimed to determine a role of P4 on proMMP-2 and - 9 and type IV collagen induced by E. coli infection in MDec. METHODS Nine HFMi were mounted in a Transwell system. MDec was stimulated with P4 or E. coli for 3-, 6-, or 24-hours. proMMP-2, -9 and type IV collagen were assessed. RESULTS Gelatin zymography revealed an increase in proMMP-9 after 3, 6, and 24 h of stimulating MDec with E. coli. Using immunofluorescence, it was confirmed the increase in the HFMi tissue and a reduction on the amount of type IV collagen leading to the separation of fetal amniochorion and MDEc. The degradative activity of proMMP-9 was reduced by 20% by coincubation with P4. CONCLUSIONS P4 modulates the activity of proMMP-9 induced by E. coli stimulation but it was unable to completely reverse the degradation of type IV collagen in human MDec tissue.
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Affiliation(s)
- Gerardo Bautista-Bautista
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Urales #800 Col. Lomas de Virreyes CP 11000, Tercer piso de la Torre de Investigación, Ciudad de México, México
| | - Santos Salguero-Zacarias
- Departamento de Tococirugia y Urgencias, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México
| | - Graciela Villeda-Gabriel
- Departamento de Inmunología e infectología, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México
| | - Guadalupe García-López
- Departamento de Fisiología y Desarrollo Celular, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes , Ciudad de México, México
| | - Mauricio Osorio-Caballero
- Departamento de Salud Sexual y Reproductiva, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México
| | - Martha Leticia Palafox-Vargas
- Departamento de Anatomía Patológica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México
| | - Ricardo Josué Acuña-González
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Urales #800 Col. Lomas de Virreyes CP 11000, Tercer piso de la Torre de Investigación, Ciudad de México, México
| | - Irlando Lara-Pereyra
- Departamento de Ginecología, Hospital General de Zona 252, Instituto Mexicano del Seguro Social, Atlacomulco, México
| | - Oscar Díaz-Ruíz
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hector Flores-Herrera
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Urales #800 Col. Lomas de Virreyes CP 11000, Tercer piso de la Torre de Investigación, Ciudad de México, México.
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Palacios-Luna JE, López-Marrufo MV, Bautista-Bautista G, Velarde-Guerra CS, Villeda-Gabriel G, Flores-Herrera O, Osorio-Caballero M, Aguilar-Carrasco JC, Palafox-Vargas ML, García-López G, Díaz-Ruíz O, Arechavaleta-Velasco F, Flores-Herrera H. Progesterone modulates extracellular heat-shock proteins and interlukin-1β in human choriodecidual after Escherichia coli infection. Placenta 2023; 142:85-94. [PMID: 37659254 DOI: 10.1016/j.placenta.2023.08.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 08/25/2023] [Accepted: 08/27/2023] [Indexed: 09/04/2023]
Abstract
INTRODUCTION Chorioamnionitis is an adverse condition in human pregnancy caused by many bacterial pathogens including Escherichia coli (E. coli); which has been associated with higher risk of preterm birth. We recently reported that human maternal decidua (MDec) tissue responds to E. coli infection by secreting extracellular heat-shock proteins (eHsp)-60, -70 and interlukin-1β (IL-1β). Previous studies have shown that progesterone (P4) regulates the immune response, but it is unknown whether P4 inhibits the secretion of eHsp. The aim of this investigation was to determine the role of P4 on the secretion of eHsp-27, -60, -70 and IL-1β in MDec after 3, 6, and 24 h of E. coli infection. METHODS Nine human feto-maternal interface (HFMi) tissues were included and mounted in the Transwell culture system. Only the maternal decidua (MDec) was stimulated for 3, 6 and 24 h with E. coli alone or in combination with progesterone and RU486. After each treatment, the HFMi tissue was recovered to determine histological changes and the culture medium recovered to evaluate the levels of eHsp-27, -60, -70 and IL-1β by ELISA and mRNA expression by RT-PCR. RESULTS No structural changes were observed in the HFMi tissue treated with P4 and RU486. However, stimulation with E. coli produces diffuse inflammation and ischemic necrosis. E. coli induced infection decreases, in time- and dose-dependent manner, eHsp-27 and increases eHsp-60, eHsp-70 and IL-1β levels. In contrast, incubation of HFMi tissue with E. coli + P4 reversed eHsp and IL-1β secretion levels relative to E. coli stimulation group but not relative to the control group. The same profile was observed on the expression of eHsp-27 and eHsp-60. DISCUSSION we found that progesterone modulates the anti-inflammatory (eHsp-27) and pro-inflammatory (eHsp-60 and eHsp-70) levels of eHsp induced by E. coli infection in human choriodecidual tissue. eHsp-60 and eHsp-70 levels were not completely reversed; maintaining the secretion of IL-1β, which has been associated with adverse events during pregnancy.
