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Cederlöf ET, Lager S, Larsson A, Sundström Poromaa I, Lindahl B, Wikström A, Christersson C. Biomarkers associated with cardiovascular disease in women with spontaneous preterm birth: A case-control study. Acta Obstet Gynecol Scand 2024; 103:970-979. [PMID: 38379394 PMCID: PMC11019525 DOI: 10.1111/aogs.14813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/21/2024] [Accepted: 02/04/2024] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Women with spontaneous preterm birth have an increased risk of cardiovascular disease later in life. Studies suggest potential pathophysiological mechanisms in common, but whether these could be identified by measurement of soluble circulating protein biomarkers in women with spontaneous preterm birth is unknown. The aim of this study was to determine if protein biomarkers associated with cardiovascular disease distinguish women with spontaneous preterm birth from healthy controls, both at pregnancy and at follow up. MATERIAL AND METHODS Study participants were identified in the population-based Uppsala biobank of pregnant women in Sweden, where plasma samples were collected in mid-pregnancy. In a first screening phase, we identified participants who subsequently experienced spontaneous preterm birth (<37 weeks) in the index pregnancy (N = 13) and controls (N = 6). In these samples, differences in protein expression were examined by comparative mass spectrometry. In a second validation phase, we invited 100 cases with previous spontaneous preterm birth in the index pregnancy and 100 controls (matched for age, body mass index, and year of delivery) from the same source population, to a follow-up visit 4-15 years after pregnancy. At follow up, we collected plasma samples and data on cardiovascular risk factors. We measured concentrations of selected biomarkers identified in the screening phase, as well as lipid profiles in samples both from pregnancy (biobank) and follow up. CLINICALTRIALS gov registration NCT05693285. RESULTS In the screening phase, fibrinogen, cadherin-5, complement C5, factor XII, plasma kallikrein, apolipoprotein M, and vitamin D-binding protein differed significantly at pregnancy. In the validation phase, 65 women agreed to participate (35 cases and 30 controls), with a median follow-up time of 11.8 years since pregnancy. The concentration of fibrinogen (p = 0.02) and triglycerides (p = 0.03) were slightly higher in cases compared with matched controls at follow up. CONCLUSIONS Compared with women without preterm birth, those with spontaneous preterm birth had slightly higher concentrations of fibrinogen, both at mid-pregnancy and a decade after pregnancy. Additionally, we found slightly higher concentration of triglycerides at follow up in women with previous spontaneous preterm birth. The relevance of this finding is uncertain but might indicate potential pathophysiological mechanisms in common between spontaneous preterm birth and cardiovascular disease.
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Affiliation(s)
| | - Susanne Lager
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical ChemistryUppsala UniversityUppsalaSweden
| | | | - Bertil Lindahl
- Department of Medical Sciences, CardiologyUppsala UniversityUppsalaSweden
- Uppsala Clinical Research CenterUppsala UniversityUppsalaSweden
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2
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Gallo DM, Fitzgerald W, Romero R, Gomez-Lopez N, Gudicha DW, Than NG, Bosco M, Chaiworapongsa T, Jung E, Meyyazhagan A, Suksai M, Gotsch F, Erez O, Tarca AL, Margolis L. Proteomic profile of extracellular vesicles in maternal plasma of women with fetal death. J Matern Fetal Neonatal Med 2023; 36:2177529. [PMID: 36813269 PMCID: PMC10395052 DOI: 10.1080/14767058.2023.2177529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
OBJECTIVES Fetal death is a complication of pregnancy caused by multiple etiologies rather than being the end-result of a single disease process. Many soluble analytes in the maternal circulation, such as hormones and cytokines, have been implicated in its pathophysiology. However, changes in the protein content of extracellular vesicles (EVs), which could provide additional insight into the disease pathways of this obstetrical syndrome, have not been examined. This study aimed to characterize the proteomic profile of EVs in the plasma of pregnant women who experienced fetal death and to evaluate whether such a profile reflected the pathophysiological mechanisms of this obstetrical complication. Moreover, the proteomic results were compared to and integrated with those obtained from the soluble fraction of maternal plasma. METHODS This retrospective case-control study included 47 women who experienced fetal death and 94 matched, healthy, pregnant controls. Proteomic analysis of 82 proteins in the EVs and the soluble fractions of maternal plasma samples was conducted by using a bead-based, multiplexed immunoassay platform. Quantile regression analysis and random forest models were implemented to assess differences in the concentration of proteins in the EV and soluble fractions and to evaluate their combined discriminatory power between clinical groups. Hierarchical cluster analysis was applied to identify subgroups of fetal death cases with similar proteomic profiles. A p-value of <.05 was used to infer significance, unless multiple testing was involved, with the false discovery rate controlled at the 10% level (q < 0.1). All statistical analyses were performed by using the R statistical language and environment-and specialized packages. RESULTS Nineteen proteins (placental growth factor, macrophage migration inhibitory factor, endoglin, regulated upon activation normal T cell expressed and presumably secreted (RANTES), interleukin (IL)-6, macrophage inflammatory protein 1-alpha, urokinase plasminogen activator surface receptor, tissue factor pathway inhibitor, IL-8, E-Selectin, vascular endothelial growth factor receptor 2, pentraxin 3, IL-16, galectin-1, monocyte chemotactic protein 1, disintegrin and metalloproteinase domain-containing protein 12, insulin-like growth factor-binding protein 1, matrix metalloproteinase-1(MMP1), and CD163) were found to have different plasma concentrations (of an EV or a soluble fraction) in women with fetal death compared to controls. There was a similar pattern of change for the dysregulated proteins in the EV and soluble fractions and a positive correlation between the log2-fold changes of proteins significant in either the EV or the soluble fraction (ρ = 0.89, p < .001). The combination of EV and soluble fraction proteins resulted in a good discriminatory model (area under the ROC curve, 82%; sensitivity, 57.5% at a 10% false-positive rate). Unsupervised clustering based on the proteins differentially expressed in either the EV or the soluble fraction of patients with fetal death relative to controls revealed three major clusters of patients. CONCLUSION Pregnant women with fetal death have different concentrations of 19 proteins in the EV and soluble fractions compared to controls, and the direction of changes in concentration was similar between fractions. The combination of EV and soluble protein concentrations revealed three different clusters of fetal death cases with distinct clinical and placental histopathological characteristics.
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Affiliation(s)
- Dahiana M Gallo
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI, USA.,Division of Intramural Research, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Department of Obstetrics and Gynecology, Universidad Del Valle, Cali, Colombia
| | - Wendy Fitzgerald
- Section on Intercellular Interactions, National Institutes of Health, Bethesda, MD, USA
| | - Roberto Romero
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI, USA.,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.,Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.,Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA.,Detroit Medical Center, Detroit, MI, USA
| | - Nardhy Gomez-Lopez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI, USA.,Division of Intramural Research, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Department of Biochemistry, Microbiology and Immunology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Dereje W Gudicha
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Nándor Gábor Than
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI, USA.,Systems, Biology of Reproduction Research Group, Institute of Enzymology, Research Centre for Natural Sciences, Budapest, Hungary.,Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary.,Maternity Private Clinic of Obstetrics and Gynecology, Budapest, Hungary
| | - Mariachiara Bosco
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI, USA.,Division of Intramural Research, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Tinnakorn Chaiworapongsa
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI, USA.,Division of Intramural Research, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Eunjung Jung
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI, USA.,Division of Intramural Research, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Arun Meyyazhagan
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI, USA.,Division of Intramural Research, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Manaphat Suksai
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI, USA.,Division of Intramural Research, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Francesca Gotsch
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI, USA.,Division of Intramural Research, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Offer Erez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI, USA.,Division of Intramural Research, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA.,Department of Obstetrics and Gynecology, HaEmek Medical Center, Afula, Israel
| | - Adi L Tarca
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI, USA.,Division of Intramural Research, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA.,Department of Computer Science, Wayne State University College of Engineering, Detroit, MI, USA
| | - Leonid Margolis
- Section on Intercellular Interactions, National Institutes of Health, Bethesda, MD, USA
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Zhang K, Jia X, Yu W, Cheng X, Li Y, Wang X, Wang J, Li Z, Mao Y, Zhao J, Li T, Chen M, Gao G, Hu C, Yan S, Zhang X. The associations of gestational weight gain and midpregnancy lipid levels with placental size and placental-to-birth weight ratio: findings from a chinese birth cohort study. BMC Pregnancy Childbirth 2023; 23:725. [PMID: 37821857 PMCID: PMC10568921 DOI: 10.1186/s12884-023-05991-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 09/11/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND The placenta serves as the sole maternal organ responsible for transmitting nutrients to the fetus, playing a crucial role in supporting standard fetal growth and development. To date, only a small number of studies have investigated the impact of maternal gestational weight gain and lipid concentrations on placental development. This study aimed to explore the influence of weight gain during pregnancy and lipid levels in the second trimester on placental weight, volume, and the placental weight ratio. METHODS This birth cohort study encompassed 1,358 mother-child pairs. Placental data for each participant was gathered immediately post-delivery, and the study incorporated data on gestational weight gain throughout pregnancy and lipid profiles from the mid-trimester. A linear regression model was employed to assess the correlations between gestational weight gain, mid-trimester lipid levels, and metrics such as placental weight, placental volume, and the placental-to-birth weight ratio (PFR). RESULTS In the study groups of pre-pregnancy underweight, normal weight, and overweight, the placental weight increased by 4.93 g (95% CI: 1.04-8.81), 2.52 g (95% CI: 1.04-3.99), and 3.30 g (95% CI: 0.38-6.22) per 1 kg of gestational weight gain, respectively. Within the pre-pregnancy underweight and normal weight groups, the placental volume increased by 6.79 cm^3 (95% CI: 3.43-10.15) and 2.85 cm^3 (95% CI: 1.31-4.39) per 1 kg of gestational weight gain, respectively. Additionally, placental weight exhibited a positive correlation with triglyceride (TG) levels (β = 9.81, 95% CI: 3.28-16.34) and a negative correlation with high-density lipoprotein (HDL-C) levels (β = - 46.30, 95% CI: - 69.49 to - 23.11). Placental volume also showed a positive association with TG levels (β = 14.54, 95% CI: 7.69-21.39). Conversely, PFR demonstrated a negative correlation with increasing HDL-C levels (β = - 0.89, 95% CI: - 1.50 to - 0.27). CONCLUSIONS Gestational weight gain was significantly correlated with both placental weight and volume. This association was especially pronounced in women who, prior to pregnancy, were underweight or of normal weight. Additionally, TG and HDL-C levels during the mid-trimester were linked to placental development.
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Affiliation(s)
- Kangdi Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xiaomin Jia
- Ma'anshan Maternal and Child Health Hospital, Ma'anshan, 243000, China
| | - Wenjie Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xin Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yingqing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xinqiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Jie Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Zhenhua Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yicheng Mao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Jiawen Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Tao Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China
| | - Maolin Chen
- Department of Gynecology and Obstetrics, Ma'anshan Maternal and Child Health Hospital, Ma'anshan, 243000, China
| | - Guopeng Gao
- Department of Child Health Care, Ma'anshan Maternal and Child Health Hospital, Ma'anshan, 243000, China
| | - Chengyang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Shuangqin Yan
- Ma'anshan Maternal and Child Health Hospital, Ma'anshan, 243000, China.
| | - Xiujun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei, 230032, China.
