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Widyaputri F, Khong EWC, Rogers SL, Nankervis AJ, Conn JJ, Sasongko MB, Shub A, Fagan XJ, Guest D, Symons RCA, Lim LL. Progression of diabetic retinopathy in women with pregestational diabetes during pregnancy and postpartum. Clin Exp Ophthalmol 2024. [PMID: 38895754 DOI: 10.1111/ceo.14410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 05/14/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Diabetic retinopathy (DR) may worsen during pregnancy, but its course in the postpartum remains poorly understood. Understanding the natural history of DR during and after pregnancy can help determine when sight-threatening DR treatment should be administered. METHODS A prospective longitudinal cohort study recruited pregnant women with pre-existing type 1 (T1D) or type 2 diabetes from two tertiary Diabetes Antenatal Clinics in Melbourne, Australia. Eye examination results in early pregnancy, late pregnancy, and up to 12-months postpartum were compared to determine DR changes. Two-field fundus photographs and optical coherence tomography scans were used to assess DR severity. RESULTS Overall, 105 (61.4%) women had at least two eye examinations during the observation period. Mean age was 33.5 years (range 19-51); 54 women (51.4%) had T1D; 63% had HbA1c <7% in early pregnancy. DR progression rate was 23.8% (95% CI 16.4-32.6). Having T1D (RR 4.96, 95% CI 1.83-13.46), pre-existing DR in either eye (RR 4.54, 95% CI 2.39-8.61), and elevated systolic blood pressure (adjusted RR 2.49, 95% CI 1.10-5.66) were associated with increased risk of progression. Sight-threatening progression was observed in 9.5% of women. Among the 19 eyes with progression during pregnancy, 15 eyes remained stable, three eyes progressed, and only one eye regressed in the postpartum. CONCLUSIONS Nearly 1 in 4 women had DR progression from conception through to 12-months postpartum; almost half of these developing sight-threatening disease. DR progression occurring during pregnancy was found to predominantly remain unchanged, or worsen, after delivery, with very few eyes spontaneously improving postpartum.
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Affiliation(s)
- Felicia Widyaputri
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
- Department of Ophthalmology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Edmund W C Khong
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Sophie L Rogers
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Alison J Nankervis
- Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Diabetes and Endocrine Service, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Jennifer J Conn
- Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Diabetes and Endocrine Service, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Muhammad B Sasongko
- Department of Ophthalmology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Alexis Shub
- Perinatal Department, Mercy Hospital for Women, Heidelberg, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Xavier J Fagan
- Department of Ophthalmology, Austin Hospital, Heidelberg, Victoria, Australia
- Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Daryl Guest
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Robert C A Symons
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Department of Surgery, Alfred Hospital, Monash University, Clayton, Victoria, Australia
| | - Lyndell L Lim
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
- Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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Hoorn QA, Zayas GA, Rodriguez EE, Jensen LM, Mateescu RG, Hansen PJ. Identification of quantitative trait loci and associated candidate genes for pregnancy success in Angus-Brahman crossbred heifers. J Anim Sci Biotechnol 2023; 14:137. [PMID: 37932831 PMCID: PMC10629031 DOI: 10.1186/s40104-023-00940-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/10/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND In beef cattle, more than 50% of the energy input to produce a unit of beef is consumed by the female that produced the calf. Development of genomic tools to identify females with high genetic merit for reproductive function could increase the profitability and sustainability of beef production. RESULTS Genome-wide association studies (GWAS) were performed using a single-step genomic best linear unbiased prediction approach on pregnancy outcome traits from a population of Angus-Brahman crossbred heifers. Furthermore, a validation GWAS was performed using data from another farm. Heifers were genotyped with the Bovine GGP F250 array that contains 221,077 SNPs. In the discovery population, heifers were bred in winter breeding seasons involving a single round of timed artificial insemination (AI) followed by natural mating for 3 months. Two phenotypes were analyzed: pregnancy outcome to first-service AI (PAI; n = 1,481) and pregnancy status at the end of the breeding season (PEBS; n = 1,725). The heritability was estimated as 0.149 and 0.122 for PAI and PEBS, respectively. In the PAI model, one quantitative trait locus (QTL), located between 52.3 and 52.5 Mb on BTA7, explained about 3% of the genetic variation, in a region containing a cluster of γ-protocadherin genes and SLC25A2. Other QTLs explaining between 0.5% and 1% of the genetic variation were found on BTA12 and 25. In the PEBS model, a large QTL on BTA7 was synonymous with the QTL for PAI, with minor QTLs located on BTA5, 9, 10, 11, 19, and 20. The validation population for pregnancy status at the end of the breeding season were Angus-Brahman crossbred heifers bred by natural mating. In concordance with the discovery population, the large QTL on BTA7 and QTLs on BTA10 and 12 were identified. CONCLUSIONS In summary, QTLs and candidate SNPs identified were associated with pregnancy outcomes in beef heifers, including a large QTL associated with a group of protocadherin genes. Confirmation of these associations with larger populations could lead to the development of genomic predictions of reproductive function in beef cattle. Moreover, additional research is warranted to study the function of candidate genes associated with QTLs.
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Affiliation(s)
- Quinn A Hoorn
- Department of Animal Sciences, Donald Henry Barron Reproductive and Perinatal Biology Research Program, and the Genetics Institute, University of Florida, Gainesville, FL, USA
| | - Gabriel A Zayas
- Department of Animal Sciences, Donald Henry Barron Reproductive and Perinatal Biology Research Program, and the Genetics Institute, University of Florida, Gainesville, FL, USA
| | - Eduardo E Rodriguez
- Department of Animal Sciences, Donald Henry Barron Reproductive and Perinatal Biology Research Program, and the Genetics Institute, University of Florida, Gainesville, FL, USA
| | - Laura M Jensen
- Present address: School of Applied Systems Biology, La Trobe University, Bundoora, VIC, 3083, Australia
| | - Raluca G Mateescu
- Department of Animal Sciences, Donald Henry Barron Reproductive and Perinatal Biology Research Program, and the Genetics Institute, University of Florida, Gainesville, FL, USA
| | - Peter J Hansen
- Department of Animal Sciences, Donald Henry Barron Reproductive and Perinatal Biology Research Program, and the Genetics Institute, University of Florida, Gainesville, FL, USA.
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Duman H, Karav S. Bovine colostrum and its potential contributions for treatment and prevention of COVID-19. Front Immunol 2023; 14:1214514. [PMID: 37908368 PMCID: PMC10613682 DOI: 10.3389/fimmu.2023.1214514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/27/2023] [Indexed: 11/02/2023] Open
Abstract
Bovine colostrum (BC) is the initial milk an animal produces after giving birth, particularly in the first few days. Numerous bioactive substances found in BC, including proteins, enzymes, growth factors, immunoglobulins, etc., are beneficial to human health. BC has a significant role to play as part of a healthy diet, with well-documented health and nutritional advantages for people. Therefore, the use of BC and its crucial derivatives in the development of functional food and pharmaceuticals for the prevention of several diseases such as gastrointestinal and respiratory system disorders is becoming increasingly popular around the world. A novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the cause of a cluster of pneumonia cases that is called Coronavirus Disease 2019 (COVID-19) in China. After the first SARS-CoV-2 virus-related fatality was announced, the illness quickly spread throughout China and to other continents, causing a pandemic. Since then, numerous studies have been initiated to develop safe and efficient treatments. To prevent viral infection and potential lingering effects, it is important to investigate alternative treatments for COVID-19. Due to its effective bioactive profile and its immunomodulatory roles in biological processes, BC might be considered a promising approach to assist in combating people affected by the SARS-CoV-2 or prevention from the virus. BC has immunomodulatory effects because to its high concentration of bioactive components such as immunoglobulins, lactoferrin, cytokines, and growth factors, etc., which might help control immunological responses, potentially fostering a balanced immune response. Furthermore, its bioactive components have a potential cross-reactivity against SARS-CoV-2, aiding in virus neutralization and its comprehensive food profile also supplies important vitamins, minerals, and amino acids, fostering a healthy immune system. Hence, the possible contributions of BC to the management of COVID-19 were reviewed in this article based on the most recent research on the subject. Additionally, the key BC components that influence immune system modulation were evaluated. These components may serve as potential mediators or therapeutic advantages in COVID-19.
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Affiliation(s)
| | - Sercan Karav
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Türkiye
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Demarinis G, Tatti F, Taloni A, Giugliano AV, Panthagani J, Myerscough J, Peiretti E, Giannaccare G. Treatments for Ocular Diseases in Pregnancy and Breastfeeding: A Narrative Review. Pharmaceuticals (Basel) 2023; 16:1433. [PMID: 37895903 PMCID: PMC10610321 DOI: 10.3390/ph16101433] [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: 07/30/2023] [Revised: 09/30/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023] Open
Abstract
Pregnancy is a medical condition in which the physiological changes in the maternal body and the potential impact on the developing fetus require a cautious approach in terms of drug administration. Individual treatment, a thorough assessment of the extent of the disease, and a broad knowledge of the therapeutic options and different routes of administration of ophthalmic drugs are essential to ensure the best possible results while minimizing risks. Although there are currently several routes of administration of drugs for the treatment of eye diseases, even with topical administration, there is a certain amount of systemic absorption that must be taken into account. Despite continuous developments and advances in ophthalmic drugs, no updated data are available on their safety profile in these contexts. The purpose of this review is both to summarize the current information on the safety of ophthalmic treatments during pregnancy and lactation and to provide a practical guide to the ophthalmologist for the treatment of eye diseases while minimizing harm to the developing fetus and addressing maternal health needs.
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Affiliation(s)
- Giuseppe Demarinis
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Via Ospedale 48, 09124 Cagliari, Italy; (G.D.); (F.T.); (E.P.)
| | - Filippo Tatti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Via Ospedale 48, 09124 Cagliari, Italy; (G.D.); (F.T.); (E.P.)
| | - Andrea Taloni
- Department of Ophthalmology, University ‘Magna Græcia’ of Catanzaro, Viale Europa, 88100 Catanzaro, Italy;
| | | | - Jesse Panthagani
- Department of Ophthalmology, Southend University Hospital, Southend-on-Sea SS0 0RY, UK; (J.P.); (J.M.)
| | - James Myerscough
- Department of Ophthalmology, Southend University Hospital, Southend-on-Sea SS0 0RY, UK; (J.P.); (J.M.)
| | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Via Ospedale 48, 09124 Cagliari, Italy; (G.D.); (F.T.); (E.P.)
| | - Giuseppe Giannaccare
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Via Ospedale 48, 09124 Cagliari, Italy; (G.D.); (F.T.); (E.P.)
- Department of Ophthalmology, University ‘Magna Græcia’ of Catanzaro, Viale Europa, 88100 Catanzaro, Italy;
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Kaur M, Kaur R, Chhabra K, Khetarpal P. Maternal candidate gene variants, epigenetic factors, and susceptibility to idiopathic recurrent pregnancy loss: A systematic review. Int J Gynaecol Obstet 2023; 162:829-841. [PMID: 36710639 DOI: 10.1002/ijgo.14701] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/13/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND Recurrent pregnancy loss is defined as the loss of two or more pregnancies and is a distressing condition for couples. OBJECTIVE To investigate the relationship between variants in the candidate susceptibility genes and epigenetic factors to identify risk factors for idiopathic recurrent pregnancy loss (iRPL). SEARCH STRATEGY A systematic literature search was performed using PubMed, Google Scholar, ScienceDirect, and Scopus databases. Insilico analysis was carried out using ShinyGO and STRING software. SELECTION CRITERIA Research papers examining the association between variations in genetic and epigenetic factors and iRPL. DATA COLLECTION AND ANALYSIS Data were independently extracted by two authors. MAIN RESULTS In total, 83 research papers were finally selected for the present study. Among all the genes involved in the pathogenesis of recurrent pregnancy loss, polymorphisms in IL superfamily genes, VEGF, ESR, and MTHFR were the most investigated. CONCLUSION Polymorphisms in angiogenesis, immune tolerance, and thrombophilia pathway genes, which occur independently or synergistically, may lead to various complications during fetal development. Identification of multi-allele risk variants and epigenetic factors in women will be helpful in the identification of high-risk pregnancies. PROSPERO REGISTRATION NUMBER Prospero CRD42021287315.