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Affiliation(s)
- Janelly Estefania Palacios-Luna
- Departamento de Inmunobioquímica. Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico
| | - Mariana Victoria López-Marrufo
- Departamento de Ginecología y Obstetricia. Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico
| | - Gerardo Bautista-Bautista
- Departamento de Inmunobioquímica. Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico
| | - Cinthia Selene Velarde-Guerra
- Departamento de Inmunobioquímica. Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico
| | - Graciela Villeda-Gabriel
- Departamento de Inmunología e Infectología, Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico
| | - Oscar Flores-Herrera
- Departamento de Bioquímica, Facultad de Medicina. Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Mauricio Osorio-Caballero
- Departamento de Salud Sexual y Reproductiva. Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico
| | - Jose Carlos Aguilar-Carrasco
- Departamento de Fisiología y Desarrollo Celular, Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México. Mexico
| | - Martha Leticia Palafox-Vargas
- Departamento de Anatomía Patológica. Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico
| | - Guadalupe García-López
- Departamento de Fisiología y Desarrollo Celular, Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México. Mexico
| | - Oscar Díaz-Ruíz
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Fabián Arechavaleta-Velasco
- Unidad de Investigación en Medicina Reproductiva. Hospital de Gineco-Obstetricia No. 4 "Luis Castelazo Ayala" Instituto Mexicano Del Seguro Social, Ciudad de México. Mexico.
| | - Hector Flores-Herrera
- Departamento de Inmunobioquímica. Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" (INPerIER), Ciudad de México, Mexico.
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Progesterone receptor isoform B regulates the Oxtr- Plcl2- Trpc3 pathway to suppress uterine contractility. Proc Natl Acad Sci U S A 2021; 118:2011643118. [PMID: 33707208 DOI: 10.1073/pnas.2011643118] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Uterine contractile dysfunction leads to pregnancy complications such as preterm birth and labor dystocia. In humans, it is hypothesized that progesterone receptor isoform PGR-B promotes a relaxed state of the myometrium, and PGR-A facilitates uterine contraction. This hypothesis was tested in vivo using transgenic mouse models that overexpress PGR-A or PGR-B in smooth muscle cells. Elevated PGR-B abundance results in a marked increase in gestational length compared to control mice (21.1 versus 19.1 d respectively, P < 0.05). In both ex vivo and in vivo experiments, PGR-B overexpression leads to prolonged labor, a significant decrease in uterine contractility, and a high incidence of labor dystocia. Conversely, PGR-A overexpression leads to an increase in uterine contractility without a change in gestational length. Uterine RNA sequencing at midpregnancy identified 1,174 isoform-specific downstream targets and 424 genes that are commonly regulated by both PGR isoforms. Gene signature analyses further reveal PGR-B for muscle relaxation and PGR-A being proinflammatory. Elevated PGR-B abundance reduces Oxtr and Trpc3 and increases Plcl2 expression, which manifests a genetic profile of compromised oxytocin signaling. Functionally, both endogenous PLCL2 and its paralog PLCL1 can attenuate uterine muscle cell contraction in a CRISPRa-based assay system. These findings provide in vivo support that PGR isoform levels determine distinct transcriptomic landscapes and pathways in myometrial function and labor, which may help further the understanding of abnormal uterine function in the clinical setting.