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4
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Masheto G, Moyo S, Mohammed T, Banda C, Raphaka C, Mayondi G, Makhema J, Shapiro R, Mosepele M, Zash R, Lockman S. Maternal biomarkers of endothelial dysfunction and pregnancy outcomes in women with and without HIV in Botswana. PLoS One 2023; 18:e0281910. [PMID: 36821530 PMCID: PMC9949641 DOI: 10.1371/journal.pone.0281910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 02/05/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Women living with HIV-1 (WLHIV) are at higher risk of having an adverse birth outcome, but the underlying mechanism(s) are unknown. We hypothesized that HIV-associated endothelial activation could adversely impact placental function and lead to impaired fetal growth or stillbirth. METHODS We used stored samples from WLHIV and HIV-negative women who had enrolled during pregnancy in the observational Botswana Tshipidi cohort. Written informed consent was obtained from the participants. We measured plasma levels of markers of endothelial activation (soluble vascular adhesion molecule 1 [VCAM-1], intercellular adhesion molecule 1 [ICAM-1] and E-selectin) from samples taken during pregnancy. We compared log10 biomarker levels by maternal HIV status and by the timing of ART initiation (ART prior to conception vs. during pregnancy; ART prior to sample collection vs. no ART prior to sampling) using t-tests and the Kruskal-Wallis rank test. We evaluated the association between these biomarkers and adverse birth outcomes (composite of stillbirth or small for gestational age [SGA]) using univariate and multivariate log-binomial regression controlling for maternal age (continuous) and timing of ART start. We also used generalized linear models (GLM) to evaluate the association between continuous birthweight (in grams) and gestational age (in weeks) and markers of endothelial dysfunction, adjusting for maternal age (continuous) and timing of ART relative to sample collection. RESULTS Specimens collected before delivery were available for 414 women (372 WLHIV and 42 HIV-negative women), with a median age of 28 years and median gestational age at sample collection of 30 weeks (range 26, 35 weeks). WLHIV had significantly higher median VCAM1 (p = 0.002) than HIV-negative women, but HIV-negative women had higher median ICAM1 (p = 0.01); e-Selectin levels did not differ by maternal HIV status. Women starting ART during pregnancy had higher log10 VCAM1 levels than those on ART before conception, regardless of whether the sample was collected before (p = 0.02) or after (p = 0.03) ART initiation. However, ICAM1 and e-Selectin did not differ significantly by ART status or ART timing. Ninety-eight women (91 WLHIV and 7 HIV-negative), or 9 (2%) and 89 (22%) included in this study, had a stillborn or SGA baby respectively. Univariate and adjusted analyses did not show significant associations between levels of any of the biomarkers with these adverse birth outcomes. However, lower birthweight (p = 0.03) and lower gestational age at delivery were associated e-Selectin and ICAM (p = 0.008), respectively. CONCLUSION Maternal HIV infection and lack of ART (or recent ART initiation) were associated with one marker of greater endothelial activation (VCAM-1), but not with other markers (ICAM-1 nor E-selectin) in pregnancy. e-Selectin was associated with lower birthweight and every unit increase in log ICAM-1 at delivery was associated with lower gestation age at delivery.
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Affiliation(s)
- Gaerolwe Masheto
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Faculty of Health Sciences, School of Allied Health Professions, University of Botswana, Gaborone, Botswana
| | | | - Christine Banda
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | | | - Gloria Mayondi
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Joseph Makhema
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Roger Shapiro
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Beth Israel Deaconess Medical Center, Boston, MA, United States of America
| | - Mosepele Mosepele
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Rebecca Zash
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Brigham and Women’s Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
| | - Shahin Lockman
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Brigham and Women’s Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
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5
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Li S, Yan B, Li TKT, Lu J, Gu Y, Tan Y, Gong F, Lam TW, Xie P, Wang Y, Lin G, Luo R. Ultra-low-coverage genome-wide association study-insights into gestational age using 17,844 embryo samples with preimplantation genetic testing. Genome Med 2023; 15:10. [PMID: 36788602 PMCID: PMC9926832 DOI: 10.1186/s13073-023-01158-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 01/26/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Very low-coverage (0.1 to 1×) whole genome sequencing (WGS) has become a promising and affordable approach to discover genomic variants of human populations for genome-wide association study (GWAS). To support genetic screening using preimplantation genetic testing (PGT) in a large population, the sequencing coverage goes below 0.1× to an ultra-low level. However, the feasibility and effectiveness of ultra-low-coverage WGS (ulcWGS) for GWAS remains undetermined. METHODS We built a pipeline to carry out analysis of ulcWGS data for GWAS. To examine its effectiveness, we benchmarked the accuracy of genotype imputation at the combination of different coverages below 0.1× and sample sizes from 2000 to 16,000, using 17,844 embryo PGT samples with approximately 0.04× average coverage and the standard Chinese sample HG005 with known genotypes. We then applied the imputed genotypes of 1744 transferred embryos who have gestational ages and complete follow-up records to GWAS. RESULTS The accuracy of genotype imputation under ultra-low coverage can be improved by increasing the sample size and applying a set of filters. From 1744 born embryos, we identified 11 genomic risk loci associated with gestational ages and 166 genes mapped to these loci according to positional, expression quantitative trait locus, and chromatin interaction strategies. Among these mapped genes, CRHBP, ICAM1, and OXTR were more frequently reported as preterm birth related. By joint analysis of gene expression data from previous studies, we constructed interrelationships of mainly CRHBP, ICAM1, PLAGL1, DNMT1, CNTLN, DKK1, and EGR2 with preterm birth, infant disease, and breast cancer. CONCLUSIONS This study not only demonstrates that ulcWGS could achieve relatively high accuracy of adequate genotype imputation and is capable of GWAS, but also provides insights into the associations between gestational age and genetic variations of the fetal embryos from Chinese population.
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Affiliation(s)
- Shumin Li
- grid.194645.b0000000121742757Department of Computer Science, The University of Hong Kong, Hong Kong, China
| | - Bin Yan
- grid.194645.b0000000121742757Department of Computer Science, The University of Hong Kong, Hong Kong, China
| | - Thomas K. T. Li
- grid.415550.00000 0004 1764 4144Department of Obstetrics & Gynecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Jianliang Lu
- grid.194645.b0000000121742757Department of Computer Science, The University of Hong Kong, Hong Kong, China
| | - Yifan Gu
- grid.216417.70000 0001 0379 7164NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Science, Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, 410008 Hunan China ,grid.477823.d0000 0004 1756 593XClinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410013 Hunan China
| | - Yueqiu Tan
- grid.216417.70000 0001 0379 7164NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Science, Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, 410008 Hunan China ,grid.477823.d0000 0004 1756 593XClinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410013 Hunan China
| | - Fei Gong
- grid.216417.70000 0001 0379 7164NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Science, Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, 410008 Hunan China ,grid.477823.d0000 0004 1756 593XClinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410013 Hunan China
| | - Tak-Wah Lam
- grid.194645.b0000000121742757Department of Computer Science, The University of Hong Kong, Hong Kong, China
| | - Pingyuan Xie
- Hunan Normal University School of Medicine, Changsha, 410013, Hunan, China. .,National Engineering and Research Center of Human Stem Cell, Changsha, Hunan, China.
| | - Yuexuan Wang
- Department of Computer Science, The University of Hong Kong, Hong Kong, China. .,College of Computer Science and Technology, Zhejiang University, Hangzhou, China.
| | - Ge Lin
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Science, Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, 410008, Hunan, China. .,Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410013, Hunan, China. .,National Engineering and Research Center of Human Stem Cell, Changsha, Hunan, China.
| | - Ruibang Luo
- Department of Computer Science, The University of Hong Kong, Hong Kong, China.
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6
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Lee JS, Choi ES, Hwang Y, Lee KS, Ahn KH. Preterm birth and maternal heart disease: A machine learning analysis using the Korean national health insurance database. PLoS One 2023; 18:e0283959. [PMID: 37000887 PMCID: PMC10065252 DOI: 10.1371/journal.pone.0283959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/21/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Maternal heart disease is suspected to affect preterm birth (PTB); however, validated studies on the association between maternal heart disease and PTB are still limited. This study aimed to build a prediction model for PTB using machine learning analysis and nationwide population data, and to investigate the association between various maternal heart diseases and PTB. METHODS A population-based, retrospective cohort study was conducted using data obtained from the Korea National Health Insurance claims database, that included 174,926 primiparous women aged 25-40 years who delivered in 2017. The random forest variable importance was used to identify the major determinants of PTB and test its associations with maternal heart diseases, i.e., arrhythmia, ischemic heart disease (IHD), cardiomyopathy, congestive heart failure, and congenital heart disease first diagnosed before or during pregnancy. RESULTS Among the study population, 12,701 women had PTB, and 12,234 women had at least one heart disease. The areas under the receiver-operating-characteristic curves of the random forest with oversampling data were within 88.53 to 95.31. The accuracy range was 89.59 to 95.22. The most critical variables for PTB were socioeconomic status and age. The random forest variable importance indicated the strong associations of PTB with arrhythmia and IHD among the maternal heart diseases. Within the arrhythmia group, atrial fibrillation/flutter was the most significant risk factor for PTB based on the Shapley additive explanation value. CONCLUSIONS Careful evaluation and management of maternal heart disease during pregnancy would help reduce PTB. Machine learning is an effective prediction model for PTB and the major predictors of PTB included maternal heart disease such as arrhythmia and IHD.
