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Zhou Y, Gan G. The levels of peripheral blood TNF-α, Decorin and neutrophils MAPK1 mRNA levels of patients with preeclampsia and their clinical significance. J Matern Fetal Neonatal Med 2023; 36:2183745. [PMID: 36852440 DOI: 10.1080/14767058.2023.2183745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Objective: This study analyzed the levels of peripheral blood tumor necrosis factor-α (TNF-α), Decorin (DCN) and Mitogen-activated protein kinase 1 (MAPK1) mRNA in neutrophils of patients with preeclampsia and their correlations, in order to provide more thoughts on the diagnosis and treatment of clinical patients. Methods: 81 patients with preeclampsia who had regular prenatal checkups and delivered in our hospital from June 2020 to April 2022 were analyzed, including 26 patients with early-onset and 55 patients with late-onset, and 50 pregnant women with normal pregnancy who had prenatal checkups and delivered in our hospital during the same period were selected as the control group. Record the clinical data of patients, record the expression of peripheral blood TNF-α, DCN and neutrophils MAPK1 mRNA of patients with early-onset, late-onset and the control group, and record the correlation between DCN level, MAPK1 mRNA expression and TNF-α level of patients with preeclampsia. Results: The diastolic and systolic blood pressures were significantly higher in early-onset and late-onset patients, and the gestational week of delivery was significantly lower in early-onset and late-onset patients, respectively (p < .05); there was no statistically significant difference in the average age, BMI, average pregnancy time, and average births between the three groups (p > .05). The expressions of peripheral blood TNF-α, DCN, and neutrophils MAPK1 mRNA of the early-onset and late-onset groups were all higher than those in the control group (p < .05); and the expressions of TNF-α, DCN, and MAPK1 mRNA in the peripheral blood of the early-onset group were all higher than those in the late-onset group (p < .05); Pearson correlation analysis showed that DCN level and TNF-α level in patients with preeclampsia were positively correlated (r = 0.98639, p < .05); Neutrophils MAPK1 mRNA expression and TNF-α level were positively correlated (r = 0.9611, p < .05). Conclusion: TNF-α, DCN and neutrophils MAPK1 mRNA were all highly expressed in the peripheral blood of patients with pre-eclampsia and were more significantly elevated in patients with early-onset preeclampsia, and the expression levels of DCN and MAPK1 mRNA were positively correlated with TNF-α levels. It is possible that all three factors are involved in the pathogenesis of preeclampsia, and are expected to be used as indicators for early prediction and diagnosis.
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Affiliation(s)
- Yanna Zhou
- Department of Obstetrics and Gynecology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
| | - Guipng Gan
- Department of Obstetrics and Gynecology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
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2
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Jancsura MK, Schmella MJ, Helsabeck N, Gillespie SL, Roberts JM, Conley YP, Hubel CA. Inflammatory markers are elevated in early pregnancy, but not late pregnancy, in women with overweight and obesity that later develop preeclampsia. Am J Reprod Immunol 2023; 90:e13763. [PMID: 37641371 PMCID: PMC10465815 DOI: 10.1111/aji.13763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/27/2023] [Accepted: 07/25/2023] [Indexed: 08/31/2023] Open
Abstract
PROBLEM Obesity and preeclampsia both involve a pathological inflammatory response, which may be how obesity increases preeclampsia risk. Previous studies have failed to assess robust measurements of inflammatory markers across gestation, specifically in overweight/ obese women in the context of preeclampsia. METHOD OF STUDY We measured 20 inflammatory markers in plasma via multiplex assay (ThermoFisher Inflammation 20 plex Human ProcartaPlex Panel) across the three trimesters of pregnancy in an existing cohort of overweight and obese women who developed preeclampsia (n = 37) and without preeclampsia (n = 74). Mann-Whitney U tests examined differences in inflammatory marker concentrations between cases and controls. Repeated measures ANOVA tests were used to explore differences in inflammatory marker concentrations over time within cases and controls. RESULTS Pro-inflammatory markers (IL-1α, IL-1β, IL-6, IFN-α, IFN-γ, GM-CSF, IL-12p70, IL-17α, TNF-α, IL-8) and anti-inflammatory markers (IL-4, IL-10, IL-13) were higher in the first and second trimester in participants who later developed preeclampsia compared to those who did not (p < .05). Only TNF-α and IL-8 remained elevated in the third trimester. Inflammatory markers did not change across pregnancy in preeclampsia cases but did increase across pregnancy in controls. CONCLUSION Our findings diverge from prior studies, predominantly of non-obese women, that report lower circulating concentrations of anti-inflammatory cytokines in preeclampsia versus normotensive pregnancy, particularly by late pregnancy. We posit that women with overweight and obesity who develop preeclampsia entered pregnancy with a heightened pro-inflammatory state likely related to obesity, which increased risk for preeclampsia. Further studies are needed to investigate if inflammatory maker profiles differ between obese and non-obese women.
