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Frimat M, Gnemmi V, Stichelbout M, Provôt F, Fakhouri F. Pregnancy as a susceptible state for thrombotic microangiopathies. Front Med (Lausanne) 2024; 11:1343060. [PMID: 38476448 PMCID: PMC10927739 DOI: 10.3389/fmed.2024.1343060] [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: 11/22/2023] [Accepted: 02/12/2024] [Indexed: 03/14/2024] Open
Abstract
Pregnancy and the postpartum period represent phases of heightened vulnerability to thrombotic microangiopathies (TMAs), as evidenced by distinct patterns of pregnancy-specific TMAs (e.g., preeclampsia, HELLP syndrome), as well as a higher incidence of nonspecific TMAs, such as thrombotic thrombocytopenic purpura or hemolytic uremic syndrome, during pregnancy. Significant strides have been taken in understanding the underlying mechanisms of these disorders in the past 40 years. This progress has involved the identification of pivotal factors contributing to TMAs, such as the complement system, ADAMTS13, and the soluble VEGF receptor Flt1. Regardless of the specific causal factor (which is not generally unique in relation to the usual multifactorial origin of TMAs), the endothelial cell stands as a central player in the pathophysiology of TMAs. Pregnancy has a major impact on the physiology of the endothelium. Besides to the development of placenta and its vascular consequences, pregnancy modifies the characteristics of the women's microvascular endothelium and tends to render it more prone to thrombosis. This review aims to delineate the distinct features of pregnancy-related TMAs and explore the contributing mechanisms that lead to this increased susceptibility, particularly influenced by the "gravid endothelium." Furthermore, we will discuss the potential contribution of histopathological studies in facilitating the etiological diagnosis of pregnancy-related TMAs.
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Affiliation(s)
- Marie Frimat
- CHU Lille, Nephrology Department, Univ. Lille, Lille, France
- Inserm, Institut Pasteur de Lille, Univ. Lille, Lille, France
| | | | | | - François Provôt
- CHU Lille, Nephrology Department, Univ. Lille, Lille, France
| | - Fadi Fakhouri
- Service of Nephrology and Hypertension, CHUV and University of Lausanne, Lausanne, Switzerland
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Guo X, Semerci N, De Assis V, Kayisli UA, Schatz F, Steffensen TS, Guzeloglu-Kayisli O, Lockwood CJ. Regulation of Proinflammatory Molecules and Tissue Factor by SARS-CoV-2 Spike Protein in Human Placental Cells: Implications for SARS-CoV-2 Pathogenesis in Pregnant Women. Front Immunol 2022; 13:876555. [PMID: 35464466 PMCID: PMC9022221 DOI: 10.3389/fimmu.2022.876555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/17/2022] [Indexed: 12/24/2022] Open
Abstract
SARS-CoV-2 infects cells via binding to ACE2 and TMPRSS2, which allows the virus to fuse with host cells. The viral RNA is detected in the placenta of SARS-CoV-2-infected pregnant women and infection is associated with adverse pregnancy complications. Therefore, we hypothesize that SARS-CoV-2 infection of placental cells induces pro-inflammatory cytokine release to contribute to placental dysfunction and impaired pregnancy outcomes. First, expression of ACE2 and TMPRSS2 was measured by qPCR in human primary cultured term cytotrophoblasts (CTBs), syncytiotrophoblast (STBs), term and first trimester decidual cells (TDCs and FTDCs, respectively), endometrial stromal cells (HESCs) as well as trophoblast cell lines HTR8, JEG3, placental microvascular endothelial cells (PMVECs) and endometrial endothelial cells (HEECs). Later, cultured HTR8, JEG3, PMVECs and HEECs were treated with 10, 100, 1000 ng/ml of recombinant (rh-) SARS-CoV-2 S-protein ± 10 ng/ml rh-IFNγ. Pro-inflammatory cytokines IL-1β, 6 and 8, chemokines CCL2, CCL5, CXCL9 and CXCL10 as well as tissue factor (F3), the primary initiator of the extrinsic coagulation cascade, were measured by qPCR as well as secreted IL-6 and IL-8 levels were measured by ELISA. Immunohistochemical staining for SARS-CoV-2 spike protein was performed in placental specimens from SARS-CoV-2–positive and normal pregnancies. ACE2 levels were significantly higher in CTBs and STBs vs. TDCs, FTDCs and HESCs, while TMPRSS2 levels were not detected in TDCs, FTDCs and HESCs. HTR8 and JEG3 express ACE2 and TMPRSS2, while PMVECs and HEECs express only ACE2, but not TMPRSS2. rh-S-protein increased proinflammatory cytokines and chemokines levels in both trophoblast and endothelial cells, whereas rh-S-protein only elevated F3 levels in endothelial cells. rh-IFNγ ± rh-S-protein augments expression of cytokines and chemokines in trophoblast and endothelial cells. Elevated F3 expression by rh-IFNγ ± S-protein was observed only in PMVECs. In placental specimens from SARS-CoV-2-infected mothers, endothelial cells displayed higher immunoreactivity against spike protein. These findings indicated that SARS-CoV-2 infection in placental cells: 1) induces pro-inflammatory cytokine and chemokine release, which may contribute to the cytokine storm observed in severely infected pregnant women and related placental dysfunction; and 2) elevates F3 expression that may trigger systemic or placental thrombosis.
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Affiliation(s)
- Xiaofang Guo
- Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, FL, United States
| | - Nihan Semerci
- Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, FL, United States
| | - Viviana De Assis
- Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, FL, United States
| | - Umit A Kayisli
- Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, FL, United States
| | - Frederick Schatz
- Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, FL, United States
| | - Thora S Steffensen
- Department of Pathology, Tampa General Hospital, Tampa, FL, United States
| | - Ozlem Guzeloglu-Kayisli
- Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, FL, United States
| | - Charles J Lockwood
- Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, FL, United States
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Expression of tissue factor and TF-mediated integrin regulation in HTR-8/SVneo trophoblast cells. J Reprod Immunol 2022; 150:103473. [PMID: 35030354 DOI: 10.1016/j.jri.2022.103473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/16/2021] [Accepted: 01/03/2022] [Indexed: 11/22/2022]
Abstract
Placenta is a crucial source of Tissue Factor (TF) to initiate coagulation. As far as the TF is concern, aberrant expression of TF has been reported to have a significant role in thrombosis, inflammation, cancer metastasis and atherosclerosis. It is evident that TF and TF-FVIIa complex has major roles in the disease process beyond hemostasis and thrombosis. On the other hand, TF-FVII-dependent signaling primarily activates PAR2 and inducing pro-angiogenic and immune-modulating cytokines in tumor environment. However, the role of TF has not been delineated in placental functions. Integrin typically binds to the extracellular matrix which in turn mediate cell-cell adhesion and cell behavior for migration. Dysregulation of integrin expression affects cell interaction, proliferation, and migration. Therefore, this study aims to ascertain the expression of TF in HTR-8/SVneo trophoblast cell line and its role in signal transduction of integrin (ITGα1, ITGα2, ITGβ1) regulation concerning the invasion of trophoblasts. We have used RT-PCR and Western blot for the gene and protein expression analysis respectively. In addition, cell migration assays, MTT, and DAPI were performed to examine migration, cytotoxicity and apoptosis effect of FVIIa. The results suggest that the gene and protein level expressions of TF were predominant in HTR-8/SVneo cell line. Further, the cytotoxicity and apoptosis in HTR-8/SVneo cells were not observed when treated with FVIIa. The cells treated with FVIIa shown a dose-dependent up-regulation of integrin(s) (**p < 0.01, *p < 0.05) when compared to control. Migration of the HTR-8/SVneo cells was observed without any apoptosis in FVIIa-treated cells when compared to that of control. On the whole, these observations delineated the TF-FVIIa interaction in modulating the TF-dependent integrin signal transduction in HTR-8/SVneo trophoblast cell line.
