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Maroudias G, Vrachnis D, Fotiou A, Loukas N, Mantzou A, Pergialiotis V, Valsamakis G, Machairiotis N, Stavros S, Panagopoulos P, Vakas P, Kanaka-Gantenbein C, Drakakis P, Vrachnis N. Measurement of Calprotectin and PTH in the Amniotic Fluid of Early Second Trimester Pregnancies and Their Impact on Fetuses with Growth Disorders: Are Their Levels Related to Oxidative Stress? J Clin Med 2024; 13:855. [PMID: 38337548 PMCID: PMC10856459 DOI: 10.3390/jcm13030855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/08/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Background: During the early stages of human fetal development, the fetal skeleton system is chiefly made up of cartilage, which is gradually replaced by bone. Fetal bone development is mainly regulated by the parathyroid hormone parathormone (PTH) and PTH-related protein, with specific calprotectin playing a substantial role in cell adhesion and chemotaxis while exhibiting antimicrobial activity during the inflammatory osteogenesis process. The aim of our study was to measure the levels of PTH and calprotectin in early second trimester amniotic fluid and to carry out a comparison between the levels observed among normal full-term pregnancies (control group) and those of the groups of embryos exhibiting impaired or enhanced growth. Methods: For the present prospective study, we collected amniotic fluid samples from pregnancies that underwent amniocentesis at 15 to 22 weeks of gestational age during the period 2021-2023. Subsequently, we followed up on all pregnancies closely until delivery. Having recorded fetal birthweights, we then divided the neonates into three groups: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Results: In total, 64 pregnancies, including 14 SGA, 10 LGA, and 40 AGA fetuses, were included in our study. Both substances were detected in early second trimester amniotic fluid in both groups. Concentrations of calprotectin differed significantly among the three groups (p = 0.033). AGA fetuses had a lower mean value of 4.195 (2.415-6.425) IU/mL, whereas LGA fetuses had a higher mean value of 6.055 (4.887-13.950) IU/mL, while SGA fetuses had a mean value of 5.475 (3.400-9.177) IU/mL. Further analysis revealed that only LGA fetuses had significantly higher calprotectin concentrations compared to AGA fetuses (p = 0.018). PTH concentration was similar between the groups, with LGA fetuses having a mean value of 13.18 (9.51-15.52) IU/mL, while SGA fetuses had a mean value of 14.18 (9.02-16.00) IU/mL, and AGA fetuses had similar concentrations of 13.35 (9.05-15.81) IU/mL. The differences in PTH concentration among the three groups were not statistically significant (p = 0.513). Conclusions: Calprotectin values in the amniotic fluid in the early second trimester were higher in LGA fetuses compared to those in the SGA and AGA categories. LGA fetuses can possibly be in a state of low-grade chronic inflammation due to excessive fat deposition, causing oxidative stress in LGA fetuses and, eventually, the release of calprotectin. Moreover, PTH concentrations in the amniotic fluid of early second trimester pregnancies were not found to be statistically correlated with fetal growth abnormalities in either LGA or SGA fetuses. However, the early time of collection and the small number of patients in our study should be taken into account.
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Affiliation(s)
- George Maroudias
- Department of Obstetrics and Gynecology, Tzaneio General Hospital, 18536 Athens, Greece
| | - Dionysios Vrachnis
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.V.); (A.F.)
| | - Alexandros Fotiou
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.V.); (A.F.)
| | - Nikolaos Loukas
- Department of Obstetrics and Gynecology, Tzaneio General Hospital, 18536 Athens, Greece
| | - Aimilia Mantzou
- First Department of Paediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece (C.K.-G.)
| | - Vasileiοs Pergialiotis
- First Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece;
| | - George Valsamakis
- Second Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Aretaieion Hospital, 11528 Athens, Greece; (G.V.)
| | - Nikolaos Machairiotis
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attikon Hospital, Rimini 1, 12462 Athens, Greece (P.P.)
| | - Sofoklis Stavros
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attikon Hospital, Rimini 1, 12462 Athens, Greece (P.P.)
| | - Periklis Panagopoulos
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attikon Hospital, Rimini 1, 12462 Athens, Greece (P.P.)
| | - Panagiotis Vakas
- Second Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Aretaieion Hospital, 11528 Athens, Greece; (G.V.)
| | - Christina Kanaka-Gantenbein
- First Department of Paediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece (C.K.-G.)
| | - Petros Drakakis
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attikon Hospital, Rimini 1, 12462 Athens, Greece (P.P.)
| | - Nikolaos Vrachnis
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attikon Hospital, Rimini 1, 12462 Athens, Greece (P.P.)
