1
|
Gudmundsdóttir HK, Hilde K, Bains KES, Färdig M, Haugen G, LeBlanc M, Nordhagen LS, Nordlund B, Rehbinder EM, Skjerven HO, Staff AC, Vettukattil R, Carlsen KCL. Fetal thoracic circumference in mid-pregnancy and infant lung function. Pediatr Pulmonol 2023; 58:35-45. [PMID: 36097818 PMCID: PMC10091718 DOI: 10.1002/ppul.26153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/22/2022] [Accepted: 09/05/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIM Impaired lung function in early infancy is associated with later wheeze and asthma, while fetal thoracic circumference (TC) predicts severity of neonatal lung hypoplasia. Exploring fetal origins of lung function in infancy, we aimed to determine if fetal TC in mid-pregnancy was associated with infant lung function. METHODS From the prospective Scandinavian general population-based PreventADALL mother-child birth cohort, all 851 3-month-old infants with tidal flow-volume measurements in the awake state and ultrasound fetal size measures at 18 (min-max 16-22) weeks gestational age were included. Associations between fetal TC and time to peak tidal expiratory flow to expiratory time (tPTEF /tE ) were analyzed in linear regression models. To account for gestational age variation, we adjusted TC for simultaneously measured general fetal size, by head circumference (TC/HC), abdominal circumference (TC/AC), and femur length (TC/FL). Multivariable models were adjusted for maternal age, maternal asthma, pre-pregnancy body mass index, parity, nicotine exposure in utero, and infant sex. RESULTS The infants (47.8% girls) were born at mean (SD) gestational age of 40.2 (1.30) weeks. The mean (SD) tPTEF /tE was 0.39 (0.08). The mean (SD) TC/HC was 0.75 (0.04), TC/AC 0.87 (0.04), and TC/FL 4.17 (0.26), respectively. Neither TC/HC nor TC/AC were associated with infant tPTEF /tE while a week inverse association was observed between TC/FL and tPTEF /tE ( β ^ $\hat{\beta }$ = -0.03, 95% confidence interval [-0.05, -0.007], p = 0.01). CONCLUSION Mid-pregnancy fetal TC adjusted for fetal head or abdominal size was not associated with tPTEF /tE in healthy, awake 3-month-old infants, while a weak association was observed adjusting for fetal femur length.
Collapse
Affiliation(s)
- Hrefna K Gudmundsdóttir
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Katarina Hilde
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Karen E S Bains
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Martin Färdig
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Guttorm Haugen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Marissa LeBlanc
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Live S Nordhagen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Health, VID Specialized University, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Eva M Rehbinder
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology and Venereology, Oslo University Hospital, Oslo, Norway
| | - Håvard O Skjerven
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne C Staff
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karin C L Carlsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
2
|
Fosheim IK, Jacobsen DP, Sugulle M, Alnaes-Katjavivi P, Fjeldstad HES, Ueland T, Lekva T, Staff AC. Serum amyloid A1 and pregnancy zone protein in pregnancy complications and correlation with markers of placental dysfunction. Am J Obstet Gynecol MFM 2023; 5:100794. [PMID: 36334725 DOI: 10.1016/j.ajogmf.2022.100794] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/06/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Hypertensive disorders of pregnancy (preeclampsia, gestational hypertension, and chronic hypertension), diabetes mellitus, and placental dysfunction confer an increased risk of long-term maternal cardiovascular disease. Preeclampsia is also associated with acute atherosis that involves lesions of uteroplacental spiral arteries, resembling early stages of atherosclerosis. Serum amyloid A1 is involved in hypercoagulability and atherosclerosis and may aggregate into amyloid-aggregations of misfolded proteins. Pregnancy zone protein may inhibit amyloid aggregation. Amyloid is involved in Alzheimer's disease and cardiovascular disease; it has been identified in preeclampsia, but its role in preeclampsia pathophysiology is unclear. OBJECTIVE We hypothesized that serum amyloid A1 would be increased and pregnancy zone protein decreased in hypertensive disorders of pregnancy and diabetic pregnancies and that serum amyloid A1 and pregnancy zone protein would correlate with placental dysfunction markers (fetal growth restriction and dysregulated angiogenic biomarkers) and acute atherosis. STUDY DESIGN Serum amyloid A1 is measurable in both the serum and plasma. In our study, plasma from 549 pregnancies (normotensive, euglycemic controls: 258; early-onset preeclampsia: 71; late-onset preeclampsia: 98; gestational hypertension: 30; chronic hypertension: 9; diabetes mellitus: 83) was assayed for serum amyloid A1 and pregnancy zone protein. The serum levels of angiogenic biomarkers soluble fms-like tyrosine kinase-1 and placental growth factor were available for 547 pregnancies, and the results of acute atherosis evaluation were available for 313 pregnancies. The clinical characteristics and circulating biomarkers were compared between the pregnancy groups using the Mann-Whitney U, chi-squared, or Fisher exact test as appropriate. Spearman's rho was calculated for assessing correlations. RESULTS In early-onset preeclampsia, serum amyloid A1 was increased compared with controls (17.1 vs 5.1 µg/mL, P<.001), whereas pregnancy zone protein was decreased (590 vs 892 µg/mL, P=.002). Pregnancy zone protein was also decreased in diabetes compared with controls (683 vs 892 µg/mL, P=.01). Serum amyloid A1 was associated with placental dysfunction (fetal growth restriction, elevated soluble fms-like tyrosine kinase-1 to placental growth factor ratio). Pregnancy zone protein correlated negatively with soluble fms-like tyrosine kinase-1 to placental growth factor ratio in all study groups. Acute atherosis was not associated with serum amyloid A1 or pregnancy zone protein. CONCLUSION Proteins involved in atherosclerosis, hypercoagulability, and protein misfolding are dysregulated in early-onset preeclampsia and placental dysfunction, which links them and potentially contributes to future maternal cardiovascular disease.
Collapse
Affiliation(s)
- Ingrid K Fosheim
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway (Drs Fosheim, Jacobsen, Sugulle, Alnaes-Katjavivi, Fjeldstad, Ueland, and Staff); Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway (Drs Fosheim, Jacobsen, Sugulle, Alnaes-Katjavivi, Fjeldstad, and Staff).
| | - Daniel P Jacobsen
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway (Drs Fosheim, Jacobsen, Sugulle, Alnaes-Katjavivi, Fjeldstad, and Staff)
| | - Meryam Sugulle
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway (Drs Fosheim, Jacobsen, Sugulle, Alnaes-Katjavivi, Fjeldstad, Ueland, and Staff); Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway (Drs Fosheim, Jacobsen, Sugulle, Alnaes-Katjavivi, Fjeldstad, and Staff)
| | - Patji Alnaes-Katjavivi
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway (Drs Fosheim, Jacobsen, Sugulle, Alnaes-Katjavivi, Fjeldstad, Ueland, and Staff); Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway (Drs Fosheim, Jacobsen, Sugulle, Alnaes-Katjavivi, Fjeldstad, and Staff)
| | - Heidi E S Fjeldstad
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway (Drs Fosheim, Jacobsen, Sugulle, Alnaes-Katjavivi, Fjeldstad, Ueland, and Staff); Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway (Drs Fosheim, Jacobsen, Sugulle, Alnaes-Katjavivi, Fjeldstad, and Staff)
| | - Thor Ueland
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway (Drs Fosheim, Jacobsen, Sugulle, Alnaes-Katjavivi, Fjeldstad, Ueland, and Staff); Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway (Drs Ueland and Lekva); K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, Tromsø, Norway (Dr Ueland)
| | - Tove Lekva
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway (Drs Ueland and Lekva)
| | - Anne C Staff
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway (Drs Fosheim, Jacobsen, Sugulle, Alnaes-Katjavivi, Fjeldstad, Ueland, and Staff); Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway (Drs Fosheim, Jacobsen, Sugulle, Alnaes-Katjavivi, Fjeldstad, and Staff)
| |
Collapse
|
3
|
Hoyer A, Rehbinder EM, Färdig M, Asad S, Lødrup Carlsen KC, Endre KMA, Granum B, Haugen G, Hedlin G, Monceyron Jonassen C, Katayama S, Konradsen JR, Landrø L, LeBlanc M, Mägi Olsson CA, Rudi K, Skjerven HO, Staff AC, Vettukattil R, Bradley M, Nordlund B, Söderhäll C. Filaggrin mutations in relation to skin barrier and atopic dermatitis in early infancy. Br J Dermatol 2021; 186:544-552. [PMID: 34698386 DOI: 10.1111/bjd.20831] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Loss-of-function mutations in the skin barrier gene filaggrin (FLG) increase the risk of atopic dermatitis (AD), but their role in skin barrier function, dry skin and eczema in infancy is unclear. OBJECTIVES To determine the role of FLG mutations for impaired skin barrier function, dry skin, eczema and AD at three months of age and through infancy. METHODS FLG mutations were analyzed in 1836 infants in the Scandinavian population-based PreventADALL study. Transepidermal water loss (TEWL), dry skin, eczema and AD were assessed at three, six and 12 months of age. RESULTS Filaggrin mutations were observed in 166 (9%) infants. At three months, carrying FLG mutations was not associated with impaired skin barrier function (TEWL > 11.3 g/m2 /h) or dry skin, but with eczema (OR(95%CI): 2.76 (1.81, 4.23), p < 0.001). At six months, mutation carriers had significantly higher TEWL than non-mutation carriers (mean (95%CI) 9.68 (8.69, 10.68) vs. 8.24 (7.97, 8.15), p < 0.01) and at three and six months an increased risk of dry skin on truncus (OR: 1.87 (1.25, 2.80), p = 0.002; 2.44 (1.51, 3.95), p < 0.001) or extensor limb surfaces (1.52 (1.04, 2.22), p = 0.028; 1.74 (1.17, 2.57), p = 0.005). FLG mutations were associated with eczema and AD in infancy. CONCLUSION Filaggrin mutations were not associated with impaired skin barrier function or dry skin in general at three months of age, but increased the risk for eczema, as well as for dry skin on truncus and extensors at three and six months.
Collapse
Affiliation(s)
- A Hoyer
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - E M Rehbinder
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway
| | - M Färdig
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - S Asad
- Dermatology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - K C Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - K M A Endre
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway
| | - B Granum
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - G Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - G Hedlin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - C Monceyron Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway.,Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - S Katayama
- Folkhälsan Research Center, Helsinki, Finland.,Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden.,Stem Cells and Metabolism Research Program, University of Helsinki, Helsinki, Finland
| | - J R Konradsen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - L Landrø
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway
| | - M LeBlanc
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - C A Mägi Olsson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - K Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - H O Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - A C Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - R Vettukattil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - M Bradley
- Dermatology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - B Nordlund
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - C Söderhäll
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
4
|
Allotey J, Snell KI, Smuk M, Hooper R, Chan CL, Ahmed A, Chappell LC, von Dadelszen P, Dodds J, Green M, Kenny L, Khalil A, Khan KS, Mol BW, Myers J, Poston L, Thilaganathan B, Staff AC, Smith GC, Ganzevoort W, Laivuori H, Odibo AO, Ramírez JA, Kingdom J, Daskalakis G, Farrar D, Baschat AA, Seed PT, Prefumo F, da Silva Costa F, Groen H, Audibert F, Masse J, Skråstad RB, Salvesen KÅ, Haavaldsen C, Nagata C, Rumbold AR, Heinonen S, Askie LM, Smits LJ, Vinter CA, Magnus PM, Eero K, Villa PM, Jenum AK, Andersen LB, Norman JE, Ohkuchi A, Eskild A, Bhattacharya S, McAuliffe FM, Galindo A, Herraiz I, Carbillon L, Klipstein-Grobusch K, Yeo S, Teede HJ, Browne JL, Moons KG, Riley RD, Thangaratinam S. Validation and development of models using clinical, biochemical and ultrasound markers for predicting pre-eclampsia: an individual participant data meta-analysis. Health Technol Assess 2021; 24:1-252. [PMID: 33336645 DOI: 10.3310/hta24720] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early identification of women at risk is needed to plan management. OBJECTIVES To assess the performance of existing pre-eclampsia prediction models and to develop and validate models for pre-eclampsia using individual participant data meta-analysis. We also estimated the prognostic value of individual markers. DESIGN This was an individual participant data meta-analysis of cohort studies. SETTING Source data from secondary and tertiary care. PREDICTORS We identified predictors from systematic reviews, and prioritised for importance in an international survey. PRIMARY OUTCOMES Early-onset (delivery at < 34 weeks' gestation), late-onset (delivery at ≥ 34 weeks' gestation) and any-onset pre-eclampsia. ANALYSIS We externally validated existing prediction models in UK cohorts and reported their performance in terms of discrimination and calibration. We developed and validated 12 new models based on clinical characteristics, clinical characteristics and biochemical markers, and clinical characteristics and ultrasound markers in the first and second trimesters. We summarised the data set-specific performance of each model using a random-effects meta-analysis. Discrimination was considered promising for C-statistics of ≥ 0.7, and calibration was considered good if the slope was near 1 and calibration-in-the-large was near 0. Heterogeneity was quantified using I 2 and τ2. A decision curve analysis was undertaken to determine the clinical utility (net benefit) of the models. We reported the unadjusted prognostic value of individual predictors for pre-eclampsia as odds ratios with 95% confidence and prediction intervals. RESULTS The International Prediction of Pregnancy Complications network comprised 78 studies (3,570,993 singleton pregnancies) identified from systematic reviews of tests to predict pre-eclampsia. Twenty-four of the 131 published prediction models could be validated in 11 UK cohorts. Summary C-statistics were between 0.6 and 0.7 for most models, and calibration was generally poor owing to large between-study heterogeneity, suggesting model overfitting. The clinical utility of the models varied between showing net harm to showing minimal or no net benefit. The average discrimination for IPPIC models ranged between 0.68 and 0.83. This was highest for the second-trimester clinical characteristics and biochemical markers model to predict early-onset pre-eclampsia, and lowest for the first-trimester clinical characteristics models to predict any pre-eclampsia. Calibration performance was heterogeneous across studies. Net benefit was observed for International Prediction of Pregnancy Complications first and second-trimester clinical characteristics and clinical characteristics and biochemical markers models predicting any pre-eclampsia, when validated in singleton nulliparous women managed in the UK NHS. History of hypertension, parity, smoking, mode of conception, placental growth factor and uterine artery pulsatility index had the strongest unadjusted associations with pre-eclampsia. LIMITATIONS Variations in study population characteristics, type of predictors reported, too few events in some validation cohorts and the type of measurements contributed to heterogeneity in performance of the International Prediction of Pregnancy Complications models. Some published models were not validated because model predictors were unavailable in the individual participant data. CONCLUSION For models that could be validated, predictive performance was generally poor across data sets. Although the International Prediction of Pregnancy Complications models show good predictive performance on average, and in the singleton nulliparous population, heterogeneity in calibration performance is likely across settings. FUTURE WORK Recalibration of model parameters within populations may improve calibration performance. Additional strong predictors need to be identified to improve model performance and consistency. Validation, including examination of calibration heterogeneity, is required for the models we could not validate. STUDY REGISTRATION This study is registered as PROSPERO CRD42015029349. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 72. See the NIHR Journals Library website for further project information.
