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Lin J, Jiang X, Dong M, Liu X, Shen Q, Huang Y, Zhang H, Ye R, Zhou H, Yan C, Yuan S, Wu X, Chen L, Wang Y, He M, Tao Y, Zhang Z, Jin W. Hepatokine Pregnancy Zone Protein Governs the Diet-Induced Thermogenesis Through Activating Brown Adipose Tissue. Adv Sci (Weinh) 2021; 8:e2101991. [PMID: 34514733 PMCID: PMC8564441 DOI: 10.1002/advs.202101991] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/23/2021] [Indexed: 05/06/2023]
Abstract
Intermittent fasting (IF), as a dietary intervention for weight loss, takes effects primarily through increasing energy expenditure. However, whether inter-organ systems play a key role in IF remains unclear. Here, a novel hepatokine, pregnancy zone protein (PZP) is identified, which has significant induction during the refeeding stage of IF. Further, loss of function studies and protein therapeutic experiment in mice revealed that PZP promotes diet-induced thermogenesis through activating brown adipose tissue (BAT). Mechanistically, circulating PZP can bind to cell surface glucose-regulated protein of 78 kDa (GRP78) to promote uncoupling protein 1 (UCP1) expression via a p38 MAPK-ATF2 signaling pathway in BAT. These studies illuminate a systemic regulation in which the IF promotes BAT thermogenesis through the endocrinal system and provide a novel potential target for treating obesity and related disorders.
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Affiliation(s)
- Jun Lin
- Key Laboratory of Animal Ecology and Conservation BiologyInstitute of ZoologyChinese Academy of SciencesBeijing100101China
| | - Xiaoxiao Jiang
- Key Laboratory of Animal Ecology and Conservation BiologyInstitute of ZoologyChinese Academy of SciencesBeijing100101China
- University of Chinese Academy of SciencesBeijing100049China
| | - Meng Dong
- Key Laboratory of Animal Ecology and Conservation BiologyInstitute of ZoologyChinese Academy of SciencesBeijing100101China
| | - Xiaomeng Liu
- Institute of Neuroscience and Translational MedicineCollege of Life Science and AgronomyZhoukou Normal UniversityZhoukou466000China
| | - Qiwei Shen
- Department of General SurgeryHuashan HospitalFudan UniversityShanghaiChina
| | - Yuanyuan Huang
- Key Laboratory of Animal Ecology and Conservation BiologyInstitute of ZoologyChinese Academy of SciencesBeijing100101China
- University of Chinese Academy of SciencesBeijing100049China
| | - Hanlin Zhang
- Key Laboratory of Animal Ecology and Conservation BiologyInstitute of ZoologyChinese Academy of SciencesBeijing100101China
- University of Chinese Academy of SciencesBeijing100049China
| | - Rongcai Ye
- Key Laboratory of Animal Ecology and Conservation BiologyInstitute of ZoologyChinese Academy of SciencesBeijing100101China
- University of Chinese Academy of SciencesBeijing100049China
| | - Huiqiao Zhou
- Key Laboratory of Animal Ecology and Conservation BiologyInstitute of ZoologyChinese Academy of SciencesBeijing100101China
- University of Chinese Academy of SciencesBeijing100049China
| | - Chunlong Yan
- College of AgricultureYanbian UniversityYanji133000China
| | - Shouli Yuan
- Key Laboratory of Animal Ecology and Conservation BiologyInstitute of ZoologyChinese Academy of SciencesBeijing100101China
- University of Chinese Academy of SciencesBeijing100049China
| | - Xiangnan Wu
- Key Laboratory of Animal Ecology and Conservation BiologyInstitute of ZoologyChinese Academy of SciencesBeijing100101China
- University of Chinese Academy of SciencesBeijing100049China
| | - Li Chen
- Key Laboratory of Animal Ecology and Conservation BiologyInstitute of ZoologyChinese Academy of SciencesBeijing100101China
- University of Chinese Academy of SciencesBeijing100049China
| | - Yanfang Wang
- State Key Laboratory of Animal NutritionInstitute of Animal ScienceChinese Academy of Agricultural SciencesBeijing100193China
| | - Min He
- Division of Endocrinology and MetabolismHuashan HospitalFudan UniversityShanghaiChina
| | - Yi Tao
- Key Laboratory of Animal Ecology and Conservation BiologyInstitute of ZoologyChinese Academy of SciencesBeijing100101China
| | - Zhaoyun Zhang
- Division of Endocrinology and MetabolismHuashan HospitalFudan UniversityShanghaiChina
| | - Wanzhu Jin
- Key Laboratory of Animal Ecology and Conservation BiologyInstitute of ZoologyChinese Academy of SciencesBeijing100101China
- University of Chinese Academy of SciencesBeijing100049China
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Abstract
PURPOSE OF REVIEW Preeclampsia is a common complication of pregnancy and contributes significantly to maternal and fetal morbidity and mortality. A protective hypercoagulable state is often developed during late pregnancy and can evolve into a prothrombotic state in patients with preeclampsia. The underlying mechanism of this prothrombotic transition remains poorly understood. We discuss recent progress in understanding the pathophysiology of preeclampsia and associated prothrombotic state. RECENT FINDINGS The hypercoagulable state developed during pregnancy is initiated by placental factors and progresses into the prothrombotic state in preeclampsia when the placenta is subjected ischemic and oxidative injuries. The cause of the preeclampsia-induced prothrombotic state is multifactorial, involving not only placental factors but also maternal conditions, which include genetic predisposition, preexisting medical conditions, and conditions acquired during pregnancy. Endotheliopathy is the primary pathology of preeclampsia and contributes to the prothrombotic state by inducing the dysregulation of coagulation, platelets, and adhesive ligands. SUMMARY Patients with preeclampsia often develop a severe prothrombotic state that predisposes them to life-threatening thrombosis and thromboembolism during and after pregnancy. Early recognition and treatment of this prothrombotic state can improve maternal and infant outcomes of preeclampsia patients.
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Affiliation(s)
- Chan Han
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuan-Yuan Chen
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing-fei Dong
- Bloodworks Research Institute, Seattle, WA, USA
- Division of Hematology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
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Krebs T, Kilic I, Mütze K, Kleinhans S, Lücking D, Hennies M, Tetens J. Establishment of a Sandwich-ELISA for simultaneous quantification of bovine pregnancy-associated glycoprotein in serum and milk. PLoS One 2021; 16:e0251414. [PMID: 33979386 PMCID: PMC8115853 DOI: 10.1371/journal.pone.0251414] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 04/26/2021] [Indexed: 11/29/2022] Open
Abstract
Bovine pregnancy-associated glycoproteins (boPAG) are expressed by trophoblast cells in the bovine placenta. The multigene family of boPAG belongs to the group of aspartic proteases. The accumulation and circulation in maternal blood and milk has made boPAG very useful and important for pregnancy diagnosis in cattle. The goal of the present study was to develop and validate a new Sandwich-ELISA which allows the detection of boPAG in maternal serum and whole milk. Therefore, 984 serum and 928 milk samples were collected monthly from 231 Holstein Friesian cows (Bos Taurus) from one week after insemination (p.i.) until six weeks postpartum. The ELISA is able to identify a cow as being pregnant at day 30 p.i. in serum and at day 40 p.i in milk with threshold values of 1.0 ng/ml in serum and 0.0165 ng/ml in milk. The postpartum half-life of boPAG was estimated to be 6.4 days in serum and 7.1 days in milk. The boPAG profile established during pregnancy in serum and milk showed a typical pattern. The amount of boPAG found in milk was 1.5 % of the amount of boPAG present in serum. In conclusion, a Sandwich-ELISA has been developed to quantify boPAG in serum and in whole milk simultaneously with the same test procedure. This is time saving for farmers and more efficient for laboratories.
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Affiliation(s)
- Tony Krebs
- Department of Animal Sciences, Georg-August-University, Goettingen, Lower Saxony, Germany
- * E-mail:
| | - Isabel Kilic
- Department of Animal Sciences, Georg-August-University, Goettingen, Lower Saxony, Germany
| | - Katja Mütze
- Hessischer Verband für Leistungs- und Qualitätsprüfungen in der Tierzucht e.V., Alsfeld, Hesse, Germany
| | - Sonja Kleinhans
- Hessischer Verband für Leistungs- und Qualitätsprüfungen in der Tierzucht e.V., Alsfeld, Hesse, Germany
| | - Daniel Lücking
- TECOdevelopment GmbH, Rheinbach, North Rhine-Westphalia, Germany
| | - Mark Hennies
- TECOdevelopment GmbH, Rheinbach, North Rhine-Westphalia, Germany
| | - Jens Tetens
- Department of Animal Sciences, Georg-August-University, Goettingen, Lower Saxony, Germany
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Reese ST, Franco GA, Schubach KM, Brandao AP, West SM, Cooke RF, Cardoso RC, Williams GL, Pohler KG. Induced prostaglandin release alters steroid concentrations but not pregnancy survival in cows. Domest Anim Endocrinol 2021; 74:106514. [PMID: 32693342 DOI: 10.1016/j.domaniend.2020.106514] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 06/17/2020] [Accepted: 06/17/2020] [Indexed: 11/27/2022]
Abstract
Embryonic mortality (EM) is a major factor limiting reproductive efficiency in cattle, and despite negative connotations related to reproductive performance, prostaglandin F2α (PGF2α) is capable of being released by the uterus by Day 30 of gestation. Therefore, the objective was to evaluate differences in PGF2α release after an oxytocin challenge between cows with high circulating concentrations of pregnancy-associated glycoproteins (PAGs) vs low PAG because of the association of increased PAG concentrations with pregnancy success. At Day 30 of gestation, pregnant cows were divided into oxytocin treatment (OT; n = 13) and control (CON; n = 12) groups. Treatment cows were further subdivided by circulating PAG concentration (high PAG, n = 7; and low PAG, n = 6). Blood samples were collected every 30 min beginning 1 h before oxytocin administration and continuing for 4 h. Prostaglandin F2α metabolite (PGFM), progesterone, estradiol-17β (E2), and PAG concentrations were quantified. The peak concentration of PGFM occurred 2 h after oxytocin injection in treatment animals and returned to baseline levels by 4 h. No correlations were observed between PAG and PGFM, progesterone, or E2 concentrations (P > 0.05). There was no difference in initial or final PGFM concentrations between groups (P > 0.05). Progesterone and E2 concentrations decreased in cows after treatment of oxytocin (P < 0.05); however, only progesterone returned to basal concentrations by the end of the sampling period. In summary, cows with high vs low PAG concentrations at Day 30 of gestation have a similar PGFM response to oxytocin challenge.
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Affiliation(s)
- S T Reese
- Pregnancy and Developmental Programming Area of Excellence, Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - G A Franco
- Pregnancy and Developmental Programming Area of Excellence, Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - K M Schubach
- Pregnancy and Developmental Programming Area of Excellence, Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - A P Brandao
- Pregnancy and Developmental Programming Area of Excellence, Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - S M West
- Pregnancy and Developmental Programming Area of Excellence, Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - R F Cooke
- Pregnancy and Developmental Programming Area of Excellence, Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - R C Cardoso
- Pregnancy and Developmental Programming Area of Excellence, Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - G L Williams
- Pregnancy and Developmental Programming Area of Excellence, Department of Animal Science, Texas A&M University, College Station, TX, USA; Animal Reproduction Laboratory, Texas A&M AgriLife Research, Beeville, TX, USA
| | - K G Pohler
- Pregnancy and Developmental Programming Area of Excellence, Department of Animal Science, Texas A&M University, College Station, TX, USA.
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Serati M, Esposito CM, Grassi S, Bollati V, Barkin JL, Buoli M. The Association between Plasma ERVWE1 Concentrations and Affective Symptoms during Pregnancy: Is This a Friendly Alien? Int J Environ Res Public Health 2020; 17:ijerph17249217. [PMID: 33317172 PMCID: PMC7763945 DOI: 10.3390/ijerph17249217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/02/2020] [Accepted: 12/08/2020] [Indexed: 12/24/2022]
Abstract
Human endogenous retroviruses (HERVs) comprise 8% of the human genome, and HERV DNA was reported to be essential in human embryonic development. Specifically, HERV-W encodes a protein, syncytin-1, alternatively known as ERVWE1 (Human Endogenous Retrovirus W EnvC7-1 Envelope Protein), participating in human placental morphogenesis and having a role in immune system regulation. Syncytin-1 activity is increased in neuropsychiatric disorders, autoimmune diseases, and cancer. In our study, forty-four women in the third trimester of pregnancy were tested for ERVWE1 plasma levels. In concomitance with blood samples the following rating scales were administered to women: the Edinburgh Postnatal Depression Scale (EPDS), State Anxiety Inventory (STAI-S), Trait Anxiety Inventory (STAI-T), and Prenatal Attachment Inventory (PAI). We found that higher ERVWE1 protein plasma levels were significantly associated with higher PAI scores (p = 0.02), an earlier gestational age at the time of blood collection (p = 0.01), a longer duration of symptoms (p = 0.03), and fewer lifetime attempted suicides (p = 0.02). Our results seem to support the role of ERVWE1 in maintaining clinical psychiatric symptoms as a result of potential prolonged inflammation. At the same time, this protein may have a protective role in pregnant women by a reduction of suicidal behavior and a better mother-fetus relationship.
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Affiliation(s)
- Marta Serati
- Department of Mental Health, ASST RHODENSE, 20024 Rho, Italy;
| | - Cecilia Maria Esposito
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (C.M.E.); (S.G.)
| | - Silvia Grassi
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (C.M.E.); (S.G.)
| | - Valentina Bollati
- EPIGET-Epidemiology, Epigenetics and Toxicology Lab-Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy;
| | - Jennifer Lynn Barkin
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA 31207, USA;
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (C.M.E.); (S.G.)
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-02-55035983; Fax: +39-02-55033140
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Noya A, Casasús I, Rodríguez-Sánchez JA, Ferrer J, Sanz A. A negative energy balance during the peri-implantational period reduces dam IGF-1 but does not alter progesterone or pregnancy-specific protein B (PSPB) or fertility in suckled cows. Domest Anim Endocrinol 2020; 72:106418. [PMID: 31958645 DOI: 10.1016/j.domaniend.2019.106418] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 08/22/2019] [Accepted: 11/12/2019] [Indexed: 10/25/2022]
Abstract
The aim of this study was to evaluate the effect of a negative energy balance during the first third of gestation on metabolic, endocrine, and pregnancy recognition parameters in 2 beef cattle breeds adapted to semiextensive conditions. Seventy-five lactating Parda de Montaña and 40 Pirenaica multiparous cows rearing calves were synchronized and timed artificial inseminated (TAI) on day 76 postpartum. Cows were assigned to one of 2 diets (CONTROL or SUBNUT; 100% or 65% of their requirements supplied) until day 82 of gestation. Pregnancy was diagnosed 37 d post-TAI using ultrasound. Blood samples were obtained to determine metabolic (glucose, NEFA, β-hydroxybutyrate, cholesterol, and urea) and endocrine (IGF-1) status throughout the first third of gestation and to determine the concentrations of progesterone and pregnancy-specific protein B (PSPB) in the peri-implantational period. Undernutrition affected both cow and calf performance. The CONTROL cows maintained BCS and BW, whereas SUBNUT cows had negative daily gains. The CONTROL lactating calves had higher BW gains than SUBNUT. These negative effects were more evident in the Pirenaica breed, which was more sensitive to undernutrition. The negative energy balance was reflected in the cows' metabolic profiles, with higher NEFA values and lower IGF-1 concentrations in SUBNUT cows. However, undernutrition did not affect dam pregnancy/TAI or pregnancy recognition and maintenance, confirming that during periods of undernourishment pregnant dams prioritize the allocation of dietary energy toward reproductive functions. Progesterone concentration on day 21 post-TAI (with a 4.8 ng/mL cut-off value) and PSPB on day 26 post-TAI (with a 0.57 ng/mL cut-off value) were determined as the earliest indicators to accurately establish dam pregnancy status, regardless of breed or nutrition treatment. In summary, early undernutrition affected cow performance and metabolic profiles and impaired lactating calf growth, but did not affect progesterone or PSPB concentrations or the pregnancy/TAI rate in suckled cows.