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Affiliation(s)
- Jue Seong Lee
- Department of Pediatric Cardiology, Korea University College of Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Eun-Saem Choi
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Yujin Hwang
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea University Anam Hospital, Seoul, Korea
- AI Center, Korea University College of Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Kwang-Sig Lee
- AI Center, Korea University College of Medicine, Korea University Anam Hospital, Seoul, Korea
- * E-mail: (KHA); (KSL)
| | - Ki Hoon Ahn
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea University Anam Hospital, Seoul, Korea
- * E-mail: (KHA); (KSL)
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7
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Cho I, Lee KN, Joo E, Kim YM, Kim TE, Park KH. Plasma E-selectin and kallistatin as predictive markers of histologic chorioamnionitis in women with preterm premature rupture of membranes. Am J Reprod Immunol 2022; 88:e13584. [PMID: 35772987 DOI: 10.1111/aji.13584] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/23/2022] [Accepted: 06/13/2022] [Indexed: 12/01/2022] Open
Abstract
PROBLEM We aimed to assess the predictive potential of 12 plasma biomarkers to predict acute histologic chorioamnionitis (HCA) in women with preterm premature rupture of membranes (PPROM) and to develop multi-biomarker panels based on these biomarkers in combination with widely used conventional laboratory markers. METHOD OF STUDY This was a retrospective cohort study involving 81 singleton pregnant women (24-34 weeks of gestation) who delivered within 96 h of blood sampling. White blood cell (WBC) count, differential counts, and C-reactive protein (CRP) levels were measured at admission. The levels of DKK-3, Fas, haptoglobin, IGFBP-2, kallistatin, MIP-1α, MMP-2, MMP-8, pentraxin 3, progranulin, E-selectin, and P-selectin were evaluated by ELISA using stored plasma samples. The primary outcome measure was acute HCA. RESULTS Multivariate analyses showed that low plasma E-selectin and kallistatin levels were independently associated with HCA occurrence after adjusting for gestational age. Using a stepwise regression analysis, a multi-biomarker panel comprising plasma E-selectin, serum CRP, and WBC was developed, which provided a good prediction of acute HCA in women with PPROM (area under the curve [AUC], 0.899), with a significantly higher AUC than that of any single variable included in the panel (P<0.05). The plasma levels of DKK-3, Fas, haptoglobin, IGFBP-2, MIP-1α, MMP-2, MMP-8, pentraxin 3, and P-selectin were not significantly associated with HCA occurrence. CONCLUSIONS This study identified E-selectin and kallistatin as potential plasma biomarkers associated with acute HCA in women with PPROM. Their combined analysis with serum CRP and WBC counts significantly improved acute HCA diagnosis. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Iseop Cho
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyong-No Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eunwook Joo
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yu Mi Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Eun Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyo Hoon Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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8
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Decreased Adiponectin Levels in Early Pregnancy Are Associated with High Risk of Prematurity for African American Women. J Clin Med 2022; 11:jcm11113213. [PMID: 35683599 PMCID: PMC9181315 DOI: 10.3390/jcm11113213] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 01/27/2023] Open
Abstract
The relationship of low maternal serum adiponectin levels with preterm delivery among a multi-ethnic group has not been extensively investigated. We examined ethnic differences in cytokine/adipokine profiles and whether they contribute to several adverse pregnancy outcomes, particularly preterm delivery. Data and samples were from a large prospective observational cohort (n = 1776) of young, generally healthy pregnant women (African American 36.4%, Hispanic 48.0%, Caucasian 15.6%). Serum cytokine/adipokine concentrations were measured at entry (mean gestational age of 16.83 weeks) using the Liminex xMap Technology. Multivariable analyses were performed. A significant difference in adiponectin level was observed among ethnic groups. African Americans had a decreased adiponectin and increased resistin levels compared to Hispanics and Caucasians (p < 0.05 to p < 0.0001 for each). Decreased adiponectin (lowest quartile) was positively associated with preterm delivery independent of usual risk factors (adjusted odds ratio (AOR) 1.46, 95% confidence interval (CI) 1.05, 2.04 for all preterm and AOR 1.84, 95% CI 1.07, 3.17 for early preterm births). The results were unchanged when women with preeclampsia were excluded. Similar results were observed in African Americans. Decreased adiponectin levels were not related to preterm birth in either Hispanics or Caucasians. Lower adiponectin levels were also significantly associated with an increased risk of developing gestational diabetes (AOR 1.72, 95% CI 1.05, 2.84) and preeclampsia (AOR 1.45, 95% CI 1.00, 2.14) in the whole cohort and in Caucasians. We did not find any consistent relationships between the other markers with outcome variables. Dysregulation in maternal adiponectin at early gestation is associated with an increased risk of preterm delivery. An ethnic difference in adiponectin levels may contribute to a higher preterm delivery rate in African American women.
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9
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Hamzaoğlu K, Alıcı Davutoğlu E, Bulut H, Madazli R. Prediction of preterm delivery in threatened preterm labour with short cervical length. J OBSTET GYNAECOL 2022; 42:1911-1916. [PMID: 35603552 DOI: 10.1080/01443615.2022.2054680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this study, we evaluated the value of the uterocervical angle (UCA), myometrial thickness (MT), sICAM-1, sVCAM-1, soluble E-selectin (sE-selectin) and pentraxin 3 (PTX3) levels in women with threatened preterm labour (TPL) in predicting spontaneous preterm birth (sPTB) within 14 days in symptomatic women with cervical length (CL) measurements between 10 and 25 mm. Forty-six patients diagnosed with TPL, 47 healthy pregnant women were evaluated in a case-control study. sE-selectin (AUC = 0.744, p = .007) and PTX3 (AUC = 0.711, p = .019) were found to be effective in predicting preterm delivery within 14 days. In conclusion, maternal sE-selectin and PTX3 levels may be helpful in identifying pregnancies that will deliver within 14 days in symptomatic women with CL measurements between 10 and 25 mm. However, maternal sICAM-1 and sVCAM-1 levels, MT and UCA are not effective in the prediction of sPTB in TPL pregnancies. Impact StatementWhat is already known on this subject? Aetiology of spontaneous preterm birth (sPTB) is unclear and believed to be multifactorial, infection, inflammation, vascular endothelial dysfunction and uteroplacental ischaemia are all considered to be related to preterm delivery syndrome. Transvaginal cervical length (CL) measurement is a good indicator of increased risk of sPTB. Inflammation is accepted to have a central role in the process of labour.What do the results of this study add? soluble E-selectin (sE-selectin) and pentraxin 3 (PTX3) levels may be helpful in identifying pregnancies that will deliver within 14 days in symptomatic women with CL measurements between 10 and 25 mm.What are the implications of these findings for clinical practice and/or further research? This study will help understand the important role of the inflammatory process in predicting spontaneous preterm birth.
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Affiliation(s)
- Kübra Hamzaoğlu
- Department of Obstetrics and Gynecology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Ebru Alıcı Davutoğlu
- Department of Obstetrics and Gynecology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Huri Bulut
- Department of Medical Biochemistry, Istinye University Medical Faculty, Istanbul, Turkey
| | - Riza Madazli
- Department of Obstetrics and Gynecology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
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10
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Täufer Cederlöf E, Lundgren M, Lindahl B, Christersson C. Pregnancy Complications and Risk of Cardiovascular Disease Later in Life: A Nationwide Cohort Study. J Am Heart Assoc 2022; 11:e023079. [PMID: 35014876 PMCID: PMC9238523 DOI: 10.1161/jaha.121.023079] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background The aim of this study was to investigate the associations between pregnancy complications and cardiovascular mortality and hospitalizations of cardiovascular disease (CVD) after adjustment for major confounding. Methods and Results In a nationwide register‐based cohort study, women with singleton births between 1973 and 2014 were included from the Swedish Medical Birth Register. Outcomes of mortality and hospitalizations of CVD were collected from the Cause of Death Register and the National Inpatient Register. The cohort was followed from the date of the first delivery until death or end of follow‐up, whichever occurred first. The pregnancy complications studied were preeclampsia or eclampsia, gestational hypertension, gestational diabetes, preterm birth, small for gestational age, and stillbirth. Among the 2 134 239 women (mean age at first pregnancy, 27.0 [SD, 5.1] and mean parity 1.96 [SD, 0.9]), 19.1% (N=407 597) had 1 of the studied pregnancy complications. All pregnancy complications were associated with all‐cause and cardiovascular mortality and hospitalization for CVD (ischemic heart disease, ischemic stroke, and peripheral artery disease) after adjustment for major confounding in a Cox proportional hazard regression model. The adjusted hazard ratio for cardiovascular mortality was 1.84 (95% CI, 1.38–2.44) for preterm birth and 3.14 (95% CI, 1.81–5.44) for stillbirth. Conclusions In this large cohort study, pregnancy complications were associated with all‐cause mortality, cardiovascular mortality, and hospitalizations for CVD, also after adjusting for confounding, including overweight, smoking, and comorbidities. The study highlights that less established pregnancy complications such as preterm birth and stillbirth are also associated with cardiovascular mortality and CVD.
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Affiliation(s)
| | - Maria Lundgren
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Bertil Lindahl
- Department of Medical Sciences, Cardiology Uppsala University Uppsala Sweden.,Uppsala Clinical Research Center Uppsala University Uppsala Sweden
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11
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Abolbaghaei A, Langlois MA, Murphy HR, Feig DS, Burger D. Circulating extracellular vesicles during pregnancy in women with type 1 diabetes: a secondary analysis of the CONCEPTT trial. Biomark Res 2021; 9:67. [PMID: 34488911 PMCID: PMC8419913 DOI: 10.1186/s40364-021-00322-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/09/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Extracellular vesicles are membrane vesicles that are released into the extracellular environment and accumulate in the circulation in vascular disease. We aimed to quantify circulating extracellular vesicles in pregnant women with type 1 diabetes and to examine associations between extracellular vesicle levels, continuous glucose measures, and pregnancy outcomes. METHODS We used plasma samples from the Continuous Glucose Monitoring in Women with Type 1 Diabetes in Pregnancy Trial study and quantified circulating extracellular vesicles by flow cytometry (n = 163). Relationships with clinical variables were assessed by repeated measures correlation. Logistic regression was used to assess associations between elevated extracellular vesicle levels and pregnancy outcomes. RESULTS Platelet extracellular vesicle levels were inversely associated with glucose time above range and glycaemic variability measures (P < 0.05). A weak positive association was observed between endothelial extracellular vesicles and mean amplitude of glycemic excursion (P < 0.05). In a univariate logistic regression model, high baseline endothelial extracellular vesicles was associated with increased risk of neonatal intensive care unit (NICU) admission (OR: 2.06, 1.03-4.10), and respiratory distress requiring ventilation (OR: 4.98, 1.04-23.92). After adjusting for HbA1c and blood pressure the relationship for NICU admission persisted and an association with hyperbilirubinemia was seen (OR: 2.56, 1.10-5.94). Elevated platelet extracellular vesicles were associated with an increased risk of NICU admission (OR: 2.18, 1.04-4.57), and hyperbilirubinemia (OR: 2.61, 1.11-6.12) after adjusting for HbA1c and blood pressure. CONCLUSIONS High levels of extracellular vesicles in early pregnancy were associated with adverse neonatal outcomes. Assessment of extracellular vesicles may represent a novel approach to personalized care in type 1 diabetes pregnancy.
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Affiliation(s)
- Akram Abolbaghaei
- Chronic Disease Program, Kidney Research Centre, Ottawa Hospital Research Institute, Ottawa, Canada
- Departments of Medicine and Cellular and Molecular Medicine, University of Ottawa, 2513-/451 Smyth Road, Ontario, K1H 8M5, Ottawa, Canada
| | - Marc-André Langlois
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Helen R Murphy
- Department of Women and Children's Health, St Thomas' Hospital, King's College London, London, UK
- Wolfson Diabetes and Endocrine Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Department of Medicine, University of East Anglia, Norwich, UK
| | - Denice S Feig
- Department of Medicine, University of Toronto, Toronto, ON, Canada.
- Sinai Health System, Toronto, ON, Canada.
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada.
| | - Dylan Burger
- Chronic Disease Program, Kidney Research Centre, Ottawa Hospital Research Institute, Ottawa, Canada.