Collapse
|
5
|
Tedner SG, Söderhäll C, Konradsen JR, Bains KES, Borres MP, Carlsen K, Carlsen KCL, Färdig M, Gerdin SW, Gudmundsdóttir HK, Haugen G, Hedlin G, Jonassen CM, Kreyberg I, Mägi CO, Nordhagen LS, Rehbinder EM, Rudi K, Skjerven HO, Staff AC, Vettukattil R, Hage M, Nordlund B, Asarnoj A. Extract and molecular-based early infant sensitization and associated factors-A PreventADALL study. Allergy 2021; 76:2730-2739. [PMID: 33751598 DOI: 10.1111/all.14805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 09/25/2020] [Revised: 01/15/2021] [Accepted: 01/21/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND More knowledge about sensitization patterns in early infancy, including impact of molecular allergology, is needed to help predict future allergy development more accurately. OBJECTIVE We aimed to determine the prevalence and patterns of allergic sensitization at 3 months of age, and explore possible associated factors. METHODS From the Scandinavian antenatally recruited PreventADALL mother-child cohort, we included 1110 3-month infants with available serum. Sensitization was defined as s-IgE of ≥0.1 kUA /L by Phadiatop Infant® (ThermoFisher Scientific) including birch, cat, grass, dog, milk, egg, peanut and wheat. Further ImmunoCAP analyses to ovomucoid, casein, Ara h 1-3, omega-5-gliadin were performed in food extract s-IgE-positive children. Maternal sensitization was defined as s-IgE ≥ 0.35 kUA /L to Phadiatop® (inhalant allergen mix) and/or Fx5 (food allergen mix) at 18-week pregnancy. RESULTS Overall 79 (7.3%) infants had specific sensitization, many with low s-IgE-levels (IQR 0.16-0.81 kUA /L), with 78 being sensitized to food extract allergens; 41 to egg, 27 to milk, 10 to peanut, and 25 to wheat. A total of 62/78 were further analysed, 18 (29%) had s-IgE to ovomucoid, casein, Ara h 1-3 and/or omega-5-gliadin. Eight infants (0.7%) were sensitized to inhalant allergens. Maternal sensitization to food allergens was associated with infant sensitization, odds ratio 3.64 (95% CI 1.53-8.68). CONCLUSION Already at 3 months of age, 7% were sensitized to food, mostly without detectable s-IgE to food allergen molecules, and <1% to inhalant allergens. Maternal food sensitization was associated with infants' sensitization.
Collapse
Affiliation(s)
- Sandra G. Tedner
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Jon R. Konradsen
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Karen E. S. Bains
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Magnus P. Borres
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Kai‐Håkon Carlsen
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Karin C. L. Carlsen
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Martin Färdig
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Sabina W. Gerdin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Hrefna K. Gudmundsdóttir
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Guttorm Haugen
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Christine M. Jonassen
- Genetic Unit Centre for Laboratory Medicine Østfold Hospital Trust Kalnes Norway
- Faculty of Chemistry, Biotechnology and Food Science Norwegian University of Life Sciences Ås Norway
| | - Ina Kreyberg
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Caroline‐Aleksi O. Mägi
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Live S. Nordhagen
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
- VID Specialized University Oslo Norway
| | - Eva M. Rehbinder
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
- Department of Dermatology Oslo University Hospital Oslo Norway
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science Norwegian University of Life Sciences Ås Norway
| | - Håvard O. Skjerven
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Anne C. Staff
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Riyas Vettukattil
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Marianne Hage
- Department of Medicine Solna Division of Immunology and Allergy Karolinska Institutet and University Hospital Stockholm Sweden
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Anna Asarnoj
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| |
Collapse
|
6
|
Fosheim IK, Johnsen GM, Alnaes-Katjavivi P, Turowski G, Sugulle M, Staff AC. Decidua basalis and acute atherosis: Expression of atherosclerotic foam cell associated proteins. Placenta 2021; 107:1-7. [PMID: 33725567 DOI: 10.1016/j.placenta.2021.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/23/2021] [Accepted: 03/01/2021] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Uteroplacental acute atherosis is frequently observed in preeclampsia, and shares features with early atherosclerotic lesions, including artery wall foam cells. The lipid-associated proteins FABP4 (fatty acid binding protein 4), perilipin-2, and LOX-1 (lectin-like oxidized LDL-receptor 1) are involved in atherosclerotic foam cell formation. Increased levels of these proteins have been associated with preeclampsia systemically and in placental tissue. Their role in acute atherosis is yet unidentified. Our aim was to describe the presence of these proteins in acute atherosis, and compare our findings to what is known in early atherosclerotic lesions. METHODS Serial sections of decidua basalis tissue from 12 normotensive (4 with acute atherosis) and 23 preeclamptic pregnancies (16 with acute atherosis) were stained with HE and immunostained for CK7, CD68, FABP4, perilipin-2, and LOX-1. Artery wall and perivascular protein expression was assessed in 190 spiral artery sections; 55 with acute atherosis. RESULTS Acute atherosis foam cells were commonly positive for perilipin-2 (55%), less often for FABP4 (13%), and never for LOX-1. LOX-1 was frequently observed in intramural trophoblasts of normal spiral arteries. Perivascularly, LOX-1 positivity of decidual stromal cells surrounding arteries with acute atherosis was significantly increased as compared to arteries lacking acute atherosis (38% vs. 15%, p < 0.001). DISCUSSION We found that perilipin-2 and FABP4 are expressed by acute atherosis foam cells, similar to atherosclerosis, supporting possible shared pathways for foam cell generation. Unlike atherosclerosis, LOX-1 is not present in acute atherosis, possibly explained by pregnancy-specific routes to decidua basalis foam cell generation.
Collapse
Affiliation(s)
- I K Fosheim
- Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
| | - G M Johnsen
- Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - P Alnaes-Katjavivi
- Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - G Turowski
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - M Sugulle
- Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
| | - A C Staff
- Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway.
| |
Collapse
|
7
|
Endre KMA, Landrø L, LeBlanc M, Gjersvik P, Lødrup Carlsen KC, Haugen G, Hedlin G, Jonassen CM, Nordlund B, Rudi K, Skjerven HO, Staff AC, Söderhäll C, Vettukattil R, Rehbinder EM. Diagnosing atopic dermatitis in infancy using established diagnostic criteria: a cohort study. Br J Dermatol 2021; 186:50-58. [PMID: 33511639 DOI: 10.1111/bjd.19831] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Diagnosing atopic dermatitis (AD) in infants is challenging. OBJECTIVES To determine the incidence and persistence of eczema and AD in infants using the UK Working Party (UKWP) and Hanifin and Rajka (H&R) criteria. METHODS A cohort of 1834 infants was examined clinically at 3, 6 and 12 months of age. AD was diagnosed by UKWP (3, 6 and 12 months) and H&R (12 months) criteria. Logistic regression models were used to assess the relationship between AD and eczema. RESULTS Eczema was observed in 628 (34·2%) infants (n = 240, n = 359 and n = 329 at 3, 6 and 12 months, respectively), with AD diagnosed in 212 (33·7%) infants with any eczema and in 64/78 (82%) infants with eczema at all three visits. The odds of AD were lower with first presentation of eczema at 6 [odds ratio (OR) 0·33, 95% confidence interval (CI) 0·22-0·48] or 12 months (OR 0·49, 95% CI 0·32-0·74) than at 3 months, and higher in infants with eczema at three (OR 23·1, 95% CI 12·3-43·6) or two (OR 6·5, 95% CI 4·3-9·9) visits vs. one visit only. At 12 months, 156/329 (47·4%) fulfilled the UKWP and/or H&R criteria; 27 (8%) fulfilled the UKWP criteria only and 65 (20%) only the H&R criteria. Of the 129 infants who fulfilled the H&R criteria, 44 (34·1%) did not meet the itch criterion. CONCLUSIONS Used in combination and at multiple timepoints, the UKWP and H&R criteria for AD may be useful in clinical research but may have limited value in most other clinical settings.
Collapse
Affiliation(s)
- K M A Endre
- Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway.,University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| | - L Landrø
- Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway.,University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| | - M LeBlanc
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - P Gjersvik
- Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway.,University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| | - K C Lødrup Carlsen
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - G Haugen
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - G Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women´s and Children´s Health, Karolinska Institutet, Stockholm, Sweden
| | - C M Jonassen
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway.,Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - B Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women´s and Children´s Health, Karolinska Institutet, Stockholm, Sweden
| | - K Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - H O Skjerven
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - A C Staff
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - C Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women´s and Children´s Health, Karolinska Institutet, Stockholm, Sweden
| | - R Vettukattil
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - E M Rehbinder
- Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway.,University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| |
Collapse
|
8
|
Devold Pay AS, Johansen K, Staff AC, Laine KH, Blix E, Økland I. Effects of external cephalic version for breech presentation at or near term in high-resource settings: A systematic review of randomized and non-randomized studies. Eur J Midwifery 2020; 4:44. [PMID: 33537645 PMCID: PMC7839085 DOI: 10.18332/ejm/128364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/09/2020] [Revised: 09/30/2020] [Accepted: 10/12/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION External cephalic version (ECV) for breech presentation involves manual manipulation of the fetus from breech to cephalic presentation at or near term, in an attempt to avoid breech birth. This systematic review summarizes the literature on the effects of ECV at or near term on pregnancy outcomes in high-resource settings. METHODS The MEDLINE, Embase, CINAHL, Cochrane Library, MIDIRS, and SweMED+ databases were searched for relevant articles published through April 2019, with no limitation on publication date. Clinical trials comparing the effects of ECV at ≥36 weeks, with or without tocolysis, with that of no ECV, conducted in northern, western, and central Europe, the USA, Canada, Australia, and New Zealand were eligible for inclusion. RESULTS Nine articles reporting on 184704 breech pregnancies were included. Pooled data showed that ECV attempts reduced the failure to achieve vaginal cephalic birth (risk ratio, RR=0.56; 95% CI: 0.45–0.71), caesarean section performance (RR=0.57; 95% CI: 0.50–0.64), and non-cephalic presentation at birth (RR=0.45; 95% CI: 0.29–0.68) compared with no ECV. ECV attempts also increased the incidence of Apgar score <7 at 5 minutes (RR=1.29; 95% CI: 1.10–1.52). CONCLUSIONS Women for whom ECV is attempted at or near term are at reduced risk of caesarean section, non-cephalic presentation at term, and failure to achieve vaginal cephalic birth. Compared with no ECV, attempted ECV was also associated with a slightly increased risk of a low Apgar score at 5 minutes. The evidence is limited by the scarcity of high-quality research and the presence of risks of bias.
Collapse
Affiliation(s)
- Aase S Devold Pay
- Department of Gynecology and Obstetrics, Division of Women Health, Oslo University Hospital, Oslo, Norway.,Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | | | - Anne C Staff
- Department of Gynecology and Obstetrics, Division of Women Health, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Katariina H Laine
- Department of Gynecology and Obstetrics, Division of Women Health, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ellen Blix
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Inger Økland
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway.,Department of Caring and Ethics, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| |
Collapse
|
9
|
Snell KIE, Allotey J, Smuk M, Hooper R, Chan C, Ahmed A, Chappell LC, Von Dadelszen P, Green M, Kenny L, Khalil A, Khan KS, Mol BW, Myers J, Poston L, Thilaganathan B, Staff AC, Smith GCS, Ganzevoort W, Laivuori H, Odibo AO, Arenas Ramírez J, Kingdom J, Daskalakis G, Farrar D, Baschat AA, Seed PT, Prefumo F, da Silva Costa F, Groen H, Audibert F, Masse J, Skråstad RB, Salvesen KÅ, Haavaldsen C, Nagata C, Rumbold AR, Heinonen S, Askie LM, Smits LJM, Vinter CA, Magnus P, Eero K, Villa PM, Jenum AK, Andersen LB, Norman JE, Ohkuchi A, Eskild A, Bhattacharya S, McAuliffe FM, Galindo A, Herraiz I, Carbillon L, Klipstein-Grobusch K, Yeo SA, Browne JL, Moons KGM, Riley RD, Thangaratinam S. External validation of prognostic models predicting pre-eclampsia: individual participant data meta-analysis. BMC Med 2020; 18:302. [PMID: 33131506 PMCID: PMC7604970 DOI: 10.1186/s12916-020-01766-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 08/26/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early identification of women at risk during pregnancy is required to plan management. Although there are many published prediction models for pre-eclampsia, few have been validated in external data. Our objective was to externally validate published prediction models for pre-eclampsia using individual participant data (IPD) from UK studies, to evaluate whether any of the models can accurately predict the condition when used within the UK healthcare setting. METHODS IPD from 11 UK cohort studies (217,415 pregnant women) within the International Prediction of Pregnancy Complications (IPPIC) pre-eclampsia network contributed to external validation of published prediction models, identified by systematic review. Cohorts that measured all predictor variables in at least one of the identified models and reported pre-eclampsia as an outcome were included for validation. We reported the model predictive performance as discrimination (C-statistic), calibration (calibration plots, calibration slope, calibration-in-the-large), and net benefit. Performance measures were estimated separately in each available study and then, where possible, combined across studies in a random-effects meta-analysis. RESULTS Of 131 published models, 67 provided the full model equation and 24 could be validated in 11 UK cohorts. Most of the models showed modest discrimination with summary C-statistics between 0.6 and 0.7. The calibration of the predicted compared to observed risk was generally poor for most models with observed calibration slopes less than 1, indicating that predictions were generally too extreme, although confidence intervals were wide. There was large between-study heterogeneity in each model's calibration-in-the-large, suggesting poor calibration of the predicted overall risk across populations. In a subset of models, the net benefit of using the models to inform clinical decisions appeared small and limited to probability thresholds between 5 and 7%. CONCLUSIONS The evaluated models had modest predictive performance, with key limitations such as poor calibration (likely due to overfitting in the original development datasets), substantial heterogeneity, and small net benefit across settings. The evidence to support the use of these prediction models for pre-eclampsia in clinical decision-making is limited. Any models that we could not validate should be examined in terms of their predictive performance, net benefit, and heterogeneity across multiple UK settings before consideration for use in practice. TRIAL REGISTRATION PROSPERO ID: CRD42015029349 .
Collapse
Affiliation(s)
- Kym I E Snell
- Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Keele, UK.
| | - John Allotey
- Barts Research Centre for Women's Health (BARC), Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Pragmatic Clinical Trials Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Melanie Smuk
- Pragmatic Clinical Trials Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Richard Hooper
- Pragmatic Clinical Trials Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Claire Chan
- Pragmatic Clinical Trials Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Asif Ahmed
- MirZyme Therapeutics, Innovation Birmingham Campus, Birmingham, UK
| | - Lucy C Chappell
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Peter Von Dadelszen
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Marcus Green
- Action on Pre-eclampsia (APEC) Charity, Worcestershire, UK
| | - Louise Kenny
- Faculty Health & Life Sciences, University of Liverpool, Liverpool, UK
| | - Asma Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust and Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - Khalid S Khan
- Barts Research Centre for Women's Health (BARC), Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Pragmatic Clinical Trials Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, Monash University, Monash Medical Centre, Clayton, Victoria, Australia
| | - Jenny Myers
- Maternal and Fetal Health Research Centre, Manchester Academic Health Science Centre, University of Manchester, Central Manchester NHS Trust, Manchester, UK
| | - Lucilla Poston
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Basky Thilaganathan
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust and Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - Anne C Staff
- Division of Obstetrics and Gynaecology, Oslo University Hospital, and Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Gordon C S Smith
- Department of Obstetrics and Gynaecology, NIHR Biomedical Research Centre, Cambridge University, Cambridge, UK
| | - Wessel Ganzevoort
- Department of Obstetrics, Amsterdam UMC University of Amsterdam, Amsterdam, The Netherlands
| | - Hannele Laivuori
- Department of Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Technology, Tampere University Hospital and Tampere University, Tampere, Finland
| | | | - Javier Arenas Ramírez
- Department of Obstetrics and Gynaecology, University Hospital de Cabueñes, Gijón, Spain
| | - John Kingdom
- Maternal-Fetal Medicine Division, Department OBGYN, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - George Daskalakis
- Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
| | - Diane Farrar
- Bradford Institute for Health Research, Bradford Teaching Hospitals, Bradford, UK
| | - Ahmet A Baschat
- Johns Hopkins Center for Fetal Therapy, Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Paul T Seed
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Federico Prefumo
- Department of Obstetrics and Gynaecology, University of Brescia, Brescia, Italy
| | - Fabricio da Silva Costa
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Henk Groen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Francois Audibert
- Department of Obstetrics and Gynecology, CHU Ste Justine, Université de Montréal, Montreal, Canada
| | - Jacques Masse
- Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Quebec City, Canada
| | - Ragnhild B Skråstad
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology - NTNU, Trondheim, Norway
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | - Kjell Å Salvesen
- Department of Obstetrics and Gynecology, Trondheim University Hospital, Trondheim, Norway
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Camilla Haavaldsen
- Department of Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway
| | - Chie Nagata
- Department of Education for Clinical Research, National Center for Child Health and Development, Tokyo, Japan
| | - Alice R Rumbold
- South Australian Health and Medical Research Institute and Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Seppo Heinonen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Lisa M Askie
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Luc J M Smits
- Care and Public Health Research Institute, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Christina A Vinter
- Department of Gynecology and Obstetrics, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Kajantie Eero
- National Institute for Health and Welfare, Helsinki, Finland
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pia M Villa
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anne K Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Louise B Andersen
- Institute for Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Jane E Norman
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Akihide Ohkuchi
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Shimotsuke-shi, Tochigi, Japan
| | - Anne Eskild
- Department of Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sohinee Bhattacharya
- Obstetrics & Gynaecology, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Alberto Galindo
- Fetal Medicine Unit, Maternal and Child Health and Development Network (SAMID), Department of Obstetrics and Gynaecology, Hospital Universitario, Instituto de Investigación Hospital, Universidad Complutense de Madrid, Madrid, Spain
| | - Ignacio Herraiz
- Fetal Medicine Unit, Maternal and Child Health and Development Network (SAMID), Department of Obstetrics and Gynaecology, Hospital Universitario, Instituto de Investigación Hospital, Universidad Complutense de Madrid, Madrid, Spain
| | - Lionel Carbillon
- Department of Obstetrics and Gynecology, Assistance Publique-Hôpitaux de Paris Université Paris, Paris, France
| | - Kerstin Klipstein-Grobusch
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Seon Ae Yeo
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joyce L Browne
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Karel G M Moons
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Cochrane Netherlands, Utrecht, The Netherlands
| | - Richard D Riley
- Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Keele, UK
| | - Shakila Thangaratinam
- Institute of Metabolism and Systems Research, WHO Collaborating Centre for Women's Health, University of Birmingham, Birmingham, UK
| |
Collapse
|
10
|
Freitag N, Tirado-Gonzalez I, Barrientos G, Powell KL, Boehm-Sturm P, Koch SP, Hecher K, Staff AC, Arck PC, Diemert A, Blois SM. Galectin-3 deficiency in pregnancy increases the risk of fetal growth restriction (FGR) via placental insufficiency. Cell Death Dis 2020; 11:560. [PMID: 32703931 PMCID: PMC7378206 DOI: 10.1038/s41419-020-02791-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/12/2020] [Accepted: 07/14/2020] [Indexed: 12/26/2022]
Abstract
Fetal growth restriction (FGR) is the most common pregnancy complication in developed countries. Pregnancies affected by FGR, frequently concur with complications and high risk of neonatal morbidity and mortality. To date, no approved treatment is available for pregnant women affected with FGR. The objective of this study was to investigate the contribution of galectin-3 (gal-3), a β-galactoside binding protein involved in pregnancy, placental function and fetal growth. We demonstrated that lack of gal-3 during mouse pregnancy leads to placental dysfunction and drives FGR in the absence of a maternal preeclampsia syndrome. Analysis of gal-3 deficient dams revealed placental inflammation and malperfusion, as well as uterine natural killer cell infiltration with aberrant activation. Our results also show that FGR is associated with a failure to increase maternal circulating gal-3 levels during the second and third trimester in human pregnancies. Placentas from human pregnancies affected by FGR displayed lower gal-3 expression, which correlated with placental dysfunction. These data highlight the importance of gal-3 in the promotion of proper placental function, as its absence leads to placental disease and subsequent FGR.
