1
|
Abascal-Saiz A, Fuente-Luelmo E, Haro M, Fioravantti V, Antolín E, Ramos-Álvarez MP, Bartha JL. Decreased Fatty Acid Oxidation Gene Expression in Pre-Eclampsia According to the Onset and Presence of Intrauterine Growth Restriction. Nutrients 2023; 15:3877. [PMID: 37764661 PMCID: PMC10536348 DOI: 10.3390/nu15183877] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/03/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Mitochondrial fatty acid oxidation (FAO) is lower in placentas with pre-eclampsia. The aim of our study was to compare the placental mRNA expression of FAO enzymes in healthy pregnancies vs. different subgroups of pre-eclampsia according to the severity, time of onset, and the presence of intrauterine growth restriction (IUGR). By using real-time qPCR, we measured the mRNA levels of long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD), medium-chain acyl-CoA dehydrogenase (MCAD), and carnitine palmitoyltransferases 1A and 2 (CPT1A, CPT2) on the maternal side (anchoring villi in the basal decidua) and on the fetal side (chorionic plate) of the placenta (n = 56). When compared to the controls, LCHAD, MCAD, and CPT2 mRNA had decreased in all pre-eclampsia subgroups globally and on the fetal side. On the maternal side, LCHAD mRNA was also lower in all pre-eclampsia subgroups; however, MCAD and CPT2 mRNA were only reduced in severe and early-onset disease, as well as CPT2 in IUGR (p < 0.05). There were no differences in CPT1A mRNA expression. We conclude that the FAO enzymes mRNA in the placenta was lower in pre-eclampsia, with higher reductions observed in severe, early-onset, and IUGR cases and more striking reductions on the fetal side.
Collapse
Affiliation(s)
- Alejandra Abascal-Saiz
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Institute for Health Research—IdiPAZ (La Paz University Hospital—Universidad Autónoma de Madrid), Paseo de la Castellana 261, 28046 Madrid, Spain; (A.A.-S.); (E.A.)
| | - Eva Fuente-Luelmo
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, CEU-San Pablo University, 28668 Boadilla del Monte, Madrid, Spain; (E.F.-L.); (M.H.); (M.P.R.-Á.)
| | - María Haro
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, CEU-San Pablo University, 28668 Boadilla del Monte, Madrid, Spain; (E.F.-L.); (M.H.); (M.P.R.-Á.)
| | | | - Eugenia Antolín
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Institute for Health Research—IdiPAZ (La Paz University Hospital—Universidad Autónoma de Madrid), Paseo de la Castellana 261, 28046 Madrid, Spain; (A.A.-S.); (E.A.)
| | - María P. Ramos-Álvarez
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, CEU-San Pablo University, 28668 Boadilla del Monte, Madrid, Spain; (E.F.-L.); (M.H.); (M.P.R.-Á.)
| | - José L. Bartha
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Institute for Health Research—IdiPAZ (La Paz University Hospital—Universidad Autónoma de Madrid), Paseo de la Castellana 261, 28046 Madrid, Spain; (A.A.-S.); (E.A.)
| |
Collapse
|
2
|
Abascal-Saiz A, Duque-Alcorta M, Fioravantti V, Antolín E, Fuente-Luelmo E, Haro M, Ramos-Álvarez MP, Perdomo G, Bartha JL. The Relationship between Angiogenic Factors and Energy Metabolism in Preeclampsia. Nutrients 2022; 14:2172. [PMID: 35631313 PMCID: PMC9145768 DOI: 10.3390/nu14102172] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/15/2022] [Accepted: 05/19/2022] [Indexed: 11/18/2022] Open
Abstract
Antiangiogenic factors are currently used for the prediction of preeclampsia. The present study aimed to evaluate the relationship between antiangiogenic factors and lipid and carbohydrate metabolism in maternal plasma and placenta. We analyzed 56 pregnant women, 30 healthy and 26 with preeclampsia (including early and late onset). We compared antiangiogenic factors soluble Fms-like Tyrosine Kinase-1 (sfLt-1), placental growth factor (PlGF), and soluble endoglin (sEng)), lipid and carbohydrate metabolism in maternal plasma, and lipid metabolism in the placenta from assays of fatty acid oxidation, fatty acid esterification, and triglyceride levels in all groups. Antiangiogenic factors sFlt-1, sFlt-1/PlGF ratio, and sEng showed a positive correlation with triglyceride, free fatty acid, and C-peptide maternal serum levels. However, there was no relationship between angiogenic factors and placental lipid metabolism parameters. Free fatty acids were predictive of elevated sFlt-1 and sEng, while C-peptide was predictive of an elevated sFlt1/PlGF ratio. The findings in this study generate a model to predict elevated antiangiogenic factor values and the relationship between them with different products of lipid and carbohydrate metabolism in maternal serum and placenta in preeclampsia.
