Correlation of enhanced oxidative stress with altered thyroid profile: Probable role in spontaneous abortion

Association of Serum Proteins Electrophoretic Pattern and Serum Hormones in Women with Spontaneous Pregnancy Loss

Background

Pregnancy is the state of carrying a developing embryo or fetus within a female body. Once pregnancy is established, a range of endocrinological events appear in its maintenance, finally helping in the successful pregnancy. The complications which are usually observed in pregnancy are gestational diabetes, preeclampsia, preterm labor, and spontaneous pregnancy loss or miscarriage, while 10%-15% of clinically recognized pregnancies terminate into spontaneous miscarriage. Thus, many attempts have been made by different researchers for the diagnosis of high-risk pregnancy on altered protein pattern using placental villous tissue or follicular fluid, but these are difficult to obtain and results of different studies are not constant.

Aim

This study was designed to identify the association (if any) among serum protein(s) electrophoretic pattern and different serum hormones in normal pregnant women (controls) and gestational age-matched women with spontaneous pregnancy loss (cases).

Materials and Methods

This study was carried out for 1½ year from October 2018 to March 2020 and included 120 participants (60 normal pregnant women and 60 women with spontaneous pregnancy loss) between 20 and 45 years of age with no mean age difference. The electrophoresis of serum was carried out using slab gel electrophoretic unit and serum thyroid-stimulating hormone (TSH), total tri-iodothyronine (TT3), total thyroxine (TT4), prolactin, and beta human chorionic gonadotropin (β-hCG) levels were analyzed using TSOSH AIA analyzer at Adesh University, Bathinda.

Results

Significant variations in the expression of proteins with molecular weight around ~150 kDa, ~50 kDa, and ~25 kDa were observed in normal pregnant women and women with spontaneous pregnancy loss. However, the protein band of ~50 kDa was found to be highly expressed in the serum of 1st and 2nd trimester women experiencing spontaneous pregnancy loss. Therefore, selected protein band of ~50 kDa was further processed by ECI-mass spectrophotometry QUAD time of flight and 365 different proteins were found, out of these; 34 proteins were found to be unidentified protein products (Verified using NCBI data base). Further, TT3, total proteins, β-hCG, and prolactin level were found to be low, whereas, TSH was found to be high in women experiencing spontaneous pregnancy loss. However, difference in the level of β-hCG in the 1st trimester and TT4 among normal pregnant women and women with spontaneous pregnancy loss was observed to be statistically insignificant.

Conclusion

This study indicated that the evaluation of serum protein variations along with hormonal profile may provide valuable information about high-risk pregnancy. Moreover, the differential expression of proteins in women with spontaneous pregnancy loss can be further explored to develop potential biomarker for the early identification of high-risk pregnancy and appropriate preventive measure.

Relationship between air pollutants and spontaneous abortion in a coal resource valley city: a retrospective cohort study

OBJECTIVE

Pollutants in the atmosphere have been linked to poor pregnancy outcomes in women. However, such investigations are scarce in metropolitan northern China. The major exposure window of air pollution affecting pregnant women is also unknown.

METHODS

For the analysis, this retrospective cohort study enrolled 6960 pregnant women recorded at Tongchuan People's Hospital from January 2018 to December 2019. Pollutant concentration values from the nearest monitoring station to the pregnant women were used to estimate exposure doses for each exposure window. Logistic regression models were created to investigate the connection between pollutants and spontaneous abortion while controlling for confounding factors.