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Affiliation(s)
- A Noya
- Centro de Investigación y Tecnología Agroalimentaria (CITA) de Aragón, Instituto Agroalimentario de Aragón - IA2 (CITA-Universidad de Zaragoza), Avenida Montañana 930, 50059 Zaragoza, Spain
| | - I Casasús
- Centro de Investigación y Tecnología Agroalimentaria (CITA) de Aragón, Instituto Agroalimentario de Aragón - IA2 (CITA-Universidad de Zaragoza), Avenida Montañana 930, 50059 Zaragoza, Spain
| | - J A Rodríguez-Sánchez
- Centro de Investigación y Tecnología Agroalimentaria (CITA) de Aragón, Instituto Agroalimentario de Aragón - IA2 (CITA-Universidad de Zaragoza), Avenida Montañana 930, 50059 Zaragoza, Spain
| | - J Ferrer
- Centro de Investigación y Tecnología Agroalimentaria (CITA) de Aragón, Instituto Agroalimentario de Aragón - IA2 (CITA-Universidad de Zaragoza), Avenida Montañana 930, 50059 Zaragoza, Spain
| | - A Sanz
- Centro de Investigación y Tecnología Agroalimentaria (CITA) de Aragón, Instituto Agroalimentario de Aragón - IA2 (CITA-Universidad de Zaragoza), Avenida Montañana 930, 50059 Zaragoza, Spain.
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Alkan H, Kivrak MB, Satilmis F, Tekindal MA, Dinc DA. Detection of twin pregnancies in ewes by pregnancy-associated glycoprotein assay and transabdominal ultrasonography. Domest Anim Endocrinol 2020; 72:106399. [PMID: 32380310 DOI: 10.1016/j.domaniend.2019.106399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/23/2019] [Accepted: 09/11/2019] [Indexed: 11/29/2022]
Abstract
The objectives of the present study were to evaluate and compare the accuracy of transabdominal ultrasonography and pregnancy-associated glycoprotein (PAG) assay in the diagnosis of twin pregnancies in ewes and to evaluate the utility of the PAG assay for predicting fetal gender in singleton pregnancies. The animals in the study consisted of 179 pregnant ewes. The number of fetuses in the ewe was determined using transabdominal ultrasonography between days 40 and 60 (on days 40, 45, 50, 55, and 60). Blood samples were collected from all the ewes on the same day to determine the PAG concentrations. The results found were highly sensitive for the detection of twin pregnancies by transabdominal ultrasonography. The accuracy of transabdominal ultrasonography in detecting twin pregnancies was found to be higher on day 60 than on other days (P < 0.05). The sensitivities of PAG assay in detecting twin pregnancies on days 40, 45, 50, 55, and 60 were 91.67%, 66.67%, 81.82%, 88.89%, and 33.33%, respectively. The accuracies of the PAG assay in detecting twin pregnancies on days 40, 45, and 50 were found to be statistically significant higher than other days (P < 0.05). The PAG assay had low sensitivity and specificity for predicting fetal gender. It was concluded that twin pregnancies in ewes can be diagnosed with high accuracy using transabdominal ultrasonography on day 60 of pregnancy and as well as using the PAG assay during the early days of pregnancy (on days 40, 45, and 50). The PAG assay is not useful for predicting fetal gender.
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Affiliation(s)
- H Alkan
- Faculty of Veterinary Medicine, Department of Obstetrics and Gynecology, Selcuk University, Konya, Turkey.
| | - M B Kivrak
- Faculty of Veterinary Medicine, Department of Obstetrics and Gynecology, Cumhuriyet University, Sivas, Turkey
| | - F Satilmis
- Faculty of Veterinary Medicine, Department of Obstetrics and Gynecology, Selcuk University, Konya, Turkey
| | - M A Tekindal
- Faculty of Veterinary Medicine, Department of Biostatistics, Selcuk University, Konya, Turkey
| | - D A Dinc
- Faculty of Veterinary Medicine, Department of Obstetrics and Gynecology, Selcuk University, Konya, Turkey
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Lu C, Liu C, Shi G. Colorimetric enzyme-linked aptamer assay utilizing hybridization chain reaction for determination of bovine pregnancy-associated glycoproteins. Mikrochim Acta 2020; 187:316. [PMID: 32383031 DOI: 10.1007/s00604-020-04301-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 04/23/2020] [Indexed: 11/25/2022]
Abstract
DNA aptamers that bind to bovine pregnancy-associated glycoproteins (bPAGs) were selected by the systematic evolution of ligands by exponential enrichment (SELEX) procedure coupled to surface plasmon resonance (SPR) and high-throughput sequencing (HTS) technology. After seven rounds of selection using carboxylated magnetic beads (MB) coated with bovine pregnancy-associated glycoproteins 9 (bPAG9) and bovine serum albumin (BSA) as target and counter targets, respectively, two aptamers designated as A1 and A24 showed high affinities to bPAG9 (Kd = 1.04 and 2.5 nM). Moreover, the specificity was determined by testing the non-targets bPAG4, bPAG6, bPAG16, BSA, and ovalbumin (OVA). Results showed that two aptamers demonstrated broad group specificity to bPAG family. Subsequently, a colorimetric sandwich enzyme-linked aptamer assay was developed for ultrasensitive detection of bPAG9 based on hybridization chain reaction (HCR) amplification strategy. The method exhibited a broad determination from 0.134 to 134 ng/mL with a detection limit of 0.037 ng/mL. The method has been successfully applied to determine bPAGs in real samples. The results demonstrate that the developed aptamers could be used as promising molecular probes for the development of pregnancy diagnostic tools. Graphical abstract In this study, we first selected aptamers against bovine pregnancy-associated glycoproteins (bPAGs) as molecular recognition elements and then developed a colorimetric enzyme-linked aptamer assay utilizing hybridization chain reaction to detect bPAGs in the serum.The GA can't be deleted, the modified GA can not upload. So themodified GA and figures will be send to CorrAdmin3@spi-global.com.
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Affiliation(s)
- Chunxia Lu
- College of Life Science and Technology, Yangtze Normal University, Chongqing, 408100, People's Republic of China
| | - Changbin Liu
- Institute of Animal Husbandry and Veterinary Science, Xinjiang Academy of Agriculture and Reclamation Science, Shihezi, 832000, People's Republic of China.
| | - Guoqing Shi
- Institute of Animal Husbandry and Veterinary Science, Xinjiang Academy of Agriculture and Reclamation Science, Shihezi, 832000, People's Republic of China
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9
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Abstract
BACKGROUND Allostatic load (AL) is a biopsychosocial model that suggests chronic psychosocial stress leads to physiological dysregulation and poor outcomes. The purpose of this study was to examine AL in pregnant women operationalized using proinflammatory cytokines and psychosocial indicators and perinatal outcomes. OBJECTIVES The aim of the study was to identify relationships between circulating cytokines/chemokines and the Prenatal Distress Questionnaire, the Maternal Antenatal Attachment Scale, the Emotional Quotient Inventory, the Life Experiences Scale, and demographics in pregnant women. METHODS A cross-sectional design was used to recruit pregnant women between 24 and 28 weeks of gestation. Blood and stress/emotional indicators were obtained after informed consent. Plasma was abstracted to simultaneously measure 29 cytokines/chemokines using a multiplex array. Cytokine/chemokine levels were compared with continuous variables using Spearman's rho and with categorical variables using Mann-Whitney U. RESULTS Twenty-five women with medically high-risk (n = 16) and low-risk (n = 9) pregnancies consented. Most women were White (68%) with a mean age of 29 years (SD = 5.9). Although several cytokines and chemokines showed significant correlations with the stress/emotional indicators, only interleukin-17A (IL-17A) was significantly associated with all of the indicators (Prenatal Distress Questionnaire: rs = .528, p = .012; Maternal Antenatal Attachment Scale: rs = -.439, p = .036; Emotional Quotient Inventory total: rs = -.545, p = .007), Life Experiences Scale (rs = .458, p = .032), birth weight (rs = -.499, p = .013), and race (p = .01). DISCUSSION Increased levels of IL-17A, a known cytokine associated with chronic stress and with poor perinatal outcomes, were associated with high prenatal distress, low maternal attachment, and lower emotional intelligence in pregnant women. Increased levels of IL-17A also were associated with lower birth weight and non-White race. Results support the model of AL in pregnant women and highlight IL-17A as a potential biomarker of AL during pregnancy.
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Affiliation(s)
- Tiffany A Moore
- Tiffany A. Moore, PhD, RN, is Assistant Professor, College of Nursing-Omaha Division, University of Nebraska Medical Center. Adam J. Case, PhD, is Assistant Professor, Department of Cellular and Integrative Physiology, College of Medicine, University of Nebraska Medical Center, Omaha. Therese L. Mathews, PhD, APRN-NP, BCBA-D, is Associate Professor, College of Nursing-Omaha Division, University of Nebraska Medical Center. Katherine Laux Kaiser, PhD, PHCNS, BC, is Professor Emeritus, College of Nursing-Omaha Division, University of Nebraska Medical Center. Matthew C. Zimmerman, PhD, is Associate Professor, Department of Cellular and Integrative Physiology, College of Medicine, University of Nebraska Medical Center, Omaha, and Director, Free Radicals in Medicine Program, Omaha, Nebraska. Crystal Modde Epstein, PhD, APRN-NP, is a Post-Doctoral Scholar, School of Nursing, University of California, San Francisco
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Graupner O, Karge A, Flechsenhar S, Seiler A, Haller B, Ortiz JU, Lobmaier SM, Axt-Fliedner R, Enzensberger C, Abel K, Kuschel B. Role of sFlt-1/PlGF ratio and feto-maternal Doppler for the prediction of adverse perinatal outcome in late-onset pre-eclampsia. Arch Gynecol Obstet 2019; 301:375-385. [PMID: 31734756 DOI: 10.1007/s00404-019-05365-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 04/01/2019] [Accepted: 10/30/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE The sFlt-1 (soluble fms-like tyrosine kinase-1)/PlGF (placental growth factor) ratio and uterine artery Doppler have shown to be helpful in the diagnosis of pre-eclampsia (PE). The predictive value of the cerebroplacental ratio (CPR) regarding adverse perinatal outcome (APO) in low-risk pregnancies is intensively discussed. We evaluated the extent to which sFlt-1/PlGF ratio and feto-maternal Doppler may be useful in predicting APO in singleton pregnancies complicated by late-onset PE and/or HELLP syndrome. METHODS This is a retrospective study from 2010 to 2018 consisting of singleton pregnancies with confirmed diagnosis of late-onset (lo ≥ 34 weeks) PE/HELLP syndrome in which sFlt-1/PlGF ratio and feto-maternal Doppler (mUtA-PI: mean uterine artery pulsatility index and CPR) were determined. The ability of sFlt-1/PlGF ratio, mUtA-PI, CPR and their combination to predict APO or SGA was evaluated using receiver operating characteristic (ROC) curves. RESULTS 67 patients were included in the final analysis. Of these, sFlt-1/PlGF was > 110 (defining angiogenic lo PE) in 40.3% (27/67), mUtA-PI was above the 95th centile in 34.3% (23/67) patients and CPR was lower than the 5th centile in 10.4% (7/67). Abnormal sFlt-1/PlGF and mUtA-PI as well as CPR were associated with a lower birth weight (BW). Late-preterm birth (< 37 weeks) as well as postnatal diagnosis of small for gestational age (SGA: BW < 3rd centile) was significantly more often in angiogenic lo PE cases. Neither sFlt-1/PIGF nor CPR or mUtA-PI were APO predictors. Only for sFlt-1/PlGF, ROC analysis revealed a significant predictive value for postnatal SGA (AUC = 0.856, p = 0.001, 95% CI 0.75-0.97). There was no statistical added value of combined SGA predictors as compared to sFlt-1/PlGF alone. CONCLUSIONS In patients with lo PE, adding sFlt-1/PlGF ratio to routine antepartum fetal surveillance may be useful to identify cases of postnatal SGA. However, further prospective studies are warranted to define the role of feto-maternal Doppler and sFlt-1/PlGF ratio as outcome predictors.
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Affiliation(s)
- Oliver Graupner
- Department of Obstetrics and Gynecology, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Anne Karge
- Department of Obstetrics and Gynecology, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Sarah Flechsenhar
- Department of Obstetrics and Gynecology, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Alina Seiler
- Department of Obstetrics and Gynecology, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Bernhard Haller
- Institute for Medical Informatics, Statistics and Epidemiology (IMedIS), University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - Javier U Ortiz
- Department of Obstetrics and Gynecology, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Silvia M Lobmaier
- Department of Obstetrics and Gynecology, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Roland Axt-Fliedner
- Department of Obstetrics and Gynecology, Division of Prenatal Medicine, University Hospital UKGM, Justus-Liebig University, Giessen, Germany
| | - Christian Enzensberger
- Department of Obstetrics and Gynecology, Division of Prenatal Medicine, University Hospital UKGM, Justus-Liebig University, Giessen, Germany
| | - Kathrin Abel
- Department of Obstetrics and Gynecology, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Bettina Kuschel
- Department of Obstetrics and Gynecology, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
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11
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Tarca AL, Romero R, Benshalom-Tirosh N, Than NG, Gudicha DW, Done B, Pacora P, Chaiworapongsa T, Panaitescu B, Tirosh D, Gomez-Lopez N, Draghici S, Hassan SS, Erez O. The prediction of early preeclampsia: Results from a longitudinal proteomics study. PLoS One 2019; 14:e0217273. [PMID: 31163045 PMCID: PMC6548389 DOI: 10.1371/journal.pone.0217273] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/08/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To identify maternal plasma protein markers for early preeclampsia (delivery <34 weeks of gestation) and to determine whether the prediction performance is affected by disease severity and presence of placental lesions consistent with maternal vascular malperfusion (MVM) among cases. STUDY DESIGN This longitudinal case-control study included 90 patients with a normal pregnancy and 33 patients with early preeclampsia. Two to six maternal plasma samples were collected throughout gestation from each woman. The abundance of 1,125 proteins was measured using high-affinity aptamer-based proteomic assays, and data were modeled using linear mixed-effects models. After data transformation into multiples of the mean values for gestational age, parsimonious linear discriminant analysis risk models were fit for each gestational-age interval (8-16, 16.1-22, 22.1-28, 28.1-32 weeks). Proteomic profiles of early preeclampsia cases were also compared to those of a combined set of controls and late preeclampsia cases (n = 76) reported previously. Prediction performance was estimated via bootstrap. RESULTS We found that 1) multi-protein models at 16.1-22 weeks of gestation predicted early preeclampsia with a sensitivity of 71% at a false-positive rate (FPR) of 10%. High abundance of matrix metalloproteinase-7 and glycoprotein IIbIIIa complex were the most reliable predictors at this gestational age; 2) at 22.1-28 weeks of gestation, lower abundance of placental growth factor (PlGF) and vascular endothelial growth factor A, isoform 121 (VEGF-121), as well as elevated sialic acid binding immunoglobulin-like lectin 6 (siglec-6) and activin-A, were the best predictors of the subsequent development of early preeclampsia (81% sensitivity, FPR = 10%); 3) at 28.1-32 weeks of gestation, the sensitivity of multi-protein models was 85% (FPR = 10%) with the best predictors being activated leukocyte cell adhesion molecule, siglec-6, and VEGF-121; 4) the increase in siglec-6, activin-A, and VEGF-121 at 22.1-28 weeks of gestation differentiated women who subsequently developed early preeclampsia from those who had a normal pregnancy or developed late preeclampsia (sensitivity 77%, FPR = 10%); 5) the sensitivity of risk models was higher for early preeclampsia with placental MVM lesions than for the entire early preeclampsia group (90% versus 71% at 16.1-22 weeks; 87% versus 81% at 22.1-28 weeks; and 90% versus 85% at 28.1-32 weeks, all FPR = 10%); and 6) the sensitivity of prediction models was higher for severe early preeclampsia than for the entire early preeclampsia group (84% versus 71% at 16.1-22 weeks). CONCLUSION We have presented herein a catalogue of proteome changes in maternal plasma proteome that precede the diagnosis of preeclampsia and can distinguish among early and late phenotypes. The sensitivity of maternal plasma protein models for early preeclampsia is higher in women with underlying vascular placental disease and in those with a severe phenotype.