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Affiliation(s)
- Mandeep Kaur
- Human Genetics Department, Punjabi University Patiala, Patiala, India
| | - Rajinder Kaur
- Human Genetics Department, Punjabi University Patiala, Patiala, India
| | - Kiran Chhabra
- Chhabra Hospital & Test Tube Baby Centre, Bathinda, India
| | - Preeti Khetarpal
- Human Genetics and Molecular Medicine Department, Central University of Punjab, Bathinda, India
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Ling XC, Kang EYC, Chen KJ, Wang NK, Liu L, Chen YP, Hwang YS, Lai CC, Yang SF, Wu WC. Associations of VEGF Polymorphisms With Retinopathy of Prematurity. Invest Ophthalmol Vis Sci 2023; 64:11. [PMID: 37272765 PMCID: PMC10246755 DOI: 10.1167/iovs.64.7.11] [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] [Received: 07/20/2022] [Accepted: 05/13/2023] [Indexed: 06/06/2023] Open
Abstract
Purpose This study investigated the associations between vascular endothelial growth factor (VEGF) polymorphisms and retinopathy of prematurity (ROP) risk. Methods Infants born prematurely at any time from 2009 to 2018 were included. Five single-nucleotide polymorphisms (SNPs) of VEGF were analyzed using real-time PCR in all infants. Multivariate logistic regression was applied to model the associations between VEGF polymorphisms and ROP susceptibility, severity, and premature clinicopathologic characteristics. Results A total of 334 patients were included and categorized into three groups: those without ROP, those with mild ROP (i.e., ROP not requiring treatment), and those with severe ROP (i.e., ROP for whom treatment was indicated). Among the female patients with ROP, those with VEGF rs3025035 CT (3.231-fold; 95% confidence interval [CI], 1.238-8.431) and a combination of CT and TT genotypes (2.643-fold; 95% CI, 1.056-6.619) exhibited significantly higher risks of severe ROP compared with those with wild-type genotypes. Female ROP infants with VEGF rs3025010 C (TC + CC) alleles had a lower risk of ROP stage ≥3 (odds ratio [OR] = 0.406; 95% CI, 0.165-0.999) than those with TT homozygotes. ROP patients with the VEGF rs10434 A allele (GA + AA) exhibited higher risks of necrotizing enterocolitis (OR = 2.750; 95% CI, 1.119-6.759) and lower risk of bronchopulmonary dysplasia (OR = 0.390; 95% CI, 0.173-0.877) than those with GG homozygotes did. Conclusions VEGF polymorphisms affect ROP risks differently in male and female infants. In female infants, VEGF rs3025035 with T alleles may predict ROP severity, and VEGF rs3025010 with C alleles may protect against severe ROP.
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Affiliation(s)
- Xiao Chun Ling
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Eugene Yu-Chuan Kang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuan-Jen Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Nan-Kai Wang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Laura Liu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yen-Po Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Tucheng, Taiwan
| | - Yih-Shiou Hwang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Chun Lai
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Hăşmăşanu MG, Procopciuc LM, Matyas M, Zonda GI, Zaharie GC. Genetic Polymorphisms of Vascular Endothelial Growth Factor in Neonatal Pathologies: A Systematic Search and Narrative Synthesis of the Literature. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040744. [PMID: 37189993 DOI: 10.3390/children10040744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/11/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023]
Abstract
(1) Background: Vascular endothelial growth factor (VEGF) is essential in vasculo- and angiogenesis due to its role in endothelial cell proliferation and migration. As a vascular proliferative factor, VEGF is one of the hallmarks of cancer and, in adult populations, the relationship between genetic polymorphism and neoplasm was widely investigated. For the neonatal population, only a few studies attempted to uncover the link between the genetic polymorphism of VEGF and neonatal pathology, especially related to late-onset complications. Our objective is to evaluate the literature surrounding VEGF genetic polymorphisms and the morbidity of the neonatal period. (2) Methods: A systematic search was initially conducted in December 2022. The PubMed platform was used to explore MEDLINE (1946 to 2022) and PubMed Central (2000 to 2022) by applying the search string ((VEGF polymorphism*) and newborn*). (3) Results: The PubMed search yielded 62 documents. A narrative synthesis of the findings was undertaken considering our predetermined subheadings (infants with low birth weight or preterm birth, heart pathologies, lung diseases, eye conditions, cerebral pathologies, and digestive pathologies). (4) Conclusion: The VEGF polymorphisms seem to be associated with neonatal pathology. The involvement of VEGF and VEGF polymorphism has been demonstrated for retinopathy of prematurity.
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Affiliation(s)
- Monica G Hăşmăşanu
- Department of Neonatology, Iuliu Haţieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Lucia M Procopciuc
- Department of Medical Biochemistry, Iuliu Haţieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Melinda Matyas
- Department of Neonatology, Iuliu Haţieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Gabriela I Zonda
- Department of Mother and Child Care, "Grigore T. Popa" University of Medicine and Pharmacy Iasi, 700115 Iași, Romania
| | - Gabriela C Zaharie
- Department of Neonatology, Iuliu Haţieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
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Nabweyambo S, Kanyerezi S, Petterson JHO, Katabazi FA, Ssekagiri A, Mwesigwa S, Mboowa G, Nakazzi F, Keesiga A, Adroma M, Bwanga F, McGovern N, Sande OJ, Nakimuli A. No association of a Vascular endothelial growth factor A (VEGFA) gene polymorphism with pre-eclampsia among pregnant women in Uganda. BMC Genomics 2023; 24:132. [PMID: 36941544 PMCID: PMC10029258 DOI: 10.1186/s12864-023-09213-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 02/27/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Vascular endothelial growth factor A (VEGFA) is a major angiogenic factor that plays an important role in the formation of blood vessels during embryonic development. VEGFA has been implicated in the pathophysiology of pre-eclampsia (PE), since pre-eclamptic women present with reduced levels of free circulating VEGFA. The 3' untranslated region (3'-UTR) of the VEGFA gene consists of elements that regulate the transcription and hence expression of the VEGFA protein in circulation. Hence it is suggested that variations thereof could underlie the reduced VEGFA levels observed in pre-eclamptic women. The purpose of this study was to investigate presence of the + 936C/T polymorphism, a common single nucleotide polymorphism (SNP) in the 3'-UTR of the VEGFA gene, and determine its association with PE among pregnant women in Uganda. RESULTS There was no significant difference observed in the allele and genotype frequencies of the + 936C/T 3' UTR-VEGFA polymorphism between pre-eclamptic and normotensive pregnant women (P > 0.05). Additionally, there was no significant difference in the median plasma levels of free VEGFA among women with the wild type, CT and TT genotypes of the + 936C/T VEGFA polymorphism (median = 0.84 pg/mL (IQR = 0.39-1.41) Vs 1.05 (0.61-1.18) Vs 1.05 (1.05-1.05) respectively, p-value = 0.7161). CONCLUSIONS These study findings indicate that the + 936C/T 3' UTR-VEGFA polymorphism had no significant association with increased susceptibility to PE among women in Uganda. Further studies with a larger sample size are recommended.
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Affiliation(s)
- Sheila Nabweyambo
- Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Stephen Kanyerezi
- The African Center of Excellence in Bioinformatics and Data-Intensive Sciences, Infectious Diseases Institute, Makerere University, Kampala, Uganda
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - John H-O Petterson
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center, University of Uppsala, Uppsala, Sweden
- Clinical Microbiology and Hospital Hygiene, Uppsala University Hospital, Uppsala, Sweden
- Sydney Institute for Infectious Diseases, School of Life and Environmental Sciences and School of Medical Sciences, the University of Sydney, Sydney, Australia
| | - Fred Ashaba Katabazi
- Medical and Molecular Laboratory, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Alfred Ssekagiri
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
- Uganda Virus Research Institute, Entebbe, Uganda
| | - Savannah Mwesigwa
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Gerald Mboowa
- The African Center of Excellence in Bioinformatics and Data-Intensive Sciences, Infectious Diseases Institute, Makerere University, Kampala, Uganda
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Faith Nakazzi
- Medical and Molecular Laboratory, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Annette Keesiga
- Department of Obstetrics and Gynaecology, Kawempe National Referral Hospital, Kampala, Uganda
| | - Moses Adroma
- Department of Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Freddie Bwanga
- Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Naomi McGovern
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, UK
| | - Obondo James Sande
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Annettee Nakimuli
- Department of Obstetrics and Gynaecology, Kawempe National Referral Hospital, Kampala, Uganda
- Department of Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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Zehden JA, Mortensen XM, Reddy A, Zhang AY. Systemic and Ocular Adverse Events with Intravitreal Anti-VEGF Therapy Used in the Treatment of Diabetic Retinopathy: a Review. Curr Diab Rep 2022; 22:525-536. [PMID: 36053385 DOI: 10.1007/s11892-022-01491-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Intravitreal anti-vascular endothelial growth factor (VEGF) agents are used routinely in the management of neovascular conditions including proliferative diabetic retinopathy and diabetic macular edema. While the efficacy of anti-VEGF agents has been well-validated, their ocular and systemic adverse events should always be considered and discussed with patients. The aim of this review is to discuss the most recent literature reports regarding the various ocular and systemic adverse events associated with intravitreal anti-VEGF treatment in diabetic retinopathy. RECENT FINDINGS The most frequently reported adverse ocular events include subconjunctival hemorrhage, vitreous hemorrhage, increased intraocular pressure, uveitis, endophthalmitis, ocular surface disease, and traumatic cataract. Subconjunctival hemorrhage and vitreous hemorrhage are the most common ocular adverse events reported with intravitreal anti-VEGF treatment. The most serious (though rare) ocular adverse events include endophthalmitis and rhegmatogenous retinal detachment. A consensus regarding the association of systemic adverse events (such as myocardial infarction, stroke, and death) with intravitreal anti-VEGF treatments has not been established. Intravitreal anti-VEGF therapy is used in the treatment of diabetic retinopathy, macular degeneration, and other diseases. These agents are associated with a variety of ocular and systemic adverse events that ophthalmologists should always consider.
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Affiliation(s)
- Jason A Zehden
- Department of Ophthalmology, University of North Carolina at Chapel Hill, 2226 Nelson Hwy Suite 200, Chapel Hill, NC, 27517, USA
| | - Xavier M Mortensen
- Department of Ophthalmology, University of North Carolina at Chapel Hill, 2226 Nelson Hwy Suite 200, Chapel Hill, NC, 27517, USA
| | - Ashvini Reddy
- Athena Eye Institute, San Antonio, TX, USA
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Alice Yang Zhang
- Department of Ophthalmology, University of North Carolina at Chapel Hill, 2226 Nelson Hwy Suite 200, Chapel Hill, NC, 27517, USA.