RESULTS

PM2.5 was a risk factor for spontaneous abortion in T3 (30-60 days before the first day of the last menstrual period [LMP]), (OR: 1.305, 95% CI: 1.143-1.490) and T4 (60-90 days before the first day of the LMP),(OR: 1.450, 95% CI: 1.239-1.696) after controlling for covariates. In the same window, PM10 was a risk factor (OR: 1.308, 95% CI: 1.140-1.500), (OR: 1.386, 95% CI: 1.184-1.621). In T2 (30 days before the first day of the LMP), T3, and T4, SO2 was a risk factor for spontaneous abortion (OR: 1.185, 95% CI: 1.025-1.371), (OR: 1.219, 95% CI: 1.071-1.396), (OR: 1.202, 95% CI: 1.040-1.389). In T3 and T4, NO2 was a risk factor (OR: 1.171, 95% CI: 1.019- 1.346), (OR: 1.443, 95% CI: 1.259-1.655). In T1 (from the first day of the LMP to the date of abortion), O3 was found to be a risk factor (OR: 1.366, 95% CI: 1.226-1.521).

CONCLUSION

Exposure to high levels of air pollutants before and during pregnancy may be a risk factor for spontaneous abortion in pregnant women. This study further illustrates the importance of reducing air pollution emissions.

Oxidative stress on vessels at the maternal-fetal interface for female reproductive system disorders: Update

Considerable evidence shows that oxidative stress exists in the pathophysiological process of female reproductive system diseases. At present, there have been many studies on oxidative stress of placenta during pregnancy, especially for preeclampsia. However, studies that directly focus on the effects of oxidative stress on blood vessels at the maternal-fetal interface and their associated possible outcomes are still incomplete and ambiguous. To provide an option for early clinical prediction and therapeutic application of oxidative stress in female reproductive system diseases, this paper briefly describes the composition of the maternal-fetal interface and the molecular mediators produced by oxidative stress, focuses on the sources of oxidative stress and the signaling pathways of oxidative stress at the maternal-fetal interface, expounds the adverse consequences of oxidative stress on blood vessels, and deeply discusses the relationship between oxidative stress and some pregnancy complications and other female reproductive system diseases.

The role of paraoxonase and myeloperoxidase as oxidative stress markers in pregnant women with hypothyroidism

Objective: This study aims to measure paraoxonase 1 (PON 1) and myeloperoxidase (MPO) levels in patients diagnosed with hypothyroidism during pregnancy by spectrophotometric method and to compare the results with healthy controls. Methods: For the study, the blood samples of 45 hypothyroid pregnant patients and 45 healthy control pregnant individuals who were compatible with the patient group in terms of age were taken. PON 1 and MPO levels in both groups were measured using spectrophotometric methods and statistical analysis was performed. Results: Serum PON 1 activity levels were significantly lower in hypothyroid pregnant patients than in the control group (p=.020). The patients group had significantly higher serum MPO concentrations than in control group (p=.020). MPO/PON-1 ratio was higher in pregnant patients with hypothyroidism than in the control group (p=.030). Conclusion: Decreased levels of PON1 with increased levels of MPO in hypothyroid pregnant patients suggest the critical role of oxidative stress in hypothyroidism during pregnancy.

Association of M55L and Q192R polymorphisms of paraoxonase 1 gene (PON1) with recurrent pregnancy loss risk: A case-control study

Background

Recurrent pregnancy loss (RPL) refers to the incidence of two or more abortions before the first half of pregnancy. Oxidative stress has been hypothesized to play a central role in RPL.

Objective

To investigate the relationship between Q192R and L55M polymorphisms of PON1 as antioxidant enzyme and the risk of RPL.

Materials and Methods

In this case–control study, 110 women with RPL (case) and 110 healthy fertile women (control) referred to the Research and Clinical Center for Infertility, Shiraz, Iran were enrolled. Genomic DNA was extracted from the peripheral blood in all participants. Polymorphisms were genotyped by polymerase chain reaction-restriction fragment length polymorphism method.

Results

Statistical analysis of Q192R polymorphism showed a significant difference for the RR genotype between the case and control group (OR = 11, CI = 1.39–86.87, p = 0.005) but none for the QR and QQ genotypes. No significant association was observed between the R and Q allelic frequency in the RPL participants compared to the control group (p = 0.53). Also, statistical analysis of the L55M polymorphism for MM genotype in the case group compared with the control group showed a significant difference (OR = 3.59, CI = 0.97–13.30, p = 0.042), but none for the LM and LL genotypes.