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Affiliation(s)
- Adi L. Tarca
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- Department of Computer Science, Wayne State University College of Engineering, Detroit, Michigan, United States of America
- * E-mail: (RR); (ALT)
| | - Roberto Romero
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, United States of America
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, Michigan, United States of America
- * E-mail: (RR); (ALT)
| | - Neta Benshalom-Tirosh
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Nandor Gabor Than
- Systems Biology of Reproduction Research Group, Institute of Enzymology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
- First Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
- Maternity Clinic, Kutvolgyi Clinical Block, Semmelweis University, Budapest, Hungary
| | - Dereje W. Gudicha
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Bogdan Done
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
| | - Percy Pacora
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Tinnakorn Chaiworapongsa
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Bogdan Panaitescu
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Dan Tirosh
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Nardhy Gomez-Lopez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- C.S. Mott Center for Human Growth and Development, Wayne State University, Detroit, Michigan, United States of America
- Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Sorin Draghici
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- Department of Computer Science, Wayne State University College of Engineering, Detroit, Michigan, United States of America
| | - Sonia S. Hassan
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Offer Erez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- Maternity Department "D," Division of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
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12
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Ogunlola M, Reddy P, Sibiya MN, O'Connor L, Borg D, Haffejee F, Ghuman S, Ngxongo T, Govender N. Circulating soluble fms-like tyrosine kinase-1, soluble endoglin and placental growth factor during pregnancy in normotensive women in KwaZulu-Natal, South Africa. Afr Health Sci 2019; 19:1821-1832. [PMID: 31656464 PMCID: PMC6794537 DOI: 10.4314/ahs.v19i2.4] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Based on the increased pre-eclampsia and HIV antenatal incidence in South Africa, we determined the angiogenic profiles due to its mechanistic link in preeclampsia development, throughout uncomplicated pregnancies in HIV positive and negative women. OBJECTIVE To determine the angiogenic profiles throughout uncomplicated pregnancies in HIV positive and HIV negative women. We explored possible correlations between angiogenic serum levels and selected maternal characteristics (HIV status, gestational age, maternal factors, and pregnancy outcomes). METHOD This study was conducted at a primary health care facility in Durban, South Africa. Forty-six pregnant women aged 18-45 years, were enrolled at 10-20, 22-30 and 32-38 weeks' gestation, respectively through convenient sampling. Serum samples were collected and quantitatively evaluated using ELISAs. Clinical and epidemiological data were analysed using STATA (version 14). A probability level of p < 0.05 was considered statistically significant. RESULTS Of those enrolled, 28.3% were nulliparous, 82% were HIV positive and none developed pre-eclampsia. Systolic and diastolic blood pressure increased slightly throughout pregnancy. Fluctuating angiogenic and anti-angiogenic levels were demonstrated during pregnancy. CONCLUSION This study contributes to the current angiogenic knowledge in normotensive pregnancies, and may assist as a reference range against which these factors may be compared in HIV complicated pregnancies.
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Affiliation(s)
- Muhammed Ogunlola
- Department of Community Health Studies, Faculty of Health Sciences, Durban University of Technology
| | - Poovendhree Reddy
- Department of Community Health Studies, Faculty of Health Sciences, Durban University of Technology
| | - Maureen N Sibiya
- Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Laura O'Connor
- Department of Chiropractic and Somatology, Faculty of Health Sciences, Durban University of Technology, SA
| | - Dorinda Borg
- Department of Chiropractic and Somatology, Faculty of Health Sciences, Durban University of Technology, SA
| | - Firoza Haffejee
- Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa
| | - Shanaz Ghuman
- Department of Community Health Studies, Faculty of Health Sciences, Durban University of Technology
| | - Thembelihle Ngxongo
- Department of Nursing, Faculty of Health Sciences, Durban University of Technology, SA
| | - Nalini Govender
- Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa
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13
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Zhao B, Han X, Meng Q, Luo Q. Early second trimester maternal serum markers in the prediction of gestational diabetes mellitus. J Diabetes Investig 2018; 9:967-974. [PMID: 29288571 PMCID: PMC6031488 DOI: 10.1111/jdi.12798] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/02/2017] [Accepted: 12/19/2017] [Indexed: 12/15/2022] Open
Abstract
AIMS/INTRODUCTION To determine whether maternal serum markers in the early second trimester are useful for prediction of gestational diabetes mellitus (GDM). MATERIALS AND METHODS A total of 876 singleton pregnancies were recruited in the present study. Blood samples were collected during 16-20 gestational weeks. GDM women were diagnosed by an oral glucose tolerance test during 24-28 gestational weeks. A total of 56 women with GDM and 73 healthy pregnant women were selected. Maternal serum concentrations of placental protein 13 (PP13), pentraxin 3 (PTX3), soluble fms-like tyrosine kinase-1 (sFlt-1), myostatin and follistatin (FST) were detected at 16-20 weeks' gestation. All of these markers concentrations were expressed as multiples of the medians. The Mann-Whitney U-test was used for comparison of the multiples of the medians of different concentrations of these five serum markers between the GDM group and the control group. Receiver operating characteristic curve analysis was applied to assess the sensitivity and specificity of significant serum markers from a Mann-Whitney U-test comparison. RESULTS Compared with healthy pregnancies, the serum levels of PP13, PTX3, sFlt-1, myostatin and FST in the early second trimester were significantly increased in patients who had developed GDM late. In screening for GDM by PP13, PTX3, sFlt-1, myostatin and FST, the detection rates were 92.3, 94.9, 94.9, 92.5 and 92.3%, respectively at 80% specificity. PTX3 and sFlt-1 were the most sensitive markers. CONCLUSIONS Maternal serum markers including PP13, PTX3, sFlt-1, myostatin and FST increase in the early second trimester of women with GDM. These five markers, especially PTX3 and sFlt-1, could have the value of prediction for those patients who would develop GDM in the late second trimester.
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Affiliation(s)
- Baihui Zhao
- Department of ObstetricsWomen's HospitalSchool of MedicineZhejiang UniversityHangzhouChina
| | - Xiujun Han
- Department of ObstetricsWomen's HospitalSchool of MedicineZhejiang UniversityHangzhouChina
| | - Qing Meng
- Department of ObstetricsWomen's HospitalSchool of MedicineZhejiang UniversityHangzhouChina
| | - Qiong Luo
- Department of ObstetricsWomen's HospitalSchool of MedicineZhejiang UniversityHangzhouChina
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14
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Griffin M, Seed PT, Duckworth S, North R, Myers J, Mackillop L, Simpson N, Waugh J, Anumba D, Kenny LC, Redman CWG, Shennan AH, Chappell LC. Predicting delivery of a small-for-gestational-age infant and adverse perinatal outcome in women with suspected pre-eclampsia. Ultrasound Obstet Gynecol 2018; 51:387-395. [PMID: 28401605 PMCID: PMC5887913 DOI: 10.1002/uog.17490] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/11/2017] [Accepted: 03/23/2017] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To evaluate the test performance of 47 biomarkers and ultrasound parameters for the prediction of delivery of a small-for-gestational-age (SGA) infant and adverse perinatal outcome in women presenting with suspected pre-eclampsia. METHODS This was a prospective, multicenter observational study in which 47 biomarkers and ultrasound parameters were measured in 397 women with a singleton pregnancy presenting with suspected preterm pre-eclampsia between 20 + 0 and 36 + 6 weeks' gestation, with the objective of evaluating them as predictors of subsequent delivery of a SGA infant and adverse perinatal outcome. Women with confirmed pre-eclampsia at enrollment were excluded. Factor analysis and stepwise logistic regression were performed in two prespecified groups stratified according to gestational age at enrollment. The primary outcome was delivery of a SGA infant with a birth weight < 3rd customized centile (SGA-3), and secondary outcomes were a SGA infant with a birth weight < 10th customized centile and adverse perinatal outcome. RESULTS In 274 women presenting at 20 + 0 to 34 + 6 weeks' gestation, 96 (35%) delivered a SGA-3 infant. For prediction of SGA-3, low maternal placental growth factor (PlGF) concentration had a sensitivity of 93% (95% CI, 84-98%) and negative predictive value (NPV) of 90% (95% CI, 76-97%) compared with a sensitivity of 71% (95% CI, 58-82%) and a NPV of 79% (95% CI, 68-87%) for ultrasound parameters (estimated fetal weight or abdominal circumference < 10th centile). No individual biomarker evaluated had a better performance than did PlGF, and marker combinations made only small improvements to the test performance. Similar results were found in 123 women presenting between 35 + 0 and 36 + 6 weeks' gestation. CONCLUSION In women presenting with suspected preterm pre-eclampsia, measurement of PlGF offers a useful adjunct for identifying those at high risk of delivering a SGA infant, allowing appropriate surveillance and timely intervention. © 2017 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M. Griffin
- Women's Health Academic CentreKing's College LondonLondonUK
| | - P. T. Seed
- Women's Health Academic CentreKing's College LondonLondonUK
| | - S. Duckworth
- Women's Health Academic CentreKing's College LondonLondonUK
| | - R. North
- Women's Health Academic CentreKing's College LondonLondonUK
| | - J. Myers
- Maternal and Fetal Health Research CentreUniversity of ManchesterManchesterUK
| | | | - N. Simpson
- Division of Women's and Children's Health, Faculty of HealthUniversity of LeedsLeedsUK
| | - J. Waugh
- Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastleUK
| | - D. Anumba
- Academic Unit of Reproductive and Developmental MedicineUniversity of SheffieldSheffieldUK
| | - L. C. Kenny
- INFANT Irish Centre for Fetal and Neonatal Translational ResearchUniversity College CorkCorkIreland
| | - C. W. G. Redman
- Nuffield Department of Obstetrics and GynaecologyUniversity of OxfordOxfordUK
| | - A. H. Shennan
- Women's Health Academic CentreKing's College LondonLondonUK
| | - L. C. Chappell
- Women's Health Academic CentreKing's College LondonLondonUK
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15
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Reese ST, Pereira MHC, Edwards JL, Vasconcelos JLM, Pohler KG. Pregnancy diagnosis in cattle using pregnancy associated glycoprotein concentration in circulation at day 24 of gestation. Theriogenology 2017; 106:178-185. [PMID: 29073542 DOI: 10.1016/j.theriogenology.2017.10.020] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [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: 08/23/2017] [Revised: 10/05/2017] [Accepted: 10/09/2017] [Indexed: 11/19/2022]
Abstract
Cattle producers are limited to day 28-30 of gestation as the earliest time point for accurate pregnancy diagnosis due to the effectiveness of ultrasound and chemical based methods, including commercially available pregnancy associated glycoproteins (PAG) tests. The objective of the current studies were to determine if early gestation circulating PAG concentrations at day 24 could be used to diagnose pregnancy in dairy cattle undergoing embryo transfer. In vitro produced embryos were transferred into Holstein x Gir cows and heifers on day 7 following ovulation. Study 1 utilized only cows (n = 101) determined to be pregnant on day 24 of gestation by progesterone concentration, as well as CL and PAG presence. In study 2, animals were not predetermined to be pregnant and both heifers (n = 111) and cows (n = 242) were used. In both studies, blood was collected at day 24 for PAG analysis as well as day 31. Final pregnancy confirmation occurred on day 60 via transrectal ultrasonography. Serum PAG concentrations were quantified using an in house PAG ELISA. Following timed embryo transfer (TET) in study 1, of the 101 cows diagnosed as pregnant on day 24, 80 cows were identified as still pregnant on day 31 of gestation (77%). Study 2 had a pregnancy rate at day 31 of 33.7% of total embryos transferred. Mean circulating PAG concentration at day 24 differed (P < 0.001) between animals diagnosed pregnant and non-pregnant at day 31 in both studies (study 1, 2.964 ± 0.262 ng/mL vs 0.946 ± 0.168 ng/mL and study 2, 1.962 ± 0.261 ng/mL vs 0.731 ± 0.109 ng/mL). Concentration of PAG between pregnant and non-pregnant cows in study 1 and 2 was significant, however, pregnant heifers in study 2 (1.562 ± 0.266 ng/mL) had concentration of PAGs that only had a tendency to differ compared to non-pregnant heifers (non-pregnant, 0.799 ± 0.290 ng/mL; P = 0.0669). Only animals that were pregnant at day 31 were analyzed in late embryo mortality analysis (heifers, n = 54; cows, n = 159), defined as pregnancy loss between day 31 and 60. Between day 31 and 60, 39 (12 in study 1 and 28 in study 2) animals experienced late embryo mortality. Circulating concentrations of PAG were not significantly different (P > 0.05), in either study, at day 24 of gestation in animals that maintained pregnancy until day 60 compared to animals that lost pregnancy between day 31 and 60 (late embryo mortality, LEM). In summary, early gestation circulating PAG concentration may have application in diagnosing pregnancy at day 24 of gestation and more work is needed to determine the potential of early gestation PAGs in predicting embryo loss in dairy.
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Affiliation(s)
- S T Reese
- Department of Animal Science, University of Tennessee, 2506 River Drive, Knoxville, TN, United States
| | - M H C Pereira
- Department of Animal Production, São Paulo State University, Botucatu, SP, Brazil
| | - J L Edwards
- Department of Animal Science, University of Tennessee, 2506 River Drive, Knoxville, TN, United States
| | - J L M Vasconcelos
- Department of Animal Production, São Paulo State University, Botucatu, SP, Brazil
| | - K G Pohler
- Department of Animal Science, University of Tennessee, 2506 River Drive, Knoxville, TN, United States.
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16
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Oller Moreno S, Cominetti O, Núñez Galindo A, Irincheeva I, Corthésy J, Astrup A, Saris WHM, Hager J, Kussmann M, Dayon L. The differential plasma proteome of obese and overweight individuals undergoing a nutritional weight loss and maintenance intervention. Proteomics Clin Appl 2017; 12. [PMID: 28371297 DOI: 10.1002/prca.201600150] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 10/27/2016] [Revised: 03/01/2017] [Accepted: 03/27/2017] [Indexed: 01/24/2023]
Abstract
PURPOSE The nutritional intervention program "DiOGenes" focuses on how obesity can be prevented and treated from a dietary perspective. We generated differential plasma proteome profiles in the DiOGenes cohort to identify proteins associated with weight loss and maintenance and explore their relation to body mass index, fat mass, insulin resistance, and sensitivity. EXPERIMENTAL DESIGN Relative protein quantification was obtained at baseline and after combined weight loss/maintenance phases using isobaric tagging and MS/MS. A Welch t-test determined proteins differentially present after intervention. Protein relationships with clinical variables were explored using univariate linear models, considering collection center, gender and age as confounding factors. RESULTS Four hundred and seventy three subjects were measured at baseline and end of the intervention; 39 proteins were longitudinally differential. Proteins with largest changes were sex hormone-binding globulin, adiponectin, C-reactive protein, calprotectin, serum amyloid A, and proteoglycan 4 (PRG4), whose association with obesity and weight loss is known. We identified new putative biomarkers for weight loss/maintenance. Correlation between PRG4 and proline-rich acidic protein 1 variation and Matsuda insulin sensitivity increment was showed. CONCLUSION AND CLINICAL RELEVANCE MS-based proteomic analysis of a large cohort of non-diabetic overweight and obese individuals concomitantly identified known and novel proteins associated with weight loss and maintenance.
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Affiliation(s)
- Sergio Oller Moreno
- Systems Nutrition, Metabonomics and Proteomics, Nestlé Institute of Health Sciences, Lausanne, Switzerland
- Signal and Information Processing for Sensing Systems, Institute for Bioengineering of Catalonia, Barcelona, Spain
| | - Ornella Cominetti
- Systems Nutrition, Metabonomics and Proteomics, Nestlé Institute of Health Sciences, Lausanne, Switzerland
| | - Antonio Núñez Galindo
- Systems Nutrition, Metabonomics and Proteomics, Nestlé Institute of Health Sciences, Lausanne, Switzerland
| | - Irina Irincheeva
- Nutrition and Metabolic Health, Nestlé Institute of Health Sciences, Lausanne, Switzerland
| | - John Corthésy
- Systems Nutrition, Metabonomics and Proteomics, Nestlé Institute of Health Sciences, Lausanne, Switzerland
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Wim H M Saris
- Department of Human Biology, NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jörg Hager
- Nutrition and Metabolic Health, Nestlé Institute of Health Sciences, Lausanne, Switzerland
| | - Martin Kussmann
- Systems Nutrition, Metabonomics and Proteomics, Nestlé Institute of Health Sciences, Lausanne, Switzerland
| | - Loïc Dayon
- Systems Nutrition, Metabonomics and Proteomics, Nestlé Institute of Health Sciences, Lausanne, Switzerland
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Rabajdová M, Dudič R, Urban P, Dudičová V, Urdzík P, Mareková M. Analysis of transcriptional activities of angiogenic biomarkers during intrauterine complications leading to preterm birth. Eur Rev Med Pharmacol Sci 2017; 21:1433-1442. [PMID: 28429366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Pre-eclampsia, growth retardation and preterm delivery are the most common reasons leading to increased maternal and perinatal mortality. The increased expression of hypoxia induced factors, such as HIF-1, triggers the overexpression of anti-angiogenic genes. The aim of this study was to determine the transcriptional activity of individual pro- and anti-angiogenic markers (VEGF, HIF-1, sEng, Flt-1, PlGF-1) in maternal blood samples from patients with spontaneous preterm labor, preterm labor in combination with pre-eclampsia and fetal growth restriction in comparison with physiologically terminated pregnancies. PATIENTS AND METHODS The transcriptional activity of specific genes was detected from the blood of patients using the chromatin immunoprecipitation capture method coupled with quantitative real-time PCR. RESULTS The maximum differences in mRNA levels of PlGF-1 and VEGF-A were detected in two groups: the group of normal-term birth with complications and the group of preterm labor with complications (both significantly lower than the control, p < 0.001). In contrast, a marked increase of mRNA levels was found in the same groups of patients for the HIF-1, endoglin and Flt-1 genes (p < 0.001). CONCLUSIONS According to our results, we can conclude that increased oxidative stress, increasing the expression levels of anti-angiogenic genes and reduction of the transcriptional activity of pro-angiogenic genes can provide additional information during diagnostics of pathological complications of labor.