- Departments of Medicine and Cellular and Molecular Medicine, University of Ottawa, 2513-/451 Smyth Road, Ontario, K1H 8M5, Ottawa, Canada.
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12
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Sharifizad M, Schmidl D, Werkmeister RM, Zeisler H, Told R, Binder J, Küssel L, Garhöfer G, Schmetterer L. Retinal vessel diameters, flicker-induced retinal vasodilation and retinal oxygen saturation in high- and low-risk pregnancy. Acta Ophthalmol 2021; 99:628-636. [PMID: 33326186 PMCID: PMC8519143 DOI: 10.1111/aos.14696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/10/2020] [Indexed: 01/12/2023]
Abstract
Purpose To compare retinal vascular parameters between high‐risk and low‐risk pregnant women over time during pregnancy. Methods In a longitudinal study, we included pregnant women with normal blood pressure and normal body mass index (BMI, group 1), pregnant women with systemic hypertension and/or overweight (group 2) and age‐matched nonpregnant healthy women (group 3). Using the dynamic vessel analyser (DVA) we investigated flicker‐induced vasodilation in retinal arteries (FLA) and veins (FLV), central retinal arterial and vein equivalent (CRAE, CRVE), arterio‐venous ratio (AVR) and retinal arterial and venous oxygen saturation (SartO2, SveinO2). Study visits were scheduled 2nd trimester (TP 2), 3rd trimester (TP 3) and postpartum (PP). Results Data from 29 women in group 1, 25 women in group 2 and 33 women in group 3 were included for analysis. FLA, FLV, CRAE, CRVE, AVR and SveinO2 were altered in group 2 (p‐values between < 0.001 and 0.009). At TP 3 the differences between groups were most pronounced. In contrast, there were only minor differences between group 1 and 3. Changes in retinal parameters were independently associated with systemic blood pressure and BMI. Conclusions The present analysis indicates that flicker‐induced retinal vasodilation, retinal vessel diameters and retinal oxygen saturation are altered in high‐risk pregnant women. Hence, these parameters are candidate biomarkers for pregnancy complications, a hypothesis that deserves further study.
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Affiliation(s)
- Mozhgan Sharifizad
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - Doreen Schmidl
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
| | - René M. Werkmeister
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - Harald Zeisler
- Department of Obstetrics and Gynecology Medical University of Vienna Vienna Austria
| | - Reinhard Told
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
- Department of Ophthalmology Medical University of Vienna Vienna Austria
| | - Julia Binder
- Department of Obstetrics and Gynecology Medical University of Vienna Vienna Austria
| | - Lorenz Küssel
- Department of Obstetrics and Gynecology Medical University of Vienna Vienna Austria
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
| | - Leopold Schmetterer
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
- Singapore Eye Research Institute Singapore Singapore
- School of Chemical and Biomedical Engineering Nanyang Technological University Singapore Singapore
- SERI‐NTU Advanced Ocular Engineering (STANCE) Singapore Singapore
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13
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Risk of chronic kidney disease in women with a history of preterm delivery: Tehran Lipid and Glucose Study. J Nephrol 2021; 34:1621-1629. [PMID: 34216382 DOI: 10.1007/s40620-021-01103-0] [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: 04/15/2021] [Accepted: 06/18/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Preterm delivery (PTD) may predict the risk of long-term maternal complications. Little is known about the association between preterm delivery and maternal risk of chronic kidney disease (CKD).This study aimed to explore whether a history of preterm delivery is associated with the risk of maternal CKD. METHODS In this population-based cohort study within the framework of the Tehran Lipid and Glucose Study (TLGS), a total of 3035 women with at least one delivery met our eligibility criteria. A time-dependent Cox proportional-hazards regression model was used to measure the hazard ratios (HRs) and 95% confidence intervals (CIs) for evaluating the association between history of preterm delivery and risk of CKD, adjusted for smoking, parity, age at first delivery, body mass index, educational level, preeclampsia, and gestational diabetes mellitus. RESULTS A total of 212 women with a history of at least one preterm delivery and 2823 women with term delivery were included. The median (interquartile range) follow-up in the preterm and term delivery groups was 16 (13.0-17.0) and 16 (14.0-17.0) years, respectively. The results of multivariate Cox regression model, adjusted for confounders, showed that the risk of CKD significantly increased by 46% in women with a history of preterm delivery. Moreover, according to the time-dependent Cox regression analysis, the risk of CKD in women with a history of preterm delivery was 2.68 (95% CI 1.02, 7.05, P = 0.04) fold higher than among those with no history of preterm delivery. CONCLUSION Pregnancy if complicated by preterm delivery, may increase the risk of future maternal morbidities. Our findings suggest that a history of preterm delivery was associated with an increased maternal risk of CKD in the long term. Further longitudinal studies are needed to confirm our findings.
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Zhang Y, Xun P, Chen C, Lu L, Shechter M, Rosanoff A, He K. Magnesium levels in relation to rates of preterm birth: a systematic review and meta-analysis of ecological, observational, and interventional studies. Nutr Rev 2021; 79:188-199. [PMID: 32483597 DOI: 10.1093/nutrit/nuaa028] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
CONTEXT Experimental studies suggest that magnesium levels in pregnant women may affect the length of gestation, as magnesium affects the activity of smooth muscle in the uterus. Little is known about the association between magnesium levels or supplementation and the rate of preterm birth. OBJECTIVE The aim of this systematic review was to summarize the data on magnesium soil levels and preterm birth rates from ecological, observational, and interventional studies. DATA SOURCES Soil magnesium levels were obtained from US Geological Survey data, and preterm birth rates were acquired from the March of Dimes Foundation. Relevant epidemiological and clinical studies published until April 2019 in peer-reviewed journals were retrieved from PubMed, Google Scholar, and related reference lists. STUDY SELECTION Original studies published in English, conducted in humans, and in which magnesium (dietary/supplemental intake or biomarkers) was an exposure and preterm birth was an outcome were included. DATA EXTRACTION Eleven studies were included in the systematic review. Meta-analysis was performed on 6 studies. Overall relative risk (RR) and corresponding 95%CIs for risk of preterm birth in relation to magnesium supplementation were estimated by a random-effects model. RESULTS The ecological study revealed an inverse correlation between magnesium content in soil and rates of preterm birth across the United States (r = -0.68; P < 0.001). Findings from 11 observational studies generally support an inverse association between serum magnesium levels and rates of preterm birth. Of the 6 eligible randomized controlled trials, which included 3068 pregnant women aged 20 to 35 years and 352 preterm infants, the pooled RR was 0.58 (95%CI, 0.35-0.96) for women in the magnesium supplementation group compared with women in the control group. CONCLUSIONS Accumulated evidence from ecological, observational, and interventional studies consistently indicates that adequate magnesium intake during pregnancy may help reduce the incidence of preterm birth.
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Affiliation(s)
- Yijia Zhang
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana, USA
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana, USA
| | - Cheng Chen
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA.,Department of Epidemiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Liping Lu
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA.,Department of Epidemiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Michael Shechter
- Olga & Lev Leviev Heart Center, Chaim Sheba Medical Center at Tel HaShomer, Ramat Gan, Israel; and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Andrea Rosanoff
- Center for Magnesium Education & Research LLC, Pahoa, Hawaii, USA
| | - Ka He
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA.,Department of Epidemiology, Columbia University Irving Medical Center, New York, New York, USA
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INSIDE Project: Individual Air Pollution Exposure, Extracellular Vesicles Signaling and Hypertensive Disorder Development in Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239046. [PMID: 33561039 PMCID: PMC7731194 DOI: 10.3390/ijerph17239046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/27/2020] [Accepted: 11/29/2020] [Indexed: 12/18/2022]
Abstract
Hypertensive disorders are common complications during pregnancy (HDP) with substantial public health impact. Acute and chronic particulate matter (PM) exposure during pregnancy increases the risk of HDP, although the underlying molecular mechanisms remain unclear. Extracellular vesicles (EVs) may be the ideal candidates for mediating the effects of PM exposure in pregnancy as they are released in response to environmental stimuli. The INSIDE project aims to investigate this mechanism in pregnancy outcomes. The study population is enrolled at the Fetal Medicine Unit of Fondazione IRCCS Ca’Granda—Ospedale Maggiore Policlinico at 10–14 weeks of gestation. Exposure to PM10 and PM2.5 is assessed using the flexible air quality regional model (FARM) and Bayesian geostatistical models. Each woman provides a blood sample for EV analysis and circulating biomarker assessment. Moreover, a subgroup of recruited women (n = 85) is asked to participate in a cardiovascular screening program including a standard clinical evaluation, a non-invasive assessment of right ventricular function, and pulmonary circulation at rest and during exercise. These subjects are also asked to wear a personal particulate sampler, to measure PM10, PM2.5, and PM1. The INSIDE study is expected to identify the health impacts of PM exposure on pregnancy outcomes.
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16
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Mistry HD, Ogalde MVH, Broughton Pipkin F, Escher G, Kurlak LO. Maternal, Fetal, and Placental Selectins in Women With Pre-eclampsia; Association With the Renin-Angiotensin-System. Front Med (Lausanne) 2020; 7:270. [PMID: 32596247 PMCID: PMC7304321 DOI: 10.3389/fmed.2020.00270] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 05/15/2020] [Indexed: 11/16/2022] Open
Abstract
Selectins [endothelial (E), platelet (P), and leucocytes (L)] are a class of cell adhesion molecules, stimulated in response to inflammation. Pre-eclampsia is characterized by inflammation, and angiotensin II is pro-inflammatory. We hypothesized that circulating maternal and fetal concentrations and placental expression of selectins would be increased in women with pre-eclampsia and would be associated with the angiotensin receptors (AT1R and AT2R). Maternal and fetal blood and placental tissue was collected at delivery from White European normotensive controls (n = 17) and women with pre-eclampsia (n = 17). Soluble (s) E-, P- and L-selectin protein concentrations were measured by ELISA and placental protein expression was examined by immunohistochemistry. Maternal sE-selectin concentrations were increased in pre-eclampsia (P < 0.001); conversely fetal sE- and sP-selectin levels were lower in pre-eclampsia (P < 0.05 for both). Staining was mainly localized to the syncytiotrophoblast for all selectins. E-selectin expression was increased, while P-selectin was decreased in placental from pre-eclampsia (P < 0.05 for both); no differences were observed for L-selectin expression. Both E- and L-selectin were positively correlated (P < 0.008; P < 0.02) with AT2R placental expression, whilst P-selectin was negatively associated with AT1R (P < 0.005), all only in the pre-eclampsia group. This novel study reports maternal, fetal and placental expression of selectins in pre-eclampsia. The increased E-selectins reflect the endothelial dysfunction, characteristic of pre-eclampsia. In contrast, the reduced P-selectins and the positive association of placental AT2Rs with both E-and L-selectin in pre-eclampsia could be a protective mechanism to limit the endothelial dysfunction.
