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Rowson S, Reddy M, De Guingand D, Langston-Cox A, Marshall S, da Silva Costa F, Palmer K. Comparison of circulating total sFLT-1 to placental-specific sFLT-1 e15a in women with suspected preeclampsia. Placenta 2022; 120:73-78. [DOI: 10.1016/j.placenta.2022.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/29/2022] [Accepted: 02/22/2022] [Indexed: 10/19/2022]
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2
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Suzuki T, Inoue T, Igarashi N, Agata C, Okubo A, Nagamatsu T, Iriyama T, Maruyama-Inoue M, Yanagi Y, Kadonosono K, Asaoka R, Azuma K, Obata R. Association between serum soluble fms-like tyrosine kinase-1 and the central choroidal thickness during pregnancy: a prospective study. BMJ Open Ophthalmol 2021; 6:e000888. [PMID: 34796270 PMCID: PMC8573653 DOI: 10.1136/bmjophth-2021-000888] [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: 08/31/2021] [Accepted: 10/23/2021] [Indexed: 11/04/2022] Open
Abstract
Objective To investigate the association between serum soluble fms-like tyrosine kinase-1 (sFlt-1) and the choroidal structure during the pregnancy. Methods and analysis This prospective study enrolled 24 eyes of 12 consecutive healthy pregnant women. Each participant was evaluated during the first, second and third trimester of pregnancy and the postpartum period. The central choroidal thickness (CCT) and Choroidal Vascular Index (CVI) were measured using enhanced depth-imaging optical coherence tomography. Moreover, serum sFlt-1 and vascular endothelial growth factor (VEGF) concentrations were measured manually using ELISA. The association between choroidal structural parameters and serum sFlt-1/VEGF was analysed using a linear mixed model. Results The CCT was significantly thicker in the second and third trimester than the postpartum period (p<0.05). In contrast, there was no significant difference in the CVI throughout pregnancy or the postpartum period. Serum sFlt-1 levels were significantly higher during pregnancy than the postpartum period (p<0.05), whereas the serum VEGF levels were significantly lower during pregnancy than the postpartum period (p<0.05). Furthermore, serum sFlt-1 levels were significantly associated with CCT throughout pregnancy (p=0.011, linear mixed model). On the contrary, sFlt-1 levels was not associated with the CVI during the pregnancy. Conclusion Our results suggest that serum sFlt-1 might have an influence on the choroidal thickness during the pregnancy.
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Affiliation(s)
- Takafumi Suzuki
- Department of Ophthalmology, Shinseikai Toyama Hospital, Imizu-gun, Toyama, Japan.,Department of Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Tatsuya Inoue
- Department of Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan.,Department of Ophthalmology and Micro-Technology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Nozomi Igarashi
- Department of Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Chisato Agata
- Department of Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Atsushi Okubo
- Department of Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Takeshi Nagamatsu
- Department of Obstetrics and Gynecology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Takayuki Iriyama
- Department of Obstetrics and Gynecology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Maiko Maruyama-Inoue
- Department of Ophthalmology and Micro-Technology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yasuo Yanagi
- Department of Ophthalmology and Micro-Technology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kazuaki Kadonosono
- Department of Ophthalmology and Micro-Technology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Keiko Azuma
- Department of Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Ryo Obata
- Department of Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
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3
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Huang L, Cai M, Li L, Zhang X, Xu Y, Xiao J, Huang Q, Luo G, Zeng Z, Jin C, Jin Y, He J, Yang W. Gut microbiota changes in preeclampsia, abnormal placental growth and healthy pregnant women. BMC Microbiol 2021; 21:265. [PMID: 34607559 PMCID: PMC8489045 DOI: 10.1186/s12866-021-02327-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/23/2021] [Indexed: 12/12/2022] Open
Abstract
Background Preeclampsia (PE) is a condition of high blood pressure that is usually concurrent with proteinuria in pregnancy. PE complicates the management of both maternal and fetal health and contributes to most adverse pregnancy outcomes, but the mechanism underlying the development of PE remains unclear. In this study, we performed a case-control study to compare the gut microbiota of PE (n = 26), abnormal placental growth (APG, n = 25) and healthy pregnant women (n = 28) and analyzed the potential pathogenic role of gut microbiota in PE progression. Results The clinical pathophysiological state did not affect the bacterial diversity, while the compositions of the gut microbiota were significantly altered in both the PE and APG groups compared with healthy pregnant women. At the phylum level, TM7 was significantly increased in women with APG. Heterogeneity was observed at the genus level, especially in genera with positive LDA scores, suggesting the stage-dependent effect of gut microbiota on the development of PE. The beneficial bacterium Lactobacillus was markedly depleted in the PE and APG groups but was only correlated with blood pressure (BP) and proteinuria levels in the PE group. Two different bacterial taxa belonged to Lactobacillus showed different correlations (OTU255 and OTU784 were significantly related to PE and APG, respectively). Conclusions Our results indicated that shifts in the gut microbiota might occur from the early stages of the development of PE, which is of possible etiological and therapeutic importance.
