Insulin resistance and serum levels of interleukin-17 and interleukin-18 in normal pregnancy

Genital Dysbiosis and Different Systemic Immune Responses Based on the Trimester of Pregnancy in SARS-CoV-2 Infection

Respiratory infections are common in pregnancy with conflicting evidence supporting their association with neonatal congenital anomalies, especially during the first trimester. We profiled cytokine and chemokine systemic responses in 242 pregnant women and their newborns after SARS-CoV-2 infection, acquired in different trimesters. Also, we tested transplacental IgG passage and maternal vaginal-rectal microbiomes. IgG transplacental passage was evident, especially with infection acquired in the first trimester. G-CSF concentration-involved in immune cell recruitment-decreased in infected women compared to uninfected ones: a beneficial event for the reduction of inflammation but detrimental to ability to fight infections at birth. The later the infection was acquired, the higher the systemic concentration of IL-8, IP-10, and MCP-1, associated with COVID-19 disease severity. All infected women showed dysbiosis of vaginal and rectal microbiomes, compared to uninfected ones. Two newborns tested positive for SARS-CoV-2 within the first 48 h of life. Notably, their mothers had acute infection at delivery. Although respiratory infections in pregnancy are reported to affect babies' health, with SARS-CoV-2 acquired early during gestation this risk seems low because of the maternal immune response. The observed vaginal and rectal dysbiosis could be relevant for neonatal microbiome establishment, although in our series immediate neonatal outcomes were reassuring.

Global knowledge, attitude, and practice towards COVID-19 among pregnant women: a systematic review and meta-analysis

BACKGROUND

Pregnant women form a specially vulnerable group due to unique changes in pregnancy, leading to a higher risk of getting a severe infection. As severe COVID-19 increases the risk of preeclampsia, preterm delivery, gestational diabetes, and low birth weight in pregnancy, there is a need to enhance pregnant women's knowledge, attitudes, and practices to prevent these complications. This systematic review and meta-analysis aimed to determine their levels of knowledge, attitudes, and practice (KAP) regarding COVID-19 at the global level.

METHODS

The systematic literature search was conducted in the English language, including Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, EMBASE, Springer, and ProQuest, from the occurrence of the pandemic until September 2022. We used The Newcastle Ottawa scale for cross-sectional studies checklist to evaluate the risk of bias in the studies. Data were extracted by a Microsoft Excel spreadsheet and analyzed by STATA software version 14. We also employed Cochran Q statistics to assess the heterogeneity of studies and utilized Inverse variance random-effects models to estimate the pooled level of pregnant women's KAP towards COVID-19 infection prevention.

RESULTS

Based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) and inclusion criteria, 53 qualified studies were acquired from several countries. In total, 51 articles (17,319 participants) for knowledge, 15 articles (6,509 participants) for attitudes, and 24 articles (11,032 participants) for practice were included in this meta-analysis. The pooled good knowledge, positive attitude, and appropriate practice in pregnant women were estimated at 59%(95%CI: 52-66%), 57%(95%CI: 42-72%), and 53%(95%CI: 41-65%), respectively. According to subgroup analysis, the level of knowledge, attitude, and practice were 61%(95%CI: 49-72), 52%(95%CI: 30-74), and 50%(95%CI: 39-60), respectively, in Africa, and 58.8%(95%CI: 49.2-68.4), 60%(95%CI: 41-80) and 60% (95%CI: 41-78), respectively, in Asia.

CONCLUSION

The Knowledge, attitude, and practice towards COVID-19 infection prevention in pregnant women were low. It is suggested that health education programs and empowerment of communities, especially pregnant women, about COVID-19 continue with better planning. For future studies, we propose to investigate the KAP of COVID-19 in pregnant women in countries of other continents and geographical regions.

Is the Novel Slot Blot a Useful Method for Quantification of Intracellular Advanced Glycation End-Products?

Various types of advanced glycation end-products (AGEs) have been identified and studied. I have reported a novel slot blot analysis to quantify two types of AGEs, glyceraldehyde-derived AGEs, also called toxic AGEs (TAGE), and 1,5-anhydro-D-fructose AGEs. The traditional slot blot method has been used for the detection and quantification of RNA, DNA, and proteins since around 1980 and is one of the more commonly used analog technologies to date. However, the novel slot blot analysis has been used to quantify AGEs from 2017 to 2022. Its characteristics include (i) use of a lysis buffer containing tris-(hydroxymethyl)-aminomethane, urea, thiourea, and 3-[3-(cholamidopropyl)-dimetyl-ammonio]-1-propane sulfonate (a lysis buffer with a composition similar to that used in two-dimensional gel electrophoresis-based proteomics analysis); (ii) probing of AGE-modified bovine serum albumin (e.g., standard AGE aliquots); and (iii) use of polyvinylidene difluoride membranes. In this review, the previously used quantification methods of slot blot, western blot, immunostaining, enzyme-linked immunosorbent assay, gas chromatography-mass spectrometry (MS), matrix-associated laser desorption/ionization-MS, and liquid chromatography-electrospray ionization-MS are described. Lastly, the advantages and disadvantages of the novel slot blot compared to the above methods are discussed.