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Affiliation(s)
- Hiten D. Mistry
- Department of Obstetrics and Gynaecology, University of Nottingham, Nottingham, United Kingdom
| | - Melissa V. Hott Ogalde
- Department of Obstetrics and Gynaecology, University of Nottingham, Nottingham, United Kingdom
| | - Fiona Broughton Pipkin
- Department of Obstetrics and Gynaecology, University of Nottingham, Nottingham, United Kingdom
| | - Geneviève Escher
- Department of Nephrology and Hypertension, University of Bern, Bern, Switzerland
- Department of Biomedical Research, University of Bern, Bern, Switzerland
| | - Lesia O. Kurlak
- Department of Obstetrics and Gynaecology, University of Nottingham, Nottingham, United Kingdom
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Lane-Cordova AD, Gunderson EP, Greenland P, Catov JM, Lewis CE, Pettee Gabriel K, Wellons MF, Carnethon MR. Life-Course Reproductive History and Cardiovascular Risk Profile in Late Mid-Life: The CARDIA Study. J Am Heart Assoc 2020; 9:e014859. [PMID: 32366209 PMCID: PMC7660840 DOI: 10.1161/jaha.119.014859] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Reproductive events, that is, a preterm birth (PTB), small‐for‐gestational‐age infant (SGA), and vasomotor symptoms of menopause, are associated with subclinical atherosclerotic cardiovascular disease (ASCVD). We evaluated whether women with a past PTB and/or SGA (henceforth PTB/SGA) were more likely to have severe vasomotor symptoms of menopause and whether the estimated 10‐year ASCVD risk was higher in women with PTB/SGA and vasomotor exposures. Methods and Results We assigned 1866 women (mean age=55±1 years) in the CARDIA (Coronary Artery Risk Development in Young Adults) study to the following categories of reproductive exposures: none, PTB/SGA only, vasomotor symptoms only, or both PTB/SGA and vasomotor symptoms. We used Kruskal‐Wallis tests to evaluate the differences in pooled cohort equation ASCVD risk scores by category and linear regression to evaluate the associations of categories with ASCVD risk scores adjusted for study center, body mass index, education, current hormone replacement therapy use, parity, and hysterectomy. Women with PTB/SGA were more likely to have severe vasomotor symptoms, 36% versus 30%, P<0.02. ASCVD risk score was higher in women with both PTB/SGA and vasomotor symptoms (4.6%; 95% CI, 4.1%–5.1%) versus women with no exposures (3.3%; 95% CI, 2.9%–3.7%) or vasomotor symptoms only (3.8%; 95% CI, 3.5%–4.0%). ASCVD risk score was higher in women PTB/SGA (4.8%; 95% CI, 3.6%–5.9%) versus no exposures. PTB/SGA and vasomotor symptoms was associated with ASCVD risk score in white women versus no exposures (β=0.40; 95% CI, 0.02–0.78). Conclusions Women with prior PTB/SGA were more likely to have severe vasomotor symptoms of menopause. Reproductive exposures were associated with an estimated 10‐year ASCVD risk in white women.
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Affiliation(s)
| | - Erica P Gunderson
- Division of Research Kaiser Permanente Northern California Oakland CA
| | - Philip Greenland
- Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Janet M Catov
- Magee-Women's Research Institute and Department of Epidemiology University of Pittsburgh Pittsburgh, PA
| | - Cora E Lewis
- Division of Preventive Medicine University of Alabama at Birmingham Birmingham, AL
| | | | | | - Mercedes R Carnethon
- Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
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Andolf E, Bladh M, Möller L, Sydsjö G. Prior placental bed disorders and later dementia: a retrospective Swedish register-based cohort study. BJOG 2020; 127:1090-1099. [PMID: 32145044 DOI: 10.1111/1471-0528.16201] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the association between a history of placental bed disorders and later dementia. DESIGN Retrospective population-based cohort study. SETTING Sweden. SAMPLE All women giving birth in Sweden between 1973 and 1993 (1 128 709). METHODS Women with and without placental bed disorders (hypertensive disorders of pregnancy including pre-eclampsia, fetal growth restriction, spontaneous preterm labour and birth, preterm premature rupture of membranes, abruptio placenta, late miscarriages) and other pregnancy complications were identified by means of the Swedish Medical Birth Register. International classification of disease was used. Data were linked to other National Registers. Participants were followed up until 2013. The Cox proportional hazards model was used to calculate hazard ratios for women with and without pregnancy complications and were adjusted for possible confounders. MAIN OUTCOME MEASURES Diagnosis of vascular dementia and non-vascular dementia. RESULTS Adjusted for cardiovascular disease and socio-demographic factors, an increased risk of vascular dementia was shown in women with previous pregnancy-induced hypertension (Hazard ratio [HR] 1.88, 95% CI 1.32-2.69), pre-eclampsia (HR 1.63, 95% CI 1.23-2.16), spontaneous preterm labour and birth (HR 1.65, 95% CI 1.12-2.42) or preterm premature rupture of membranes (HR 1.60, 95% CI 1.08-2.37). No statistically significant increased risk was seen for other pregnancy complications or non-vascular dementia even though many of the point estimates indicated increased risks. CONCLUSIONS Women with placental bed disorders have a higher risk for vascular disease. Mechanisms behind the abnormal placentation remain elusive, although maternal constitutional factors, abnormal implantation as well as impaired angiogenesis have been suggested. TWEETABLE ABSTRACT Placental bed syndromes associated with vascular dementia even after adjusting for cardiovascular disease.
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Affiliation(s)
- E Andolf
- Division of Obstetrics and Gynaecology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
| | - M Bladh
- Department of Obstetrics and Gynaecology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - L Möller
- Department of Obstetrics and Gynaecology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - G Sydsjö
- Department of Obstetrics and Gynaecology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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19
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Long-Term Cardiovascular Risks Associated With Adverse Pregnancy Outcomes. J Am Coll Cardiol 2019; 73:2106-2116. [DOI: 10.1016/j.jacc.2018.12.092] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/16/2018] [Accepted: 12/02/2018] [Indexed: 12/21/2022]
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Chen X, Stein TP, Steer RA, Scholl TO. Individual free fatty acids have unique associations with inflammatory biomarkers, insulin resistance and insulin secretion in healthy and gestational diabetic pregnant women. BMJ Open Diabetes Res Care 2019; 7:e000632. [PMID: 31245005 PMCID: PMC6557537 DOI: 10.1136/bmjdrc-2018-000632] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/27/2019] [Accepted: 03/27/2019] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE We investigated the relationships of maternal circulating individual free fatty acids (FFA) with insulin resistance, insulin secretion and inflammatory biomarkers during mid-pregnancy. RESEARCH DESIGN AND METHODS The data were drawn from a prospective cohort of generally healthy pregnant women (n=1368, African-American 36%, Hispanic 48%, Caucasian 16%) in Camden, NJ. We quantitatively determined 11 FFAs, seven cytokine/adipokine, homeostatic model assessment of insulin resistance (HOMA-IR) and C-peptide levels from the fasting blood samples that were collected at 16 weeks of gestation. Multivariate analyses were performed along with separate analyses for each individual FFA. RESULTS High HOMA-IR (p<0.001) and C-peptide (p<0.0001) levels were positively associated with a twofold to fourfold increased risk for developing gestational diabetes mellitus (GDM). Negative relationships were found with specific FFAs (molecular percentage, palmitoleic, oleic, linolenic, myristic acids) and HOMA-IR and C-peptide levels (p<0.01 to p<0.0001). In contrast, palmitic, stearic, arachidonic, dihomo-γ-linolenic (DGLA) and docosahexaenoic acids were positively associated with HOMA-IR and C-peptide (p<0.01 to p<0.0001). The individual FFAs also predicted cytokine/adipokine levels. For example, women who had elevated DGLA (highest quartile) were twice as (adjusted OR 2.06, 95% CI 1.42 to 2.98) likely to have higher interleukin (IL)-8 (p<0.0001) levels. Conversely, women with high palmitoleic, oleic, and linolenic acid levels had reduced odds (≥2-fold, p<0.01 to p<0.001) for having higher IL-8, IL-6 or tumor necrosis factor-alpha levels. CONCLUSION Our results suggest that maternal individual FFAs uniquely affect insulin resistance and secretion. The effects are either direct or indirect via modulation of the inflammatory response. Modifying the composition of FFAs may help in reducing the risk of GDM.
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Affiliation(s)
- Xinhua Chen
- Obstetrics and Gynecology Research, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - T Peter Stein
- Surgery, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Robert A Steer
- Psychiatry, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Theresa O Scholl
- Obstetrics and Gynecology Research, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
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21
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Lappas M. Identification of SMAD3 as a Novel Mediator of Inflammation in Human Myometrium In Vitro. Mediators Inflamm 2018; 2018:3140420. [PMID: 30363688 PMCID: PMC6180979 DOI: 10.1155/2018/3140420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/31/2018] [Accepted: 08/09/2018] [Indexed: 02/01/2023] Open
Abstract
Preterm birth remains the primary cause of early neonatal death and is a major determinant for long-term health consequences. Aberrant intrauterine inflammation and infection are known to augment the synthesis of proinflammatory cytokines and induce uterine contractions, which can subsequently lead to preterm birth. The transforming growth factor-β (TGF-β) superfamily members regulate numerous cellular processes through the activation of intracellular mediators known as mothers against decapentaplegic homolog (SMADs). Studies in nongestational tissues have shown that SMAD3 plays a role in immune regulation and inflammation; however, its role in human labour remains unknown. Thus, the present study aimed at (i) characterising the expression of SMAD3 in the human myometrium; (ii) determining the effect of bacterial and viral products and proinflammatory cytokines on SMAD3 transcriptional activity in primary human myometrial cells; and (iii) investigating the effect of SMAD3 siRNA knockdown on the production of prolabour mediators in primary human myometrial cells. Phosphorylated (i.e., active) SMAD3 protein expression was lower in the myometrium after spontaneous term labour compared to the myometrium from nonlabouring women. Using a luciferase assay, the proinflammatory cytokines IL-1β and TNF, and viral analogue polyinosinic : polycytidylic acid (poly(I : C)) significantly reduced SMAD3 transcriptional activity in human primary myometrial cells. Loss-of-function studies found that SMAD3 knockdown in myometrial cells significantly increased IL-1β- and poly(I : C)-induced proinflammatory cytokines (IL-1A, IL-6), chemokines (IL-8, MCP-1), the adhesion molecule ICAM-1, COX-2 mRNA expression, and subsequent PGF2α release. In conclusion, SMAD3 deficiency is associated with increased production of proinflammatory and prolabour mediators in the human myometrium.
