Genetic risk score for gestational weight gain

Gestational weight gain (GWG) involves health consequences for both mother and offspring. Genetic factors seem to play a role in the GWG trait. For small effect sizes of a single genetic polymorphism (SNP), a genetic risk score (GRS) summarizing risk-associated variation from multiple SNPs can serve as an effective approach to genetic association analysis. The aim of the study was to analyze the association between genetic risk score (GRS) and gestational weight gain (GWG). GWG was calculated for a total of 342 healthy Polish women of Caucasian origin, aged 19 to 45 years. The SNPs rs9939609 (FTO), rs6548238 (TMEM18), rs17782313 (MC4R), rs10938397 (GNPDA2), rs10913469 (SEC16B), rs1137101 (LEPR), rs7799039 (LEP), and rs5443 (GNB3) were genotyped using commercial TaqMan SNP assays. A simple genetic risk score was calculated into two ways: GRS1 based on the sum of risk alleles from each of the SNPs, while GRS2 based on the sum of risk alleles of FTO, LEPR, LEP, and GNB3. Positive association between GRS2 and GWG (β = 0.12, p = 0.029) was observed. Genetic risk variants of TMEM18 (p = 0.006, OR = 2.6) and GNB3 (p < 0.001, OR = 3.3) are more frequent in women with increased GWG, but a risk variant of GNPDA2 (p < 0.001, OR = 2.7) is more frequent in women with adequate GWG, and a risk variant of LEPR (p = 0.011, OR = 3.1) in women with decreased GWG. GRS2 and genetic variants of TMEM18, GNB3, GNPDA2, and LEPR are associated with weight gain during pregnancy.

Guidelines of the Polish Society of Gynecologists and Obstetricians, the Polish Society for Vaccinology, and the Polish Society for Family Medicine on vaccinating women with reproductive plans and pregnant or breastfeeding women

The following Guidelines present the most up-to-date treatment and management recommendations, which may be modified and altered after detailed analysis of a specific clinical situation, which in turn might lead to future modifications and updates.

Common Variants in One-Carbon Metabolism Genes (MTHFR, MTR, MTHFD1) and Depression in Gynecologic Cancers

We investigated the association between methylenetetrahydrofolate reductase (gene MTHFR 677C>T, rs1801133), 5-methyltetrahydrofolate-homocysteine methyltransferase (MTR 2756A>G, rs1805087), and methylenetetrahydrofolate dehydrogenase, cyclohydrolase and formyltetrahydrofolate synthetase 1 (gene MTHFD1 1958G>A, rs2236225)-well-studied functional variants involved in one-carbon metabolism-and gynecologic cancer risk, and the interaction between these polymorphisms and depression. A total of 200 gynecologic cancer cases and 240 healthy controls were recruited to participate in this study. Three single-nucleotide variants (SNVs) (rs1801133, rs1805087, rs2236225) were genotyped using the PCR-restriction fragment length polymorphism method. Depression was assessed in all patients using the Hamilton Depression Scale. Depression was statistically significantly more frequent in women with gynecologic cancers (69.5% vs. 34.2% in controls, p < 0.001). MTHFD1 rs2236225 was associated with an increased risk of gynecologic cancers (in dominant OR = 1.53, p = 0.033, and in log-additive models OR = 1.37, p = 0.024). Moreover, an association was found between depression risk and MTHFR rs1801133 genotypes in the controls but not in women with gynecologic cancers (in codominant model CC vs. TT: OR = 3.39, 95%: 1.49-7.74, p = 0.011). Cancers of the female reproductive system are associated with the occurrence of depression, and ovarian cancer may be associated with the rs2236225 variant of the MTHFD1 gene. In addition, in healthy aging women in the Polish population, the rs1801133 variant of the MTHFR gene is associated with depression.

The Influence of Various Hydration Strategies (Isotonic, Water, and No Hydration) on Hematological Indices, Plasma Volume, and Lactate Concentration in Young Men during Prolonged Cycling in Elevated Ambient Temperatures

BACKGROUND

Increased internal body temperature during dehydration can be accompanied by water-electrolyte imbalances, higher levels of lactate during and after physical exertion, and changes in blood volume. Adequate hydration with carbohydrate-electrolyte fluids during physical activity can prevent dehydration and delay the onset of fatigue, allowing for proper biochemical and hematological reactions during exertion. A suitable drinking plan should consider the pre-exercise hydration level as well as the requirements for fluids, electrolytes, and substrates before, during, and after exercise. The objective of this study was to assess the impact of different hydration strategies (isotonic, water, and no hydration) on hematological indicators (hemoglobin concentration, hematocrit number, erythrocyte count, leukocyte count, and mean corpuscular volume) and lactate concentration during prolonged physical exertion in a high-temperature environment in young men.

METHODS

The research method was quasi-experimental. The study involved 12 healthy men aged 20.6 ± 0.9 years, who were characterized by a body height (BH) of 177.2 ± 4.8 cm, a body mass (BM) of 74.4 ± 7.6 kg, a lean body mass (LBM) of 61.1 ± 6.1 kg, and a body mass index (BMI) of 23.60 ± 0.48. Measurements were taken of body composition and hematological and biochemical indicators. The main tests consisted of three series of tests separated by a one-week break. During the tests, the men performed a 120 min exercise with an intensity of 110 W on a cycle ergometer in a thermo-climatic chamber at an ambient temperature of 31 ± 2 °C. During exertion, the participants consumed isotonic fluids or water in an amount of 120-150% of the lost water every 15 min. The participants who exercised without hydration did not consume any fluids.

RESULTS

Significant differences in serum volume were observed between the use of isotonic beverage and no hydration (p = 0.002) and between the use of isotonic beverage and water (p = 0.046). Immediately after the experimental exercise, hemoglobin values were significantly higher with no hydration than with water (p = 0.002). An even stronger significance of differences in hemoglobin was observed between no hydration and isotonic beverage consumption (p < 0.001). There was a statistically significant difference in the number of leukocytes between the consumption of isotonic beverage and no hydration (p = 0.006).

CONCLUSIONS

Each active hydration strategy allows for a better maintenance of water-electrolyte homeostasis during physical exertion in a high-temperature environment, and isotonic beverage consumption had a greater impact on hydrating extracellular spaces with the smallest changes in hematological indicators.

Anti-Candida and Antibiofilm Activity of Selected Lamiaceae Essential Oils

BACKGROUND

Candidiasis is a common oral and vaginal infection. Some papers have presented that the essential oils of Lamiaceae plants can have antifungal activity. This study aimed to investigate the activity of 7 essential oils of the Lamiaceae family with known phytochemical compositions against Candida fungi.

METHODS

Forty-four strains belonging to six species were tested: C. albicans, C. glabrata, C. guilliermondii, C. krusei, C. parapsilosis, and C. tropicalis. During this investigation, the following methods were used: determination of the minimal inhibitory concentrations (MICs), biofilm inhibition studies, and in silicotoxicity tests.

RESULTS

Essential oils of lemon balm (Melissa officinalis) and oregano (Origanum vulgare) showed the best anti-Candida activity, with MIC values below 3.125 mg/mL. Lavender (Lavandula stoechas), mint (Mentha × piperita), rosemary (Rosmarinus officinalis), and thyme (Thymus vulgaris) essential oils were also very active (0.39 to 6.25 or 12.5 mg/mL). Sage (Salvia officinalis) essential oil presented the lowest activity, with MIC values ranging from 3.125 to 100 mg/mL. In an antibiofilm study using MIC values, oregano and thyme essential oils showed the greatest effect, followed by lavender, mint, and rosemary oils. The weakest antibiofilm activity was observed with the lemon balm and sage oils. In silico toxicity research suggests that most of main compounds of Lamiaceae essential oils probably do not exhibit carcinogenicity, mutagenicity, or cytotoxicity.