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Affiliation(s)
- McKenzie K Jancsura
- College of Nursing Martha S. Pitzer Center for Women, Children and Youth, The Ohio State University, Columbus, USA
| | | | | | - Shannon L Gillespie
- College of Nursing Martha S. Pitzer Center for Women, Children and Youth, The Ohio State University, Columbus, USA
| | - James M Roberts
- Departments of Obstetrics Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, USA
- Department of Epidemiology and Clinical and Translational Research, University of Pittsburgh School of Medicine, Pittsburgh, USA
- Magee-Womens Research Institute, Pittsburgh, United States
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, USA
| | - Carl A Hubel
- Departments of Obstetrics Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, USA
- Magee-Womens Research Institute, Pittsburgh, United States
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3
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Zhong Q, Yao C, Zhong W. Causal Relationship Between Inflammation and Preeclampsia: Genetic Evidence from a Mendelian Randomization Study. Twin Res Hum Genet 2023; 26:231-235. [PMID: 37458219 DOI: 10.1017/thg.2023.27] [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: 09/14/2023]
Abstract
Preeclampsia (PE) is a hypertensive disorder of pregnancy. PE patients were reported to have higher serum levels of C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) than those in healthy controls. However, whether the expressions of these inflammation biomarkers have a causal relationship with PE is unspecified. We applied the Mendelian randomization method to infer the causal relationship between inflammation biomarkers (e.g., CRP, IL-6, interleukin 1 receptor antagonist [IL-1ra] and TNF-α) and PE. Single nucleotide polymorphisms (SNPs) strongly related to inflammation biomarkers were used as instrumental variables. CRP, IL-1ra and IL-6 levels showed no significant effect on PE progression, while the genetic predicted higher level of TNF-α significantly increased the risk of PE (OR per 1-SD increase in TNF-α: 4.33; 95% CI [1.99, 9.39]; p = .00021). The findings suggest that pro-inflammatory activity of TNF-α could be a determinant for PE progression. More antenatal care should be given to those pregnant women with higher level of inflammation biomarkers, especially TNF-α.
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Affiliation(s)
- Qiongxiang Zhong
- No.2 Obstetrics and Gynecology Department, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Chanjiao Yao
- No.2 Obstetrics and Gynecology Department, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Wei Zhong
- No.2 Obstetrics and Gynecology Department, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
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4
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Escudero C, Kupka E, Ibañez B, Sandoval H, Troncoso F, Wikström AK, López-Espíndola D, Acurio J, Torres-Vergara P, Bergman L. Brain Vascular Dysfunction in Mothers and Their Children Exposed to Preeclampsia. Hypertension 2023; 80:242-256. [PMID: 35920147 DOI: 10.1161/hypertensionaha.122.19408] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Preeclampsia is a maternal syndrome characterized by the new onset of hypertension and proteinuria after 20 weeks of gestation associated with multisystemic complications, including brain alterations. Indeed, brain complications associated with preeclampsia are the leading direct causes of fetal and maternal morbidity and mortality, especially in low- and middle-income countries. In addition to the well-recognized long-term adverse cardiovascular effects of preeclampsia, women who have had preeclampsia have higher risk of stroke, dementia, intracerebral white matter lesions, epilepsy, and perhaps also cognitive decline postpartum. Furthermore, increasing evidence has also associated preeclampsia with similar cognitive and cerebral disorders in the offspring. However, the mechanistic links between these associations remain unresolved. This article summarizes the current knowledge about the cerebrovascular complications elicited by preeclampsia and the potential pathophysiological mechanisms involved, emphasizing the impaired brain vascular function in the mother and their offspring.
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Affiliation(s)
- Carlos Escudero
- Vascular Physiology Laboratory, Department of Basic Sciences, Faculty of Basic Sciences, University of Bío-Bío, Chillán, Chile (C.E., B.I., H.S., F.T., J.A.).,Group of Research and Innovation in Vascular Health (GRIVAS Health), Chillán, Chile (C.E., J.A., P.T.-V.)
| | - Ellen Kupka
- Institute of Clinical Sciences, Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Sweden (E.K.)
| | - Belen Ibañez
- Vascular Physiology Laboratory, Department of Basic Sciences, Faculty of Basic Sciences, University of Bío-Bío, Chillán, Chile (C.E., B.I., H.S., F.T., J.A.)
| | - Hermes Sandoval
- Vascular Physiology Laboratory, Department of Basic Sciences, Faculty of Basic Sciences, University of Bío-Bío, Chillán, Chile (C.E., B.I., H.S., F.T., J.A.)
| | - Felipe Troncoso
- Vascular Physiology Laboratory, Department of Basic Sciences, Faculty of Basic Sciences, University of Bío-Bío, Chillán, Chile (C.E., B.I., H.S., F.T., J.A.)
| | - Anna-Karin Wikström
- Department of Women's and Children's Health, Uppsala University, Sweden (A.K.W., L.B.)
| | - Daniela López-Espíndola
- Escuela de Tecnología Médica, Facultad de Medicina, Universidad de Valparaíso, Chile (D.L.-E.)
| | - Jesenia Acurio
- Vascular Physiology Laboratory, Department of Basic Sciences, Faculty of Basic Sciences, University of Bío-Bío, Chillán, Chile (C.E., B.I., H.S., F.T., J.A.).,Group of Research and Innovation in Vascular Health (GRIVAS Health), Chillán, Chile (C.E., J.A., P.T.-V.)
| | - Pablo Torres-Vergara
- Group of Research and Innovation in Vascular Health (GRIVAS Health), Chillán, Chile (C.E., J.A., P.T.-V.).,Departamento de Farmacia, Facultad de Farmacia, Universidad de Concepción, Chile (P.T.-V.)
| | - Lina Bergman
- Department of Women's and Children's Health, Uppsala University, Sweden (A.K.W., L.B.).,Department of Obstetrics and Gynecology, Stellenbosch University, South Africa (L.B.).,Department of clinical sciences, Sahlgrenska Academy, Gothenburg University, Sweden (L.B.)