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Affiliation(s)
- Martha Lappas
- Obstetrics, Nutrition, and Endocrinology Group, Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia
- Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Victoria, Australia
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22
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Lane-Cordova AD, Gunderson EP, Carnethon MR, Catov JM, Reiner AP, Lewis CE, Dude AM, Greenland P, Jacobs DR. Pre-pregnancy endothelial dysfunction and birth outcomes: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Hypertens Res 2018; 41:282-289. [PMID: 29449706 PMCID: PMC6311125 DOI: 10.1038/s41440-018-0017-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/29/2017] [Accepted: 10/03/2017] [Indexed: 11/09/2022]
Abstract
Endothelial dysfunction is a form of subclinical cardiovascular disease that may be involved in preterm birth and small-for-gestational-age deliveries. However, concentrations of biomarkers of endothelial dysfunction before pregnancy have rarely been measured. We hypothesized that higher levels of biomarkers of endothelial dysfunction (cellular adhesion molecules and selectins) would be associated with odds of preterm birth and/or small-for-gestational-age deliveries. We included 235 women from the Coronary Artery Risk Development in Young Adults (CARDIA) study who were nulliparous at Y7, reported ≥1 live birth through Y25, and had ≥1 biomarker measured at Y7. We tested for associations between individual biomarkers and an averaged z-score representing total endothelial dysfunction with preterm birth and/or small-for-gestational-age deliveries using Poisson regression, adjusted for demographic and clinical characteristics at the exam immediately preceding index birth. At Y7, total evidence of endothelial dysfunction was similar in women who did (n = 59) and did not have (n = 176) preterm birth and/or small-for-gestational-age deliveries. There was no association between biomarkers of endothelial dysfunction (either individual biomarker or total score) with odds of preterm birth and/or small-for-gestational-age deliveries after adjustment: IRR = 1.01, 95% CI: 0.74, 1.39, p = 0.93 for total endothelial biomarker score. Associations were not modified by race. We conclude that biomarkers of endothelial dysfunction in nulliparous women, measured ~3 years before pregnancy, did not identify women at risk for preterm birth and/or small-for-gestational-age deliveries. This suggests that the maternal endothelial dysfunction that is believed to contribute to these birth outcomes may not be detectable before pregnancy.
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Affiliation(s)
- Abbi D Lane-Cordova
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - Erica P Gunderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Janet M Catov
- Department of Obstetrics and Gynecology, Magee Women's Institute and Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alex P Reiner
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Cora E Lewis
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Annie M Dude
- Department of Maternal-Fetal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Philip Greenland
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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23
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Docheva N, Romero R, Chaemsaithong P, Tarca AL, Bhatti G, Pacora P, Panaitescu B, Chaiyasit N, Chaiworapongsa T, Maymon E, Hassan SS, Erez O. The profiles of soluble adhesion molecules in the "great obstetrical syndromes" . J Matern Fetal Neonatal Med 2018; 32:2113-2136. [PMID: 29320948 DOI: 10.1080/14767058.2018.1427058] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of this study was to determine the profiles of maternal plasma soluble adhesion molecules in patients with preeclampsia, small-for-gestational-age (SGA) fetuses, acute pyelonephritis, preterm labor with intact membranes (PTL), preterm prelabor rupture of the membranes (preterm PROM), and fetal death. MATERIALS AND METHODS A cross-sectional study was conducted to determine maternal plasma concentrations of sE-selectin, sL-selectin, and sP-selectin as well as sICAM-1, sVCAM-1, and sPECAM-1 in patients with (1) an uncomplicated pregnancy (control, n = 100); (2) preeclampsia (n = 94); (3) SGA fetuses (in women without preeclampsia/hypertension, n = 45); (4) acute pyelonephritis (n = 25); (5) PTL (n = 53); (6) preterm PROM (n = 24); and (7) fetal death (n = 34). Concentrations of soluble adhesion molecules and inflammatory cytokines (tumor necrosis factor (TNF)-α and interleukin (IL)-8) were determined with sensitive and specific enzyme-linked immunoassays. RESULTS In comparison to women with a normal pregnancy, (1) women with preeclampsia had higher median concentrations of sE-selectin, sP-selectin, and sVCAM-1, and a lower concentration of sL-selectin (all p values < .001); (2) patients with SGA fetuses had higher median concentrations of sE-selectin, sP-selectin, and sVCAM-1 (all p values < .05); (3) patients with a fetal death had higher median concentrations of sE-selectin and sP-selectin (all p values < .05); (4) patients with acute pyelonephritis had higher median plasma concentrations of sE-selectin, sICAM-1, and sVCAM-1 (all p values < .001); (5) patients with preeclampsia and acute pyelonephritis, plasma concentrations of sVCAM-1, sE-selectin, and sP-selectin correlated with those of the proinflammatory cytokines TNF-α and interleukin (IL)-8 (all p values < .05); (6) patients with PTL had a higher median concentration of sP-selectin and a lower median concentration of VCAM-1 (all p values < .05); and (7) women with preterm PROM had lower median concentrations of sL-selectin and sVCAM-1 (all p values < .05). CONCLUSIONS The results of this study show that endothelial cell activation/dysfunction reflected by the plasma concentration of sE-selectin is not specific to preeclampsia but is present in pregnancies complicated by SGA fetuses, acute pyelonephritis, and fetal death. Collectively, we report that each obstetrical syndrome appears to have a stereotypical profile of soluble adhesion molecules in the peripheral circulation.
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Affiliation(s)
- Nikolina Docheva
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Roberto Romero
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,c Department of Obstetrics and Gynecology , University of Michigan , Ann Arbor , MI , USA.,d Department of Epidemiology and Biostatistics , Michigan State University , East Lansing , MI , USA.,e Center for Molecular Medicine and Genetics , Wayne State University , Detroit , MI , USA
| | - Piya Chaemsaithong
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Adi L Tarca
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Gaurav Bhatti
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Percy Pacora
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Bogdan Panaitescu
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Noppadol Chaiyasit
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Tinnakorn Chaiworapongsa
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Eli Maymon
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA.,f Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beersheba , Israel
| | - Sonia S Hassan
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA.,g Department of Physiology , Wayne State University School of Medicine , Detroit , MI , USA
| | - Offer Erez
- a Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit , MI , USA.,b Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA.,f Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beersheba , Israel
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McLaughlin K, Audette MC, Parker JD, Kingdom JC. Mechanisms and Clinical Significance of Endothelial Dysfunction in High-Risk Pregnancies. Can J Cardiol 2018; 34:371-380. [PMID: 29571421 DOI: 10.1016/j.cjca.2018.01.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 01/05/2018] [Accepted: 01/07/2018] [Indexed: 10/18/2022] Open
Abstract
The maternal cardiovascular system undergoes critical anatomic and functional adaptations to achieve a successful pregnancy outcome which, if disrupted, can result in complications that significantly affect maternal and fetal health. Complications that involve the maternal cardiovascular system are among the most common disorders of pregnancy, including gestational hypertension, preeclampsia, gestational diabetes, and impaired fetal growth. As a central feature, maternal endothelial dysfunction is hypothesized to play a predominant role in mediating the pathogenesis of these high-risk pregnancies, and as such, might proceed and precipitate the clinical presentation of these pregnancy disorders. Improving or normalizing maternal endothelial function in high-risk pregnancies might be an effective therapeutic strategy to ameliorate maternal and fetal clinical outcomes.
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Affiliation(s)
- Kelsey McLaughlin
- Department of Medicine, Division of Cardiology, Sinai Health System, University of Toronto, Toronto, Ontario, Canada; The Centre for Women's and Infant's Health at the Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
| | - Melanie C Audette
- The Centre for Women's and Infant's Health at the Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
| | - John D Parker
- Department of Medicine, Division of Cardiology, Sinai Health System, University of Toronto, Toronto, Ontario, Canada
| | - John C Kingdom
- The Centre for Women's and Infant's Health at the Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, Division of Maternal-Fetal Medicine, Sinai Health System, University of Toronto, Toronto, Ontario, Canada.
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25
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Liong S, Lim R, Barker G, Lappas M. Hepatitis A virus cellular receptor 2 (HAVCR2) is decreased with viral infection and regulates pro-labour mediators OA. Am J Reprod Immunol 2017; 78. [PMID: 28466996 DOI: 10.1111/aji.12696] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 03/29/2017] [Indexed: 12/13/2022] Open
Abstract
PROBLEM Intrauterine infection caused by viral infection has been implicated to contribute to preterm birth. Hepatitis A virus cellular receptor 2 (HAVCR2) regulates inflammation in non-gestational tissues in response to viral infection. METHOD OF STUDY The aims of this study were to determine the effect of: (i) viral dsRNA analogue polyinosinic:polycytidylic acid (poly(I:C)) on HAVCR2 expression; and (ii) HAVCR2 silencing by siRNA (siHAVCR2) in primary amnion and myometrial cells on poly(I:C)-induced inflammation. RESULTS In human foetal membranes and myometrium, HAVCR2 mRNA and protein expression was decreased when exposed to poly(I:C). Treatment of primary amnion and myometrial cells with poly(I:C) significantly increased the expression and release of pro-inflammatory cytokines TNF, IL1A, IL1B and IL6; the expression of chemokines CXCL8 and CCL2; the expression and secretion of adhesion molecules ICAM1 and VCAM1; and PTGS2 and PTGFR mRNA expression and the release of prostaglandin PGF2α . This increase was significantly augmented in cells transfected with siHAVCR2. Furthermore, mRNA expression of anti-inflammatory cytokines IL4 and IL10 was significantly decreased. CONCLUSION Collectively, our data suggest that HAVCR2 regulates cytokines, chemokines, prostaglandins and cell adhesion molecules in the presence of viral infection. This suggests a potential for HAVCR2 activators as therapeutics for the management of preterm birth associated with viral infections.
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Affiliation(s)
- Stella Liong
- Obstetrics, Nutrition and Endocrinology Group, Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Vic., Australia.,Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Vic., Australia
| | - Ratana Lim
- Obstetrics, Nutrition and Endocrinology Group, Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Vic., Australia.,Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Vic., Australia
| | - Gillian Barker
- Obstetrics, Nutrition and Endocrinology Group, Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Vic., Australia.,Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Vic., Australia
| | - Martha Lappas
- Obstetrics, Nutrition and Endocrinology Group, Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Vic., Australia.,Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Vic., Australia
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26
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Pasaribu HP, Hariman H, Roeshadi RH, Koh SCL. Soluble vascular cell adhesion molecule-1 and magnesium sulfate with nifedipine treatment in Indonesian women with severe pre-eclampsia. Interv Med Appl Sci 2017; 8:97-102. [PMID: 28203390 DOI: 10.1556/1646.8.2016.3.4] [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] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Endothelial cell activation in pre-eclampsia is associated with elevated soluble vascular cell adhesion molecule-1 (sVCAM-1) levels. The objective of the study was to determine whether sVCAM-1 levels in Indonesian women with pre-eclampsia were similar to other ethnic studies and to determine the effects of magnesium sulfate with nifedipine on blood pressure. METHODS A total of 61 pregnant women were admitted, who had normal pregnancy (n = 25) and severe pre-eclampsia (n = 36). Blood sampling was performed at admission to the study, 1 h after placental separation, and 24 h postpartum. sVCAM-1 and blood pressure levels were determined. RESULTS The mean ages in normal pregnancy (n = 25) and in severe pre-eclampsia (n = 36) are 30.0 ± 3.4 years and 27.1 ± 6.1 years, respectively. Significantly elevated sVCAM-1 was seen in pre-eclampsia. No significant variation in sVCAM-1 levels during the study periods was seen in both groups of cohorts. Magnesium sulfate infusion and nifedipine significantly lowered the blood pressure level. CONCLUSION Elevated sVCAM-1 levels were also seen in Indonesian women with severe pre-eclampsia. The placenta may not be the only source of elevated sVCAM-1 and that endothelial dysfunction persists beyond the postpartum period. Magnesium sulfate together with nifedipine significantly lowered blood pressure. The determination of elevated sVCAM-1 in pregnancy as a risk marker for endothelial dysfunction is therefore suggested.