CONCLUSIONS

The obtained results showed that Lamiaceae essential oils have anti-Candida and antibiofilm activity. Further research is required to confirm the safety and efficacy of essential oils in the topical treatment of candidiasis.

Plant Preparations and Compounds with Activities against Biofilms Formed by Candida spp

Fungi from the genus Candida are very important human and animal pathogens. Many strains can produce biofilms, which inhibit the activity of antifungal drugs and increase the tolerance or resistance to them as well. Clinically, this process leads to persistent infections and increased mortality. Today, many Candida species are resistant to drugs, including C. auris, which is a multiresistant pathogen. Natural compounds may potentially be used to combat multiresistant and biofilm-forming strains. The aim of this review was to present plant-derived preparations and compounds that inhibit Candida biofilm formation by at least 50%. A total of 29 essential oils and 16 plant extracts demonstrate activity against Candida biofilms, with the following families predominating: Lamiaceae, Myrtaceae, Asteraceae, Fabaceae, and Apiacae. Lavandula dentata (0.045–0.07 mg/L), Satureja macrosiphon (0.06–8 mg/L), and Ziziphora tenuior (2.5 mg/L) have the best antifungal activity. High efficacy has also been observed with Artemisia judaica, Lawsonia inermis, and Thymus vulgaris. Moreover, 69 plant compounds demonstrate activity against Candida biofilms. Activity in concentrations below 16 mg/L was observed with phenolic compounds (thymol, pterostilbene, and eugenol), sesquiterpene derivatives (warburganal, polygodial, and ivalin), chalconoid (lichochalcone A), steroidal saponin (dioscin), flavonoid (baicalein), alkaloids (waltheriones), macrocyclic bisbibenzyl (riccardin D), and cannabinoid (cannabidiol). The above compounds act on biofilm formation and/or mature biofilms. In summary, plant preparations and compounds exhibit anti-biofilm activity against Candida. Given this, they may be a promising alternative to antifungal drugs.

Vitamin D3 and its receptor in selected obstetrical complications

Vitamin D3 (VD3) and its steroidal nuclear receptor are necessary for proper development of a pregnancy. They play a key role in implantation, modulate the mother's immune response to the developing fetus, influence the final development of a placenta, and regulate blood pressure and glucose tolerance. VD3 deficiency can lead to the occurrence of obstetric complications such as recurrent miscarriages, preeclampsia, intrauterine growth restriction, gestational diabetes and preterm labor. VD3 deficiency is a common phenomenon across the globe; because of the higher demand placed on their bodies, pregnant women are more likely to develop VD3 deficiency. During pregnancy, VD3 supplementation is a safe method of treatment without risk of side effects or intoxication. To obtain the greatest efficacy, VD3 supplementation should start at the pregnancy planning stage, under control of the VD3 serum concentration, which should exceed 30 ng/mL (75 nmol/L); this is to start the positive effect of the optimal VD3 concentration from the beginning of a pregnancy.

The importance of NFκB1 rs4648068 and RUNX2 rs7771980 polymorphisms in bone metabolism of postmenopausal Polish women

OBJECTIVES

Osteoporosis is a multifactorial disease that causes a loss of bone density. However, genetic factors play an increasingly important role in its development. To thoroughly understand the molecular mechanisms, polymorphic variants of genes candidate for osteoporosis are still being sought. The aim of our study was to investigate the influence of NFκB1 gene rs4648068 (A>G) and RUNX2 gene rs7771980 (-1025T>C) polymorphisms on the risk of osteoporosis.

MATERIAL AND METHODS

A group of 675 postmenopausal Caucasian women (109 women with osteopenia, 333 with osteoporosis and 233 with normal T-score) were examined. The bone mineral density (BMD) at the lumbar spine (L1-L4) was measured by dual energy x-ray absorptiometry (DXA). The analysis of NFκB1 and RUNX2 polymorphisms was performed using real-time PCR method.

RESULTS

Analysis of NFκB1 gene rs4648068 polymorphism showed that the GG genotype was slightly more frequent in the study groups compared to the control group. In the osteoporosis group, patients with the G allele in the genotype have lower bone mineral density values. For the RUNX2 rs7771980 polymorphism, in women with osteopenia we observed an increased incidence of TC heterozygotes compared to the control group (29.40% vs 24.90%, p > 0.05), and in women with osteoporosis, the TT genotype was more common (78.70% vs 73.80%, p > 0.05). No correlation was observed between the genotypes and the clinical parameters.

CONCLUSIONS

The analysis showed no significant relationship between the genotypic distribution and the individual clinical parameters. However, it is suggested an association between the rs4648068 polymorphism of the NFκB1 gene and an increased risk of developing osteoporosis.

Cervical cancer screening in Poland in current SARS-CoV-2 pandemic: Interim guidelines of the Polish Society of Gynecologists and Obstetricians and the Polish Society of Colposcopy and Cervical Pathophysiology - a summary January 2021

The Polish Society of Colposcopy and Cervical Pathophysiology (PTKiPSM) together with the Polish Society of Gynecologists and Obstetricians (PTGiP) issued a final summary of interim guidelines for secondary cervical cancer prevention during the SARS-CoV-2 pandemic based on the analysis of the latest directional publications and the authors' own experiences. The aim of the summary is to facilitate the implementation of the most effective possible screening of cervical precancerous lesions and cervical cancer due to temporary significant limitation of screening as a consequence of the ongoing epidemiological threat. These final guidelines are taking into account the 2020 call of the World Health Organization (WHO) for global epidemiological elimination of cervical cancer. The guidelines supplement the interim guidelines of PTKiPSM and PTGiP announced in March 2020 on the possible deferral of diagnostic and therapeutic procedures in patients with abnormal screening tests results in secondary prevention of cervical cancer in current pandemic.

Plant Phenolics and Extracts in Animal Models of Preeclampsia and Clinical Trials-Review of Perspectives for Novel Therapies

The current health requirements set the direction in pharmacological research, especially as regards diseases that require improvement of existing therapeutic regimens. Such diseases include preeclampsia, which is a hypertensive disorder of pregnancy during which there occurs progressive increasing activation of the immune system through elevation of pro-inflammatory cytokines and antiangiogenic factors, which is dangerous for the mother and fetus. A promising field of research for new drugs to treat this disease is the study of natural phenolic compounds of plant origin and herbal extracts, which are complex matrices of chemical compounds with broad biological activities. Many plant substances with anti‑inflammatory and anti‑hypertensive properties are known, but studies in animal models of preeclampsia and clinical trials concerning this disease constitute a new and developing research trend of significant medical importance. The aim of our research review was to identify and analyze the results of already available studies on baicalin, curcumin, epigallocatechin gallate, punicalagin, quercetin, resveratrol, salvianolic acid A (danshensu), silibinin, and vitexin, as well as plant extracts from Brassica oleracea L., Euterpe oleracea Mart., Moringa oleifera Lam., Punica granatum L., Silybum marianum (L.) Gaertner, Thymus schimperi Ronniger, Uncaria rhynchophylla (Miq.) Miq. ex Havil., and Vitis vinifera L., which are potential and promising candidates for further research and for potential new therapies.