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Affiliation(s)
- M Rabajdová
- Department of Medical and Clinical Biochemistry, P. J. Šafárik University in Košice, Faculty of Medicine, Košice, Slovakia.
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Triunfo S, Crovetto F, Rodriguez-Sureda V, Scazzocchio E, Crispi F, Dominguez C, Gratacos E, Figueras F. Changes in uterine artery Doppler velocimetry and circulating angiogenic factors in the first half of pregnancies delivering a small-for-gestational-age neonate. Ultrasound Obstet Gynecol 2017; 49:357-363. [PMID: 27241056 DOI: 10.1002/uog.15978] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/24/2016] [Accepted: 05/25/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To assess the relationship between longitudinal changes in placental Doppler indices and maternal circulating angiogenic factors in the first half of pregnancy and delivery of a small-for-gestational-age (SGA) neonate, and ascertain whether longitudinal evaluation of these variables improves the prediction achieved by second-trimester cross-sectional evaluation. METHODS From a prospective cohort of unselected singleton pregnancies undergoing first-trimester screening for aneuploidy, 138 were included in this study. Of these, 46 were complicated by SGA (delivering after 34 weeks' gestation with a birth weight < 10th centile) and 92 were appropriate-for-gestational-age (AGA) pregnancies, which were included as controls (ratio 1:2). First-to-second trimester longitudinal changes in uterine artery (UtA) Doppler indices and maternal circulating levels of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were analyzed. RESULTS Compared with the AGA group, SGA pregnancies had significantly higher UtA impedance in the first (Z-score: 0.46 vs -0.57; P < 0.001) and second (Z-score: 1.71 vs -0.75; P < 0.001) trimesters. Likewise, the sFlt-1/PlGF ratio was significantly higher in SGA than in AGA pregnancies in the first (98.0 vs 67.9; P = 0.01) and early second (22.4 vs 8.8; P < 0.001) trimesters. The predictive performance of the longitudinal changes in UtA Doppler indices for SGA was significantly lower than that of second-trimester cross-sectional values (area under receiver-operating characteristics curve (AUC), 60.8% vs 84.3%; P = 0.0035). The detection rate of SGA, at a 10% false-positive rate (FPR), was 17.7% by longitudinal changes in UtA Doppler and 56.2% by second-trimester cross-sectional UtA Doppler values. Similarly, the predictive performance of the longitudinal changes in PlGF was significantly lower than that of early second-trimester cross-sectional values (AUC, 71.4% vs 76.5%; P = 0.008). The detection rate of SGA at a 10% FPR was 40.6% when screening by longitudinal changes in PlGF and 52.1% when screening by early second-trimester cross-sectional values. CONCLUSIONS First- and second-trimester UtA Doppler velocimetry and maternal circulating angiogenic markers have clinical utility as a cross-sectional assessment for the identification of pregnancies at high risk of delivering a SGA neonate, however, they do not improve prediction when their longitudinal changes are used. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- S Triunfo
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Center for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - F Crovetto
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Center for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
- Ca'Granda, Ospedale Maggiore Policlinico, Dipartimento Ostetricia e Ginecologia, Università degli Studi di Milano, Milan, Italy
| | - V Rodriguez-Sureda
- Biochemistry and Molecular Biology Research Centre for Nanomedicine, Hospital Univeritari Vall d'Hebron, Barcelona, and Centre for Biomedical Research on Rare Disease (CIBER-ER), Instituto de Salud Carlos III, Madrid, Spain
| | - E Scazzocchio
- Obstetrics, Gynecology and Reproductive Medicine Department, Institut Universitari Dexeus, Barcelona, Spain
| | - F Crispi
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Center for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - C Dominguez
- Biochemistry and Molecular Biology Research Centre for Nanomedicine, Hospital Univeritari Vall d'Hebron, Barcelona, and Centre for Biomedical Research on Rare Disease (CIBER-ER), Instituto de Salud Carlos III, Madrid, Spain
| | - E Gratacos
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Center for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - F Figueras
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Center for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
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Check JH, Rosenberg A, Check DL, DiAntonio A, Rui H, Cohen R, DiAntonio G. Serum levels of the immunomodulatory protein, the progesterone induced blocking factor (PIBF) which is found in high levels during pregnancy is not higher in women with progesterone (P) receptor (R) positive vs. negative breast cancer. CLIN EXP OBSTET GYN 2017; 44:187-189. [PMID: 29746019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE To determine if serum levels of the immunomodulatory protein, the progesterone induced blocking factor (PIBF), which is present in high levels during normal pregnancy, is present in higher levels in women with breast cancer positive for progesterone receptors. The study would also determine whether the presence or absence of the estrogen receptor in any way modifies PIBF expression. MATERIALS AND METHODS PIBF using a research ELISA was evaluated in the follicular phase in 21 women with receptor status as follows: seven with estrogen receptor (ER)+ and progesterone receptor (PR)+, seven with ER- and PR+, and seven with ER+ and PR. RESULTS The results showed no differences in serum PIBF in the three groups. The serum PIBF levels were no different than historical controls in the follicular phase. CONCLUSIONS Measurement of serum PIBF does not seem to be an important marker to use to either detect women with breast cancer or to help determine tumor virulence or potential specific therapies. If PIBF plays a role in helping cancer cells to escape immune surveillance, it seems that the intracytoplasmic PIBF would be the form most likely operative.
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Chaiworapongsa T, Romero R, Whitten AE, Korzeniewski SJ, Chaemsaithong P, Hernandez-Andrade E, Yeo L, Hassan SS. The use of angiogenic biomarkers in maternal blood to identify which SGA fetuses will require a preterm delivery and mothers who will develop pre-eclampsia. J Matern Fetal Neonatal Med 2016; 29:1214-28. [PMID: 26303962 DOI: 10.3109/14767058.2015.1048431] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine (1) whether maternal plasma concentrations of angiogenic and anti-angiogenic factors can predict which mothers diagnosed with "suspected small for gestational age fetuses (sSGA)" will develop pre-eclampsia (PE) or require an indicated early preterm delivery (≤ 34 weeks of gestation); and (2) whether risk assessment performance is improved using these proteins in addition to clinical factors and Doppler parameters. METHODS This prospective cohort study included women with singleton pregnancies diagnosed with sSGA (estimated fetal weight <10th percentile) between 24 and 34 weeks of gestation (n = 314). Plasma concentrations of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1), soluble endoglin (sEng) and placental growth factor (PlGF) were determined in maternal blood obtained at the time of diagnosis. Doppler velocimetry of the umbilical (Umb) and uterine (UT) arteries was performed. The outcomes were (1) subsequent development of PE; and (2) indicated preterm delivery at ≤ 34 weeks of gestation (excluding deliveries as a result of spontaneous preterm labor, preterm pre-labor rupture of membranes or chorioamnionitis). RESULTS (1) The prevalence of PE and indicated preterm delivery was 9.2% (n = 29/314) and 7.3% (n = 23/314), respectively; (2) the area under the receiver operating characteristic curve (AUC) for the identification of patients who developed PE and/or required indicated preterm delivery was greater than 80% for the UT artery pulsatility index (PI) z-score and each biochemical marker (including their ratios) except sVEGFR-1 MoM; (3) using cutoffs at a false positive rate of 15%, women with abnormal plasma concentrations of angiogenic/anti-angiogenic factors were 7-13 times more likely to develop PE, and 12-22 times more likely to require preterm delivery than those with normal plasma MoM concentrations of these factors; (4) sEng, PlGF, PIGF/sEng and PIGF/sVEGFR-1 ratios MoM, each contributed significant information about the risk of PE beyond that provided by clinical factors and/or Doppler parameters: women who had low MoM values for these biomarkers were at 5-9 times greater risk of developing PE than women who had normal values, adjusting for clinical factors and Doppler parameters (adjusted odds ratio for PlGF: 9.1, PlGF/sEng: 5.6); (5) the concentrations of sVEGFR-1 and PlGF/sVEGFR-1 ratio MoM, each contributed significant information about the risk of indicated preterm delivery beyond that provided by clinical factors and/or Doppler parameters: women who had abnormal values were at 8-9 times greater risk for indicated preterm delivery, adjusting for clinical factors and Doppler parameters; and (6) for a two-stage risk assessment (Umb artery Doppler followed by Ut artery Doppler plus biochemical markers), among women who had normal Umb artery Doppler velocimetry (n = 279), 21 (7.5%) developed PE and 11 (52%) of these women were identified by an abnormal UT artery Doppler mean PI z-score (>2SD): a combination of PlGF/sEng ratio MoM concentration and abnormal UT artery Doppler velocimetry increased the sensitivity of abnormal UT artery Doppler velocimetry to 76% (16/21) at a fixed false-positive rate of 10% (p = 0.06). CONCLUSION Angiogenic and anti-angiogenic factors measured in maternal blood between 24 and 34 weeks of gestation can identify the majority of mothers diagnosed with "suspected SGA" who subsequently developed PE or those who later required preterm delivery ≤ 34 weeks of gestation. Moreover, incorporation of these biochemical markers significantly improves risk assessment performance for these outcomes beyond that of clinical factors and uterine and umbilical artery Doppler velocimetry.
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Crovetto F, Triunfo S, Crispi F, Rodriguez-Sureda V, Roma E, Dominguez C, Gratacos E, Figueras F. First-trimester screening with specific algorithms for early- and late-onset fetal growth restriction. Ultrasound Obstet Gynecol 2016; 48:340-348. [PMID: 26846589 DOI: 10.1002/uog.15879] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 12/23/2015] [Accepted: 01/30/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To develop optimal first-trimester algorithms for the prediction of early and late fetal growth restriction (FGR). METHODS This was a prospective cohort study of singleton pregnancies undergoing first-trimester screening. FGR was defined as an ultrasound estimated fetal weight < 10(th) percentile plus Doppler abnormalities or a birth weight < 3(rd) percentile. Logistic regression-based predictive models were developed for predicting early and late FGR (cut-off: delivery at 34 weeks). The model included the a-priori risk (maternal characteristics), mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1). RESULTS Of the 9150 pregnancies included, 462 (5%) fetuses were growth restricted: 59 (0.6%) early and 403 (4.4%) late. Significant contributions to the prediction of early FGR were provided by black ethnicity, chronic hypertension, previous FGR, MAP, UtA-PI, PlGF and sFlt-1. The model achieved an overall detection rate (DR) of 86.4% for a 10% false-positive rate (area under the receiver-operating characteristics curve (AUC): 0.93 (95% CI, 0.87-0.98)). The DR was 94.7% for FGR with pre-eclampsia (PE) (64% of cases) and 71.4% for FGR without PE (36% of cases). For late FGR, significant contributions were provided by chronic hypertension, autoimmune disease, previous FGR, smoking status, nulliparity, MAP, UtA-PI, PlGF and sFlt-1. The model achieved a DR of 65.8% for a 10% false-positive rate (AUC: 0.76 (95% CI, 0.73-0.80)). The DR was 70.2% for FGR with PE (12% of cases) and 63.5% for FGR without PE (88% of cases). CONCLUSIONS The optimal screening algorithm was different for early vs late FGR, supporting the concept that screening for FGR is better performed separately for the two clinical forms. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- F Crovetto
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
- Department of Obstetrics and Gynecology, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - S Triunfo
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - F Crispi
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - V Rodriguez-Sureda
- Biochemistry and Molecular Biology Research Centre for Nanomedicine, Hospital Universitari Vall d'Hebron, and Centre for Biomedical Research on Rare Diseases (CIBERER), Barcelona, Spain
| | - E Roma
- Obstetrics and Gynecology Department, Althaia, Network Healthcare Manresa Foundation, Barcelona, Spain
| | - C Dominguez
- Biochemistry and Molecular Biology Research Centre for Nanomedicine, Hospital Universitari Vall d'Hebron, and Centre for Biomedical Research on Rare Diseases (CIBERER), Barcelona, Spain
| | - E Gratacos
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - F Figueras
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
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Hudić I, Szekeres-Bartho J, Stray-Pedersen B, Fatušić Z, Polgar B, Ećim-Zlojutro V. Lower Urinary and Serum Progesterone-Induced Blocking Factor in Women with Preterm Birth. J Reprod Immunol 2016; 117:66-9. [PMID: 27479613 DOI: 10.1016/j.jri.2016.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 07/01/2016] [Accepted: 07/14/2016] [Indexed: 11/30/2022]
Abstract
The aim of the study was to compare urine and serum concentrations of PIBF at 24-28 gestational weeks in women with preterm birth, with those of women who delivered at term and to evaluate the impact of PIBF on the outcome of pregnancy. Case-control study was performed in period from 1.6.2010-31.7.2013. Biological samples (urine and serum) were collected from 126 pregnant women. All biological samples were obtained at 24-28 gestation weeks. We measured PIBF concentration and compared women who delivered preterm and those who delivered at term. Thirteen of 126 pregnant women (10.3%) who were included in the study delivered preterm. Among women that actually delivered preterm, median concentrations of PIBF were significantly lower (12.3ng/ml; 101.3ng/ml) than in women who delivered at term (77.0ng/ml; 412.7ng/ml). The serum and urine 24-28 gestational weeks PIBF in those who delivered preterm were generally low from 24 to 37 gestational weeks, while the serum and urine PIBF concentration reached a peak in those delivering between 37-38 gestational weeks, even significantly different from those delivering at 39 to 40 and after 40 gestational weeks. Preterm birth may be predictable at 24-28 gestational week by lower than normal pregnancy PIBF values and measurement of PIBF concentration in biological fluids at that time may be of importance in clinical practice.
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Affiliation(s)
- Igor Hudić
- Clinic of Gynecology and Obstetrics, University Clinical Center, Tuzla, Bosnia and Herzegovina; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Julia Szekeres-Bartho
- Department of Medical Biology, Medical School, Pecs University, MTA-PTE Human Reproduction Scientific Research Group, Janos Szentagothai Research Centre, University of Pecs, Hungary
| | - Babill Stray-Pedersen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Obstetrics and Gynecology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Zlatan Fatušić
- Clinic of Gynecology and Obstetrics, University Clinical Center, Tuzla, Bosnia and Herzegovina
| | - Beata Polgar
- Department of Medical Biology, Medical School, Pecs University, MTA-PTE Human Reproduction Scientific Research Group, Janos Szentagothai Research Centre, University of Pecs, Hungary
| | - Vesna Ećim-Zlojutro
- Clinic of Gynecology and Obstetrics, University Clinical Center of Republic of Srpska, Banja Luka, Bosnia and Herzegovina
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Seravalli V, Grimpel YI, Meiri H, Blitzer M, Baschat AA. Relationship between first-trimester serum placental protein-13 and maternal characteristics, placental Doppler studies and pregnancy outcome. J Perinat Med 2016; 44:543-9. [PMID: 26910737 DOI: 10.1515/jpm-2015-0324] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 01/18/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To examine potential correlations between maternal serum placental protein-13 (PP-13) and first trimester maternal and placental factors, and to evaluate the association of this marker with adverse pregnancy outcome. METHODS Serum samples from prospectively enrolled patients between 11 and 13 weeks and 6 days were analyzed for PP-13 using an ELISA assay. The relationships between maternal serum PP-13 levels and gestational age, maternal age, ethnicity, parity, smoking status, body mass index (BMI), mean arterial blood pressure, uterine and umbilical artery Doppler parameters were examined. The association between first-trimester PP-13 levels and subsequent pre-eclampsia and delivery of a small for gestational age (SGA) neonate was also investigated, after excluding patients who received aspirin. RESULTS In 908 patients, PP-13 levels ranged from 8.0 to 537.5 pg/mL. A significant negative correlation was identified between PP13 and BMI (Spearman rho -0.20, P<0.0001). Smoking significantly decreased PP-13 (P<0.01). No relationship was identified with the other parameters. In a subgroup of 668 low-risk patients who did not receive aspirin, PP-13 levels were not associated with development of pre-eclampsia, SGA or the combination of them. CONCLUSION First-trimester PP-13 levels are significantly correlated with BMI and smoking. These correlations appear independent of uterine and umbilical artery resistance. In low risk patients, PP-13 levels fail to predict the risk for pre-eclampsia or SGA.
