1
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Xue S, Wang L, Wei J, Liu Y, Ding G, Dai P. Clinical application of single nucleotide polymorphism microarray analysis in pregnancy loss in Northwest China. Front Genet 2023; 14:1319624. [PMID: 38155718 PMCID: PMC10754489 DOI: 10.3389/fgene.2023.1319624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
Background: Spontaneous abortion is the most common complication of early pregnancy. In this study, we aim to investigate the clinical application value of genetic diagnosis using single nucleotide polymorphism (SNP) microarray analysis on the products of conception and to characterize the types of genetic abnormalities and their prevalence in pregnancy loss in Northwest China. Methods: Over 48 months, we selected 652 products of conception, which included chorionic villi, fetal tissues, germ cell samples, amniotic fluid samples, cord blood samples, and a cardiac blood sample. We analyzed the distribution of chromosomal abnormalities leading to fetal arrest or abortion using SNP array. The patients were then categorized divided into groups based on maternal age, gestational age, number of miscarriages, and maternal ethnic background. The incidences of various chromosomal abnormalities in each group were compared. Results: Of the 652 cases, 314 (48.16%) exhibited chromosomal abnormalities. These included 286 cases with numerical chromosomal abnormalities, 24 cases with copy number variation, and four cases with loss of heterozygosity. Among them, there were 203 trisomy cases, 55 monosomy cases, and 28 polyploidy cases. In the subgroup analysis, significant differences were found in the frequency of numerical chromosomal abnormalities and copy number variation between the advanced and younger maternal age group as well as between the early and late abortion groups. Furthermore, we identified significant differences in the frequency of numerical chromosomal abnormalities between the first spontaneous abortion and recurrent miscarriage groups. However, there were no significant differences in the frequency of numerical chromosomal abnormalities between the Han and Uighur groups. Conclusion: Our research highlights chromosomal abnormalities as the primary cause of spontaneous abortion, with a higher incidence in early pregnancy and among women of advanced age. The use of SNP array analysis emerges as an effective and reliable technique for chromosome analysis in aborted fetuses. This method offers a comprehensive and dependable genetic investigation into the etiology of miscarriage, establishing itself as a valuable routine selection for genetic analysis in cases of natural abortions.
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Affiliation(s)
- ShuYuan Xue
- The College of Life Sciences, Northwest University, Xi’an, Shanxi, China
- Prenatal Diagnosis Center, Urumqi Maternal and Child Healthcare Hospital, Urumqi, Xinjiang, China
| | - LiXia Wang
- Prenatal Diagnosis Center, Urumqi Maternal and Child Healthcare Hospital, Urumqi, Xinjiang, China
| | - Jie Wei
- Prenatal Diagnosis Center, Urumqi Maternal and Child Healthcare Hospital, Urumqi, Xinjiang, China
| | - YuTong Liu
- College of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - GuiFeng Ding
- Department of Obstetrics, Urumqi Maternal and Child Healthcare Hospital, Urumqi, Xinjiang, China
| | - PengGao Dai
- The College of Life Sciences, Northwest University, Xi’an, Shanxi, China
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2
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Ticconi C, Di Simone N, Campagnolo L, Fazleabas A. Clinical consequences of defective decidualization. Tissue Cell 2021; 72:101586. [PMID: 34217128 DOI: 10.1016/j.tice.2021.101586] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/23/2021] [Accepted: 06/23/2021] [Indexed: 02/07/2023]
Abstract
Decidualization is characterized by a series of genetic, metabolic, morphological, biochemical, vascular and immune changes occurring in the endometrial stroma in response to the implanting embryo or even before conception and involves the stromal cells of the endometrium. It is a fundamental reproductive event occurring in mammalian species with hemochorial placentation. A growing body of experimental and clinical evidence strongly suggests that defective or disrupted decidualization contributes to the establishment of an inappropriate maternal-fetal interface. This has relevant clinical consequences, ranging from recurrent implantation failure and recurrent pregnancy loss in early pregnancy to several significant complications of advanced gestation. Moreover, recent evidence indicates that selected diseases of the endometrium, such as chronic endometritis and endometriosis, can have a detrimental impact on the decidualization response in the endometrium and may help explain some aspects of the reduced reproductive outcome associated with these conditions. Further research efforts are needed to fully understand the biomolecular mechanisms ans events underlying an abnormal decidualization response. This will permit the development of new diagnostic and therapeutic strategies aimed to improve the likelihood of achieveing a successful pregnancy.