- Vascular Biology, Molecular and Clinical Sciences Research Institute, St George’s University of London, London SW17, UK
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Exporting Proteins Associated with Senescence Repair via Extracellular Vesicles May Be Associated with Early Pregnancy Loss. Cells 2022; 11:cells11182772. [PMID: 36139348 PMCID: PMC9496689 DOI: 10.3390/cells11182772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/29/2022] [Accepted: 09/05/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction: Dysfunction of placental development is involved in early pregnancy loss. Senescent changes have been seen in missed miscarriage, one type of pregnancy loss. Extracellular vesicles (EVs) have been widely implicated in the pathogenesis of diseases. In this study, we investigated the protein profiles in placental EVs derived from missed miscarriage in comparison with healthy pregnancy. We also investigated whether cargos packed into EVs are involved in the dysfunctional development of the placenta seen in missed miscarriage. Methods: Proteomic analysis of placental EVs derived from healthy and missed-miscarriage placentae was performed. Three senescence-repair-associated proteins, replication protein A-70 (RPA-70), proteasome activator subunit-4 (PMSE-4), and protein activated kinase-2, (PAK-2) were examined in placental EVs and placentae, and in placental explants that had been treated with or without GW4869, by western blotting and immunohistochemistry. Results: The total number of proteins associated with placental EVs was not different between the two groups. However, there were 106 and 151 abundantly expressed proteins associated with placental micro- or nano-EVs from missed miscarriage in comparison with EVs from controls. Of these abundant proteins, 59 and 81 proteins in placental micro- or nano-EVs, respectively, are associated with DNA damage/repair and cell death/survival. We further found higher levels of three senescence-repair-associated proteins (RPA-70, PMSE-4, and PAK-2) associated with placental EVs, but lower levels of these proteins in missed-miscarriage placentae. Regarding inhibition of EV formation or release by GW4869, we found that the expression of these three proteins was higher in GW4869-treated placental explants from missed miscarriage. Discussion: Our data may suggest that “inadvertently” sorting of cargos and exporting proteins associated with senescence-repair by placental EVs may be associated with the dysfunction of placental development seen in missed miscarriage.
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Relationship between vascular cell adhesion molecule-1 and morbidly adherent placenta. J Gynecol Obstet Hum Reprod 2018; 47:549-553. [PMID: 29857167 DOI: 10.1016/j.jogoh.2018.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/22/2018] [Accepted: 05/28/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Morbidly adherent placenta is a clinical condition of which prevalance is steadily increasing. It is described as the invasion of the placenta into the uterine wall through the myometrium and beyond. Vascular cell adhesion molecule-1 is a calcium independent transmembrane glycoprotein. Several studies have shown that vascular cell adhesion molecule-1 increases invasion in tumor cells. In our study we investigated the expression of vascular cell adhesion molecule-1 which has been shown to increase invasion in various tumors in morbidly adherent placenta cases. MATERIAL AND METHOD This is a prospective case-control study. Eighty-four patients who were diagnosed with morbidly adherent placenta and 96 patients without any risk factors as a control group were included in the study. Vascular cell adhesion molecule-1 staining was examined by immune-histochemical staining in placental samples. RESULTS The patients included in the study were similar in terms of demographic characteristics. Of the 84 patients in the morbidly adherent placenta group, 65 (74.7%) showed positive staining. This number was 39 (40.6%) in the control group. Staining in morbidly adherent placenta group was statistically significantly higher (p<0.05). DISCUSSION The etiology of morbidly adherent placenta is still a clinically unknown condition. This study is the first study on this field in the literature. In our study, we showed that vascular cell adhesion molecule-1 expression increased in morbidly adherent placenta group. Although the entire pathogenesis is not explained this can be considered as a step for understanding this subject.