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Abstract
A short cervix in the second trimester is a significant risk factor for spontaneous preterm birth, preterm prelabor rupture of membranes, and subsequent adverse perinatal outcome. The pathophysiology is complex and multifactorial with inflammatory and/or infectious processes often involved. Biomarkers have been developed in an effort to predict preterm birth with varying degrees of success. The treatment options of cerclage, progesterone, pessary, and combination therapy are reviewed. Evidence-based protocols are summarized for singleton and multiple gestation.
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Gravitte A, Archibald T, Cobble A, Kennard B, Brown S. Liquid chromatography-mass spectrometry applications for quantification of endogenous sex hormones. Biomed Chromatogr 2020; 35:e5036. [PMID: 33226656 DOI: 10.1002/bmc.5036] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/20/2020] [Accepted: 11/20/2020] [Indexed: 01/18/2023]
Abstract
Liquid chromatography, coupled with tandem mass spectrometry, presents a powerful tool for the quantification of the sex steroid hormones 17-β estradiol, progesterone and testosterone from biological matrices. The importance of accurate quantification with these hormones, even at endogenous levels, has evolved with our understanding of the role these regulators play in human development, fertility and disease risk and manifestation. Routine monitoring of these analytes can be accomplished by immunoassay techniques, which face limitations on specificity and sensitivity, or using gas chromatography-mass spectrometry. LC-MS/MS is growing in capability and acceptance for clinically relevant quantification of sex steroid hormones in biological matrices and is able to overcome many of the limitations of immunoassays. Analyte specificity has improved through the use of novel derivatizing agents, and sensitivity has been refined through the use of high-resolution chromatography and mass spectrometric technology. This review highlights these innovations, among others, in LC-MS/MS steroid hormone analysis captured in the literature over the last decade.
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Affiliation(s)
- Amy Gravitte
- James H Quillen College of Medicine, East Tennessee State University, Department of Biomedical Sciences, Johnson City, TN, USA
| | - Timothy Archibald
- Bill Gatton College of Pharmacy, East Tennessee State University, Department of Pharmaceutical Sciences, Johnson City, TN, USA
| | - Allison Cobble
- Bill Gatton College of Pharmacy, East Tennessee State University, Department of Pharmaceutical Sciences, Johnson City, TN, USA
| | - Benjamin Kennard
- Bill Gatton College of Pharmacy, East Tennessee State University, Department of Pharmaceutical Sciences, Johnson City, TN, USA
| | - Stacy Brown
- Bill Gatton College of Pharmacy, East Tennessee State University, Department of Pharmaceutical Sciences, Johnson City, TN, USA
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Schiffer L, Adaway JE, Baranowski ES, Arlt W, Keevil BG. A novel high-throughput assay for the measurement of salivary progesterone by liquid chromatography tandem mass spectrometry. Ann Clin Biochem 2018; 56:64-71. [DOI: 10.1177/0004563218780904] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Liquid chromatography tandem mass spectrometry (LC-MS/MS) enables specific and sensitive quantification of steroids with a high throughput. Saliva sampling is advantageous for multisample profiling over longer periods of time, as it is non-invasive, cheap, can be carried out at home and does not require the attendance of clinical personnel. We developed a rapid LC-MS/MS for the measurement of salivary progesterone, frequently assessed as ovulation marker in patients desiring fertility. Methods Samples (300 μL) were prepared by supported liquid extraction using dichloromethane and were reconstituted in 40% methanol. Chromatography was performed using a C8 column with a water/methanol gradient containing 0.1% formic acid and 2 mmol/L ammonium acetate. Quantification was performed with a Waters TQ-S mass spectrometer. Results Total run time was 5.5 min. The lower limit of quantification was 20 pmol/L (1.2 fmol on column). Inter- and intra-assay comparison showed coefficients of variation and bias between measured and nominal concentrations of less than 11%. Mean recovery was 91%. Interference with a large set of natural and synthetic steroids was excluded. The assay was successfully applied to measure progesterone variation during the menstrual cycle ( n = 9) and diurnal variations during luteal phase ( n = 7) in regularly cycling women. Discussion We present a novel LC-MS/MS assay for the determination of salivary progesterone with high-throughput potential. The applicability of the assay for progesterone profiling during the menstrual cycle is demonstrated.