Combined Effects of Methyldopa and Flavonoids on the Expression of Selected Factors Related to Inflammatory Processes and Vascular Diseases in Human Placenta Cells-An In Vitro Study

The aim of the study was to investigate combined effects of flavonoids (apigenin, baicalein, chrysin, quercetin, and scutellarin) and methyldopa on the expression of selected proinflammatory and vascular factors in vitro for prediction of their action in pregnancy-induced hypertension. The research was conducted on a trophoblast-derived human choriocarcinoma cell line and a primary human umbilical vein endothelial cell line. Cytotoxicity of compounds in selected concentrations (20, 40, and 100 µmol) was measured using the MTT test and the concentration of 40 µmol was selected for further analysis. Subsequently, their effects with methyldopa on the expression of selected markers responsible for inflammation (TNF-α; IL-1β; IL-6) and vascular effects (hypoxia-inducible factor 1α—HIF-1α; placental growth factor—PIGF; transforming growth factor β—TGF-β; vascular endothelial growth factor—VEGF) at the mRNA and protein levels were assessed. It was found that every combined administration of a flavonoid and methyldopa in these cells induced a down-regulating effect on all tested factors, except PIGF, especially at the mRNA expression level. As hypertension generally raises TNF-α, IL-1β, IL-6, HIF-1α, TGF-β, and VEGF mRNA expression and/or protein levels, the results obtained in the studied model may provide a positive prognostic factor for such activity in vivo.

FokI vitamin D receptor polymorphism as a protective factor in intrahepatic cholestasis of pregnancy

OBJECTIVES

Intrahepatic cholestasis in pregnancy (ICP) is a pregnancy-specific liver disorder. Its etiology is not fully understood. Increasing evidence indicates the important role of vitamin D and the vitamin D receptor (VDR) in this disorder. The presence of polymorphic variants in the VDR gene could influence its activity and susceptibility to ICP development. The goal of the study was to investigate the role of four genetic polymorphisms of the VDR gene - Fok (rs731236), Bsm (rs1544410), Apa (rs7975232), and Taq (rs731236) - in the etiology of ICP in Polish women.

MATERIAL AND METHODS

Ninety-eight women with confirmed ICP and 215 healthy pregnant women as a control group were recruited to the study. We examined four SNPs of the VDR gene: BsmI (rs7975232), TaqI (rs1544410), ApaI (rs228570), FokI (rs731236). Genotyping was performed using the PCR/RFLP method.

RESULTS

We observed higher frequency (borderline significant) of the Ff-ff genotypes containing at least one mutated allele of the VDR FokI polymorphism in the control group compared to the ICP group (p = 0.045, OR = 1.71, 95% CI 1.01-2.88). The frequency of the mutated f allele was slightly higher in controls (49.1%) than in the ICP group (43.4%) (OR = 1.26, 95% CI 0.90-1.77), but the difference was not statistically significant (p = 0.196).

CONCLUSIONS

Our results showed that the maternal VDR FokI polymorphism could play a protective role in ICP development and probably modulate the risk of ICP occurrence in pregnant women in the Polish population. In the future, to confirm these observations, research in larger, ethnically stratified and clinically analyzed groups is necessary.

The 2020 race towards SARS-CoV-2 specific vaccines

The global outbreak of a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) highlighted a requirement for two pronged clinical interventions such as development of effective vaccines and acute therapeutic options for medium-to-severe stages of "coronavirus disease 2019" (COVID-19). Effective vaccines, if successfully developed, have been emphasized to become the most effective strategy in the global fight against the COVID-19 pandemic. Basic research advances in biotechnology and genetic engineering have already provided excellent progress and groundbreaking new discoveries in the field of the coronavirus biology and its epidemiology. In particular, for the vaccine development the advances in characterization of a capsid structure and identification of its antigens that can become targets for new vaccines. The development of the experimental vaccines requires a plethora of molecular techniques as well as strict compliance with safety procedures. The research and clinical data integrity, cross-validation of the results, and appropriated studies from the perspective of efficacy and potently side effects have recently become a hotly discussed topic. In this review, we present an update on latest advances and progress in an ongoing race to develop 52 different vaccines against SARS-CoV-2. Our analysis is focused on registered clinical trials (current as of November 04, 2020) that fulfill the international safety and efficacy criteria in the vaccine development. The requirements as well as benefits and risks of diverse types of SARS-CoV-2 vaccines are discussed including those containing whole-virus and live-attenuated vaccines, subunit vaccines, mRNA vaccines, DNA vaccines, live vector vaccines, and also plant-based vaccine formulation containing coronavirus-like particle (VLP). The challenges associated with the vaccine development as well as its distribution, safety and long-term effectiveness have also been highlighted and discussed.

Single nucleotide vitamin D receptor polymorphisms (FokI, BsmI, ApaI, and TaqI) in the pathogenesis of prematurity complications

The vitamin D receptor (VDR), coded by the VDR gene, plays a pivotal role in executing cellular functions when bound by the active form of vitamin D. Gene polymorphisms in this receptor have been increasingly associated with a heightened state of vulnerability to certain diseases. However, limited data is available concerning the role of VDR gene polymorphisms in preterm infant complications. In 114 premature infants (< 32 weeks gestation) we analyze four single nucleotide VDR polymorphisms (rs2228570 (FokI), rs1544410 (BsmI), rs797532 (ApaI), rs731236 (TaqI)) for their association with respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) and retinopathy of prematurity (ROP). The results show that BPD was almost four times more likely in infants with the genotype CC of ApaI (rs7975232) (OR 3.845; p = 0.038). While both BPD and NEC were 2.1 times more likely to occur in preterm infants with the allele C of ApaI (rs7975232) (respectively: OR 2.111 and OR 2.129, p < 0.05). The ApaI VDR polymorphism appears to influence incidence of BPD and NEC in preterm infants. Considering VDR polymorphisms in future genetic investigations, in preterm complications, may prove clinically relevant.

MTHFR genetic polymorphism and the risk of intrauterine fetal death in Polish women

OBJECTIVES

To evaluate the role of MTHFR genetic variants in the etiology of intrauterine fetal death in the second part of pregnancy at women from Polish population.

MATERIAL AND METHODS

A case-control study was performed on a 76 women with a positive history of at least one in- trauterine fetal death after 22 gestational week and 400 healthy controls. The MTHFR genotyping for polymorphic sites 667C > T, 1298A > C, 1793G > A was determined by polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP) method.

RESULTS

For 1298A > C polymorphism, no statistically significant higher frequency of AA vs. AC+CC genotype was observed in the IUFD group 67.1 % vs. 55.2% in the control group (OR = 0.61, p = 0.05, pcorr = 0.15). We observed overrepresentation of three-locus haplotype CCG (p = 0.20; pcorr = 0.56) and two-locus haplotype CC (p = 0.17; pcorr = 0.48) in the IUFD group compared to controls.

CONCLUSIONS

There was no observed relationships in genotype frequency of MTHFR 677C > T and 1793G > A variants, however 1298A > C showed a slightly higher but statistically insignificant prevalence in IUFD compared to the controls in Polish population. Further studies on a larger population are needed.

Importance of polymorphic variants of phosphatidylethanolamine N-methyltransferase (PEMT) gene in the etiology of intrauterine fetal death in the Polish population

OBJECTIVES

Intrauterine fetal death (IUFD) is a multifactorial disorder and one of the most severe obstetrical complications. Our primary aim was to study the possible associations between polymorphic variants of the PEMT gene and IUFD in the Polish population.

STUDY DESIGN

The case-control study involved 76 mothers with IUFD occurrence and 215 mothers of healthy children. Genetic analysis of the four single nucleotide polymorphisms in the PEMT gene (rs4646406, rs4244593, rs897453 and rs12325817) was performed with the PCR/RFLP method.