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Affiliation(s)
- Carlo Ticconi
- Department of Surgical Sciences, Section of Gynecology and Obstetrics, University Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
| | - Nicoletta Di Simone
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy; IRCCS, Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - Luisa Campagnolo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
| | - Asgerally Fazleabas
- Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, Grand Rapids, MI, 49503, USA.
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3
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Abstract
PURPOSE OF REVIEW Human reproduction is remarkably inefficient; with pregnancy loss occurring in 10-30% of clinically recognized pregnancies. Of those, 3-5% of couples experience recurrent pregnancy loss (RPL), more than 50% of who never receive an underlying diagnosis. Herein, we review evidence that genetic changes, including pathogenic variant(s) in highly penetrant genes, may provide an explanation for a proportion of couples with pregnancy loss. RECENT FINDINGS Genetic abnormalities that may predispose to pregnancy loss include chromosomal aneuploidy, copy number variants, single-gene changes and others. Although previously limited by the need for hypothesis-driven assessment, advancement of various molecular technologies have sheparded in the opportunity to identify molecular cause of highly heterogeneous conditions, including RPL. The identification of causative genetic aberrations associated with RPL demonstrates a promising area of further research. SUMMARY The journey of human development from a single-cell zygote to a term infant is complex process. Early research into copy number variants and highly penetrant single-gene changes may provide diagnosis for a proportion of couples with RPL as well as inform genes critical for early human development.
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Affiliation(s)
- Christina G Tise
- Division of Medical Genetics, Department of Pediatrics, Stanford University, Stanford, California, USA
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4
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Ticconi C, Pietropolli A, Specchia M, Nicastri E, Chiaramonte C, Piccione E, Scambia G, Di Simone N. Pregnancy-Related Complications in Women with Recurrent Pregnancy Loss: A Prospective Cohort Study. J Clin Med 2020; 9:jcm9092833. [PMID: 32882985 PMCID: PMC7564138 DOI: 10.3390/jcm9092833] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/31/2020] [Accepted: 08/31/2020] [Indexed: 12/16/2022] Open
Abstract
The aim of this prospective cohort study was to determine whether women with recurrent pregnancy loss (RPL) have an increased risk of pregnancy complications compared to normal pregnant women. A total of 1092 singleton pregnancies were followed, 431 in women with RPL and 661 in normal healthy women. The prevalence of the following complications was observed: threatened miscarriage, miscarriage, cervical insufficiency, chromosomal/genetic abnormalities, fetal anomalies, oligohydramnios, polyhydramnios, fetal growth restriction, intrauterine fetal death, gestational diabetes mellitus (GDM), preeclampsia, placenta previa, abruptio placentae, pregnancy-related liver disorders, and preterm premature rupture of the membranes. The odds ratio and 95% CI for each pregnancy complication considered were determined by comparing women with RPL and normal healthy women. Women with RPL had an overall rate of pregnancy complications higher than normal women (OR = 4.37; 95% CI: 3.353–5.714; p < 0.0001). Their risk was increased for nearly all the conditions considered. They also had an increased risk of multiple concomitant pregnancy complications (OR = 4.64; 95% CI: 3.10–6.94, p < 0.0001). Considering only women with RPL, women with ≥3 losses had a higher risk of pregnancy complications than women with two losses (OR = 1.269; 95% CI: 1.112–2.386, p < 0.02). No differences were found in the overall risk of pregnancy complications according to the type, explained or unexplained, of RPL. Women with secondary RPL had an increased risk of GDM than women with primary RPL. Pregnancy in women with RPL should be considered at high risk.