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5
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Waker CA, Kaufman MR, Brown TL. Current State of Preeclampsia Mouse Models: Approaches, Relevance, and Standardization. Front Physiol 2021; 12:681632. [PMID: 34276401 PMCID: PMC8284253 DOI: 10.3389/fphys.2021.681632] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/24/2021] [Indexed: 12/14/2022] Open
Abstract
Preeclampsia (PE) is a multisystemic, pregnancy-specific disorder and a leading cause of maternal and fetal death. PE is also associated with an increased risk for chronic morbidities later in life for mother and offspring. Abnormal placentation or placental function has been well-established as central to the genesis of PE; yet much remains to be determined about the factors involved in the development of this condition. Despite decades of investigation and many clinical trials, the only definitive treatment is parturition. To better understand the condition and identify potential targets preclinically, many approaches to simulate PE in mice have been developed and include mixed mouse strain crosses, genetic overexpression and knockout, exogenous agent administration, surgical manipulation, systemic adenoviral infection, and trophoblast-specific gene transfer. These models have been useful to investigate how biological perturbations identified in human PE are involved in the generation of PE-like symptoms and have improved the understanding of the molecular mechanisms underpinning the human condition. However, these approaches were characterized by a wide variety of physiological endpoints, which can make it difficult to compare effects across models and many of these approaches have aspects that lack physiological relevance to this human disorder and may interfere with therapeutic development. This report provides a comprehensive review of mouse models that exhibit PE-like symptoms and a proposed standardization of physiological characteristics for analysis in murine models of PE.
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Affiliation(s)
- Christopher A Waker
- Department of Neuroscience, Cell Biology, and Physiology, Boonshoft School of Medicine, Wright State University, Dayton, OH, United States
| | - Melissa R Kaufman
- Department of Neuroscience, Cell Biology, and Physiology, Boonshoft School of Medicine, Wright State University, Dayton, OH, United States
| | - Thomas L Brown
- Department of Neuroscience, Cell Biology, and Physiology, Boonshoft School of Medicine, Wright State University, Dayton, OH, United States
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6
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Gatford KL, Andraweera PH, Roberts CT, Care AS. Animal Models of Preeclampsia: Causes, Consequences, and Interventions. Hypertension 2020; 75:1363-1381. [PMID: 32248704 DOI: 10.1161/hypertensionaha.119.14598] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Preeclampsia is a common pregnancy complication, affecting 2% to 8% of pregnancies worldwide, and is an important cause of both maternal and fetal morbidity and mortality. Importantly, although aspirin and calcium are able to prevent preeclampsia in some women, there is no cure apart from delivery of the placenta and fetus, often necessitating iatrogenic preterm birth. Preclinical models of preeclampsia are widely used to investigate the causes and consequences of preeclampsia and to evaluate safety and efficacy of potential preventative and therapeutic interventions. In this review, we provide a summary of the published preclinical models of preeclampsia that meet human diagnostic criteria, including the development of maternal hypertension, together with new-onset proteinuria, maternal organ dysfunction, and uteroplacental dysfunction. We then discuss evidence from preclinical models for multiple causal factors of preeclampsia, including those implicated in early-onset and late-onset preeclampsia. Next, we discuss the impact of exposure to a preeclampsia-like environment for later maternal and progeny health. The presence of long-term impairment, particularly cardiovascular outcomes, in mothers and progeny after an experimentally induced preeclampsia-like pregnancy, implies that later onset or reduced severity of preeclampsia will improve later maternal and progeny health. Finally, we summarize published intervention studies in preclinical models and identify gaps in knowledge that we consider should be targets for future research.
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Affiliation(s)
- Kathryn L Gatford
- From the Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Australia
| | - Prabha H Andraweera
- From the Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Australia
| | - Claire T Roberts
- From the Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Australia
| | - Alison S Care
- From the Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Australia
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7
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Sureshchandra S, Marshall NE, Messaoudi I. Impact of pregravid obesity on maternal and fetal immunity: Fertile grounds for reprogramming. J Leukoc Biol 2019; 106:1035-1050. [PMID: 31483523 DOI: 10.1002/jlb.3ri0619-181r] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 12/12/2022] Open
Abstract
Maternal pregravid obesity results in several adverse health outcomes during pregnancy, including increased risk of gestational diabetes, preeclampsia, placental abruption, and complications at delivery. Additionally, pregravid obesity and in utero exposure to high fat diet have been shown to have detrimental effects on fetal programming, predisposing the offspring to adverse cardiometabolic, endocrine, and neurodevelopmental outcomes. More recently, a deeper appreciation for the modulation of offspring immunity and infectious disease-related outcomes by maternal pregravid obesity has emerged. This review will describe currently available animal models for studying the impact of maternal pregravid obesity on fetal immunity and review the data from clinical and animal model studies. We also examine the burden of pregravid obesity on the maternal-fetal interface and the link between placental and systemic inflammation. Finally, we discuss future studies needed to identify key mechanistic underpinnings that link maternal inflammatory changes and fetal cellular reprogramming events.