The prevalence and independent influencing factors of obesity and underweight in patients with schizophrenia: a multicentre cross-sectional study

BACKGROUND

Few studies have investigated the weight of patients with schizophrenia in China.

OBJECTIVE

The aim of this study was to analyse the prevalence, clinical characteristics and influencing factors of obesity and underweight in patients with chronic schizophrenia in China.

METHODS

A total of 325 patients with schizophrenia and 172 sex- and age-matched healthy controls from the community were recruited. Socio-demographic data and laboratory measurements were collected for all subjects. Using the Positive and Negative Syndrome Scale (PANSS), we evaluated the psychiatric symptoms of patients with schizophrenia. According to the body mass index (BMI) criteria in China, BMI ≥ 28 kg/m² indicates obesity, and BMI < 18.5 kg/m² indicates underweight.

RESULTS

Of the patients with schizophrenia, 16.3% were obese, and 6.8% were underweight; 11.0% of the healthy controls were obese, and 3.5% were underweight. There was no difference between the two groups in the prevalence of obesity and underweight. After controlling for relevant variables, the obesity rate remained non significant, but the underweight rate appeared to be different. The multinomial regression analysis revealed that among the patients with schizophrenia, female sex, triglyceride level and LDL level were independent risk factors for obesity and that HDL level was an independent protective factor against obesity. In contrast, male sex and HDL level were independent risk factors for underweight.

CONCLUSION

We found that the patients with schizophrenia had an increased rate of underweight and some factors related to weight.

LEVEL OF EVIDENCE

Level V, descriptive study.

Similarity and difference between palmoplantar pustulosis and pustular psoriasis

Palmoplantar pustulosis is a chronic inflammatory disorder characterized by sterile pustules predominantly involving the palms and soles. Palmoplantar pustulosis has many similar aspects to psoriasis, either plaque and pustular type, namely familial occurrence between palmoplantar pustulosis and psoriasis, the appearance of the Köbner phenomenon, joint involvement, and nail involvement. Pustular psoriasis is classified into generalized and localized types, and there are a number of papers regarding palmoplantar pustulosis as an acral variant of localized pustular psoriasis. Many Japanese dermatologists consider palmoplantar pustulosis to be a distinct entity from pustular psoriasis, and the coexistence of palmoplantar pustulosis and psoriasis is rare. However, outside Japan, palmoplantar pustulosis is often considered to be palmoplantar psoriasis or palmoplantar pustular psoriasis, and extra-palmoplantar lesions are also considered to be psoriasis. The purpose of the current review is to compare the similarities and differences between palmoplantar pustulosis and generalized/localized pustular psoriasis. Japanese patients with palmoplantar pustulosis have a close relationship with focal infection, and the associated bone-joint manifestation exclusively involves the anterior chest wall. Furthermore, pediatric occurrence of palmoplantar pustulosis is extremely rare, and difference of genetic background between palmoplantar pustulosis and psoriasis has also been reported. Treatment of focal infection often results in dramatic effects on both cutaneous lesions and joint pain of palmoplantar pustulosis. Those findings suggest that palmoplantar pustulosis should be separately considered from either palmoplantar psoriasis or palmoplantar pustular psoriasis. The clinicopathological features and therapeutic approach of both diseases are discussed.

The Presence of Serum TgAb Suggests Lower Risks for Glucose and Lipid Metabolic Disorders in Euthyroid General Population From a National Survey