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Affiliation(s)
- Lihui Huang
- Changsha Hospital for Maternal and Child Health Care, Hunan, China
| | - Min Cai
- Changsha Hospital for Maternal and Child Health Care, Hunan, China
| | - Li Li
- Changsha Hospital for Maternal and Child Health Care, Hunan, China.,Hengyang Medical College, University of South China, Hengyang, China
| | - Xin Zhang
- Changsha Hospital for Maternal and Child Health Care, Hunan, China
| | - Yang Xu
- Changsha Hospital for Maternal and Child Health Care, Hunan, China
| | - Jianhua Xiao
- Hengyang Medical College, University of South China, Hengyang, China
| | - Qian Huang
- Changsha Hospital for Maternal and Child Health Care, Hunan, China
| | - Guijuan Luo
- Changsha Hospital for Maternal and Child Health Care, Hunan, China
| | - Zhaoyang Zeng
- College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, China
| | - Cuiyuan Jin
- College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, China
| | - Yuanxiang Jin
- College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, China
| | - Jun He
- Changsha Hospital for Maternal and Child Health Care, Hunan, China.
| | - Weitao Yang
- Changsha Hospital for Maternal and Child Health Care, Hunan, China.
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4
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Napso T, Zhao X, Lligoña MI, Sandovici I, Kay RG, George AL, Gribble FM, Reimann F, Meek CL, Hamilton RS, Sferruzzi-Perri AN. Placental secretome characterization identifies candidates for pregnancy complications. Commun Biol 2021; 4:701. [PMID: 34103657 PMCID: PMC8187406 DOI: 10.1038/s42003-021-02214-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 05/12/2021] [Indexed: 11/09/2022] Open
Abstract
Alterations in maternal physiological adaptation during pregnancy lead to complications, including abnormal birthweight and gestational diabetes. Maternal adaptations are driven by placental hormones, although the full identity of these is lacking. This study unbiasedly characterized the secretory output of mouse placental endocrine cells and examined whether these data could identify placental hormones important for determining pregnancy outcome in humans. Secretome and cell peptidome analyses were performed on cultured primary trophoblast and fluorescence-activated sorted endocrine trophoblasts from mice and a placental secretome map was generated. Proteins secreted from the placenta were detectable in the circulation of mice and showed a higher relative abundance in pregnancy. Bioinformatic analyses showed that placental secretome proteins are involved in metabolic, immune and growth modulation, are largely expressed by human placenta and several are dysregulated in pregnancy complications. Moreover, proof-of-concept studies found that secreted placental proteins (sFLT1/MIF and ANGPT2/MIF ratios) were increased in women prior to diagnosis of gestational diabetes. Thus, placental secretome analysis could lead to the identification of new placental biomarkers of pregnancy complications.
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Affiliation(s)
- Tina Napso
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Xiaohui Zhao
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Marta Ibañez Lligoña
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Ionel Sandovici
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
- Metabolic Research Laboratories, MRC Metabolic Diseases Unit, Department of Obstetrics and Gynaecology, The Rosie Hospital, Cambridge, UK
| | - Richard G Kay
- Wellcome-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Amy L George
- Wellcome-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Fiona M Gribble
- Wellcome-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Frank Reimann
- Wellcome-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Claire L Meek
- Wellcome-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Russell S Hamilton
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
- Department of Genetics, University of Cambridge, Cambridge, UK
| | - Amanda N Sferruzzi-Perri
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK.
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5
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Amaral LM, Cottrell JN, Comley KM, Cunningham MW, Witcher A, Vaka VR, Ibrahim T, LaMarca B. 17-Hydroxyprogesterone caproate improves hypertension and renal endothelin-1 in response to sFlt-1 induced hypertension in pregnant rats. Pregnancy Hypertens 2020; 22:151-155. [PMID: 32980622 DOI: 10.1016/j.preghy.2020.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 08/25/2020] [Accepted: 09/05/2020] [Indexed: 11/18/2022]
Abstract
Preeclampsia (PE) is characterized by new onset hypertension in association with elevated soluble fms-like tyrosine kinase-1 (sFlt-1) and preproendothelin-1 (PPET-1) levels. Currently there is no effective treatment for PE except for early delivery of the fetal placental unit, making PE a leading cause for premature births worldwide. Administration of 17-hydroxyprogesterone caproate (17-OHPC) is used for prevention of recurrent preterm birth. This study was designed to test the hypothesis that 17-OHPC improves hypertension and ET-1 in response to elevated sFlt-1 in pregnant rats. sFlt-1 was infused into normal pregnant (NP) Sprague-Dawley rats (3.7 μg·kg-1·day-1 for 6 days, gestation days 13-19) in the presence or absence of 17-OHPC (3.32 mg/kg) administered via intraperitoneal injection on gestational days 15 and 18. Mean arterial blood pressure (MAP), pup and placenta weights, renal cortex PPET-1 mRNA levels and nitrate-nitrite levels were measured on GD 19. Infusion of sFlt-1 into NP rats elevated mean arterial pressure (MAP) compared with control NP rats: 115 ± 1 (n = 13) vs. 99 ± 2 mmHg (n = 12, p < 0.05). 17-OHPC attenuated this hypertension reducing MAP to 102 ± 3 mmHg in sFlt-1 treated pregnant rats (n = 8). Neither pup nor placental weight was affected by sFlt-1 or 17-OHPC. Importantly, renal cortex PPET-1 mRNA levels were elevated 3 fold in NP + sFlt-1 rats compare to NP rats, which decreased with 17-OHPC administration. Plasma nitrate-nitrite levels were 44 ± 9 µM in NP rats (n = 9), 20 ± 3 µM in NP + sFlt-1 (n = 7), which increased to 42 ± 11 µM NP + sFlt-1 + 17OHPC (n = 6). Administration of 17-OHPC improves clinical characteristics of preeclampsia in response to elevated sFlt-1 during pregnancy.