Collapse
Affiliation(s)
- Alejandra Abascal-Saiz
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, La Paz University Hospital, Paseo de la Castellana 261, 28046 Madrid, Spain; (A.A.-S.); (E.A.)
| | - Marta Duque-Alcorta
- Department of Clinical Chemistry, La Paz University Hospital, 28046 Madrid, Spain;
| | - Victoria Fioravantti
- Department of Pediatric Hematology and Oncology, Hospital Infantil Universitario Niño Jesus, 28009 Madrid, Spain;
| | - Eugenia Antolín
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, La Paz University Hospital, Paseo de la Castellana 261, 28046 Madrid, Spain; (A.A.-S.); (E.A.)
| | - Eva Fuente-Luelmo
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, CEU-San Pablo University, 28668 Madrid, Spain; (E.F.-L.); (M.H.); (M.P.R.-Á.)
| | - María Haro
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, CEU-San Pablo University, 28668 Madrid, Spain; (E.F.-L.); (M.H.); (M.P.R.-Á.)
| | - María P. Ramos-Álvarez
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, CEU-San Pablo University, 28668 Madrid, Spain; (E.F.-L.); (M.H.); (M.P.R.-Á.)
| | - Germán Perdomo
- Unidad de Excelencia Instituto de Biología y Genética Molecular, University of Valladolid-CSIC, 47003 Valladolid, Spain;
| | - José L. Bartha
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, La Paz University Hospital, Paseo de la Castellana 261, 28046 Madrid, Spain; (A.A.-S.); (E.A.)
| |
Collapse
|
3
|
Sainz Bueno JA, Cerrillos González L, Abascal-Saiz A, Rodríguez Gallego MV, López Pérez R, Fernández Alonso AM, de la Cruz Conty ML, Alonso Saiz R, Molina Oller M, Santamaría Ortiz A, Martínez-Pérez Ó. Association of ABO and Rh blood groups with obstetric outcomes in SARS-CoV-2 infected pregnancies: A prospective study with a multivariate analysis. Eur J Obstet Gynecol Reprod Biol 2021; 264:41-48. [PMID: 34271364 PMCID: PMC8260552 DOI: 10.1016/j.ejogrb.2021.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/04/2021] [Indexed: 01/15/2023]
Abstract
Objective To evaluate the influence of ABO and Rh blood groups on morbidity among SARS-CoV-2 infected pregnancies. Design Prospective observational study. Setting 78 centers of the Spanish Obstetric Emergency Group. Population Pregnant women with SARS-CoV-2 tested with polymerase-chain-reaction between 26-February and 5-November 2020. A cohort of 1278 SARS-CoV-2(+) pregnant women was analyzed and a concurrent comparison group of 1453 SARS-COV-2(−) patients was established. Methods Data were collected from medical charts. SARS-COV-2(+) was compared with SARS-COV-2(−) for differences in distribution of blood groups. We performed multivariate analysis, controlling for maternal age and ethnicity, to evaluate association of ABO and Rh blood groups with maternal and perinatal outcomes in SARS-CoV-2(+) patients with adjusted odds ratios (aOR) and 95% confidence intervals (CI). Main outcomes measures Medical morbidity: Symptomatic COVID-19 and medical complications. Obstetric outcomes: caesarean delivery, preterm deliveries, preterm premature rupture of membranes (PPROM), hemorrhagic events, pre-eclampsia, maternal and neonatal mortality, stillbirth. Results Differences were noted between blood types and Rh for age and ethnicity comparing SARS-CoV-2(+) and SARS-CoV-2(−) groups (p < 0.05). Among the SARS-CoV-2(+) cohort, the odds of symptomatic COVID-19 and obstetric hemorrhagic event were higher in Rh+ vs Rh− mothers (aOR 1.48, 95% CI 1.02–2.14, p = 0.037, and aOR 8.72, 95% CI 1.20–63.57, p = 0.033, respectively), and PPROM were higher among blood type A vs non-A mothers (aOR 2.06, 95% CI 1.01–4.18, p = 0.046). Conclusions In SARS-CoV-2(+) pregnant women, Rh− status was associated with a lower risk of symptomatic COVID-19, while Rh+ and blood group A were associated with obstetric hemorrhage and PPROM, respectively.