Collapse
Affiliation(s)
- Nancy Freitag
- Experimental and Clinical Research Center, a Cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, and Charité - Universitätsmedizin Berlin, Berlin, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department for Psychosomatic Medicine, Berlin, Germany
| | - Irene Tirado-Gonzalez
- Experimental and Clinical Research Center, a Cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, and Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gabriela Barrientos
- Laboratorio de Medicina Experimental, Hospital Alemán, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Katie L Powell
- Division of Perinatal Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, 2065, Australia
| | - Philipp Boehm-Sturm
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universitätzu Berlin, and Berlin Institute of Health, Department of Experimental Neurology, Center for Stroke Research, Berlin, Germany.,NeuroCure Cluster of Excellence and Charité Core Facility 7 T Experimental MRIs, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan P Koch
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universitätzu Berlin, and Berlin Institute of Health, Department of Experimental Neurology, Center for Stroke Research, Berlin, Germany.,NeuroCure Cluster of Excellence and Charité Core Facility 7 T Experimental MRIs, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Kurt Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20251, Germany
| | - Anne C Staff
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gyneacology, Oslo University Hospital, Oslo, Norway
| | - Petra C Arck
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20251, Germany
| | - Anke Diemert
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20251, Germany
| | - Sandra M Blois
- Experimental and Clinical Research Center, a Cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, and Charité - Universitätsmedizin Berlin, Berlin, Germany. .,Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20251, Germany.
| |
Collapse
|
11
|
Dyrkorn OA, Staff AC, Kulseng-Hanssen S, Dimoski T, Svenningsen R. The completeness and accuracy of the Norwegian Female Incontinence Registry. Acta Obstet Gynecol Scand 2020; 99:1618-1625. [PMID: 32640493 DOI: 10.1111/aogs.13951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 03/24/2020] [Revised: 05/20/2020] [Accepted: 06/30/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Medical quality registries have gained popularity as tools for monitoring the quality of medical treatments and they serve as data sources for research. The Norwegian Female Incontinence Registry (NFIR) was established in 1998 to monitor and improve the quality of surgery for women with stress and mixed urinary incontinence in Norway and to collect data for research. This study aimed to assess the completeness and accuracy of the Norwegian Female Incontinence Registry, and potential differences in data accuracy over time and according to surgical volume of the reporting hospitals. MATERIAL AND METHODS A random selection of 300 women from a total of 20 610 operated for urinary incontinence between 1998 and 2016 reported to the Norwegian Female Incontinence Registry from 28 public hospitals were selected for validation. The database completeness was estimated for 2008-2017 by comparing surgical procedures registered both in the Norwegian Female Incontinence Registry and the Norwegian National Patient Registry. Historical data recorded in the Registry for 10 selected key variables were extracted and compared with the patients' individual medical records at the reporting hospitals as reference. The reviewers were blinded to the previously stored information. The intraclass correlation coefficient for continuous variables and Cohen's kappa for categorical variables were calculated. RESULTS Primary source data on 285 of the 300 women selected from Norwegian Female Incontinence Registry were successfully retrieved. The completeness of the registry has increased from 61% in 2008 to 99% in 2017. The national coverage has increased from 12 reporting departments in 1998 to all 38 public departments performing female incontinence surgery in 2017. Excellent accuracy was found for both continuous variables (intraclass correlation coefficient >0.94) and categorical variables (Cohen's kappa >0.86). No differences in data accuracy were found comparing high-volume hospitals with low-volume hospitals, or when comparing data accuracy over time. CONCLUSIONS The Norwegian Female Incontinence Registry is a reliable tool for quality assessment of incontinence surgery and research. The registry completeness has improved over time and now contains data on nearly all women undergoing incontinence surgery in Norway.
Collapse
Affiliation(s)
- Ole A Dyrkorn
- Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne C Staff
- Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | | | - Rune Svenningsen
- Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway.,The Norwegian Female Incontinence Registry, Oslo, Norway
| |
Collapse
|
12
|
Bowe S, Staff AC, Sugulle M. Gestational age reference ranges for umbilical cord blood lactate: An external validation study of post-date pregnancies. Acta Obstet Gynecol Scand 2020; 99:1430-1433. [PMID: 32441769 DOI: 10.1111/aogs.13922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/27/2020] [Revised: 04/15/2020] [Accepted: 05/18/2020] [Indexed: 11/30/2022]
Abstract
A previous study published in 2008 by Wiberg et al demonstrated increasing umbilical cord blood lactate at delivery by gestational age in vigorous offspring (n = 10 169, gestational age 24-43 weeks). Based on these results the authors concluded that gestational age-independent umbilical cord lactate cut-off could give false-negative or false-positive diagnosis of lacticemia. To our knowledge, these findings have not been incorporated into clinical interpretations in delivery units. To perform an external validity study for the findings by Wiberg et al, we analyzed umbilical cord blood lactate levels according to gestational age in a post-date delivery study population at our large, tertiary obstetric unit. The parallel finding of our study to that of Wiberg et al highlights the importance of using available gestational age dependent reference ranges (eg as presented in Wiberg's publication), when interpreting umbilical cord blood lactate levels for fetal wellbeing.
Collapse
Affiliation(s)
- Sophie Bowe
- Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne C Staff
- Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Meryam Sugulle
- Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
13
|
Kreyberg I, Hilde K, Bains KES, Carlsen KH, Granum B, Haugen G, Hedlin G, Jonassen CM, Nordhagen LS, Nordlund B, Rueegg CS, Sjøborg KD, Skjerven HO, Staff AC, Vettukattil R, Lødrup Carlsen KC. Snus in pregnancy and infant birth size: a mother-child birth cohort study. ERJ Open Res 2019; 5:00255-2019. [PMID: 31803771 PMCID: PMC6885591 DOI: 10.1183/23120541.00255-2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/07/2019] [Indexed: 11/16/2022] Open
Abstract
Rationale While recent studies show that maternal use of snus during pregnancy is increasing, the potential effects on infant birth size is less investigated, with conflicting results. Objectives We aimed to determine if maternal use of snus during pregnancy influences the infant anthropometric and proportional size measures at birth. Methods In 2313 mother–child pairs from the population-based, mother–child birth cohort PreventADALL (Preventing Atopic Dermatitis and ALLergies) in Norway and Sweden, we assessed nicotine exposure by electronic questionnaire(s) at 18 and 34 weeks of pregnancy, and anthropometric measurements at birth. Associations between snus exposure and birth size outcomes were analysed by general linear regression. Results Birthweight was not significantly different in infants exposed to snus in general, and up to 18 weeks of pregnancy in particular, when adjusting for relevant confounders including maternal age, gestational age at birth, pre-pregnancy body mass index, parity, fetal sex and maternal gestational weight gain up to 18 weeks. We found no significant effect of snus use on the other anthropometric or proportional size measures in multivariable linear regression models. Most women stopped snus use in early pregnancy. Conclusion Exposure to snus use in early pregnancy, with most women stopping when knowing about their pregnancy, was not associated with birth size. We were unable to conclude on effects of continued snus use during pregnancy because of lack of exposure in our cohort. Snus use in pregnancy, reported by 7.1% of 2313 women, was not associated with infant birth size. As most women stopped snus use by 6 weeks gestational age, it was not possible to assess potential birth size effects of persistent use during pregnancy.http://bit.ly/2IG8Vnk
Collapse
Affiliation(s)
- Ina Kreyberg
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Katarina Hilde
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Karen Eline S Bains
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Kai-Håkon Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Berit Granum
- Dept of Toxicology and Risk Assessment, Norwegian Institute of Public Health, Oslo, Norway
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Christine M Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway.,Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Live S Nordhagen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,VID Specialized University, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Corina S Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Katrine D Sjøborg
- Dept of Obstetrics and Gynaecology, Østfold Hospital Trust, Kalnes, Norway
| | - Håvard O Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne C Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | | |
Collapse
|
14
|
Scioscia M, Dekker GA, Chaouat G, Dawonauth L, Dechend R, Goldman-Wohl D, Gumilar E, Karumanchi SA, Kell DB, Rademacher TW, Robertson S, Saito S, Scherjon S, Staff AC, Vatish M, Robillard PY. A top priority in pre-eclampsia research: development of a reliable and inexpensive urinary screening test. Lancet Glob Health 2019; 7:e1312-e1313. [PMID: 31537353 DOI: 10.1016/s2214-109x(19)30319-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 06/28/2019] [Indexed: 01/28/2023]
Affiliation(s)
- Marco Scioscia
- Department of Obstetrics and Gynaecology, Policlinico Hospital, Abano Terme, Padua 35031, Italy.
| | - Gustaaf A Dekker
- Robinson Research Institute and School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Gérard Chaouat
- Institut National de Santé et de Recherche Médicale, INSERM UMR-976, Saint-Louis Hospital, Research Center, Paris, France
| | - Lalita Dawonauth
- Department of Medicine, Faculty of Science, University of Mauritius, Réduit, Mauritius
| | - Ralf Dechend
- Experimental and Clinical Research Center, Max-Delbrück Center for Molecular Medicine and Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Debra Goldman-Wohl
- Magda and Richard Hoffman Center for Human Placenta Research, Department of Obstetrics and Gynecology, Hebrew University Hadassah Medical Center, Jerusalem, Israel
| | - Erry Gumilar
- Department Obstetrics & Gynecology, DR Soetomo-UNAIR Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - S Ananth Karumanchi
- Departments of Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Nephrology Division, Departments of Medicine, Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Douglas B Kell
- School of Chemistry, The University of Manchester, Manchester, UK
| | - Thomas W Rademacher
- Division of Infection and Immunity, University College London Medical School, London, UK; Middlesex University, London, UK
| | - Sarah Robertson
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Shigeru Saito
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Sicco Scherjon
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Anne C Staff
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway; Faculty of Medicine, University of Oslo, Norway
| | - Manu Vatish
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford, UK
| | - Pierre-Yves Robillard
- Service de Réanimation néonatale, Centre d'Etudes Périnatales Océan Indien, Centre Hospitalier Universitaire Sud-Réunion, Saint-Pierre, France
| |
Collapse
|
15
|
Dyrkorn OA, Staff AC, Kulseng-Hanssen S, Schiøtz HA, Svenningsen R. Childbirth after mid-urethral sling surgery: effects on long-term success and complications. Int Urogynecol J 2019; 31:485-492. [PMID: 31410519 DOI: 10.1007/s00192-019-04067-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 05/19/2019] [Accepted: 07/22/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS To evaluate long-term outcomes in women with one or more childbirths after mid-urethral sling (MUS) surgery and potential differences in outcomes based on mode of delivery. METHODS A population-based cohort study using data from two national registries. Women registered with childbirth after MUS (case group) or without childbirth after MUS (control group), with equal follow-up time, underwent a structured telephone interview using a validated short-form urinary disease-specific questionnaire. Primary outcomes were current stress urinary incontinence (SUI) rate and change in cure rate. Secondary outcomes were effect of delivery mode, rates of repeat operations for SUI, complications, treatment satisfaction and urgency urinary incontinence rate. Childbirth as an independent risk factor for SUI recurrence was also evaluated. RESULTS Seventy-two women with and 156 women without childbirth after MUS were included. Median follow-up time was 10 years for both groups. Subjective SUI cure rates were 82% (cases) and 75% (controls), respectively (p = 0.31). A significantly lower SUI cure rate was seen in the women with more than one childbirth after MUS (50% vs. 88% p = 0.006). No differences in primary or secondary outcomes were found between groups at follow-up, nor did mode of delivery affect outcomes. Childbirth after MUS was not an independent risk factor for subjective SUI recurrence (OR 0.8 CI 0.3-1.7). CONCLUSIONS No differences in outcomes were seen between groups at follow-up independently of delivery mode. However, having more than one delivery after MUS seems to impact the continence status.
Collapse
Affiliation(s)
- Ole A Dyrkorn
- Department of Obstetrics and Gynecology, Oslo University Hospital, PB 4950, Nydalen, 0424, Oslo, Norway.
- Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Anne C Staff
- Department of Obstetrics and Gynecology, Oslo University Hospital, PB 4950, Nydalen, 0424, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Hjalmar A Schiøtz
- Department of Obstetrics and Gynecology, Vestfold Hospital Trust, Tønsberg, Norway
| | - Rune Svenningsen
- Department of Obstetrics and Gynecology, Oslo University Hospital, PB 4950, Nydalen, 0424, Oslo, Norway
- The Norwegian Female Incontinence Registry, Oslo, Norway
| |
Collapse
|
16
|
Kreyberg I, Bains KES, Carlsen KH, Granum B, Gudmundsdóttir HK, Haugen G, Hedlin G, Hilde K, Jonassen CM, Nordhagen LS, Nordlund B, Sjøborg KD, Skjerven HO, Staff AC, Söderhäll C, Vettukatil RM, Lødrup Carlsen KC. Stopping when knowing: use of snus and nicotine during pregnancy in Scandinavia. ERJ Open Res 2019; 5:00197-2018. [PMID: 30972353 PMCID: PMC6452060 DOI: 10.1183/23120541.00197-2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 12/26/2018] [Indexed: 12/02/2022] Open
Abstract
The risk of adverse health effects in offspring due to maternal tobacco smoking during pregnancy is well documented [1], including epigenetic changes persisting in the offspring after prenatal exposure [2]. The effects of fetal exposure to nicotine from non-combustible tobacco products, such as snus or nicotine-replacement therapies (NRTs), are less clear. Use of snus leads to systemic absorption of nicotine into the maternal circulatory system, with subsequent exposure of the foetus through the placenta [3]. In young women, the use of snus increases in parallel with decreasing smoking rates but the use in pregnancy is unclear. Our aims were to determine the prevalence of snus use, smoking and other nicotine-containing product use during pregnancy, and to identify predictors for snus use in pregnancy. Prevalence was determined for 2528 women in Norway and Sweden based on the Preventing Atopic Dermatitis and ALLergies (PreventADALL) study, a population-based, mother–child birth cohort. Electronic questionnaires were completed in pregnancy week 18 and/or week 34, and potential predictors of snus use were analysed using logistic regression models. Ever use of any snus, tobacco or nicotine-containing products was reported by 35.7% of women, with similar rates of snus use (22.5%) and smoking (22.6%). Overall, 11.3% of women reported any use of nicotine-containing products in pregnancy up to 34 weeks, most often snus alone (6.5%). Most women (87.2%) stopped using snus by week 6 of pregnancy. Snus use in pregnancy was inversely associated with age and positively associated with urban living and personal or maternal history of smoking. While 11.3% of women used snus or other nicotine-containing products at some time, most stopped when recognising their pregnancy. Younger, urban living, previously smoking women were more likely to use snus in pregnancy. Of the 11.3% of women using any nicotine products in pregnancy (most often snus (6.5%)), the majority stop within pregnancy week 6. Snus use is associated with urban living, previous smoking, in utero smoking exposure of the index woman and lower age.http://ow.ly/Gyg230nmxIo
Collapse
Affiliation(s)
- Ina Kreyberg
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karen E S Bains
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Kai-H Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Berit Granum
- Dept of Toxicology and Risk Assessment, Norwegian Institute of Public Health, Oslo, Norway
| | - Hrefna K Gudmundsdóttir
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Katarina Hilde
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Christine M Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway.,Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Live S Nordhagen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,VID Specialized University, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Katrine D Sjøborg
- Dept of Obstetrics and Gynaecology, Østfold Hospital Trust, Kalnes, Norway
| | - Håvard O Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne C Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Dept of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Riyas M Vettukatil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
17
|
Oversand SH, Staff AC, Volløyhaug I, Svenningsen R. Impact of levator muscle avulsions on Manchester procedure outcomes in pelvic organ prolapse surgery. Acta Obstet Gynecol Scand 2019; 98:1046-1054. [PMID: 30859546 DOI: 10.1111/aogs.13604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 08/05/2018] [Accepted: 03/05/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Levator ani muscle avulsions potentially increase recurrence after anterior colporrhaphies. We aimed at evaluating the impact of avulsions on anatomical and patient-reported outcomes 1 year after the Manchester procedure for primary anterior compartment pelvic organ prolapse. MATERIAL AND METHODS Prospective cohort study of 189 women undergoing the Manchester procedure between October 2014 and January 2017. Avulsions were diagnosed by transperineal ultrasound. Women with and without avulsions were compared for 1-year postoperative outcomes; Pelvic Organ Prolapse Quantification measurements, subjective satisfaction (1-worse to 4-cured), failure (new prolapse treatment), response to validated questionnaires on pelvic floor distress and sexual function, and a composite outcome (subjectively cured and optimal anterior compartment outcome (stage 0-I)). Optimal mid-compartment outcome was defined as cervix ≥5 cm above the hymen. Factors potentially associated with poor anatomical outcomes (anterior compartment stage ≥II) or pelvic floor distress were analyzed using regression analyses. RESULTS Fewer women with avulsions (present in 50.8%) obtained optimal mid-compartment outcomes (88.2% vs 77.1%; P = 0.05). The groups were otherwise similar in terms of mid-compartment reduction, anterior compartment results, failure rate, subjective satisfaction, pelvic floor/sexual symptoms, and combined optimal subjective and anatomical outcome. Only preoperative anterior compartment stage ≥III was associated with poor anatomical outcome (P < 0.01). A high preoperative symptom score was associated with a high postoperative symptom score (P < 0.001). CONCLUSIONS Although fewer women with avulsions obtained optimal mid-compartment results, avulsions had no impact on other anatomical or symptomatic outcomes 1 year after the Manchester procedure for primary anterior compartment prolapse.
Collapse
Affiliation(s)
- Sissel H Oversand
- Department of Gynecology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne C Staff
- Department of Gynecology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Volløyhaug
- Department of Obstetrics and Gynecology, Trondheim University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Rune Svenningsen
- Department of Gynecology, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
18
|
Moe K, Alnaes-Katjavivi P, Størvold GL, Sugulle M, Johnsen GM, Redman CW, Dechend R, Staff AC. Classical Cardiovascular Risk Markers in Pregnancy and Associations to Uteroplacental Acute Atherosis. Hypertension 2018; 72:695-702. [DOI: 10.1161/hypertensionaha.118.10964] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kjartan Moe
- From the Faculty of Medicine, University of Oslo, Norway (K.M., P.A.-K., G.L.S., G.M.J., A.C.S.)
- Division of Obstetrics and Gynaecology (K.M., P.A.-K., G.L.S., M.S., G.M.J., A.C.S.)
| | - Patji Alnaes-Katjavivi
- From the Faculty of Medicine, University of Oslo, Norway (K.M., P.A.-K., G.L.S., G.M.J., A.C.S.)
- Division of Obstetrics and Gynaecology (K.M., P.A.-K., G.L.S., M.S., G.M.J., A.C.S.)
| | - Gro L. Størvold
- From the Faculty of Medicine, University of Oslo, Norway (K.M., P.A.-K., G.L.S., G.M.J., A.C.S.)
- Division of Obstetrics and Gynaecology (K.M., P.A.-K., G.L.S., M.S., G.M.J., A.C.S.)
- Institute for Experimental Medical Research (G.L.S., G.M.J.), Oslo University Hospital, Norway
| | - Meryam Sugulle
- Division of Obstetrics and Gynaecology (K.M., P.A.-K., G.L.S., M.S., G.M.J., A.C.S.)
| | - Guro M. Johnsen
- From the Faculty of Medicine, University of Oslo, Norway (K.M., P.A.-K., G.L.S., G.M.J., A.C.S.)
- Division of Obstetrics and Gynaecology (K.M., P.A.-K., G.L.S., M.S., G.M.J., A.C.S.)
- Institute for Experimental Medical Research (G.L.S., G.M.J.), Oslo University Hospital, Norway
| | - Christopher W.G. Redman
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, United Kingdom (C.W.G.R.)
| | - Ralf Dechend
- HELIOS Clinic, Berlin-Buch, Germany (R.D.)
- Experimental and Clinical Research Center, Charité Medical Faculty and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany (R.D.)
| | - Anne C. Staff
- From the Faculty of Medicine, University of Oslo, Norway (K.M., P.A.-K., G.L.S., G.M.J., A.C.S.)
- Division of Obstetrics and Gynaecology (K.M., P.A.-K., G.L.S., M.S., G.M.J., A.C.S.)
| |
Collapse
|
19
|
Fonnes T, Trovik J, Edqvist PH, Fasmer KE, Marcickiewicz J, Tingulstad S, Staff AC, Bjørge L, Amant F, Haldorsen IS, Werner H, Akslen LA, Tangen IL, Krakstad C. Asparaginase-like protein 1 expression in curettage independently predicts lymph node metastasis in endometrial carcinoma: a multicentre study. BJOG 2018; 125:1695-1703. [PMID: 29989298 DOI: 10.1111/1471-0528.15403] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Correct preoperative identification of high-risk patients is important to optimise surgical treatment and improve survival. We wanted to explore if asparaginase-like protein 1 (ASRGL1) expression in curettage could predict lymph node metastases and poor outcome, potentially improving preoperative risk stratification. DESIGN Multicentre study. SETTING Ten hospitals in Norway, Sweden and Belgium. POPULATION Women diagnosed with endometrial carcinoma. METHODS ASRGL1 expression in curettage specimens from 1144 women was determined by immunohistochemistry. MAIN OUTCOME MEASURES ASRGL1 status related to disease-specific survival, lymph node status, preoperative imaging parameters and clinicopathological data. RESULTS ASRGL1 expression had independent prognostic value in multivariate survival analyses, both in the whole patient population (hazard ratio (HR) 1.63, 95% CI 1.11-2.37, P = 0.012) and in the low-risk curettage histology subgroup (HR 2.54, 95% CI 1.44-4.47, P = 0.001). Lymph node metastases were more frequent in women with low expression of ASRGL1 compared with women with high ASRGL1 levels (23% versus 10%, P < 0.001), and low ASRGL1 level was found to independently predict lymph node metastases (odds ratio 2.07, 95% CI 1.27-3.38, P = 0.003). CONCLUSIONS Low expression of ASRGL1 in curettage independently predicts lymph node metastases and poor disease-specific survival. TWEETABLE ABSTRACT Low ASRGL1 expression in curettage predicts lymph node metastasis and poor survival in endometrial carcinoma.
Collapse
Affiliation(s)
- T Fonnes
- Department of Clinical Science, Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.,Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
| | - J Trovik
- Department of Clinical Science, Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.,Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
| | - P-Hd Edqvist
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.,Science for Life Laboratory, Uppsala, Sweden
| | - K E Fasmer
- Department of Radiology, Centre for Nuclear Medicine/PET, Haukeland University Hospital, Bergen, Norway.,Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - J Marcickiewicz
- Department of Gynaecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Obstetrics and Gynaecology, Halland's Hospital Varberg, Varberg, Sweden
| | - S Tingulstad
- Department of Gynaecology, St Olav's Hospital, Trondheim, Norway
| | - A C Staff
- Department of Gynaecology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - L Bjørge
- Department of Clinical Science, Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.,Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
| | - F Amant
- Department of Gynaecologic Oncology, UZGasthuisberg, KU Leuven, Leuven, Belgium.,Centre for Gynaecologic Oncology, Netherlands Cancer Institute and Academic Medical Centre, Amsterdam, the Netherlands
| | - I S Haldorsen
- Department of Radiology, Haukeland University Hospital, Bergen, Norway.,Section for Radiology, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Hmj Werner
- Department of Clinical Science, Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.,Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
| | - L A Akslen
- Section for Pathology, Department of Clinical Medicine, Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.,Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - I L Tangen
- Department of Clinical Science, Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.,Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
| | - C Krakstad
- Department of Clinical Science, Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.,Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
20
|
Barrientos G, Pussetto M, Rose M, Staff AC, Blois SM, Toblli JE. Defective trophoblast invasion underlies fetal growth restriction and preeclampsia-like symptoms in the stroke-prone spontaneously hypertensive rat. Mol Hum Reprod 2018; 23:509-519. [PMID: 28402512 DOI: 10.1093/molehr/gax024] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [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: 10/11/2016] [Accepted: 04/07/2017] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What is the impact of chronic hypertension on placental development, fetal growth and maternal outcome in the stroke-prone spontaneously hypertensive rat (SHRSP)? SUMMARY ANSWER SHRSP showed an impaired remodeling of the spiral arteries and abnormal pattern of trophoblast invasion during placentation, which were associated with subsequent maternal glomerular injury and increased baseline hypertension as well as placental insufficiency and asymmetric fetal growth restriction (FGR). WHAT IS KNOWN ALREADY A hallmark in the pathogenesis of preeclampsia (PE) is abnormal placentation with defective remodeling of the spiral arteries preceding the onset of the maternal syndrome. Pregnancies affected by chronic hypertension display an increased risk for PE, often associated with poor maternal and fetal outcomes. However, the impact of chronic hypertension on the placentation process as well as the nature of the factors promoting the development of PE in pregnant hypertensive women remain elusive. STUDY DESIGN, SIZE, DURATION Timed pregnancies [n = 5] were established by mating 10-12-week-old SHRSP and Wistar Kyoto (WKY, normotensive controls) females with congenic males. Maternal systolic blood pressures (SBPs) were recorded pre-mating, throughout pregnancy (GD1-19) and post-partum by the tail-cuff method. On selected dates, 24 h urine- and blood samples were collected, and animals were euthanized for isolation of implantation sites and kidneys for morphometrical analyses. PARTICIPANTS/MATERIALS, SETTING, METHODS The 24 h proteinuria and the albumin:creatinine ratio were used for evaluation of maternal renal function. Renal injury was assessed on periodic acid Schiff, Masson's trichrome and Sirius red stainings. Placental and fetal weights were recorded on gestation day (GD)18 and GD20, followed by determination of fetal cephalization indexes and developmental stage, according to the Witschi scale. Morphometric analyses of placental development were conducted on hematoxylin-eosin stained tissue sections collected on GD14 and GD18, and complemented with immunohistochemical evaluation of isolectin B4 binding for assessment of placental vascularization. Analyses of vascular wall alpha actin content, perforin-positive natural killer (NK) cells and cytokeratin expression by immunohistochemistry were used for evaluation of spiral artery remodeling and trophoblast invasion. MAIN RESULTS AND THE ROLE OF CHANCE SHRSP females presented significantly increased SBP records from GD13 to GD17 (SBPGD13 = 183.9 ± 3.9 mmHg, P < 0.005 versus baseline) and increased proteinuria at GD18 (P < 0.01 versus WKY). Histological examination of GD18 kidneys revealed glomerular enlargement and mesangial matrix expansion, which were not evident in pregnant WKY or age-matched virgin SHRSP. At GD20, SHRSP displayed a significant reduction of placental mass (P < 0.01 versus WKY) and signs of placental insufficiency (i.e. hypertrophy and reduced branching morphogenesis of the labyrinth layer), associated with decreased offspring weights and increased cephalization index (both P < 0.001 versus WKY) indicating asymmetric FGR. Notably, SHRSP placentas displayed an incomplete remodeling of spiral arteries starting as early as GD14, with luminal narrowing and reduced densities of perivascular NK cells followed by decreased infiltration of endovascular trophoblasts at GD18. LARGE SCALE DATA n/a. LIMITATIONS, REASONS FOR CAUTION A pitfall of the present study is the differences in the blood pressure profiles between rats and humans (i.e. unlike pregnancies affected by PE, blood pressure in SHRSP and other hypertensive rat models decreases pre-delivery), which limits extrapolation of the results. WIDER IMPLICATIONS OF THE FINDINGS Our findings provide new insights on the role of chronic hypertension as a risk factor for PE by interfering with early events during the placentation process. The SHRSP strain represents an attractive model for further studies aimed at addressing the relative contribution of intrinsic (i.e. placental) and extrinsic (i.e. decidual/vascular) factors to defective spiral artery remodeling in pregnancies affected by PE. STUDY FUNDING AND COMPETING INTEREST(S) This work was supported by research grants from Fundación Florencio Fiorini to G.B., from Charité Stiftung to S.M.B. and University of Buenos Aires (UBACyt) to J.T. The authors have no competing interests to declare.