RESULTS

Three oef the analyzed PEMT polymorphisms (rs4646406, rs4244593, and rs8974) were significantly associated with IUFD in the Polish population. Among them, PEMT variant rs4244593 was associated with increased risk of IUFD in three genetic inheritance models. Results were statistically significant even after applying Bonferroni correction for multiple comparisons (p < 0.0125). The distribution of all haplotypes except TAGC was not different between cases and controls, however, after applying permutation test, none of the haplotypes showed a relation with IUFD.

CONCLUSIONS

The present findings indicate that PEMT polymorphisms may be associated with the susceptibility to IUFD in the Polish population.

Polymorphic variants of genes involved in choline pathway and the risk of intrauterine fetal death

OBJECTIVES

Choline and folate metabolism disturbances may be involved in the occurrence of intrauterine fetal death (IUFD). The proper activity of this metabolism could be determined by genetic variants involved in choline pathway e.g. CHKA (gene encoding choline kinase α), PCYT1A (gene encoding CCTα) and CHDH (gene encoding choline dehydrogenase). Our study aimed at determining the genotype and allele frequencies of CHKA rs7928739, PCYT1A rs712012, PCYT1A rs7639752, CHDH rs893363 and CHDH rs2289205 polymorphisms in mothers with IUFD occurrence.

MATERIAL AND METHODS

The study involved 76 mothers with IUFD occurrence and 215 mothers of healthy children. Genetic analysis was performed with the use of PCR/RFLP method.

RESULTS

The frequency of genotypes and alleles of studied polymorphisms was similar in both groups. The study revealed no association of PCYT1A, CHKA and CHDH polymorphisms in analysed groups of women. While evaluating the co-existence of analysed polymorphisms statistically significant correlation was revealed. Co-existence of CHKA rs7928739 AC/CHDH rs2289205 AA genotypes was observed statistically more frequently in the study group than in the control group (p = 0,031).

CONCLUSIONS

There is no correlation between single CHKA rs7928739, PCYT1A rs712012, PCYT1A rs7639752, CHDH rs893363 and CHDH rs2289205 polymorphisms and the incidence of intrauterine fetal death. However, revealed statistically significant difference between co-existence of CHKA rs7928739 AC/CHDH rs2289205 AA genotypes between study groups suggest the need of further analysis.

Coexistence of ACE (I/D) and PAI-1 (4G/5G) gene variants in recurrent miscarriage in Polish population

OBJECTIVES

Recurrent miscarriage (RM) is one of the most common obstetric complications. Numerous studies have suggested that genetic variants leading to an impaired balance between coagulation and fibrinolysis may contribute to elevated risk of pregnancy loss. The aim of the study was to investigate a possible association between angiotensin-converting enzyme (ACE, rs1799752) I/D and plasminogen activator inhibitor type 1 (PAI-1, rs1799768) 4G/5G polymorphisms with RM among Polish women.

MATERIAL AND METHODS

DNA was extracted from peripheral blood samples of 152 women with a history of ≥ 2 consecutive pregnancy losses before 22 weeks of gestation, and 180 healthy controls with at least 1 live birth at term and no history of pregnancy loss. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) were used to identify the polymorphisms.

RESULTS

No statistically significant differences were found in genotype and allele frequencies of the studied polymorphisms. The most relevant difference between the study group and controls was found for the ID genotype distribution of the ACE gene (52.6 vs. 46.7%, OR = 1.27, p = 0.28). The analysis of genotype coexistence revealed a higher incidence of the combination of the ACE II and the PAI-1 4G/4G genotypes in the control group (10.0 vs.5.9% in control group; p = 0.17).

CONCLUSIONS

The obtained results suggest no apparent association between the ACE I/D, PAI-1 4G/5G polymorphisms and increased RM susceptibility in the analyzed Polish population.

The RANKL/RANK/OPG signal trail: significance of genetic polymorphisms in the etiology of postmenopausal osteoporosis

OBJECTIVES

Recent studies have demonstrated that disorders of bone metabolism, which is regulated by RANK/RANKL/OPG signaling pathway, are the cause of osteoporosis. The aim of the study was to investigate the distribution of genotypes of the RANK 575C>T and RANKL -643C>T polymorphisms and to analyze their relationship with bone parameters in postmenopausal women.

MATERIAL AND METHODS

A total of 310 postmenopausal Caucasian women (139 with osteoporosis, 107 with osteopenia, and 64 healthy postmenopausal controls) were included. Bone mineral density (BMD) at the lumbar region of the spine (L2-L4) was measured by dual energy X-ray absorptiometry (DXA). Genetic analysis was performed using the PCR-RFLP method.

RESULTS

Analysis of the frequency of genotypes and alleles of the RANK 575C>T and RANKL -643C>T polymorphisms did not show any statistically significant differences between the study groups (osteoporosis and osteopenia) and postmenopausal women with normal t-score value (ns). Notably, a significant association between the RANKL -643C>T polymorphism and body mass, such as BMI values in osteoporotic women (p<0.05), was observed.

CONCLUSIONS

Our results suggest lack of association between the 575C>T RANK polymorphism and the development of osteoporosis. The -643C>T RANKL polymorphism, through its significant influence on body weight and BMI value, may contribute to the development of osteoporosis in postmenopausal women.

Correlation between factor VII and PAI-1 genetic variants and recurrent miscarriage

BACKGROUND

Polymorphisms which are presented below may be the cause of inherited thrombophilia and may result in pregnancy loss. The hypothesis is based on a number of cardiology studies which have confirmed the involvement of these polymorphisms in thrombotic incidents.

OBJECTIVES

To evaluate the role of polymorphisms of factor VII gene (Arg353Gln, -122T > C) and PAI-1 gene (-675 4G/5G) in the etiology of recurrent miscarriage.

MATERIAL AND METHODS

The study group included 152 women with a positive history of ≥ 2 consecutive pregnancy losses (114 and 38 women with 2 and ≥ 3 miscarriages, respectively), while 180 healthy women were recruited as controls. Genetic analysis was performed with the use of PCR/RFLP.

RESULTS

Lower frequency of Arg353/Gln353 was observed in women with 2 and ≥ 3 miscarriages as compared to controls (21.1% vs. 23.9% and 13.2% vs. 23.9%, respectively). The frequency of Gln353 was lower in women with ≥ 3 miscarriages as compared to controls (6.6% vs. 11.9%, p = ns). The frequency of -122TT was higher in women with ≥ 3 miscarriages as compared to controls (86.84% vs. 76.67%, p = ns), whereas -122TC was more frequent in controls (13.16% vs. 22.78% in controls, p = ns). The frequency of -122T was higher in patients with ≥ 3 abortions as compared to controls (93.42% vs. 88.06%, p = ns), and -122C was observed more frequently in controls (6.58% vs. 11.94% in controls, p = ns). There were no significant differences as far as the -675 4G/5G polymorphism was concerned.

CONCLUSIONS

The obtained results suggest a possible protective role of Gln353 and -122C alleles in recurrent miscarriage.

The importance of polymorphic variants of collagen 1A2 gene (COL1A2) in the development of osteopenia and osteoporosis in postmenopausal women

OBJECTIVES

Collagen type I plays an important role in the bone matrix and is encoded by COL1A2 (collagen type I alpha 2) gene that may be a potential candidate for osteoporotic fracture. The aim of this study is to determine whether EcoRI, Del38 and PvuII polymorphisms of COL1A2 are associated with the development of osteoporosis and osteopenia in post-menopausal Polish women. Moreover, analysis of relationship between frequency of COL1A2 gene polymorphic variants and clinical parameters of bone turnover and degree of osteoporosis was performed.

MATERIAL AND METHODS

The study group comprised of women with osteoporosis (n = 90), osteopenia (n = 56) and healthy individuals (n = 56). The EcoRI, Del38 and PvuII polymorphisms in COL1A2 gene were detected by PCR-RFLP method.