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Wu CQ, Nichols K, Carwana M, Cormier N, Maratta C. Preterm birth after recurrent pregnancy loss: a systematic review and meta-analysis. Fertil Steril 2022; 117:811-819. [DOI: 10.1016/j.fertnstert.2022.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 12/19/2022]
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11
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Choo PP, Md Din N, Azmi N, Bastion MLC. Review of the management of sight-threatening diabetic retinopathy during pregnancy. World J Diabetes 2021; 12:1386-1400. [PMID: 34630896 PMCID: PMC8472492 DOI: 10.4239/wjd.v12.i9.1386] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/25/2021] [Accepted: 08/12/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetes mellitus (DM) is a noncommunicable disease reaching epidemic proportions around the world. It affects younger individuals, including women of childbearing age. Diabetes can cause diabetic retinopathy (DR), which is potentially sight threatening when severe nonproliferative DR (NPDR), proliferative DR (PDR), or sight-threatening diabetic macular oedema (STDME) develops. Pregnancy is an independent risk factor for the progression of DR. Baseline DR at the onset of pregnancy is an important indicator of progression, with up to 10% of women with baseline NPDR progressing to PDR. Progression to sight-threatening DR (STDR) during pregnancy causes distress to the patient and often necessitates ocular treatment, which may have a systemic effect. Management includes prepregnancy counselling and, when possible, conventional treatment prior to pregnancy. During pregnancy, closer follow-up is required for those with a long duration of DM, poor baseline control of blood sugar and blood pressure, and worse DR, as these are risk factors for progression to STDR. Conventional treatment with anti-vascular endothelial growth factor agents for STDME can potentially lead to foetal loss. Treatment with laser photocoagulation may be preferred, and surgery under general anaesthesia should be avoided. This review provides a management plan for STDR from the perspective of practising ophthalmologists. A review of strategies for maintaining the eyesight of diabetic women with STDR with emphasis on prepregnancy counselling and planning, monitoring and safe treatment during pregnancy, and management of complications is presented.
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Affiliation(s)
- Priscilla Peixi Choo
- Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Wilayah Persekutuan, Malaysia
| | - Norshamsiah Md Din
- Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Wilayah Persekutuan, Malaysia
| | - Nooraniah Azmi
- Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Wilayah Persekutuan, Malaysia
- Department of Ophthalmology, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Mae-Lynn Catherine Bastion
- Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Wilayah Persekutuan, Malaysia
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12
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Milk Proteins-Their Biological Activities and Use in Cosmetics and Dermatology. Molecules 2021; 26:molecules26113253. [PMID: 34071375 PMCID: PMC8197926 DOI: 10.3390/molecules26113253] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 02/06/2023] Open
Abstract
Milk and colostrum have high biological potential, and due to their natural origin and non-toxicity, they have many uses in cosmetics and dermatology. Research is ongoing on their potential application in other fields of medicine, but there are still few results; most of the published ones are included in this review. These natural products are especially rich in proteins, such as casein, β-lactoglobulin, α-lactalbumin, lactoferrin, immunoglobulins, lactoperoxidase, lysozyme, and growth factors, and possess various antibacterial, antifungal, antiviral, anticancer, antioxidant, immunomodulatory properties, etc. This review describes the physico-chemical properties of milk and colostrum proteins and the natural functions they perform in the body and compares their composition between animal species (cows, goats, and sheep). The milk- and colostrum-based products can be used in dietary supplementation and for performing immunomodulatory functions; they can enhance the effects of certain drugs and can have a lethal effect on pathogenic microorganisms. Milk products are widely used in the treatment of dermatological diseases for promoting the healing of chronic wounds, hastening tissue regeneration, and the treatment of acne vulgaris or plaque psoriasis. They are also increasingly regarded as active ingredients that can improve the condition of the skin by reducing the number of acne lesions and blackheads, regulating sebum secretion, ameliorating inflammatory changes as well as bestowing a range of moisturizing, protective, toning, smoothing, anti-irritation, whitening, soothing, and antiaging effects.
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13
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Morya AK, Gogia S, Gupta A, Prakash S, Solanki K, Naidu AD. Motherhood: What every ophthalmologist needs to know. Indian J Ophthalmol 2021; 68:1526-1532. [PMID: 32709768 PMCID: PMC7640830 DOI: 10.4103/ijo.ijo_2033_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this review article is to summarize the available literature on physiologic and pathologic ocular changes during pregnancy and the effect of diseases in pregnancy. A literature search was conducted using PUBMED, MEDLINE, and Cochrane library in English. In addition, the cited references in the published articles were manually reviewed for the relevant results. Pregnancy encompasses a multitude of changes in all body systems, including the visual system of the female. The changes can be physiological, i.e., changes occurring in the lids and adnexa, cornea, conjunctiva, changes in tear film composition and intraocular pressure, retina, choroid, and visual field. Pathological changes in a pregnant woman's eye include changes related to preeclampsia and eclampsia, central serous chorioretinopathy, retinal artery or vein occlusions, and disseminated intravascular coagulation. Preexisting diseases like diabetic retinopathy, Graves' disease, idiopathic intracranial hypertension, various inflammatory conditions can undergo changes in their course during pregnancy. Ophthalmic medications can have an effect on both mother and the baby and hence should be used cautiously. In addition, intrauterine infections play a major role in causing inflammation in the eye of the baby. Hence, vaccination of the mother prior to pregnancy plays an important role in preventing intrauterine infections in the neonate. A regular eye examination in the perinatal period plays a vital role in recognizing ophthalmic pathologies which might require a prompt medical intervention. Pathological ocular diseases should be discriminated from physiologic changes to establish an individualized treatment or preventive plan. This approach to ocular benefits of treatment to the mother should always weigh against the potential harm to the fetus.
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Affiliation(s)
- Arvind K Morya
- Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India
| | - Sonalika Gogia
- Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India
| | - Arushi Gupta
- Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India
| | - Sujeet Prakash
- Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India
| | - Kanchan Solanki
- Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India
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Galaziou A, Filidou E, Spathakis M, Arvanitidis K, Arzou BC, Galazios G, Koutlaki N, Nikolettos N, Kolios G. Imbalance of growth factors mRNA expression associated with oxidative stress in the early pregnancy loss. J Matern Fetal Neonatal Med 2021; 35:6150-6156. [PMID: 33820497 DOI: 10.1080/14767058.2021.1907337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to examine the role of growth factors associated with angiogenesis and oxidative stress in the pathogenesis of spontaneous miscarriage. METHODS We performed a comparative mRNA expression analysis of VEGF, PlGF, Flt-1, Angiogenin and Endoglin using Real-Time PCR, in the placenta and decidua collected from 12 patients presenting with spontaneous abortion and from 14 women undergoing induced abortion, during the first and second trimester of pregnancy. RESULTS The mRNA expression of Flt-1 was significantly upregulated in the placenta of spontaneous abortions (5.17-fold, IQR: 2.72-9.11, p < 0.01). The placental expression of the soluble isoforms of Flt-1, sFlt-1 e15a and sFlt-1 i13, was also significantly upregulated in spontaneous abortions (sFlt-1 e15a: 2.35-fold, IQR: 0.98-2.83, p < 0.01; sFlt-1 i13: 3.47-fold, IQR: 2.37-5.08, p < 0,05). Placental tmFlt-1, PlGF and Endoglin showed a tendency of higher expression levels in spontaneous abortions, although they did not reach statistical significance (tmFlt-1: 7.42-fold, IQR: 3.58-14.32; PlGF: 2.36-fold, IQR: 0.90-4.12; Endoglin: 1.97-fold, IQR: 1.18-2.43). VEGF and Angiogenin mRNA expression in induced, as well as in spontaneous abortions, did not convey any statistically significant difference. In the decidua, the expression levels of Flt-1 and its splice variants sFlt-1 e15a, sFlt-1 i13 and tmFlt-1 did not show any statistically significant differences, as was the case for the rest of the herein examined growth factors. CONCLUSIONS In this study, we observed higher levels of sFlt-1 mRNA expression in the placenta of spontaneous abortions, while expression of other growth factors in placenta and decidua remained constant. This suggests that an imbalance of sFlt-1 expression in the placenta might contribute to the pathogenesis of spontaneous abortion, probably via oxidative stress, providing a possible biomarker for prompt identification of this condition.
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Affiliation(s)
- Aspasia Galaziou
- Department of Obstetrics and Gynecology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis
| | - Eirini Filidou
- Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Michail Spathakis
- Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Arvanitidis
- Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Bourazan Chalil Arzou
- Department of Obstetrics and Gynecology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis
| | - George Galazios
- Department of Obstetrics and Gynecology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis
| | - Nikoleta Koutlaki
- Department of Obstetrics and Gynecology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis
| | - Nikos Nikolettos
- Department of Obstetrics and Gynecology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis
| | - George Kolios
- Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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Pacheco-Romero J, Acosta O, Huerta D, Cabrera S, Vargas M, Mascaro P, Huamán M, Sandoval J, López R, Mateus J, Gil E, Guevara E, Butrica N, Catari D, Bellido D, Custodio G, Naranjo A. Genetic markers for preeclampsia in Peruvian women. Colomb Med (Cali) 2021; 52:e2014437. [PMID: 33911318 PMCID: PMC8054708 DOI: 10.25100/cm.v52i1.4437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/13/2020] [Accepted: 01/28/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Preeclampsia is a multiorgan disorder associated with maternal and perinatal morbi-mortality. In Peru, incidence is 10% and accounts for 22% of maternal deaths. Genome and genetic epidemiological studies have found an association between preeclampsia and genetic polymorphisms. OBJECTIVE To determine the association of the vascular endothelial growth factor (VEGF) +936 C/T and +405 G/C, interleukine-6 (IL-6) -174 G/C, IL-1β-511 C/T, Apo A-1-75 G/A, Apo B-100 2488 C/T (Xbal) polymorphisms with preeclampsia in pregnant Peruvian women. METHODS Were included preeclamptic and healthy (control) pregnant women. Maternal blood samples were subjected to DNA extraction, and molecular genetic analysis was conducted using the PCR-RFLP technique and following a specific protocol for each gene. Allele and genotypic frequencies in the cases and controls were compared. RESULTS No association was found between the VEGF+936C/T and VEGF+405 polymorphisms and preeclampsia. The frequencies of the GG genotypes and the G allele of the -174 G/C polymorphism in the IL6 gene in preeclamptic and controls showed significant differences, with higher frequencies in cases. For the -511 C/T polymorphism of the IL-1β gene, no significant differences were found in the frequencies of TT genotypes compared with CT+CC. The genotypes and alleles of the Apo-A1-75 G/A and Apo-B100 Xbal variants showed no significant differences between cases and controls. CONCLUSION No association was found between the studied genetic markers and preeclampsia. However, in the -174G/C polymorphism of the IL-6 gene, significant differences were found mainly in the GG genotype and G allele.