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Affiliation(s)
- Carlo Ticconi
- Department of Surgical Sciences, Section of Gynecology and Obstetrics, University Tor Vergata, 00168 Rome, Italy; (A.P.); (E.N.); (E.P.)
- Correspondence:
| | - Adalgisa Pietropolli
- Department of Surgical Sciences, Section of Gynecology and Obstetrics, University Tor Vergata, 00168 Rome, Italy; (A.P.); (E.N.); (E.P.)
| | - Monia Specchia
- Unità Operativa Complessa (U.O.C.) di Ostetricia e Patologia Ostetrica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A.Gemelli Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), 00168 Rome, Italy; (M.S.); (N.D.S.)
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Elena Nicastri
- Department of Surgical Sciences, Section of Gynecology and Obstetrics, University Tor Vergata, 00168 Rome, Italy; (A.P.); (E.N.); (E.P.)
| | - Carlo Chiaramonte
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133 Rome, Italy;
| | - Emilio Piccione
- Department of Surgical Sciences, Section of Gynecology and Obstetrics, University Tor Vergata, 00168 Rome, Italy; (A.P.); (E.N.); (E.P.)
| | - Giovanni Scambia
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- U.O.C. di Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Nicoletta Di Simone
- Unità Operativa Complessa (U.O.C.) di Ostetricia e Patologia Ostetrica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A.Gemelli Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), 00168 Rome, Italy; (M.S.); (N.D.S.)
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
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5
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Bruno V, Lindau R, Jenmalm MC, Ticconi C, Piccione E, Pietropolli A, Ernerudh J. First-trimester trophoblasts obtained by chorionic villus sampling maintain tolerogenic and proteomic features in successful pregnancies despite a history of unexplained recurrent pregnancy loss. Am J Reprod Immunol 2020; 84:e13314. [PMID: 32734710 DOI: 10.1111/aji.13314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/03/2020] [Accepted: 07/21/2020] [Indexed: 01/06/2023] Open
Abstract
PROBLEM While there are several known causes for recurrent pregnancy loss (RPL), about 50% are unexplained (uRPL), and in these cases, an aberrant immune regulation seems to be involved. Although fetally derived trophoblast cells have a key role in immune regulation, it is difficult to study their immune function during pregnancy, and it is not known whether trophoblast function may be an inherent aberration in uRPL or whether it is associated with the outcome of the current pregnancy. METHOD OF STUDY Chorionic villus sampling (CVS) was performed for clinical indications at 12 weeks of gestation. Superfluous materials, divided in small explants, were cultured for 20-24 hours, and supernatants (conditioned medium) were collected from 36 women with singleton normal pregnancies, of whom 9 women had a history of RPL. The secreted immune protein profile was measured by proximity extension assay, and the conditioned medium was further used in functional ex vivo models to assess ability to polarize blood monocytes and CD4+ T cells into immune regulatory phenotypes, as detected by flow cytometry. RESULTS Conditioned medium from chorionic villi, human fetally derived placental tissue, was able to induce a decidual-type of M2-like macrophages, as well as an expansion of Treg cells ex vivo, both in women with uRPL and in control women. The preserved immunological properties were confirmed by a maintained immune protein profile in RPL compared with controls. CONCLUSION Trophoblasts in an ex vivo model maintain tolerogenic and proteomic profile features in successful pregnancies, despite a previous history of RPL.