RESULTS

In women with osteoporosis the TT genotype of EcoRI polymorphism had the lowest Z-score value compared to other genotypes (p = 0.034). In case of Del28 polymorphism, there was a statistically significant correlation between lower BMI values and the DD genotype in women with osteopenia (p = 0.041). There was no statistically significant correlation between polymorphic variants of Del28 polymorphism and clinical parameters of women with osteoporosis. The analysis of PvuII polymorphism showed that in women with osteopenia the CC genotype had the lowest body weight compared to other genotypes (p = 0.039). PvuII polymorphism and clinical parameters in the group of women with osteoporosis had no statistically significant correlations.

CONCLUSIONS

The analyzed COL1A2 polymorphisms seem to be related to osteoporosis development and their particular clinical parameters. Hence, the COL1A2 polymorphism may be a genetic risk factor related to the development of osteoporosis.

Contribution of inherited thrombophilia to recurrent miscarriage in the Polish population

INTRODUCTION

The aim of the study was to evaluate the contribution of genetic variants determining inherited thrombophilia to recurrent miscarriage (RM) in the Polish population. The following polymorphisms were analyzed: 1691G>A, 1328T>C of coagulation factor V, 20210G>A of coagulation factor II, R353Q (11496G>A) of coagulation factor VII, 667C>T, 1298A>C, 1793G>A of MTHFR.

MATERIAL AND METHODS

A total of 359 women with ≥ 2 subsequent recurrent miscarriages (303 < 13 weeks of gestation (w.g.) and 56 between 13-22 w.g.) and 400 healthy controls were included in the study. Frequency of the genetic polymor-phisms was determined with the PCR/RFLP method.

RESULTS

Higher frequency of the 20210GA genotype was found in the RM < 13 w.g. (2.97 vs. 1.50% in controls, OR = 2.01, ns) and the RM 13-22 w.g. (5.36 vs. 1.50% in controls, OR = 3.72, p = 0.09) subgroups. Statistically significantly higher frequency of the 11496GA genotype was noted in controls as compared to the RM 13-22 w.g. subgroup (10.71 vs. 23.00% in controls, OR = 0.40, p = 0.02). Statistically significantly higher frequency of the 1793GA genotype was observed in the RM < 13 w.g. subgroup as compared to controls (12.21 vs. 7.75% in controls, OR = 1.66, p = 0.03). No significant correlations were found as far as the rest of the analyzed polymorphisms are concerned.

CONCLUSIONS

The obtained results suggest that the 1793G>A MTHFR, R353Q (11496G>A) factor VII gene and the 20210G>A factor II gene polymorphisms play a role in the etiology of RM in the Polish population.

Polymorphisms of collagen 1A1 (COL1A1) gene and their relation to bone mineral density in postmenopausal women

OBJECTIVES

The goal of this study was to evaluate the frequency of Sp1 +1245G>T (rs 1800012) and -199 7G>T (rs 1107946) COL1A1 gene polymorphisms in postmenopausal women with osteoporosis and osteopenia as well as assessing their relations with the clinical parameters and parameters of bone turnover.

STUDY DESIGN

The study included 538 (236 postmenopausal and 302 healthy reproductive) Polish women. The postmenopausal group included women with osteoporosis (n = 90), osteopenia (n = 90), as well as healthy individuals (n = 56). All women of reproductive age were healthy BMD was marked in the L2-L4 lumbar region of the spine using dual energy X-ray absorptiometry (DXA). Genomic DNA was isolated from peripheral blood, the genotype frequency of investigated polymorphisms was determined by PCR-RFLP technique.

RESULTS

The frequency of Sp1 +1245G>T and -1997G>T polymorphisms of COL1A1 gene showed no statistically significant differences between group with osteoporosis, osteopenia and correct T-score and women of reproductive age. In postmenopausal women it was found that osteopenia and osteoporosis were correlated with age, birth weight, age of last menses occurrence, height, body weight and BMI value. Clinical parameters in all groups of women did not show any statistically significant correlation with frequency of Sp1 +1245G>T and -1997G>T COL1A1 polymorphisms.

CONCLUSIONS

An evaluation of Sp1 +1245G>T (rs1800012) and -1997G>T(rs 1107946) COL1A1 polymorphisms showed any influence of these genetic variants on osteoporosis development in Polish postmenopausal women. The presented correlation between osteoporosis and age, birth weight, age of last menses occurrence, height, body weight and BMI value confirms the important role of environmental factors in disease etiology.

[Retroperitoneal fibrosis--case report and literature review]

The purpose of the study was to present the symptoms, diagnostic methods, and treatment in retroperitoneal fibrosis (RPF). We present a case of a 53-year-old woman admitted to the hospital due to low back and abdominal pain complaints lasting a year. Ultrasonography revealed a myoma located along the right bank of the uterus. Six months after myoma enucleation, the patient underwent relaparotomy due to intensifying pain. The surgery revealed the presence of highly vascularized tissue; ureteral structure and topography of the right retroperitoneal were abolished, and anatomical borders were obliterated. Ureteral right catheter was placed, retroperitoneal adhesions were released and tissue fragments were collected from the retroperitoneal space for intraoperative histopathological examination. The result of histopathological examination indicated the presence of eosinophiia, adult fibroblasts proliferation, lymphocyte and plasmocyte infiltration, which confirmed the diagnosis of RPF. Corticosteroid therapy, which was applied during the postoperative period, minimized the pain.

DRD1 and DRD4 dopamine receptors in the etiology of preeclampsia

INTRODUCTION

Recent reports have suggested an association between genetic polymorphisms of dopamine receptors and the development of an increased risk of chronic hypertension, as well as preeclampsia (PE).

OBJECTIVES

The aim of the study was to evaluate the impact of the -48A>G DRD1 and -521C>T DRD4 polymorphisms in the etiology of PE among Polish women.

MATERIAL AND METHODS

Ninety-eight preeclamptic women and 120 healthy pregnant controls were enrolled in the study The investigated polymorphisms of the DRD 1 and DRD4 genes were identified using PCR/RFLP methods.

RESULTS

As far as the -48A>G DRD 1 polymorphism is concerned, the mutated -48GG genotype was more often found in controls (14.2%) than in the PE group (10.2%, ns), and the subgroup with severe PE (8.2%). Also, the frequency of the mutated -48G allele was higher in controls (39.6%) than in the PE group (33.2%, ns), and in the subgroup with severe PE (31.6%, ns). As for the -521C>TDRD4 polymorphism, a similar occurrence of the mutated -521 TTgenotype and the -521T allele in all of the investigate groups was observed. Lower serum concentrations of total protein (5.59 g/L and 5.57 g/L vs. 6.17 g/L in carriers of the -52100 genotype, p=0.02) were noted in patients with the mutated homozygous -521 TT genotype and heterozygous -521CT genotype of DRD4.

CONCLUSIONS

The obtained results suggest a possible protective role of the mutated -48G DRD1 allele in the etiology of preeclampsia, especially its severe form. The presence of the mutated -521 T DRD4 allele could influence the decrease of total blood protein in preeclamptic patients. The observed frequency of dopamine DRD1 and DRD4 polymorphisms is similar to the distribution of these variants in other Caucasian populations.

[Cesarean scar pregnancy]

Pregnancy in the uterine scare after previous caesarean section is the rarest type of ectopic pregnancy Due to the possibility of life-threatening complications, cesarean scar pregnancy (CSP) needs rapid and proper diagnosis and management. Hereby we present 3 cases of women with CSP, diagnosed and treated at the Department of Gynecology and Obstetrics of Jagiellonian University Medical College, in Krakow, in 2013, as well as literature review.