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Affiliation(s)
- José Pacheco-Romero
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Oscar Acosta
- Universidad Nacional Mayor de San Marcos, Faculty of Pharmacy and Biochemistry, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of Pharmacy and BiochemistryLimaPeru
| | - Doris Huerta
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Santiago Cabrera
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Marlene Vargas
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Pedro Mascaro
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Moisés Huamán
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - José Sandoval
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Rudy López
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Julio Mateus
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
- Atrium Health, Charlotte, North Carolina, USA.Atrium HealthCharlotteNorth CarolinaUSA
| | - Enrique Gil
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Enrique Guevara
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Nitza Butrica
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Diana Catari
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - David Bellido
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Gina Custodio
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Andrea Naranjo
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
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16
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Naderan M, Sabzevary M, Rezaii K, Banafshehafshan A, Hantoushzadeh S. Intravitreal anti-vascular endothelial growth factor medications during pregnancy: current perspective. Int Ophthalmol 2020; 41:743-751. [PMID: 33044671 DOI: 10.1007/s10792-020-01610-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/01/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE Anti-vascular endothelial growth factor (VEGF) medications are widely used for treatment of a number of vitreoretinal disorders. However, the evidence for their effect on fetal and maternal health during pregnancy is very limited. The goal of this article is to accumulate evidence for the indications of anti-VEGF medications during pregnancy and their effects on maternal and fetal health. METHODS Review of literature regarding anti-VEGF administration during pregnancy and using PubMed database without language or date limit. RESULTS The main indications for treatment with intravitreal anti-VEGF medications include choroidal neovascularization (CNV) followed by retinal vascular occlusion (RVO) and complications of diabetes such as neovascular glaucoma, diabetic retinopathy (DR) and diabetic macular edema (DME). Among anti-VEGF medications, only ranibizumab and bevacizumab have been used during pregnancy with latter by far more than the former. CONCLUSION Women of childbearing age should be consulted regarding the potential adverse effects of anti-VEGF medications on fetal health and the risk of early pregnancy loss. They should be strongly encouraged to use appropriate contraceptive methods during treatment. A timely obstetrics consultation may help in this situation. Attempt for pregnancy should be withheld for at least 3 months following last injection of ranibizumab and aflibercept, and for at least 6 months following last injection of bevacizumab.
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Affiliation(s)
- Morteza Naderan
- Department of Ophthalmology, Farabi Eye Hospital Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin square, South Karegar street, Tehran, Iran.
| | - Masomeh Sabzevary
- Maternal, Fetal, and Neonatal Research Center, Yas Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Keivan Rezaii
- Department of Ophthalmology, Farabi Eye Hospital Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin square, South Karegar street, Tehran, Iran
| | - Ali Banafshehafshan
- Department of Ophthalmology, Farabi Eye Hospital Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin square, South Karegar street, Tehran, Iran
| | - Seddigheh Hantoushzadeh
- Maternal, Fetal, and Neonatal Research Center, Valiasr Hospital, Imam Khomeini Hospital Complexs, Tehran University of Medical Sciences, Tehran, Iran
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17
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Wang X, Sun T, Chen G, Gao H. Association between Vascular Endothelial Growth Factor Gene Polymorphisms and Pre-Eclampsia Susceptibility: An Updated Meta-Analysis. Immunol Invest 2019; 49:120-133. [PMID: 31455120 DOI: 10.1080/08820139.2019.1659812] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: The aim of this study was to assess the genetic association between vascular endothelial growth factor (VEGF) gene polymorphisms and the risk of pre-eclampsia (PE).Methods: A systematic literature search of several databases (PubMed, Embase, and the China National Knowledge Infrastructure (CNKI)) was conducted for case-control trials comparing VEGF polymorphisms (+936C/T, -634G/C, -2578C/A, and -1154G/A) with the risk of PE. Meta-analysis was performed using the Stata 12.0 software.Results: Twenty-three case-control studies on a total of 2597 PE patients and 3075 controls were included in our meta-analysis. The +936C/T polymorphism was observed to be associated with the risk of PE in the overall population (T vs. C: odds ratios (OR) = 1.434, 95% confidence interval (CI) = 1.120-1.836, P = .004). However, the -634G/C, -2578C/A, and -1154G/A polymorphisms showed no association with the risk of PE. A subgroup analysis based on ethnicity found that the +936C/T polymorphism was associated with the risk of PE in both Europeans and Asians. Furthermore, the -634G/C polymorphism was found to be associated with the risk of PE in Europeans (C vs. G: OR = 1.428, 95% CI = 1.141-1.778, P = .002). The polymorphisms at other loci were not associated with the risk of PE.Conclusion: This meta-analysis suggests that VEGF +936C/T polymorphism, rather than -634G/C, -2578C/A, or -1154G/A polymorphisms, is associated with the risk of PE in the overall study population. However, the -634G/C polymorphism may be associated with the risk of developing PE in Europeans.
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Affiliation(s)
- Xiaoyi Wang
- Internal Medicine Department, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Tao Sun
- Internal Medicine Department, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Guochang Chen
- Internal Medicine Department, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Hong Gao
- Internal Medicine Department, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
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18
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Trifonova EA, Swarovskaya MG, Ganzha OA, Voronkova OV, Gabidulina TV, Stepanov VA. The interaction effect of angiogenesis and endothelial dysfunction-related gene variants increases the susceptibility of recurrent pregnancy loss. J Assist Reprod Genet 2019; 36:717-726. [PMID: 30680517 DOI: 10.1007/s10815-019-01403-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 01/09/2019] [Indexed: 01/08/2023] Open
Abstract
PURPOSE The role of genetic polymorphisms in the pathogenesis of recurrent pregnancy loss (RPL) has been studied intensively. Complex diseases, including miscarriage, are believed to have a polygenic basis, and gene-gene interactions can play a significant role in the etiology of the disease. This study was conducted to investigate the association of gene-gene interactions with angiogenesis, endothelial dysfunction-related gene polymorphisms, and RPL. METHODS A case-control study was conducted with 253 unrelated RPL patients with 2 or more spontaneous pregnancy losses and 339 healthy women with no history of pregnancy complications. Genotyping of single-nucleotide polymorphisms (SNPs) was performed using real-time polymerase chain reaction (real-time PCR), restriction fragment length polymorphism (RFLP), or allele-specific polymerase chain reaction methods. RESULTS The genotypes 677TT of the MTHFR gene, 936TT, 936CT, and 634CC, 634GC of the VEGF gene, and allele 894T of the NOS3 gene were associated with a predisposition to RPL in the Russian population. A significant role of additive and epistatic effects in the gene-gene interactions of the SNPs of SERPINE-1, ACE, NOS3, MTHFR, and VEGF genes in RPL was demonstrated. CONCLUSIONS The results showed that gene-gene interactions are important for RPL susceptibility. Additionally, analysis of the genotype combinations of several allelic variants provides more information on RPL risk than analysis of independent polymorphic markers.
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Affiliation(s)
- E A Trifonova
- Research Institute of Medical Genetics, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia.,Siberian State Medical University, Tomsk, Russia
| | - M G Swarovskaya
- Research Institute of Medical Genetics, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia. .,Siberian State Medical University, Tomsk, Russia.
| | - O A Ganzha
- Siberian State Medical University, Tomsk, Russia
| | | | | | - V A Stepanov
- Research Institute of Medical Genetics, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
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19
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Feig DS, Berger H, Donovan L, Godbout A, Kader T, Keely E, Sanghera R. Diabetes and Pregnancy. Can J Diabetes 2018; 42 Suppl 1:S255-S282. [DOI: 10.1016/j.jcjd.2017.10.038] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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20
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Vascular endothelial growth factor single nucleotide polymorphisms and haplotypes in pre-eclampsia: A case-control study. Cytokine 2017. [PMID: 28651127 DOI: 10.1016/j.cyto.2017.06.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
An association between vascular endothelial growth factor (VEGFA) gene variants and altered VEGF secretion and preeclampsia (PE) were described, often with inconclusive findings. An ethnic contribution to the association of VEGFA polymorphisms with PE and its associated features was also suggested. To investigate whether common VEGFA single nucleotide polymorphisms (SNP) are linked with PE and associated features in Tunisian women. A case-control study involving 300 women with PE, and 300 age-matched control women. Genotyping of VEGFA rs833052, rs699947, rs833061, rs1570360, rs2010963, rs25648, rs833068, rs833070, rs3025020, and rs3025039SNPs was done by real-time PCR. Minor allele frequency (MAF) of rs833052, rs699947, rs833061, rs1570360, rs2010963, rs25648, rs833068, rs833070, rs3025020, and rs3025039 VEGFA SNP, were not significantly different between PE cases and control women. In addition, there was lack of association of the genotypes of VEGFA SNPs with PE, irrespective of the genetic model used. Seven-locus (rs699947, rs833061, rs1570360, rs2010963, rs25648, rs833068 and rs833070) haplotype analysis demonstrated positive association of ATGCCAA, ACAGCAG and CCAGCGG, and negative association of CCAGCAA and ATGCCGG haplotypes with PE, all of which except for ACAGCAG remained associated with PE after correcting for multiple comparisons. Increased and reduced PE severity was associated with ATGCCAA, and with ATGCCGG and CCAGCAA haplotypes, respectively. Furthermore, carriage of CCGGTAG haplotype was associated with reduced risk of PE. Our study suggests that VEGFA haplotypes, more so than individual SNPs, play a role in PE pathogenesis in Tunisian women. These findings need confirmation in other ethnic populations.
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Mas A, Prusinski L, Yang Q, Diaz-Gimeno P, Stone L, Diamond MP, Simón C, Al-Hendy A. Role of Stro1+/CD44+ stem cells in myometrial physiology and uterine remodeling during pregnancy. Biol Reprod 2017; 96:70-80. [PMID: 28395335 PMCID: PMC5803774 DOI: 10.1095/biolreprod.116.143461] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/31/2016] [Accepted: 11/22/2016] [Indexed: 12/17/2022] Open
Abstract
Regulation of myometrial functions during pregnancy has been considered the result of the integration of endocrine and mechanical signals. Nevertheless, uterine regeneration is poorly understood, and the cellular source within the gravid uterus is largely unexplored.In this study, we isolated and quantified the myometrial stem cells (MSC) population from pregnant female Eker rat uteri, by using Stro1/CD44 surface markers. We demonstrated that prior parity significantly increased the percentage of Stro1+/CD44+ MSC because of injured tissue response. Interestingly, we established that Stro1+/CD44+ MSC respond efficiently to physiological cues when they were treated in vitro under different dose-dependent pregnant rat serum.Previous studies reveal strong regulatory links between O2 availability and stem cell function. Based on these premises, cell proliferation assays showed that isolated Stro1+/CD44+ MSC possess a higher proliferative rate under hypoxic versus normoxic conditions. We also detected a total of 37 upregulated and 44 downregulated hypoxia-related genes, which were differentially expressed in Stro1+/CD44+ MSC, providing an alternative approach to infer into complex molecular mechanisms such as energy metabolism, inflammatory response, uterine expansion, and/or remodeling.Since these cells preferentially grow under low oxygen conditions, we propose that the increase of the rat uterus during pregnancy involves myometrial oxygen consumption, thereby enhancing MSC proliferation. Moreover, pregnancy-induced mechanical stretching results in hypoxic conditions, ultimately creating an environment that promotes stem cell proliferation and further uterine enlargement, which is essential for a successful pregnancy. In summary, all of these data support that rat Stro1+/CD44+ MSC contribute to uterine enlargement during pregnancy.