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Affiliation(s)
- Valentina Bruno
- Section of Gynecology, Academic Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Academic Department of Surgical Sciences, Section of Gynecology, Tor Vergata University, Rome, Italy
| | - Robert Lindau
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Maria C Jenmalm
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Carlo Ticconi
- Academic Department of Surgical Sciences, Section of Gynecology, Tor Vergata University, Rome, Italy
| | - Emilio Piccione
- Academic Department of Surgical Sciences, Section of Gynecology, Tor Vergata University, Rome, Italy
| | - Adalgisa Pietropolli
- Academic Department of Surgical Sciences, Section of Gynecology, Tor Vergata University, Rome, Italy
| | - Jan Ernerudh
- Department of Clinical Immunology and Transfusion Medicine, Linköping University, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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6
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Bruno V, Ticconi C, Martelli F, Nuccetelli M, Capogna MV, Sorge R, Piccione E, Pietropolli A. Uterine and placental blood flow indexes and antinuclear autoantibodies in unexplained recurrent pregnancy loss: should they be investigated in pregnancy as correlated potential factors? A retrospective study. BMC Pregnancy Childbirth 2020; 20:44. [PMID: 31959152 PMCID: PMC6971936 DOI: 10.1186/s12884-020-2724-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 01/07/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The potential role of antinuclear antibodies (ANA) in recurrent pregnancy loss (RPL) pathogenesis is still debated, although some evidences suggest that they could affect pregnancy outcome, leading to a higher miscarriage rate in these patients. A hypothesized mechanism is through changes in uterine flow in pre-conceptional stage, by modifying endometrial receptivity in RPL. However, scant data are available, in pregnancy, about their role in RPL placental perfusion, also in relation to its potential treatments, such as low molecular weight heparin (LMWH). The aim of this study is to retrospectively further investigate the correlation between two-dimensional (2D) and three-dimensional (3D) uterine and placental flow indexes and the presence or the absence of ANA in women with unexplained RPL (uRPL), treated or not treated with LMWH. METHODS 2D Doppler measurement of pulsatility index (PI) of the uterine arteries and 3D ultrasonography determination of vascularization index (VI), flow index (FI) and vascularization flow index (VFI) was carried out with the aid of the virtual organ computer-aided analysis (VOCAL) technique in LMWH treated (n 24) and not treated-uRPL patients (n 20) and in the relative control group (n 27), each group divided in ANA+ and ANA- subgroups. Serum assay for the presence of ANA was performed in all women. RESULTS No differences were found in PI, VFI and VI values, by comparing the different groups. A difference in VI values was found for ANA- patients between RPL women not treated with LMWH and the treated ones (p = 0,01), which have lower VI values and similar to controls. By considering only ANA- treated and not treated RPL patients, the ROC curve shows an area of 0,80 and at the VI cut-off of 11,08 a sensitivity of 85% and a specificity of 67%. CONCLUSIONS LMWH could exert a potential beneficial effect in restoring the physiological blood flow supply in terms of VI in uRPL ANA- status, suggesting to include ANA and VI investigations in the RPL diagnostic algorithm in a research context, since further studies are needed to clarify this challenging hypothesis in order to try to ameliorate ANA and abnormal placental vascularization negative influence on RPL pregnancy outcome .
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Affiliation(s)
- Valentina Bruno
- Academic Department of Biomedicine and Prevention, Section of Gynecology, University of Rome "Tor Vergata", Via Montpellier, 1 -, 00133, Rome, Italy.
| | - Carlo Ticconi
- Academic Department of Surgical Sciences, Section of Gynecology, Tor Vergata University Hospital, Viale Oxford, 81 -, 00133, Rome, Italy
| | - Federica Martelli
- Academic Department of Biomedicine and Prevention, Section of Gynecology, University of Rome "Tor Vergata", Via Montpellier, 1 -, 00133, Rome, Italy
| | - Marzia Nuccetelli
- Department of Experimental Medicine and Surgery, Tor Vergata University Hospital, Viale Oxford, 81 -, 00133, Rome, Italy
| | - Maria Vittoria Capogna
- Academic Department of Surgical Sciences, Section of Gynecology, Tor Vergata University Hospital, Viale Oxford, 81 -, 00133, Rome, Italy
| | - Roberto Sorge
- Department of Systems Medicine, Laboratory of Biometry, University of Rome "Tor Vergata", Via Montpellier, 1 -, 00133, Rome, Italy