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Jadli A, Ghosh K, Shetty S. Prediction of small-for-gestational-age at 35-37 weeks of gestation: too late for management? Ultrasound Obstet Gynecol 2016; 47:385. [PMID: 26940676 DOI: 10.1002/uog.15739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 08/26/2015] [Indexed: 06/05/2023]
Affiliation(s)
- A Jadli
- Department of Haemostasis Thrombosis, National Institute of Immunohaematology (ICMR), Mumbai, 400012, India
| | - K Ghosh
- Department of Haemostasis Thrombosis, National Institute of Immunohaematology (ICMR), Mumbai, 400012, India
| | - S Shetty
- Department of Haemostasis Thrombosis, National Institute of Immunohaematology (ICMR), Mumbai, 400012, India
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Barcelo A, Bauça JM, Yañez A, Fueyo L, Gomez C, de la Peña M, Pierola J, Rodriguez A, Sanchez-de-la-Torre M, Abad J, Mediano O, Amilibia J, Masdeu MJ, Teran J, Montserrat JM, Mayos M, Sanchez-de-la-Torre A, Barbé F. Impact of Obstructive Sleep Apnea on the Levels of Placental Growth Factor (PlGF) and Their Value for Predicting Short-Term Adverse Outcomes in Patients with Acute Coronary Syndrome. PLoS One 2016; 11:e0147686. [PMID: 26930634 PMCID: PMC4773070 DOI: 10.1371/journal.pone.0147686] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 09/08/2015] [Accepted: 01/07/2016] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Placental growth factor (PlGF) induces angiogenesis and promotes tissue repair, and plasma PlGF levels change markedly during acute myocardial infarction (AMI). Currently, the impact of obstructive sleep apnea (OSA) in patients with AMI is a subject of debate. Our objective was to evaluate the relationships between PlGF levels and both the severity of acute coronary syndrome (ACS) and short-term outcomes after ACS in patients with and without OSA. METHODS A total of 538 consecutive patients (312 OSA patients and 226 controls) admitted for ACS were included in this study. All patients underwent polygraphy in the first 72 hours after hospital admission. The severity of disease and short-term prognoses were evaluated during the hospitalization period. Plasma PlGF levels were measured using an electrochemiluminescence immunoassay. RESULTS Patients with OSA were significantly older and more frequently hypertensive and had higher BMIs than those without OSA. After adjusting for age, smoking status, BMI and hypertension, PlGF levels were significantly elevated in patients with OSA compared with patients without OSA (19.9 pg/mL, interquartile range: 16.6-24.5 pg/mL; 18.5 pg/mL, interquartile range: 14.7-22.7 pg/mL; p<0.001), and a higher apnea-hypopnea index (AHI) was associated with higher PlGF concentrations (p<0.003). Patients with higher levels of PlGF had also an increased odds ratio for the presence of 3 or more diseased vessels and for a Killip score>1, even after adjustment. CONCLUSIONS The results of this study show that in patients with ACS, elevated plasma levels of PlGF are associated with the presence of OSA and with adverse outcomes during short-term follow-up. TRIAL REGISTRATION ClinicalTrials.gov NCT01335087.
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Affiliation(s)
- Antonia Barcelo
- Hospital Universitari Son Espases, Palma, Illes Balears, Spain
| | | | - Aina Yañez
- Hospital Universitari Son Espases, Palma, Illes Balears, Spain
| | - Laura Fueyo
- Hospital Universitari Son Espases, Palma, Illes Balears, Spain
| | - Cristina Gomez
- Hospital Universitari Son Espases, Palma, Illes Balears, Spain
| | | | - Javier Pierola
- Hospital Universitari Son Espases, Palma, Illes Balears, Spain
| | | | | | - Jorge Abad
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain
| | - Olga Mediano
- Hospital Universitario de Guadalajara, Guadalajara, Castilla-La Mancha, Spain
| | - Jose Amilibia
- Hospital Universitario Cruces, Bilbao, Basque Country, Spain
| | | | - Joaquin Teran
- Hospital General Yagüe, Burgos, Castilla-León, Spain
| | | | - Mercè Mayos
- Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | | | - Ferran Barbé
- Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Catalonia, Spain
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Valiño N, Giunta G, Gallo DM, Akolekar R, Nicolaides KH. Biophysical and biochemical markers at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. Ultrasound Obstet Gynecol 2016; 47:194-202. [PMID: 26094952 DOI: 10.1002/uog.14928] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 06/09/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the potential value of biophysical and biochemical markers at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. METHODS This was a screening study in 8268 singleton pregnancies at 30-34 weeks' gestation. Estimated fetal weight (EFW), uterine artery (UtA) pulsatility index (PI), umbilical artery (UA) PI, fetal middle cerebral artery (MCA) PI, mean arterial pressure (MAP), serum placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured. The detection rate (DR) and false-positive rate (FPR) of screening by each biomarker were estimated for stillbirth, pre-eclampsia, delivery of small-for-gestational-age (SGA) neonate, Cesarean section for fetal distress before or during labor, umbilical arterial cord blood pH ≤7.0 or umbilical venous cord blood pH ≤7.1, 5-min Apgar score < 7 and admission to the neonatal unit (NNU). RESULTS Multivariable regression analysis demonstrated that significant prediction of PE was provided by PlGF, sFlt-1, MAP and MCA-PI, with a DR of 98% for PE delivering < 37 weeks' gestation and 56% for those delivering ≥ 37 weeks, at a 10% FPR. Prediction of SGA was provided by EFW, PlGF, sFlt-1, UtA-PI, UA-PI and MCA-PI, with a DR of 88% for SGA delivering < 37 and 51% for those delivering ≥ 37 weeks' gestation, at a 10% FPR. Prediction of stillbirth was provided by EFW, UtA-PI and MCA-PI, with DR of 30% at 10% FPR. Prediction of Cesarean section for fetal distress before labor was provided by EFW, sFlt-1, UtA-PI and UA-PI, with a DR of 90% at a 10% FPR. Prediction of fetal distress in labor was provided by EFW and sFlt-1, with a DR of 16% at a 10% FPR. There were no significant differences from the normal outcome group in any of the biomarkers for low cord blood pH, low Apgar score or NNU admission for cases other than those with PE and/or SGA. CONCLUSION At 30-34 weeks' gestation, biomarkers of impaired placentation and fetal hypoxemia provide good prediction of PE, SGA and fetal distress before labor, but poor or no prediction of stillbirth and adverse events in labor or after birth.
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Affiliation(s)
- N Valiño
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - G Giunta
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - D M Gallo
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - R Akolekar
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Department of Fetal Medicine, Medway Maritime Hospital, Gillingham, Kent, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Cohen RA, Check JH, Dougherty MP. Evidence that exposure to progesterone alone is a sufficient stimulus to cause a precipitous rise in the immunomodulatory protein the progesterone induced blocking factor (PIBF). J Assist Reprod Genet 2016; 33:221-9. [PMID: 26634256 PMCID: PMC4759003 DOI: 10.1007/s10815-015-0619-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 08/11/2015] [Accepted: 11/12/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To determine if exposure to progesterone alone is sufficient to increase the production of the immunomodulatory protein known as the progesterone induced blocking factor (PIBF). Also to determine what method of progesterone delivery or form of P best stimulates PIBF secretion. METHODS Serum samples from patients with infertility and paid volunteers were evaluated for both PIBF and progesterone at various times during the follicular phase and the luteal phase in both natural cycles and cycles involving embryo transfer after endogenous and exogenous progesterone exposure and after various synthetic progestins. PIBF was measured by a non-commercial research ELISA assay. Comparisons were made of serum PIBF before and after exposure to progesterone, 17-hydroxyprogesterone, and oral contraceptives. PIBF was also measured before and after transfer of embryos. RESULTS Progesterone alone without exposure to the fetal allogeneic stimulus was able to produce a marked increase in serum PIBF. Neither a synthetic progestin (19-nortestosterone derivative) nor 17-hydroxyprogesterone caused an increase in PIBF. Some PIBF is generally detected even in the follicular phase. CONCLUSIONS A previous concept considered that an allogeneic stimulus, e.g., from the fetal semi-allograft, was necessary to induce de novo progesterone receptors in gamma delta T cells, which, in turn, when exposed to a high concentration of progesterone, would secrete high levels of PIBF. These data show that exposure to an allogeneic stimulus is not needed to cause a marked rise in PIBF, merely progesterone alone is sufficient.
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Affiliation(s)
- Rachael A Cohen
- Department of Obstetrics and Gynecology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Jerome H Check
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cooper Medical School of Rowan University, Camden, NJ, USA.
- , 7447 Old York Road, Melrose Park, PA, 19027, USA.
| | - Michael P Dougherty
- Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Zhou M, Wang J, Wang W, Huang W, Ding X, Zhang X. Placenta Growth Factor in Eyes with Neovascular Glaucoma Is Decreased after Intravitreal Ranibizumab Injection. PLoS One 2016; 11:e0146993. [PMID: 26785251 PMCID: PMC4718677 DOI: 10.1371/journal.pone.0146993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 10/15/2014] [Accepted: 12/28/2015] [Indexed: 12/31/2022] Open
Abstract
Purpose To evaluate changes in the concentrations of placental growth factor (PlGF) and vascular endothelial growth factor-A (VEGF-A) in aqueous humor of patients with neovascular glaucoma (NVG) before and after an intravitreal injection of ranibizumab (IVR) and to determine the underlying correlation between the levels. Methods The prospective interventional comparative study involved 20 eyes of 20 patients with surgery-required advanced NVG and 20 control subjects from January 2013 to November 2013. The NVG eyes received the IVR treatment before glaucoma surgery. Aqueous humor was collected at the time of the IVR injection (pre- IVR) and at the time of antiglaucomatous surgery (post-IVR). Aqueous humor was also collected at the time of cataract surgery in normal control. Aqueous humor and plasma VEGF-A and PlGF levels were measured with an enzyme-linked immunosorbent assay methods, respectively. Results The mean aqueous humor PlGF and VEGF-A concentrations in the pre-IVR eyes were significantly higher than in those of the control subjects (p<0.001), whereas the plasma levels showed no significant difference. There was a statistically significant correlation between the aqueous humor PlGF and the VEGF-A concentration (r = 0.612, p = 0.003). The mean aqueous humor PlGF in the post-IVR eyes dramatically decreased from 1078.36 ± 755.83 to 177.64 ± 151.73 pg/mL (p<0.001). The VEGF-A level showed a similar trend from 3697.64 ± 2104.47 pg/mL to 183.54 ± 130.35 pg/mL (p<0.001). Conclusions Aqueous humor concentrations of VEGF-A and PlGF were significantly elevated in the eyes with NVG, and there was a positive correlation between the levels. After an IVR treatment, VEGF-A and PlGF were significantly decreased in NVG eyes.
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Affiliation(s)
- Minwen Zhou
- Department of Ophthalmology, Shanghai First People’s Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
| | - Jiawei Wang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Wei Wang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Wenbin Huang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Xiaoyan Ding
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Xiulan Zhang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
- * E-mail:
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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. Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia. N Engl J Med 2016; 374:13-22. [PMID: 26735990 DOI: 10.1056/nejmoa1414838] [Citation(s) in RCA: 942] [Impact Index Per Article: 117.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to placental growth factor (PlGF) is elevated in pregnant women before the clinical onset of preeclampsia, but its predictive value in women with suspected preeclampsia is unclear. METHODS We performed a prospective, multicenter, observational study to derive and validate a ratio of serum sFlt-1 to PlGF that would be predictive of the absence or presence of preeclampsia in the short term in women with singleton pregnancies in whom preeclampsia was suspected (24 weeks 0 days to 36 weeks 6 days of gestation). Primary objectives were to assess whether low sFlt-1:PlGF ratios (at or below a derived cutoff) predict the absence of preeclampsia within 1 week after the first visit and whether high ratios (above the cutoff) predict the presence of preeclampsia within 4 weeks. RESULTS In the development cohort (500 women), we identified an sFlt-1:PlGF ratio cutoff of 38 as having important predictive value. In a subsequent validation study among an additional 550 women, an sFlt-1:PlGF ratio of 38 or lower had a negative predictive value (i.e., no preeclampsia in the subsequent week) of 99.3% (95% confidence interval [CI], 97.9 to 99.9), with 80.0% sensitivity (95% CI, 51.9 to 95.7) and 78.3% specificity (95% CI, 74.6 to 81.7). The positive predictive value of an sFlt-1:PlGF ratio above 38 for a diagnosis of preeclampsia within 4 weeks was 36.7% (95% CI, 28.4 to 45.7), with 66.2% sensitivity (95% CI, 54.0 to 77.0) and 83.1% specificity (95% CI, 79.4 to 86.3). CONCLUSIONS An sFlt-1:PlGF ratio of 38 or lower can be used to predict the short-term absence of preeclampsia in women in whom the syndrome is suspected clinically. (Funded by Roche Diagnostics.).
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Affiliation(s)
- Harald Zeisler
- From the Department of Obstetrics and Gynecology, Medical University Vienna, Vienna (H.Z.); the Department of Obstetrics, Maternal-Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Barcelona, and the Maternal and Child Health and Development Network, Instituto de Salud Carlos III, Madrid (E.L.); the Department of Obstetrics and Gynecology, University of Liege, Liege, Belgium (F.C.); Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom (M.V.); the Departments of Gynecology and Obstetrics, Oslo University Hospital, and University of Oslo, Oslo (A.C.S.); the Department of Women's and Children's Health, Karolinska University Hospital, and Karolinska Institute, Stockholm (M. Sennström), and the Department of Women's and Children's Health, Uppsala University, Uppsala (M.O.) - both in Sweden; Pregnancy Research Centre, Department of Perinatal Medicine, Royal Women's Hospital and Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, VIC, Australia (S.P.B.); the Department of Obstetrics, University of Leipzig, Leipzig (H.S.), Roche Diagnostics, Penzberg (P.D., M. Schoedl), and the Department of Obstetrics, Campus Virchow-Klinikum Charité, Berlin (S.V.) - all in Germany; and Roche Diagnostics International, Rotkreuz, Switzerland (D.A., M.H.)
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Affiliation(s)
- Ellen W Seely
- From the Endocrinology, Diabetes, and Hypertension Division, Brigham and Women's Hospital, Boston (E.W.S.)
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Check JH, DiAntonio G, DiAntonio A, Duroseau M. The progesterone receptor antagonist mifepristone does not lower serum progesterone induced blocking factor (PIBF) in the presence of progesterone. CLIN EXP OBSTET GYN 2016; 43:189-191. [PMID: 27132407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE To determine if mifepristone can lower serum levels of a progesterone (P) induced immunomodulatory protein believed to be needed for the fetus to escape immune surveillance. MATERIALS AND METHODS A female volunteer had her serum P induced blocking factor (PIBF) increased by ingestion of oral micronized P. While remaining on P mifepristone, 200 mg/day was given for six days when another serum PIBF level was obtained. RESULTS The serum PIBF was 273 ng/ml after five days of oral micronized P. It increased further to 737 ng/ml despite taking six days of 200 mg mifepristone. CONCLUSIONS The mechanism for inducing abortion by mifepristone does not seem to be related to decreasing serum levels of PIBF. This does not eliminate the possibility that the mechanism involves reducing the intracytoplasmic PIBF levels.
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Decoster L, Vande Broek I, Neyns B, Majois F, Baurain JF, Rottey S, Rorive A, Anckaert E, De Mey J, De Brakeleer S, De Grève J. Biomarker Analysis in a Phase II Study of Sunitinib in Patients with Advanced Melanoma. Anticancer Res 2015; 35:6893-6899. [PMID: 26637913] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM To investigate the efficacy of sunitinib in patients with advanced melanoma and to correlate angiogenic biomarkers with response and survival. PATIENTS AND METHODS We performed a phase II study in patients with advanced pre-treated melanoma. The primary endpoint was tumor response. Blood samples for biomarker analysis including vascular endothelial growth factor (VEGF), and its receptors VEGFR1 and -2, placental growth factor (PlGF) and circulating endothelial cells (CEC) were collected at baseline and during the first cycle. RESULTS Four out of 39 patients (13%) achieved a partial response and eight (26%) stable disease. Time to progression was at least six months in seven patients. High baseline VEGFR1 levels and high baseline PlGF levels were both associated with a non-significant worse survival (p=0.08 for both). CONCLUSION Sunitinib demonstrates limited activity in unselected patients with refractory advanced melanoma, but a minority of patients experienced long-term disease control. Identification of these patients remains a challenge.