Collapse
Affiliation(s)
- G Barrientos
- Laboratory of Experimental Medicine, Hospital Alemán, School of Medicine, University of Buenos Aires, CONICET. Av. Pueyrredon 1640 (C1118AAT), Buenos Aires, Argentina.,Charité-Center for Internal Medicine and Dermatology, Division of General Internal and Psychosomatic Medicine, Reproductive Medicine Research Group, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - M Pussetto
- Laboratory of Experimental Medicine, Hospital Alemán, School of Medicine, University of Buenos Aires, CONICET. Av. Pueyrredon 1640 (C1118AAT), Buenos Aires, Argentina
| | - M Rose
- Charité-Center for Internal Medicine and Dermatology, Division of General Internal and Psychosomatic Medicine, Reproductive Medicine Research Group, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - A C Staff
- Department of Obstetrics and Department of Gynaecology, Women's Division, Oslo University Hospital, Ullevål and University of Oslo, Oslo, Norway
| | - S M Blois
- Charité-Center for Internal Medicine and Dermatology, Division of General Internal and Psychosomatic Medicine, Reproductive Medicine Research Group, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J E Toblli
- Laboratory of Experimental Medicine, Hospital Alemán, School of Medicine, University of Buenos Aires, CONICET. Av. Pueyrredon 1640 (C1118AAT), Buenos Aires, Argentina
| |
Collapse
|
21
|
Schalekamp-Timmermans S, Arends LR, Alsaker E, Chappell L, Hansson S, Harsem NK, Jälmby M, Jeyabalan A, Laivuori H, Lawlor DA, Macdonald-Wallis C, Magnus P, Myers J, Olsen J, Poston L, Redman CW, Staff AC, Villa P, Roberts JM, Steegers EA. Fetal sex-specific differences in gestational age at delivery in pre-eclampsia: a meta-analysis. Int J Epidemiol 2018; 46:632-642. [PMID: 27605586 PMCID: PMC5837300 DOI: 10.1093/ije/dyw178] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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] [Accepted: 05/27/2016] [Indexed: 12/27/2022] Open
Abstract
Background: Pre-eclampsia (PE) is a major pregnancy disorder complicating up to 8% of pregnancies. Increasing evidence indicates a sex-specific interplay between the mother, placenta and fetus. This may lead to different adaptive mechanisms during pregnancy. Methods: We performed an individual participant data meta-analysis to determine associations of fetal sex and PE, with specific focus on gestational age at delivery in PE. This was done on 219 575 independent live-born singleton pregnancies, with a gestational age at birth between 22.0 and 43.0 weeks of gestation, from 11 studies participating in a worldwide consortium of international research groups focusing on pregnancy. Results: Of the women, 9033 (4.1%) experienced PE in their pregnancy and 48.8% of the fetuses were female versus 51.2% male. No differences in the female/male distribution were observed with respect to term PE (delivered ≥ 37 weeks). Preterm PE (delivered < 37 weeks) was slightly more prevalent among pregnancies with a female fetus than in pregnancies with a male fetus [odds ratio (OR) 1.11, 95% confidence interval (CI) 1.02–1.21]. Very preterm PE (delivered < 34 weeks) was even more prevalent among pregnancies with a female fetus as compared with pregnancies with a male fetus (OR 1.36, 95% CI 1.17–1.59). Conclusions: Sexual dimorphic differences in the occurrence of PE exist, with preterm PE being more prevalent among pregnancies with a female fetus as compared with pregnancies with a male fetus and with no differences with respect to term PE.
Collapse
Affiliation(s)
| | | | - Lidia R Arends
- Institute of Psychology, and Department of Pedagogical Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands, and Erasmus Medical Centre, Department of Biostatistics, Rotterdam, The Netherlands
| | - Elin Alsaker
- Norwegian Institute of Public Health, Oslo, Norway
| | - Lucy Chappell
- Women's Health Academic Centre, King's College London and King's Health Partners, London, UK
| | - Stefan Hansson
- Lund University, Department of Clinical Sciences, Obstetrics and Gynecology, Lund, Sweden, and Skåne University Hospital, Perinatal Unit, Malmo, Sweden
| | - Nina K Harsem
- Oslo University Hospital, Department of Obstetrics, Oslo, Norway
| | - Maya Jälmby
- Lund University, Department of Clinical Sciences, Obstetrics and Gynecology, Lund, Sweden, and Skåne University Hospital, Department of Obstetrics and Gynecology, Malmo, Sweden
| | - Arundhathi Jeyabalan
- University of Pittsburgh School of Medicine, Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Pittsburgh, PA, USA
| | - Hannele Laivuori
- Medical and Clinical Genetics and Obstetrics and Gynecology, and Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Debbie A Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, School of Social and Community Medicine, Bristol, UK
| | - Corrie Macdonald-Wallis
- MRC Integrative Epidemiology Unit at the University of Bristol, School of Social and Community Medicine, Bristol, UK
| | - Per Magnus
- Norwegian Institute of Public Health, Oslo, Norway
| | - Jenny Myers
- Maternal & Fetal Health Research Centre, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Jørn Olsen
- Aarhus University, Institute of Clinical Epidemiology, Aarhus, Denmark, and UCLA Los Angeles, Los Angeles, CA, USA
| | - Lucilla Poston
- Women's Health Academic Centre, King's College London and King's Health Partners, London, UK
| | - Christopher W Redman
- Nuffield Department of Obstetrics and Gynecology, John Radcliffe Hospital, Oxford, UK
| | - Anne C Staff
- Oslo University Hospital, Department of Obstetrics and Department of Gynecology, University of Oslo, Oslo, Norway
| | - Pia Villa
- Obstetrics and Gynecology, and Clinical Graduate School in Pediatrics and Obstetrics/Gynecology, University of Helsinki, Helsinki, Finland
| | - James M Roberts
- Department of Obstetrics, Gynecology and Reproductive Sciences, Epidemiology and Clinical and Translational Research University of Pittsburgh, Pittsburgh, PA, USA
| | - Eric A Steegers
- Erasmus Medical Centre, Department of Obstetrics and Gynecology, Rotterdam, The Netherlands
| |
Collapse
|
22
|
Abstract
INTRODUCTION AND HYPOTHESIS Classical native-tissue techniques for pelvic organ prolapse (POP) repairs, such as the Manchester procedure (MP), have been revitalized because of vaginal mesh complications. However, there are conflicting opinions regarding sufficient apical (mid-compartment) support by the MP and concerns about the risk of dyspareunia. The aims of this study were therefore to investigate anatomical and patient-reported outcomes 1 year after MP. METHODS Prospective cohort study of 153 females undergoing an MP for anterior compartment POP between October 2014 and June 2016. Pre- and 1-year postoperative evaluations included POP-Q measurements and the questionnaires Pelvic Floor Distress Inventory Short Form 20 (PFDI-20) and POP/Urinary Incontinence Sexual Questionnaire (PISQ-12). RESULTS At 1 year, 97% (148/153) attended the follow-up. Significant anatomical improvements (p < 0.01) were obtained in all compartments. Mean Ba was -1.1 (± 1.4), mean C -5.9 (± 1.7) and mean D -7.0 (± 1.2) at follow-up. Point C ≤ -5 was present in 81.1%. POP-Q stage 0-1 was obtained in 99.3% in the mid-compartment (C < -1), but only in 48.6% in the anterior compartment (Ba < -1). A significant reduction in symptom scores was obtained for PFDI-20 (p < 0.01) and PISQ-12 (p = 0.01). No significant changes were seen in dyspareunia rates (q.5, PISQ-12), but 5.6% reported de novo dyspareunia. Concerning POP symptoms, 96.0% reported being cured or significantly improved. CONCLUSIONS The Manchester procedure provides adequate apical support, albeit inferior anatomical anterior compartment results, and 96.0% reported being subjectively cured or substantially better at 1-year follow-up, with no significant change in dyspareunia.
Collapse
Affiliation(s)
- Sissel Hegdahl Oversand
- Department of Gynaecology, Oslo University Hospital, Ulleval, Pb 4956 Nydalen, 0424, Oslo, Norway.
- Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Anne C Staff
- Department of Gynaecology, Oslo University Hospital, Ulleval, Pb 4956 Nydalen, 0424, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ellen Borstad
- Department of Gynaecology, Oslo University Hospital, Ulleval, Pb 4956 Nydalen, 0424, Oslo, Norway
| | - Rune Svenningsen
- Department of Gynaecology, Oslo University Hospital, Ulleval, Pb 4956 Nydalen, 0424, Oslo, Norway
| |
Collapse
|
23
|
Abstract
Pre‐eclampsia is a complex disease with significant maternal and fetal morbidity and mortality. Its syndromic nature makes diagnosis and management difficult. The field is rapidly evolving with the definition of pre‐eclampsia being challenged by some organisations, with proteinuria no longer being essential in the presence of other features. In the last decade, angiogenic factors, in particular soluble fms‐like tyrosine kinase 1 (sFlt‐1), have emerged as important molecules in the pathogenesis of pre‐eclampsia. Here we review the most recent evidence regarding the potential of these factors as biomarkers and therapeutic targets for pre‐eclampsia. Tweetable abstract A review of angiogenic factors, sFlt‐1 and PlGF, in the diagnosis, prediction and management of pre‐eclampsia. A review of angiogenic factors, sFlt‐1 and PlGF, in the diagnosis, prediction and management of pre‐eclampsia.
Collapse
Affiliation(s)
- A S Cerdeira
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK
| | - S Agrawal
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK
| | - A C Staff
- Division of Obstetrics and Gynaecology, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - C W Redman
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK
| | - M Vatish
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK
| |
Collapse
|
24
|
Njølstad TS, Werner HM, Marcickiewicz J, Tingulstad S, Staff AC, Oddenes K, Bjørge L, Engh ME, Woie K, Tjugum J, Lode MS, Amant F, Salvesen HB, Trovik J. Late-week surgical treatment of endometrial cancer is associated with worse long-term outcome: Results from a prospective, multicenter study. PLoS One 2017; 12:e0182223. [PMID: 28771617 PMCID: PMC5542466 DOI: 10.1371/journal.pone.0182223] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 07/15/2017] [Indexed: 11/22/2022] Open
Abstract
Surgery is the cornerstone in primary endometrial cancer treatment, and with curative intent it constitutes total hysterectomy and bilateral salpingo-oopherectomy. In addition, lymphadenectomy is performed in selected patients dependent on a preoperative risk assessment. Recent reports from the surgical approach to esophageal cancer reveal worse outcome when esophagectomy is performed later in the week. On this basis, we set out to explore weekday of surgery in relation to long-term outcome in 1302 endometrial cancer patients prospectively included in the MoMaTEC multicenter study. Day of surgery was dichotomized as early-week (Monday-Tuesday) or late-week (Wednesday-Friday), and evaluated as a discrete variable. Adjusted for patient age, Body Mass Index (BMI), FIGO stage, and histology, surgery performed later in the week was associated with 50.9% increased risk of all-cause death (p = 0.029). Among high-stage patients (FIGO stage III and IV), 5-year disease-specific survival proportions were 53.0% for early-week operated vs. 40.2% for late-week operated (p = 0.005 for difference). In multivariate survival analysis of high-stage patients, late-week surgery correlated with an increased risk of disease-specific death by 88.7% and all-cause death by 76.4% (p<0.017). Evaluating only patients who underwent lymphadenectomy, the adverse prognostic effect of being operated late-week remained for both disease-specific and all-cause death (HR 2.151 and HR 1.912, p = 0.004). Whether surgery was performed early- or late-week was not influenced by patient age, BMI, preoperative histology risk classification, FIGO stage or postoperative histology (all p>0.05). In conclusion, endometrial cancer surgery conducted late-week is associated with worse long-term outcome. Our findings are most evident among patients with higher FIGO stages, and patients who underwent more extensive surgical procedure (lymphadenectomy). With support from other studies, our results suggest that high-risk patients may benefit from surgery earlier in the week.
Collapse
Affiliation(s)
- Tormund S. Njølstad
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
- Centre for Cancer Biomarkers (CCBIO), University of Bergen, Bergen, Norway
| | - Henrica M. Werner
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
- Centre for Cancer Biomarkers (CCBIO), University of Bergen, Bergen, Norway
| | - Janusz Marcickiewicz
- Department of Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Obstetrics and Gynecology, Halland’s Hospital Varberg, Varberg, Sweden
| | | | - Anne C. Staff
- University of Oslo and Department of Gynecology, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Klaus Oddenes
- Department of Obstetrics and Gynecology, Haugesund Hospital, Haugesund, Norway
| | - Line Bjørge
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
- Centre for Cancer Biomarkers (CCBIO), University of Bergen, Bergen, Norway
| | - Marie E. Engh
- Department of Gynecology, Akershus University Hospital, Lørenskog, Norway
| | - Kathrine Woie
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
- Centre for Cancer Biomarkers (CCBIO), University of Bergen, Bergen, Norway
| | - Jostein Tjugum
- Department of Obstetrics and Gynecology, Førde Central Hospital, Førde, Norway
| | - Margaret S. Lode
- Department of Obstetrics and Gynecology, Ålesund Hospital, Ålesund, Norway
| | - Frederic Amant
- Gynecologic Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Center for Gynecologic Oncology (CGOA), Antoni van Leeuwenhoek, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Helga B. Salvesen
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
- Centre for Cancer Biomarkers (CCBIO), University of Bergen, Bergen, Norway
| | - Jone Trovik
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
- Centre for Cancer Biomarkers (CCBIO), University of Bergen, Bergen, Norway
| |
Collapse
|
25
|
Tangen IL, Kopperud RK, Visser NC, Staff AC, Tingulstad S, Marcickiewicz J, Amant F, Bjørge L, Pijnenborg JM, Salvesen HB, Werner HM, Trovik J, Krakstad C. Expression of L1CAM in curettage or high L1CAM level in preoperative blood samples predicts lymph node metastases and poor outcome in endometrial cancer patients. Br J Cancer 2017; 117:840-847. [PMID: 28751757 PMCID: PMC5589986 DOI: 10.1038/bjc.2017.235] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/23/2017] [Accepted: 06/28/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Several studies have identified L1 cell adhesion molecule (L1CAM) as a strong prognostic marker in endometrial cancer. To further underline the clinical usefulness of this biomarker, we investigated L1CAM as a predictive marker for lymph node metastases and its prognostic impact in curettage specimens and preoperative plasma samples. In addition, we aimed to validate the prognostic value of L1CAM in hysterectomy specimen. METHODS Immunohistochemical staining of L1CAM was performed for 795 hysterectomy and 1134 curettage specimen from endometrial cancer patients. The L1CAM level in preoperative blood samples from 372 patients was determined using ELISA. RESULTS Expression of L1CAM in curettage specimen was significantly correlated to L1CAM level in corresponding hysterectomy specimen (P<0.001). Both in curettage and preoperative plasma samples L1CAM upregulation was significantly associated with features of aggressive disease and poor outcome (P<0.001). The L1CAM was an independent predictor of lymph node metastases, after correction for curettage histology, both in curettage specimen (P=0.002) and plasma samples (P=0.048). In the hysterectomy samples L1CAM was significantly associated with poor outcome (P<0.001). CONCLUSIONS We demonstrate that preoperative evaluation of L1CAM levels, both in curettage or plasma samples, predicts lymph node metastases and adds valuable information on patient prognosis.
