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Yin Y, Xie S, Xu Q, Liao L, Chen H, Zhou R. Circulating chemerin levels in preeclampsia: a systematic review and meta-analysis. Lipids Health Dis 2023; 22:179. [PMID: 37864182 PMCID: PMC10588206 DOI: 10.1186/s12944-023-01941-w] [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: 08/04/2023] [Accepted: 10/13/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Preeclampsia (PE) is a new-onset pregnancy-specific disorder with a high prevalence that leads to over 70 000 maternal and 500 000 foetal fatalities worldwide each year. The level of chemerin, a newly identified adipokine, is increased in diabetic and obese patients. Currently, there are several studies describing the relationship between maternal circulating chemerin levels and PE. Therefore, this study aimed to assess their association in pooled samples. METHODS Four databases were systematically searched to identify potential studies that reported circulating chemerin levels in PE and normal pregnancy groups. Standardized mean differences (SMDs), 95% confidence intervals (CIs), and 95% prediction intervals (PIs) were calculated using a random-effects meta-analysis. The probability of heterogeneity was also investigated by sensitivity analysis, subgroup analysis, and meta-regression. RESULTS Thirteen studies in 11 articles with a total of 860 PE patients and 1309 women with normal pregnancies met the inclusion criteria. The results of the meta-analysis revealed that circulating chemerin, which levels in PE patients were considerably higher than those in controls (SMD = 1.39, 95% CI: 1.02, 1.77, 95% PI: -0.07, 2.86). Moreover, sensitivity analysis determined that the outcomes of the overall pooled results were not affected after the elimination of any study. Notably, subgroup analysis demonstrated a similar expression pattern irrespective of geographic location, severity, timing of sampling, and sample size. Last, there were no factors that significantly impacted the overall estimate, according to meta-regression. CONCLUSIONS This meta-analysis is the first to assess circulating chemerin levels in PE patients. The findings indicate that circulating chemerin levels may be a potential marker to diagnose PE.
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Affiliation(s)
- Yangxue Yin
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, No. 20, section 3, Renmin South Road, Wuhou District, Chengdu, Sichuan, 610041, China
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, China
| | - Shuangshuang Xie
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, No. 20, section 3, Renmin South Road, Wuhou District, Chengdu, Sichuan, 610041, China
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, China
| | - Qin Xu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, No. 20, section 3, Renmin South Road, Wuhou District, Chengdu, Sichuan, 610041, China
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, China
| | - Lingyun Liao
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, No. 20, section 3, Renmin South Road, Wuhou District, Chengdu, Sichuan, 610041, China
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, China
| | - Hongqin Chen
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, No. 20, section 3, Renmin South Road, Wuhou District, Chengdu, Sichuan, 610041, China
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, China
| | - Rong Zhou
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, No. 20, section 3, Renmin South Road, Wuhou District, Chengdu, Sichuan, 610041, China.
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, China.
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Medina G, González-Cortés FR, Sánchez-González A, Vázquez-Rodríguez JG, Ordoñez-González I, Jiménez-Arellano MP, García-Collinot G, Morales-Montalvo SI, Florez-Durante OI, Cruz-Domínguez MP, Colorado-Cruz MF, Zurita-Muñoz MA, Cruz-Arteaga G, Sánchez-Enriquez C, Jara LJ, Saavedra MÁ. The prognostic value of neutrophile/lymphocyte ratio and serum chemerin to predict maternal-fetal complications in pregnant systemic lupus erythematosus patients. Lupus 2023; 32:1409-1417. [PMID: 37840528 DOI: 10.1177/09612033231206446] [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] [Indexed: 10/17/2023]
Abstract
BACKGROUND Pregnancy in SLE continues to be a challenge. The neutrophil-to-lymphocyte ratio (NLR) and chemerin are predictors of preeclampsia in the general population; however, their role as predictors of maternal-fetal complications in pregnant SLE patients has not been analyzed. OBJECTIVE To investigate the prognostic value of NLR and serum chemerin, to predict maternal-fetal complications in pregnant SLE patients, and compare both biomarkers among three study groups. METHODS Design: Analytical cross-sectional study of cases and controls with the following study groups: systemic lupus erythematosus (SLE), preeclampsia, and healthy. NLR and chemerin serum were determined between 20 and 25 weeks of gestation. Patients were evaluated every 4-6 weeks until pregnancy resolution. Maternal and fetal outcomes were registered. We employed Receiver Operating Characteristic (ROC) curves to validate prognostic values. RESULTS Seventy pregnant patients were included: 20 with SLE, 20 with preeclampsia, and 30 healthy pregnant women; NLR values were 4 (2.3-5.6) in SLE, 6 (4.6-9.2) in preeclampsia, and 2.8 (2.1-2.9) in the group of healthy women (p = .0001). Chemerin levels were: 26 (15.3-56.2) in SLE, 96 (37.3-146.2) in preeclampsia, and 24.6 ng/mL (15.3-47.4) in the healthy group (p = .007) Maternal complications were observed in 11 (55%), 20 (100%), and 8 (26%) per group, respectively. Thrombocytopenia was the most frequent complication in all pregnant women, followed by hypertensive disorders. Fetal complications were registered in 12 (60%), 16 (80%), and 2 (6.7%), respectively. Congenital malformations and prematurity were the most frequent fetal complications. NLR had good diagnostic accuracy in predicting maternal-fetal complications (AUROC 0.715) p = .015, CI 95% 0.56-0.86, cut-off point level: 2.9, sensitivity 61%, specificity 78%, positive predictive value (PPV) 65%, negative predictive value (NPV) 75%. Regarding chemerin, a cut-off point level >43 ng/mL had a sensitivity of 75%, specificity of 72% AUROC 0.75, p = .001, CI 95% 0.61-0.89, PPV 51.7% NPV 87.8%, meaning that 51.7% of patients with chemerin levels >43 ng/mL have or will have preeclampsia. CONCLUSION The NLR may help predict maternal-fetal complications in SLE pregnancy, constituting a marker of subclinical inflammation. Chemerin levels may be associated with preeclampsia. These biomarkers could improve the care of SLE patients with timely intervention of potential complications during pregnancy.