Conclusion

The findings showed a significant correlation between the Q192R polymorphisms and the L55M PON1 enzyme and RPL in this study population.

The investigation of the role of sirtuin-1 on embryo implantation in oxidative stress-induced mice

PURPOSE

Implantation is essential for a successful pregnancy. Despite the increasing number of studies, implantation is still an unknown process. This study aimed to determine whether sirtuin-1 has a role in embryo implantation in oxidative stress-induced mice.

METHODS

Pregnant mice were separated into 5 groups: control, vehicle, paraquat, SRT1720, and SRT1720+Paraquat. Paraquat is a herbicide and is used to induce oxidative stress. SRT1720 is a specific sirtuin-1 activator. Implantation and inter-implantation sites were removed in the morning of the 5th day of pregnancy after Chicago blue injection was performed. Sirtuin-1 and Forkhead box O1 (FoxO1) were detected by immunohistochemistry and Western blot while acetylated lysine was evaluated by Western blot analysis. Reactive oxygen and nitrogen species (ROS/RNS) and superoxide dismutase (SOD) activity were determined by fluorometric and spectrometric methods, respectively.

RESULTS

Although there was no embryo implantation in paraquat-treated mice, 5 out of 9 SRT1720+Paraquat-treated mice had implantation sites which were significantly higher compared to the paraquat-treated group. Sirtuin-1 and FoxO1 expressions were increased at implantation sites of SRT1720-treated mice. ROS/RNS levels were decreased, while deacetylated FoxO1 levels and SOD activity were increased in SRT1720-treated mice.

CONCLUSION

Our findings suggest that sirtuin-1 may play a role in embryo implantation against oxidative stress through FoxO1-SOD signaling.

Spiritual Intelligence and Post-abortion Depression: A Coping Strategy

Loss of pregnancy is a major stressor which can cause mental disorders. In stressful conditions, spiritual intelligence can be used as a coping strategy to manage and cope with the stressor. It may also produce positive outcomes in spontaneous abortion. This study aimed to assess the relationship of spiritual intelligence with depression after spontaneous abortion. This cross-sectional descriptive-correlational study was done in 2015-2016 on 185 women with spontaneous abortion who were hospitalized in the postnatal care ward of Kowsar teaching hospital, Qazvin, Iran. Data collection was performed in two steps. In the first step, a demographic and obstetric characteristics questionnaire and the Spiritual Intelligence Self-Report Inventory were completed by participants during their hospital stay. In the second step, i.e., 7 days after spontaneous abortion, the Edinburgh Postnatal Depression Scale was completed for each participant over the phone. Variables which were found in univariate analysis to have a significant correlation with depression were entered into multiple logistic regression analysis to assess their roles in predicting depression. Most women were depressed (54%). Multiple logistic regression analysis revealed that the significant predictors of depression were women's educational status (OR 0.419; CI 0.18-0.93), gestational age at the time of abortion (OR 1.121; CI 1.02-1.22), and the personal meaning production dimension of spiritual intelligence (OR 0.82; CI 0.73-0.91). Spiritual intelligence is significantly correlated with post-abortion depression. Developing and following strategies for promoting spiritual intelligence can alleviate depression, stress, and anxiety after spontaneous abortion and also help manage complicated pregnancies.

Comparative Study on Different Hormones between Normal Pregnant Women and Women Experiencing Miscarriage

Background:

Pregnancy leads to a complex alteration in hormonal levels and metabolism in the maternal and fetal system and if undesirable alteration is experienced, complications may be seen. Common complications of pregnancy include gestational diabetes, preeclampsia, preterm labor, and pregnancy loss or miscarriage. Miscarriage is defined as a spontaneous pregnancy loss occurring before 20 weeks of gestation. It has been seen in around 10%–15% of clinically recognized pregnancies.