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Affiliation(s)
- Aymara Mas
- Department of Obstetrics and Gynecology, Augusta University, Augusta, Georgia, USA
| | - Lauren Prusinski
- Department of Obstetrics and Gynecology, Augusta University, Augusta, Georgia, USA
| | - Qiwei Yang
- Department of Obstetrics and Gynecology, Augusta University, Augusta, Georgia, USA
| | - Patricia Diaz-Gimeno
- Fundacion Instituto Valenciano de Infertilidad (FIVI), Department of Obstetrics & Gynecology, School of Medicine, Valencia University and Instituto Universitario IVI/INCLIVA, Valencia, Spain
| | - Lelyand Stone
- Department of Obstetrics and Gynecology, Augusta University, Augusta, Georgia, USA
| | - Michael P Diamond
- Department of Obstetrics and Gynecology, Augusta University, Augusta, Georgia, USA
| | - Carlos Simón
- Igenomix, Valencia, Spain; Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain; Department of Pediatrics, Obstetrics, and Gynecology, Universidad de Valencia, Instituto Universitario IVI, Valencia, Spain; Department of Obstetrics and Gynecology, School of Medicine, Stanford University, Stanford, CA
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, Augusta University, Augusta, Georgia, USA
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Polizzi S, Mahajan VB. Intravitreal Anti-VEGF Injections in Pregnancy: Case Series and Review of Literature. J Ocul Pharmacol Ther 2015; 31:605-10. [PMID: 26302032 PMCID: PMC4677108 DOI: 10.1089/jop.2015.0056] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 07/30/2015] [Indexed: 12/22/2022] Open
Abstract
The use of intravitreal antivascular endothelial growth factor (anti-VEGF) injection is gaining wide acceptance as an off-label therapy for diseases that may affect pregnant women. However, these drugs may cause systemic side effects in the mother and fetal harm. This could lead specialists to not administer the drug or women to abort the fetus or to refuse treatment during pregnancy. We report the course of pregnancy in 3 women treated with intravitreal bevacizumab and provide a review of the literature on the use of intravitreal anti-VEGF in pregnancy. Our patients did not have any drug-related adverse event and delivered healthy full-term infants, although one of the women had risk factors for miscarriage. Infants reached all developmental milestones appropriately during infancy. A literature search on the use of intravitreal anti-VEGF injection in pregnancy was undertaken. Data for this review were identified by searches of PubMed and references from relevant articles using the search terms "pegaptanib," "bevacizumab," "ranibizumab," "aflibercept," "anti-VEGF," "intravitreal injection," "pregnant," "pregnancy," "abortion," "miscarriage," "preeclampsia," "embryo-fetal toxicity," "fetal malformations," "teratogenesis," "adverse events," and "maternofetal complications" in multiple combinations. We believe that intravitreal anti-VEGF can be given during pregnancy only when potential benefit to the woman justifies the potential risks to the fetus. When making a decision about whether to give drugs during pregnancy, it is important to consider the timing of exposure and its relationship to windows of developmental sensitivity. We believe that this review will be useful to specialists to inform and possibly treat their pregnant patients.
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Affiliation(s)
- Silvio Polizzi
- Department of Translational Surgery and Medicine, Eye Clinic, University of Florence, Florence, Italy
| | - Vinit B. Mahajan
- Omics Laboratory, University of Iowa, Iowa City, Iowa
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa
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Salimi S, Yaghmaei M, Tabatabaei E, Mokhtari M, Naghavi A. Vascular endothelial growth factor (VEGF)-634G/C polymorphism was associated with severe pre-eclampsia and lower serum VEGF level. J Obstet Gynaecol Res 2015; 41:1877-83. [PMID: 26486233 DOI: 10.1111/jog.12825] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 06/29/2015] [Accepted: 07/05/2015] [Indexed: 02/02/2023]
Abstract
AIM Vascular endothelial growth factor (VEGF) is an angiogenic factor whose production is increased in pre-eclampsia (PE). Therefore, the present study was conducted aiming at assessing the possible association of VEGF polymorphisms with PE susceptibility in the southeast of Iran. MATERIAL AND METHODS Overall, 192 PE women and 186 unrelated age-matched normotensive pregnant women were genotyped for the VEGF-2578C/A (rs699947), -1154G/A (rs1570360), and -634G/C (rs2010963) polymorphisms using the polymerase chain reaction-restriction fragment length polymorphism method. Serum VEGF levels were determined by the enzyme-linked immunosorbent assay method. RESULTS There was no significant difference in VEGF-2578C/A, -1154G/A and -634G/C polymorphisms between PE women and controls. However, the frequency of VEGF-634GC and CC genotypes was significantly higher in women with severe PE compared to mild PE and controls. In addition, serum VEGF levels were significantly lower in PE women. The VEGF-634CC genotype was associated with lower serum VEGF levels compared to the VEGF-634GG genotype. Moreover, serum VEGF levels were significantly lower in individuals with the VEGF-634CC genotype compared to VEGF-634GC genotype only in the control group. The mean serum VEGF levels did not differ significantly between genotypes of VEGF-2587C/A and -1154G/A polymorphisms. CONCLUSION Our findings suggest that the association of VEGF-634G/C polymorphisms with severe PE and the VEGF-634CC genotype was correlated with lower serum VEGF levels.
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Affiliation(s)
- Saeedeh Salimi
- Cellular and Molecular Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.,Department of Clinical Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Minoo Yaghmaei
- Department of Obstetrics and Gynecology, School of Medicine, Shahid Beheshty University of Medical Sciences, Tehran, Iran
| | - Ehsan Tabatabaei
- Department of Clinical Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mojgan Mokhtari
- Department of Obstetrics and Gynecology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.,Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Anoosh Naghavi
- Cellular and Molecular Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.,Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modarres University, Tehran, Iran
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Rada CC, Murray G, England SK. The SK3 channel promotes placental vascularization by enhancing secretion of angiogenic factors. Am J Physiol Endocrinol Metab 2014; 307:E935-43. [PMID: 25249506 PMCID: PMC4315447 DOI: 10.1152/ajpendo.00319.2014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Proper placental perfusion is essential for fetal exchange of oxygen, nutrients, and waste with the maternal circulation. Impairment of uteroplacental vascular function can lead to pregnancy complications, including preeclampsia and intrauterine growth restriction (IUGR). Potassium channels have been recognized as regulators of vascular proliferation, angiogenesis, and secretion of vasoactive factors, and their dysfunction may underlie pregnancy-related vascular diseases. Overexpression of one channel in particular, the small-conductance calcium-activated potassium channel 3 (SK3), is known to increase vascularization in mice, and mice overexpressing the SK3 channel (SK3(T/T) mice) have a high rate of fetal demise and IUGR. Here, we show that overexpression of SK3 causes fetal loss through abnormal placental vascularization. We previously reported that, at pregnancy day 14, placentas isolated from SK3(T/T) mice are smaller than those obtained from wild-type mice. In this study, histological analysis reveals that SK3(T/-) placentas at this stage have abnormal placental morphology, and microcomputed tomography shows that these placentas have significantly larger and more blood vessels than those from wild-type mice. To identify the mechanism by which these vascularization defects occur, we measured levels of vascular endothelial growth factor (VEGF), placental growth factor, and the soluble form of VEGF receptor 1 (sFlt-1), which must be tightly regulated to ensure proper placental development. Our data reveal that overexpression of SK3 alters systemic and placental ratios of the angiogenic factor VEGF to antiangiogenic factor sFlt-1 throughout pregnancy. Additionally, we observe increased expression of hypoxia-inducing factor 2α in SK3(T/-) placentas. We conclude that the SK3 channel modulates placental vascular development and fetal health by altering VEGF signaling.
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Affiliation(s)
- Cara C Rada
- Department of Obstetrics and Gynecology, Division of Basic Science Research, Washington University School of Medicine, St. Louis, Missouri
| | - Grace Murray
- Department of Obstetrics and Gynecology, Division of Basic Science Research, Washington University School of Medicine, St. Louis, Missouri
| | - Sarah K England
- Department of Obstetrics and Gynecology, Division of Basic Science Research, Washington University School of Medicine, St. Louis, Missouri
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Ikewaki N, Sonoda T, Inoko H. Unique properties of cluster of differentiation 93 in the umbilical cord blood of neonates. Microbiol Immunol 2014; 57:822-32. [PMID: 24033555 DOI: 10.1111/1348-0421.12097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 08/19/2013] [Accepted: 09/04/2013] [Indexed: 11/30/2022]
Abstract
It has previously been reported by these authors that cluster of differentiation (CD) 93 is co-expressed on naive T-lymphocytes (CD4(+) CD45RA(+) cells) in neonatal umbilical cord blood cells (UCBCs) but not on normal adult peripheral blood cells (PBCs). In this study, expression of CD93 on other lymphocyte subsets and the concentration of soluble formed CD93 (sCD93) in serum or culture supernatants from neonatal umbilical cord blood (UCB) was examined. It was found that CD93 is also co-expressed on CD2(+) , CD16(+) , CD56(+) or CD25(+) cells in the lymphocyte population of neonatal UCBCs, but not on normal adult PBCs. The concentrations of sCD93 in serum and culture supernatants from neonatal UCB were significantly greater than those from normal adult peripheral blood. The concentrations of sCD93 in culture supernatants from neonatal UCBCs and normal adult PBCs treated with phorbol 12-myristate 13-acetate (PMA) were significantly enhanced compared with those without PMA treatment. The degree of enhancement of sCD93 by PMA in culture supernatants from neonatal UCBCs was significantly greater than that of normal adult PBCs and enhancement of sCD93 by PMA in the culture supernatants from neonatal UCBCs and normal adult PBCs was significantly suppressed by PKC inhibitor. Interestingly, the high concentration of serum sCD93 in neonates was significantly decreased in sera from infants at 1 month after birth. Expression of CD93 on the lymphocyte population of PBCs from infants at 1 month after birth was also significantly decreased, compared with that for neonatal UCBCs. These findings indicate that CD93 in neonatal UCB has unique properties as an immunological biomarker.
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Affiliation(s)
- Nobunao Ikewaki
- Laboratories of Clinical Immunology, Department of Animal Pharmaceutical Science, Kyushu University of Health and Welfare School of Pharmaceutical Sciences, 1714-1 Yoshino-machi, Nobeoka-shi, Miyazaki, 882-8508
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Risk of placental dysfunction disorders after prior miscarriages: a population-based study. Am J Obstet Gynecol 2014; 211:34.e1-8. [PMID: 24495667 DOI: 10.1016/j.ajog.2014.01.041] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 12/13/2013] [Accepted: 01/28/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The objective of the investigation was to study the association between prior miscarriages and the risks of placental dysfunction disorders, including preeclampsia, stillbirth, birth of a small for gestational age (SGA) infant, placental abruption, and spontaneous preterm birth. STUDY DESIGN In a population-based cohort study including 619,587 primiparous women, we estimated risks of placental dysfunction disorders for women with 1 (n = 68,185), 2 (n = 11,410) and 3 or more (n = 3823) self-reported prior miscarriages. Risks were calculated as odds ratios by unconditional logistic regression analysis and adjustments were made for maternal age, early pregnancy body mass index, height, smoking habits, country of birth, years of formal education, in vitro fertilization, chronic hypertension, pregestational diabetes, hypothyroidism, systemic lupus erythematosis, fetal sex, and year of childbirth. RESULTS Compared with women with no prior miscarriage, women with 1 prior miscarriage had almost no increased risks. Women with 2 prior miscarriages had increased risks of spontaneous preterm birth, preterm (<37 weeks) SGA infant, and placental abruption. The rates of all disorders were higher for women with 3 or more prior miscarriages compared with women without prior miscarriages: preeclampsia, 5.83% vs 4.27%; stillbirth, 0.69% vs 0.33%, SGA infant, 5.09% vs 3.22%, placental abruption, 0.81% vs 0.41%; and spontaneous preterm birth, 6.45% vs 4.40%. The adjusted odds ratios for preterm (<37 weeks) disorders in women with 3 prior miscarriages were approximately 2. CONCLUSION History of 2 or more miscarriages is associated with an increased risk of placental dysfunction disorders and should be regarded as a risk factor in antenatal care.