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Affiliation(s)
- Gabriela Medina
- Translational Research Unit, Hospital de Especialidades Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Antonio Sánchez-González
- Rheumatology Department, Hospital de Especialidades Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Juan G Vázquez-Rodríguez
- Intensive Care Unit, Hospital de Gineco-Obstetricia No. 3, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - María P Jiménez-Arellano
- Hospital de Gineco-Obstetricia No. 3, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Grettel García-Collinot
- Hospital de Gineco-Obstetricia No. 3, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Oscar I Florez-Durante
- Translational Research Unit, Hospital de Especialidades Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - María P Cruz-Domínguez
- Universidad Nacional Autónoma de México, Mexico City, Mexico
- Direction of Education and Research, Hospital de Especialidades Centro Médico Nacional La Raza "Dr Antonio Fraga Mouret," Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Miguel A Zurita-Muñoz
- Unidad de Medicina Familiar No. 20, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Gilberto Cruz-Arteaga
- Unidad de Medicina Familiar No. 20, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Luis J Jara
- Division of Rheumatology, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Miguel Á Saavedra
- Research Division, Instituto Mexicano del Seguro Social, Hospital de Especialidades Centro Médico Nacional La Raza, Mexico City, Mexico
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Tan L, Lu X, Danser AHJ, Verdonk K. The Role of Chemerin in Metabolic and Cardiovascular Disease: A Literature Review of Its Physiology and Pathology from a Nutritional Perspective. Nutrients 2023; 15:2878. [PMID: 37447205 DOI: 10.3390/nu15132878] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Chemerin is a novel adipokine that plays a major role in adipogenesis and lipid metabolism. It also induces inflammation and affects insulin signaling, steroidogenesis and thermogenesis. Consequently, it likely contributes to a variety of metabolic and cardiovascular diseases, including atherosclerosis, diabetes, hypertension and pre-eclampsia. This review describes its origin and receptors, as well as its role in various diseases, and subsequently summarizes how nutrition affects its levels. It concludes that vitamin A, fat, glucose and alcohol generally upregulate chemerin, while omega-3, salt and vitamin D suppress it. Dietary measures rather than drugs acting as chemerin receptor antagonists might become a novel tool to suppress chemerin effects, thereby potentially improving the aforementioned diseases. However, more detailed studies are required to fully understand chemerin regulation.
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Affiliation(s)
- Lunbo Tan
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC, 3015 CN Rotterdam, The Netherlands
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Xifeng Lu
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - A H Jan Danser
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC, 3015 CN Rotterdam, The Netherlands
| | - Koen Verdonk
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC, 3015 CN Rotterdam, The Netherlands
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Kabbani N, Blüher M, Stepan H, Stumvoll M, Ebert T, Tönjes A, Schrey-Petersen S. Adipokines in Pregnancy: A Systematic Review of Clinical Data. Biomedicines 2023; 11:biomedicines11051419. [PMID: 37239090 DOI: 10.3390/biomedicines11051419] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/29/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Adipokines are signaling proteins involved in metabolic, endocrinological, vascular and immunogenic processes. Associations of various adipokines with not only insulin resistance but also with increased insulin sensitivity, increased systolic blood pressure, and atherosclerosis highlight the significance of adipokines in several components of metabolic syndrome and metabolic diseases in general. As pregnancy presents a unique metabolic state, the role of adipokines in pregnancy, and even in various pregnancy complications, appears to be key to elucidating these metabolic processes. Many studies in recent years have attempted to clarify the role of adipokines in pregnancy and gestational pathologies. In this review, we aim to investigate the changes in maternal adipokine levels in physiological gestation, as well as the association of adipokines with pregnancy pathologies, such as gestational diabetes mellitus (GDM) and preeclampsia (PE). Furthermore, we will analyze the association of adipokines in both maternal serum and cord blood with parameters of intrauterine growth and various pregnancy outcomes.
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Affiliation(s)
- Noura Kabbani
- Department of Obstetrics, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Matthias Blüher
- Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, 04103 Leipzig, Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München, The University of Leipzig and University Hospital Leipzig, 04103 Leipzig, Germany
| | - Holger Stepan
- Department of Obstetrics, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Michael Stumvoll
- Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Thomas Ebert
- Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Anke Tönjes
- Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, 04103 Leipzig, Germany
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Pankiewicz K, Issat T. Understanding the Role of Chemerin in the Pathophysiology of Pre-Eclampsia. Antioxidants (Basel) 2023; 12:antiox12040830. [PMID: 37107205 PMCID: PMC10135338 DOI: 10.3390/antiox12040830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023] Open
Abstract
Chemerin is a multifaceted adipokine that is involved in multiple biological processes, including inflammation, angiogenesis, adipogenesis, and energy metabolism, as well as oxidative stress. There is a vast body of evidence for a crucial role of chemerin in the development of different cardiovascular diseases. Blood chemerin levels, as well as its placental expression, are elevated in patients with pre-eclampsia (PE) and correlate positively with the severity of the disease. This narrative review summarizes the current knowledge about the potential role of chemerin during PE development, with a particular focus on its involvement in oxidative stress and endothelial dysfunction.