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Affiliation(s)
- Lore Decoster
- Department of Medical Oncology, Oncology Centre, University Hospital Brussel, Brussels, Belgium
| | | | - Bart Neyns
- Department of Medical Oncology, Oncology Centre, University Hospital Brussel, Brussels, Belgium
| | - Françoise Majois
- Department of Medical Oncology, Jolimont Hospital, Haine Saint Paul, Belgium
| | | | - Sylvie Rottey
- Department of Medical Oncology, University Hospital Gent, Gent, Belgium
| | - Andrée Rorive
- Department of Medical Oncology, University Hospital Sart Tilman, Liège, Belgium
| | - Ellen Anckaert
- Department of Clinical Chemistry and Radioimmunology, University Hospital Brussel, Brussels, Belgium
| | - Johan De Mey
- Department of Radiology, University Hospital Brussel, Brussels, Belgium
| | - Sylvia De Brakeleer
- Laboratory of Molecular and Medical Oncology, University Hospital Brussel, Brussels, Belgium
| | - Jacques De Grève
- Department of Medical Oncology, Oncology Centre, University Hospital Brussel, Brussels, Belgium
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Syngelaki A, Kotecha R, Pastides A, Wright A, Nicolaides KH. First-trimester biochemical markers of placentation in screening for gestational diabetes mellitus. Metabolism 2015; 64:1485-9. [PMID: 26362726 DOI: 10.1016/j.metabol.2015.07.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [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: 05/14/2015] [Revised: 07/11/2015] [Accepted: 07/15/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate whether first-trimester biochemical markers of placentation, including pregnancy-associated plasma protein-A (PAPP-A) and placental growth factor (PLGF), are altered in women that subsequently develop gestational diabetes mellitus (GDM) and to examine their potential value in improving the performance of screening for GDM by maternal characteristics and medical history. METHODS The study population of 31,225 singleton pregnancies, including 787 cases that developed GDM, was drawn from women undergoing routine prospective screening for pregnancy complications at 11-13 weeks' gestation. Maternal serum PAPP-A and PLGF were measured and the levels were expressed as multiples of the median (MoM) after adjustment for maternal characteristics and medical history. The performance of screening for GDM by maternal factors and MoM values of PAPP-A and PLGF was evaluated by receiver operating characteristic (ROC) curves. RESULTS In the GDM group, compared to the unaffected group, the median PAPP-A was reduced (0.949, 95% CI 0.913-0.987 MoM) (p=0.0009) and median PLGF was increased (1.053, 95% CI 1.023-1.083 MoM) (p=0.004). The performance of screening for GDM by maternal factors was not improved by the addition of PAPP-A and/or PLGF. CONCLUSIONS First trimester maternal serum PAPP-A and PLGF are not useful in screening for GDM.
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Affiliation(s)
- Argyro Syngelaki
- Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK
| | - Reena Kotecha
- Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK
| | - Alice Pastides
- Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK
| | - Alan Wright
- Institute of Health Research, University of Exeter, Exeter, UK
| | - Kypros H Nicolaides
- Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK.
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Bakalis S, Peeva G, Gonzalez R, Poon LC, Nicolaides KH. Prediction of small-for-gestational-age neonates: screening by biophysical and biochemical markers at 30-34 weeks. Ultrasound Obstet Gynecol 2015; 46:446-451. [PMID: 25826154 DOI: 10.1002/uog.14863] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 03/25/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the potential value of combined screening by maternal characteristics and medical history (maternal factors), estimated fetal weight (EFW), uterine artery pulsatility index (UtA-PI), mean arterial pressure (MAP) and serum levels of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) at 30-34 weeks' gestation in the prediction of delivery of small-for-gestational-age (SGA) neonates, in the absence of pre-eclampsia (PE). METHODS This was a screening study in 9472 singleton pregnancies at 30-34 weeks' gestation, comprising 469 that delivered SGA neonates and 9003 cases unaffected by SGA, PE or gestational hypertension. Multivariable logistic regression analysis was used to determine if UtA-PI, MAP and serum PlGF or sFlt-1, individually or in combination, improved the prediction of SGA neonates provided from screening by maternal factors and EFW. RESULTS Compared to the normal group, mean log10 multiples of the median (MoM) values of UtA-PI, MAP and serum sFlt-1 were significantly higher and log10 MoM PlGF was lower in the SGA group. Multivariable logistic regression analysis demonstrated that in the prediction of SGA neonates with a birth weight < 5(th) percentile, delivering < 5 weeks and ≥ 5 weeks after assessment, there were significant independent contributions from maternal factors, EFW, UtA-PI, MAP, and serum PlGF and sFlt-1, but the best performance was provided by a combination of maternal factors, EFW, UtA-PI, MAP and serum PlGF, excluding sFlt-1. Combined screening predicted, at a 10% false-positive rate, 89%, 94%, 96% of SGA neonates delivering at 32-36 weeks' gestation with birth weight < 10(th) , < 5(th) and < 3(rd) percentiles, respectively; the respective detection rates of combined screening for SGA neonates delivering ≥ 37 weeks were 57%, 65% and 72%. CONCLUSION Combined screening by maternal factors and biophysical and biochemical markers at 30-34 weeks' gestation could identify a high proportion of pregnancies that will deliver SGA neonates.
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Affiliation(s)
- S Bakalis
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - G Peeva
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - R Gonzalez
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - L C Poon
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Korevaar TIM, Steegers EAP, de Rijke YB, Visser WE, Jaddoe VWV, Visser TJ, Medici M, Peeters RP. Placental Angiogenic Factors Are Associated With Maternal Thyroid Function and Modify hCG-Mediated FT4 Stimulation. J Clin Endocrinol Metab 2015. [PMID: 26204137 DOI: 10.1210/jc.2015-2553] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT The thyroid has a high vascular density and this vascularity may be influenced by pregnancy-specific angiogenic factors. Proangiogenic placental growth factor (PlGF) and antiangiogenic soluble FMS-like tyrosine kinase-1 (sFlt1; a vascular endothelial growth factor [VEGF] and PlGF antagonist) are important pregnancy-specific angiogenesis regulators. We previously showed that fetal levels of sFlt1 and PlGF are associated with newborn thyroid function. However, the maternal thyroid may also be affected as PlGF and VEGF are secreted into the maternal circulation and cause a concomitant increase of sFlt1 to overcome adverse effects of angiogenesis overstimulation. DESIGN, SETTING, AND PARTICIPANTS Maternal sFlt1, PlGF, TSH, FT4, or human chorionic gonadotropin (hCG) levels were determined during early pregnancy (<18 wk) in 5517 women from the Generation R study. Analyses were adjusted for relevant covariates and interaction between hCG and angiogenic factors was investigated. RESULTS Increasing levels of sFlt1 were associated with a decrease in FT4 and T4 (both P < .001), and an increased risk of subclinical hypothyroidism (odds ratio [OR] for high levels, 2.37; 95% CI, 1.16-4.83; P = .02) and isolated hypothyroxinemia (linear P = .02; OR, 3.05; 95% CI, 1.42-6.55; P = .004). Increasing levels of PlGF were associated with a decrease in TSH and FT4 levels (both P < .001), and an increased risk of isolated hypothyroxinemia (linear P = .002; OR, 1.77; 95% CI, 1.02-3.06; P = .04). High levels of hCG decreased the difference in FT4 between low and high sFlt1. In women with high PlGF levels, the hCG-mediated increase in FT4 levels was attenuated. CONCLUSION sFlt1 and PlGF are novel determinants of maternal thyroid (dys)function during early pregnancy and the response of the maternal thyroid function to hCG stimulation. These data provide novel insights into the pregnancy specific thyroid function physiology and suggest that high levels of pro- and anti-angiogenic factors may be a risk factor for adverse pregnancy outcomes via their effects on maternal thyroid function.
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Affiliation(s)
- Tim I M Korevaar
- The Generation R Study Group (T.I.M.K., V.W.V.J.); and Departments of Internal Medicine (T.I.M.K., Y.B.d.R., W.E.V., T.J.V., M.M., R.P.P.), Rotterdam Thyroid Center (T.I.M.K., W.E.V., T.J.V., M.M., R.P.P.), and Epidemiology (V.W.V.J.), Erasmus Medical Center, 3015 GE Rotterdam, The Netherlands; Departments of Obstetrics and Gynecology (E.A.P.S.), Clinical Chemistry (Y.B.d.R.), and Pediatrics (V.W.V.J.), Erasmus Medical Center-Sophia Children's Hospital, 3015 CE Rotterdam, The Netherlands
| | - Eric A P Steegers
- The Generation R Study Group (T.I.M.K., V.W.V.J.); and Departments of Internal Medicine (T.I.M.K., Y.B.d.R., W.E.V., T.J.V., M.M., R.P.P.), Rotterdam Thyroid Center (T.I.M.K., W.E.V., T.J.V., M.M., R.P.P.), and Epidemiology (V.W.V.J.), Erasmus Medical Center, 3015 GE Rotterdam, The Netherlands; Departments of Obstetrics and Gynecology (E.A.P.S.), Clinical Chemistry (Y.B.d.R.), and Pediatrics (V.W.V.J.), Erasmus Medical Center-Sophia Children's Hospital, 3015 CE Rotterdam, The Netherlands
| | - Yolanda B de Rijke
- The Generation R Study Group (T.I.M.K., V.W.V.J.); and Departments of Internal Medicine (T.I.M.K., Y.B.d.R., W.E.V., T.J.V., M.M., R.P.P.), Rotterdam Thyroid Center (T.I.M.K., W.E.V., T.J.V., M.M., R.P.P.), and Epidemiology (V.W.V.J.), Erasmus Medical Center, 3015 GE Rotterdam, The Netherlands; Departments of Obstetrics and Gynecology (E.A.P.S.), Clinical Chemistry (Y.B.d.R.), and Pediatrics (V.W.V.J.), Erasmus Medical Center-Sophia Children's Hospital, 3015 CE Rotterdam, The Netherlands
| | - W Edward Visser
- The Generation R Study Group (T.I.M.K., V.W.V.J.); and Departments of Internal Medicine (T.I.M.K., Y.B.d.R., W.E.V., T.J.V., M.M., R.P.P.), Rotterdam Thyroid Center (T.I.M.K., W.E.V., T.J.V., M.M., R.P.P.), and Epidemiology (V.W.V.J.), Erasmus Medical Center, 3015 GE Rotterdam, The Netherlands; Departments of Obstetrics and Gynecology (E.A.P.S.), Clinical Chemistry (Y.B.d.R.), and Pediatrics (V.W.V.J.), Erasmus Medical Center-Sophia Children's Hospital, 3015 CE Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group (T.I.M.K., V.W.V.J.); and Departments of Internal Medicine (T.I.M.K., Y.B.d.R., W.E.V., T.J.V., M.M., R.P.P.), Rotterdam Thyroid Center (T.I.M.K., W.E.V., T.J.V., M.M., R.P.P.), and Epidemiology (V.W.V.J.), Erasmus Medical Center, 3015 GE Rotterdam, The Netherlands; Departments of Obstetrics and Gynecology (E.A.P.S.), Clinical Chemistry (Y.B.d.R.), and Pediatrics (V.W.V.J.), Erasmus Medical Center-Sophia Children's Hospital, 3015 CE Rotterdam, The Netherlands
| | - Theo J Visser
- The Generation R Study Group (T.I.M.K., V.W.V.J.); and Departments of Internal Medicine (T.I.M.K., Y.B.d.R., W.E.V., T.J.V., M.M., R.P.P.), Rotterdam Thyroid Center (T.I.M.K., W.E.V., T.J.V., M.M., R.P.P.), and Epidemiology (V.W.V.J.), Erasmus Medical Center, 3015 GE Rotterdam, The Netherlands; Departments of Obstetrics and Gynecology (E.A.P.S.), Clinical Chemistry (Y.B.d.R.), and Pediatrics (V.W.V.J.), Erasmus Medical Center-Sophia Children's Hospital, 3015 CE Rotterdam, The Netherlands
| | - Marco Medici
- The Generation R Study Group (T.I.M.K., V.W.V.J.); and Departments of Internal Medicine (T.I.M.K., Y.B.d.R., W.E.V., T.J.V., M.M., R.P.P.), Rotterdam Thyroid Center (T.I.M.K., W.E.V., T.J.V., M.M., R.P.P.), and Epidemiology (V.W.V.J.), Erasmus Medical Center, 3015 GE Rotterdam, The Netherlands; Departments of Obstetrics and Gynecology (E.A.P.S.), Clinical Chemistry (Y.B.d.R.), and Pediatrics (V.W.V.J.), Erasmus Medical Center-Sophia Children's Hospital, 3015 CE Rotterdam, The Netherlands
| | - Robin P Peeters
- The Generation R Study Group (T.I.M.K., V.W.V.J.); and Departments of Internal Medicine (T.I.M.K., Y.B.d.R., W.E.V., T.J.V., M.M., R.P.P.), Rotterdam Thyroid Center (T.I.M.K., W.E.V., T.J.V., M.M., R.P.P.), and Epidemiology (V.W.V.J.), Erasmus Medical Center, 3015 GE Rotterdam, The Netherlands; Departments of Obstetrics and Gynecology (E.A.P.S.), Clinical Chemistry (Y.B.d.R.), and Pediatrics (V.W.V.J.), Erasmus Medical Center-Sophia Children's Hospital, 3015 CE Rotterdam, The Netherlands
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Poon LC, Lesmes C, Gallo DM, Akolekar R, Nicolaides KH. Prediction of small-for-gestational-age neonates: screening by biophysical and biochemical markers at 19-24 weeks. Ultrasound Obstet Gynecol 2015; 46:437-445. [PMID: 25988293 DOI: 10.1002/uog.14904] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 05/08/2015] [Accepted: 05/12/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the value of combined screening by maternal characteristics and medical history, fetal biometry and biophysical and biochemical markers at 19-24 weeks' gestation, for prediction of delivery of small-for-gestational-age (SGA) neonates, in the absence of pre-eclampsia (PE), and examine the potential value of such assessment in deciding whether the third-trimester scan should be at 32 and/or 36 weeks' gestation. METHODS This was a screening study in 7816 singleton pregnancies, including 389 (5.0%) that delivered SGA neonates with birth weight < 5(th) percentile (SGA < 5(th) ), in the absence of PE. Multivariable logistic regression analysis was used to determine if screening by a combination of maternal factors, fetal biometry, uterine artery pulsatility index (UtA-PI) and maternal serum concentrations of placental growth factor (PlGF) and α-fetoprotein (AFP) had significant contribution in predicting SGA neonates. A model was developed for selecting the gestational age for third-trimester assessment, at 32 and/or 36 weeks, based on the results of screening at 19-24 weeks. RESULTS Significant independent contributions to the prediction of SGA < 5(th) were provided by maternal factors, fetal biometry, UtA-PI and serum PlGF and AFP. The detection rate (DR) of such combined screening at 19-24 weeks was 100%, 78% and 42% for SGA < 5(th) delivering < 32, at 32-36 and ≥ 37 weeks' gestation, respectively, at a false-positive rate (FPR) of 10%. In a hypothetical model, it was estimated that if the desired objective of prenatal screening is to predict about 80% of the cases of SGA < 5(th) , it would be necessary to select 11% of the population at the 19-24-week assessment to be reassessed at 32 weeks and 44% to be reassessed at 36 weeks; 57% would not require a third-trimester scan. CONCLUSION Prenatal prediction of a high proportion of SGA neonates necessitates the undertaking of screening in the third trimester of pregnancy, in addition to assessment in the second trimester, and the timing of such screening, at 32 and/or 36 weeks, should be contingent on the results of the assessment at 19-24 weeks.