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Gene-gene interactions and gene polymorphisms of VEGFA and EG-VEGF gene systems in recurrent pregnancy loss. J Assist Reprod Genet 2014; 31:699-705. [PMID: 24671265 DOI: 10.1007/s10815-014-0223-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 03/14/2014] [Indexed: 01/18/2023] Open
Abstract
PURPOSE Both vascular endothelial growth factor A (VEGFA) and endocrine gland-derived vascular endothelial growth factor (EG-VEGF) systems play major roles in angiogenesis. A body of evidence suggests VEGFs regulate critical processes during pregnancy and have been associated with recurrent pregnancy loss (RPL). However, little information is available regarding the interaction of these two major major angiogenesis-related systems in early human pregnancy. This study was conducted to investigate the association of gene polymorphisms and gene-gene interaction among genes in VEGFA and EG-VEGF systems and idiopathic RPL. METHODS A total of 98 women with history of idiopathic RPL and 142 controls were included, and 5 functional SNPs selected from VEGFA, KDR, EG-VEGF (PROK1), PROKR1 and PROKR2 were genotyped. We used multifactor dimensionality reduction (MDR) analysis to choose a best model and evaluate gene-gene interactions. Ingenuity pathways analysis (IPA) was introduced to explore possible complex interactions. RESULTS Two receptor gene polymorphisms [KDR (Q472H) and PROKR2 (V331M)] were significantly associated with idiopathic RPL (P<0.01). The MDR test revealed that the KDR (Q472H) polymorphism was the best loci to be associated with RPL (P=0.02). IPA revealed EG-VEGF and VEGFA systems shared several canonical signaling pathways that may contribute to gene-gene interactions, including the Akt, IL-8, EGFR, MAPK, SRC, VHL, HIF-1A and STAT3 signaling pathways. CONCLUSION Two receptor gene polymorphisms [KDR (Q472H) and PROKR2 (V331M)] were significantly associated with idiopathic RPL. EG-VEGF and VEGFA systems shared several canonical signaling pathways that may contribute to gene-gene interactions, including the Akt, IL-8, EGFR, MAPK, SRC, VHL, HIF-1A and STAT3.
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Almawi WY, Saldanha FL, Mahmood NA, Al-Zaman I, Sater MS, Mustafa FE. Relationship between VEGFA polymorphisms and serum VEGF protein levels and recurrent spontaneous miscarriage. Hum Reprod 2013; 28:2628-35. [PMID: 23900206 DOI: 10.1093/humrep/det308] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
STUDY QUESTION Is recurrent spontaneous miscarriage (RSM) associated with changes in vascular endothelial growth factor (VEGF) serum levels, and with polymorphisms in the VEGFA gene? SUMMARY ANSWER Reduced serum VEGF levels, and VEGFA -460T/C (rs833061), 398G/A (rs833068), -583T/C (rs3025020) variants, were associated with RSM. WHAT IS KNOWN ALREADY Reduced expression of VEGF has been linked with spontaneous miscarriage, likely due to defective fetal and placental angiogenesis. Since VEGF production is in part inherited, VEGFA polymorphisms associated with altered VEGF secretion have been investigated for their association with RSM, often with variable conclusions. STUDY DESIGN, SIZE, DURATION A retrospective case-control study, which was conducted between January 2011 and April 15, 2012. PARTICIPANTS/MATERIALS, SETTING, METHODS Subjects comprised 296 women with RSM (mean age: 31.6 ± 5.4 year), and 305 age-matched (mean age: 31.6 ± 4.9 year) control Arab women, who had attended outpatient obstetrics and gynecology clinics in two teaching hospitals in Bahrain. VEGFA -2578C/A (rs699947), -460T/C (rs833061), -1154G/A (rs15703060), -634G/C (rs2010963), 398G/A (rs833068), 497G/A (rs833070), -583T/C (rs3025020) and 936C/T (rs3025039) genotyping was done by real-time PCR, with defined clusters; VEGF serum levels were measured by ELISA. MAIN RESULTS AND THE ROLE OF CHANCE Higher minor allele frequency (MAF) and genotype distribution of -460T/C [corrected P (Pc) = 0.003], 398G/A (Pc = 0.016) and -583T/C (Pc < 0.001) single nucleotide polymorphisms (SNPs) were seen in RSM cases than control women. Increased RSM risk was seen with homozygous -460T/C and 398G/A SNPs and with heterozygous -583T/C, which had a stronger effect when homozygous. Serum VEGF levels were significantly reduced in RSM cases compared with control women (P = 0.016), and correlated with -460T/C, 398G/A and -583T/C genotypes. Haploview analysis revealed heterogeneity in linkage disequilibrium between VEGFA variants, and two blocks were identified: Block 1 comprising -2578C/A, -460T/C and -1154G/A, while Block 2 contained -634G/C, 398G/A, 497G/A, -583T/C and 936C/T. Both negatively and positively RSM-associated 3-locus (Block 1) and 5-locus (Block 2) VEGFA haplotypes were identified, after controlling for a number of covariates. LIMITATIONS, REASONS FOR CAUTION The study was retrospective and can only demonstrate association and not a cause-effect relationship. Furthermore, it was limited to Bahraini Arabs,thereby necessitating parallel studies on other ethnic groups. WIDER IMPLICATIONS OF THE FINDINGS Reduced VEGF secretion, and specific VEGFA variants may contribute to the pathogenesis of RSM. However, the association of VEGFA SNPs with RSM appears to be independent of their association with altered VEGF serum levels. The differential association of VEGFA variants with RSM is in line with previous findings on the contribution of ethnicity/racial background to genetic association studies.
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Affiliation(s)
- Wassim Y Almawi
- Department of Medical Biochemistry, College of Medicine and Medical Sciences, Arabian Gulf University, PO Box 22979, Manama, Bahrain
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Conti E, Zezza L, Ralli E, Caserta D, Musumeci MB, Moscarini M, Autore C, Volpe M. Growth factors in preeclampsia: a vascular disease model. A failed vasodilation and angiogenic challenge from pregnancy onwards? Cytokine Growth Factor Rev 2013; 24:411-25. [PMID: 23800655 DOI: 10.1016/j.cytogfr.2013.05.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Revised: 04/30/2013] [Accepted: 05/21/2013] [Indexed: 12/25/2022]
Abstract
Preeclampsia is the major cause of maternofetal and neonatal morbi-mortality including intrauterine growth retardation, miscarriages and stillbirths. Inadequate vascular dilation and angiogenesis represent the crucial underlying defect of gravidic hypertension, denoting a failed response to the vasodilatory and pro-angiogenic challenge imposed by pregnancy, especially if multifetal. A similar pathogenesis appears involved in gestational diabetes. In this review we aimed to provide a hint on understanding the deeply involved angiogenic disorders which eventually culminate in utero-placental failure. The key players in these complex processes may be found in an intricate network of growth factors (GFs) and GF inhibitors, controlled by several vascular risk factors modulated by environment and genes, which eventually impact on early and late cardiovascular outcomes of mother and fetus.
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Affiliation(s)
- E Conti
- Cardiology, Clinical and Molecular Medicine Department, "Sapienza" University of Rome, Italy.
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30
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Junovich G, Azpiroz A, Incera E, Ferrer C, Pasqualini A, Gutierrez G. Endometrial CD16+and CD16−NK Cell Count in Fertility and Unexplained Infertility. Am J Reprod Immunol 2013; 70:182-9. [DOI: 10.1111/aji.12132] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 04/03/2013] [Indexed: 11/29/2022] Open
Affiliation(s)
| | | | | | | | | | - Gabriela Gutierrez
- Halitus Medical Institute; Buenos Aires Argentina
- Fundación Repro; Buenos Aires Argentina
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li L, donghong L, shuguang W, hongbo Z, jing Z, shengbin L. Polymorphisms in the vascular endothelial growth factor gene associated with recurrent spontaneous miscarriage. J Matern Fetal Neonatal Med 2012; 26:686-90. [DOI: 10.3109/14767058.2012.746305] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rah H, Jeon YJ, Lee BE, Choi DH, Yoon TK, Lee WS, Kim NK. Association of kinase insert domain-containing receptor (KDR) gene polymorphisms with idiopathic recurrent spontaneous abortion in Korean women. Fertil Steril 2012; 99:753-760.e8. [PMID: 23158831 DOI: 10.1016/j.fertnstert.2012.10.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 10/11/2012] [Accepted: 10/23/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate whether kinase insert domain-containing receptor (KDR) gene polymorphisms are risk factors for recurrent spontaneous abortion (RSA) in Korean women. DESIGN Case-control study. SETTING University hospital. PATIENT(S) Three hundred twenty-seven idiopathic RSA patients and 230 controls with Korean ethnicity. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The KDR -604T→C (rs2071559), 1192G→A (rs2305948), and 1719A→T (rs1870377) polymorphisms were assessed. RESULT(S) KDR -604TC and TC+CC genotypes were more prevalent in RSA patients than in controls (adjusted odds ratio [AOR] = 2.091 and 2.076, respectively). KDR -604TC+CC/1192GG, -604TC+CC/1719AA, and -604TC+CC/1719TA+TT combined genotypes exhibited higher frequencies in RSA patients (AOR = 2.422, 2.611, and 2.216, respectively). KDR -604C/1192G/1719A, -604C/1192G/1719T, -604C/1192G, -604C/1719A, and -604C/1719T haplotype frequencies were higher in RSA patients (OR = 1.778, 2.659, 2.089, 1.678, and 1.806, respectively), whereas -604T/1192G/1719A, -604T/1192G, and -604T/1719A haplotype frequencies were lower in RSA patients (OR = 2.422, 2.611, and 2.216, respectively). No association was found between RSA and KDR 1192G→A or 1719A→T. CONCLUSION(S) An association between the KDR -604T→C polymorphism and RSA was found in Korean women. Carriers of the -604C variant allele were more frequent among RSA patients than among controls, suggesting that KDR -604C may confer RSA risk. The association of 1719A→T with RSA that was found in Taiwanese Han women was not observed in Korean women.
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Affiliation(s)
- Hyungchul Rah
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam, South Korea
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Chedraui P, Solis EJ, Bocci G, Gopal S, Russo E, Escobar GS, Hidalgo L, Pérez-López FR, Genazzani AR, Mannella P, Simoncini T. Feto-placental nitric oxide, asymmetric dimethylarginine and vascular endothelial growth factor (VEGF) levels and VEGF gene polymorphisms in severe preeclampsia. J Matern Fetal Neonatal Med 2012; 26:226-32. [PMID: 23039092 DOI: 10.3109/14767058.2012.733760] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To measure plasma nitric oxide (NO), asymmetric dimethylarginine (ADMA) and vascular endothelial growth factor (VEGF) levels and VEGF gene polymorphisms in fetal circulation in severe preeclampsia. METHODS Cord vessels of singleton gestations complicated with severe preeclampsia 36 weeks or more (n = 31) and controls were sampled upon delivery for analyte measuring. Additionally, DNA was extracted from umbilical vein whole blood to determine the frequency of VEGF gene single nucleotide polymorphisms (SNPs): -2578 A/C, -1498 C/T, -1154 A/G, -634 C/G and +936 C/T. Coefficient correlations between analyte levels and placental and neonatal weight were calculated. RESULTS NO plasma levels in umbilical vessels (artery and vein) were significantly higher in preeclampsia cases as compared to controls (4.67 ± 3.0 vs. 0.82 ± 0.90; 4.46 ± 3.0 vs. 0.82 ± 0.99 mmol/L, respectively, p = 0.0001 both). ADMA levels displayed a similar increased trend in both fetal vessels, but this did not reach statistical significance (2.57 ± 1.03 vs. 2.34 ± 0.57; 2.74 ± 0.94 vs. 2.42 ± 0.59 mmol/L, respectively, p > 0.05). VEGF was significantly lower in artery but not in vein in preeclampsia cases (200.48 ± 225.62 vs. 338.61 ± 287.03 pg/mL, p = 0.04). A significant positive correlation was found between NO and ADMA levels (artery and vein) among preeclampsia cases. Overall, the frequency of the studied VEGF gene SNPs did not differ among pre-eclamptic cases and controls; nevertheless, a significant trend toward lower umbilical vein VEGF levels was observed in pre-eclampsia cases in the presence of -2578 CC and -1154 AG genotypes. CONCLUSION Near term gestations complicated with severe preeclampsia presented higher NO levels in fetal circulation, which correlated to ADMA and lower artery VEGF values. More research is warranted to confirm that selected VEGF SNPs may be associated with lower umbilical vein VEGF.