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Affiliation(s)
- Suhas Sureshchandra
- Department of Molecular Biology and Biochemistry, University of California Irvine, Irvine, CA, USA
| | - Nicole E Marshall
- Maternal-Fetal Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Ilhem Messaoudi
- Department of Molecular Biology and Biochemistry, University of California Irvine, Irvine, CA, USA
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8
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Lambert JA, Carlisle MA, Lam A, Aggarwal S, Doran S, Ren C, Bradley WE, Dell'Italia L, Ambalavanan N, Ford DA, Patel RP, Jilling T, Matalon S. Mechanisms and Treatment of Halogen Inhalation-Induced Pulmonary and Systemic Injuries in Pregnant Mice. Hypertension 2017; 70:390-400. [PMID: 28607126 DOI: 10.1161/hypertensionaha.117.09466] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 04/05/2017] [Accepted: 05/10/2017] [Indexed: 11/16/2022]
Abstract
Inhalation of oxidant gases has been implicated in adverse outcomes in pregnancy, but animal models to address mechanisms and studies to identify potential pregnancy-specific therapies are lacking. Herein, we show that inhalation of bromine at 600 parts per million for 30 minutes by pregnant mice on the 15th day of embryonic development results in significantly lower survival after 96 hours than an identical level of exposure in nonpregnant mice. On the 19th embryonic day, bromine-exposed pregnant mice have increased systemic blood pressure, abnormal placental development, severe fetal growth restriction, systemic inflammation, increased levels of circulating antiangiogenic short fms-like tyrosine kinase-1, and evidence of pulmonary and cardiac injury. Treatment with tadalafil, an inhibitor of type 5 phosphodiesterase, by oral gavage 1 hour post-exposure and then once daily thereafter, attenuated systemic blood pressures, decreased inflammation, ameliorated pulmonary and cardiac injury, and improved maternal survival (from 36% to 80%) and fetal growth. These pathological changes resemble those seen in preeclampsia. Nonpregnant mice did not exhibit any of these pathological changes and were not affected by tadalafil. These findings suggest that pregnant women exposed to bromine may require particular attention and monitoring for signs of preeclampsia-like symptoms.
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Affiliation(s)
- James A Lambert
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Matthew A Carlisle
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Adam Lam
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Saurabh Aggarwal
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Stephen Doran
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Changchun Ren
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Wayne E Bradley
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Louis Dell'Italia
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Namasivayam Ambalavanan
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - David A Ford
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Rakesh P Patel
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Tamas Jilling
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.)
| | - Sadis Matalon
- From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.).
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9
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Pendeloski KPT, Ono E, Torloni MR, Mattar R, Daher S. Maternal obesity and inflammatory mediators: A controversial association. Am J Reprod Immunol 2017; 77. [PMID: 28328066 DOI: 10.1111/aji.12674] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 02/22/2017] [Indexed: 12/11/2022] Open
Abstract
The link between maternal obesity and inflammatory mediators is still unclear. Our aim was to summarize the main findings of recently published studies on this topic. We performed a search in Medline for studies published in the last years on obesity, human pregnancy, and inflammatory mediators. We report the findings of 30 studies. The characteristics and number of participants, study design, gestational age at sample collection, and type of sample varied widely. Approximately two-thirds of them investigated more than one mediator, and 50% included participants in only one trimester of pregnancy. The most frequently investigated mediators were leptin, tumour necrosis factor-alpha (TNF-α), and interleukin (IL)-6. Almost all studies reported an association between maternal obesity, leptin, and C-reactive protein (CRP) serum levels but not with IL-1β and IL-10. The association of IL-6, TNF-α, monocyte chemo-attractant protein-1 (MCP-1), adiponectin, and resistin with maternal obesity is still controversial. To clarify the physiopathological link between maternal obesity and inflammation, more high-quality studies are needed.
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Affiliation(s)
| | - Erika Ono
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
| | - Maria Regina Torloni
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
| | - Rosiane Mattar
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
| | - Silvia Daher
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
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Pseuderanthemum palatiferum leaf extract inhibits the proinflammatory cytokines, TNF-α and IL-6 expression in LPS-activated macrophages. Food Chem Toxicol 2016; 97:11-22. [DOI: 10.1016/j.fct.2016.08.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 08/15/2016] [Accepted: 08/16/2016] [Indexed: 11/19/2022]
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11
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Abstract
Pregestational obesity is a significant risk factor for adverse pregnancy outcomes. Maternal obesity is associated with a specific proinflammatory, endocrine and metabolic phenotype that may lead to higher supply of nutrients to the feto-placental unit and to excessive fetal fat accumulation. In particular, obesity may influence placental fatty acid (FA) transport in several ways, leading to increased diffusion driving force across the placenta, and to altered placental development, size and exchange surface area. Animal models show that maternal obesity is associated with increased expression of specific FA carriers and inflammatory signaling molecules in placental cotyledonary tissue, resulting in enhanced lipid transfer across the placenta, dislipidemia, fat accumulation and possibly altered development in fetuses. Cell culture experiments confirmed that inflammatory molecules, adipokines and FA, all significantly altered in obesity, are important regulators of placental lipid exchange. Expression studies in placentas of obese-diabetic women found a significant increase in FA binding protein-4 expression and in cellular triglyceride content, resulting in increased triglyceride cord blood concentrations. The expression and activity of carriers involved in placental lipid transport are influenced by the endocrine, inflammatory and metabolic milieu of obesity, and further studies are needed to elucidate the strong association between maternal obesity and fetal overgrowth.