| | - Emilio Piccione
- Academic Department of Surgical Sciences, Section of Gynecology, Tor Vergata University Hospital, Viale Oxford, 81 -, 00133, Rome, Italy
| | - Adalgisa Pietropolli
- Academic Department of Systems Medicine, Section of Gynecology, University of Rome "Tor Vergata", Via Montpellier, 1 -, 00133, Rome, Italy
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7
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Time-to-Pregnancy in Women with Unexplained Recurrent Pregnancy Loss: A Controlled Study. Reprod Sci 2020; 27:1121-1128. [DOI: 10.1007/s43032-019-00122-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 09/13/2019] [Indexed: 10/25/2022]
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8
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Mikhailova VA, Khokhlova EV, Bazhenov DO, Agnaeva AO, Kozyreva AR, Bespalova ON, Selkov SA, Sokolov DI. Changes in expression of Ki-67, CD16 and CD56 by natural killer cells from peripheral blood mononuclear cells in the setting of recurrent miscarriage after in vitro culturing in the presence of trophoblast cells and IL-2. Cytotechnology 2019; 71:861-871. [PMID: 31317282 PMCID: PMC6664104 DOI: 10.1007/s10616-019-00331-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 07/09/2019] [Indexed: 11/25/2022] Open
Abstract
The aim of this research was to assess the proliferative activity of Natural Killer Cells (NK cells) from Peripheral Blood Mononuclear Cells (PBMCs) in the presence of trophoblast cells in women with a history of recurrent miscarriages. We examined the peripheral blood of women with recurrent miscarriage in the proliferative (n = 12) or secretory (n = 13) phase of their menstrual cycle, and pregnant women with a history of recurrent miscarriage at 6-7 weeks of their current pregnancy (n = 14). Controls were fertile non-pregnant women in the proliferative (n = 11) or secretory (n = 13) phase of their menstrual cycle, and pregnant women at 6-7 weeks of a physiologically normal pregnancy (n = 20). We used IL-2 as a factor maintaining PBMCs viability during long-term culturing. We established that culturing in the presence of IL-2 contributed to an increase in the number of CD56+CD16- NK cells and to a decrease in the number of CD56+CD16+ NK cells from PBMCs compared with these numbers before culturing in both healthy women and in women with recurrent miscarriage. After culturing of PBMCs in the presence of trophoblast cells and IL-2 (compared with culturing without trophoblast cells), the intensity of Ki-67 expression by NK cells was reduced in the whole NK cell population (CD3-CD56+), and in the CD56+CD16- and CD56+CD16+ populations of NK cells in women with recurrent miscarriage and in healthy controls. The intensity of CD56 expression was reduced in the presence of trophoblast cells and IL-2 in non-pregnant women with recurrent miscarriage in the secretory versus the proliferative phase of the menstrual cycle.
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Affiliation(s)
- V A Mikhailova
- Federal State Budgetary Scientific Institution Research Institute of Obstetrics, Gynecology, and Reproductology Named After D.O. Ott, Saint Petersburg, Russia.
| | - E V Khokhlova
- Federal State Budgetary Scientific Institution Research Institute of Obstetrics, Gynecology, and Reproductology Named After D.O. Ott, Saint Petersburg, Russia
| | - D O Bazhenov
- Federal State Budgetary Scientific Institution Research Institute of Obstetrics, Gynecology, and Reproductology Named After D.O. Ott, Saint Petersburg, Russia
- Federal State Budgetary Scientific Institution Research Institute of Experimental Medicine, Saint Petersburg, Russia
| | - A O Agnaeva
- Federal State Budgetary Scientific Institution Research Institute of Obstetrics, Gynecology, and Reproductology Named After D.O. Ott, Saint Petersburg, Russia
| | - A R Kozyreva
- Federal State Budgetary Scientific Institution Research Institute of Obstetrics, Gynecology, and Reproductology Named After D.O. Ott, Saint Petersburg, Russia
| | - O N Bespalova
- Federal State Budgetary Scientific Institution Research Institute of Obstetrics, Gynecology, and Reproductology Named After D.O. Ott, Saint Petersburg, Russia
| | - S A Selkov
- Federal State Budgetary Scientific Institution Research Institute of Obstetrics, Gynecology, and Reproductology Named After D.O. Ott, Saint Petersburg, Russia
| | - D I Sokolov
- Federal State Budgetary Scientific Institution Research Institute of Obstetrics, Gynecology, and Reproductology Named After D.O. Ott, Saint Petersburg, Russia
- Federal State Budgetary Scientific Institution Research Institute of Experimental Medicine, Saint Petersburg, Russia
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9