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Talab AY, Aboali Hamza H, Mostafa TM. Antepartum and postpartum changes in adipokines, endothelial dysfunction, inflammatory markers and other biochemical parameters in preeclamptic women: A prospective observational cohort study. J Appl Biomed 2021; 19:62-72. [PMID: 34907717 DOI: 10.32725/jab.2021.004] [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: 08/30/2020] [Accepted: 01/22/2021] [Indexed: 11/05/2022] Open
Abstract
This study aimed at evaluating the role played by insulin resistance, lipid metabolism disorder, oxidative stress, resistin, vaspin, Interleukin-18 and asymmetric dimethyl arginine as a marker for endothelial dysfunction in the pathogenesis of preeclampsia. This prospective observational cohort study involved 60 women who were classified into: 20 non-pregnant women (group 1 or control group), 20 normally pregnant women (group 2) and 20 preeclamptic women (group 3) at their third trimester. The pregnant women were assessed at their third trimester and further re-evaluated four weeks after delivery. The assessment included demography, assessment of proteinuria and urinary protein to creatinine ratio, blood pressure measurement and assessment of fasting blood glucose, fasting insulin level, lipid panel and the circulating levels of malondialdehyde, resistin, vaspin, interleukin-18 and asymmetric dimethyl arginine. Preeclamptic women showed more atherogenic lipid profile, significantly higher Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and significantly elevated levels of malondialdehyde, resistin, vaspin and interleukin-18 than the other study groups. Serum asymmetric dimethyl arginine concentration showed non-significant difference among the three study groups. The levels of resistin and vaspin showed significant decrease four weeks postpartum in preeclamptic group. We concluded that, preeclampsia was associated with insulin resistance, dyslipidemia, oxidative stress, inflammation and significant changes in adipokines; resistin and vaspin. Furthermore, the significant increase in the serum levels of resistin and vaspin at the third trimester and their significant decline four weeks postpartum in preeclamptic group focus the attention on the role played by these adipokines in the pathogenesis of preeclampsia.
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Affiliation(s)
- Amany Yasseen Talab
- Tanta University, Faculty of Pharmacy, Department of Clinical Pharmacy, Tanta, Egypt
| | - Haitham Aboali Hamza
- Menofya University, Faculty of Medicine, Department of Obstetrics & Gynecology, Shibin El Kom, Egypt
| | - Tarek Mohamed Mostafa
- Tanta University, Faculty of Pharmacy, Department of Clinical Pharmacy, Tanta, Egypt
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Ives CW, Sinkey R, Rajapreyar I, Tita ATN, Oparil S. Preeclampsia-Pathophysiology and Clinical Presentations: JACC State-of-the-Art Review. J Am Coll Cardiol 2021; 76:1690-1702. [PMID: 33004135 DOI: 10.1016/j.jacc.2020.08.014] [Citation(s) in RCA: 258] [Impact Index Per Article: 86.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/14/2020] [Accepted: 08/03/2020] [Indexed: 01/01/2023]
Abstract
Preeclampsia is a hypertensive disorder of pregnancy. It affects 2% to 8% of pregnancies worldwide and causes significant maternal and perinatal morbidity and mortality. Hypertension and proteinuria are the cornerstone of the disease, though systemic organ dysfunction may ensue. The clinical syndrome begins with abnormal placentation with subsequent release of antiangiogenic markers, mediated primarily by soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng). High levels of sFlt-1 and sEng result in endothelial dysfunction, vasoconstriction, and immune dysregulation, which can negatively impact every maternal organ system and the fetus. This review comprehensively examines the pathogenesis of preeclampsia with a specific focus on the mechanisms underlying the clinical features. Delivery is the only definitive treatment. Low-dose aspirin is recommended for prophylaxis in high-risk populations. Other treatment options are limited. Additional research is needed to clarify the pathophysiology, and thus, identify potential therapeutic targets for improved treatment and, ultimately, outcomes of this prevalent disease.
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Affiliation(s)
- Christopher W Ives
- Tinsley Harrison Internal Medicine Residency Program, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Rachel Sinkey
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, Alabama; Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Indranee Rajapreyar
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Alan T N Tita
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, Alabama; Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Suzanne Oparil
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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Wang L, Zhang J. Long intergenic ncRNA 00473 improves the invasion of trophoblastic cells via miR-16-5p. Pregnancy Hypertens 2021; 23:174-184. [PMID: 33422740 DOI: 10.1016/j.preghy.2020.12.003] [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] [Received: 07/15/2020] [Revised: 11/03/2020] [Accepted: 12/09/2020] [Indexed: 01/20/2023]
Abstract
Preeclampsia (PE) is a common disease among pregnant women and is characterized by high blood pressure, edemas, proteinuria, etc. However, the underlying mechanism of PE is still not clear. Our results may provide a new understanding of the pathogenesis of PE and a therapeutical target for the treatment of the disease. Levels of long intergenic ncRNA 00473 (LINC00473), miR-16-5p, MMP2, MMP9, Bcl-2, Bax, and C caspase-3 in placental tissues or human trophoblastic cells were assessed. HTR8/SVneo and JEG-3 cells were transfected with LINC00473, miR-16-5p mimic, LINC00473 siRNA, or miR-16-5p inhibitor alone, or co-transfected with LINC00473 and miR-16-5p mimic or LINC00473 siRNA and miR-16-5p inhibitor. Viability, apoptosis, migration and invasion of cells were assessed by Cell Counting Kit-8, flow cytometry, wound healing assay and Transwell assay, respectively. The target gene of LINC00473 was analyzed using Starbase and dual-luciferase reporter assay. LINC00473 level was down-regulated in placental tissues of PE patients. LINC00473 overexpression increased cell viability, migration, invasion, and MMP2, MMP9 and Bcl-2 levels, yet decreased the apoptosis rates and Bax and C caspase-3 levels in cells; however, LINC00473 silencing had the opposite effect. LINC00473 targeted miR-16-5p and miR-16-5p level was negatively related to LINC00473 level. MiR-16-5p mimic reversed the promoting effect of LINC00473 overexpression on the invasion of HTR8/SVneo and JEG-3 cells, while miR-16-5p inhibitor reversed the inhibitory effect of LINC00473 silencing on the invasion of these cells. In conclusion, LINC00473 improved the invasion of human trophoblastic cells via miR-16-5p.