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Docheva N, Romero R, Chaemsaithong P, Tarca AL, Bhatti G, Pacora P, Panaitescu B, Chaiyasit N, Chaiworapongsa T, Maymon E, Hassan SS, Erez O. The profiles of soluble adhesion molecules in the "great obstetrical syndromes" . J Matern Fetal Neonatal Med 2018; 32:2113-2136. [PMID: 29320948 DOI: 10.1080/14767058.2018.1427058] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of this study was to determine the profiles of maternal plasma soluble adhesion molecules in patients with preeclampsia, small-for-gestational-age (SGA) fetuses, acute pyelonephritis, preterm labor with intact membranes (PTL), preterm prelabor rupture of the membranes (preterm PROM), and fetal death. MATERIALS AND METHODS A cross-sectional study was conducted to determine maternal plasma concentrations of sE-selectin, sL-selectin, and sP-selectin as well as sICAM-1, sVCAM-1, and sPECAM-1 in patients with (1) an uncomplicated pregnancy (control, n = 100); (2) preeclampsia (n = 94); (3) SGA fetuses (in women without preeclampsia/hypertension, n = 45); (4) acute pyelonephritis (n = 25); (5) PTL (n = 53); (6) preterm PROM (n = 24); and (7) fetal death (n = 34). Concentrations of soluble adhesion molecules and inflammatory cytokines (tumor necrosis factor (TNF)-α and interleukin (IL)-8) were determined with sensitive and specific enzyme-linked immunoassays. RESULTS In comparison to women with a normal pregnancy, (1) women with preeclampsia had higher median concentrations of sE-selectin, sP-selectin, and sVCAM-1, and a lower concentration of sL-selectin (all p values < .001); (2) patients with SGA fetuses had higher median concentrations of sE-selectin, sP-selectin, and sVCAM-1 (all p values < .05); (3) patients with a fetal death had higher median concentrations of sE-selectin and sP-selectin (all p values < .05); (4) patients with acute pyelonephritis had higher median plasma concentrations of sE-selectin, sICAM-1, and sVCAM-1 (all p values < .001); (5) patients with preeclampsia and acute pyelonephritis, plasma concentrations of sVCAM-1, sE-selectin, and sP-selectin correlated with those of the proinflammatory cytokines TNF-α and interleukin (IL)-8 (all p values < .05); (6) patients with PTL had a higher median concentration of sP-selectin and a lower median concentration of VCAM-1 (all p values < .05); and (7) women with preterm PROM had lower median concentrations of sL-selectin and sVCAM-1 (all p values < .05). CONCLUSIONS The results of this study show that endothelial cell activation/dysfunction reflected by the plasma concentration of sE-selectin is not specific to preeclampsia but is present in pregnancies complicated by SGA fetuses, acute pyelonephritis, and fetal death. Collectively, we report that each obstetrical syndrome appears to have a stereotypical profile of soluble adhesion molecules in the peripheral circulation.