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6
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Chen Y, Wu L, Liu H, Li Z, Li L, Wu X, Lei Q, Yin A, Tong J, Liu K, Guan X, Zeng C, Zhang H, Wan Y, Huang X, Huang P, Yang Q, Zhou X, Niu J. Third-Trimester Maternal Serum Chemerin and Hypertension After Preeclampsia: A Prospective Cohort Study. J Am Heart Assoc 2023; 12:e027930. [PMID: 36847060 PMCID: PMC10111437 DOI: 10.1161/jaha.122.027930] [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] [Indexed: 03/01/2023]
Abstract
Background Limited data are available for postpartum hypertension prediction after preeclampsia. Methods and Results We examined the association between maternal serum chemerin levels in patients with preeclampsia and blood pressure (BP) levels after delivery in a prospective birth cohort of 15 041 singleton pregnant women. A total of 310 cases among 322 patients with preeclampsia (follow-up rate, 96.3%) were followed up during a mean 2.8 years after delivery. Compared with matched uncomplicated controls (n=310), serum chemerin measured at ≈35 gestational weeks was significantly increased in preeclampsia (171.8±49.2 versus 140.2±53.5 ng/mL; P<0.01) and positively correlated with the occurrence of postpartum hypertension, defined as either BP ≥130/80 mm Hg (per 1-SD increase: odds ratio [OR], 4.01 [95% CI, 2.77-5.81]) or as BP ≥140/90 mm Hg (per 1-SD increase: OR, 1.70 [95% CI, 1.28-2.25]) in patients with preeclampsia. The addition of chemerin levels improved the predictive performance of the clinical variable-derived prediction models for postpartum hypertension (for BP ≥130/80 mm Hg: area under the curve, 0.903 [95% CI, 0.869-0.937], Δ area under the curve, 0.070, P<0.001; for BP ≥140/90 mm Hg: area under the curve, 0.852 [95% CI, 0.803-0.902], Δ area under the curve, 0.030, P=0.002). The decision curve analysis revealed a net benefit of the chemerin-based prediction model for postpartum BP ≥130/80 mm Hg. Conclusions This study provides the first evidence supporting the independent predictive role of third-trimester maternal chemerin levels for postpartum hypertension after preeclampsia. Future study is warranted for external validation of this finding.
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Affiliation(s)
- Yixuan Chen
- Department of Obstetrics Shenzhen Maternity and Child Healthcare Hospital Shenzhen Guangdong China.,The First School of Clinical Medicine Southern Medical University Shenzhen Guangdong China
| | - Linlin Wu
- Department of Obstetrics and Gynecology, the Eighth Affiliated Hospital Sun Yat-sen University Shenzhen Guangdong China
| | - Hangkuan Liu
- Department of Cardiology Tianjin Medical University General Hospital Tianjin China
| | - Ziping Li
- Department of Cardiology Tianjin Medical University General Hospital Tianjin China
| | - Linjie Li
- Department of Cardiology Tianjin Medical University General Hospital Tianjin China
| | - Xiaoxia Wu
- Department of Obstetrics Shenzhen Maternity and Child Healthcare Hospital Shenzhen Guangdong China
| | - Qiong Lei
- Department of Obstetrics and Gynecology, the Eighth Affiliated Hospital Sun Yat-sen University Shenzhen Guangdong China
| | - Aiqi Yin
- Department of Obstetrics Shenzhen Maternity and Child Healthcare Hospital Shenzhen Guangdong China.,The First School of Clinical Medicine Southern Medical University Shenzhen Guangdong China
| | - Jianing Tong
- Department of Obstetrics and Gynecology, the Eighth Affiliated Hospital Sun Yat-sen University Shenzhen Guangdong China
| | - Kan Liu
- Department of Obstetrics Shenzhen Maternity and Child Healthcare Hospital Shenzhen Guangdong China.,The First School of Clinical Medicine Southern Medical University Shenzhen Guangdong China
| | - Xiaonian Guan
- Department of Obstetrics Shenzhen Maternity and Child Healthcare Hospital Shenzhen Guangdong China.,The First School of Clinical Medicine Southern Medical University Shenzhen Guangdong China
| | - Cuiping Zeng
- Department of Obstetrics and Gynecology, the Eighth Affiliated Hospital Sun Yat-sen University Shenzhen Guangdong China
| | - Huafan Zhang
- Department of Obstetrics Shenzhen Maternity and Child Healthcare Hospital Shenzhen Guangdong China.,The First School of Clinical Medicine Southern Medical University Shenzhen Guangdong China
| | - Yanmei Wan
- Department of Obstetrics Shenzhen Maternity and Child Healthcare Hospital Shenzhen Guangdong China.,The First School of Clinical Medicine Southern Medical University Shenzhen Guangdong China
| | - Xuna Huang
- Department of Obstetrics Shenzhen Maternity and Child Healthcare Hospital Shenzhen Guangdong China.,The First School of Clinical Medicine Southern Medical University Shenzhen Guangdong China
| | - Pingping Huang
- Department of Obstetrics and Gynecology, the Eighth Affiliated Hospital Sun Yat-sen University Shenzhen Guangdong China
| | - Qing Yang
- Department of Cardiology Tianjin Medical University General Hospital Tianjin China
| | - Xin Zhou
- Department of Cardiology Tianjin Medical University General Hospital Tianjin China
| | - Jianmin Niu
- Department of Obstetrics Shenzhen Maternity and Child Healthcare Hospital Shenzhen Guangdong China.,The First School of Clinical Medicine Southern Medical University Shenzhen Guangdong China
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7
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Yu M, Yang Y, Huang C, Ge L, Xue L, Xiao Z, Xiao T, Zhao H, Ren P, Zhang JV. Chemerin: A Functional Adipokine in Reproductive Health and Diseases. Biomedicines 2022; 10:biomedicines10081910. [PMID: 36009457 PMCID: PMC9406010 DOI: 10.3390/biomedicines10081910] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 11/30/2022] Open
Abstract
As a multifaceted adipokine, chemerin has been found to perform functions vital for immunity, adiposity, and metabolism through its three known receptors (chemokine-like receptor 1, CMKLR1; G-protein-coupled receptor 1, GPR1; C-C motif chemokine receptor-like 2, CCRL2). Chemerin and the cognate receptors are also expressed in the hypothalamus, pituitary gland, testis, ovary, and placenta. Accumulating studies suggest that chemerin participates in normal reproduction and underlies the pathological mechanisms of certain reproductive system diseases, including polycystic ovary syndrome (PCOS), preeclampsia, and breast cancer. Herein, we present a comprehensive review of the roles of the chemerin system in multiple reproductive processes and human reproductive diseases, with a brief discussion and perspectives on future clinical applications.