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Affiliation(s)
- Linyan Wang
- Laboratory Services, Gansu Maternal and Child Health Hospital, Qilihe District, Lanzhou City, Gansu Province 730050, China
| | - Juan Zhang
- Obstetrics Department, Baoji Maternal and Child Health Hospital, Baoji City, Shaanxi Province, 721000, China.
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Borisova AV, Konnon SRD, Tosto V, Gerli S, Radzinsky VE. Obstetrical complications and outcome in patients with endometriosis. J Matern Fetal Neonatal Med 2020; 35:2663-2677. [PMID: 32674641 DOI: 10.1080/14767058.2020.1793326] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Endometriosis is a disease that has a profound impact on the quality of life of women, due to the associated chronic pelvic pain, dysmenorrhea, dyspareunia and infertility. However, even getting long-awaited pregnancy (often after assisted reproductive technologies), patients with endometriosis have a high risk of obstetric complications, such as miscarriage, preterm birth, preeclampsia, placental abnormalities, hemorrhage in labor, birth of small for gestational age infants, stillbirth and higher cesarean section rate. In addition, during pregnancy acute complications of endometriosis may occur, such as spontaneous hemoperitoneum, which is rare but life-threatening conditions that in most cases require surgical intervention. The mechanisms of the observed complications in pregnant women with endometriosis are not fully understood. This review presents literature data and personal considerations on the effect of endometriosis on pregnancy outcome and the occurrence of complications, as well as their possible underlined mechanisms. Based on this, we proposed ways to reduce the risk of obstetric complications in pregnant women with a history of endometriosis.
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Affiliation(s)
- Anna V Borisova
- Department of Obstetrics and Gynecology with the Course of Perinatology, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - Setonde Romeo D Konnon
- Department of Obstetrics and Gynecology with the Course of Perinatology, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - Valentina Tosto
- Department of Obstetrics and Gynecology, Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Sandro Gerli
- Department of Obstetrics and Gynecology, Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Viktor E Radzinsky
- Department of Obstetrics and Gynecology with the Course of Perinatology, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
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8
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Gong F, Chai W, Wang J, Cheng H, Shi Y, Cui L, Jia G. miR-214-5p suppresses the proliferation, migration and invasion of trophoblast cells in pre-eclampsia by targeting jagged 1 to inhibit notch signaling pathway. Acta Histochem 2020; 122:151527. [PMID: 32113857 DOI: 10.1016/j.acthis.2020.151527] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 02/10/2020] [Accepted: 02/10/2020] [Indexed: 02/07/2023]
Abstract
MicroRNA-214-5p has been reported to be expressed in placental tissue and suppressed the proliferation and invasion of various tumor cells. However, the role of miR-214-5p in pre-eclampsia has not been reported. We aimed to explore the effects of miR-214-5p in proliferation, migration, and invasion of placental trophoblast cells. RT-qPCR was used to quantify the miR-214-5p expression level in placental samples and four types of trophoblast cell lines. Cell proliferation was monitored by CCK-8 and Edu staining assays. Flow cytometry was used to determine the cell cycle. Wound healing and transwell assays were performed to measure the migratory and invasive capacities in JEG-3 and BEWO cells. In addition, we investigated whether miR-214-5p targeted Jagged 1 to regulate the Notch signaling pathway to affect trophoblast cells by luciferase assay and western blot. The expression of miR-214-5p was significantly increased in the placenta of patients with PE. Moreover, the proliferation, migration, and invasion of JEG-3 cells transfected with miR-214-5p mimic were inhibited. The results were reversed when BEWO cells were transfected with miR-214-5p inhibitor. The dual-luciferase assay demonstrated that miR-214-5p directly regulated Jagged 1. The expression of the proteins associated with the Notch signaling pathway, Jagged 1, Notch 1, HEY 1 and HES 1 were all decreased when Jagged 1 was negatively regulated by miR-214-5p. miR-214-5p directly down-regulated Jagged 1 expression, then suppressed proliferation, migration, and invasion of human placental trophoblast cells by inhibiting the Notch signaling pathway.
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Bijl RC, Cornette JMJ, van den Bosch AE, Duvekot JJ, Molinger J, Willemsen SP, Koning AHJ, Roos-Hesselink JW, Franx A, Steegers-Theunissen RPM, Koster MPH. Study protocol for a prospective cohort study to investigate Hemodynamic Adaptation to Pregnancy and Placenta-related Outcome: the HAPPO study. BMJ Open 2019; 9:e033083. [PMID: 31712350 PMCID: PMC6858161 DOI: 10.1136/bmjopen-2019-033083] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION The importance of cardiovascular health in relation to pregnancy outcome is increasingly acknowledged. Women who develop certain pregnancy complications, in particular preeclampsia, are at higher risk for future cardiovascular disease. Independent of its outcome, pregnancy requires a substantial adaptive response of the maternal cardiovascular system. In the Hemodynamic Adaptation to Pregnancy and Placenta-related Outcome (HAPPO) study, we aim to examine longitudinal maternal haemodynamic adaptation to pregnancy from the preconception period onwards. We hypothesise that women who will develop adverse pregnancy outcomes have impaired cardiovascular health before conception, leading to haemodynamic maladaptation to pregnancy and diminished uteroplacental vascular development. METHODS AND ANALYSIS In this prospective cohort study embedded in the Rotterdam periconception cohort, 200 women with a history of placenta-related pregnancy complications (high-risk group) and 100 women with an uncomplicated obstetric history (low-risk group) will be included. At five moments (preconception, first, second and third trimester and postdelivery), women will undergo an extensive examination of the macrocirculatory and microcirculatory system and uteroplacental vascular development. The main outcome measures are differences in maternal haemodynamic adaptation to pregnancy between women with and without placenta-related pregnancy complications. In a multivariate linear mixed model, the relationship between maternal haemodynamic adaptive parameters, (utero)placental vascularisation indices and clinical outcomes (occurrence of pregnancy complications, embryonic and fetal growth trajectories, miscarriage rate, gestational age at delivery, birth weight) will be studied. Subgroup analysis will be performed to study baseline and trajectory differences between high-risk and low-risk women, independent of subsequent pregnancy outcome. ETHICS AND DISSEMINATION This study protocol was approved by the Medical Ethics Committee of the Erasmus MC, Rotterdam, the Netherlands (MEC 2018-150). Results will be disseminated to the medical community by publications in peer-reviewed journals and presentations at scientific congresses. Also, patient associations will be informed and the public will be informed by dissemination through (social) media. TRIAL REGISTRATION NUMBER NL7394 (www.trialregister.nl).