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Ticconi C, Capogna MV, Martelli F, Borelli B, Bruno V, Ergasti R, Sorge R, Piccione E, Pietropolli A. Ectopic pregnancy in women with recurrent miscarriage. J Obstet Gynaecol Res 2018; 44:852-860. [PMID: 29442402 DOI: 10.1111/jog.13607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 01/08/2018] [Indexed: 12/01/2022]
Abstract
AIM The aim of this study was to investigate the possible association between recurrent miscarriage (RM) and ectopic pregnancy (EP). METHODS In this case-control retrospective study, the clinical cards of women followed as outpatients in the RM and low-risk pregnancy offices of the Obstetrics and Gynecology Unit at the Policlinico Tor Vergata University Hospital were carefully reviewed for the occurrence of EP. RESULTS Overall, 598 women with RM and 2043 normal women without RM (controls) were included in the study. Among these women, 4974 pregnancies were analyzed, in which 2028 miscarriages occurred. The EP rate (3.51%) was significantly higher in RM than in control women (1.51%) [odds ratio = 2.31 (95% confidence interval: 2.3-2.4)]; it was particularly high in women with primary RM (5.11%). However, when EP rates were calculated not by women but by overall pregnancies, no differences could be found between RM and control women. In control women, the absence of a miscarriage in the reproductive history was associated with a lower rate of EP. CONCLUSIONS Women with RM, particularly primary RM, are at increased risk of EP. This increased risk seems to be dependent on the high number of pregnancies occurring in women with RM rather than to specific characteristics of these women.
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Affiliation(s)
- Carlo Ticconi
- Academic Department of Biomedicine and Prevention, Section of Gynecology and Obstetrics, Tor Vergata University, Rome, Italy.,Clinical Department of Surgery, Section of Gynecology and Obstetrics, Fondazione Policlinico Tor Vergata University Hospital, Rome, Italy
| | - Maria V Capogna
- Academic Department of Biomedicine and Prevention, Section of Gynecology and Obstetrics, Tor Vergata University, Rome, Italy.,Clinical Department of Surgery, Section of Gynecology and Obstetrics, Fondazione Policlinico Tor Vergata University Hospital, Rome, Italy
| | - Federica Martelli
- Academic Department of Biomedicine and Prevention, Section of Gynecology and Obstetrics, Tor Vergata University, Rome, Italy.,Clinical Department of Surgery, Section of Gynecology and Obstetrics, Fondazione Policlinico Tor Vergata University Hospital, Rome, Italy
| | - Barbara Borelli
- Academic Department of Biomedicine and Prevention, Section of Gynecology and Obstetrics, Tor Vergata University, Rome, Italy.,Clinical Department of Surgery, Section of Gynecology and Obstetrics, Fondazione Policlinico Tor Vergata University Hospital, Rome, Italy
| | - Valentina Bruno
- Academic Department of Biomedicine and Prevention, Section of Gynecology and Obstetrics, Tor Vergata University, Rome, Italy.,Clinical Department of Surgery, Section of Gynecology and Obstetrics, Fondazione Policlinico Tor Vergata University Hospital, Rome, Italy
| | - Raffaella Ergasti
- Academic Department of Biomedicine and Prevention, Section of Gynecology and Obstetrics, Tor Vergata University, Rome, Italy.,Clinical Department of Surgery, Section of Gynecology and Obstetrics, Fondazione Policlinico Tor Vergata University Hospital, Rome, Italy
| | - Roberto Sorge
- Laboratory of Biometry, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Emilio Piccione
- Academic Department of Biomedicine and Prevention, Section of Gynecology and Obstetrics, Tor Vergata University, Rome, Italy.,Clinical Department of Surgery, Section of Gynecology and Obstetrics, Fondazione Policlinico Tor Vergata University Hospital, Rome, Italy
| | - Adalgisa Pietropolli
- Academic Department of Biomedicine and Prevention, Section of Gynecology and Obstetrics, Tor Vergata University, Rome, Italy.,Clinical Department of Surgery, Section of Gynecology and Obstetrics, Fondazione Policlinico Tor Vergata University Hospital, Rome, Italy
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10
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Abstract
Choosing an evidence-based workup and treatment for recurrent pregnancy loss is imperative to provide best patient care and create a culture that permits rigorous research into potential (not yet evidence-based) tests and therapeutics. As health sciences technologies become more sophisticated, more precise, and less expensive, new tools may be developed that allow better evaluation and treatment of couples with recurrent pregnancy loss. The goal must remain optimizing value and adhering to evidence-based care.