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Spradley FT, Palei AC, Granger JP. Increased risk for the development of preeclampsia in obese pregnancies: weighing in on the mechanisms. Am J Physiol Regul Integr Comp Physiol 2015; 309:R1326-43. [PMID: 26447211 DOI: 10.1152/ajpregu.00178.2015] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 09/28/2015] [Indexed: 11/22/2022]
Abstract
Preeclampsia (PE) is a pregnancy-specific disorder typically presenting as new-onset hypertension and proteinuria. While numerous epidemiological studies have demonstrated that obesity increases the risk of PE, the mechanisms have yet to be fully elucidated. Growing evidence from animal and human studies implicate placental ischemia in the etiology of this maternal syndrome. It is thought that placental ischemia is brought about by dysfunctional cytotrophoblast migration and invasion into the uterus and subsequent lack of spiral arteriole widening and placental perfusion. Placental ischemia/hypoxia stimulates the release of soluble placental factors into the maternal circulation where they cause endothelial dysfunction, particularly in the kidney, to elicit the clinical manifestations of PE. The most recognized of these factors are the anti-angiogenic sFlt-1 and pro-inflammatory TNF-α and AT1-AA, which promote endothelial dysfunction by reducing levels of the provasodilator nitric oxide and stimulating production of the potent vasoconstrictor endothelin-1 and reactive oxygen species. We hypothesize that obesity-related metabolic factors increase the risk for developing PE by impacting various stages in the pathogenesis of PE, namely, 1) cytotrophoblast migration and placental ischemia; 2) release of soluble placental factors into the maternal circulation; and 3) maternal endothelial and vascular dysfunction. This review will summarize the current experimental evidence supporting the concept that obesity and metabolic factors like lipids, insulin, glucose, and leptin affect placental function and increase the risk for developing hypertension in pregnancy by reducing placental perfusion; enhancing placental release of soluble factors; and by increasing the sensitivity of the maternal vasculature to placental ischemia-induced soluble factors.
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Affiliation(s)
- Frank T Spradley
- Department of Physiology and Biophysics, Cardiovascular-Renal Research Center, Women's Health Research Center, The University of Mississippi Medical Center, Jackson, Mississippi
| | - Ana C Palei
- Department of Physiology and Biophysics, Cardiovascular-Renal Research Center, Women's Health Research Center, The University of Mississippi Medical Center, Jackson, Mississippi
| | - Joey P Granger
- Department of Physiology and Biophysics, Cardiovascular-Renal Research Center, Women's Health Research Center, The University of Mississippi Medical Center, Jackson, Mississippi
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13
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Barry DR, Utzschneider KM, Tong J, Gaba K, Leotta DF, Brunzell JD, Easterling TR. Intraabdominal fat, insulin sensitivity, and cardiovascular risk factors in postpartum women with a history of preeclampsia. Am J Obstet Gynecol 2015; 213:104.e1-104.e11. [PMID: 26003058 PMCID: PMC5181653 DOI: 10.1016/j.ajog.2015.05.040] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 04/03/2015] [Accepted: 05/18/2015] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Women who develop preeclampsia have a higher risk of future cardiovascular disease and diabetes compared to women who have uncomplicated pregnancies. We hypothesized that women with prior preeclampsia would have increased visceral adiposity that would be a major determinant of their metabolic and cardiovascular risk factors. STUDY DESIGN We compared intraabdominal fat (IAF) area, insulin sensitivity index (SI), fasting lipids, low-density lipoprotein relative flotation rate, and brachial artery flow-mediated dilatation in 49 women with prior preeclampsia and 22 controls who were at least 8 months postpartum and matched for age, parity, body mass index, and months postpartum. Women were eligible if they did not smoke tobacco, use hormonal contraception, have chronic hypertension, or have a history of gestational diabetes. RESULTS The groups were similar for age (mean ± SD: prior preeclampsia 33.4 ± 6.6 vs control 34.6 ± 4.3 years), parity (median: 1 for both), body mass index (26.7 ± 5.9 vs 24.0 ± 7.3 kg/m(2)), and months postpartum (median [25th-75th percentile]: 16 [13-38] vs 16.5 [13-25]). There were no significant differences in IAF area and SI. Despite this, women with preeclampsia had lower high-density lipoprotein (46.0 ± 10.7 vs 51.3 ± 9.3 mg/dL; P < .05), smaller/denser low-density lipoprotein relative flotation rate (0.276 ± 0.022 vs 0.289 ± 0.016; P = .02), higher systolic (114.6 ± 10.9 vs 102.3 ± 7.5 mm Hg) and diastolic (67.6 ± 7.5 vs 60.9 ± 3.6 mm Hg; P < .001) blood pressures, and impaired flow-mediated dilatation (4.5 [2-6.7] vs 8.8 [4.5-9.1] percent change, P < .05) compared to controls. In a subgroup analysis, women with nonsevere preeclampsia (n = 17) had increased IAF (98.3 [60.1-122.2]) vs 63.1 [40.1-70.7] cm(2); P = .02) and decreased SI (4.18 [2.43-5.25] vs 5.5 [3.9-8.3] × 10(-5) min(-1)/pmol/L; P = .035) compared to the controls, whereas women with severe preeclampsia (n = 32) were not different for IAF and SI. IAF was negatively associated with SI and positively associated with cardiovascular risk factors even after adjusting for the matching variables and total body fat. CONCLUSION Women with prior preeclampsia have an atherogenic lipid profile and endothelial dysfunction compared to matched control subjects despite having similar adiposity and insulin sensitivity, suggesting that there are mechanisms separate from obesity and insulin resistance that lead to their cardiovascular risk factors. Visceral adiposity may have a role in contributing to these risk factors in the subgroup of women who have preeclampsia without severe features.