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Affiliation(s)
- Rianne C Bijl
- Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, The Netherlands
| | - Jérôme M J Cornette
- Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Johannes J Duvekot
- Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, The Netherlands
| | - Jeroen Molinger
- Department of Intensive Care Adults, Erasmus MC, Rotterdam, The Netherlands
- Department of Anesthesiology & Intensive Care Medicine, Human Physiology and Pharmacology Lab (HPPL), Duke Medicine, Durham, North Carolina, USA
| | - Sten P Willemsen
- Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, The Netherlands
- Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands
| | | | | | - Arie Franx
- Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Maria P H Koster
- Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, The Netherlands
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Wu D, Xu Y, Zou Y, Zuo Q, Huang S, Wang S, Lu X, He X, Wang J, Wang T, Sun L. Long Noncoding RNA 00473 Is Involved in Preeclampsia by LSD1 Binding-Regulated TFPI2 Transcription in Trophoblast Cells. MOLECULAR THERAPY. NUCLEIC ACIDS 2018; 12:381-392. [PMID: 30195776 PMCID: PMC6036867 DOI: 10.1016/j.omtn.2018.05.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 05/19/2018] [Accepted: 05/21/2018] [Indexed: 11/25/2022]
Abstract
Preeclampsia (PE) is a syndrome manifested by high blood pressure that could develop in the latter half of pregnancy; however, the underlying mechanisms are not understood. Recent evidence points to the function of noncoding RNAs (ncRNAs) as novel regulators of the invasion, migration, proliferation, and apoptosis of trophoblasts involved in the development of placental vasculature. Here, we investigated the role of long intergenic ncRNA 00473 (linc00473) in PE and the associated molecular mechanisms. The expression of linc00473 was downregulated in the placenta of patients with severe PE as revealed by qRT-PCR analysis. In vitro, linc00473 knockdown in trophoblast cell lines HTR-8/SVneo, JAR, and JEG3 significantly inhibited cell proliferation and promoted apoptosis, whereas linc00473 overexpression stimulated trophoblast proliferation. The mechanistic insights were provided by RNA-seq and qRT-PCR, which revealed that linc00473 could regulate the transcription of genes relevant to cell growth, migration, and apoptosis. In particular, linc00473 inhibited the expression of tissue factor pathway inhibitor 2 (TFPI2) through binding to lysine-specific demethylase 1 (LSD1). These results indicate that linc00473 could be involved in the pathogenesis and development of PE and may be a candidate biomarker as well as therapeutic target for this disease.
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Affiliation(s)
- Dan Wu
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Yetao Xu
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Yanfen Zou
- Department of Obstetrics and Gynecology, the Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, 20 Yuhuangding East Road, Shandong Province, China
| | - Qing Zuo
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Shiyun Huang
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Sailan Wang
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Xiyi Lu
- Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Xuezhi He
- Department of Anatomy, Histology and Embryology, The Research Center for Bone and Stem Cells, Nanjing Medical University, Nanjing, 211166, Jiangsu Province, China
| | - Jing Wang
- Department of Anatomy, Histology and Embryology, The Research Center for Bone and Stem Cells, Nanjing Medical University, Nanjing, 211166, Jiangsu Province, China
| | - Tianjun Wang
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Lizhou Sun
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
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11
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Babayev SN, Kanchwala M, Xing C, Akgul Y, Carr BR, Word RA. Thrombin Alters Human Endometrial Stromal Cell Differentiation During Decidualization. Reprod Sci 2018; 26:278-288. [PMID: 29658436 DOI: 10.1177/1933719118768705] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Vaginal bleeding and subchorionic hematomas are associated with increased risk of both early and late pregnancy loss. Thrombin generation may play a pivotal role in the development of these complications. To determine the effects of thrombin on human endometrial stromal cells (hESCs), cells were treated with thrombin at baseline or during decidualization with cyclic adenosine monophosphate (cAMP)+medroxyprogesterone acetate (MPA). Next-generation RNA sequencing revealed that markers of decidualization (IGF-1, IGFBP-1, and prolactin [PRL]) were induced after the initiation of decidualization, whereas thrombin suppressed insulin-like growth factor ( IGF)-1, Insulin-like growth factor binding protein ( IGFBP)-1, and PRL gene expression at baseline and during decidualization. These effects were mediated through protease activated receptor (PAR)-1- and PAR-1-independent pathways. Thrombin decreased the secretion of a key marker of decidualization (PRL), altered the morphological transformation of decidualizing hESCs, and activated genes involved in matrix degradation and proinflammatory chemokines ( Interleukin-8 and Interleukin-6). Genes encoding factors important for matrix stability ( Col1α1, LOX) were suppressed. We suggest that intrauterine bleeding and generation of thrombin accentuates leukocyte extravasation and endometrial inflammation, impairs decidualization, and endometrial support of early pregnancy.
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Affiliation(s)
- Samir N Babayev
- 1 Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mohammed Kanchwala
- 2 Eugene McDermott Center for Human Growth and Development, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Chao Xing
- 2 Eugene McDermott Center for Human Growth and Development, University of Texas Southwestern Medical Center, Dallas, TX, USA.,3 Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,4 Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Yucel Akgul
- 5 Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bruce R Carr
- 1 Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ruth Ann Word
- 1 Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,6 Department of Obstetrics and Gynecology, The Cecil H. and Ida Green Center for Reproductive Biological Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
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12
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Han AR, Lee SK. Immune modulation of i.v. immunoglobulin in women with reproductive failure. Reprod Med Biol 2018; 17:115-124. [PMID: 29692668 PMCID: PMC5902469 DOI: 10.1002/rmb2.12078] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 11/09/2017] [Indexed: 12/11/2022] Open
Abstract
Background The mechanism of maternal immune tolerance of the semi‐allogenic fetus has been explored extensively. The immune reaction to defend from invasion by pathogenic microorganisms should be maintained during pregnancy. An imbalance between the immune tolerance to the fetus and immune activation to the pathogenic organisms is associated with poor pregnancy outcomes. This emphasizes that the immune mechanism of successful reproduction is not just immune suppression, but adequate immune modulation. Methods In this review, the action of i.v. immunoglobulin G (IVIg) on the immune system and its efficacy in reproductive failure (RF) was summarized. Also suggested is the indication of IVIg therapy for women with RF. Main findings (Results) Based on the mechanism of the immune regulation of IVIg and following confirmation of the immune modulation effects of it in various aberrant immune parameters in patients with RF, it is obvious that IVIg is effective in recurrent pregnancy losses and repeated implantation failures with immunologic disturbances. Conclusion The authors recommend IVIg therapy in patients with RF with aberrant cellular immunologic parameters, including a high natural killer cell proportion and its cytotoxicity or elevated T helper 1 to T helper 2 ratio, based on each clinic's cut‐off values. Further clinical studies about the safety of IVIg in the fetus and its efficacy in other immunologic abnormalities of RF are needed.