Aim:

This study was designed to evaluate the levels of different serum hormones between cases and controls group.

Materials and Methods:

Pregnant women before 20 weeks of gestation were selected based on inclusion and exclusion criteria, visiting Adesh hospital Bathinda. After recording the history, blood was drawn and serum thyroid-stimulating hormones (TSH), total tri-iodothyronine (TT3), total thyroxine (TT4), prolactin and beta-human chorionic gonadotropin (β-hCG) were analyzed using TSOSH automated immunoassay analyzer.

Results:

Overall data and data of the 1^st trimester suggested significant differences in the mean level of serum TT3, TSH, β-hCG, and prolactin between controls and cases (P ≤ 0.05). However, serum TT4 did not show a significant difference (P > 0.05). In 2^nd-trimester significant difference in the mean level of serum TSH was only observed between controls and cases (P ≤ 0.05). Similarly, after applying Pearson's correlation, an inverse relation was only observed between serum TT3 and TSH of both control and cases (P ≤ 0.05).

Conclusion:

This study emphasized that screening of women during pregnancy for different serum hormones may provide useful lead about the fate of pregnancy and better understanding of different hormones may reduce the rate of miscarriages and other complications related to pregnancy.

Hormones and oxidative stress: an overview

In aerobes, oxygen is essential for maintenance of life. However, incomplete reduction of oxygen leads to generation of reactive oxygen species. These oxidants oxidise biological macromolecules present in their vicinity and thereby impair cellular functions causing oxidative stress (OS). Aerobes have evolved both enzymatic and nonenzymatic antioxidant defences to protect themselves from OS. Although hormones as means of biological coordination involve in regulation of physiological activities of tissues by regulating metabolism, any change in their normal titre leads to pathophysiological states. While, hormones such as melatonin, insulin, oestrogen, progesterone display antioxidant features, thyroid hormone, corticosteroids and catecholamines elicit free radical generation and OS, and the role of testosterone in inducing OS is debateable. This review is an attempt to understand the impact of free radical generation and cross talk between the hormones modulating antioxidant defence system under various pathophysiological conditions.

C677T polymorphism increases the risk of early spontaneous abortion

Purpose

To investigate the relationship of the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism in male population having spouses with early spontaneous abortion.

Methods

A total of 345 males whose spouses had at least one early spontaneous abortion were included in the study group, and 145 males who planned to have a second child were included in the control group. Semen was collected in a sterile cup by masturbation. After liquefaction, the sperm concentration and forward motility sperm rate (PR) were obtained. The genomic DNA was extracted from peripheral vein, followed by MTHFR C677T polymorphism detection through PCR-gold magnetic nanoparticle chromatography.

Results

The numbers of alleles and genotypes of MTHFR in the case group were 303 (C), 387 (T), 64 (CC), 175 (CT), and 106 (TT) cases, respectively. The numbers of allele and genotype of MTHFR in the control group were 167 (C), 123 (T), 145 (CC), 65 (CT), and 29 (TT) cases. There were significant differences in the distribution frequency of genotypes (χ² = 17.005, P = 0.000) and alleles (χ² = 15.295, P = 0.000) between the two groups. For cases with more spontaneous abortion, more cases had CT and TT phenotypes. Participants with genotype CT had the highest sperm concentration and PR in both groups (P < 0.05).

Conclusions

MTHFR could affect sperm DNA integrity through affecting DNA methylation, which led to an increase in the rate of early spontaneous abortion in spouses.

Electronic supplementary material

The online version of this article (10.1007/s10815-019-01500-2) contains supplementary material, which is available to authorized users.