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Affiliation(s)
- Nikolina Docheva
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Roberto Romero
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,c Department of Obstetrics and Gynecology , University of Michigan , Ann Arbor , MI , USA.,d Department of Epidemiology and Biostatistics , Michigan State University , East Lansing , MI , USA.,e Center for Molecular Medicine and Genetics , Wayne State University , Detroit , MI , USA
| | - Piya Chaemsaithong
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Adi L Tarca
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Gaurav Bhatti
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Percy Pacora
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Bogdan Panaitescu
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Noppadol Chaiyasit
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Tinnakorn Chaiworapongsa
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Eli Maymon
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA.,f Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beersheba , Israel
| | - Sonia S Hassan
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA.,g Department of Physiology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Offer Erez
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA.,f Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beersheba , Israel
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Pattern of adhesive molecules expression in placenta of non-complicated ART pregnancies. Placenta 2016; 48:126-132. [DOI: 10.1016/j.placenta.2016.10.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 10/19/2016] [Accepted: 10/31/2016] [Indexed: 01/03/2023]
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Human Decidual Stromal Cells as a Component of the Implantation Niche and a Modulator of Maternal Immunity. J Pregnancy 2016; 2016:8689436. [PMID: 27239344 PMCID: PMC4864559 DOI: 10.1155/2016/8689436] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 02/26/2016] [Accepted: 03/27/2016] [Indexed: 12/27/2022] Open
Abstract
The human decidua is a specialized tissue characterized by embryo-receptive properties. It is formed during the secretory phase of menstrual cycle from uterine mucosa termed endometrium. The decidua is composed of glands, immune cells, blood and lymph vessels, and decidual stromal cells (DSCs). In the process of decidualization, which is controlled by oestrogen and progesterone, DSCs acquire specific functions related to recognition, selection, and acceptance of the allogeneic embryo, as well as to development of maternal immune tolerance. In this review we discuss the relationship between the decidualization of DSCs and pathological obstetrical and gynaecological conditions. Moreover, the critical influence of DSCs on local immune cells populations as well as their relationship to the onset and maintenance of immune tolerance is described.
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Orak U, Celik E, Kavak SB, Demirel İ, Atilgan R, Aydin S, Sapmaz E. Tenascin C levels in patients with mild and severe preeclampsia. J Matern Fetal Neonatal Med 2015; 29:270-3. [DOI: 10.3109/14767058.2014.998191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Ugur Orak
- Department of Obstetrics and Gynecology, Firat Medical Center, School of Medicine, Firat University, Elazig, Turkey,
| | - Ebru Celik
- Department of Obstetric and Gynecology, Special Medical Park Hospital, Elazig, Turkey,
| | - Salih Burcin Kavak
- Department of Obstetrics and Gynecology, Firat Medical Center, School of Medicine, Firat University, Elazig, Turkey,
| | | | - Remzi Atilgan
- Department of Obstetrics and Gynecology, Firat Medical Center, School of Medicine, Firat University, Elazig, Turkey,
| | - Suleyman Aydin
- Department of Biochemistry, Firat University, Elazig, Turkey
| | - Ekrem Sapmaz
- Department of Obstetrics and Gynecology, Firat Medical Center, School of Medicine, Firat University, Elazig, Turkey,
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Placenta-derived angiogenic proteins and their contribution to the pathogenesis of preeclampsia. Angiogenesis 2014; 18:115-23. [DOI: 10.1007/s10456-014-9452-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 11/16/2014] [Indexed: 10/24/2022]
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Miranda J, Romero R, Korzeniewski SJ, Schwartz AG, Chaemsaithong P, Stampalija T, Yeo L, Dong Z, Hassan SS, Chrousos GP, Gold P, Chaiworapongsa T. The anti-aging factor α-klotho during human pregnancy and its expression in pregnancies complicated by small-for-gestational-age neonates and/or preeclampsia. J Matern Fetal Neonatal Med 2013; 27:449-57. [PMID: 23808483 DOI: 10.3109/14767058.2013.818652] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE α-klotho, a protein with anti-aging properties, has been involved in important biological processes, such as calcium/phosphate metabolism, resistance to oxidative stress, and nitric oxide production in the endothelium. Recent studies have suggested a role of α-klotho in endocrine regulation of mineral metabolism and postnatal growth in infants. Yet, the role of α-klotho during pregnancy remains largely unknown. The aim of this study was to determine whether maternal plasma concentration of α-klotho changes during pregnancy and evaluate its expression in pregnancies complicated by small for gestational age (SGA) and/or preeclampsia (PE). STUDY DESIGN This cross-sectional study included patients in the following groups: (1) non pregnant women (n = 37); (2) uncomplicated pregnancy (n = 130); (3) PE without an SGA neonate (PE; n = 58); (4) PE with an SGA neonate (PE and SGA; n = 52); and (5) SGA neonate without PE (SGA; n = 52). Plasma concentrations of α-klotho were determined by ELISA. RESULTS The median plasma α-klotho concentration was higher in pregnant than in non-pregnant women. Among women with an uncomplicated pregnancy, the median plasma concentration of α-klotho increased as a function of gestational age (Spearman Rho = 0.2; p = 0.006). The median (interquartile range) plasma concentration of α-klotho in women with PE and SGA [947.6 (762-2013) pg/mL] and SGA without PE [1000 (585-1567) pg/mL] were 21% and 17% lower than that observed in women with an uncomplicated pregnancy [1206.6 (894-2012) pg/mL], (p = 0.005 and p = 0.02), respectively. Additionally, there were no significant differences in the median plasma concentration of α-klotho between uncomplicated pregnancies and women with PE without an SGA neonate (p = 0.5). CONCLUSION Maternal plasma concentration of α-klotho was higher during pregnancy than in a non-pregnant state. Moreover, the median maternal plasma concentration of α-klotho was lower in mothers who delivered an SGA neonate than in those with an uncomplicated pregnancy regardless of the presence or absence of PE.