Coexistence of the 677C>T and 1298A>C MTHFR polymorphisms and its significance in the population of Polish women

OBJECTIVES

The aim of the study was to evaluate the frequency of the 677C>T and 1298A>C polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) gene, as well as the coexistence of both these genetic variants in women from the Polish population.

MATERIAL AND METHODS

A total of 662 women from the Polish population were enrolled in the study group. The frequency of the investigated genotypes of the 677C>T and 1298A>C polymorphisms of the MTHFR gene was analyzed with the use of PCR/RFLP methods.

RESULTS

The frequency of the 677CC, 677CT and 677TT genotypes in the studied population of women was 50.60%, 39.88% and 9.52%, respectively As to the 1298AA, 1298AC and 1298CC genotypes, the obtained results were as follows: 42.75%, 47.88% and 9.37%, respectively (Tables II and III). Simultaneous analysis revealed the most frequent coexistence of 677CC/1298AC (28.85%), 677CT/1298AA (20.85%) and 677CT/1298AC (19.03%) genotypes. The coexistence of 677CC/1298AA (12.39%), 677CC/1298CC (9.37%) and 677TT/1298AA (9.51%) genotypes was observed less frequently In the studied population of Polish women, the coexistence of 677CT/1298CC, 677TT/1298AC and 677TT/1298CC genotypes has been not observed.

CONCLUSIONS

The frequency and coexistence of genotypes of the 677C>T and 1298A>C MTHFR gene polymorphisms in the studied population of Polish women is similar to other North-European populations. Women carriers of the mutated variants of both, 677C>T and 1298A>C polymorphisms of the MTHFR gene should receive special perinatal care in order to prevent fetal defects and thrombosis-related complications during pregnancy It is vital to emphasize the significance of proper education of folate supplementation, especially in pregnant patients and women of reproductive age.

Survivin in ovary tumors

INTRODUCTION

Survivin is a member of the inhibitor of apoptosis protein (IAP) family which are selectively overexpressed in human neoplasms, and its expression has been shown to be connected with cell proliferation. We analyzed survivin expression in ovarian epithelial neoplasms to evaluate its role in the development of ovarian tumors.

MATERIAL AND METHODS

Immunohistochemistry assays were conducted in 137 cases (48 ovarian carcinoma, 43 borderline ovarian carcinoma, 46 benign ovarian tumor and 20 samples of normal ovarian tissue of ovarian epithelial neoplasms. Histological types included serous (n = 68) and mucinous (n = 69) tumors. All tumors were reviewed histopathologically and classified according to the WHO criteria.

RESULTS

Survivin expression in the group of serous neoplasms was detected in 24.0% (6 of 25) of benign cases, in 60.0% (12 of 20) of borderline tumors, and 91.0% (24 of 47) of ovarian carcinomas. In the group of mucinous tumors, survivin expression was found in 33.5% (7 of 21) of benign cases, 43.5% (10 of 23) of borderline tumors, and 80.0% (20 of 25) of malignant tumors.

CONCLUSIONS

Our results demonstrate that survivin overexpression may play a crucial role in the development of epithelial ovarian neoplasms and be an important prognostic factor for the influence of survivin expression on epithelial ovarian cancers.

[The role of Wnt/β-catenin pathway and LRP5 protein in metabolism of bone tissue and osteoporosis etiology]

Osteoporosis is a metabolic bone disease, manifested by decreased bone mineral density microarchitectural disturbances of bone tissue, and increased risk of bone fractures. Owing to large-scale morbidity particularly among postmenopausal women, nowadays osteoporosis constitutes a significant global health problem. In recent years, much attention has been paid to the role of signaling Wnt/β-catenin pathway and LRP protein in the pathomechanism of osteoporosis, indicating a possible contribution of polymorphic variants of the candidate LRP5 gene to disease development. The goal of our study is to present contemporary research on signaling Wnt/β-catenin pathway and mechanism of LRP protein action in the process of bone tissue metabolism and etiology of osteoporosis.

Analysis of -11391G>A and +45>G polymorphisms of ADIPOQ gene in women with excessive weight gain during pregnancy

OBJECTIVES

The aim of our study was to evaluate the frequency of genotypes and alleles of the -11391G>A and +45T>G polymorphisms of the ADIPOQ gene in Polish women with excessive weight gain during pregnancy. A possible correlation between these polymorphisms and selected clinical and anthropometric parameters has been analyzed.

MATERIAL AND METHODS

A total of 153 pregnant Caucasian women of Polish origin with normal pre-pregnancy body mass were analyzed: 78 women with excessive weight gain (study group) and 75 women with normal weight gain during pregnancy (control group). The analysis of the polymorphisms was performed by PCR/RFLP.

RESULTS

The influence of the -11391G>A polymorphism on body mass and BMI values at the end of pregnancy (p < 0.05) was observed. We also detected a correlation of the +45T>G polymorphism with body mass at the end of pregnancy and pre-pregnancy WHR values (p < 0.05).

CONCLUSIONS

The observed effect of the -11391G>A polymorphism on the parameters assessed at the end of pregnancy (BMI and body mass), suggests a protective role of the -11391A genetic variant in excessive weight gain. It is claimed that the mutated +45G allele of the +45T>G ADIPOQ polymorphism shows a possible connection with higher pre-pregnancy WHR values and body mass at the end of pregnancy Our findings suggest a possible contribution of the -11391G>A and +45T>G polymorphisms of the ADIPOQ gene to the pathomechanism of excessive weight gain in pregnant women from the Polish population. This observation should be confirmed in a larger sample size study

The contribution of Hind III C>G PAI-1 gene polymorphism in etiology of recurrent miscarriages

OBJECTIVES

The goal of the study was to assess the relationship of HindIII C>G PAI-1 gene polymorphism with increased risk of recurrent miscarriages.

MATERIAL AND METHODS

A whole of 152 women with a history of at least two miscarriages were classified into analysis. The study group was divided twice (114 subjects with 2 miscarriages and 38 subjects with >3 miscarriages, 123 subjects with miscarriages at <13gw, and 29 subjects with miscarriages in <21 gw). The controls consisted of 180 women with a positive history of at least one pregnancy and birth of a healthy term newborn, and a negative history of miscarriage. The analysed polymorphisms were determined by PCR/RFLP methods.

RESULTS

The occurrence of HindIII GG genotype in the whole study group was 25.7% and 20.0% in controls (OR= 1.38, p=0. 14). HindIII G allele was also observed more frequently in the whole study group (45.7% vs. 42.2% in controls, OR=1. 15, p=0.20). The occurrence of HindIII GG genotype was higher in the subgroup of women with >3 miscarriages (31.6% vs. 20.0% in controls, OR= 1.85, p=0.09). HindIII G allele was also noted more frequently in the subgroup of women with >3 miscarriages (50.0% vs. 42.2% in controls, OR=1.37, p=0. 13). A tendency of higher frequency of HindIII GG genotype and HindIII G allele was also noted in the subgroup of patients with miscarriages in the first and second trimester (HindIII GG: 31.0% vs. 20.0% in controls, OR= 1.80, p=O. 14, HindIII G: 51.7% vs. 42.2% in controls, OR=1.4 7, p=0.11).

CONCLUSIONS

Mutated HindIII G allele and HindIII GG genotype of HindIII C>G polymorphism probably augment the risk of recurrent miscarriages.