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Affiliation(s)
- L C Poon
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - C Lesmes
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - D M Gallo
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - R Akolekar
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Fetal Medicine Unit, Medway Maritime Hospital, Gillingham, Kent, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Zhang W, Zhang T, Lou Y, Yan B, Cui S, Jiang L, Han B. Placental growth factor promotes metastases of non-small cell lung cancer through MMP9. Cell Physiol Biochem 2015; 37:1210-8. [PMID: 26418253 DOI: 10.1159/000430244] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Neovascularization and invasion coordinate cancer metastases in non-small cell lung cancer (NSCLC). However, the underlying molecular mechanisms are poorly understood. Recently, a substantial role of placental growth factor (PLGF) in cancer cell invasion has been acknowledged in several types of cancer, whereas a possible involvement of PLGF in the metastases of NSCLC has not been studied. METHODS Here, we analyzed the levels of PLGF and matrix metalloproteinase 9 (MMP9) in NSCLC specimens. We modified either PLGF or MMP9 levels in a NSCLC cell line A549, and examined the effects on the levels of MMP9 and PLGF. The cell invasiveness was quantified in a transwell cell migration assay. Pathway inhibitors were applied to determine the molecular mechanisms underlying the control of MMP9 by PLGF. RESULTS We found that PLGF and MMP9 levels both significantly increased in the NSCLC specimens and were strongly correlated. Overexpression of PLGF in NSCLC cells increased the levels of MMP9 and cell invasiveness, while inhibition of PLGF in NSCLC cells decreased the levels of MMP9 and cell invasiveness. However, modification of MMP9 levels in NSCLC cells did not alter the levels of PLGF. These data suggest that PLGF may regulate MMP9 in NSCLC cells, but not vice versa. Moreover, inhibition of MMP9 in PLGF-overexpressing NSCLC cells abolished the effects of PLGF on cell invasiveness, suggesting that PLGF increases cell invasion via MMP9. Furthermore, suppression of MAPK-p38, but not suppression of either MAPK-p42/p44, or PI3k, or JNK signaling, substantially abolished the effect of PLGF on MMP9, suggesting that PLGF may activate MMP9 via MAPK-p38 signaling pathway. CONCLUSION PLGF-stimulated cancer invasion may be mediated through its effects on MMP9 activation in NSCLC cells.
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Matsui M, Samejima KI, Takeda Y, Tanabe K, Morimoto K, Okamoto K, Tagawa M, Onoue K, Okayama S, Kawata H, Kawakami R, Akai Y, Saito Y. Prognostic Impact of Placental Growth Factor on Mortality and Cardiovascular Events in Dialysis Patients. Am J Nephrol 2015; 42:117-25. [PMID: 26368550 DOI: 10.1159/000439187] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 08/01/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND Placental growth factor (PlGF), a member of the vascular endothelial growth factor (VEGF) family, has recently emerged as a predictor of survival and cardiovascular risk. Along with others, we have shown an independent association between PlGF and cardiovascular events in CKD patients, but not much is known about patients receiving dialysis. METHODS We studied 205 dialysis patients undergoing cardiac catheterization at the Nara Medical University between April 1, 2004, and December 31, 2012. Serum levels of PlGF and VEGF were measured with ELISA in all the patients. RESULTS During a median follow-up of 20 months, 121 participants died from any cause or experienced a cardiovascular event. In the fully adjusted analysis, having an above-median PlGF or VEGF level was associated with a hazards ratio for adverse outcomes of 2.55 (1.72-3.83) and 1.39 (0.95-2.04), respectively. Using a multimarker strategy in a model with age, serum albumin, history of coronary artery disease, brain natriuretic peptide and PlGF, patients with 2, 3 and 4 positive markers had a 3.82-, 5.77- and 6.59-fold higher risk of mortality or a cardiovascular event, respectively, compared to those with no positive markers. The model with PlGF had a significantly higher c-statistic, integrated discrimination improvement index and category-free net reclassification improvement index than the model without PlGF. CONCLUSION PlGF is independently associated with mortality and cardiovascular events, but the association between VEGF and adverse events was attenuated with covariate adjustment. The addition of PlGF to models with established clinical predictors provides additional useful prognostic information in patients receiving dialysis.
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Affiliation(s)
- Masaru Matsui
- First Department of Internal Medicine, Nara Medical University, Kashihara, Japan
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40
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Affiliation(s)
- Christina W Chen
- Division of Nephrology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass., USA
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Xu Y, Zhai S, Luo X, Zhang Y, Ran L, Ren L. [Noninvasive prenatal screen of trisomy-21 using maternal plasma fetal free RNA allelic ratio]. Zhonghua Fu Chan Ke Za Zhi 2015; 50:568-575. [PMID: 26675178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Through the detections of the heterozygote frequencies tests of fetal specific genes PLAC4 and COL6A2 mRNA alleles in plasma of pregnant women, to explore its possibility of application in the noninvasive prenatal screenings of trisomy-21. METHODS A toltal of 500 cases (males and females 250 cases respectively)of Han ethnic groups with Henan Provice of China who were subject to the physical checkup clinic of the Third Affiliated Hospital, Zhengzhou University from June to December, 2013 were selected as the healthy physical checkup group, and such techniques as DNA sequencing and PCR-restriction fragment length polymorphism (RFLP) were adopted to the determinations of the heterozygote frequencies of the single nucleotide polymorphism (SNP) of the PLAC4 and COL6A2 genes in the maternal peripheral blood in the healthy physical checkup group, and the differential comparisons of the determination results of the SNP heterozygote frequencies and the corresponding heterozygote frequencies in the National Center for Biotechnology Information (NCBI) database; 30 cases of healthy pregnant women who spontaneously underwent pregnancy checkups at the maternity clinic were randomly selected as the healthy pregnancy group, and real-time fluorescence quantitative reverse transcription-PCR technique was adopted for determining the expression levels of PLAC4 and COL6A2 mRNA in the peripheral blood of pregnant women of 8 weeks, 10 weeks, 12 weeks, 14 weeks and 16 weeks; 40 cases of the same phase were selected for acting as the specimens for the karyotype analyses of the amniotic fluid cells, among which 20 cases were trisomy-21, and the 20 cases of the negative control group, and reverse transcription-multiplex ligation dependent probe amplification (RT-MLPA) technique was adopted for screening the fetal trisomy-21. RESULTS (1) The allele heterozygote frequencies of the SNP of the healthy physical checkup group: determinations of the genotypes and hybrid rates of the 10 SNP sites of the PLAC4 and COL6A2 genes indicated that those with higher heterozygote frequencies were respectively rs7717, rs559, rs1044598, rs59066201 and rs1042917, with population coverage of 98%. Among them, the allele hybrid rates of rs59066201 were never seen in the NCBI database; in the respective comparisons of the allele hybrid rates of rs8130833, rs9977003 and rs7844 with the hybrid rates of the NCBI database, the variations had statistical significance (P < 0.05). (2) The expression levels of PLAC4 and COL6A2 mRNA of the different pregnancy weeks of the healthy pregnancy group: the levels of PLAC4 mRNA in the peripheral blood of women of 8 weeks, 10 weeks, 12 weeks, 14 weeks and 16 weeks of pregnancy were respectively 7.22 ± 1.05, 8.02 ± 1.41, 9.51 ± 1.69, 11.33 ± 2.11 and 13.31 ± 2.58, with their expression levels rising along with the increase of the pregnancy weeks; among them, the comparison of pregnancy 8 weeks and pregnancy 10 weeks, the variations had no statistical significance (P > 0.05); in the mutual comparisons among the expression levels of the various pregnancy weeks, the variations had statistical significance (P < 0.05). The expression levels of COL6A2 mRNA in 8 weeks, 10 weeks, 12 weeks, 14 weeks and 16 weeks were respectively 8.95 ± 1.28, 11.19 ± 1.36, 15.00 ± 1.58, 16.87 ± 1.72 and 18.96 ± 2.79, with their expression levels rising along with the increase of the pregnancy weeks, and in the mutual comparisons between the expression levels of the various pregnancy weeks, the variations all had statistical significance (P < 0.05). (3) Prenatal screenings of trisomy-21 in the validation group of the trisome: a total of 5 sites of rs7717, rs559, rs1044598, rs59066201 and rs1042917 were selected from the allele heterozygote frequencies of SNP sites were selected from the subjects of the healthy physical checkup group, and 10 cases of trisomy-21 specimens and 10 cases of negative CTR specimens were accurately determined, with the sensitivity reached 80% (17/20), and the specificity reached 90% (18/20). One case of the trisomy-21 and two negative cases were both homozygotes, and among the trisomy-21 specimens of two cases, only one SNP was a heterozygote, and it was impossible to conduct screenings on these 5 cases, with the screening accuracy reaching 100% (35/35). CONCLUSIONS Fetal specific genes PLAC4 and COL6A2 mRNA are expressed in the peripheral blood of pregnant women in different gestational age; its expression level increases with the increase of gestational age. Among them, five SNP including rs7717, rs559, rs1044598, rs59066201 and rs1042917 show highest heterogeneity rate, which is different from the corresponding heterogeneity rate in NCBI database. RT-MLPA technology is a rapid, effective, noninvasive and low cost method of prenatal screening 21 trisomy.
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Affiliation(s)
- Yajuan Xu
- Department of Obstetrics, Third Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China;
| | - Shanshan Zhai
- Department of Obstetrics, Third Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Xiaohua Luo
- Department of Obstetrics, Third Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Yingying Zhang
- Department of Obstetrics, Third Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Limin Ran
- Department of Obstetrics, Third Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Lidan Ren
- Department of Obstetrics, Third Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
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Bakalis S, Gallo DM, Mendez O, Poon LC, Nicolaides KH. Prediction of small-for-gestational-age neonates: screening by maternal biochemical markers at 30-34 weeks. Ultrasound Obstet Gynecol 2015; 46:208-215. [PMID: 25826797 DOI: 10.1002/uog.14861] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 03/25/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the potential value of serum placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), pregnancy-associated plasma protein-A (PAPP-A), free β-human chorionic gonadotropin (β-hCG) and α-fetoprotein (AFP) at 30-34 weeks' gestation in the prediction of delivery of small-for-gestational-age (SGA) neonates, in the absence of pre-eclampsia (PE). METHODS This was a screening study in singleton pregnancies at 30-34 weeks' gestation, including 490 that delivered SGA neonates and 9360 cases that were unaffected by SGA, PE or gestational hypertension (normal outcome). Multivariable logistic regression analysis was used to determine if screening by serum PlGF, sFlt-1, PAPP-A, free β-hCG and AFP, individually or in combination, improved the prediction of SGA neonates provided by screening with maternal characteristics and medical history (maternal factors), and estimated fetal weight (EFW) from fetal head circumference, abdominal circumference and femur length. RESULTS Compared to the normal group, the mean log10 multiples of the median (MoM) values of PlGF and AFP were significantly lower and the mean log10 MoM values of sFlt-1 and free β-hCG were significantly higher in the SGA group with a birth weight < 5(th) percentile (SGA < 5(th)) delivering < 5 weeks following assessment. The best model for prediction of SGA was provided by a combination of maternal factors, EFW and serum PlGF. Such combined screening, predicted, at a 10% false-positive rate, 85%, 93% and 92% of SGA neonates delivering < 5 weeks following assessment with birth weight < 10(th), < 5(th) and < 3(rd) percentiles, respectively; the respective detection rates of combined screening for SGA neonates delivering ≥ 5 weeks following assessment were 57%, 64% and 71%. CONCLUSION Combined screening by maternal factors, EFW and serum PlGF at 30-34 weeks' gestation can identify a high proportion of pregnancies that subsequently deliver SGA neonates.
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Affiliation(s)
- S Bakalis
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - D M Gallo
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - O Mendez
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - L C Poon
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Griffin M, Seed PT, Webster L, Myers J, MacKillop L, Simpson N, Anumba D, Khalil A, Denbow M, Sau A, Hinshaw K, von Dadelszen P, Benton S, Girling J, Redman CWG, Chappell LC, Shennan AH. Diagnostic accuracy of placental growth factor and ultrasound parameters to predict the small-for-gestational-age infant in women presenting with reduced symphysis-fundus height. Ultrasound Obstet Gynecol 2015; 46:182-190. [PMID: 25826778 PMCID: PMC4744762 DOI: 10.1002/uog.14860] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 03/25/2015] [Accepted: 03/25/2015] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To assess the diagnostic accuracy of placental growth factor (PlGF) and ultrasound parameters to predict delivery of a small-for-gestational-age (SGA) infant in women presenting with reduced symphysis-fundus height (SFH). METHODS This was a multicenter prospective observational study recruiting 601 women with a singleton pregnancy and reduced SFH between 24 and 37 weeks' gestation across 11 sites in the UK and Canada. Plasma PlGF concentration < 5(th) centile, estimated fetal weight (EFW) < 10(th) centile, umbilical artery Doppler pulsatility index > 95(th) centile and oligohydramnios (amniotic fluid index < 5 cm) were compared as predictors for a SGA infant < 3(rd) customized birth-weight centile and adverse perinatal outcome. Test performance statistics were calculated for all parameters in isolation and in combination. RESULTS Of the 601 women recruited, 592 were analyzed. For predicting delivery of SGA < 3(rd) centile (n = 78), EFW < 10(th) centile had 58% sensitivity (95% CI, 46-69%) and 93% negative predictive value (NPV) (95% CI, 90-95%), PlGF had 37% sensitivity (95% CI, 27-49%) and 90% NPV (95% CI, 87-93%); in combination, PlGF and EFW < 10(th) centile had 69% sensitivity (95% CI, 55-81%) and 93% NPV (95% CI, 89-96%). The equivalent receiver-operating characteristics (ROC) curve areas were 0.79 (95% CI, 0.74-0.84) for EFW < 10(th) centile, 0.70 (95% CI, 0.63-0.77) for low PlGF and 0.82 (95% CI, 0.77-0.86) in combination. CONCLUSIONS For women presenting with reduced SFH, ultrasound parameters had modest test performance for predicting delivery of SGA < 3(rd) centile. PlGF performed no better than EFW < 10(th) centile in determining delivery of a SGA infant.
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Affiliation(s)
- M. Griffin
- Women's Health Academic CentreKing's College LondonLondonUK
| | - P. T. Seed
- Women's Health Academic CentreKing's College LondonLondonUK
| | - L. Webster
- Women's Health Academic CentreKing's College LondonLondonUK
| | - J. Myers
- Maternal and Fetal Health Research Centre, Manchester Academic Health Science CentreUniversity of ManchesterManchesterUK
| | | | - N. Simpson
- Section of Obstetrics & Gynaecology, Institute of Biochemical & Clinical SciencesUniversity of LeedsLeedsUK
| | - D. Anumba
- Academic Unit of Reproductive and Developmental MedicineUniversity of SheffieldSheffieldUK
| | - A. Khalil
- St George's Hospital Medical SchoolUniversity of LondonLondonUK
| | | | - A. Sau
- University HospitalLewishamLondonUK
| | | | - P. von Dadelszen
- Department of Obstetrics and GynaecologyUniversity of British ColumbiaVancouverCanada
| | - S. Benton
- Department of Obstetrics and GynaecologyUniversity of British ColumbiaVancouverCanada
| | - J. Girling
- West Middlesex University HospitalIsleworthMiddlesexUK
| | - C. W. G. Redman
- Nuffield Department of Obstetrics and GynaecologyUniversity of OxfordOxfordUK
| | - L. C. Chappell
- Women's Health Academic CentreKing's College LondonLondonUK
| | - A. H. Shennan
- Women's Health Academic CentreKing's College LondonLondonUK
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Fadigas C, Peeva G, Mendez O, Poon LC, Nicolaides KH. Prediction of small-for-gestational-age neonates: screening by placental growth factor and soluble fms-like tyrosine kinase-1 at 35-37 weeks. Ultrasound Obstet Gynecol 2015; 46:191-197. [PMID: 25825848 DOI: 10.1002/uog.14862] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 03/25/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the potential value of maternal serum placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) at 35-37 weeks' gestation in the prediction of delivery of small-for-gestational-age (SGA) neonates, in the absence of pre-eclampsia (PE). METHODS This was a screening study in singleton pregnancies at 35-37 weeks, including 158 that delivered SGA neonates with birth weight < 5(th) percentile and 3701 cases unaffected by SGA, PE or gestational hypertension. Multivariable logistic regression analysis was used to determine if measuring serum levels of PlGF and sFlt-1 improved the prediction of delivery of SGA neonates provided by screening with maternal characteristics and medical history (maternal factors), and estimated fetal weight (EFW) from fetal head circumference, abdominal circumference and femur length. RESULTS Compared to the normal group, the median PlGF multiples of the median (MoM) was significantly lower and the median sFlt-1 MoM was significantly higher in the SGA group. Combined screening by maternal factors and EFW at 35-37 weeks predicted, at 10% false-positive rate (FPR), 90%, 92% and 94% of SGA neonates with birth weight < 10(th), < 5(th) and < 3(rd) percentiles, respectively, delivering < 2 weeks following assessment; the respective values for SGA delivering ≥ 37 weeks were 66%, 73% and 80%. When PlGF and sFlt-1 were added to a model that combines maternal factors and EFW, sFlt-1 did not remain as a significant independent predictor of SGA < 5(th). Combined screening by maternal factors, EFW and serum PlGF, predicted, at a 10% FPR, 88%, 96% and 94% of SGA neonates with birth weight < 10(th), < 5(th) and < 3(rd) percentiles, respectively, delivering < 2 weeks following assessment and the respective values for SGA delivering ≥ 37 weeks were 64%, 75% and 80%. CONCLUSION sFlt-1 does not provide significant independent prediction of SGA, in the absence of PE, in addition to combined testing by maternal factors and fetal biometry at 35-37 weeks; whilst the addition of PlGF alone marginally improves the performance of screening.