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Affiliation(s)
- Ming Yu
- Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Key Laboratory of Metabolic Health, Shenzhen 518055, China
| | - Yali Yang
- Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Key Laboratory of Metabolic Health, Shenzhen 518055, China
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen 518055, China
| | - Chen Huang
- Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Key Laboratory of Metabolic Health, Shenzhen 518055, China
| | - Lei Ge
- Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Key Laboratory of Metabolic Health, Shenzhen 518055, China
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen 518055, China
| | - Li Xue
- Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Key Laboratory of Metabolic Health, Shenzhen 518055, China
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen 518055, China
| | - Zhonglin Xiao
- Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Key Laboratory of Metabolic Health, Shenzhen 518055, China
| | - Tianxia Xiao
- Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Key Laboratory of Metabolic Health, Shenzhen 518055, China
| | - Huashan Zhao
- Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Key Laboratory of Metabolic Health, Shenzhen 518055, China
| | - Peigen Ren
- Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Key Laboratory of Metabolic Health, Shenzhen 518055, China
| | - Jian V. Zhang
- Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Key Laboratory of Metabolic Health, Shenzhen 518055, China
- Correspondence:
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Zhang Q, Xiao Z, Lee CL, Duan YG, Fan X, Yeung WSB, Chiu PCN, Zhang JV. The Regulatory Roles of Chemerin-Chemokine-Like Receptor 1 Axis in Placental Development and Vascular Remodeling During Early Pregnancy. Front Cell Dev Biol 2022; 10:883636. [PMID: 35656551 PMCID: PMC9152263 DOI: 10.3389/fcell.2022.883636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Chemerin is an adipokine that regulates metabolism in pregnancy. An elevation of serum chemerin level is associated with pregnancy complications. Consistently, we demonstrated that the chemerin expression was increased in placenta of preeclamptic patients at deliveries. The G protein-coupled receptor chemokine-like receptor 1 (CMKLR1) mediates the actions of chemerin. The functions of the chemerin-CMKLR1 axis in maintaining pregnancy are still unknown. In this study, we demonstrated that CMKLR1 was expressed in the decidual natural killer (dNK) cells and chorionic villi of human. Chemerin suppressed the proliferation of the dNK cells in vitro. Specific antagonist of CMKLR1, α-Neta abolished the suppressive effect of spent medium from chemerin-treated dNK cells culture on extravillous trophoblast invasion. Activation of the chemerin-CMKLR1 axis promoted fusion and differentiation of human cytotrophoblast to syncytiotrophoblast in vitro. We generated Cmklr1 knockout mice and showed that the Cmklr1 deficiency negatively affected pregnancy outcome in terms of number of implantation sites, litter size and fetal weight at birth. Histologically, the Cmklr1 deficiency impaired formation of the syncytiotrophoblast layer II, induced enlargement of the maternal lacunae in the labyrinth, increased the diameter of the spiral arteries and increased trophoblast invasion in the decidua. The Cmklr1 deficient placenta also displayed an increased number of dNK cells and serum IL-15 level. In summary, the chemerin-CMKLR1 axis regulated placental development and spiral artery remodeling in early pregnancy.
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Affiliation(s)
- Qingqing Zhang
- Shenzhen Key Laboratory of Fertility Regulation, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Obstetrics and Gynecology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Zhonglin Xiao
- Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Cheuk-Lun Lee
- Shenzhen Key Laboratory of Fertility Regulation, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Obstetrics and Gynecology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yong-Gang Duan
- Department of Obstetrics and Gynecology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Xiujun Fan
- Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - William S. B. Yeung
- Shenzhen Key Laboratory of Fertility Regulation, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Obstetrics and Gynecology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Philip C. N. Chiu
- Shenzhen Key Laboratory of Fertility Regulation, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Obstetrics and Gynecology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: Philip C. N. Chiu, ; Jian V. Zhang,
| | - Jian V. Zhang
- Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen Key Laboratory of Metabolic Health, Shenzhen, China
- *Correspondence: Philip C. N. Chiu, ; Jian V. Zhang,
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Placental Trophoblast Specific Overexpression of Chemerin Induces Preeclampsia-like Symptoms. Clin Sci (Lond) 2022; 136:257-272. [PMID: 35103285 PMCID: PMC8844909 DOI: 10.1042/cs20210989] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 11/17/2022]
Abstract
Maternal circulating levels of the adipokine chemerin are elevated in preeclampsia, but its origin and contribution to preeclampsia remain unknown. We therefore studied 1) placental chemerin expression and release in human pregnancy, and 2) the consequences of chemerin overexpression via lentivirus-mediated trophoblast-specific gene manipulation in both mice and immortalized human trophoblast. Placental chemerin expression and release were increased in women with preeclampsia, and their circulating chemerin levels correlated positively with the soluble Fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor ratio, a well-known biomarker of preeclampsia severity. Placental trophoblast chemerin overexpression in mice induced a preeclampsia-like syndrome, involving hypertension, proteinuria, and endotheliosis, combined with diminished trophoblast invasion, a disorganized labyrinth layer, and upregulation of sFlt-1 and the inflammation markers nuclear factor-kappa B, tumor necrosis factor-α and interleukin-1β. It also led to embryo resorption, while maternal serum chemerin levels correlated negatively with fetal weight in mice. Chemerin overexpression in human trophoblasts upregulated sFlt-1, reduced vascular endothelial factor-A, and inhibited migration and invasion, as well as tube formation during co-culture with human umbilical vein endothelial cells. The chemokine-like receptor 1 (CMKLR1) antagonist α-NETA prevented the latter phenomena, although it did not reverse the chemerin-induced downregulation of the phosphoinositide 3-kinase/Akt pathway. In conclusion, upregulation of placental chemerin synthesis disturbs normal placental development via its CMKLR1 receptor, thereby contributing to fetal growth restriction/resorption and the development of preeclampsia. Chemerin might be a novel biomarker of preeclampsia, and inhibition of the chemerin/CMKLR1 pathway is a promising novel therapeutic strategy to treat preeclampsia.