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Affiliation(s)
- Peter Chedraui
- High Risk Pregnancy Labor and Delivery Unit, Enrique C. Sotomayor Obstetrics and Gynecology Hospital Guayaquil, Ecuador.
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Al-Habboubi HH, Mahdi N, Abu-Hijleh TM, Abu-Hijleh FM, Sater MS, Almawi WY. The relation of vascular endothelial growth factor (VEGF) gene polymorphisms on VEGF levels and the risk of vasoocclusive crisis in sickle cell disease. Eur J Haematol 2012; 89:403-9. [PMID: 22925497 DOI: 10.1111/ejh.12003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2012] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The association of vascular endothelial growth factor (VEGFA) variants and VEGF secretion with sickle cell disease (SCD) vasoocclusive crisis (VOC) was investigated in 210 VOC patients and 114 pain-free control patients. METHODS VEGFA -2578C/A (rs699947), -460T/C (rs833061), -1154G/A (rs15703060), -634G/C (rs2010963), 398G/A (rs833068), 497G/A (rs833070), -583T/C (rs3025020), and 936C/T (rs3025039) were carried out by real-time PCR. RESULTS Higher frequency of rs2010963 C-allele, rs833068 A-allele, and rs3025020 C-allele and significant differences in rs2010963, rs833068, and rs3025020 genotype distribution were seen in VOC than steady-state patients. Increased VOC risk was seen with rs2010963 as heterozygous and more as homozygous, and in rs833068 and rs3025020 homozygous carriers. While there were no differences in VEGF levels between VOC and steady-state controls, there was a progressive decline in serum VEGF in rs2010963 and rs833068 heterozygous and homozygous genotypes, but an opposite trend was seen in VOC patients. Haploview analysis revealed high LD between rs699947, rs833061, rs1570360, rs2010963, rs833068, and rs833070, but weak or no LD between rs3025020 and rs3025039 and other SNPs. Six-locus (rs699947/rs833061/rs1570360/rs2010963/rs833068/rs833070) VEGFA haplotype analysis identified haplotype 111111 to be negatively (OR = 0.68) and haplotype 111222 to be positively (OR = 1.89) associated with VOC. rs2010963, rs833068, and rs3025020 were correlated with VOC type, while rs3025020 was correlated with hospitalization, VOC treatment, and duration. CONCLUSION Specific VEGFA variants contribute to the pathogenesis of SCD VOC.
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Affiliation(s)
- Hebah H Al-Habboubi
- Department of Medical Biochemistry, Arabian Gulf University, Manama, Bahrain
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Bosco C, González J, Gutiérrez R, Parra-Cordero M, Barja P, Rodrigo R. Oxidative damage to pre-eclamptic placenta: immunohistochemical expression of VEGF, nitrotyrosine residues and von Willebrand factor. J Matern Fetal Neonatal Med 2012; 25:2339-45. [PMID: 22612323 DOI: 10.3109/14767058.2012.695823] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine the relationship of biomarkers of placental damage by oxidative stress in pre-eclamptic placenta. METHODS A case-control study was performed on a population of 14 pregnant women with PE and 12 women with normal pregnancies. Immunohistochemical expressions of VEGF, vWF distribution, (Na + K)-ATPase activity, and abundance of nitrotyrosine residues, were assessed in the placental tissue. RESULTS Women with pre-eclampsia showed increased VEGF expression and abundance of nitrotyrosine residues in placental villous, and plasma vWF levels (p < 0.05), whereas placental (Na + K)-ATPase activity were significantly reduced. The syncytiotrophoblast and the maternal space of pre-eclamptic placenta showed diminished and increased vWF expression, respectively, but no significant differences in its expression were found in the placental endothelium and stroma (p < 0.05). CONCLUSIONS It could be suggested that increased oxidative stress and VEGF contribute to enhance the impairment of placental perfusion by increasing peroxynitrite formation, product of the NO and superoxide reaction, thereby partly contributing to account for the pathophysiology of this disease. The presence of vWF in the maternal space and its diminished expression in syncytiotrophoblast of pre-eclamptic placenta also might have pathogenic implications.
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Affiliation(s)
- Cleofina Bosco
- Anatomy and Developmental Biology Programme, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
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Magdoud K, Dendana M, Herbepin V, Hizem S, Ben Jazia K, Messaoudi S, Almawi WY, Touraine R, Mahjoub T. Identification of specific vascular endothelial growth factor susceptible and protective haplotypes associated with recurrent spontaneous miscarriages. Hum Reprod 2012; 27:1536-41. [DOI: 10.1093/humrep/des033] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Daher S, Mattar R, Gueuvoghlanian-Silva BY, Torloni MR. Genetic Polymorphisms and Recurrent Spontaneous Abortions: An Overview of Current Knowledge. Am J Reprod Immunol 2012; 67:341-7. [DOI: 10.1111/j.1600-0897.2012.01123.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 02/06/2012] [Indexed: 01/09/2023] Open
Affiliation(s)
- Silvia Daher
- Department of Obstetrics; Sao Paulo Federal University; Sao Paulo; Brazil
| | - Rosiane Mattar
- Department of Obstetrics; Sao Paulo Federal University; Sao Paulo; Brazil
| | | | - Maria R. Torloni
- Department of Obstetrics; Sao Paulo Federal University; Sao Paulo; Brazil
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Atis A, Oruc O, Aydin Y, Cetincelik U, Goker N. Vascular endothelial growth factor gene +813CC polymorphism of foetus is associated with preterm labour but not with pre-eclampsia in Turkish pregnant women. Int J Immunogenet 2012; 39:241-6. [PMID: 22257487 DOI: 10.1111/j.1744-313x.2011.01082.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We investigated the effect of polymorphism at +813 locus of vascular endothelial growth factor (VEGF) gene on predisposition to preterm labour and pre-eclampsia (PE). We examined polymorphism of the VEGF +813 gene of foetuses from umbilical cord blood in 31 cases of preterm labour, 34 pre-eclamptic and 58 healthy term labour. VEGF +813 gene polymorphisms were studied using a polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis. In preterm group, foetal CC genotype was found at 80.6%, and CT genotype was seen at 19.4%. No any TT genotype was detected in preterm group. CC genotype of VEGF 813 gene was significantly more frequent than CT genotype (P = 0.04). Foetuses with CC genotype VEGF+813 gene have an increased risk for preterm labour. C allele frequency was 90.3 and 76.7% in preterm and control groups, respectively. T allele frequency was 9.7 and 23.3% in preterm and control groups, respectively. C allele was significantly associated with preterm labour (P = 0.02). OR of C and T alleles for preterm labour was 2.8 (CI: 1.1-7.2). In PE group, foetal CC genotype of +813 locus was found in 67.6%, and CT genotype was seen in 29.4%. Only one TT genotype was detected in 2.9% of PE group. There was no association between PE and VEGF gene genotypes and alleles at +813 locus. These results suggest that foetal VEGF gene polymorphism of +813 CC seems to be highly associated with preterm labour, whereas in PE, foetal VEGF gene polymorphism at +813 locus is not related. Especially, C allele was significantly associated with preterm labour. Carriage of the +813C allele of the VEGF gene has been found 2.8 times increased susceptibility to the development of preterm labour in Turkish women and may be an independent risk factor for prematurity. There was no association between PE and VEGF gene genotypes and alleles at +813 locus. We suggest to search for foetal aetiologies or genetic susceptibility in preterm labour, whereas in PE, not foetal, but maternal susceptibility is to be investigated.
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Affiliation(s)
- A Atis
- Department of Obstetrics and Gynecology, Third Obstetrics and Gynecology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
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Al-Khateeb GM, Mustafa FE, Sater MS, Almawi WY. Effect of the functional VEGFA-583C/T variant on vascular endothelial growth factor levels and the risk of recurrent spontaneous miscarriage. Fertil Steril 2011; 95:2471-3. [PMID: 21458805 DOI: 10.1016/j.fertnstert.2011.03.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 02/16/2011] [Accepted: 03/07/2011] [Indexed: 11/28/2022]
Abstract
The association of vascular endothelial growth factor (VEGF) -583C/T variant with recurrent miscarriage (RSM) was investigated in 173 RSM cases and 248 control women. Increased minor allele and genotype frequencies of -583C/T, and reduced serum VEGF concentrations were associated with increased risk of RSM.
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Affiliation(s)
- Ghada M Al-Khateeb
- Department of Medical Biochemistry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Xiang P, Li Z, Di H, Nie S, Yan W. The associations between maternal and fetal angiotensinogen M235T polymorphism and pregnancy-induced hypertension in Chinese women. Reprod Sci 2011; 18:640-4. [PMID: 21266663 DOI: 10.1177/1933719110395405] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study was to investigate whether the maternal and fetal angiotensinogen (AGT) M235T polymorphism were associated with the risk of pregnancy-induced hypertension (PIH) in Chinese Han ethnic women. Using a case-control mother-baby dyads study, a total of 226 maternal/offspring pairs were recruited at Anyang Maternal and Child Health Hospital from January 2008 to December 2009. Genomic DNA was extracted from maternal venous and cord blood. We genotyped the AGT M235T polymorphism by using PCR-RFLP assay and examined the association with PIH using logistic regression analysis. In the current study, the maternal AGT M235T polymorphism showed no effect on the risk of PIH (P = .786) while the fetal AGT M235T polymorphism is significantly associated with PIH in Chinese Han ethnic women (P = .004). The fetus carrying TT genotype is a protective factor in developing PIH in the study population (OR = .28, 95% CI = .14-0.59).
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Affiliation(s)
- Pan Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science &Technology, Wuhan, China
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Traina E, Daher S, Moron AF, Sun SY, Franchim CS, Mattar R. Polymorphisms in VEGF, progesterone receptor and IL-1 receptor genes in women with recurrent spontaneous abortion. J Reprod Immunol 2010; 88:53-7. [PMID: 20956022 DOI: 10.1016/j.jri.2010.07.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2010] [Revised: 07/11/2010] [Accepted: 07/20/2010] [Indexed: 01/23/2023]
Abstract
Hormonal, inflammatory and vascular alterations during pregnancy are thought to be involved in pregnancy loss. The role of progesterone, the actions of which involve cytokines and vascular endothelial growth factor (VEGF), has been thoroughly studied. Genetic factors are involved in modulation of these molecules, and several genes have been associated with recurrent spontaneous abortion (RSA), as well other obstetric conditions. Here we investigate the relationship between RSA and gene polymorphisms of the progesterone receptor (PROGINS), interleukin-1 receptor 1 (PstI) and vascular endothelial growth factor (VEGF) (-634, 936). This case-controlled study comprised a total of 89 women with idiopathic RSA and a control group of 191 women with at least two successful pregnancies and no miscarriages. Genomic DNA was extracted from whole blood, and polymorphism genotyping was conducted by digesting PCR products with specific restriction endonucleases. No correlations were found in any of the investigated polymorphisms, even among dominant, co-dominant and additive inheritance models and alleles. Our results support the hypothesis that these specific gene polymorphisms are not the major determinant of pregnancy success. Although we did not find any correlations, the investigation of these and other polymorphisms remains a challenge in the evaluation of RSA.