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Affiliation(s)
- Darcy R Barry
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Washington, Seattle, WA.
| | - Kristina M Utzschneider
- Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, Department of Veterans Affairs Puget Sound Health Care System, and University of Washington, University of Washington, Seattle, WA
| | - Jenny Tong
- Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Duke University, Durham, NC
| | - Kersten Gaba
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Washington, Seattle, WA
| | - Daniel F Leotta
- Applied Physics Laboratory, University of Washington, Seattle, WA
| | - John D Brunzell
- Division of Metabolism, Endocrinology, and Nutrition, Seattle, WA
| | - Thomas R Easterling
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Washington, Seattle, WA
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14
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Abstract
The incidence of obesity is increasing at an alarming rate. There is compelling evidence that obesity increases the risk of preeclampsia about 3-fold, and in developed countries is the leading attributable risk for the disorder. In this presentation we explore this relationship and propose targets for future studies guided by the much more extensively studied relationship of obesity to cardiovascular disease. We further address the hypothesis that asymmetric dimethyl arginine (ADMA), an endogenous inhibitor of nitric oxide synthase, may be one convergence point for the mechanism by which obesity increases the risk of preeclampsia. We conclude with consideration of the clinical implications of this information.
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Peiris HN, Georgiou H, Lappas M, Kaitu'u-Lino T, Salomón C, Vaswani K, Rice GE, Mitchell MD. Expression of Myostatin in Intrauterine Growth Restriction and Preeclampsia Complicated Pregnancies and Alterations to Cytokine Production by First-Trimester Placental Explants Following Myostatin Treatment. Reprod Sci 2015; 22:1202-11. [PMID: 25736326 DOI: 10.1177/1933719115572482] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Preeclampsia (PE) and intrauterine growth restriction (IUGR) are major obstetric health problems. Higher levels of T-helper (Th) 1 (proinflammatory) cytokines have been observed in pregnancies complicated with PE and IUGR; this is in contrast to the predominant Th2 (anti-inflammatory) cytokine environment found in uncomplicated pregnancies. Myostatin is best known as a negative regulator of muscle development and reportedly has a role in fat deposition, glucose metabolism, and cytokine modulation (outside the placenta). Myostatin concentrations in plasma and protein expression in placental tissue are significantly higher in women with PE. Expression of myostatin in IUGR and PE-IUGR and the effect of this protein on the cytokine production from the placenta is unknown. In the current study, significant differences were identified in the expression of myostatin in pregnancies complicated with IUGR, PE, and PE with IUGR. Furthermore, cytokine production by first-trimester placental tissues was altered following myostatin treatment.
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Affiliation(s)
| | - Harry Georgiou
- Department of Obstetrics & Gynaecology, The University of Melbourne, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Martha Lappas
- Department of Obstetrics & Gynaecology, The University of Melbourne, Mercy Hospital for Women, Heidelberg, Victoria, Australia Department of Obstetrics and Gynaecology, Obstetrics, Nutrition and Endocrinology Group, University of Melbourne, Melbourne, Victoria, Australia
| | - Tu'uhevaha Kaitu'u-Lino
- Department of Obstetrics & Gynaecology, The University of Melbourne, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Carlos Salomón
- The University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Kanchan Vaswani
- The University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Gregory E Rice
- The University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Murray D Mitchell
- The University of Queensland Centre for Clinical Research, Brisbane, Australia
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Founds SA, Ren D, Roberts JM, Jeyabalan A, Powers RW. Follistatin-like 3 across gestation in preeclampsia and uncomplicated pregnancies among lean and obese women. Reprod Sci 2014; 22:402-9. [PMID: 24700053 DOI: 10.1177/1933719114529372] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to examine circulating maternal follistatin-like 3 (FSTL-3) by gestational age and obesity in pregnancy and preeclampsia. FSTL-3 was quantified in maternal plasma collected in each trimester from prepregnancy body mass index-determined groups: 15 lean and 24 obese controls and 20 obese women who developed preeclampsia. Repeated measures mixed models and logistic regression were conducted (P ≤ .05). FSTL-3 was not related to maternal adiposity. FSTL-3 changed across pregnancy in lean controls and obese preeclampsia but not in obese controls. FSTL-3 was higher in preeclampsia in the second trimester compared to lean controls and in the third trimester compared to both control groups. Elevated FSTL-3 at mid-gestation was associated with an increased odds of preeclampsia (odds ratio 3.15; 95% confidence interval 1.19-8.36; P = .02). Elevated FSTL-3 concentrations were attributable to preeclampsia and were associated with increased likelihood of later developing preeclampsia, suggesting further study as a biomarker prior to clinically evident disease.