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11
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Bruno V, Rizzacasa B, Pietropolli A, Capogna MV, Massoud R, Ticconi C, Piccione E, Cortese C, Novelli G, Amati F. OLR1 and Loxin Expression in PBMCs of Women with a History of Unexplained Recurrent Miscarriage: A Pilot Study. Genet Test Mol Biomarkers 2017; 21:363-372. [PMID: 28409654 DOI: 10.1089/gtmb.2016.0331] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
AIMS The aim of this study was to evaluate the expression of OLR1 and its alternative splicing isoform Loxin in unexplained recurrent miscarriage (uRM). METHODS Sixty-three women of reproductive age were recruited and were divided into four groups: 18 pregnant and 23 non-pregnant women with uRM, and 12 pregnant and 10 non-pregnant women with physiological pregnancies. Complementary DNA derived from peripheral blood mononuclear cells (PBMCs) was analyzed by quantitative real-time PCR to evaluate the expression of OLR1 and Loxin. Oxidized low-density lipoproteins (ox-LDLs) were assayed from serum by a commercially available kit. RESULTS Pregnant uRM women presented with a higher, though not significant, OLR1/Loxin ratio and a higher ox-LDLs serum level (p ≤ 0.05) compared with pregnant control women. OLR1 and Loxin levels were significantly decreased in non-pregnant uRM women compared with the control (OLR1: 0.00018 vs. 0.00043, p ≤ 0.005; Loxin: 0.00018 vs. 0.00060, p ≤ 0.005, respectively). Loxin expression decreased by about two-thirds (p ≤ 0.005) in pregnant women compared with non-pregnant control women. A higher expression of OLR1 in pregnant women compared with non-pregnant women with uRM (p ≤ 0.05) was observed, but no variation in Loxin expression was observed. CONCLUSIONS The results of this study show an association of peripheral OLR1 and Loxin expression levels in uRM women, and they suggest the possible existence of an uncontrolled oxidative stress in these women in the first trimester of pregnancy.