The importance of rs1021737 and rs482843 polymorphisms of cystathionine gamma-lyase in the etiology of preeclampsia in the Caucasian population

INTRODUCTION

Recently an increasing number of reports indicate the participation of genetic factors in the pathogenesis of preeclampsia (PE). The genes involved in the synthesis of nitric oxide that participates in the vasolidation, may play an important role in the development of this disorder. Hydrogen sulfide (H2S) which is produced by cystathionine gamma-lyase exhibits a similar effect to nitric oxide. It is suggested that certain polymorphisms of the CTH gene may participate in the development of chronic hypertension and preeclampsia.

AIM OF THE STUDY

To evaluate the frequency of genotypes and alleles of rs1021737 and rs482843 polymorphisms of CTH gene in women with preeclampsia from Wielkopolska region.

MATERIAL AND METHODS

The study group consisted of 60 patients with diagnosed preeclampsia, into the control group 120 healthy pregnant women were enrolled. The examined rs1021737 and rs482843 polymorphisms of CTH gene were determined using PCR-RFLP method.

RESULTS

Analysis of rs482843 polymorphism in the CTH gene showed a statistically significant difference in the prevalence of mutated GG genotype (p<0.000001) and mutated G allele (p<0.000001) in the group of pregnant women with PE compared to the control group. There was no such correlation for the rs1021737 polymorphism. Furthermore, there are also no relationship between studied polymorphisms and selected clinical and biochemical parameters.

CONCLUSIONS

The results of rs482843 polymorphism analysis suggest that mutated GG genotype predisposes to preeclampsia occurrence. There was no such relationship for the rs1021737 polymorphism of CTH gene. Hence, further studies based on the determination of CSE expression level in women with PE may confirm the observed relationship between the rs482843 polymorphism and the risk of preeclampsia.

The evaluation of the predictive value of TNF-alpha concentration in maternal serum in the prediction of neonatal and maternal infection

INTRODUCTION

The consequences of uncomplicated PPROM are serious, and the presence of overt intraamniotic infection (IAI) is associated with a significant increase in both, the maternal and fetal morbidity and mortality rate. TNF-alpha is a cytokine involved in systemic inflammation and plays an important role in modulating the acute phase reaction.

AIM

The aim of this study was to evaluate the predictive value of TNF-alpha levels in maternal serum within 6 hours after pprom and in the period of up to 12 hours after delivery in the prediction of neonatal and maternal infection.

MATERIAL AND METHODS

The investigation was conducted on a group of 56 women diagnosed with PPROM between 30+0 and 36+6 weeks gestational age. In the period of up to 6 hrs from pprom first sample of 10 ml of maternal venous blood for laboratory testing was taken and the level of TNF-alpha was measured. A second sample of venous blood was taken within 12 hrs from delivery to reassess the TNF-alpha levels. All the participants were divided retrospectively into four groups depending on the occurrence of adverse neonatal and maternal outcome. Measuring the concentration of TNF-alpha in maternal serum was performed using the elisa method (enzyme-linked immunosorbent assay).

RESULTS

A statistically significant difference in the second assay (up to 12 hours after delivery) between the patients with and without signs of maternal infection was observed concerning the TNF-alpha serum level. The concentration of this cytokine in maternal serum after delivery was 1.79 and 1.36 pg/ml (p < 0.05) respectively whereas within 6 hours from the PPROM in those two groups it was comparable (1.25 vs. 7.37 pg/ml - ns). Analogous observations were made in case of adverse neonatal outcome, where the TNF-alpha serum level within 12 hours after delivery was 1.70 and 1.45 pg/ml (p < 0.05) and in the period of up to 6 hours from pprom was 1.25 vs. 1.38 pg/ml (ns) respectively

CONCLUSIONS

1. In our investigation the maternal serum TNF-alpha concentration testing within 6 hours from PPROM between 30+0 and 36+6 weeks of gestation did not allow for the identification of patients who are more likely to develop signs of maternal infection and whose infant was at risk of neonatal infection after delivery 2. In case of pprom between 30+0 and 36+6 weeks of gestation maternal serum TNF-alpha concentration testing in the period of up to 12 hours after delivery may be a useful diagnostic tool for identification of patients with an increased risk of maternal and neonatal infection. 3. The lower the gestational age at PPROM and at delivery the risk of neonatal infection was greater.

The importance of MTHFR, MTR, MTRR and CSE expression levels in Caucasian women with preeclampsia

OBJECTIVE

Preeclampsia (PE) is a major cause of maternal and perinatal mortality and morbidity. The studies suggest that both polymorphisms and changes of expression in genes encoding enzymes involved in the methionine and homocysteine metabolism (MHM), such as methylenetetrahydrofolate, reductase (MTHFR), methionine synthase (MTR), methionine synthase reductase (MTRR) and cystathionine gamma-lyase (CSE), could play a role in the development of hypertension during pregnancy. The aim of the study was to determine the expression level of MTHFR, MTR, MTRR and CSE genes in the development of PE in Caucasian women.

STUDY DESIGN

The control group consisted of 74 healthy pregnant women and 90 patients with diagnosed pre-eclampsia. Total RNA was isolated from placenta and the mRNA level of examined genes was to determine using real-time PCR.

RESULTS

The expression level of MTHFR gene showed no statistically significant difference in the study group as compared to the control group. An increase of mRNA levels for MTR and CTH was observed by 124.7% (p<0.0001) and 26.6% (p>0.05), respectively. However, a decrease of placental expression was noted for MTRR by 50% in preeclamptic women as compared to control group (p<0.0001).

CONCLUSIONS

Our findings suggest that the elevated RNA expression of MTR in placenta of preeclamptic patients is probably results of a potential compensation mechanism of the MHM while elevated CSE expression indicates that homocysteine may be eliminated through the alternate transsulfuration pathway.

[Bone loss in women with malignant genital neoplasms]

Nowadays, women with genital cancers live longer due to early diagnosis and better treatment schemes. Only few studies assessed bone mass in patients with genital cancer Osteoporosis is a condition characterized by progressive loss of bone mass, weakening of the spatial structure of the bone, and increased susceptibility to fractures. Osteopenia is a condition of reduced, but not yet reaching the pathological values, bone density in relation to norms for age and sex. Metastases are the primary cause of death in cancer patients. It is estimated that approximately half of people dying due to cancer have bone metastases. Osteoporosis in neoplastic disease may occur due to bone metastases or therapy-related adverse effects, i.e. reduced bone mineral density (BMD). Bone microenvironment provides a good medium for the growth of cancer cells. BMD of the femur and spine should be measured by DXA. Computed tomography (CT) and magnetic resonance imaging (MRI) are the techniques used to detect bone metastases. Lifestyle is the key to improving the quality of life and maximize any pharmacological treatment in cancer patients. It is proposed that treatment of cancer without bone metastases does not require therapy increasing bone mass. Further studies in women treated for gynecological malignancies undergoing oophorectomy and adjuvant treatment are needed to elucidate the mechanisms associated with bone loss.

[Selected aspects of oral contraception side effects]

The first hormonal pill was approved in the 60s of the twentieth century Since that time, oral contraception has been used worldwide by dozens of women due to its high availability as well as relative ease and safety of taking. The main side effects of oral contraception include elevated risk for venous thromboembolism (VTE). Estrogens increase the probability of VTE development, depending on the dose in medication, and third-generation progestins increase the risk of VTE development more than older-generation progestins. Also, the coexistence of hereditary thrombophilia increases the risk of VTE development in women using oral contraceptives. Other side effects include changes in the carbohydrate and lipid economy Progestins in oral contraceptives decrease HDL cholesterol levels but increase LDL cholesterol and total cholesterol levels. Additionally estrogens are a recognized mitogenic factor for the epithelium of the mammary gland, acting proliferative on the glandular tissue and in the same way influence on the increased risk of breast cancer development. Patients sometimes complain about some subjective side symptoms such as headache, mood changes, nausea, back pain, breast pain and swelling, as well as decreased libido. Some patients discontinue oral contraception due to fear of side effects or temporary ailments before con- sulting their doctor what may result in unintended pregnancy The aim of the following paper was to present most frequent side effects of oral contraception, ways of their moni- toring and diagnosis.