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Affiliation(s)
- Ae R Han
- Department of Obstetrics and Gynecology Gangseo Mizmedi Hospital Seoul South Korea.,Department of Obstetrics and Gynecology Eulji University College of Medicine Daejeon South Korea
| | - Sung K Lee
- Department of Obstetrics and Gynecology Konyang University College of Medicine Daejeon South Korea
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Yamamoto E, Niimi K, Kiyono T, Yamamoto T, Nishino K, Nakamura K, Kotani T, Kajiyama H, Shibata K, Kikkawa F. Establishment and characterization of cell lines derived from complete hydatidiform mole. Int J Mol Med 2017; 40:614-622. [PMID: 28713902 PMCID: PMC5547987 DOI: 10.3892/ijmm.2017.3067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 07/05/2017] [Indexed: 12/04/2022] Open
Abstract
Gestational trophoblastic diseases (GTDs) are a group of diseases characterized by abnormal cellular proliferation of atypical trophoblasts. A hydatidiform mole is an abnormal pregnancy caused by genetic fertilization disorders, and it can be classified as a complete hydatidiform mole (CHM) or a partial hydatidiform mole. The aim of this study was to establish cell lines from CHMs and to characterize the cells for future studies concerning GTD. HMol1-2C, HMol1-3B, HMol1-8 and HMol3-1B were established from primary cultures of CHM explants following the introduction of different combinations of genes including human telomerase reverse transcriptase (hTERT), a mutant form of CDK (CDK4R24C), cyclin D1, p53C234, MYC and HRAS. HMol1-2C, HMol1-3B, and HMol3-1B were confirmed to originate from trophoblasts of androgenic, homozygous CHMs. These three cell lines exhibited low human chorionic gonadotropin secretion, low migration and invasion abilities, and the potential to differentiate into syncytiotrophoblastic cells via forskolin treatment. These results suggest that these cells exhibit characteristics of trophoblastic cells, especially cytotrophoblastic cells. HMol1-8 was found to consist of diploid cells and originated from maternal cells, suggesting that they were derived from decidual cells. In conclusion, we successfully established three cell lines from CHMs by introduction of hTERT and other genes. Analysis revealed that the genetic origin of each cell line was identical with that of the original molar tissue, and the cell lines exhibited characteristics of trophoblastic cells, which are similar to undifferentiated cytotrophoblasts.
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Affiliation(s)
- Eiko Yamamoto
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Kaoru Niimi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Tohru Kiyono
- Division of Carcinogenesis and Cancer Prevention, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Toshimichi Yamamoto
- Department of Legal Medicine and Bioethics, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Kimihiro Nishino
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Kenichi Nakamura
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Tomomi Kotani
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Kiyosumi Shibata
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Fumitaka Kikkawa
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
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14
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Erez O, Romero R, Vaisbuch E, Than NG, Kusanovic JP, Mazaki-Tovi S, Gotsch F, Mittal P, Dong Z, Chaiworapongsa T, Kim CJ, Nhan-Chang CL, Kim SK, Yeo L, Mazor M, Hassan SS. Tissue factor activity in women with preeclampsia or SGA: a potential explanation for the excessive thrombin generation in these syndromes. J Matern Fetal Neonatal Med 2017; 31:1568-1577. [PMID: 28521572 DOI: 10.1080/14767058.2017.1320543] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of this study was to determine whether the activity of tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in the plasma of women with preeclampsia (PE) and small for gestational age (SGA) neonate differ from that of normal pregnant women and whether they are related to specific placental lesions. METHODS This cross-sectional study included the following groups: (1) normal pregnancy (n = 68); (2) PE (n= 128); and (3) SGA (n = 56). Maternal plasma TF and TFPI activity was determined with chromogenic assays. RESULTS (1) The median maternal plasma TF activity, but not TFPI activity, differed among the study groups (p < .0001 and p = .4, respectively); (2) patients with PE had a higher median maternal plasma TF activity than women with normal pregnancies (p < .0001) and mothers with SGA fetuses (p = .002); (3) among patients with PE, those with distal villous hypoplasia had a higher median maternal TF activity than those without these placental lesions (p = .018); and (4) following adjustment for confounding variables, maternal plasma TF and TFPI activity were not associated with an SGA neonate. CONCLUSIONS Plasma TF activity is higher in women with PE than in those with SGA or normal pregnancies. We propose that these changes may be responsible, at least in part, for the increased in-vivo thrombin generation observed in this obstetrical syndrome.
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Affiliation(s)
- Offer Erez
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Roberto Romero
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,c Department of Obstetrics and Gynecology , University of Michigan , Ann Arbor , MI , USA.,d Department of Epidemiology and Biostatistics , Michigan State University , East Lansing , MI , USA.,e Center for Molecular Medicine and Genetics , Wayne State University , Detroit , MI , USA
| | - Edi Vaisbuch
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Nandor Gabor Than
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA.,f Maternity Private Department, Kutvolgyi Clinical Block , Semmelweis University , Budapest , Hungary.,g Systems Biology of Reproduction Lendulet Research Group , Institute of Enzymology, Research Centre for Natural Sciences, Hungarian Academy of Sciences , Budapest , Hungary.,h First Department of Pathology and Experimental Cancer Research , Semmelweis University , Budapest , Hungary
| | - Juan Pedro Kusanovic
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,i Department of Obstetrics and Gynecology, Center for Research and Innovation in Maternal-Fetal Medicine (CIMAF) , Sótero del Río Hospital , Santiago , Chile.,j Division of Obstetrics and Gynecology, Faculty of Medicine , Pontificia Universidad Católica de Chile , Santiago , Chile
| | - Shali Mazaki-Tovi
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Francesca Gotsch
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,k Department of Obstetrics and Gynecology, Azienda , Ospedaliera Universitaria Integrata , Verona , Italy
| | - Pooja Mittal
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Zhong Dong
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Tinnakorn Chaiworapongsa
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Chong Jai Kim
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,l Department of Pathology , University of Ulsan College of Medicine , Seoul , Republic of Korea
| | - Chia-Ling Nhan-Chang
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA.,m Department of Obstetrics and Gynecology , Columbia University , New York , NY , USA
| | - Sun Kwon Kim
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Lami Yeo
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Moshe Mazor
- n Department of Obstetrics and Gynecology , Ben-Gurion University , Beer-Sheva , Israel
| | - Sonia S Hassan
- a Perinatology Research Branch , NICHD/NIH/DHHS , Bethesda , MD, and Detroit, MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
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15
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Impact of blood hypercoagulability on in vitro fertilization outcomes: a prospective longitudinal observational study. Thromb J 2017; 15:9. [PMID: 28360822 PMCID: PMC5371230 DOI: 10.1186/s12959-017-0131-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/06/2017] [Indexed: 11/10/2022] Open
Abstract
Background Blood coagulation plays a crucial role in the blastocyst implantation process and its alteration may be related to in vitro fertilization (IVF) failure. We conducted a prospective observational longitudinal study in women eligible for IVF to explore the association between alterations of coagulation with the IVF outcome and to identify the biomarkers of hypercoagulability which are related with this outcome. Methods Thirty-eight women eligible for IVF (IVF-group) and 30 healthy, age-matched women (control group) were included. In the IVF-group, blood was collected at baseline, 5–8 days after administration of gonadotropin-releasing hormone agonist (GnRH), before and two weeks after administration of human follicular stimulating hormone (FSH). Pregnancy was monitored by measurement of βHCG performed 15 days after embryo transfer. Thrombin generation (TG), minimal tissue factor-triggered whole blood thromboelastometry (ROTEM®), procoagulant phospholipid clotting time (Procoag-PPL®), thrombomodulin (TMa), tissue factor activity (TFa), factor VIII (FVIII), factor von Willebrand (FvW), D-Dimers and fibrinogen were assessed at each time point. Results Positive IVF occurred in 15 women (40%). At baseline, the IVF-group showed significantly increased TG, TFa and TMa and significantly shorter Procoag-PPL versus the control group. After initiation of hormone treatment TG was significantly higher in the IVF-positive as compared to the IVF-negative group. At all studied points, the Procoag-PPL was significantly shorter and the levels of TFa were significantly higher in the IVF-negative group compared to the IVF-positive one. The D-Dimers were higher in the IVF negative as compared to IVF positive group. Multivariate analysis retained the Procoag-PPL and TG as predictors for the IVF outcome. Conclusions Diagnosis of women with hypercoagulability and their stratification to risk of IVF failure using a model based on the Procoag-PPL and TG is a feasible strategy for the optimization of IVF efficiency that needs to be validated in prospective trials.