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Affiliation(s)
- Lina Schiffer
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Joanne E Adaway
- Biochemistry Department, Wythenshawe Hospital, Manchester University NHS Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Elizabeth S Baranowski
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Wiebke Arlt
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Brian G Keevil
- Biochemistry Department, Wythenshawe Hospital, Manchester University NHS Trust, Manchester Academic Health Sciences Centre, Manchester, UK
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Comparison of intramuscular progesterone with oral nifedipine for treating threatened preterm labor: A randomized controlled trial. Med J Islam Repub Iran 2017; 31:56. [PMID: 29445685 PMCID: PMC5804454 DOI: 10.14196/mjiri.31.56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Indexed: 01/18/2023] Open
Abstract
Background: Threatened preterm labor (TPL) is the leading cause of hospitalization during pregnancy. Tocolytic agents are the
primary therapeutic options for TPL. The aim of this study is to compare intramuscular progesterone with oral nifedipine as a tocolytic
agent.
Methods: This randomized controlled trial was carried out in a teaching hospital (Shahid Akbarabadi) in Tehran, Iran, from December
2011 to November 2012. Three hundred and fifteen singleton pregnant women aged >18 yrs at 26-34 weeks’ gestation with the diagnosis
of threatened preterm labor (TPL) were randomly received either intramuscular progesterone or oral nifedipine for tocolysis. Maternal
and neonatal outcomes were then compared between the two interventions. P value less than 0.05 was considered statistically significant.
IRCT registration number of this study is IRCT201112198469N1
Results: The success rate of progesterone and nifedipine in treating TPL were 83% and 82.7%, respectively. There was no significant
difference between the two interventions with regard to gestational age at delivery, type of delivery, the time interval until the delivery,
birth weight, NICU admission rate and hospital stays. Progesterone administration was associated with lower duration of NICU stay as
compared with nifedipine (0.33±0.77 days vs.1.5±3.2 days, p<0.05). None of the two drugs caused any major side effects.
Conclusion: Single dose intramuscular progesterone is as effective as oral nifedipine in treating TPL. It also significantly reduces the
NICU stay.
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Langmia IM, Apalasamy YD, Omar SZ, Mohamed Z. Progesterone Receptor (PGR) gene polymorphism is associated with susceptibility to preterm birth. BMC MEDICAL GENETICS 2015; 16:63. [PMID: 26286601 PMCID: PMC4593226 DOI: 10.1186/s12881-015-0202-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 07/14/2015] [Indexed: 01/27/2023]
Abstract
BACKGROUND Preterm birth (PTB) is the major cause of death in newborn and the second major cause of death in children less than 5 years old worldwide. Genetic polymorphism has been implicated as a factor for the occurrence of preterm birth. The aim of this study is to evaluate whether polymorphism in the progesterone receptor (PGR) is associated with susceptibility to preterm birth. METHODS A total of 135 women with preterm and 532 women with term deliveries were genotyped for PGR gene polymorphisms (rs660149, rs471767, rs10895068) using Sequenom MassARRAY platform. RESULTS The G allele of PGR rs660149 polymorphism was significantly associated with susceptibility to PTB in the Malay women. The odds of G allele occurring among Malay women with preterm delivery was twice that of Malay women with term delivery (OR 2.3, 95 % CI (1.2-4.5, P = 0.011). Alternatively, no significant association was observed between PGR rs660149 polymorphisms and susceptibility to PTB in Chinese and Indian women. CONCLUSIONS This study shows that variability in the occurrence of PTB across ethnicities in Malaysia is partly due to differences in genetic background. We therefore suggest that in addition to life style and environmental factors, genetic factor should be greatly considered in this population. Prior information on the genetic composition of women may help in the identification and management of women at risk of preterm birth complication.