Interdependence of oxidative/antioxidant system indicators and thyroid status under conditions of prolonged exposure to small doses of radiation

We have studied the interdependence of the intensity of oxidative processes/antioxidant level and the thyroid status parameters in a group of students aged 18–24 who lived for a long time in the territory of enhanced radioecological control (density of soil contamination by isotopes (137Cs 3.7 ∙ 104 – 18.5 ∙ 104 Bq/m2). We examined 50 people from relatively environmentally friendly areas (control group) and 50 people from IV radiation zone (experimental group). In the experimental group, there were no individuals with clinical manifestations of thyroid pathology. However, subgroups with signs of hyperthyroidism and hypothyroidism were identified. We evaluated the level of cortisol, thyrotrophic hormone (TSH), triiodothyronine (T3), thyroxine (T4), malonic dialdehyde (MDA), ceruloplasmin (CP), transferrin (Tf), sulfhydryl groups (SH); we calculated the oxidative stress index (OSI). The research was conducted one month before the examination time and also during the exams as a factor in increased emotional stress. A lowered CP level was found in the subgroup with signs of hypothyroidism; SH groups – in all subgroups, separated by thyroid status. The oxidative stress index was higher in all students examined of the experimental group, compared with the control. The growth of MDA level is marked in the experimental group – it is the most strongly pronounced in conditions of additional emotional load in people with signs of hyperthyroidism and hypothyroidism. CP level significantly decreased in the subgroup of hyperthyroidism on the background of T3 decrease. OSI increased in all students examined from the experimental group. In the subgroup of hypothyroidism it became significantly higher than in the subgroup of euthyroidism. A positive correlation between the levels of CP and T3 was found. The highest values of the correlation coefficients were noted for subgroups with signs of hyperthyroidism and hypothyroidism, with the coefficient significance increasing under conditions of emotional stress. The index of oxidative stress in the experimental group positively correlated with the level of TSH – in terms of emotional stress, the statistical significance of the coefficients disappeared. In the subgroups divided by thyroid status, variability of interactions between OSI and T3 was observed but it was not statistically significant. It was found that the participation of thyroid status in supporting redox homeostasis in people aged 18–24 who suffered from chronic small-doze radiation exposure was realized mainly by the influence on the antioxidant system. The ability of thyroid hormones to maintain a proper antioxidant state was suppressed in this group. The unbalanced relationship between thyroid hormones and oxidative stress indicators is strongly manifested under conditions of additional emotional stress.

Oxidative stress biomarkers in amniotic fluid of pregnant women with hypothyroidism

Purpose: Hypothyroidism in pregnancy is the serious state that may lead to fetal morbidity and mortality. Oxidative stress biomarkers in the amniotic fluid can provide important information on the health, development and maturation of the fetus during pregnancy. In this study, we examined whether maternal hypothyroidism contributes to increased oxidative stress biomarkers in the amniotic fluid during the first trimester of pregnancy. Materials and methods: The study was conducted on healthy pregnant women and pregnant women with hypothyroidism (gestational age: 16-18 weeks). Oxidative stress biomarkers, such as superoxide anion (O₂^•-), hydrogen peroxide (H₂O₂), nitric oxide (NO), peroxynitrite (ONOO^-), lipid peroxide (LPO), reduced glutathione (GSH) and oxidized glutathione (GSSG) were assayed in the amniotic fluid. Results: The results of this study indicated that concentrations of O₂^•- and NO are significantly higher, while the concentration of H₂O₂ is significantly lower in the amniotic fluid of pregnant women with hypothyroidism in comparison to healthy pregnant women. There were no differences in concentrations of LPO, GSH and GSSG among tested groups. Also, we found that amniotic fluid concentration of O₂^•- is negatively correlated with the body weight and Apgar score values of the newborns. Conclusion: These results suggest that pregnancy hypothyroidism is characterized by the amniotic fluid oxidative stress. Incorporation of the oxidative stress biomarkers measurement in the amniotic fluid may be of clinical importance in the management of pregnancy hypothyroidism.