Collapse
Affiliation(s)
- José Antonio Sainz Bueno
- Gynaecology and Obstetrics Department, G. Chacon (Viamed Santa Angela de la Cruz Hospital), Sevilla, Andalucía, Spain; Valme University Hospital and University of Seville, Spain.
| | | | | | | | - Rocío López Pérez
- Gynaecology and Obstetrics Department, Santa Lucía Hospital, Cartagena, Murcia, Spain
| | | | - Maria Luisa de la Cruz Conty
- Fundación de Investigación Biomédica, Puerta de Hierro University Hospital of Majadahonda. Majadahonda, Madrid, Spain
| | - Rubén Alonso Saiz
- Gynaecolgy and Obstetrics Department, Burgos Hospital, Burgos, Castilla y León, Spain
| | | | | | - Óscar Martínez-Pérez
- Obstetrics and Gynaecology Department, Puerta de Hierro University Hospital of Majadahonda. Majadahonda, Madrid, Spain; Autónoma University of Madrid, Spain.
| | | |
Collapse
|
4
|
Engels Calvo V, Cruz Melguizo S, Abascal-Saiz A, Forcén Acebal L, Sánchez-Migallón A, Pintado Recarte P, Cuenca Marín C, Marcos Puig B, Del Barrio Fernández PG, Nieto Velasco O, de la Cruz Conty ML, Martínez-Perez O. Perinatal outcomes of pregnancies resulting from assisted reproduction technology in SARS-CoV-2-infected women: a prospective observational study. Fertil Steril 2021; 116:731-740. [PMID: 33972083 PMCID: PMC8041182 DOI: 10.1016/j.fertnstert.2021.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/26/2022]
Abstract
Objective To evaluate the perinatal and maternal outcomes of pregnancies in women infected with SARS-CoV-2, comparing spontaneous and in vitro fertilization (IVF) pregnancies (with either own or donor oocytes). Design Multicenter, prospective, observational study. Setting 78 centers participating in the Spanish COVID19 Registry. Patient(s) 1,347 pregnant women with SARS-CoV-2 positive results registered consecutively between February 26 and November 5, 2020. Intervention(s) The patients’ information was collected from their medical records, and multivariable regression analyses were performed, controlling for maternal age and the clinical presentation of the infection. Main Outcome Measure(s) Obstetrics and neonatal outcomes, pregnancy comorbidities, intensive care unit admission, mechanical ventilation need, and medical conditions. Result(s) The IVF group included 74 (5.5%) women whereas the spontaneous pregnancy group included 1,275 (94.5%) women. The operative delivery rate was high in all patients, especially in the IVF group, where cesarean section became the most frequent method of delivery (55.4%, compared with 26.1% of the spontaneous pregnancy group). The reason for cesarean section was induction failure in 56.1% of the IVF patients. IVF women had more gestational hypertensive disorders (16.2% vs. 4.5% among spontaneous pregnancy women, adjusted odds ratio [aOR] 5.31, 95% confidence interval [CI] 2.45–10.93) irrespective of oocyte origin. The higher rate of intensive care unit admittance observed in the IVF group (8.1% vs. 2.4% in the spontaneous pregnancy group) was attributed to preeclampsia (aOR 11.82, 95% CI 5.25–25.87), not to the type of conception. Conclusion(s) A high rate of operative delivery was observed in pregnant women infected with SARS-CoV-2, especially in those with IVF pregnancies; method of conception did not affect fetal or maternal outcomes, except for preeclampsia. Clinical Trial Registration Number NCT04558996.