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Affiliation(s)
- Jezid Miranda
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda , MD and Detroit, MI , USA
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Abstract
OBJECTIVE To identify factors related to retained placenta in the context of contemporary obstetric practice. METHODS This was a case-control study comparing 408 cases of retained placenta and an equivalent number of control individuals. Epidemiological and delivery-related variables were registered in computerized prenatal and in-hospital medical records. Univariable and multivariable logistic regressions were used for estimation of risk ratios and statistical significance. RESULTS Independent risk factors for retained placenta were: previous retained placenta (odds ratio [OR] 12.61, 95% confidence interval [CI] 3.61-44.08); preterm delivery (OR 3.28, 95% CI 1.60-6.70); oxytocin use for 195-415 minutes (OR 2.00, 95% CI 1.20-3.34); oxytocin use more than 415 minutes (OR 6.55, 95% CI 3.42-12.54, number needed to harm 2.3); preeclampsia (OR 2.85, 95% CI 1.20-6.78); two or more previous miscarriages (OR 2.62, 95% CI 1.31-5.20); and one or more previous abortion (OR 1.58, 95% CI 1.09-2.28). Parity of two or more had a seemingly protective effect (OR 0.40, 95% CI 0.24-0.70), as did smoking at the start of pregnancy (OR 0.28, 95% CI 0.09-0.88). Retained placenta was significantly associated with an increased risk of postpartum hemorrhage. The OR related to blood loss exceeding 500 mL, 1,000 mL, and 2,000 mL and the need for blood transfusion was 33.07 (95% CI 20.57-53.16), 43.44 (95% CI 26.57-71.02), 111.24 (95% CI 27.26-454.00), and 37.48 (95% CI 13.63-103.03), respectively. Diabetes was numerically overrepresented in the case group, but the power of the study to detect a significant difference in risk outcome was insufficient. CONCLUSION Identifying risk factors for retained placenta is important in the assessment of women after delivery. The increased risk associated with duration of oxytocin use is of interest, considering its widespread use. LEVEL OF EVIDENCE II.
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Li CF, Gou WL, Li XL, Wang SL, Yang T, Chen Q. Reduced expression of survivin, the inhibitor of apoptosis protein correlates with severity of preeclampsia. Placenta 2011; 33:47-51. [PMID: 22033156 DOI: 10.1016/j.placenta.2011.10.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Revised: 09/27/2011] [Accepted: 10/11/2011] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Preeclampsia is a major complication of pregnancy affecting maternal and fetal health. Although the pathogenesis of preeclampsia is unclear, it is believed that trophoblast apoptosis plays an important role in the pathogenesis of preeclampsia during pregnancy. Survivin is a member of the inhibitor of apoptosis protein family that uniquely promotes trophoblast proliferation. In this study we investigated the alteration of survivin levels during pregnancy and compared the survivin protein and mRNA between preeclampsia and normal pregnancy. METHODS The mRNA level of survivin in first, second and third trimester placentae was measured by Real-time PCR. The expression of survivin in preeclamptic placentae (including severe and mild preeclampsia) and in age-matched normal placentae was measured by immunohistochemistry. The mRNA levels of survivin in preeclamptic or normal placentae were measured by Real-time PCR. RESULTS The mRNA level of survivin was significantly reduced throughout gestation. The mRNA level of survivin in preeclamptic placentae was significantly reduced compared to that in normal placenta. The mRNA level of survivin in severe preeclamptic placentae was further significantly reduced compared to that in mild preeclamptic placentae. In addition, survivin was expressed on syncytiotrophoblasts and cytotrophoblasts and the expression of survivin was significantly decreased in preeclamptic placenta compared to that in normal placenta (p=0.01). Furthermore the expression of survivin in severe preeclamptic placentae was significantly lower than that in mild preeclamptic placentae. CONCLUSION Our current data suggests lower placental expression of survivin may be associated with the severity of preeclampsia.