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Quan XZ, Ye JH, Yang XZ, Xie Y. HOXA9-induced chemerin signals through CMKLR1/AMPK/TXNIP/NLRP3 pathway to induce pyroptosis of trophoblasts and aggravate preeclampsia. Exp Cell Res 2021; 408:112802. [PMID: 34461109 DOI: 10.1016/j.yexcr.2021.112802] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/18/2021] [Accepted: 08/22/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Up-regulated chemerin correlates with the risk and the severity of preeclampsia. In this study, we examined impacts and underlying mechanisms by which chemerin regulates pyroptosis and trophoblast inflammation. METHODS An in vivo preeclampsia model was established in rats and trophoblasts challenged with hypoxia/reoxygenation (H/R) with or without exogenous chemerin were used as the in vitro model. Expressions of homeobox A9 (HOXA9), chemerin, chemerin receptor (the chemokine-like receptor 1 (CMKLR1)), activated AMP-activated protein kinase (AMPK), thioredoxin-interacting protein (TXNIP), and markers related to NOD-like receptor pyrin-containing receptor 3 (NLRP3) inflammasome were examined by Western blot, and in response to AMPK inhibitor, targeting CMKLR1 or HOXA9. Cell viability and death were examined by CCK-8 and Hoechst staining, respectively. Productions of IL-1β and IL-18 in serum or culture medium were measured by ELISA. Transcriptional regulation of HOXA9 on chemerin was examined by combining expressional analysis, chromatin immunoprecipitation, and luciferase reporter assays. RESULTS Up-regulations of HOXA9, chemerin, CMKLR1, TXNIP, and NLRP3 inflammasome were observed in both in vivo and in vitro models of preeclampsia, which were associated with increased death of trophoblasts and productions of IL-1β and IL-18. CMKLR1 and activated-AMPK essentially mediated chemerin effects in trophoblasts. HOXA9 directly activated the transcription of chemerin. CONCLUSIONS HOXA9 directly activates the transcription of chemerin, which, by activating the AMPK/TXNIP/NLRP3 inflammasome, promotes pyroptosis and inflammation of trophoblasts, and contributes to preeclampsia. Therefore, targeting chemerin signaling may benefit the prevention and/or treatment of preeclampsia.
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Affiliation(s)
- Xiao-Zhen Quan
- Department of Reproductive Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441021, Hubei Province, PR China
| | - Jin-Hai Ye
- Department of Reproductive Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441021, Hubei Province, PR China
| | - Xue-Zhou Yang
- Department of Reproductive Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441021, Hubei Province, PR China.
| | - Yue Xie
- Department of Reproductive Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441021, Hubei Province, PR China.
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Bogdanet D, Reddin C, Murphy D, Doheny HC, Halperin JA, Dunne F, O’Shea PM. Emerging Protein Biomarkers for the Diagnosis or Prediction of Gestational Diabetes-A Scoping Review. J Clin Med 2021; 10:jcm10071533. [PMID: 33917484 PMCID: PMC8038821 DOI: 10.3390/jcm10071533] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/02/2021] [Accepted: 04/02/2021] [Indexed: 02/06/2023] Open
Abstract
Introduction: Gestational diabetes (GDM), defined as hyperglycemia with onset or initial recognition during pregnancy, has a rising prevalence paralleling the rise in type 2 diabetes (T2DM) and obesity. GDM is associated with short-term and long-term consequences for both mother and child. Therefore, it is crucial we efficiently identify all cases and initiate early treatment, reducing fetal exposure to hyperglycemia and reducing GDM-related adverse pregnancy outcomes. For this reason, GDM screening is recommended as part of routine pregnancy care. The current screening method, the oral glucose tolerance test (OGTT), is a lengthy, cumbersome and inconvenient test with poor reproducibility. Newer biomarkers that do not necessitate a fasting sample are needed for the prompt diagnosis of GDM. The aim of this scoping review is to highlight and describe emerging protein biomarkers that fulfill these requirements for the diagnosis of GDM. Materials and Methods: This scoping review was conducted according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines for scoping reviews using Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing & Allied Health Literature (CINAHL), PubMed, Embase and Web of Science with a double screening and extraction process. The search included all articles published in the literature to July 2020. Results: Of the 3519 original database citations identified, 385 were eligible for full-text review. Of these, 332 (86.2%) were included in the scoping review providing a total of 589 biomarkers studied in relation to GDM diagnosis. Given the high number of biomarkers identified, three post hoc criteria were introduced to reduce the items set for discussion: we chose only protein biomarkers with at least five citations in the articles identified by our search and published in the years 2017-2020. When applied, these criteria identified a total of 15 biomarkers, which went forward for review and discussion. Conclusions: This review details protein biomarkers that have been studied to find a suitable test for GDM diagnosis with the potential to replace the OGTT used in current GDM screening protocols. Ongoing research efforts will continue to identify more accurate and practical biomarkers to take GDM screening and diagnosis into the 21st century.
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Affiliation(s)
- Delia Bogdanet
- College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland;
- Centre for Diabetes Endocrinology and Metabolism, Galway University Hospital, Newcastle Road, H91YR71 Galway, Ireland; (C.R.); (D.M.); (H.C.D.); (P.M.O.)