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Affiliation(s)
- Sandra A Founds
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA Magee-Womens Research Institute and Foundation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dianxu Ren
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA Center for Research and Evaluation, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - James M Roberts
- Magee-Womens Research Institute and Foundation, University of Pittsburgh, Pittsburgh, PA, USA Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA Clinical and Translational Research Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Arun Jeyabalan
- Magee-Womens Research Institute and Foundation, University of Pittsburgh, Pittsburgh, PA, USA Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert W Powers
- Magee-Womens Research Institute and Foundation, University of Pittsburgh, Pittsburgh, PA, USA Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA
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17
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Abstract
Preeclampsia is a pregnancy-specific disorder that affects 2-8% of all pregnancies and remains a leading cause of maternal and perinatal morbidity and mortality worldwide. Diagnosis is based on new onset of hypertension and proteinuria. Multiple organ systems can be affected, with severe disease resulting. The wide range of risk factors reflects the heterogeneity of preeclampsia. Obesity, which is increasing at an alarming rate, is also a risk factor for preeclampsia as well as for later-life cardiovascular disease. Exploring common features may provide insight into the pathophysiologic mechanisms underlying preeclampsia among obese and overweight women.
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Affiliation(s)
- Arun Jeyabalan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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18
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Lau SY, Guild SJ, Barrett CJ, Chen Q, McCowan L, Jordan V, Chamley LW. Tumor necrosis factor-alpha, interleukin-6, and interleukin-10 levels are altered in preeclampsia: a systematic review and meta-analysis. Am J Reprod Immunol 2013; 70:412-27. [PMID: 23790133 DOI: 10.1111/aji.12138] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 04/19/2013] [Indexed: 02/05/2023] Open
Abstract
PROBLEM Published reports testing the association between cytokine levels and preeclampsia are conflicting. This comprehensive systematic review and meta-analysis aimed at testing the association between preeclampsia and maternal circulating tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, and IL-10. METHOD OF STUDY A systematic literature search of studies reporting maternal circulating TNF-α, IL-6, and IL-10 in women with preeclampsia and normotensive pregnant women was conducted yielding 41, 28, and 12 eligible reports, respectively. RESULTS Both mild preeclampsia and severe preeclampsia were associated with elevated TNF-α [mean difference (MD) = 7.34 pg/mL, 95% CI 5.02-9.66 and MD = 7.91 pg/mL, 95% CI 4.72-11.10, respectively] and IL-6 (MD = 61.01 pg/mL, 95% CI 14.24-107.77 and MD = 28.54 pg/mL, 95% CI 15.90-41.17, respectively) in the third trimester. Preeclampsia was also associated with elevated levels of IL-10 (MD = 5.54, 95% CI 0.69-10.38). The systematic review of studies reporting median data was in consensus with the parametric data. CONCLUSION This systematic review and meta-analysis with accompanying summary of non-parametric data shows elevated maternal circulating TNF-α, IL-6, and IL-10 levels in preeclampsia.
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Affiliation(s)
- Sien Yee Lau
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand; Department of Physiology, University of Auckland, Auckland, New Zealand
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Tayal D, Goswami B, Patra SK, Tripathi R, Khaneja A. Association of inflammatory cytokines, lipid peroxidation end products and nitric oxide with the clinical severity and fetal outcome in preeclampsia in Indian women. Indian J Clin Biochem 2013; 29:139-44. [PMID: 24757293 DOI: 10.1007/s12291-013-0320-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 03/24/2013] [Indexed: 11/25/2022]
Abstract
Preeclampsia is a multisystem disorder associated with maternal hypertension, placental abnormalities and adverse fetal outcomes. The various pathways involved in its etiology include endothelial dysfunction, inflammatory milieu, lipid peroxidation and immunological imbalance. The present study was conducted to evaluate the causative and predictive role of nitric oxide, lipid peroxidation end products (MDA) and inflammatory cytokines (IL-6, TNF-α) in clinical presentation, severity and fetal outcome in preeclampsia. The study population was divided into 3 groups- Non- pregnant females comprising the control population; G1 and G2 groups included normal pregnant and pregnant females with preeclampsia with 50 patients in each group. Nitric Oxide and MDA levels were found to be highest in the preeclamptic patients as compared to other two groups. ROC curve analysis shows the superiority of the inflammatory markers as determinants of severity of preeclampsia which suggests the emerging role of pro inflammatory markers in the various pathological changes in preeclampsia. TNF-α emerged as the best marker in multivariate analysis and thus, has the potential for being used as a marker for PIH. Our study illustrates the multifactorial etiology of preeclampsia involving oxidative stress, proinflammatory milieu and endothelial dysfunction.