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16
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Lee CL, Lam KKW, Vijayan M, Koistinen H, Seppala M, Ng EHY, Yeung WSB, Chiu PCN. The Pleiotropic Effect of Glycodelin-A in Early Pregnancy. Am J Reprod Immunol 2016; 75:290-7. [DOI: 10.1111/aji.12471] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 12/02/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
- Cheuk-Lun Lee
- Department of Obstetrics and Gynaecology; LKS Faculty of Medicine; The University of Hong Kong; Hong Kong Hong Kong
- Centre for Reproduction, Development and Growth; LKS Faculty of Medicine; The University of Hong Kong; Hong Kong Hong Kong
- Shenzhen Key Laboratory of Fertility Regulation; Department of Obstetrics and Gynecology; The University of Hong Kong-Shenzhen Hospital; Hong Kong Hong Kong
| | - Kevin K. W. Lam
- Department of Obstetrics and Gynaecology; LKS Faculty of Medicine; The University of Hong Kong; Hong Kong Hong Kong
- Shenzhen Key Laboratory of Fertility Regulation; Department of Obstetrics and Gynecology; The University of Hong Kong-Shenzhen Hospital; Hong Kong Hong Kong
| | - Madhavi Vijayan
- Department of Obstetrics and Gynaecology; LKS Faculty of Medicine; The University of Hong Kong; Hong Kong Hong Kong
| | - Hannu Koistinen
- Department of Clinical Chemistry and Obstetrics and Gynecology; University of Helsinki and Helsinki University Central Hospital; Helsinki Finland
| | - Markku Seppala
- Department of Clinical Chemistry and Obstetrics and Gynecology; University of Helsinki and Helsinki University Central Hospital; Helsinki Finland
| | - Ernest H. Y. Ng
- Department of Obstetrics and Gynaecology; LKS Faculty of Medicine; The University of Hong Kong; Hong Kong Hong Kong
- Centre for Reproduction, Development and Growth; LKS Faculty of Medicine; The University of Hong Kong; Hong Kong Hong Kong
- Shenzhen Key Laboratory of Fertility Regulation; Department of Obstetrics and Gynecology; The University of Hong Kong-Shenzhen Hospital; Hong Kong Hong Kong
| | - William S. B. Yeung
- Department of Obstetrics and Gynaecology; LKS Faculty of Medicine; The University of Hong Kong; Hong Kong Hong Kong
- Centre for Reproduction, Development and Growth; LKS Faculty of Medicine; The University of Hong Kong; Hong Kong Hong Kong
- Shenzhen Key Laboratory of Fertility Regulation; Department of Obstetrics and Gynecology; The University of Hong Kong-Shenzhen Hospital; Hong Kong Hong Kong
| | - Philip C. N. Chiu
- Department of Obstetrics and Gynaecology; LKS Faculty of Medicine; The University of Hong Kong; Hong Kong Hong Kong
- Centre for Reproduction, Development and Growth; LKS Faculty of Medicine; The University of Hong Kong; Hong Kong Hong Kong
- Shenzhen Key Laboratory of Fertility Regulation; Department of Obstetrics and Gynecology; The University of Hong Kong-Shenzhen Hospital; Hong Kong Hong Kong
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17
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Fetomaternal immune cross-talk and its consequences for maternal and offspring's health. Nat Med 2013; 19:548-56. [PMID: 23652115 DOI: 10.1038/nm.3160] [Citation(s) in RCA: 405] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 03/06/2013] [Indexed: 12/12/2022]
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18
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Oh SH, Kim HY. Predictive Value of Maternal Serum Markers for Preeclampsia. KOSIN MEDICAL JOURNAL 2012. [DOI: 10.7180/kmj.2012.27.2.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
<p>The study performed a systematic review of screening for preeclampsia with the combination of vascular parameters and maternal serum markers in the first and early second trimester. We identified eligible studies through a search of Medline, and, for each included study, we focused on the relationship between the maternal serum markers and preeclampsia. In the selected literature, a combination of maternal serum markers was analyzed, also. Several tests suggested moderate or convincing prediction of early preeclampsia, but screening for late preeclampsia was poor. Literatures for serum markers were selected. Each serum marker was identified independently, and where relevant, a combination of these markers was analyzed. Encouraging results for the first trimester screening were observed when it was combined with other markers. Even in the first trimester of pregnancy, we can present the reliable results for the prediction of early preeclampsia. Detection rate for combination markers may yield higher detection rate and be promising to identify patients at high risk of developing preeclampsia.</p>
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Barbaux S, Gascoin-Lachambre G, Buffat C, Monnier P, Mondon F, Tonanny MB, Pinard A, Auer J, Bessières B, Barlier A, Jacques S, Simeoni U, Dandolo L, Letourneur F, Jammes H, Vaiman D. A genome-wide approach reveals novel imprinted genes expressed in the human placenta. Epigenetics 2012; 7:1079-90. [PMID: 22894909 PMCID: PMC3466192 DOI: 10.4161/epi.21495] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Genomic imprinting characterizes genes with a monoallelic expression, which is dependent on the parental origin of each allele. Approximately 150 imprinted genes are known to date, in humans and mice but, though computational searches have tried to extract intrinsic characteristics of these genes to identify new ones, the existing list is probably far from being comprehensive. We used a high-throughput strategy by diverting the classical use of genotyping microarrays to compare the genotypes of mRNA/cDNA vs. genomic DNA to identify new genes presenting monoallelic expression, starting from human placental material. After filtering of data, we obtained a list of 1,082 putative candidate monoallelic SNPs located in more than one hundred candidate genes. Among these, we found known imprinted genes, such as IPW, GRB10, INPP5F and ZNF597, which contribute to validate the approach. We also explored some likely candidates of our list and identified seven new imprinted genes, including ZFAT, ZFAT-AS1, GLIS3, NTM, MAGI2, ZC3H12Cand LIN28B, four of which encode zinc finger transcription factors. They are, however, not imprinted in the mouse placenta, except for Magi2. We analyzed in more details the ZFAT gene, which is paternally expressed in the placenta (as ZFAT-AS1, a non-coding antisense RNA) but biallelic in other tissues. The ZFAT protein is expressed in endothelial cells, as well as in syncytiotrophoblasts. The expression of this gene is, moreover, downregulated in placentas from complicated pregnancies. With this work we increase by about 10% the number of known imprinted genes in humans.