Collapse
Affiliation(s)
- Ingvild L Tangen
- Department of Gynaecology and Obstetrics, Haukeland University Hospital, 5053 Bergen, Norway.,Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway
| | - Reidun K Kopperud
- Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway
| | - Nicole Cm Visser
- Department of Pathology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Anne C Staff
- Department of Gynaecology, Oslo University Hospital, 0424 Oslo, Norway.,Faculty of Medicine, University of Oslo, 0424 Oslo, Norway
| | - Solveig Tingulstad
- Department of Gynaecology, St. Olav's Hospital, 7006 Trondheim, Norway.,Department of Laboratory Medicine, Children's and Women's Health (LBK), Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Janusz Marcickiewicz
- Department of Obstetrics and Gynaecology, Halland's Hospital Varberg, 43281 Varberg, Sweden
| | - Frédéric Amant
- Department of Oncology and Gynaecologic Oncology, Leuven Cancer Institute, 3000 Leuven, Belgium.,Center for Gynaecologic Oncology Amsterdam (CGOA), Netherlands Cancer Institute, 1006 BE Amsterdam, The Netherlands
| | - Line Bjørge
- Department of Gynaecology and Obstetrics, Haukeland University Hospital, 5053 Bergen, Norway.,Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway
| | - Johanna Ma Pijnenborg
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Helga B Salvesen
- Department of Gynaecology and Obstetrics, Haukeland University Hospital, 5053 Bergen, Norway.,Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway
| | - Henrica Mj Werner
- Department of Gynaecology and Obstetrics, Haukeland University Hospital, 5053 Bergen, Norway.,Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway
| | - Jone Trovik
- Department of Gynaecology and Obstetrics, Haukeland University Hospital, 5053 Bergen, Norway.,Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway
| | - Camilla Krakstad
- Department of Gynaecology and Obstetrics, Haukeland University Hospital, 5053 Bergen, Norway.,Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway
| |
Collapse
|
26
|
Oversand SH, Staff AC, Sandvik L, Volløyhaug I, Svenningsen R. Levator ani defects and the severity of symptoms in women with anterior compartment pelvic organ prolapse. Int Urogynecol J 2017. [DOI: 10.1007/s00192-017-3390-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
27
|
Przybyl L, Golic M, Haase N, Rugor J, Solano ME, Arck PC, Gauster M, Huppertz B, Stoppe C, Bernhagen J, Peetz D, Staff AC, Müller DN, Dechend R, Herse F. Verminderte CD74-Expression und gestörte Makrophagen-Trophoblasten Interaktion in der Präeklampsie. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
28
|
Golic M, Haase N, Herse F, Wehner A, Pijnenborg R, Vercruysse L, Luft F, Alnaes-Katjavivi P, Staff AC, Henrich W, Verlohren S, Müller DN, Dechend R. Natural killer cell reduction induces uteroplacental vasculopathy and fetal growth restriction in wild type rats. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
29
|
Hveem TS, Njølstad TS, Nielsen B, Syvertsen RA, Nesheim JA, Kjæreng ML, Kildal W, Pradhan M, Marcickiewicz J, Tingulstad S, Staff AC, Haugland HK, Eraker R, Oddenes K, Rokne JA, Tjugum J, Lode MS, Amant F, Werner HMJ, Bjørge L, Albregtsen F, Liestøl K, Salvesen HB, Trovik J, Danielsen HE. Changes in Chromatin Structure in Curettage Specimens Identifies High-Risk Patients in Endometrial Cancer. Cancer Epidemiol Biomarkers Prev 2016; 26:61-67. [PMID: 27587790 DOI: 10.1158/1055-9965.epi-16-0215] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/17/2016] [Accepted: 07/01/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Most endometrial carcinoma patients are diagnosed at an early stage with a good prognosis. However, a relatively low fraction with lethal disease constitutes a substantial number of patients due to the high incidence rate. Preoperative identification of patients with high risk and low risk for poor outcome is necessary to tailor treatment. Nucleotyping refers to characterization of cell nuclei by image cytometry, including the assessment of chromatin structure by nuclear texture analysis. This method is a strong prognostic marker in many cancers but has not been evaluated in preoperative curettage specimens from endometrial carcinoma. METHODS The prognostic impact of changes in chromatin structure quantified with Nucleotyping was evaluated in preoperative curettage specimens from 791 endometrial carcinoma patients prospectively included in the MoMaTEC multicenter trial. RESULTS Nucleotyping was an independent prognostic marker of disease-specific survival in preoperative curettage specimens among patients with Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage I-II disease (HR=2.9; 95% CI, 1.2-6.5; P = 0.013) and significantly associated with age, FIGO stage, histologic type, histologic grade, myometrial infiltration, lymph node status, curettage histology type, and DNA ploidy. CONCLUSIONS Nucleotyping in preoperative curettage specimens is an independent prognostic marker for disease-specific survival, with potential to supplement existing parameters for risk stratification to tailor treatment. IMPACT This is the first study to evaluate the prognostic impact of Nucleotyping in curettage specimens from endometrial carcinoma and shows that this may be a clinically useful prognostic marker in endometrial cancer. External validation is warranted. Cancer Epidemiol Biomarkers Prev; 26(1); 61-67. ©2016 AACR.
Collapse
Affiliation(s)
- Tarjei S Hveem
- Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.,Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway.,Department of Informatics, University of Oslo, Oslo, Norway
| | - Tormund S Njølstad
- KG Jebsen Center for Gynecologic Cancer Research, Haukeland University Hospital, Bergen, Norway.,Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Birgitte Nielsen
- Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.,Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway
| | - Rolf Anders Syvertsen
- Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.,Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway
| | - John Arne Nesheim
- Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.,Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway
| | - Marna L Kjæreng
- Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.,Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway
| | - Wanja Kildal
- Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.,Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway
| | - Manohar Pradhan
- Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.,Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway
| | - Janusz Marcickiewicz
- Department of Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Halland's Hospital Varberg, Varberg, Sweden
| | | | - Anne C Staff
- Department of Gynecology, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Hans K Haugland
- Department of Pathology, The Gade Institute, Haukeland University Hospital, Bergen, Norway
| | - Runar Eraker
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway.,University of Oslo, Oslo, Norway
| | - Klaus Oddenes
- Department of Obstetrics and Gynecology, Haugesund Hospital, Haugesund, Norway
| | - Jan A Rokne
- Department of Obstetrics and Gynecology, Hospital of Vestfold, Tønsberg, Norway
| | - Jostein Tjugum
- Department of Obstetrics and Gynecology, Førde Hospital, Førde, Norway
| | - Margaret S Lode
- Department of Obstetrics and Gynecology, Ålesund Hospital, Ålesund, Norway
| | - Frederic Amant
- Department of Gynecologic Oncology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Henrica M J Werner
- KG Jebsen Center for Gynecologic Cancer Research, Haukeland University Hospital, Bergen, Norway.,Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Fritz Albregtsen
- Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.,Department of Informatics, University of Oslo, Oslo, Norway
| | - Knut Liestøl
- Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway.,Department of Informatics, University of Oslo, Oslo, Norway
| | - Helga B Salvesen
- KG Jebsen Center for Gynecologic Cancer Research, Haukeland University Hospital, Bergen, Norway.,Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jone Trovik
- KG Jebsen Center for Gynecologic Cancer Research, Haukeland University Hospital, Bergen, Norway.,Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Håvard E Danielsen
- Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway. .,Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway.,Department of Informatics, University of Oslo, Oslo, Norway.,Nuffield Division of Clinical Laboratory Sciences, University of Oxford, Oxford, United Kingdom
| | | |
Collapse
|
30
|
Moksnes LR, Svenningsen R, Schiøtz HA, Moe K, Staff AC, Kulseng-Hanssen S. Sling mobilization in the management of urinary retention after mid-urethral sling surgery. Neurourol Urodyn 2016; 36:1091-1096. [DOI: 10.1002/nau.23046] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 05/12/2016] [Indexed: 11/12/2022]
Affiliation(s)
| | - Rune Svenningsen
- Department of Gynecology; Oslo University Hospital; Ullevål, Oslo Norway
| | - Hjalmar A. Schiøtz
- Department of Obstetrics and Gynecology; Vestfold Hospital; Tønsberg Norway
| | - Kjartan Moe
- Faculty of Medicine; University of Oslo; Oslo Norway
| | - Anne C. Staff
- Department of Gynecology; Oslo University Hospital; Ullevål, Oslo Norway
- Faculty of Medicine; University of Oslo; Oslo Norway
| | | |
Collapse
|
31
|
Fodstad K, Staff AC, Laine K. Episiotomy preferences, indication, and classification--a survey among Nordic doctors. Acta Obstet Gynecol Scand 2016; 95:587-95. [PMID: 26814151 DOI: 10.1111/aogs.12856] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 06/30/2015] [Accepted: 01/18/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Episiotomy performance impacts perineal health and rates of obstetric anal sphincter injuries (OASIS). Our objective was to assess self-reported episiotomy practice and opinions on clinical indication for episiotomy among Nordic physicians and to investigate potential misclassification. MATERIAL AND METHODS A survey was conducted among doctors attending the 2012 Nordic obstetrical and gynecological conference. Participants were asked to draw an episiotomy on a photo of a perineum with a crowning fetal head similarly to their clinical practice if an episiotomy was clinically indicated, and to name the technique drawn. Differences in outcome measures were compared by country of practice and seniority. RESULTS The majority of the 297 participants (47%) drew a lateral episiotomy according to our classification by incision point and angle, but as many as 64% of these 138 doctors misclassified this as mediolateral episiotomy. Only 20% drew a mediolateral episiotomy, the great majority classifying it accurately, but 8% misclassified their mediolateral cut as a lateral episiotomy. One-third of episiotomies were nonclassifiable. In general, doctors in Finland, Sweden, and Norway more often favored lateral episiotomies compared with doctors in Denmark and Iceland. There were significant differences between Finnish and Norwegian vs. Danish and Swedish doctors in perception of clinical indications for episiotomy. CONCLUSIONS The great variation in self-reported episiotomy performance between Nordic physicians and large misclassification rates indicate that educational programs are warranted. Use of uniform classification and appropriate techniques may be crucial to investigate the role of episiotomies in preventing OASIS.
Collapse
Affiliation(s)
- Kathrine Fodstad
- Department of Obstetrics and Department of Gynecology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne C Staff
- Department of Obstetrics and Department of Gynecology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Katariina Laine
- Department of Obstetrics and Department of Gynecology, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
32
|
Holwerda KM, Weedon-Fekjær MS, Staff AC, Nolte IM, van Goor H, Lely AT, Faas MM. The association of single nucleotide polymorphisms of the maternal cystathionine-β-synthase gene with early-onset preeclampsia. Pregnancy Hypertens 2015; 6:60-5. [PMID: 26955774 DOI: 10.1016/j.preghy.2015.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 12/08/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Preeclampsia (PE) is a pregnancy complication, characterized by hypertension and proteinuria. The transsulfuration pathway may be involved in its pathophysiology, since homocysteine, cystathionine and cysteine are increased in PE. Cystathionine-β-synthase (CBS) is a key-enzyme in the pathway, converting homocysteine into cysteine via cystathionine. Another product of CBS is hydrogen sulfide (H2S), a vasodilatory, proangiogenic and cytoprotective gas that is thought to play a role in placental and vascular function during pregnancy. Since single nucleotide polymorphisms (SNPs) can affect CBS expression and/or function, we studied tag-SNPs in the CBS gene in PE patients. STUDY DESIGN Controls (n=75), early-onset (n=45), and late-onset PE (n=52) cases were genotyped for six tag-SNPs in the CBS gene; rs12329764, rs2851391, rs234713, rs234706, rs1789953, and rs11203172. Plasma homocysteine, cysteine and cystathionine were determined during pregnancy. MAIN OUTCOME MEASURES Early-onset PE, late-onset PE. RESULTS Women with the minor allele of rs11203172 have a reduced risk for early-onset PE. Compared to women without the minor allele, normotensive pregnant women with the minor allele of rs11203172 and rs234713 have lower cysteine levels. Women with the minor allele of rs1789953 have increased levels of cysteine and cystathionine, compared to women without. CONCLUSION The CBS tag-SNP rs11203172 is associated with a decreased risk for early-onset PE. Decreased cysteine concentrations in normotensive pregnant women carrying the minor allele of rs11203172, may be due to increased cysteine conversion to H2S by CBS. Higher H2S levels may positively affect placentation and vascular function during pregnancy and decrease their risk for PE.
Collapse
Affiliation(s)
- Kim M Holwerda
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30001, 9713 GZ Groningen, The Netherlands.
| | - M Susanne Weedon-Fekjær
- University of Oslo, Department of Obstetrics and Gynaecology, Oslo University Hospital, Ulleval, 0424 Oslo, Norway.
| | - Anne C Staff
- University of Oslo, Department of Obstetrics and Gynaecology, Oslo University Hospital, Ulleval, 0424 Oslo, Norway.
| | - Ilja M Nolte
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30001, 9713 GZ Groningen, The Netherlands.
| | - Harry van Goor
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30001, 9713 GZ Groningen, The Netherlands.
| | - A Titia Lely
- Department of Obstetrics and Gynecology, University Medical Center Utrecht, University of Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - Marijke M Faas
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30001, 9713 GZ Groningen, The Netherlands; Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| |
Collapse
|
33
|
Pay A, Frøen JF, Staff AC, Jacobsson B, Gjessing HK. Prediction of small-for-gestational-age status by symphysis-fundus height: a registry-based population cohort study. BJOG 2015; 123:1167-73. [PMID: 26644370 DOI: 10.1111/1471-0528.13727] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To develop a chart for risk of small-for-gestational-age (SGA) at birth depending on deviations in symphysis-fundus (SF) height values for gestational age during pregnancy weeks 24-42. DESIGN Registry-based population cohort study. SETTING Antenatal clinics, Västra Götaland County, Sweden, 2005-2010. POPULATION The study included 42 018 women with ultrasound-dated singleton pregnancies who delivered at Sahlgrenska University Hospital. Data (including 282 713 SF height measurements) were extracted from the hospital's computerised obstetric database. METHODS Linear and binary regression analyses were used to derive prediction models with deviations in birthweight (BW) and SF height by gestational age as dependent and independent variables, respectively. Receiver operating characteristic curves were generated to evaluate the predictive value of the model in detecting SGA. MAIN OUTCOME MEASURES Birthweight and small-for-gestational-age. RESULTS Symphysis-fundus height accounted for 3% of individual BW variance at 24 weeks, increasing gradually to 20% at 40 weeks. Maternal factors explained an additional 10 percentage points of BW variance. Receiver operating characteristic curves confirmed that SF height was a stronger SGA predictor in late than in early pregnancy. Using an SGA relative risk cut-off limit of ≥2-fold, the overall sensitivity was 50% and the overall specificity 80%. Only the most recent SF measurement was useful in predicting BW deviation; previous measurements added nothing to the predictive value. CONCLUSIONS The ability of SF measurements to detect SGA status at birth increases with gestational age. Only the most recent SF measurement has predictive value; a static or falling pattern of SF values did not increase SGA likelihood. TWEETABLE ABSTRACT New SF curves predict SGA best in late pregnancy; only the most recent SF measurement has predictive value.
Collapse
Affiliation(s)
- Asd Pay
- Departments of Obstetrics and Gynaecology, Women's and Children's Division, Oslo University Hospital, Oslo, Norway.,Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway
| | - J F Frøen
- Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway
| | - A C Staff
- Departments of Obstetrics and Gynaecology, Women's and Children's Division, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - B Jacobsson
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden.,Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway
| | - H K Gjessing
- Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| |
Collapse
|
34
|
Przybyl L, Haase N, Golic M, Rugor J, Solano ME, Arck PC, Gauster M, Huppertz B, Bernhagen J, Bucala R, Luft FC, Staff AC, Mueller DN, Dechend R, Herse F. Abstract 042: Cd74-dysregulation of Macrophage-trophoblastic Interactions in the Preeclamptic Placenta. Hypertension 2015. [DOI: 10.1161/hyp.66.suppl_1.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives:
Preeclamptic pregnancies feature placental anomalies. Villous trophoblast differentiation during placental development is regulated by feto-placental macrophages and disturbance of this well-balanced regulation can lead to pathological pregnancies. We hypothesized that Cluster of differentiation 74 (CD74) dysregulation of placental macrophages, leading to altered macrophage-trophoblast interaction, is involved in preeclampsia.
Methods and Results:
We performed microarray analysis of placental tissue. CD74 was one of the most down-regulated (-2.5 fold) genes in placentas from preeclamptic women. We confirmed this finding in early onset (<34 gestational week, n=26) and late onset (≥34 gestational week, n=24) samples from preeclamptic women, compared to healthy pregnant controls (n=28) by real-time RT-PCR and on protein level by Western blot and flow cytometry. We localized CD74 expression in placental macrophages by immunofluorescence, flow cytometry, and real-time RT-PCR. Number and mean fluorescence intensity (MFI) of CD74-positive macrophages were significantly lower in preeclamptic placentas (7692 MFI ± 4402), as compared to controls (16283 MFI ± 3047). In CD74-silenced macrophages, expression of adhesion molecules ALCAM (-2 fold), ICAM4 (-2.1 fold), and Syndecan-2 (-1.9 fold) was lower compared to control. Macrophage adhesion to a trophoblast layer were diminished (-1.3 fold). Naïve and activated macrophages lacking CD74 showed a shift towards a pro-inflammatory signature with an increased secretion of TNFalpha(21.8 pg/ml ± 13.2 vs. 8 pg/ml ± 4.3), CCL5 (1.9 ng/ml ± 0.4 vs. 0.8 ng/ml ± 0.2) and MCP-1 (3 ng/ml ± 2.6 vs. 1 ng/ml ± 0.5), when co-cultured with trophoblasts compared to control macrophages. CD74-knockout mice showed disturbed placental morphology, reduced junctional zone (1.6 mm2 ± 0.3 vs. 2.3 mm2 ± 0.5) and smaller placentas (0.09 g ± 0.01 vs. 0.11 g ± 0.02) with fetal growth restriction (0.7 g ± 0.1 vs. 0.9 g ± 0.2) when compared to WT mice.
Conclusions:
We found that CD74 downregulation in placental macrophages is present in preeclampsia. CD74 downregulation led to altered macrophage activation towards a pro-inflammatory signature, a disturbed crosstalk with trophoblasts and an abnormal placental morphology.