- Correspondence: ; Tel.: +35-38-3102-7771
| | - Catriona Reddin
- Centre for Diabetes Endocrinology and Metabolism, Galway University Hospital, Newcastle Road, H91YR71 Galway, Ireland; (C.R.); (D.M.); (H.C.D.); (P.M.O.)
| | - Dearbhla Murphy
- Centre for Diabetes Endocrinology and Metabolism, Galway University Hospital, Newcastle Road, H91YR71 Galway, Ireland; (C.R.); (D.M.); (H.C.D.); (P.M.O.)
| | - Helen C. Doheny
- Centre for Diabetes Endocrinology and Metabolism, Galway University Hospital, Newcastle Road, H91YR71 Galway, Ireland; (C.R.); (D.M.); (H.C.D.); (P.M.O.)
| | - Jose A. Halperin
- Divisions of Haematology, Brigham & Women’s Hospital, Boston, MA 02115, USA;
| | - Fidelma Dunne
- College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland;
- Centre for Diabetes Endocrinology and Metabolism, Galway University Hospital, Newcastle Road, H91YR71 Galway, Ireland; (C.R.); (D.M.); (H.C.D.); (P.M.O.)
| | - Paula M. O’Shea
- Centre for Diabetes Endocrinology and Metabolism, Galway University Hospital, Newcastle Road, H91YR71 Galway, Ireland; (C.R.); (D.M.); (H.C.D.); (P.M.O.)
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Gutaj P, Sibiak R, Jankowski M, Awdi K, Bryl R, Mozdziak P, Kempisty B, Wender-Ozegowska E. The Role of the Adipokines in the Most Common Gestational Complications. Int J Mol Sci 2020; 21:ijms21249408. [PMID: 33321877 PMCID: PMC7762997 DOI: 10.3390/ijms21249408] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/03/2020] [Accepted: 12/08/2020] [Indexed: 12/12/2022] Open
Abstract
Adipocytokines are hormonally active molecules that are believed to play a key role in the regulation of crucial biological processes in the human body. Numerous experimental studies established significant alterations in the adipokine secretion patterns throughout pregnancy. The exact etiology of various gestational complications, such as gestational diabetes, preeclampsia, and fetal growth abnormalities, needs to be fully elucidated. The discovery of adipokines raised questions about their potential contribution to the molecular pathophysiology of those diseases. Multiple studies analyzed their local mRNA expression and circulating protein levels. However, most studies report conflicting results. Several adipokines such as leptin, resistin, irisin, apelin, chemerin, and omentin were proposed as potential novel early markers of heterogeneous gestational complications. The inclusion of the adipokines in the standard predictive multifactorial models could improve their prognostic values. Nonetheless, their independent diagnostic value is mostly insufficient to be implemented into standard clinical practice. Routine assessments of adipokine levels during pregnancy are not recommended in the management of both normal and complicated pregnancies. Based on the animal models (e.g., apelin and its receptors in the rodent preeclampsia models), future implementation of adipokines and their receptors as new therapeutic targets appears promising but requires further validation in humans.
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Affiliation(s)
- Paweł Gutaj
- Department of Reproduction, Chair of Obstetrics, Gynecology, and Gynecologic Oncology, Poznań University of Medical Sciences, 60-535 Poznan, Poland; (R.S.); (E.W.-O.)
- Correspondence: ; Tel.: +61-854-65-55
| | - Rafał Sibiak
- Department of Reproduction, Chair of Obstetrics, Gynecology, and Gynecologic Oncology, Poznań University of Medical Sciences, 60-535 Poznan, Poland; (R.S.); (E.W.-O.)
- Department of Histology and Embryology, Poznań University of Medical Sciences, 60-781 Poznan, Poland;
| | - Maurycy Jankowski
- Department of Anatomy, Poznań University of Medical Sciences, 60-781 Poznan, Poland; (M.J.); (R.B.)
| | - Karina Awdi
- Student’s Scientific Society, Poznan University of Medical Sciences, 60-806 Poznan, Poland;
| | - Rut Bryl
- Department of Anatomy, Poznań University of Medical Sciences, 60-781 Poznan, Poland; (M.J.); (R.B.)
| | - Paul Mozdziak
- Physiology Graduate Program, North Carolina State University, Raleigh, NC 27695-7608, USA;
| | - Bartosz Kempisty
- Department of Histology and Embryology, Poznań University of Medical Sciences, 60-781 Poznan, Poland;
- Department of Anatomy, Poznań University of Medical Sciences, 60-781 Poznan, Poland; (M.J.); (R.B.)
- Department of Obstetrics and Gynecology, University Hospital, Masaryk University, 625 00 Brno, Czech Republic
- Department of Veterinary Surgery, Institute of Veterinary Medicine, Nicolaus Copernicus University in Toruń, 87-100 Torun, Poland
| | - Ewa Wender-Ozegowska
- Department of Reproduction, Chair of Obstetrics, Gynecology, and Gynecologic Oncology, Poznań University of Medical Sciences, 60-535 Poznan, Poland; (R.S.); (E.W.-O.)
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Daskalakis G, Bellos I, Nikolakea M, Pergialiotis V, Papapanagiotou A, Loutradis D. The role of serum adipokine levels in preeclampsia: A systematic review. Metabolism 2020; 106:154172. [PMID: 32027908 DOI: 10.1016/j.metabol.2020.154172] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 01/27/2020] [Accepted: 02/02/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Preeclampsia represents a major pregnancy complication, associated with high rates of perinatal morbidity. The aim of this systematic review is to accumulate current literature evidence in order to examine the pattern of serum adipokine levels among preeclamptic women and asses their potential efficacy in the prediction of the disease. METHODS Medline, Scopus, CENTRAL, Clinicaltrials.gov and Google Scholar databases were systematically searched from inception. All observational studies reporting serum adipokine values among preeclamptic and healthy pregnant women were held eligible. RESULTS A total of 163 studies were included, comprising 23,482 women. Leptin was evaluated in 91 studies and its values were found to be significantly elevated in preeclamptic women during all pregnancy trimester, independently of disease onset and severity. Preeclampsia was also associated with increased serum fatty acid binding protein-4 and chemerin levels, when measured both during the 1st and 3rd trimester. Data concerning the rest adipokines were either conflicting or limited to reach firm conclusions. Quality of evidence was evaluated to be high for leptin, moderate for serum fatty acid binding protein-4 and chemerin and low for the other adipokines. CONCLUSIONS The existing evidence suggests that preeclampsia is linked to increased levels of leptin, chemerin and fatty acid binding protein-4 in all pregnancy trimesters and forms of the disease. Inconsistent data currently exists concerning the role of the other adipokines. Large-scale prospective studies should longitudinally evaluate the serum concentration of novel adipokines and define the optimal threshold and timing of measurement to be widely applied in clinical practice.