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Umbilical artery chemokine CCL16 is associated with preterm preeclampsia and fetal growth restriction. Cytokine 2012; 60:377-84. [PMID: 22857868 DOI: 10.1016/j.cyto.2012.07.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Revised: 06/30/2012] [Accepted: 07/06/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cytokines and growth factors synthesized by placental trophoblasts are suggested to induce endothelial and vascular smooth muscle cell apoptosis and affect angiogenesis. OBJECTIVE To investigate cord blood and placental immunoproteins in order to find new clues on pathogenetic factors of preterm preeclampsia. METHODS Cord blood samples were collected on 163 consecutive preterm deliveries prior to 32 gestational weeks. Placental function, clinical risk factors and 107 umbilical artery immunoproteins were analyzed. Classification and regression trees analysis was used to detect associations between the immunoproteins, clinical parameters and preterm preeclampsia. Placental expression of the immunoproteins and their receptors were subsequently investigated. RESULTS Preeclampsia complicated 34% of the pregnancies in this preterm cohort. Umbilical artery CCL16, CCL24, and CCL23 were associated with preeclampsia, CCL16 showing the strongest relationship with an OR (95% CI) of 24.5 (5.4-112.0). High umbilical artery CCL16 was also characteristic to fetuses with severe growth restriction (<3rd percentile). CCL16, CCL24 and their receptors, CCR1 and CCR3 were expressed in preeclamptic placentas. CONCLUSIONS High umbilical artery CCL16 is prominently detected in preterm preeclamptic pregnancies with severe growth restriction. A link to compensatory proangiogenic mechanisms has to be considered.
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Han AR, Ahn H, Vu P, Park JC, Gilman-Sachs A, Beaman K, Kwak-Kim J. Obstetrical Outcome of Anti-Inflammatory and Anticoagulation Therapy in Women with Recurrent Pregnancy Loss or Unexplained Infertility. Am J Reprod Immunol 2012; 68:418-27. [DOI: 10.1111/j.1600-0897.2012.01178.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Accepted: 06/21/2012] [Indexed: 11/27/2022] Open
Affiliation(s)
- Ae Ra Han
- Reproductive Medicine Program; Department of Obstetrics and Gynecology; The Chicago Medical School at Rosalind Franklin University of Medicine and Science; Vernon Hills; IL; USA
| | - Hyunkyong Ahn
- Maternal-fetal medicine; Department of Obstetrics and Gynecology; Cheil General Hospital & Women's Healthcare Center; Kwandong University; College of Medicine; Seoul; Korea
| | - Peter Vu
- Reproductive Medicine Program; Department of Obstetrics and Gynecology; The Chicago Medical School at Rosalind Franklin University of Medicine and Science; Vernon Hills; IL; USA
| | - Joon Cheol Park
- Department of Obstetrics and Gynecology; School of Medicine; Keimyung University; Daegu; Korea
| | - Alice Gilman-Sachs
- Department of Microbiology and Immunology; The Chicago Medical School at Rosalind Franklin University of Medicine and Science; Vernon Hills; IL; USA
| | - Kenneth Beaman
- Department of Microbiology and Immunology; The Chicago Medical School at Rosalind Franklin University of Medicine and Science; Vernon Hills; IL; USA
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Mikat B, Gellhaus A, Wagner N, Birdir C, Kimmig R, Köninger A. Early detection of maternal risk for preeclampsia. ISRN OBSTETRICS AND GYNECOLOGY 2012; 2012:172808. [PMID: 22852092 PMCID: PMC3407628 DOI: 10.5402/2012/172808] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2012] [Accepted: 06/19/2012] [Indexed: 01/19/2023]
Abstract
Preeclampsia is one of the leading causes of maternal and fetal morbidity and mortality. New molecular insights offer new possibilities of early diagnosis of elevated maternal risk. Maternal risk factors, biophysical parameters like Doppler examination of the uterine arteries and biochemical parameters allow early risk calculation. Preventive and effective therapeutic agents like acetylsalicylacid can be started in the early second trimester. This article reviews the diagnostic possibilities of early risk calculation to detect women having high risk for preeclampsia and the potential benefits for them, the offspring and health care systems. We provide risk calculation for preeclampsia as an important and sensible part of first trimester screening.
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Affiliation(s)
- B Mikat
- Department of Obstetrics and Gynecology, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
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23
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Evaluation of 7 serum biomarkers and uterine artery Doppler ultrasound for first-trimester prediction of preeclampsia: a systematic review. Obstet Gynecol Surv 2011; 66:225-39. [PMID: 21756405 DOI: 10.1097/ogx.0b013e3182227027] [Citation(s) in RCA: 124] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED Preeclampsia (PE) affects 1% to 2% of pregnant women and is a leading cause of maternal and perinatal morbidity and mortality worldwide. The clinical syndrome of PE arises in the second half of pregnancy. However, many underlying factors including defective placentation may already be apparent in the first and early second trimester in many patients. In clinical practice, there is currently no reliable screening method in the first trimester of pregnancy with sufficient accuracy to identify women at high risk to develop PE. Early identification of high-risk pregnancy may facilitate the development of new strategies for antenatal surveillance or prevention and thus improve maternal and perinatal outcome. The aim of this systematic review was to study the literature on the predictive potential of first-trimester serum markers and of uterine artery Doppler velocity waveform assessment (Ut-A Doppler). Literature on the 7 most studied serum markers (ADAM12, fβ-hCG, Inhibin A, Activin A, PP13, PlGF, and PAPP-A) and Ut-A Doppler was primarily selected. In the selected literature, a combination of these markers was analyzed, and where relevant, the value of maternal characteristics was added. Measurements of serum markers and Ut-A Doppler were performed between week 8 + 0 and 14 + 0 GA. Low levels of PP13, PlGF, and PAPP-A and elevated level of Inhibin A have been found to be significantly associated with the development of PE later in pregnancy. The detection rates of single markers, fixed at 10% false-positive rate, in the prediction of early-onset PE were relatively low, and ranged from 22% to 83%. Detection rates for combinations of multiple markers varied between 38% and 100%. Therefore, a combination of multiple markers yields high detection rates and is promising to identify patients at high risk of developing PE. However, large scale prospective studies are required to evaluate the power of this integrated approach in clinical practice. TARGET AUDIENCE Obstetricians and Gynecologists, Family physicians Learning Objectives: After completion of this article, the reader should be better able to appraise the recent literature on the development of preeclampsia in the first-trimester, evaluate the predictive value of first-trimester markers and use first-trimester markers, either individually or in combination, to assess the risk of preeclampsia.