Collapse
Affiliation(s)
- Virginia Engels Calvo
- Fertility Unit, Department of Gynecology and Obstetrics, Puerta de Hierro University Hospital of Majadahonda, Madrid, Spain
| | - Sara Cruz Melguizo
- Maternal-Fetal Medicine Unit, Department Obstetrics and Gynecology, Hospital Universitario Puerta de Hierro.Majadahonda, Madrid, Spain
| | | | - Laura Forcén Acebal
- Department of Gynecology and Obstetrics, University Hospital 12 de Octubre, Madrid, Spain
| | - Amalia Sánchez-Migallón
- Maternal-fetal Medicine Unit, Department of Gynecology and Obstetrics, QuirónSalud Dexeus University Hospital, Barcelona, Spain
| | - Pilar Pintado Recarte
- Department of Gynecology and Obstetrics, Gregorio Marañon University Hospital, Madrid, Spain
| | - Celia Cuenca Marín
- Maternal-fetal Medicine Unit, Department of Gynecology and Obstetrics, Regional Hospital of Málaga, Málaga, Spain
| | - Beatriz Marcos Puig
- Maternal-fetal Medicine Unit, Department of Gynecology and Obstetrics, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Pablo G Del Barrio Fernández
- Maternal-fetal Medicine Unit, Department of Gynecology and Obstetrics, University Hospital of Getafe, Madrid, Spain
| | - Olga Nieto Velasco
- Maternal-fetal Medicine Unit, Department of Gynecology and Obstetrics, QuirónSalud Madrid University Hospital, Madrid, Spain
| | | | - Oscar Martínez-Perez
- Maternal-Fetal Medicine Unit, Department Obstetrics and Gynecology, Hospital Universitario Puerta de Hierro.Majadahonda, Madrid, Spain.
| | | |
Collapse
|
5
|
Abascal-Saiz A, Fuente-Luelmo E, Haro M, de la Calle M, Ramos-Álvarez MP, Perdomo G, Bartha JL. Placental Compartmentalization of Lipid Metabolism: Implications for Singleton and Twin Pregnancies. Reprod Sci 2020; 28:1150-1160. [PMID: 33171514 DOI: 10.1007/s43032-020-00385-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/01/2020] [Indexed: 11/27/2022]
Abstract
The study of placental lipid metabolism in uncomplicated pregnancies has not been developed in the literature to date. Its importance lies in expanding the knowledge of placental function to enable comparison with pathological pregnancies in future research. The aim of the present study was to compare the lipid metabolic activity and storage of the maternal and fetal sides of the placenta in healthy pregnancies. Moreover, we compare singleton vs. twin pregnancies to determine if placental metabolic needs differ. We analyzed placental explants from uncomplicated pregnancies, 20 from singleton and 8 from bichorial-biamniotic twin pregnancies (n = 28). Six cotyledon fragments were collected from each placenta at different distances from the umbilical cord, three close to the chorionic plate (hereinafter, we will refer to them as "fetal side") and another three close to the anchoring villi into the decidua basalis (referred to as "maternal side"). The samples were analyzed for quantitative assay placental fatty acid oxidation (FAO) and esterification (FAE) activities and triglyceride levels. The location of lipid storage in the chorionic villi was assessed by Oil red-O staining. Placental fatty acid oxidation did not show differences when comparing the maternal and fetal sides of the placenta or between single and twin pregnancies. When comparing placental sides, FAE was increased twofold in the maternal side compared to the fetal side of the placenta (P = 0.013). The tendency for lipogenesis in the placenta was exemplified by the FAE/FAO ratio, which was a 37.1% higher on the maternal side (P = 0.019). Despite this, triglyceride levels were five times higher in the fetal side than in the maternal one (P = 0.024). When analyzing singleton vs. twins, FAE was superior in the fetal side in multiple pregnancies (× 2.6, P = 0.007) and the FAE/FAO ratio was significantly higher in twins than in singleton pregnancies, on both sides of the placenta. Despite this finding, triglyceride levels were similar in twin and singleton pregnancies. Comparing the placentas of twins in the same pregnancy, there were no differences in lipid metabolism (FAO or FAE) or placental triglyceride levels between the two co-twins. Using Oil red-O staining, lipid storage in chorionic villi was found to be located on the syncytiotrophoblast cells and not in the connecting axis. The maternal side of the placenta is more active in the esterification of fatty acids, while the storage of neutral lipids concentrates on the fetal side. Moreover, multiple gestations have increased esterification without changes in the concentration of placental triglycerides, probably due to a higher transfer to the fetal circulation in response to the greater energy demand from twin fetuses.