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Affiliation(s)
- Georgios Daskalakis
- First Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Bellos
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Greece.
| | - Melina Nikolakea
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Greece
| | - Vasilios Pergialiotis
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Greece
| | - Angeliki Papapanagiotou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Loutradis
- First Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Nassar SZ, Badae NM. Protective effect of vitamin D supplementation in a rat modal of preeclampsia: a possible implication of chemerin. Hypertens Pregnancy 2019; 38:149-156. [DOI: 10.1080/10641955.2019.1597108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Seham Zakaria Nassar
- Medical Physiology departement, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Noha Mohamed Badae
- Medical Physiology departement, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Abstract
Preeclampsia (PE) is one of the leading causes of maternal morbidity and mortality worldwide. This disease is believed to occur in two stages with placental dysfunction in early pregnancy leading to maternal clinical findings after 20 weeks of gestation, as consequence of systemic inflammation, oxidative stress, and endothelial dysfunction. Much evidence suggests that PE women display an overshooting inflammatory response throughout pregnancy due to an unbalanced regulation of innate and adaptive immune responses. Recently, it has been suggested that dysregulation of endogenous protective pathways might be associated with PE etiopathogenesis. Resolution of inflammation is an active process coordinated by mediators from diverse nature that regulate key cellular events to restore tissue homeostasis. Inadequate or insufficient resolution of inflammation is believed to play an important role in the development of chronic inflammatory diseases, like PE. In this narrative review, we discuss possible pro-resolution pathways that might be compromised in PE women, which could be targets to novel therapeutic strategies in this disease.
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16
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Lurins J, Lurina D, Tretjakovs P, Mackevics V, Lejnieks A, Rapisarda V, Baylon V. Increased serum chemerin level to predict early onset of aortic valve stenosis. Biomed Rep 2017; 8:31-36. [PMID: 29387388 PMCID: PMC5768061 DOI: 10.3892/br.2017.1010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 10/23/2017] [Indexed: 11/29/2022] Open
Abstract
Inflammation appears to be the cause of aortic valve (AoV) stenosis and identification of predictive biomarkers is therefore imperative. The aim of the current study was to evaluate the potential role of serum chemerin and fibroblast growth factor-21 (FGF-21) in the pathogenesis of the disease. A total of 102 patients were selected based on certain criteria and divided into an aortic stenosis group and a control group. Patients with AoV stenosis were subdivided into three groups depending on the severity according to the echocardiography criteria: Aortic jet velocity, Vmax (m/sec); mean pressure gradient, PG (mmHg); aortic valve area (AVA), cm2; and indexed AVA, cm2/m2. Patients were graded as: Severe: Vmax >4 m/sec, PG >40 mmHg, AVA <1.0 cm2, indexed AVA <0.6; moderate: Vmax 3.0–4.0 m/sec, PG 20–40 mmHg, AVA 1.0–1.5 cm2, indexed AVA 0.60–0.85; mild: Vmax 2.5–2.9 m/sec, PG <20 mmHg, AVA >1.5 cm2, indexed AVA >0.85. ELISA was used for the detection of chemerin and FGF-21. Post-hoc analysis with Tukey's correction was performed. The highest chemerin levels were found in mild and moderate AoV stenosis and decreased along with the grade of severity, compared with the control group. The FGF-21 level was increased in all the stenosis groups, reaching the highest level at severe stenosis. Receiver-operating characteristic analysis of chemerin in all the AoV stenosis groups without grading the severity included, area under the curve (AUC)=0.76; 0.70–0.80= fair; P<0.001 and for mild AoV stenosis was AUC=0.82; 0.80–0.90= good; P<0.001. In conclusion, chemerin is a good diagnostic biomarker for mild AoV stenosis, while FGF-21 is a moderate diagnostic marker.
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Affiliation(s)
- Juris Lurins
- Department of Doctoral Studies, Riga Stradins University, Riga, LV 1007, Latvia
| | - Dace Lurina
- Zemgale Health Centre, Jelgava, LV 3001, Latvia
| | - Peteris Tretjakovs
- Faculty of Medicine, Department of Human Physiology and Biochemistry, Riga Stradins University, Riga, LV 1007, Latvia
| | - Vitolds Mackevics
- Faculty of Medicine, Department of Internal Diseases, Riga Stradins University, Riga, LV 1002, Latvia
| | - Aivars Lejnieks
- Faculty of Medicine, Department of Internal Diseases, Riga Stradins University, Riga, LV 1002, Latvia
| | - Venerando Rapisarda
- Department of Clinical and Experimental Medicine, Occupational Medicine, University Hospital 'Policlinico-Vittorio Emanuele', University of Catania, I-95123 Catania, Italy
| | - Vincenzo Baylon
- Newton Lewis Institute-ISR - Life Science Park, San Gwann 3000, Malta
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Montagnana M, Danese E, Lippi G, Fava C. Blood laboratory testing for early prediction of preeclampsia: chasing the finish line or at the starting blocks? Ann Med 2017; 49:240-253. [PMID: 27791388 DOI: 10.1080/07853890.2016.1255350] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Preeclampsia (PE) affects 2-8% of pregnancies worldwide, thus representing an important cause of maternal and neonatal morbidity, up to death. Many studies have been designed to identify putative biomarkers for accurate and timely diagnosing PE, but only some of them were focused on specific and sensitive biomarkers for early prediction of this life-threatening condition. In particular, some prospective studies aimed to investigate the predictive role of circulating biomarkers before 20 weeks of gestation in the general pregnant population yielded conflicting results. This article is hence centered on results obtained in studies investigating the predictive performances of angiogenic, anti-angiogenic, inflammatory, endocrine, and epigenetic biomarkers. The available evidence suggests that angiogenic and anti-angiogenic molecules, in particular the sFlt1:PlGF ratio, may be considered the biomarkers with the best diagnostic performance in the second trimester. However, doubts remain about their use in clinical settings before the 20th gestational week. Even lower evidence is available for other biomarkers, due to the fact that some positive results have not been confirmed in ensuing investigations, whereas unresolved analytical issues still contribute to make their clinical reliability rather questionable. Differential expression of microRNAs seems also a promising evidence for early prediction of PE, but additional research and well-designed prospective studies are needed to identify and validate routine predictive tests. KEY MESSAGES Preeclampsia affects 2-8% of pregnant women worldwide, thus remaining one of the leading causes of maternal and neonatal morbidity and mortality. Several studies have investigated the predictive role of circulating biomarkers before 20th week of gestation with conflicting results. Additional research and well-designed prospective studies are needed to identify and validate predictive tests in clinical practice.