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Xiong Y, Zhou SF, Zhou R, Yang D, Xu ZF, Lou YT, Guo QS, Hu R, Peng T, Ma D, Li XT. Alternations of Maternal and Cord Plasma Hemostasis in Preeclampsia Before and After Delivery. Hypertens Pregnancy 2010; 30:347-58. [DOI: 10.3109/10641950903572274] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mayor-Lynn K, Toloubeydokhti T, Cruz AC, Chegini N. Expression profile of microRNAs and mRNAs in human placentas from pregnancies complicated by preeclampsia and preterm labor. Reprod Sci 2010; 18:46-56. [PMID: 21079238 DOI: 10.1177/1933719110374115] [Citation(s) in RCA: 213] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
MicroRNAs (miRNAs) have emerged as key regulators of gene expression stability implicated in cell proliferation, apoptosis, and development, whereas their altered expression has been associated with various pathological disorders. The objective of this study was to assess the expression profile of miRNAs and their predicted target genes in placentas from patients with preeclampsia (PC) and preterm (PT) labor as compared to normal term (NT) pregnancies. Using microarray profiling of 820 miRNAs and 18,630 mRNA transcripts, the analysis indicated that 283 of these miRNAs and 9119 mRNAs were expressed in all placentas, of which the relative expression of 20 miRNAs (P < .05 and ≥ 1.5-fold) and 120 mRNAs (P < .05, and 2-fold cutoff) was differentially expressed in PT and PC as compared to NT. The expression of miR-15b, miR-181a, miR-200C, miR-210, miR-296-3p, miR-377, miR-483-5p, and miR-493 and a few of their predicted target genes: matrix metalloproteinases (MMP-1, MMP-9), a disintegrin and metalloproteinase domains (ADAM-17, ADAM-30), tissue inhibitor of metalloproteinase 3 (TIMP-3); suppressor of cytokine signaling 1 (SOCS1); Stanniocalcin (STC2); corticotropin-releasing hormone (CRH), CRH-binding protein (CRHBP); and endothelin-2 (EDN2) were validated in these cohorts using real-time polymerase chain reaction (PCR), some displaying an inverse correlation with the expression of their predicted target genes. Functional analysis indicated that the products of these genes regulate cellular activities considered critical in normal placental functions and those affected by PC and PT labor. In conclusion, the results provide further evidence that placentas affected by PC and PT labor display an altered expression of a number of miRNAs with potential regulatory functions on the expression of specific target genes whose altered expression and function have been associated with these pregnancy complications.
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Li M, Huang SJ. Innate immunity, coagulation and placenta-related adverse pregnancy outcomes. Thromb Res 2009; 124:656-62. [PMID: 19683334 DOI: 10.1016/j.thromres.2009.07.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2009] [Revised: 07/13/2009] [Accepted: 07/20/2009] [Indexed: 01/18/2023]
Abstract
Maternal immunity undergoes subtle adjustment in order to tolerate the semi-allogeneic embryo and maintain the host defense against potential pathogens. Concomitantly, coagulation systems change from an anti-coagulant state to a pro-coagulant state to meet the hemostatic challenge of placentation and delivery. Innate immunity and blood coagulation systems are the first line of defense to protect a host against exogenous challenges, including alloantigens and mechanical insults, and preserve the integrity of an organism. The interactions between coagulation and immune systems have been extensively studied. Immune cells play a pivotal role in the initiation of the coagulation cascade, whereas coagulation proteases display substantial immuno-modulatory effects. Upon exogenous challenges, the immune and coagulation systems are capable of potentiating each other leading to a vicious cycle. Natural killer (NK) cells, macrophages (Mphis) and dendritic cells (DCs) are three major innate immune cells that have been demonstrated to play essential roles in early pregnancy. However, immune maladaptation and hemostatic imbalance have been suggested to be responsible for adverse pregnant outcomes, such as preeclampsia (PE), miscarriage, recurrent spontaneous abortion (RSA) and intrauterine growth restriction (IUGR). In this review, we will summarize the mutual regulation between blood coagulation and innate immune systems as well as their roles in the maintenance of normal pregnancy and in the pathogenesis of adverse pregnancy outcomes.
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Affiliation(s)
- Min Li
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut 06520-8063, USA
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A role for menstruation in preconditioning the uterus for successful pregnancy. Am J Obstet Gynecol 2009; 200:615.e1-6. [PMID: 19136085 DOI: 10.1016/j.ajog.2008.11.037] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Revised: 09/22/2008] [Accepted: 11/18/2008] [Indexed: 12/13/2022]
Abstract
Menstruation is widely viewed as serving no purpose other than to reinitiate the endometrial cycle in the absence of pregnancy. Yet, it is striking that cyclic endometrial decidualization followed by menstrual shedding is confined to the few species, including human beings, where placenta formation entails deep trophoblast invasion of maternal tissues and its vasculature. Both menstruation and pregnancy are inflammatory conditions that cause a degree of physiological ischemia-reperfusion tissue injury, albeit much more so in pregnancy. Thus, the emergence of cyclic menstruation may not have been an evolutionary coincidence but serves to protect uterine tissues from the profound hyperinflammation and oxidative stress associated with deep placentation, a process known as preconditioning. The concept of menstrual preconditioning provides a novel paradigm for understanding how reproductive disorders impact on pregnancy outcome. For example, endometriosis could be viewed as a disorder of exaggerated menstrual preconditioning that confers protection against placentation-related disorders, such as preeclampsia.
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Stephansson O, Kieler H, Granath F, Falconer H. Endometriosis, assisted reproduction technology, and risk of adverse pregnancy outcome. Hum Reprod 2009; 24:2341-7. [DOI: 10.1093/humrep/dep186] [Citation(s) in RCA: 165] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Gellersen B, Fernandes MS, Brosens JJ. Non-genomic progesterone actions in female reproduction. Hum Reprod Update 2008; 15:119-38. [PMID: 18936037 DOI: 10.1093/humupd/dmn044] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The steroid hormone progesterone is indispensable for mammalian procreation by controlling key female reproductive events that range from ovulation to implantation, maintenance of pregnancy and breast development. In addition to activating the progesterone receptors (PRs)-B and -A, members of the superfamily of ligand-dependent transcription factors, progesterone also elicits a variety of rapid signalling events independently of transcriptional or genomic regulation. This review covers our current knowledge on the mechanisms and relevance of non-genomic progesterone signalling in female reproduction. METHODS PubMed was searched up to August 2008 for papers on progesterone actions in ovary/breast/endometrium/myometrium/brain, focusing primarily on non-genomic signalling mechanisms. RESULTS Convergence and intertwining of rapid non-genomic events and the slower transcriptional actions critically determine the functional response to progesterone in the female reproductive system in a cell-type- and environment-specific manner. Several putative progesterone-binding moieties have been implicated in rapid signalling events, including the 'classical' PR and its variants, progesterone receptor membrane component 1, and the novel family of membrane progestin receptors. Progesterone and its metabolites have also been implicated in the allosteric regulation of several unrelated receptors, such as gamma-aminobutyric acid type A, oxytocin and sigma(1) receptors. CONCLUSIONS Identification of the mechanisms and receptors that relay rapid progesterone signalling is an area of research fraught with difficulties and controversy. More in-depth characterization of the putative receptors is required before the non-genomic progesterone pathway in normal and pathological reproductive function can be targeted for pharmacological intervention.
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