Purpose: The expressions of antibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) are very common in the sera of patients with autoimmune thyroid diseases (AITD). The relationship between thyroid autoantibodies and the occurrence of glucose and lipid metabolic disorders remains unclear. This study was performed to investigate the correlation between the presence of serum TPOAb/TgAb and those metabolic disorders in euthyroid general population. Methods: The data of this study were derived from the Thyroid Disease, Iodine status, and Diabetes National epidemiological (TIDE) survey from all 31 provinces of mainland China. A total of 17,964 euthyroid subjects including 5,802 males (4,000 with TPOAb^-TgAb^- and 1,802 with TPOAb⁺/TgAb⁺) and 12,162 females (8,000 with TPOAb^-TgAb^- and 4,162 with TPOAb⁺/TgAb⁺) were enrolled in this study. The blood glucose and lipid levels were compared between individuals with TPOAb^-TgAb^- and those with TPOAb⁺TgAb^-, TPOAb^-TgAb⁺, TPOAb⁺TgAb⁺. Results: Both fasting blood glucose (FBG) concentration and the proportion of individuals with impaired FBG (IFG) showed the decreased trends in TPOAb^-TgAb⁺ males as compared with TPOAb^-TgAb^- men. There were significantly lower FBG and higher HDL-C levels as well as tendencies toward decreased incidences of IGT and hypertriglyceridemia in TPOAb^-TgAb⁺ females when compared with TPOAb^-TgAb^- women. Binary logistic regression analysis further showed that serum TgAb single positivity in males was an independent protective factor for IFG with an OR of 0.691 (95% CI, 0.503-0.949). For females, serum TgAb single positivity was an independent protective factor for hypertriglyceridemia with an OR of 0.859 (95% CI, 0.748-0.987). Trend test showed that with the increase of serum TgAb level, there were significant decreases in the prevalence of IFG among the men with TSH ≤ 2.5 mIU/L and that of hypertriglyceridemia in the women, especially among non-obese females. Conclusion: Serum TgAb single positivity may imply a reduced risk of IFG in euthyroid men and that of hypertriglyceridemia in euthyroid women. The mechanisms for the independent protective roles of TgAb await further investigation.

Effects of Fish Oil Supplementation on Gestational Diabetes Mellitus (GDM): A Systematic Review

Context

One of the most common complications of pregnancy is gestational diabetes mellitus (GDM), which is increasing worldwide. Experimental and epidemiological studies have shown that higher intake of n-3 long-chain polyunsaturated fatty acids may decrease the risk of various diseases such as diabetes. The objective of this study was to assess the effect of fish oil supplementation on the prevention and treatment of GDM.

Evidence Acquisition

This systematic review was performed by searching several databases, including PubMed, Scopus, Google Scholar, the Cochrane Library, ProQuest, Science Direct SID, Magiran and IranMedex since 1983. The researchers also searched for references in reviewed clinical trial articles in which fish oil supplementation was compared with placebo or no supplementation.

Results

Only two published and in-press articles are included in this review. Based on these studies, docosahexaenoic acid (DHA)-enriched fish oil (800 mg/d) had no effect on prevention of GDM [0.97 (95% CI: 0.74, 1.27)]. Furthermore, omega-3 fatty acid supplementation containing 180 mg of eicosapentaenoic acid (EPA) and 120 mg DHA had beneficial effects on insulin resistance in women with GDM (change from baseline: 1.5 ± 7.5 vs ‏3.5 ± 8.5 mIU/mL, P = 0.02) but did not influence fasting plasma glucose, homeostatic model assessment-Beta cell function (HOMA-B), the quantitative insulin sensitivity check index (QUICKI), or lipid profiles (P > 0.05).

Conclusions

There is not enough evidence to support or refute the routine use of fish oil supplements during pregnancy for the prevention or treatment of diabetes. It is suggested that further randomized controlled trials be conducted to evaluate the role of fish oil supplementation in pregnancy.

Association of Tumor Growth Factor-β and Interferon-γ Serum Levels With Insulin Resistance in Normal Pregnancy

Pregnancy is related to change in glucose metabolism and insulin production. The aim of our study was to determine the association of serum IFN-γ and TGF-β levels with insulin resistance during normal pregnancy. This cross sectional study was carried out on 97 healthy pregnant (in different trimesters) and 28 healthy non-pregnant women. Serum TGF-β and IFN-γ level were measured by ELISA method. Pregnant women had high level TGF-β and low level IFN-γ as compared non-pregnant women. Maternal serum TGF-β concentration significantly increased in third trimester as compared first and second trimester of pregnancy. Maternal serum IFN-γ concentration significantly decreased in third trimester as compared first and second trimester of pregnancy. Pregnant women exhibited higher score of HOMA IR as compared non-pregnant women. There were association between gestational age with body mass index (r=0.28, P=0.005), TGF-β (r=0.45, P<0.001) and IFN-γ (r=-0.50, P<0.001). There was significant association between Insulin resistance and TGF-β (r=0.17, p=0.05). Our findings suggest that changes in maternal cytokine level in healthy pregnant women were anti-inflammatory. Furthermore, Tumor Growth Factor-β appears has a role in induction insulin resistance in healthy pregnant women. However, further studies needed to evaluate role of different cytokines on insulin resistance in normal pregnancy.