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Affiliation(s)
- C F Li
- First Hospital Affiliated Medical School of Xian Jiaotong University, Xian, China
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Perrone MG, Scilimati A. β3-Adrenoceptor ligand development history through patent review. Expert Opin Ther Pat 2011; 21:505-36. [DOI: 10.1517/13543776.2011.561316] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Liosi S, Briana DD, Gourgiotis D, Boutsikou M, Baka S, Marmarinos A, Hassiakos D, Malamitsi-Puchner A. Calprotectin in human cord blood: relation to perinatal parameters and restricted fetal growth. J Perinat Med 2010; 38:523-6. [PMID: 20629495 DOI: 10.1515/jpm.2010.082] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To determine cord blood levels of calprotectin, a protein that is increased in inflammatory states and released by activated neutrophils has apoptosis-inducing activity. MATERIALS AND METHODS Cord-blood calprotectin concentrations were determined in intrauterine-growth-restricted (IUGR, usually associated with increased neutrophil activation and apoptosis, n=50) and appropriate-for-gestational-age (AGA, n=110) single full-term pregnancies, and were correlated with perinatal demographic parameters. RESULTS No significant differences exists between the IUGR and AGA groups, implying that calprotectin at birth does not reflect increased neutrophil activation and apoptosis expected in IUGR. However, in IUGRs, calprotectin concentrations increased with every gestational week [b=45.3, 95% confidence interval (CI): 13.5-77.1, P=0.006], suggesting concomitant up-regulation of neutrophil activation and apoptosis. A combined group showed significantly decreased calprotectin concentrations in cesarean sections [b=-74.5, 95% CI: -115.2-(-33.9), P<0.001], pointing to excessive inflammatory response in vaginal deliveries. Finally, birth weight, customized centile, gender, maternal age and parity do not impact on cord blood calprotectin concentrations. CONCLUSIONS Cord blood calprotectin concentrations at term are independent of intrauterine growth, gender, parity and maternal age and probably do not reflect the increased neutrophil activation and excessive apoptosis expected in IUGR.
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Affiliation(s)
- Sofia Liosi
- Division of Neonatal, 2nd Department of Obstetrics and Gynecology, Athens University Medical School, Athens, Greece
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A single-nucleotide polymorphism (-670) of the maternal Fas gene is associated with intrauterine growth restriction. Am J Obstet Gynecol 2009; 201:620.e1-4. [PMID: 19716115 DOI: 10.1016/j.ajog.2009.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Revised: 05/21/2009] [Accepted: 07/06/2009] [Indexed: 12/30/2022]
Abstract
OBJECTIVE We sought to determine whether the Fas (-670) single-nucleotide polymorphism is associated with intrauterine growth restriction. STUDY DESIGN Twenty-seven pregnant women with intrauterine growth restriction in the absence of preeclampsia and 50 pregnant women with uncomplicated pregnancies were studied. DNA was extracted from maternal and infant buccal smears and allelic discrimination was performed for Fas (-670). Student t test, chi2, and z tests were used. RESULTS There were no differences in maternal age, race, or parity between the intrauterine growth restriction and control patients. Mothers of intrauterine growth restriction infants had a significantly different genotype distribution for this single nucleotide polymorphism, and for the ratio of GG genotype (GG, AA: 0.41, 0.18 maternal intrauterine growth restriction; 0.14, 0.32 controls; respectively, P=.03). These genotype differences were significantly different in white, but not black mothers with intrauterine growth restriction (P=.03, and .3; respectively). In contrast, no differences were found in infants' Fas (-670) single-nucleotide polymorphism genotypes. CONCLUSION This study demonstrates an association between the maternal Fas (-670) single-nucleotide polymorphism and the development of intrauterine growth restriction.