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Affiliation(s)
- Evelyn Traina
- Obstetrics Departament, Universidade Federal de São Paulo, São Paulo, Brazil.
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Bussen S, Bussen D. Influence of the vascular endothelial growth factor on the development of severe pre-eclampsia or HELLP syndrome. Arch Gynecol Obstet 2010; 284:551-7. [DOI: 10.1007/s00404-010-1704-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Accepted: 09/22/2010] [Indexed: 12/25/2022]
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Su MT, Lin SH, Lee IW, Chen YC, Hsu CC, Pan HA, Kuo PL. Polymorphisms of endocrine gland-derived vascular endothelial growth factor gene and its receptor genes are associated with recurrent pregnancy loss. Hum Reprod 2010; 25:2923-30. [PMID: 20847187 DOI: 10.1093/humrep/deq256] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Endocrine gland-derived vascular endothelial growth factor (EG-VEGF) and its receptor genes [prokineticin receptor 1 (PKR1) and prokineticin receptor 2 (PKR2)] have been identified in the last decade and their expression is restricted to the steroidogenic glands (ovary, testis, adrenal gland and placenta). Their expression patterns also suggest a close relationship to early pregnancy. However, little information is available regarding the role of EG-VEGF and its receptors (PKR1 and PKR2) in recurrent pregnancy loss (RPL). This study was conducted to investigate the association between polymorphisms of EG-VEGF and its receptor genes (PKR1 and PKR2) and idiopathic RPL. METHODS In this case-control study, 115 women with a history of idiopathic RPL and 170 controls were included. A total of 11 tag single nucleotide polymorphisms (SNPs) selected from EG-VEGF, PKR1 and PKR2 were genotyped. We further used multifactor dimensionality reduction (MDR) analysis to choose a best model and evaluate gene-gene interactions. RESULTS Two tag SNPs of PKR1 (rs4627609, rs6731838) and one tag SNP of PKR2 (rs6053283) were significantly associated with idiopathic RPL (P < 0.05). The frequencies of haplotypes C-G and T-A of PKR1 and haplotype A-G-C-G-G of PKR2 were significantly increased in women with idiopathic RPL (P < 0.05); MDR tests revealed gene-gene interactions between three loci [EG-VEGF (rs7513898), PKR1(rs6731838), PKR2(rs6053283)] based on the association model (P = 0.008). The adjusted odds ratio of high- and low-risk genotype combinations in the three-locus model was 3.94 (95% confidence interval: 2.38-6.52). CONCLUSIONS EG-VEGF receptor (PKR1, PKR2) gene polymorphisms and haplotypes were associated with idiopathic RPL. These three genes (EG-VEGF, PKR1 and PRK2) jointly contribute to RPL in the Taiwanese Han population.
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Affiliation(s)
- Mei-Tsz Su
- Division of Genetics, Department of Obstetrics and Gynecology, National Cheng Kung University, Tainan, Taiwan
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Vaziri SAJ, Kim J, Ganapathi MK, Ganapathi R. Vascular endothelial growth factor polymorphisms: role in response and toxicity of tyrosine kinase inhibitors. Curr Oncol Rep 2010; 12:102-8. [PMID: 20425594 DOI: 10.1007/s11912-010-0085-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Angiogenesis is central to the growth of normal tissues and tumors. Inhibiting this pathway has been a strategy for drug development for tumors not responsive to most agents used in chemotherapy. Notably, signaling mediated by vascular endothelial growth factor (VEGF) is a key target because aberrant signaling via this pathway is frequently associated with neoangiogenesis in tumors. The drug-discovery effort to blunt VEGF signaling has led to the approval of bevacizumab and several receptor tyrosine kinase inhibitors (TKIs) that have shown efficacy in the clinical management of breast, colorectal, lung, and kidney cancer. Understanding the genetic variability in VEGF and VEGF receptor has led to identifying genotypic variations (single nucleotide polymorphisms [SNPs]) associated with treatment outcome and toxicity. Notably, identification of SNPs in VEGF associated with angiogenesis inhibitor treatment-induced hypertension and outcome provides exciting opportunities for personalized medicine to improve outcome and reduced toxicity with these novel TKIs.
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Affiliation(s)
- Susan A J Vaziri
- Taussig Cancer Institute - R40, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
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Gómez LM, Sammel MD, Appleby DH, Elovitz MA, Baldwin DA, Jeffcoat MK, Macones GA, Parry S. Evidence of a gene-environment interaction that predisposes to spontaneous preterm birth: a role for asymptomatic bacterial vaginosis and DNA variants in genes that control the inflammatory response. Am J Obstet Gynecol 2010; 202:386.e1-6. [PMID: 20350647 DOI: 10.1016/j.ajog.2010.01.042] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2009] [Revised: 12/31/2009] [Accepted: 01/15/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE We determined whether an environmental exposure to bacterial vaginosis (BV) modified genetic susceptibilities for spontaneous preterm delivery within genes that regulate the inflammatory response. STUDY DESIGN Maternal DNA samples and vaginal smears for Gram staining were collected from 743 women (68 preterm births). We used a 1536-single nucleotide polymorphism (SNP) custom chip to study associations between genotype distributions and preterm birth. RESULTS For 8 SNPs in 3 genes (protein kinase C alpha, fms-like tyrosine kinase 1, and interleukin 6), the odds ratios for preterm birth ranged from 1.9-4.0 among women with susceptible genotypes who were BV positive. The odds ratios for preterm birth were 2.0-5.0 times greater among women who were BV positive than among women who were BV negative. The significance of these differences was demonstrated by logistic regression analyses for genotype/BV interaction. CONCLUSION These results demonstrate that the risk of preterm delivery that is associated with tag SNPs in genes that regulate the inflammatory response is modified by an environmental exposure such as bacterial vaginosis.
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Schmidt-Erfurth U. Clinical safety of ranibizumab in age-related macular degeneration. Expert Opin Drug Saf 2010; 9:149-65. [PMID: 20001757 DOI: 10.1517/14740330903418422] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
IMPORTANCE OF THE FIELD Clinical safety of pharmaceutical products in the elderly is vital because of their increased risk of cardiac and other adverse events. AREAS COVERED IN THIS REVIEW Search of the Medline database, including articles and abstracts from 1984 to 2009. WHAT THE READER WILL GAIN Knowledge of ocular and systemic risks: The rate of endophthalmitis was 0.05% per injection (MARINA) and <0.1% per injection (ANCHOR), rates confirmed in a retrospective analysis of 14,320 injections. Moderate increases in intraocular pressure were transient, and incidences of intraocular inflammation were rarely serious. Systemic arterial thromboembolic events occurred in 4.6 and 0% of ranibizumab-treated patients and in 3.8 and 0% of sham-treated patients in MARINA (2 years) and PIER (1 year), respectively. In SAILOR, there was a numerically higher rate of cerebrovascular stroke with 0.5 mg ranibizumab compared with 0.3 mg ranibizumab (1.2 vs 0.7%), which was a non-statistically significant trend in patients with a history of stroke. TAKE HOME MESSAGE Although further studies to investigate the risk of stroke with ranibizumab therapy are required, repeated intravitreal ranibizumab was well tolerated and not associated with clinically significant safety risks during up to 2 years of treatment.
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Affiliation(s)
- Ursula Schmidt-Erfurth
- Medical University of Vienna, Department of Ophthalmology, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
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Elito J, Daher S, Fernandes da Silva MO, Marconi NMH, Pendeloski KPT, Moron AF, Camano L. Association study of vascular endothelial growth factor and polymorphisms of its gene with ectopic pregnancy. Am J Reprod Immunol 2009; 63:120-5. [PMID: 20015329 DOI: 10.1111/j.1600-0897.2009.00769.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PROBLEM In ectopic pregnancy, increased levels of vascular endothelial growth factor are present. The aims of this study were to determine the association between -634C/G, -460T/C, and +936C/T vascular endothelial growth factor (VEGF) polymorphisms and ectopic pregnancy, and to determine whether serum levels of VEGF were affected by genetic factors. METHOD of study This is a case-control study wherein 74 women with a history of ectopic pregnancy in a tertiary care center were compared to 134 post-menopausal controls with two pregnancies and no ectopic pregnancy for the genotyping of VEGF polymorphisms. For 35 patients with the diagnosis of ectopic pregnancy, serum concentrations of VEGF were obtained before the treatment. Genotyping of VEGF (-634C/G, -460T/C, and +936C/T) polymorphisms was performed by PCR, followed by endonuclease digestion. ELISA was performed to evaluate the VEGF serum levels. RESULTS The -634C/G, -460T/C, and +936C/T VEGF polymorphisms were not associated with ectopic pregnancy (P = 0.170, P = 0.285, and P = 0.700, respectively). The serum levels of VEGF were not associated with the genotype of -634C/G, -460T/C, and +936C/T VEGF polymorphisms (P = 0.702; P = 0.347, and P = 0.256, respectively). CONCLUSION There was no association between ectopic pregnancy and -634C/G, -460T/C, and +936C/T VEGF polymorphisms. There was no correlation between VEGF genotype and the expression of VEGF in blood samples.
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Affiliation(s)
- Julio Elito
- Department of Obstetrics of the Federal University of São Paulo, São Paulo, SP, Brazil.
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Allison JL, Schust DJ. Recurrent first trimester pregnancy loss: revised definitions and novel causes. Curr Opin Endocrinol Diabetes Obes 2009; 16:446-50. [PMID: 19779333 DOI: 10.1097/med.0b013e3283327fc5] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW First trimester pregnancy loss affects up to 15% of clinically recognized pregnancies. Whereas most couples will proceed to have successful subsequent pregnancies, 2-4% will suffer recurrent losses, often with no identifiable cause. In fact, up to 40-50% of patients suffering recurrent pregnancy loss (RPL) will have no identifiable cause for their losses. Whereas the high incidence of spontaneous fetal aneuploidy will ensure that this number will never fall to zero, its level suggests that additional causes and appropriate diagnostic testing await discovery. The definition, diagnostic work-up and appropriate interventions among patients with RPL remain controversial. Here, we will review those papers published in the last 1-2 years that improve our understanding of the definition of RPL, that confirm the utility of present testing paradigms or that pose novel causes and diagnostic approaches to patients with a history of RPL. RECENT FINDINGS Standard definitions of RPL have been suggested by the American Society of Reproductive Medicine. Suggested potential diagnostic testing for RPL has been expanded to include male factors and new paradigms that address placental function, including the role of vascular endothelial growth factor, thrombosis and maternal-fetal immunology. SUMMARY Standardized definitions for RPL and standardized approaches to initiating the RPL work-up will aid in study design and improve the applicability and implications of published findings. Appropriate investigation of novel causes for RPL may decrease the percentage of patients carrying the diagnosis of unexplained RPL.
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Affiliation(s)
- Jana L Allison
- University of Missouri-Columbia, Obstetrics, Gynecology and Women's Health, Columbia, 65201, USA
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