Collapse
Affiliation(s)
- Lukasz Przybyl
- Experimental and Clinical Rsch Cntr (ECRC), Berlin, Germany
| | - Nadine Haase
- Max-Delbrueck Cntr for Molecular Medicine in the Hemholtz Association, Berlin, Germany
| | - Michaela Golic
- Experimental and Clinical Rsch Cntr (ECRC), Berlin, Germany
| | - Julianna Rugor
- Experimental and Clinical Rsch Cntr (ECRC), Berlin, Germany
| | | | - Petra C Arck
- Univ Med Cntr Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | | | | | | | - Dominik N Mueller
- Max-Delbrueck Cntr for Molecular Medicine in the Hemholtz Association, Berlin, Germany
| | - Ralf Dechend
- Experimental and Clinical Rsch Cntr (ECRC), Berlin, Germany
| | - Florian Herse
- Max-Delbrueck Cntr for Molecular Medicine in the Hemholtz Association, Berlin, Germany
| |
Collapse
|
35
|
Zeisler H, Llurba E, Chantraine F, Vatish M, Staff AC, Sennström M, Olovsson M, Brennecke SP, Stepan H, Allegranza D, Dilba P, Schoedl M, Hund M, Verlohren S. Prädiktion der Präeklampsie mit dem sFlt-1/PlGF-Quotienten – die PROGNOSIS-Studie. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1548681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
36
|
Rasmussen LG, Lykke JA, Staff AC. Angiogenic biomarkers in pregnancy: defining maternal and fetal health. Acta Obstet Gynecol Scand 2015; 94:820-32. [DOI: 10.1111/aogs.12629] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 03/04/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Lene G. Rasmussen
- Department of Obstetrics and Gynecology; Oslo University Hospital; Oslo Norway
- Faculty of Medicine; University of Copenhagen; Copenhagen Denmark
| | - Jacob A. Lykke
- Faculty of Medicine; University of Copenhagen; Copenhagen Denmark
- Department of Obstetrics and Gynecology; Hvidovre University Hospital; Copenhagen Denmark
- Departement of Obstetrics; Rigshospitalet Copenhagen University Hospital; Copenhagen Denmark
| | - Anne C. Staff
- Department of Obstetrics and Gynecology; Oslo University Hospital; Oslo Norway
- Faculty of Medicine; University of Oslo; Oslo Norway
| |
Collapse
|
37
|
Barbaux S, Erwich JJHM, Favaron PO, Gil S, Gallot D, Golos TG, Gonzalez-Bulnes A, Guibourdenche J, Heazell AEP, Jansson T, Laprévote O, Lewis RM, Miller RK, Monk D, Novakovic B, Oudejans C, Parast M, Peugnet P, Pfarrer C, Pinar H, Roberts CT, Robinson W, Saffery R, Salomon C, Sexton A, Staff AC, Suter M, Tarrade A, Wallace J, Vaillancourt C, Vaiman D, Worton SA, Lash GE. IFPA meeting 2014 workshop report: Animal models to study pregnancy pathologies; new approaches to study human placental exposure to xenobiotics; biomarkers of pregnancy pathologies; placental genetics and epigenetics; the placenta and stillbirth and fetal growth restriction. Placenta 2015; 36 Suppl 1:S5-10. [PMID: 25703592 DOI: 10.1016/j.placenta.2015.01.196] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 11/15/2022]
Abstract
Workshops are an important part of the IFPA annual meeting as they allow for discussion of specialized topics. At IFPA meeting 2014 there were six themed workshops, five of which are summarized in this report. These workshops related to various aspects of placental biology but collectively covered areas of animal models, xenobiotics, pathological biomarkers, genetics and epigenetics, and stillbirth and fetal growth restriction.
Collapse
Affiliation(s)
- S Barbaux
- Institut Cochin, INSERM U1016, Université Paris Descartes, Paris, France
| | - J J H M Erwich
- Department of Obstetrics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - P O Favaron
- School of Veterinary Medicine and Animal Science, University of São Paulo, Brazil
| | - S Gil
- Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - D Gallot
- CHU Clermont-Ferrand, Pôle Gynéco-Obstétrique-Reproduction Humaine, CHU Estaing, Clermont-Ferrand, France; Université d'Auvergne, Faculté de Médecine, Clermont-Ferrand, France
| | - T G Golos
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, WI, USA; Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | - A E P Heazell
- Maternal and Fetal Health Research Centre, Institute of Human Development, University of Manchester, Manchester, UK; St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - T Jansson
- Department of Obstetrics and Gynecology, University of Texas-San Antonio, San Antonio, TX, USA
| | - O Laprévote
- Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - R M Lewis
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - R K Miller
- School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - D Monk
- Imprinting and Cancer Group, Cancer Epigenetic and Biology Program, Institut d'Investigació Biomedica de Bellvitge, Hospital Duran i Reynals, Barcelona, Spain
| | - B Novakovic
- Murdoch Childrens Research Institute, University of Melbourne, Melbourne, Australia
| | - C Oudejans
- VU University Medical Center, Amsterdam, The Netherlands
| | - M Parast
- Department of Pathology, Sanford Consortium for Regenerative Medicine, University of California San Diego, La Jolla, CA, USA
| | - P Peugnet
- INRA, UMR1198 Developmental Biology and Reproduction, Jouy en Josas, France
| | - C Pfarrer
- Department of Anatomy, University of Veterinary Medicine Hannover, Germany
| | - H Pinar
- WIH, Division of Perinatal Pathology, Brown University, Providence, RI, USA
| | - C T Roberts
- Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - W Robinson
- Department of Medical Genetics, University of British Columbia, Canada; Child & Family Research Institute, Vancouver, British Columbia, Canada
| | - R Saffery
- Murdoch Childrens Research Institute, University of Melbourne, Melbourne, Australia
| | - C Salomon
- University of Queensland Centre for Clinical Research, Centre for Clinical Diagnostics, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - A Sexton
- Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), Seattle Children's, WA, USA
| | - A C Staff
- Department of Obstetrics and Gynecology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - M Suter
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - A Tarrade
- INRA, UMR1198 Developmental Biology and Reproduction, Jouy en Josas, France; Fondation PremUp, Paris, France
| | - J Wallace
- Rowett Institute of Nutrition and Health, University of Aberdeen, Aberdeen, UK
| | - C Vaillancourt
- INRS-Institut Armand-Frappier and BioMed Research Center, Laval University, Québec, Canada
| | - D Vaiman
- AP-HP, INSERM - Université Paris Descartes, Paris, France
| | - S A Worton
- Maternal and Fetal Health Research Centre, Institute of Human Development, University of Manchester, Manchester, UK; St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - G E Lash
- Reproductive and Vascular Biology Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
| |
Collapse
|
38
|
Trovik J, Wik E, Werner HM, Krakstad C, Helland H, Vandenput I, Njolstad TS, Stefansson IM, Marcickiewicz J, Tingulstad S, Staff AC, Amant F, Akslen LA, Salvesen HB. Hormone receptor loss in endometrial carcinoma curettage predicts lymph node metastasis and poor outcome in prospective multicentre trial. Eur J Cancer 2013; 49:3431-41. [DOI: 10.1016/j.ejca.2013.06.016] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 06/12/2013] [Accepted: 06/17/2013] [Indexed: 01/29/2023]
|
39
|
Svenningsen R, Staff AC, Schiøtz HA, Western K, Sandvik L, Kulseng-Hanssen S. Risk factors for long-term failure of the retropubic tension-free vaginal tape procedure. Neurourol Urodyn 2013; 33:1140-6. [PMID: 23946255 DOI: 10.1002/nau.22466] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 05/16/2013] [Accepted: 06/25/2013] [Indexed: 11/09/2022]
Abstract
AIMS To investigate potential risk factors for long-term (10-year) subjective and objective failure of the retropubic tension-free vaginal tape procedure (TVT). METHODS Secondary risk analysis was performed using data from a recently published multi-center study that were merged with additional preoperative and operative data individually stored in the Norwegian Female Incontinence Registry (NFIR). Subjective data from 483 women and objective data from 327 women were obtained 10 years after retropubic TVT surgery. A validated questionnaire was used for subjective outcome data and a stress test for objective outcome data. Uni- and multivariate logistic regression analyses were performed using preoperative and operative variables extracted from the NFIR. The outcomes were 10-year subjective failure defined as women stating not cured, and objective failure was defined as ≥1 g urinary leakage during stress testing. RESULTS Age ≥56 years at the time of TVT surgery was associated with both long-term subjective failure (adjusted OR: 2.15, CI: 1.40-3.30) and long-term objective failure (adjusted OR: 2.81, CI: 1.30-6.09). Mixed incontinence was associated with subjective, but not objective failure if the urgency incontinence component was severe (adjusted OR: 2.33, CI: 1.27-4.28). Surgical complications occurring at or immediately following surgery were associated with both outcomes in the univariate analyses, but were only an independent risk factor for subjective failure in the multivariate analysis (adjusted OR: 3.02, CI: 1.53-5.95). CONCLUSIONS Age ≥56 years, a severe preoperative urgency incontinence component and surgical complications seem to represent independent risk factors for long-term (10-year) failure.
Collapse
Affiliation(s)
- Rune Svenningsen
- Department of Gynaecology, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Norway
| | | | | | | | | | | |
Collapse
|
40
|
Golic M, Herse F, Haase N, Przybyl L, Karumanchi SA, Verlohren S, Henrich W, Staff AC, Dechend R. Neue Aspekte zur Expression von soluble fms-like tyrosine kinase 1 (sFlt1). Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
41
|
Svenningsen R, Staff AC, Schiøtz HA, Western K, Kulseng-Hanssen S. Long-term follow-up of the retropubic tension-free vaginal tape procedure. Int Urogynecol J 2013; 24:1271-8. [DOI: 10.1007/s00192-013-2058-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Accepted: 01/19/2013] [Indexed: 11/30/2022]
|
42
|
Herse F, Lamarca B, Hubel CA, Kaartokallio T, Lokki AI, Ekholm E, Laivuori H, Gauster M, Huppertz B, Sugulle M, Ryan MJ, Novotny S, Brewer J, Park JK, Kacik M, Hoyer J, Verlohren S, Wallukat G, Rothe M, Luft FC, Muller DN, Schunck WH, Staff AC, Dechend R. Cytochrome P450 subfamily 2J polypeptide 2 expression and circulating epoxyeicosatrienoic metabolites in preeclampsia. Circulation 2012; 126:2990-9. [PMID: 23155181 DOI: 10.1161/circulationaha.112.127340] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Preeclampsia is a multisystem disorder of pregnancy, originating in the placenta. Cytochrome P450 (CYP)-dependent eicosanoids regulate vascular function, inflammation, and angiogenesis, which are mechanistically important in preeclampsia. METHODS AND RESULTS We performed microarray screening of placenta and decidua (maternal placenta) from 25 preeclamptic women and 23 control subjects. The CYP subfamily 2J polypeptide 2 (CYP2J2) was upregulated in preeclamptic placenta and decidua. Reverse-transcription polymerase chain reaction confirmed the upregulation, and immunohistochemistry localized CYP2J2 in trophoblastic villi and deciduas at 12 weeks and term. The CYP2J2 metabolites, 5,6-epoxyeicosatrienoic acid (EET), 14,15-EET, and the corresponding dihydroxyeicosatrienoic acids, were elevated in preeclamptic women compared with controls in the latter two thirds of pregnancy and after delivery. Stimulating a trophoblast-derived cell line with the preeclampsia-associated cytokine tumor necrosis factor-α enhanced CYP2J2 gene and protein expression. In 2 independent rat models of preeclampsia, reduced uterine-perfusion rat and the transgenic angiotensin II rat, we observed elevated EET, dihydroxyeicosatrienoic acid, and preeclamptic features that were ameliorated by the CYP epoxygenase inhibitor N-(methylsulfonyl)-2-(2-propynyloxy)-benzenehexanamide (MsPPOH). Uterine arterial rings of these rats also dilated in response to MsPPOH. Furthermore, 5,6-EET could be metabolized to a thromboxane analog. In a bioassay, 5,6-EET increased the beating rate of neonatal cardiomyocytes. Blocking thromboxane synthesis reversed that finding and also normalized large-conductance calcium-activated potassium channel activity. CONCLUSIONS Our data implicate CYP2J2 in the pathogenesis of preeclampsia and as a potential candidate for the disturbed uteroplacental remodeling, leading to hypertension and endothelial dysfunction.
Collapse
Affiliation(s)
- Florian Herse
- Experimental and Clinical Research Center, Lindenberger Weg 80, 13125 Berlin, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Johnsen GM, Basak S, Weedon-Fekjær MS, Staff AC, Duttaroy AK. Docosahexaenoic acid stimulates tube formation in first trimester trophoblast cells, HTR8/SVneo. Placenta 2011; 32:626-632. [PMID: 21741084 DOI: 10.1016/j.placenta.2011.06.009] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 06/07/2011] [Accepted: 06/14/2011] [Indexed: 11/27/2022]
Abstract
Angiogenesis is a key factor in the placentation process and vascular remodeling that involves several growth factors such as vascular endothelial growth factor (VEGF) and angiopoietin-like protein 4 (ANGPTL4). PPARs are involved in the placentation process but not much information is available on whether their ligands such as fatty acids have any effects on these processes. We therefore investigated the effect of fatty acids (arachidonic acid, 20:4 n-6(ARA), eicosapentaenoic acid, 20:5 n-3(EPA), docosahexaenoic acid, 22:6 n-3 (DHA) and oleic acid, 18:1 n-9 (OA)) on tube formation (as a measure of angiogenesis) on matrigel in the first trimester trophoblast cells, HTR8/SVneo. In addition we also investigated the effects of fatty acids on expression of genes involved in angiogenesis (VEGF and ANGPTL4) and lipid metabolism in these cells. Gene expression was determined after incubating these cells with different fatty acids for 24 h using real-time qRT-PCR, whereas VEGF and ANGPTL4 proteins were measured by respective ELISA kits. Of all the fatty acids tested, DHA increased tube formation to the greatest extent. DHA-induced increase in tube length was 583%, 247% and 70% over control, OA and EPA, respectively (p < 0.05). In addition, DHA stimulated cell proliferation by 150% of these cells. Of all fatty acids investigated, only DHA stimulated VEGF mRNA expression and protein secretion compared with control. Unlike DHA, other fatty acids (OA, EPA, ARA) stimulated ANGPTL4 mRNA expression and protein secretion in these cells. An inhibitor of VEGF decreased DHA stimulated tube formation in these cells. Altogether these data indicate that DHA may potently influence the placentation process by stimulating tube formation and this effect may be mediated in part via VEGF in first trimester trophoblast cells.