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Affiliation(s)
- Lorena M Amaral
- Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, United States.
| | - Jesse N Cottrell
- Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS 39216, United States
| | - Kyleigh M Comley
- Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, United States
| | - Mark W Cunningham
- Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, United States
| | - Alexis Witcher
- Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, United States
| | - Venkata Ramana Vaka
- Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, United States
| | - Tarek Ibrahim
- Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, United States
| | - Babbette LaMarca
- Pharmacology, University of Mississippi Medical Center, Jackson, MS 39216, United States
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6
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Black C, Rolnik DL, Al-Amin A, Kane SC, Stolarek C, White A, Da Silva Costa F, Brennecke S. Prediction of preterm pre-eclampsia at midpregnancy using a multivariable screening algorithm. Aust N Z J Obstet Gynaecol 2020; 60:675-682. [PMID: 32124434 DOI: 10.1111/ajo.13113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 11/28/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Competing risk models used for midpregnancy prediction of preterm pre-eclampsia have shown detection rates (DR) of 85%, at fixed false-positive rate (FPR) of 10%. The full algorithm used between 19+0 and 24+6 weeks includes maternal factors, mean arterial pressure (MAP), mean uterine artery pulsatility index (UtAPI), serum placental growth factor (PlGF) level in multiples of the median (MoM), and soluble Fms-like tyrosine kinase-1 (sFlt-1) level in MoM. AIMS To assess performance of the Fetal Medicine Foundation (FMF) algorithm at midpregnancy to screen for preterm (<37 weeks) pre-eclampsia. The outcome measured was preterm pre-eclampsia. MATERIALS AND METHODS This is a prospective study including singleton pregnancies at 19-22 weeks gestation. Maternal bloods were collected and analysed using three different immunoassay platforms. Maternal characteristics, medical history, MAP, mean UtAPI, serum PlGF MoM and serum sFlt-1 MoM were used for risk assessment. DR and FPR were calculated, and receiver operating characteristic curves produced. RESULTS Five hundred and twelve patients were included. Incidence of preterm pre-eclampsia was 1.6%. Using predicted risk of pre-eclampsia of one in 60 or more and one in 100 or higher, as given by the FMF predictive algorithm, the combination with the best predictive performance for preterm pre-eclampsia included maternal factors, MAP, UtAPI and PlGF MoM, giving DRs of 100% and 100%, respectively, and FPRs of 9.3 for all platforms and 12.9-13.5, respectively. Addition of sFlt-1 to the algorithm did not appear to improve performance. sFlt-1 MoM and PlGF MoM values obtained on the different platforms performed very similarly. CONCLUSIONS Second trimester combined screening for preterm pre-eclampsia by maternal history, MAP, mean UtAPI and PlGF MoM using the FMF algorithm performed very well in this patient population.
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Affiliation(s)
- Carin Black
- Pregnancy Research Centre, Department of Maternal-Fetal Medicine, Royal Women's Hospital, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, The Royal Women's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Daniel Lorber Rolnik
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.,Perinatal Services Monash Medical Centre, Melbourne, Victoria, Australia
| | - Ahmed Al-Amin
- Pauline Gandel Imaging Centre, Royal Women's Hospital, Melbourne, Victoria, Australia.,Monash Ultrasound for Women, Melbourne, Victoria, Australia
| | - Stefan C Kane
- Pregnancy Research Centre, Department of Maternal-Fetal Medicine, Royal Women's Hospital, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, The Royal Women's Hospital, The University of Melbourne, Melbourne, Victoria, Australia.,Pauline Gandel Imaging Centre, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Caroline Stolarek
- Pregnancy Research Centre, Department of Maternal-Fetal Medicine, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Adrienne White
- Pregnancy Research Centre, Department of Maternal-Fetal Medicine, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Fabricio Da Silva Costa
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.,Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Shaun Brennecke
- Pregnancy Research Centre, Department of Maternal-Fetal Medicine, Royal Women's Hospital, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, The Royal Women's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
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