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Machaalani R, Makris A, Thornton C, Hennessy A. Vascular Endothelial Growth Factor Receptor 1 (Flt1) and Apoptosis in the Preeclamptic Placenta and Effects of in vivo Anti-hypertensive Exposure. Hypertens Pregnancy 2009; 27:361-73. [DOI: 10.1080/10641950802020552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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van de Geijn FE, Dolhain RJ, van Rijs W, Hazes JM, de Groot CJ. Mannose-binding lectin genotypes and pre-eclampsia: A case-control study. Hum Immunol 2007; 68:888-93. [DOI: 10.1016/j.humimm.2007.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Revised: 09/14/2007] [Accepted: 10/02/2007] [Indexed: 11/16/2022]
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Jeschke U, Mayr D, Schiessl B, Mylonas I, Schulze S, Kuhn C, Friese K, Walzel H. Expression of galectin-1, -3 (gal-1, gal-3) and the Thomsen-Friedenreich (TF) antigen in normal, IUGR, preeclamptic and HELLP placentas. Placenta 2007; 28:1165-73. [PMID: 17664004 DOI: 10.1016/j.placenta.2007.06.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2006] [Revised: 06/14/2007] [Accepted: 06/15/2007] [Indexed: 12/11/2022]
Abstract
BACKGROUND Galectin-1 (gal-1) and galectin-3 (gal-3), which are members of the mammalian beta-galactoside-binding proteins, recognise preferentially (Galbeta1-4GlcNAc) sequences of several cell surface oligosaccharides. In addition, gal-1 also binds to the Thomsen-Friedenreich (TF) antigen (Galbeta1-3GalNAc-). MATERIALS AND METHODS Slides of frozen and paraffin-embedded placental tissue of patients with fetal intrauterine growth retardation (IUGR), preeclampsia, haemolysis, elevated liver enzymes, low platelets (HELLP) and normal term placentas were incubated with monoclonal and polyclonal antibodies against gal-1, gal-3 and TF. Staining reaction was performed with the avidin-biotinylated peroxidase complex (ABC) reagent. The intensity of the immunohistochemical reaction on the slides was analysed using a semi-quantitative score. The identity of galectin-expressing cells was analysed by using a double immunofluorescence method. RESULTS We demonstrated immunohistochemically that the expression of gal-1 and gal-3 on the extravillous trophoblast (EVT) is significantly up-regulated in preeclamptic and HELLP placentas and unchanged compared with normal controls in IUGR placentas. The expression of the TF antigen is significantly up-regulated in IUGR and preeclamptic extravillous trophoblast cells and unchanged in HELLP placentas compared with normal controls. In addition, the expression of gal-1 is significantly up-regulated in the decidual tissue of preeclamptic placentas and in the villous trophoblast tissue of HELLP placentas. CONCLUSION Our data showed that gal-1, gal-3 and TF were up-regulated on the membrane of EVT in preeclamptic placentas. In addition, the expression of gal-1 is significantly up-regulated in decidual tissue of preeclamptic placentas and villous trophoblast tissue of HELLP placentas. Taking into consideration the results of this study, we speculate that expression of both galectins and TF on the membrane of preeclamptic EVT and up-regulation of gal-1 in preeclamptic decidual cells may at least in part compensate for the apoptotic effects of maternal immune cells.
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Affiliation(s)
- U Jeschke
- Ludwig Maximilians University of Munich, Department of Obstetrics and Gynaecology, Maistrasse 11, 80337 Munich, Germany
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