Collapse
Affiliation(s)
- G M Johnsen
- Department of Nutrition, Institute for Basic Medical Sciences, Faculty of Medicine, University of Oslo, POB 1046 Blindern, N-0316 Oslo, Norway
| | - S Basak
- Department of Nutrition, Institute for Basic Medical Sciences, Faculty of Medicine, University of Oslo, POB 1046 Blindern, N-0316 Oslo, Norway
| | - M S Weedon-Fekjær
- Department of Nutrition, Institute for Basic Medical Sciences, Faculty of Medicine, University of Oslo, POB 1046 Blindern, N-0316 Oslo, Norway
| | - A C Staff
- Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Obstetrics and Gynaecology, Oslo University Hospital, Ullevål, Oslo, Norway
| | - A K Duttaroy
- Department of Nutrition, Institute for Basic Medical Sciences, Faculty of Medicine, University of Oslo, POB 1046 Blindern, N-0316 Oslo, Norway.
| |
Collapse
|
44
|
Herse F, Fain JN, Janke J, Engeli S, Kuhn C, Frey N, Weich HA, Bergmann A, Kappert K, Karumanchi SA, Luft FC, Muller DN, Staff AC, Dechend R. Adipose Tissue-Derived Soluble Fms-Like Tyrosine Kinase 1 Is an Obesity-Relevant Endogenous Paracrine Adipokine. Hypertension 2011; 58:37-42. [DOI: 10.1161/hypertensionaha.111.171322] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Florian Herse
- From the Experimental and Clinical Research Center (F.H., J.J., A.B., F.C.L., D.N.M., R.D.), Medical Faculty of the Charité and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Molecular Sciences (J.N.F.), College of Medicine, University of Tennessee Health Science Center, Memphis, TN; Institute of Clinical Pharmacology (S.E.), Medical School of Hannover, Hannover, Germany; Department of Cardiology (C.K., N.F.), University Schleswig-Holstein, Kiel, Germany; Helmholtz
| | - John N. Fain
- From the Experimental and Clinical Research Center (F.H., J.J., A.B., F.C.L., D.N.M., R.D.), Medical Faculty of the Charité and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Molecular Sciences (J.N.F.), College of Medicine, University of Tennessee Health Science Center, Memphis, TN; Institute of Clinical Pharmacology (S.E.), Medical School of Hannover, Hannover, Germany; Department of Cardiology (C.K., N.F.), University Schleswig-Holstein, Kiel, Germany; Helmholtz
| | - Juergen Janke
- From the Experimental and Clinical Research Center (F.H., J.J., A.B., F.C.L., D.N.M., R.D.), Medical Faculty of the Charité and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Molecular Sciences (J.N.F.), College of Medicine, University of Tennessee Health Science Center, Memphis, TN; Institute of Clinical Pharmacology (S.E.), Medical School of Hannover, Hannover, Germany; Department of Cardiology (C.K., N.F.), University Schleswig-Holstein, Kiel, Germany; Helmholtz
| | - Stefan Engeli
- From the Experimental and Clinical Research Center (F.H., J.J., A.B., F.C.L., D.N.M., R.D.), Medical Faculty of the Charité and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Molecular Sciences (J.N.F.), College of Medicine, University of Tennessee Health Science Center, Memphis, TN; Institute of Clinical Pharmacology (S.E.), Medical School of Hannover, Hannover, Germany; Department of Cardiology (C.K., N.F.), University Schleswig-Holstein, Kiel, Germany; Helmholtz
| | - Christian Kuhn
- From the Experimental and Clinical Research Center (F.H., J.J., A.B., F.C.L., D.N.M., R.D.), Medical Faculty of the Charité and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Molecular Sciences (J.N.F.), College of Medicine, University of Tennessee Health Science Center, Memphis, TN; Institute of Clinical Pharmacology (S.E.), Medical School of Hannover, Hannover, Germany; Department of Cardiology (C.K., N.F.), University Schleswig-Holstein, Kiel, Germany; Helmholtz
| | - Norbert Frey
- From the Experimental and Clinical Research Center (F.H., J.J., A.B., F.C.L., D.N.M., R.D.), Medical Faculty of the Charité and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Molecular Sciences (J.N.F.), College of Medicine, University of Tennessee Health Science Center, Memphis, TN; Institute of Clinical Pharmacology (S.E.), Medical School of Hannover, Hannover, Germany; Department of Cardiology (C.K., N.F.), University Schleswig-Holstein, Kiel, Germany; Helmholtz
| | - Herbert A. Weich
- From the Experimental and Clinical Research Center (F.H., J.J., A.B., F.C.L., D.N.M., R.D.), Medical Faculty of the Charité and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Molecular Sciences (J.N.F.), College of Medicine, University of Tennessee Health Science Center, Memphis, TN; Institute of Clinical Pharmacology (S.E.), Medical School of Hannover, Hannover, Germany; Department of Cardiology (C.K., N.F.), University Schleswig-Holstein, Kiel, Germany; Helmholtz
| | - Astrid Bergmann
- From the Experimental and Clinical Research Center (F.H., J.J., A.B., F.C.L., D.N.M., R.D.), Medical Faculty of the Charité and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Molecular Sciences (J.N.F.), College of Medicine, University of Tennessee Health Science Center, Memphis, TN; Institute of Clinical Pharmacology (S.E.), Medical School of Hannover, Hannover, Germany; Department of Cardiology (C.K., N.F.), University Schleswig-Holstein, Kiel, Germany; Helmholtz
| | - Kai Kappert
- From the Experimental and Clinical Research Center (F.H., J.J., A.B., F.C.L., D.N.M., R.D.), Medical Faculty of the Charité and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Molecular Sciences (J.N.F.), College of Medicine, University of Tennessee Health Science Center, Memphis, TN; Institute of Clinical Pharmacology (S.E.), Medical School of Hannover, Hannover, Germany; Department of Cardiology (C.K., N.F.), University Schleswig-Holstein, Kiel, Germany; Helmholtz
| | - S. Ananth Karumanchi
- From the Experimental and Clinical Research Center (F.H., J.J., A.B., F.C.L., D.N.M., R.D.), Medical Faculty of the Charité and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Molecular Sciences (J.N.F.), College of Medicine, University of Tennessee Health Science Center, Memphis, TN; Institute of Clinical Pharmacology (S.E.), Medical School of Hannover, Hannover, Germany; Department of Cardiology (C.K., N.F.), University Schleswig-Holstein, Kiel, Germany; Helmholtz
| | - Friedrich C. Luft
- From the Experimental and Clinical Research Center (F.H., J.J., A.B., F.C.L., D.N.M., R.D.), Medical Faculty of the Charité and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Molecular Sciences (J.N.F.), College of Medicine, University of Tennessee Health Science Center, Memphis, TN; Institute of Clinical Pharmacology (S.E.), Medical School of Hannover, Hannover, Germany; Department of Cardiology (C.K., N.F.), University Schleswig-Holstein, Kiel, Germany; Helmholtz
| | - Dominik N. Muller
- From the Experimental and Clinical Research Center (F.H., J.J., A.B., F.C.L., D.N.M., R.D.), Medical Faculty of the Charité and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Molecular Sciences (J.N.F.), College of Medicine, University of Tennessee Health Science Center, Memphis, TN; Institute of Clinical Pharmacology (S.E.), Medical School of Hannover, Hannover, Germany; Department of Cardiology (C.K., N.F.), University Schleswig-Holstein, Kiel, Germany; Helmholtz
| | - Anne C. Staff
- From the Experimental and Clinical Research Center (F.H., J.J., A.B., F.C.L., D.N.M., R.D.), Medical Faculty of the Charité and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Molecular Sciences (J.N.F.), College of Medicine, University of Tennessee Health Science Center, Memphis, TN; Institute of Clinical Pharmacology (S.E.), Medical School of Hannover, Hannover, Germany; Department of Cardiology (C.K., N.F.), University Schleswig-Holstein, Kiel, Germany; Helmholtz
| | - Ralf Dechend
- From the Experimental and Clinical Research Center (F.H., J.J., A.B., F.C.L., D.N.M., R.D.), Medical Faculty of the Charité and Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Molecular Sciences (J.N.F.), College of Medicine, University of Tennessee Health Science Center, Memphis, TN; Institute of Clinical Pharmacology (S.E.), Medical School of Hannover, Hannover, Germany; Department of Cardiology (C.K., N.F.), University Schleswig-Holstein, Kiel, Germany; Helmholtz
| |
Collapse
|
45
|
Trovik J, Wik E, Stefansson IM, Marcickiewicz J, Tingulstad S, Staff AC, Njolstad TS, Vandenput I, Amant F, Akslen LA, Salvesen HB. Stathmin overexpression identifies high-risk patients and lymph node metastasis in endometrial cancer. Clin Cancer Res 2011; 17:3368-77. [PMID: 21242118 DOI: 10.1158/1078-0432.ccr-10-2412] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Overexpression of the oncogen Stathmin has been linked to aggressive endometrial carcinoma and a potential for PI3Kinase inhibitors in this disease. We wanted to validate the prognostic value of Stathmin expression in a large prospective multicenter setting. As lymph node sampling is part of current surgical staging, we also aimed to test if Stathmin expression in endometrial curettage specimens could predict lymph node metastasis. EXPERIMENTAL DESIGN A total of 1,076 endometrial cancer patients have been recruited from 10 centers to investigate the biological tumor marker Stathmin in relation to clinicopathologic variables, including lymph node status and survival. Stathmin immunohistochemical staining was carried out in 477 hysterectomy and 818 curettage specimens. RESULTS Seventy-one percent of the patients (n = 763) were subjected to lymph node sampling, of which 12% had metastatic nodes (n = 94). Overexpression of Stathmin was detected in 37% (302 of 818) of the curettage and in 18% (84 of 477) of the hysterectomy specimens investigated. Stathmin overexpression in curettage and hysterectomy specimens were highly correlated and significantly associated with nonendometrioid histology, high grade, and aneuploidy. Stathmin analysis in preoperative curettage samples significantly correlated with, and was an independent predictor of, lymph node metastases. High Stathmin expression was associated with poor disease-specific survival (P ≤ 0.002) both in curettage and hysterectomy specimens. CONCLUSIONS Stathmin immunohistochemical staining identifies endometrial carcinomas with lymph node metastases and poor survival. The value, as a predictive marker for response to PI3Kinase inhibition and as a tool to stratify patients for lymph node sampling in endometrial carcinomas, remains to be determined.
Collapse
Affiliation(s)
- Jone Trovik
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Hering L, Herse F, Geusens N, Verlohren S, Wenzel K, Staff AC, Brosnihan KB, Huppertz B, Luft FC, Muller DN, Pijnenborg R, Cartwright JE, Dechend R. Effects of circulating and local uteroplacental angiotensin II in rat pregnancy. Hypertension 2010; 56:311-8. [PMID: 20530295 DOI: 10.1161/hypertensionaha.110.150961] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The renin-angiotensin (Ang) system is important during placental development. Dysregulation of the renin-Ang system is important in preeclampsia (PE). Female rats transgenic for the human angiotensinogen gene crossed with males transgenic for the human renin gene develop the PE syndrome, whereas those of the opposite cross do not. We used this model to study the role of Ang II in trophoblast invasion, which is shallow in human PE but deeper in this model. We investigated the following groups: PE rats, opposite-cross rats, Ang II-infused rats (1000 ng/kg per day), and control rats. Ang II infusion increased only circulating Ang II levels (267.82 pg/mL), opposite cross influenced only uteroplacental Ang II (13.52 fmol/mg of protein), and PE increased both circulating (251.09 pg/mL) and uteroplacental (19.24 fmol/mg of protein) Ang II. Blood pressure and albuminuria occurred in the models with high circulating Ang II but not in the other models. Trophoblast invasion increased in PE and opposite-cross rats but not in Ang II-infused rats. Correspondingly, uterine artery resistance index increased in Ang II-infused rats but decreased in PE rats. We then studied human trophoblasts and villous explants from first-trimester pregnancies with time-lapse microscopy. Local Ang II dose-dependently increased migration by 75%, invasion by 58%, and motility by 282%. The data suggest that local tissue Ang II stimulates trophoblast invasion in vivo in the rat and in vitro in human cells, a hitherto fore unrecognized function. Conceivably, upregulation of tissue Ang II in the maternal part of the placenta represents an important growth factor for trophoblast invasion and migration.
Collapse
Affiliation(s)
- Lydia Hering
- Helios Klinikum, Schwanebecker Chaussee 50, 13125 Berlin, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Eskild A, Jeansson S, Jenum PA, Staff AC, Thadhani R, Karumanchi A, Vatten LJ. Levels of angiogenic factors in pregnancy and post-partum bleeding. Acta Obstet Gynecol Scand 2008; 87:1081-3. [PMID: 18792843 DOI: 10.1080/00016340802415622] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We have studied if serum levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and placenta growth factor (PlGF) in pregnancy could predict excess post-partum bleeding. In 392 normotensive singleton pregnancies, concentrations of sFlt-1 and PlGF in the first, second, and third trimester were compared between women with and without excess post-partum bleeding, defined as blood loss volume of at least 500 mL. Mean concentrations of sFlt-1 were consistently higher in all three trimesters among women who had excess post-partum bleeding compared to women without this, but significantly higher only in the second trimester. For PlGF, there were no significant differences between the groups. High concentrations of the anti-angiogenic factor sFlt-1 in maternal circulation during pregnancy may be associated with an increased risk of excess post-partum bleeding.
Collapse
Affiliation(s)
- Anne Eskild
- Department of Obstetrics and Gynecology, Akershus University Hospital and the Faculty of Medicine, University of Oslo, Norway.
| | | | | | | | | | | | | |
Collapse
|
48
|
Hering L, Herse F, Verlohren S, Park JK, Wellner M, Qadri F, Pijnenborg R, Staff AC, Huppertz B, Muller DN, Luft FC, Dechend R. Trophoblasts reduce the vascular smooth muscle cell proatherogenic response. Hypertension 2008; 51:554-9. [PMID: 18195163 DOI: 10.1161/hypertensionaha.107.102905] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Maternal spiral artery remodeling is the consequence of controlled trophoblast invasive interaction with the maternal cellular environment and is fundamentally important for successful placentation. In preeclampsia, trophoblast invasion is shallow, remodeling is incomplete, and vessels develop an inflammatory appearance, termed "acute atherosis." We noted that, in our preeclampsia, human renin-human angiotensinogen transgenic rat model, complement component 3 (C3), and tumor necrosis factor-alpha were upregulated and heavily expressed in atherotic uteroplacental vessels. We next used coculture involving human trophoblasts, rat vascular smooth muscle cells (VSMCs), and human VSMCs to observe VSMC-trophoblast regulatory interactions. Tumor necrosis factor-alpha induced complement C3 and interleukin-6 expression in VSMCs. We found that trophoblasts were able to reduce VSMC C3 and interleukin-6 expression after the VSMCs were stimulated with tumor necrosis factor-alpha. However, a direct VSMC-trophoblast cell-cell contact was necessary for this anti-inflammatory response. We also studied double-transgenic VSMCs that express inflammatory components and exhibit accelerated proliferation ("synthetic" phenotype). Trophoblasts could not downregulate C3 in these cells. We then examined uteroplacental tissues from preeclamptic and control patients. In control deciduas, only traces of C3 staining were observed, and vessels were thin walled without thrombus formation. In preeclampsia, the decidual vessels showed atherosis, thrombus formation, and C3 expression. Our data suggest that fetally derived trophoblasts require direct cell-cell contact with maternally derived VSMCs to downregulate VSMC C3 and interleukin-6 expression and to avoid atherosis. The findings also implicate C3 in the placental vasculopathy observed in preeclampsia.
Collapse
Affiliation(s)
- Lydia Hering
- Experimental and Clinical Research Center, Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Herse F, Hering L, Janke J, Engeli S, Gorzcelniak K, Kittelsen Harsem N, Jordan J, Homuth V, Luft FC, Staff AC, Muller DN, Dechend R. Adipocyten produzieren den Angiogenese-Inhibitor soluble fms-like-tyrosine kinase (sFLT-1). Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-1032344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
50
|
Herse F, Dechend R, Harsem NK, Wallukat G, Janke J, Qadri F, Hering L, Muller DN, Luft FC, Staff AC. Dysregulation of the circulating and tissue-based renin-angiotensin system in preeclampsia. Hypertension 2007; 49:604-11. [PMID: 17261642 DOI: 10.1161/01.hyp.0000257797.49289.71] [Citation(s) in RCA: 181] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The renin-angiotensin system (RAS) participates in preeclampsia; however, the relative contributions from the circulating RAS and the tissue-based, uteroplacental RAS are unknown. We hypothesized that the tissue-based uteroplacental RAS is dysregulated in preeclampsia. We performed microarray and gene expression studies and confirmed the findings on the protein level by immunohistochemistry in ureteroplacental units from 10 preeclamptic women and 10 women with uneventful pregnancies. All of the women were delivered by cesarean section. We also analyzed plasma renin activity and circulating agonistic angiotensin II type 1 (AT1) receptor autoantibodies. In preeclampsia, we found that the angiotensin II AT1 receptor gene was 5-fold upregulated in decidua (maternal origin). We also found AT1 autoantibodies in preeclamptic women and in their offspring by neonatal cardiomyocyte bioassay compared with women with normal pregnancies and their infants (mother: 17.5+/-2.2 versus 0.05+/-0.4; fetus: 14.5+/-1.8 versus 0.5+/-0.5 Deltabpm). Gene expressions for renin (35.0-fold), angiotensin-converting enzyme (2.9-fold), and angiotensinogen (8.9-fold) were higher in decidua than placenta (fetal origin) in both control and preeclamptic women, whereas the AT1 receptor was expressed 10-fold higher in placenta than in decidua in both groups. Our findings elucidate the ureteroplacental unit RAS in preeclamptic and normal pregnancies. We found that, in preeclampsia, the AT1 receptor expression is particularly high in decidua, combined with pregnancy-specific tissue RAS involving decidual angiotensin II production and AT1 autoantibodies. We also showed that AT1 autoantibodies cross the ureteroplacental barrier. These components could participate in the pathophysiology of preeclampsia.
Collapse
Affiliation(s)
- Florian Herse
- Medical Faculty of the Charité, Franz-Volhard Clinic, HELIOS Klinikum, Berlin, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|