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Affiliation(s)
- Hotma Partogi Pasaribu
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universitas Sumatera Utara , Medan, Indonesia
| | - Herman Hariman
- Department of Clinical Pathology, Faculty of Medicine, Universitas Sumatera Utara , Medan, Indonesia
| | - R Haryono Roeshadi
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universitas Sumatera Utara , Medan, Indonesia
| | - Stephen C L Koh
- Department of Clinical Pathology, Faculty of Medicine, Universitas Sumatera Utara , Medan, Indonesia
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Chen X, Scholl TO, Stein TP, Steer RA, Williams KP. Maternal Circulating Lipid Profile during Early Pregnancy: Racial/Ethnic Differences and Association with Spontaneous Preterm Delivery. Nutrients 2017; 9:E19. [PMID: 28045435 PMCID: PMC5295063 DOI: 10.3390/nu9010019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 12/13/2016] [Accepted: 12/23/2016] [Indexed: 11/17/2022] Open
Abstract
Prior reports on the association between altered maternal serum lipid levels with preterm delivery are inconsistent. Ethnic differences in serum lipids during pregnancy and their relation to preterm delivery have not been studied. We examined the relationships of six maternal lipids during early pregnancy with the risk of spontaneous preterm delivery (SPTD). The design represents a case-control study nested within a large prospective, multiethnic cohort of young, generally healthy pregnant women. SPTD cases (n = 183) and controls who delivered at term (n = 376) were included. SPTD is defined as delivery at <37 completed weeks of gestation without indicated conditions. We found that African-American women had significantly increased levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (apoA1), and lower triglyceride (TG) and apolipoprotein B (apoB) levels compared to Hispanic and non-Hispanic Caucasians combined. Elevated HDL-C and apoA1 concentrations were significantly associated with an increased odds of SPTD after controlling for potential confounding factors. The adjusted odds ratio (AOR) was 1.91 (95% confidence interval (CI) 1.15, 3.20) for the highest quartile of HDL-C relative to the lowest quartile, and for apoA1 the AOR was 1.94 (95% CI 1.16, 3.24). When controlling for ethnicity, the results remained comparable. These data suggest that pregnant African-American women had a more favorable lipid profile suggestive of a reduction in cardiovascular risk. Despite this, increased HDL-C and apoA1 were both found to be associated with SPTD.
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Affiliation(s)
- Xinhua Chen
- Department of Obstetrics/Gynecology, School of Osteopathic Medicine, Rowan University, Stratford, NJ 08084, USA.
| | - Theresa O Scholl
- Department of Obstetrics/Gynecology, School of Osteopathic Medicine, Rowan University, Stratford, NJ 08084, USA.
| | - Thomas P Stein
- Department of Surgery, School of Osteopathic Medicine, Rowan University, Stratford, NJ 08084, USA.
| | - Robert A Steer
- Department of Psychiatry, School of Osteopathic Medicine, Rowan University, Stratford, NJ 08084, USA.
| | - Keith P Williams
- Department of Obstetrics/Gynecology, School of Osteopathic Medicine, Rowan University, Stratford, NJ 08084, USA.
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Christian LM, Blair LM, Porter K, Lower M, Cole RM, Belury MA. Polyunsaturated Fatty Acid (PUFA) Status in Pregnant Women: Associations with Sleep Quality, Inflammation, and Length of Gestation. PLoS One 2016; 11:e0148752. [PMID: 26859301 PMCID: PMC4747600 DOI: 10.1371/journal.pone.0148752] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/22/2016] [Indexed: 02/03/2023] Open
Abstract
Mechanistic pathways linking maternal polyunsaturated fatty acid (PUFA) status with gestational length are poorly delineated. This study examined whether inflammation and sleep quality serve as mediators, focusing on the antiinflammatory ω-3 docosahexaenoic acid (DHA; 22:6n3) and proinflammatory ω-6 arachidonic acid (AA; 20:4n6). Pregnant women (n = 135) provided a blood sample and completed the Pittsburgh Sleep Quality Index (PSQI) at 20–27 weeks gestation. Red blood cell (RBC) fatty acid levels were determined by gas chromatography and serum inflammatory markers [interleukin (IL)-6, IL-8, tumor necrosis factor-α, IL-1β, and C-reactive protein] by electrochemiluminescence using high sensitivity kits. Both higher serum IL-8 (95% CI = 0.10,3.84) and poor sleep (95% CI = 0.03,0.28) served as significant mediators linking lower DHA:AA ratios with shorter gestation. Further, a serial mediation model moving from the DHA:AA ratio → sleep → IL-8 → length of gestation was statistically significant (95% CI = 0.02, 0.79). These relationships remained after adjusting for depressive symptoms, age, BMI, income, race, and smoking. No interactions with race were observed in relation to length of gestation as a continuous variable. However, a significant interaction between race and the DHA:AA ratio in predicting preterm birth was observed (p = 0.049); among African Americans only, odds of preterm birth decreased as DHA:AA increased (p = 0.048). These data support a role for both inflammatory pathways and sleep quality in linking less optimal RBC PUFA status with shorter gestation in African American and European American women and suggest that African-Americans have greater risk for preterm birth in the context of a low DHA:AA ratio.
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Affiliation(s)
- Lisa M. Christian
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- Department of Psychology, The Ohio State University, Columbus, Ohio, United States of America
- * E-mail:
| | - Lisa M. Blair
- College of Nursing, The Ohio State University, Columbus, Ohio, United States of America
| | - Kyle Porter
- Center for Biostatistics, The Ohio State University, Columbus, Ohio, United States of America
| | - Mary Lower
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
| | - Rachel M. Cole
- Program of Nutrition in the Department of Human Sciences, The Ohio State University, Columbus, Ohio, United States of America
| | - Martha A. Belury
- Program of Nutrition in the Department of Human Sciences, The Ohio State University, Columbus, Ohio, United States of America
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Chen X, Bai G, Scholl TO. Spontaneous Preterm Delivery, Particularly with Reduced Fetal Growth, is Associated with DNA Hypomethylation of Tumor Related Genes. ACTA ACUST UNITED AC 2016; 3. [PMID: 27500275 PMCID: PMC4975560 DOI: 10.4172/2376-127x.1000215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Preterm delivery and sub-optimal fetal growth are associated with each other and affect both mother and infant. Our aim was to determine (i) whether there are detectable differences in DNA methylation between early and late gestation and (ii) whether changes in DNA methylation from entry are associated with spontaneous preterm delivery with and without reduced fetal growth. Methods We conducted a case-control study nested within a large prospective cohort. Gene specific methylation was measured by Methyl-Profiler PCR Array in a Human Breast Cancer Signature Panel of 24 genes from maternal peripheral leukocytes genomic DNA at entry and 3rd trimester (sampled at 16 and 30 weeks of gestation, respectively). Clonal bisulfite DNA sequencing was performed to confirm the changes in selected genes (CYP1B1, GADD45A and CXCL12). Multivariable analysis was used for data analysis. Results There was significantly decrease in DNA methylation in 15 of 24 genes during the 3rd trimester in cases of spontaneous preterm delivery (n=23) as compared to the controls (n=19) (p<0.05–p<0.01 for each gene). Similar results were observed by bisulfite sequencing for 3 genes. The change in DNA methylation between late and early gestation was significantly different in cases (overall decrease in methylation was −4.0 ± 1.5%) compared to the controls (overall increase in methylation was 12.6 ± 2.19%, p<0.0001). A graded pattern of DNA methylation was observed in 15 genes. Cases who delivered preterm with reduced fetal growth had the lowest level of methylation, cases delivering preterm without reduced fetal growth were next and term controls were highest in methylation (p for trend <0.05 to p<0.01 for each gene). Cases of preterm delivery also had significantly lower dietary choline intake. Conclusions These data suggest that epigenetic modification is associated with an increased risk of spontaneous preterm delivery, spontaneous preterm delivery with reduced fetal growth in particular.
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Affiliation(s)
- Xinhua Chen
- Department of Obstetrics and Gynecology, Rowan University - School of Osteopathic Medicine, Stratford, NJ, USA
| | - Guang Bai
- Department of Neural and Pain Sciences, University of Maryland, School of Dentistry, Baltimore, MD, USA
| | - Theresa O Scholl
- Department of Obstetrics and Gynecology, Rowan University - School of Osteopathic Medicine, Stratford, NJ, USA
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Chen X, Scholl TO. Ethnic Differences in Maternal Adipokines during Normal Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 13:ijerph13010008. [PMID: 26703679 PMCID: PMC4730399 DOI: 10.3390/ijerph13010008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/03/2015] [Accepted: 09/07/2015] [Indexed: 11/17/2022]
Abstract
Two adipokines (adiponectin and resistin) have opposite relations with insulin resistance and inflammation. Our major focus was to determine whether there were detectable ethnic differences in maternal adipokines during pregnancy. We also explored the correlation of the adipokines with maternal glucose homeostasis, blood pressure and anthropometric parameters. Pregnant women (n = 1634) were from a large prospective cohort study in Camden NJ (African-American 36.8%; Hispanic 47.6%; Caucasian 15.6%). Serum adiponectin and resistin were measured at entry (week 16.8) and the 3rd trimester (week 30.7) using the Luminex xMapTechnology. Significant differences were observed among ethnic groups, controlling for confounding variables. African American women were exceptional in that they had decreased adiponectin and increased resistin throughout the course of pregnancy (p < 0.05 to p < 0.0001) and a greater than two fold risk of simultaneously exhibiting low adiponectin (lowest tertile) and high resistin (highest tertile) compared to Caucasians and/or Hispanics. The cohort as a whole and each ethnic group showed similar negative correlations between adiponectin, and glucose homeostasis, blood pressure and anthropometric parameters but there was lesser correspondence with resistin. Our data underscore the need for further research on ethnic variation in adipokines and other physiologic biomarkers during complicated and uncomplicated pregnancy.
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Affiliation(s)
- Xinhua Chen
- Department of Obstetrics and Gynecology, School of Osteopathic Medicine, Rowan University, Two Medical Center Drive, Suite 390, Stratford, NJ 08084, USA.
| | - Theresa O Scholl
- Department of Obstetrics and Gynecology, School of Osteopathic Medicine, Rowan University, Two Medical Center Drive, Suite 390, Stratford, NJ 08084, USA.