The -323P0/P10 factor VII gene polymorphism and the risk of recurrent miscarriage

OBJECTIVES

Genetically determined disturbances in the activity of coagulation factor VII may lead to obstetric complications. The aim of the study was to evaluate the correlation between -323P0/P10 factor VII gene polymorphism and the risk of recurrent miscarriage.

MATERIAL AND METHODS

The study group consisted of 152 women with a history of > or = 2 miscarriages. The control group comprised 180 women with no history of miscarriage and > or = 1 pregnancy who gave birth to a healthy newborn at term. The study group was further subdivided twice into two subgroups: 1174 patients with a history of 2 miscarriages and 38 subjects with a history of > or = 3 miscarriages, and 123 patients with miscarriages < 13 gw. and 29 with miscarriages < 21 gw. Genetic analysis was performed with the use of PCR/RFLP.

RESULTS

Overrepresentation of P0/P0 genotype and lower frequency of P0/P10 genotype was noted in the study group as compared to controls (P0/P0: 80.26 vs. 76.67%, p = 0.25; P0/P10: 18.42 vs. 22.78%, p = 0.20). A higher presentation of P0/P0 genotype and P0 allele, lower frequency of P0/P10 genotype and P10 allele was observed in the subgroup of women with > or = 3 miscarriages as compared to controls (P0/P0: 8.84 vs. 76.67%, p = 0.12; P0: 93.42 vs. 88.06%, p = 0.12; P0/P10:13.16 vs. 22.78%, p = 0.13; P10: 11.94 vs. 6.58%, p = 0.12).

CONCLUSIONS

The obtained results suggest a probable protective role of -323P10 allele against the risk of miscarriage in women with > or = 3 recurrent pregnancy losses.

Vertical transmission of HPV in pregnancy. A prospective clinical study of HPV-positive pregnant women

INTRODUCTION

Human papillomavirus (HPV) is the most common sexually transmitted infection. Data reporting vertical transmission of HPV from the mother to the fetus are inconsistent and scant. Vertical transmission may occur by hematogenic route (transplacental), or by ascending contamination, or through the birth canal, which may result in the dreaded and rare laryngeal papillomatosis. Infected sperm at fertilization is a potential route of infection, too.

OBJECTIVE

The objective of the study was to evaluate the rate of vertical transmission of HPV in HPV-positive pregnant women to their newborn infants, as well as the risk factors of HPV vertical transmission.

MATERIAL AND METHODS

The clinical material was provided by 136 pregnant women, aged 18-45 years. Out of this group, 30 (22.05%) women with abnormal Pap test and positive DNA HPV test were prospectively observed Neonatal status, i.e. DNA HPV from the nasopharyngeal smear was recorded in all infants during the perinatal period. The conventional Pap test was performed with the cervix brush in all women. The Bethesda 2011 classification system was applied.

RESULTS

An average C Reactive Protein (CRP) concentration in the studied pregnant women was 711.6083 (Std Dev--12.93). The most frequent cytological findings in the cervical smears from the examined women were ASCUS, n = 13 (43.3%), then--LSIL, n = 10 (33.3%), HSIL--n = 5 (16.7%) and AGC--n = 2 (6.7%). In the neonates, the presence of LR HPV DNA was detected in 9 cases (30.0%) and HR HPV DNA in 7 cases (23.3%). Fourteen neonates (46.7%) tested HPV DNA negative in the perinatal period.

CONCLUSIONS

HPV infection (incidental or chronic) is observed in approximately 22% of pregnant women from the Matopolska province. Neonatal HPV infection in HPV-positive women was observed in 53.3% of the subjects. CRP concentration > 10 mg/dl in the serum of pregnant women statistically significantly (p 0.001) reduces the risk of vertical transmission of HPV from the mother to the fetus.

[Delayed delivery in a triplet pregnancy--a case report]

In multiple pregnancy the following may be considered to delay the delivery: bed rest, antibiotics, tocolytics, steroids, and, possibly cervical cerclage. Analysis of uterine contraction intensity reevaluation of the chorion and the amnion, as well as monitoring of the mother and the fetus are also very important. Clinical and laboratory parameters ought to be carefully monitored to prevent intra-amniotic infection. We present a case of a delayed delivery in a trichorionic, triamniotic, triplet pregnancy after IVF. The first and the second fetuses were delivered spontaneously at 23 and 26 weeks of gestation, respectively. The third fetus was delivered by a cesarean section at 26 weeks of gestation. The delay between the first and the second/third fetuses was 18 days. Only the second child survived. At present, the psychomotor development of the infant is considered as normal.

The influence of soybean extract on the expression level of selected drug transporters, transcription factors and cytochrome P450 genes encoding phase I drug-metabolizing enzymes

OBJECTIVE

Soybean phytoestrogens, such as genistein and daidzein, reduce climacteric symptoms and the risk of certain chronic diseases such as cancer and cardiovascular diseases. Despite their widespread use in functional foods and dietary supplements, there is very little data available on their safety and herb-drug interactions, especially with antineoplastic agents. Hence, the aim of our study was to assess the effects of soybean extracts on the expression level of CYP genes and their transcriptional factors. We also investigated the effect of soybean on the mRNA level of transporters, such as P-glycoprotein (MDRI) and multidrug resistance-associated proteins (MRP1, MRP2).

MATERIALS AND METHODS

Wistar rats were fed a standardized soybean extract (100 mg/kg, p.o.). cDNA was synthesized from total RNA isolated from different tissues (liver and intestinal epithelium) using reverse transcription. Gene expression level was analyzed by RT-PCR method.

RESULTS

We demonstrated a significant increase of CYP1A1 mRNA level (by 89%, p = 0.002 and 125%, p = 0.004) as compared with the control group. An increase of AHR and CAR expression after 10 days was also observed (by 60%, p < 0.001 and 52%, p > 0.05, respectively). Additionally an inductive effect for CYP2D1 by 22% (p = 0.008), Mdr1a by 267% (p < 0.0001), Mdr2b by 86% (p < 0.00001), Mrp1 by 9-fold (p < 0.0001), Mrp2 by 83% (p < 0.0001) in the liver and for Mrp2 by 35% (p < 0.001) in the intestinal epithelium, was evaluated. A significant decrease of mRNA level was observed for CYP3A1 (human CYP3A4) in the liver and Mdr1b in the intestinal epithelium. Moreove, we also showed a slight decrease in the amount of mRNA for CAR, PXR and ARNT after 3 days.

CONCLUSIONS

Our results suggest that Glycine max may change the expression level of CYPs, especially CYP3A4 and CYP1A 7, involved in biotransformation of xenobiotics (drugs, procarcinogens) and may participate in clinically significant interactions with drugs metabolized by these enzymes. Moreover an increase of CYP1A1 (homologue to human CYPIA 1) mRNA level may not only reduce the carcinogenicity of foreign compounds, but may also activate some compounds to their carcinogenicity In case of transporters, it is considered that an increase of their expression in the body may lead to increased fetoprotection. Also, it may reduce both, the exposure of sensitive tissues (e.g. brain, placenta) to xenobiotics and treatment effectiveness of certain diseases. Hence, the search for a safe substance that could effectively modulate transporter activity especially in the treatment of certain hormone -dependent disorders, e.g. osteoporosis and breast cancer occurring mainly in postmenopausal period, continues.