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Affiliation(s)
- Immaculate Mbongo Langmia
- Department of Pharmacology, Pharmacogenomics Laboratory, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Yamunah Devi Apalasamy
- Department of Pharmacology, Pharmacogenomics Laboratory, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Siti Zawaih Omar
- Department of Obstetrics and Gynecology, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Zahurin Mohamed
- Department of Pharmacology, Pharmacogenomics Laboratory, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Carvajal JA. Docosahexaenoic acid supplementation early in pregnancy may prevent deep placentation disorders. BIOMED RESEARCH INTERNATIONAL 2014; 2014:526895. [PMID: 25019084 PMCID: PMC4082939 DOI: 10.1155/2014/526895] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 06/03/2014] [Indexed: 11/26/2022]
Abstract
Uteroplacental ischemia may cause preterm birth, either due to preterm labor, preterm premature rupture of membranes, or medical indication (in the presence of preeclampsia or fetal growth restriction). Uteroplacental ischemia is the product of defective deep placentation, a failure of invasion, and transformation of the spiral arteries by the trophoblast. The failure of normal placentation generates a series of clinical abnormalities nowadays called "deep placentation disorders"; they include preeclampsia, fetal growth restriction, preterm labor, preterm premature rupture of membranes, in utero fetal death, and placental abruption. Early reports suggested that a LC-PUFAs (long chain polyunsaturated fatty acids) rich diet reduces the incidence of deep placentation disorders. Recent randomized controlled trials are inconsistent to show the benefit of docosahexaenoic acid (DHA) supplementation during pregnancy to prevent deep placentation disorders, but most of them showed that DHA supplementation was associated with lower risk of early preterm birth. We postulate that DHA supplementation, early in pregnancy, may reduce the incidence of deep placentation disorders. If our hypothesis is correct, DHA supplementation, early in pregnancy, will become a safe and effective strategy for primary prevention of highly relevant pregnancy diseases, such as preterm birth, preeclampsia, and fetal growth restriction.
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Affiliation(s)
- Jorge A. Carvajal
- Unidad de Medicina Materno Fetal, División de Obstetricia y Ginecología, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, 8330024 Santiago, Chile
- Centro de Investigaciones Médicas, Pontificia Universidad Católica de Chile, Marcoleta 391, 8330024 Santiago, Chile
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Abstract
PURPOSE OF REVIEW In spite of the advances made in the management of pregnancies in women with systemic lupus erythematosus (SLE), maternal complications and adverse fetal outcomes still exceed the rate of pregnancy complications in the general population. An intriguing question relates to the observation that pregnancy loss, intrauterine growth restriction (IUGR), preterm birth, and preeclampsia remain major complications in SLE pregnancies, not substantially altered by improved therapy and monitoring. RECENT FINDINGS From the review of the recent literature on the pathogenesis of pregnancy loss, IUGR, preeclampsia, and prematurity, it appears that clinical or subclinical inflammation, presence of autoantibodies, hormonal dysfunction, and immune alterations of lupus contribute to pregnancy complications. Impairment of early placenta development leads to poor vascularization, resulting in placental ischemia and subsequent endothelial damage. Depending on the extent of the pathological process, pregnancy loss, IUGR, and preeclampsia can develop. SUMMARY Early recognition of pregnancy complications is desirable in order to prevent their development or to prompt intervention that improves the outcomes. Several biomarkers have been investigated for their ability to predict complications at an early stage of pregnancy. However, up to date only lupus anticoagulant has emerged as a consistent predictor for adverse pregnancy outcomes.
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Vejrazkova D, Vcelak J, Vankova M, Lukasova P, Bradnova O, Halkova T, Kancheva R, Bendlova B. Steroids and insulin resistance in pregnancy. J Steroid Biochem Mol Biol 2014. [PMID: 23202146 DOI: 10.1016/j.jsbmb.2012.11.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Metabolism of glucose during pregnancy reflects the equilibrium between lactogenic hormones stimulating insulin production and counterregulatory hormones inducing insulin resistance. In physiological pregnancies, insulin-mediated glucose uptake is substantially decreased and insulin secretion increased to maintain euglycemia. This common state of peripheral insulin resistance arises also due to steroid spectra changes. In this review article, we have focused on the role of steroid hormones (androgens, estrogens, gestagens, mineralocorticoids, glucocorticoids, as well as secosteroid vitamin D) in the impairment of glucose tolerance in pregnancy and in the pathogenesis of gestational diabetes mellitus. This article is part of a Special Issue entitled 'Pregnancy and Steroids'.
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