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Impaired Circulating Angiogenic Cells Mobilization and Metalloproteinase-9 Activity after Dynamic Exercise in Early Metabolic Syndrome. BIOMED RESEARCH INTERNATIONAL 2015; 2015:920356. [PMID: 26557715 PMCID: PMC4628701 DOI: 10.1155/2015/920356] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/22/2015] [Accepted: 05/25/2015] [Indexed: 11/18/2022]
Abstract
Increased levels of adhesion molecules or metalloproteinases (MMPs) may indicate endothelial dysfunction. Exercise mobilizes circulating angiogenic cells (CACs) from bone marrow in healthy subjects, improving vascular function. However, it is unclear whether this mechanism is preserved in the early stages of metabolic syndrome (early MetS). We aimed to evaluate the acute effects of exercise on adhesion molecules, angiogenic factors, MMPs, and CACs in early MetS. Fifteen subjects with early MetS and nine healthy controls underwent an exercise session and a nonexercise session, randomly. Adhesion molecules, angiogenic factors, CACs, and MMPs were evaluated before and after exercise or nonexercise sessions. At baseline, levels of sE-selectin, sICAM-1, and MMP-9 were higher in early MetS than in controls (P ≤ 0.03). After exercise, sE-selectin, sICAM-1, and MMP-9 levels were still higher in early MetS (P < 0.05). Subjects with early MetS presented less CACs (P = 0.02) and higher MMP-9 activity (P ≤ 0.04), while healthy controls presented higher MMP-2 activity after exercise. There was no difference between moments in nonexercise session (P > 0.05). In conclusion, subjects with early MetS already presented impaired endothelial function at rest along with a decrease in CACs and an increase in MMP-9 activity in response to exercise.
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Blair LM, Porter K, Leblebicioglu B, Christian LM. Poor Sleep Quality and Associated Inflammation Predict Preterm Birth: Heightened Risk among African Americans. Sleep 2015; 38:1259-67. [PMID: 25845693 DOI: 10.5665/sleep.4904] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 03/07/2015] [Indexed: 12/18/2022] Open
Abstract
STUDY OBJECTIVES Poor sleep promotes inflammation. In turn, inflammation is a causal mechanism in term as well as preterm parturition. In the United States, a persistent racial disparity in preterm birth exists, with African Americans showing ∼1.5 times greater risk. This study examined associations among sleep quality, serum proinflammatory cytokines, and length of gestation in a racially diverse sample of 138 pregnant women. DESIGN Observational. MEASUREMENTS Women completed the Pittsburgh Sleep Quality Index (PSQI) and other psychosocial and behavioral measures during midpregnancy. Serum levels of interleukin (IL)-6, IL-8, IL-1β, and tumor necrosis factor (TNF)-α were determined by high-sensitivity assays. Birth outcomes were determined via medical record review. RESULTS Among African American women (n = 79), shorter gestation was predicted by poorer overall sleep (rs = -0.35, P = 0.002) as well the following PSQI subscales: subjective sleep quality (rs = -0.34, P = 0.002), sleep latency (rs = -0.27, P = 0.02), and sleep efficiency (rs = -0.27, P = 0.02). African American women with poor sleep quality (PSQI > 5) had 10.2 times the odds of preterm birth compared to those with good sleep quality. In contrast, among European American women (n = 53), gestational length was not significantly predicted by sleep quality (Ps > 0.12). Bootstrapping analyses showed that, among African Americans, IL-8 significantly mediated the association between sleep quality and length of gestation (indirect effect estimate -0.029; 95% confidence interval -0.06, -0.002). CONCLUSIONS The data provide novel evidence that African American women exhibit greater inflammation in response to sleep disturbance than European American women and these effects correspond with length of gestation. Racial differences in susceptibility to sleep induced immune dysregulation may contribute to marked racial disparities in preterm birth.
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Affiliation(s)
- Lisa M Blair
- College of Nursing, The Ohio State University, Columbus, OH
| | - Kyle Porter
- Center for Biostatistics, The Ohio State University, Columbus, OH
| | | | - Lisa M Christian
- Department of Psychiatry, The Institute for Behavioral Medicine Research, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Psychology, The Ohio State University, Columbus, OH
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Kac G, Mendes RH, Farias DR, Eshriqui I, Rebelo F, Benaim C, Vilela AAF, Lima NS, Peres WAF, Salles GF. Hepatic, renal and inflammatory biomarkers are positively associated with blood pressure changes in healthy pregnant women: a prospective cohort. Medicine (Baltimore) 2015; 94:e683. [PMID: 25997037 PMCID: PMC4602876 DOI: 10.1097/md.0000000000000683] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This article evaluates the association of hepatic, renal, and inflammatory biomarkers with changes in systolic (SBP) and diastolic (DBP) blood pressure (BP) during healthy pregnancies.A prospective cohort study with 225 healthy pregnant women was conducted in Rio de Janeiro, Brazil. SBP and DBP were evaluated throughout pregnancy (5th-13th, 20th-26th, and 30th-36th gestational weeks) and were the outcomes. The following biomarkers were measured at the first trimester and analyzed according to tertiles of the sample distribution and were considered the main independent predictors: alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), uric acid (UA), creatinine (Cr), and C-reactive protein (CRP) concentrations. The statistical analysis included 3 stages of modeling with the longitudinal linear mixed-effects procedures: Model 1 was adjusted for gestational age and quadratic gestational age; Model 2 included interactions between the biomarkers and gestational age; and Model 3 was adjusted for self-reported skin color, education, parity, early-pregnancy body mass index (BMI) (under/normal <25; overweight/obese ≥25 kg/m), smoking habit, and leisure-time physical activity. Additional models were performed for CRP and UA with the inclusion of interaction terms between the biomarkers and BMI.Women classified in the third tertile of the ALP (≥61.1 U/L; βSBP = 3.474; 95% confidence interval [CI]: 0.955-5.992; βDBP = 3.291; 95% CI: 1.098-5.485), ALT (≥14.3 U/L; βSBP = 2.232; 95% CI: 0.221-4.242; βDBP = 2.355; 95% CI: 0.721-3.989), and Cr values (≥48.6 μmol/L; βDBP = 1.927; 95% CI: 0.347-3.508) presented higher BP levels during pregnancy compared to those in the first and second tertiles. Women in the highest tertile of the ALP concentration distribution presented a lower rate of change in SBP and DBP during pregnancy (interaction term with gestational age βSBP = -0.004; 95% CI: -0.007 to -0.001; P = 0.02; βDBP = -0.003; 95% CI: -0.006 to -0.001; P = 0.01). Higher UA concentrations were associated with higher SBP levels only in overweight/obese women (β = 3.878; 95% CI: 0.687-7.068), whereas higher CRP concentrations (≥2.6 mg/L) were associated with higher DBP in under/normal weight women (β =2.252; 95% CI: 0.267-4.236).ALP, ALT, and Cr concentrations were positively associated with BP levels, whereas ALP was associated with a lower rate of change in BP. The associations of UA and CRP with BP differ according to the early-pregnancy BMI.
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Affiliation(s)
- Gilberto Kac
- From the Nutritional Epidemiology Observatory (GK, DRF, IE, FR, CB, AAFV, NSL), Department of Social and Applied Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro; BRAIN Laboratory (Basic Research and Advanced Investigations in Neurosciences) (RHM), Hospital de Clínicas de Porto Alegre, Porto Alegre; Graduate Program in Nutrition (GK, DRF, IE, CB, AAFV, NSL), Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro; Graduate Program in Epidemiology in Public Health (FR), National School of Public Health, Oswaldo Cruz Foundation; Department of Nutrition and Dietetics (WAFP), Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro; and Department of Internal Medicine (GFS), University Hospital Clementino Fraga Filho, Medical School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Wang X, Zhang R, Gu L, Zhang Y, Zhao X, Bi K, Chen X. Cell-based screening identifies the active ingredients from Traditional Chinese Medicine formula Shixiao San as the inhibitors of atherosclerotic endothelial dysfunction. PLoS One 2015; 10:e0116601. [PMID: 25699522 PMCID: PMC4336328 DOI: 10.1371/journal.pone.0116601] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 12/12/2014] [Indexed: 12/25/2022] Open
Abstract
In this study, we performed a phenotypic screening in human endothelial cells exposed to oxidized low density lipoprotein (an in vitro model of atherosclerotic endothelial dysfunction) to identify the effective compounds in Shixiao San. After investigating the suitability and reliability of the cell-based screening method using atorvastatin as the positive control drug, this method was applied in screening Shixiao San and its extracts. The treatment of n-butanol fraction on endothelial cells exhibited stronger healing effects against oxidized low density lipoprotein-induced insult when compared with other fractions. Cell viability, the level of nitric oxide, endothelial nitric oxide synthase and endothelin-1 were measured, respectively. The assays revealed n-butanol fraction significantly elevated the survival ratio of impaired cells in culture. In parallel, n-butanol fraction exhibited the highest inhibition of inflammation. The generation of prostaglandin-2 and adhesion molecule (soluble intercellular adhesion molecule-1) was obviously declined. Furthermore, n-butanol fraction suppressed the production of reactive oxygen species and malondialdehyde, and restored the activity of superoxide dismutase. Compounds identification of the n-butanol fraction was carried out by ultra high liquid chromatography coupled to quadrupole time-of-flight tandem mass spectrometry. The active ingredients including quercetin-3-O-(2G-α-l-rhamnosyl)-rutinoside, quercetin-3-O-neohesperidoside, isorhamnetin-3-O-neohesperidoside and isorhamnetin-3-O-rutinoside revealed the ability of anti-atherosclerosis after exposing on endothelial cells. The current work illustrated the pharmacology effect of Shixiao San and clearly indicated the major active components in Shixiao San. More importantly, the proposed cell-based screening method might be particularly suitable for fast evaluating the anti-atherosclerosis efficacy of Traditional Chinese Medicines and screening out the interesting ingredients of Traditional Chinese Medicines.
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Affiliation(s)
- Xiaofan Wang
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | - Ruowen Zhang
- Department of Pathology, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, United States of America
| | - Liqiang Gu
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | - Yuanyuan Zhang
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | - Xu Zhao
- School of Traditional Chinese Material Medica, Shenyang Pharmaceutical University, Shenyang, China
| | - Kaishun Bi
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | - Xiaohui Chen
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
- * E-mail:
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Lao TT. The mother--the long-term implications on metabolic and cardiovascular complications. Best Pract Res Clin Obstet Gynaecol 2014; 29:244-55. [PMID: 25261964 DOI: 10.1016/j.bpobgyn.2014.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 06/02/2014] [Indexed: 01/21/2023]
Abstract
There is cumulating evidence linking the occurrence of pregnancy complications, including miscarriage, stillbirth, hypertensive disorders of pregnancy, gestational diabetes mellitus, preterm birth, and fetal growth restriction, with increased future risk of type 2 diabetes mellitus, and hospitalization and death due to cardiovascular and cerebrovascular diseases. Such association is largely related to genetic predisposition and shared pathophysiological mechanisms and changes, which may precede the index pregnancy. Awareness of this association would allow identification of the at-risk women for implementation of preventive measures to reduce the recurrence risk of these complications and mitigate the future development of metabolic and cardiovascular diseases worldwide.
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Affiliation(s)
- Terence T Lao
- Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
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