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Affiliation(s)
- C Fadigas
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - G Peeva
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - O Mendez
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - L C Poon
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Poldervaart JM, Röttger E, Dekker MS, Zuithoff NPA, Verheggen PWHM, de Vrey EA, Wildbergh TX, van ‘t Hof AWJ, Mosterd A, Hoes AW. No Added Value of Novel Biomarkers in the Diagnostic Assessment of Patients Suspected of Acute Coronary Syndrome. PLoS One 2015; 10:e0132000. [PMID: 26177390 PMCID: PMC4503345 DOI: 10.1371/journal.pone.0132000] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 06/09/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Despite the availability of high-sensitive troponin (hs-cTnT), there is still room for improvement in the diagnostic assessment of patients suspected of acute coronary syndrome (ACS). Apart from serial biomarker testing, which is time-consuming, novel biomarkers like copeptin have been proposed to expedite the early diagnosis of suspected ACS in addition to hs-cTnT. We determined whether placenta derived growth factor (PlGF), soluble Fms-like tyrosine kinase 1 (sFlt-1), myoglobin, N-terminal prohormone B-type Natriuretic Peptide (NT-proBNP), growth-differentiation factor 15 (GDF-15) and copeptin improved early assessment of chest pain patients. METHODS This prospective, single centre diagnostic FAME-ER study included patients presenting to the ED with symptoms suggestive of ACS. Blood was collected to measure biomarkers, notably, hs-cTnT was retrospectively assessed. Added value of markers was judged by increase in AUC using multivariable logistic regression. RESULTS Of 453 patients enrolled, 149 (33%) received a final diagnosis of ACS. Hs-cTnT had the highest diagnostic value in both univariable and multivariable analysis. PPVs of the biomarkers ranged from 23.5% (PlGF) to 77.9% (hs-cTnT), NPVs from 67.0% (PlGF) to 86.4% (hs-cTnT). Only myoglobin yielded diagnostic value in addition to clinical symptoms and electrocardiography (ECG) (AUC of clinical model 0.80) with AUC of 0.84 (p<0.001). However, addition of hs-cTnT was superior (AUC 0.89, p<0.001). Addition of the biomarkers to our clinical model and hs-cTnT did not or only marginally (GDF-15) improved diagnostic performance. CONCLUSION When assessing patients suspected of ACS, only myoglobin had added diagnostic value beyond clinical symptoms and ECG. However, when combined with hs-cTnT, it yields no additional diagnostic value. PlGF, sFlt-1, NT-proBNP, GDF-15 and copeptin had no added value to the clinical model or hs-cTnT.
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Affiliation(s)
- Judith M. Poldervaart
- Julius Center for Health Sciences and Primary Care, University Medical Center, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
- * E-mail:
| | - Emma Röttger
- Faculty of Medicine, Utrecht University, Universiteitsweg 98, 3584 CG, Utrecht, the Netherlands
| | - Marieke S. Dekker
- Department of Cardiology, Isala Clinics, Dokter van Heesweg 2, 8025 AB, Zwolle, the Netherlands
- Department of Cardiology, Meander Medical Center, Maatweg 3, 3813 TZ, Amersfoort, the Netherlands
| | - Nicolaas P. A. Zuithoff
- Julius Center for Health Sciences and Primary Care, University Medical Center, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Peter W. H. M. Verheggen
- Department of Cardiology, Meander Medical Center, Maatweg 3, 3813 TZ, Amersfoort, the Netherlands
| | - Evelyn A. de Vrey
- Department of Cardiology, Meander Medical Center, Maatweg 3, 3813 TZ, Amersfoort, the Netherlands
| | - Thierry X. Wildbergh
- Department of Cardiology, Meander Medical Center, Maatweg 3, 3813 TZ, Amersfoort, the Netherlands
| | - Arnoud W. J. van ‘t Hof
- Department of Cardiology, Isala Clinics, Dokter van Heesweg 2, 8025 AB, Zwolle, the Netherlands
| | - Arend Mosterd
- Department of Cardiology, Meander Medical Center, Maatweg 3, 3813 TZ, Amersfoort, the Netherlands
| | - Arno W. Hoes
- Julius Center for Health Sciences and Primary Care, University Medical Center, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
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Souders CA, Maynard SE, Yan J, Wang Y, Boatright NK, Sedan J, Balyozian D, Cheslock PS, Molrine DC, Simas TAM. Circulating Levels of sFlt1 Splice Variants as Predictive Markers for the Development of Preeclampsia. Int J Mol Sci 2015; 16:12436-53. [PMID: 26042465 PMCID: PMC4490453 DOI: 10.3390/ijms160612436] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 05/06/2015] [Accepted: 05/25/2015] [Indexed: 11/17/2022] Open
Abstract
Angiogenic biomarkers, including soluble fms-like tyrosine kinase 1 (sFlt1), are thought to be predictors of preeclampsia onset; however, improvement is needed before a widespread diagnostic test can be utilized. Here we describe the development and use of diagnostic monoclonal antibodies specific to the two main splice variants of sFlt1, sFlt1-1 and sFlt1-14. These antibodies were selected for their sensitivity and specificity to their respective sFlt1 isoform in a capture ELISA format. Data from this pilot study suggest that sFlt1-1 may be more predictive of preeclampsia than total sFlt1. It may be possible to improve current diagnostic platforms if more specific antibodies are utilized.
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Affiliation(s)
- Colby A Souders
- MassBiologics of the University of Massachusetts Medical School, Boston, MA 02126, USA.
| | - Sharon E Maynard
- Department of Medicine, Division of Nephrology, Lehigh Valley Health Network, University of South Florida Morsani College of Medicine, Allentown, PA 18105, USA.
| | - Jing Yan
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, MA 01655, USA.
| | - Yang Wang
- MassBiologics of the University of Massachusetts Medical School, Boston, MA 02126, USA.
| | - Naomi K Boatright
- MassBiologics of the University of Massachusetts Medical School, Boston, MA 02126, USA.
| | - Jessica Sedan
- MassBiologics of the University of Massachusetts Medical School, Boston, MA 02126, USA.
| | - David Balyozian
- MassBiologics of the University of Massachusetts Medical School, Boston, MA 02126, USA.
| | - Peter S Cheslock
- MassBiologics of the University of Massachusetts Medical School, Boston, MA 02126, USA.
| | - Deborah C Molrine
- MassBiologics of the University of Massachusetts Medical School, Boston, MA 02126, USA.
| | - Tiffany A Moore Simas
- Department of Obstetrics and Gynecology, University of Massachusetts Medical School/ UMass Memorial Health Care, Worcester, MA 01605, USA.
- Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA 01655, USA.
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Lin L, Huang Y, Yu Y, Yang Y. [Expression of progesterone-induced blocking factor in severe preeclampsia and its association with immune tolerance imbalance]. Nan Fang Yi Ke Da Xue Xue Bao 2015; 35:848-851. [PMID: 26111683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To explore progesterone-induced blocking factor (PIBF) expression in the placenta and blood of patients with severe preeclampsia and its relationship with immune tolerance imbalance. METHODS Forty-seven patients admitted between January and December, 2012 were enrolled in this study, including 25 patients with early-onset severe preeclampsia (EOPE) and 22 with late-onset severe preeclampsia (LOPE), with 25 women with normal pregnancy serving as control group. The antenatal blood and postpartum placenta were collected for immunohistochemical staining to detect PIBF expression in the placenta and for testing serum PIBF level using ELISA. Flow cytometry was used to detect the percentage of circulating Th1 and Th2 cells and the Th1/Th2 ratio was calculated. RESULTS PIBF was expressed in decidual cells, syncytiotrophoblasts and partial cytotrophablasts. The serum PIBF levels were 213.58 ± 44.93 ng/ml in EOPE group, 243.00∓61.19 ng/ml in LOPE group and 273.91 ± 48.57 ng/ml in control group. There were significant differences in serum PIBF, blood Th1/Th2 and placenta PIBF-IOD among the 3 groups (P<0.05). EOPE group had significantly lower serum PIBF, lower llacental PIBF quantity (PIBF-IOD) and higher blood Th1/Th2 than the control group (P<0.05). Serum PIBF in women with severe preeclampsia was positively correlated with placenta PIBF-IOD and negatively with blood Th1/Th2 ratio (P<0.05), but a negative correlation between serum PIBF and 24-hour urinary protein was found only in EOPE group (P<0.05). CONCLUSION The immune tolerance imbalance mediated by PIBF may participate in the pathogenesis of severe preeclampsia. PIBF, the immune suppressor secreted by lymphocytes of pregnancy women, is also a protective factor against severe preeclampsia, which is expected to be a new target in therapy.
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Affiliation(s)
- Liang Lin
- 1Department of Obstetrics and Gynecology, Southern Medical University affiliated Nanfang Hospital, Guangzhou 510515, China; 2Provincial Clinical Institute of Fujian Medical University , Fuzhou 350001, China. E-mail:
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Curti A, Zucchini C, De Maggio I, Ismail YS, Morano D, Falcone V, Meriggiola MC, Farina A. Fetal cardiac defects and third-trimester maternal serum placental growth factor. Ultrasound Obstet Gynecol 2015; 45:751-752. [PMID: 25488892 DOI: 10.1002/uog.14748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 11/18/2014] [Accepted: 11/25/2014] [Indexed: 06/04/2023]
Affiliation(s)
- A Curti
- Department of Medical Surgical Sciences, Division of Obstetrics and Prenatal Medicine, St Orsola Malpighi Hospital, University of Bologna, 13 Via Massarenti, 40138, Bologna, Italy
| | - C Zucchini
- Department of Specialist, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - I De Maggio
- Department of Medical Surgical Sciences, Division of Obstetrics and Prenatal Medicine, St Orsola Malpighi Hospital, University of Bologna, 13 Via Massarenti, 40138, Bologna, Italy
| | - Y S Ismail
- Department of Medical Surgical Sciences, Division of Obstetrics and Prenatal Medicine, St Orsola Malpighi Hospital, University of Bologna, 13 Via Massarenti, 40138, Bologna, Italy
| | - D Morano
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - V Falcone
- Department of Medical Surgical Sciences, Division of Obstetrics and Prenatal Medicine, St Orsola Malpighi Hospital, University of Bologna, 13 Via Massarenti, 40138, Bologna, Italy
| | - M C Meriggiola
- Department of Medical Surgical Sciences, Division of Obstetrics and Prenatal Medicine, St Orsola Malpighi Hospital, University of Bologna, 13 Via Massarenti, 40138, Bologna, Italy
| | - A Farina
- Department of Medical Surgical Sciences, Division of Obstetrics and Prenatal Medicine, St Orsola Malpighi Hospital, University of Bologna, 13 Via Massarenti, 40138, Bologna, Italy
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March MI, Geahchan C, Wenger J, Raghuraman N, Berg A, Haddow H, Mckeon BA, Narcisse R, David JL, Scott J, Thadhani R, Karumanchi SA, Rana S. Circulating Angiogenic Factors and the Risk of Adverse Outcomes among Haitian Women with Preeclampsia. PLoS One 2015; 10:e0126815. [PMID: 25965397 PMCID: PMC4428697 DOI: 10.1371/journal.pone.0126815] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 04/07/2015] [Indexed: 12/11/2022] Open
Abstract
Objective Angiogenic factors are strongly associated with adverse maternal and fetal outcomes among women with preterm preeclampsia (PE) in developed countries. We evaluated the role of angiogenic factors and their relationship to adverse outcomes among Haitian women with PE. Material and Methods We measured plasma antiangiogenic soluble fms-like tyrosine kinase 1 (sFlt1) and proangiogenic placental growth factor (PlGF) levels in women with PE (n=35) compared to controls with no hypertensive disorders (NHD) (n=43) among subjects with singleton pregnancies that delivered at Hospital Albert Schweitzer (HAS) in Haiti. We divided the preeclamptic women into two groups, early onset (≤ 34 weeks) and late onset (>34 weeks) and examined relationships between sFlt1/PlGF ratios on admission and adverse outcomes (abruption, respiratory complications, stroke, renal insufficiency, eclampsia, maternal death, birth weight <2500 grams, or fetal/neonatal death) in women with PE subgroups as compared to NHD groups separated by week of admission. Data are presented as median (25th-75th centile), n (%), and proportions. Results Among patients with PE, most (24/35) were admitted at term. Adverse outcome rates in PE were much higher among the early onset group compared to the late onset group (100.0% vs. 54.2%, P=0.007). Plasma angiogenic factors were dramatically altered in both subtypes of PE. Angiogenic factors also correlated with adverse outcomes in both subtypes of PE. The median sFlt1/PlGF ratios for subjects with early onset PE with any adverse outcome vs. NHD <=34 weeks with no adverse outcome were 703.1 (146.6, 1614.9) and 9.6 (3.5, 58.6); P<0.001). Among late onset group the median sFlt1/PlGF ratio for women with any adverse outcome was 130.7 (56.1, 242.6) versus 22.4 (10.2, 58.7; P=0.005) in NHD >34 weeks with no adverse outcome. Conclusion PE-related adverse outcomes are common in women in Haiti and are associated with profound angiogenic imbalance regardless of gestational age at presentation.
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Affiliation(s)
- Melissa I. March
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Division of Maternal Fetal Medicine/Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States of America
| | - Carl Geahchan
- Center for Vascular Biology and Research, Beth Israel Deaconess Medical Center Boston, MA, United States of America
| | - Julia Wenger
- Division of Nephrology/Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Nandini Raghuraman
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
| | - Anders Berg
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States of America
| | - Hamish Haddow
- Savjani Institute for Health Research, Windham, ME, United States of America
| | - Bri Ann Mckeon
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
| | - Rulx Narcisse
- Department of Obstetrics and Gynecology, Hospital Albert Schweitzer, Deshapelles, Haiti
| | - Jean Louis David
- Department of Obstetrics and Gynecology, Hospital Albert Schweitzer, Deshapelles, Haiti
| | - Jennifer Scott
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Division of Women’s Health/Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - Ravi Thadhani
- Division of Nephrology/Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - S. Ananth Karumanchi
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Division of Maternal Fetal Medicine/Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States of America
- Center for Vascular Biology and Research, Beth Israel Deaconess Medical Center Boston, MA, United States of America
- Division of Nephrology/Department of Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA, United States of America
- Howard Hughes Medical Institute, Boston, MA, United States of America
| | - Sarosh Rana
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Division of Maternal Fetal Medicine/Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States of America
- Maternal Fetal Medicine/Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, United States of America
- * E-mail:
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Tsiakkas A, Duvdevani N, Wright A, Wright D, Nicolaides KH. Serum soluble fms-like tyrosine kinase-1 in the three trimesters of pregnancy: effects of maternal characteristics and medical history. Ultrasound Obstet Gynecol 2015; 45:584-590. [PMID: 25678265 DOI: 10.1002/uog.14817] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 02/04/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To define the contribution of maternal variables which influence the measured level of maternal serum soluble fms-like tyrosine kinase-1 (sFlt-1) in screening for pregnancy complications. METHODS Maternal characteristics and medical history were recorded and serum sFlt-1 was measured in women with a singleton pregnancy attending for three routine hospital visits at 11 + 0 to 13 + 6, 19 + 0 to 24 + 6 and 30 + 0 to 34 + 6 or 35 + 0 to 37 + 6 weeks' gestation. For pregnancies delivering phenotypically normal live births or stillbirths ≥ 24 weeks' gestation, variables from maternal demographic characteristics and medical history that are important in the prediction of sFlt-1 were determined from a linear mixed-effects multiple regression. RESULTS Serum sFlt-1 was measured in 7066 cases in the first trimester, 8078 in the second trimester and 10,464 in the third trimester. Significant independent contributions to serum sFlt-1 were provided by gestational age, maternal weight, racial origin, cigarette smoking, birth-weight Z-score of the neonate in the previous pregnancy and interpregnancy interval. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured level of serum sFlt-1 and express the values as multiples of the median (MoMs). The model was shown to provide an adequate fit of MoM values for all covariates, both in pregnancies that developed pre-eclampsia and in those without this pregnancy complication. CONCLUSIONS A model was fitted to express measured serum sFlt-1 across the three trimesters of pregnancy as MoMs, after adjusting for variables from maternal characteristics and medical history that affect this measurement.
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Affiliation(s)
- A Tsiakkas
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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