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Affiliation(s)
- Martina Montagnana
- a Sezione di Biochimica Clinica, Dipartimento di Neuroscienze , Biomedicina e Movimento Università di Verona , Italy
| | - Elisa Danese
- a Sezione di Biochimica Clinica, Dipartimento di Neuroscienze , Biomedicina e Movimento Università di Verona , Italy
| | - Giuseppe Lippi
- a Sezione di Biochimica Clinica, Dipartimento di Neuroscienze , Biomedicina e Movimento Università di Verona , Italy
| | - Cristiano Fava
- b Sezione di Medicina Interna C, Dipartimento di Medicina , Università di Verona , Italy
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Kell DB, Kenny LC. A Dormant Microbial Component in the Development of Preeclampsia. Front Med (Lausanne) 2016; 3:60. [PMID: 27965958 PMCID: PMC5126693 DOI: 10.3389/fmed.2016.00060] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 11/04/2016] [Indexed: 12/12/2022] Open
Abstract
Preeclampsia (PE) is a complex, multisystem disorder that remains a leading cause of morbidity and mortality in pregnancy. Four main classes of dysregulation accompany PE and are widely considered to contribute to its severity. These are abnormal trophoblast invasion of the placenta, anti-angiogenic responses, oxidative stress, and inflammation. What is lacking, however, is an explanation of how these themselves are caused. We here develop the unifying idea, and the considerable evidence for it, that the originating cause of PE (and of the four classes of dysregulation) is, in fact, microbial infection, that most such microbes are dormant and hence resist detection by conventional (replication-dependent) microbiology, and that by occasional resuscitation and growth it is they that are responsible for all the observable sequelae, including the continuing, chronic inflammation. In particular, bacterial products such as lipopolysaccharide (LPS), also known as endotoxin, are well known as highly inflammagenic and stimulate an innate (and possibly trained) immune response that exacerbates the inflammation further. The known need of microbes for free iron can explain the iron dysregulation that accompanies PE. We describe the main routes of infection (gut, oral, and urinary tract infection) and the regularly observed presence of microbes in placental and other tissues in PE. Every known proteomic biomarker of "preeclampsia" that we assessed has, in fact, also been shown to be raised in response to infection. An infectious component to PE fulfills the Bradford Hill criteria for ascribing a disease to an environmental cause and suggests a number of treatments, some of which have, in fact, been shown to be successful. PE was classically referred to as endotoxemia or toxemia of pregnancy, and it is ironic that it seems that LPS and other microbial endotoxins really are involved. Overall, the recognition of an infectious component in the etiology of PE mirrors that for ulcers and other diseases that were previously considered to lack one.
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Affiliation(s)
- Douglas B. Kell
- School of Chemistry, The University of Manchester, Manchester, UK
- The Manchester Institute of Biotechnology, The University of Manchester, Manchester, UK
- Centre for Synthetic Biology of Fine and Speciality Chemicals, The University of Manchester, Manchester, UK
- *Correspondence: Douglas B. Kell,
| | - Louise C. Kenny
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
- Department of Obstetrics and Gynecology, University College Cork, Cork, Ireland
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Early Pregnancy Biomarkers in Pre-Eclampsia: A Systematic Review and Meta-Analysis. Int J Mol Sci 2015; 16:23035-56. [PMID: 26404264 PMCID: PMC4613350 DOI: 10.3390/ijms160923035] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 08/30/2015] [Accepted: 09/13/2015] [Indexed: 01/12/2023] Open
Abstract
Pre-eclampsia (PE) complicates 2%–8% of all pregnancies and is an important cause of perinatal morbidity and mortality worldwide. In order to reduce these complications and to develop possible treatment modalities, it is important to identify women at risk of developing PE. The use of biomarkers in early pregnancy would allow appropriate stratification into high and low risk pregnancies for the purpose of defining surveillance in pregnancy and to administer interventions. We used formal methods for a systematic review and meta-analyses to assess the accuracy of all biomarkers that have been evaluated so far during the first and early second trimester of pregnancy to predict PE. We found low predictive values using individual biomarkers which included a disintegrin and metalloprotease 12 (ADAM-12), inhibin-A, pregnancy associated plasma protein A (PAPP-A), placental growth factor (PlGF) and placental protein 13 (PP-13). The pooled sensitivity of all single biomarkers was 0.40 (95% CI 0.39–0.41) at a false positive rate of 10%. The area under the Summary of Receiver Operating Characteristics Curve (SROC) was 0.786 (SE 0.02). When a combination model was used, the predictive value improved to an area under the SROC of 0.893 (SE 0.03). In conclusion, although there are multiple potential biomarkers for PE their efficacy has been inconsistent and comparisons are difficult because of heterogeneity between different studies. Therefore, there is an urgent need for high quality, large-scale multicentre research in biomarkers for PE so that the best predictive marker(s) can be identified in order to improve the management of women destined to develop PE.
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