Collapse
Affiliation(s)
- Alejandra Abascal-Saiz
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Eva Fuente-Luelmo
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, CEU-San Pablo University, Madrid, Spain
| | - María Haro
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, CEU-San Pablo University, Madrid, Spain
| | - María de la Calle
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - María P Ramos-Álvarez
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, CEU-San Pablo University, Madrid, Spain
| | - Germán Perdomo
- Department of Health Sciences, University of Burgos, Burgos, Spain.,Institute of Molecular Biology and Genetic (IMBG), CSIC - University of Valladolid, Valladolid, Spain
| | - José L Bartha
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain.
| |
Collapse
|
6
|
Abascal-Saiz A, De la Calle M, Herrero B, Rodríguez R, Antolín E, Bertha JL. [Giant sacrococcygeal teratoma in twin pregnancy]. Ginecol Obstet Mex 2014; 82:843-850. [PMID: 25826969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
UNLABELLED Sacrococcygeal teratoma tumors are more frequent in infants alive. It is characterized by its benign histology in the majority of the cases diagnosed prenatally; it is necessary to follow narrow to prevent neonatal complications that can lead to urinary tract complications and fecal, high-output heart failure, hydrops and, in extreme cases, the death of the fetus. CASE REPORT Primigravidae 30 years old, with gestation twins, bicorial, biamniotic in the first trimester of pregnancy to one of the twins is diagnosed sacrococcygeus teratoma giant, with favorable monitoring in the maternal-fetal Medicine Unit of the University Hospital of La Paz in Madrid, and with postnatal resection surgery successful. We review the diagnostic procedures and treatment of this tumor in unique and twin gestations.
Collapse
|
7
|
Abascal-Saiz A, Sotillo-Mallo L, de Santiago J, Zapardiel I. Management of borderline ovarian tumours: a comprehensive review of the literature. Ecancermedicalscience 2014; 8:403. [PMID: 24605135 PMCID: PMC3931534 DOI: 10.3332/ecancer.2014.403] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Indexed: 12/13/2022] Open
Abstract
Borderline ovarian tumours differ from epithelial ovarian cancer by their low incidence, frequent association with infertility, low association with mutations in BCRA genes, different percentages of the most common histological types, early stage diagnosis, and high survival rate, even when associated with peritoneal involvement. They occur in younger women, which is why one of the objectives in these patients will be the preservation of fertility. The management of these tumours has been widely discussed and still continues to be controversial. The latest findings underscore the importance of full staging in both radical and conservative surgery, to choose the most comprehensive treatment and obtain an accurate prognosis. One of the objectives of this article shall be the in-depth review of the indications, benefits, and disadvantages of each type of surgery, as well as the usefulness of the medical treatment. In addition, the article aims to review follow-up guidelines and to clarify the main prognostic factors that affect recurrence and survival of these patients.
Collapse
Affiliation(s)
| | | | | | - Ignacio Zapardiel
- Gynaecological Oncology Unit, La Paz University Hospital, Madrid, Spain
| |
Collapse
|