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Affiliation(s)
- Devika Tayal
- Department of Biochemistry, Lala Ram Swaroop Institute, New Delhi, India
| | - Binita Goswami
- Department of Biochemistry, Lady Hardinge Medical College, New Delhi, India
| | - S K Patra
- Department of Biochemistry, Lady Hardinge Medical College, New Delhi, India
| | - Reva Tripathi
- Department of Obstetrics & Gynaecology, Maulana Azad Medical College & Associated LN Hospital, New Delhi, India
| | - Alka Khaneja
- Department of Biochemistry, Maulana Azad Medical College & Associated LN Hospital, New Delhi, India
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Latendresse G, Ruiz RJ, Wong B. Psychological distress and SSRI use predict variation in inflammatory cytokines during pregnancy. ACTA ACUST UNITED AC 2013; 3:184-191. [PMID: 24524011 DOI: 10.4236/ojog.2013.31a034] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Evidence supports the premise that maternal psychological distress adversely affects pregnancy outcomes and that inflammatory markers and placentally-produced corticotrophin-releasing hormone (pCRH) are likely mediating factors. The primary aim of the study was to explore the associations between maternal psychological distress, use of selective serotonin re-uptake inhibitors, pCRH, and maternal plasma inflammatory markers during pregnancy. Measures of maternal plasma pCRH, Interleukins-1, 6, & 10, C-Reactive Protein, Macrophage Migration Inhibitory Factor, and Tumor Necrosis Factor-α were completed in 100 pregnant women. Measures of depression, anxiety, and perceived stress were completed, as well as collection of demographic/behavioral data, e.g. use of selective serotonin re-uptake inhibitors (SSRIs). Significant correlations were found at 14-20 weeks gestation between IL-6 & 10, and depression, anxiety, and perceived stress. Also at 14 - 20 weeks gestation, IL10 levels were significantly lower in women with 4th quartile pCRH levels and IL1β, IL6, and IL10 were significantly lower among women who took an SSRI during pregnancy. After controlling for maternal age, BMI, pCRH level, and SSRI use, psychological distress remained to explain variation in maternal inflammatory markers. These results might suggest that future research should focus on whether depression and anxiety are effectively being treated during pregnancy, and how such a scenario might contribute to an immune system pathway to poor pregnancy outcome.
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Affiliation(s)
| | - R Jeanne Ruiz
- College of Nursing, University of Texas-Austin, Austin, USA
| | - Bob Wong
- College of Nursing, University of Utah, Salt Lake City, USA
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Xie C, Yao MZ, Liu JB, Xiong LK. A meta-analysis of tumor necrosis factor-alpha, interleukin-6, and interleukin-10 in preeclampsia. Cytokine 2011; 56:550-9. [DOI: 10.1016/j.cyto.2011.09.021] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 08/29/2011] [Accepted: 09/26/2011] [Indexed: 12/11/2022]
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Obesity and the placenta: A consideration of nutrient exchange mechanisms in relation to aberrant fetal growth. Placenta 2010; 32:1-7. [PMID: 21030077 DOI: 10.1016/j.placenta.2010.09.019] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 09/12/2010] [Accepted: 09/30/2010] [Indexed: 01/22/2023]
Abstract
The obesity epidemic, including childhood obesity, is rapidly gaining strength as one of the most significant challenges to the health of the global community in the 21st Century. The proportion of women who are obese at the beginning of pregnancy is also increasing. These women and their babies are at high risk of pregnancy complications, and of programming for metabolic disease in adult life. In particular, maternal obesity is associated with aberrant fetal growth, encompassing both growth restricted and large for gestational age, or macrosomic fetuses. This article considers the potential effect of obesity and adipose tissue on placental nutrient exchange mechanisms in relation to aberrant fetal growth. The review emphasizes the dearth of work on this topic to date despite its importance to current and future healthcare of the population.
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Founds SA, Catov JM, Gallaher MJ, Harger GF, Markovic N, Roberts JM. Is there evidence of separate inflammatory or metabolic forms of preeclampsia? Hypertens Pregnancy 2010; 30:1-10. [PMID: 20462373 DOI: 10.3109/10641950903322907] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To examine whether high insulin resistance versus high inflammation identifies subtypes of preeclampsia. METHODS A cytokine panel, glucose and insulin were measured in 37 preeclampsia plasma samples. Wilcoxon rank sum assessed median concentration of HOMA(IR) by pro-inflammatory:anti-inflammatory ratio. Regression stratifying by BMI and preterm birth was conducted. RESULTS There was no difference in median HOMA(IR) by the pro-inflammatory:anti-inflammatory ratio (p = 0.16). No subsets scatterplot clusters emerged. A positive correlation between HOMAlog and the ratio was significant (p = 0.04). CONCLUSIONS No dichotomous subsets of preeclampsia by inflammation versus insulin resistance were detected. Contrary to our hypothesis, insulin resistance was higher as inflammation increased in preeclampsia.
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Affiliation(s)
- Sandra A Founds
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA.
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ÜstÜn Y, Engin-ÜstÜn Y, Özkaplan E, Otlu B, Sait TekerekoĞlu M. Association ofHelicobacter pyloriinfection with systemic inflammation in preeclampsia. J Matern Fetal Neonatal Med 2010; 23:311-4. [DOI: 10.3109/14767050903121456] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Maternal obesity and markers of inflammation in pregnancy. Cytokine 2009; 47:61-4. [PMID: 19505831 DOI: 10.1016/j.cyto.2009.05.004] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 04/09/2009] [Accepted: 05/07/2009] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To evaluate whether obesity is associated with changes in pro-inflammatory and immunomodulatory cytokines in pregnancy. METHODS We performed a cross-sectional study using maternal serum from the early second trimester to examine biomarkers associated with inflammation in relation to maternal body mass index (n=80 total). RESULTS Leptin and high sensitivity C-reactive protein were significantly different between groups and increased with increasing body mass index. MCP-1 was significantly increased in the morbidly obese mothers. Interleukin-2 exhibited a U-shaped relationship with body mass index; transforming growth factor-beta1 demonstrated a nonsignificant negative trend with body mass index; and the levels of hepatocyte growth factor and tumor necrosis factor-alpha did not differ appreciably between groups. CONCLUSIONS Maternal obesity in pregnancy is associated with changes in cytokines, protein hormones and acute phase proteins in the second trimester, with an increase in MCP-1 in the morbid obesity category, and an increase in Leptin and hsCRP with increasing BMI category.
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