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Affiliation(s)
- Valentina Bruno
- 1 Academic Department of Biomedicine and Prevention, Section of Gynecology and Obstetrics, University of Rome Tor Vergata and Department of Surgery, Section of Gynecology and Obstetrics, Tor Vergata University Hospital , Rome, Italy .,2 Department of Surgery, Section of Gynecology and Obstetrics, Tor Vergata University Hospital, Rome , Italy
| | - Barbara Rizzacasa
- 3 Department of Biomedicine and Prevention, Section of Genetics, University of Rome Tor Vergata , Rome, Italy
| | - Adalgisa Pietropolli
- 1 Academic Department of Biomedicine and Prevention, Section of Gynecology and Obstetrics, University of Rome Tor Vergata and Department of Surgery, Section of Gynecology and Obstetrics, Tor Vergata University Hospital , Rome, Italy .,2 Department of Surgery, Section of Gynecology and Obstetrics, Tor Vergata University Hospital, Rome , Italy
| | - Maria Vittoria Capogna
- 1 Academic Department of Biomedicine and Prevention, Section of Gynecology and Obstetrics, University of Rome Tor Vergata and Department of Surgery, Section of Gynecology and Obstetrics, Tor Vergata University Hospital , Rome, Italy .,2 Department of Surgery, Section of Gynecology and Obstetrics, Tor Vergata University Hospital, Rome , Italy
| | - Renato Massoud
- 4 Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Tor Vergata University Hospital , Rome, Italy
| | - Carlo Ticconi
- 1 Academic Department of Biomedicine and Prevention, Section of Gynecology and Obstetrics, University of Rome Tor Vergata and Department of Surgery, Section of Gynecology and Obstetrics, Tor Vergata University Hospital , Rome, Italy .,2 Department of Surgery, Section of Gynecology and Obstetrics, Tor Vergata University Hospital, Rome , Italy
| | - Emilio Piccione
- 1 Academic Department of Biomedicine and Prevention, Section of Gynecology and Obstetrics, University of Rome Tor Vergata and Department of Surgery, Section of Gynecology and Obstetrics, Tor Vergata University Hospital , Rome, Italy .,2 Department of Surgery, Section of Gynecology and Obstetrics, Tor Vergata University Hospital, Rome , Italy
| | - Claudio Cortese
- 4 Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Tor Vergata University Hospital , Rome, Italy
| | - Giuseppe Novelli
- 3 Department of Biomedicine and Prevention, Section of Genetics, University of Rome Tor Vergata , Rome, Italy
| | - Francesca Amati
- 3 Department of Biomedicine and Prevention, Section of Genetics, University of Rome Tor Vergata , Rome, Italy
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Barišić A, Pereza N, Hodžić A, Kapović M, Peterlin B, Ostojić S. Functional single nucleotide polymorphisms of matrix metalloproteinase 7 and 12 genes in idiopathic recurrent spontaneous abortion. J Assist Reprod Genet 2016; 34:365-371. [PMID: 27987113 DOI: 10.1007/s10815-016-0848-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 11/22/2016] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the potential association of matrix metalloproteinase 7 (MMP7) -181 A/G and MMP12 -82 A/G functional single nucleotide polymorphisms (SNP) with idiopathic recurrent spontaneous abortion (IRSA) in Slovenian reproductive couples. METHODS A case-control study was conducted on 149 couples with 3 or more consecutive idiopathic spontaneous pregnancy loses and 149 women and men with at least 2 live births and no history of pregnancy complications. Genotyping of MMP7 -181 A/G and MMP12 -82 A/G SNPs was performed using polymerase chain reaction and restriction fragment length polymorphism methods. RESULTS There were no statistically significant differences in the distribution of MMP7 -181 A/G and MMP12 -82 A/G genotype, allele, or haplotype frequencies between IRSA patients and controls, as well as patients' primary and secondary IRSA. We also found no association of MMP7 -181 A/G and MMP12 -82 A/G genotypes, alleles, and haplotypes with IRSA. CONCLUSIONS We found no evidence to support the association between IRSA and MMP7 -181 A/G and MMP12 -82 A/G SNPs in Slovenian reproductive couples.
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Affiliation(s)
- Anita Barišić
- Department of Biology and Medical Genetics, Faculty of Medicine, University of Rijeka, B. Branchetta 20, 51000, Rijeka, Croatia
| | - Nina Pereza
- Department of Biology and Medical Genetics, Faculty of Medicine, University of Rijeka, B. Branchetta 20, 51000, Rijeka, Croatia
| | - Alenka Hodžić
- Clinical Institute of Medical Genetics, Department of Gynaecology and Obstetrics, UMC Ljubljana, 1000, Ljubljana, Slovenia
| | - Miljenko Kapović
- Department of Biology and Medical Genetics, Faculty of Medicine, University of Rijeka, B. Branchetta 20, 51000, Rijeka, Croatia
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, Department of Gynaecology and Obstetrics, UMC Ljubljana, 1000, Ljubljana, Slovenia
| | - Saša Ostojić
- Department of Biology and Medical Genetics, Faculty of Medicine, University of Rijeka, B. Branchetta 20, 51000, Rijeka, Croatia.
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