Aspirin triggered-lipoxin A4 reduces the adhesion of human polymorphonuclear neutrophils to endothelial cells initiated by preeclamptic plasma

INTRODUCTION

Preeclampsia is a disorder of pregnancy, characterized by hypertension and proteinuria after 20 weeks of gestation. Here, we evaluated the role of aspirin triggered-lipoxin A(4) (ATL, 15-epi-LXA(4)) on the modulation of the adhesion of human polymorphonuclear neutrophils (PMN) to endothelial cells initiated by preeclamptic plasma.

MATERIALS AND METHODS

Plasma from preeclamptic, normotensive pregnant, and non-pregnant women were analyzed for factors involved in regulating angiogenesis, inflammation and lipid peroxidation. Plasma from preeclamptic women was added to human umbilical vein endothelial cells, and the adhesion of PMN (incubated with or without ATL) to cells was evaluated.

RESULTS

Preeclampsia was associated with some augmented anti-angiogenic, oxidative and pro-inflammatory markers, as well as increasing human PMN-endothelial cell adhesion. This cell adhesion was reduced when human PMN were incubated with ATL prior to addition to endothelial monolayers.

DISCUSSIONS AND CONCLUSIONS

Our results are the starting point for further research on the efficacy and rational use of aspirin in preeclampsia.

[Relationship between methylenetetrahydrofolate reductase polymorphism and homocysteine levels in women with recurrent pregnancy loss: a nutrigenetic perspective]

The objective of this study was to evaluate if there is any difference in the proportion of methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms and the homocysteine levels in a group of women with recurrent pregnancy loss (RPL) and a control group. Ninety-three patients with diagnosis of three or more gestational losses and 206 healthy women with two or more children, were included. After acceptance of informed consent, samples of peripheral blood were taken to determine the genetic polymorphisms of MTHFR C677T and the plasmatic levels of homocysteine. The carriers of the homozygous mutation TT of MTHFR 677T polymorphism were 12.9% (12 of 93) in the group of patients and 14.6% (30 of 206) in the control group; 46.2% (43 of 93) and 40% (83 of 206) in the group of patients and controls respectively, were heterozygous CT for MTHFR gene. The levels of homocysteine were 7.2 micromol/ml in the group of patients and 7.7 mmol/l in controls. There was no relationship between MTHFR gene polymorphisms and the increase of homocysteine levels, nor of these one with RPL. From the nutrigenetics perspective we suggest that studies related to MTHFR polymorphisms and the risk of disease include the levels of folate and B6 and B12 vitamins participating in the tetrahydrofolate cycle for trying to establish a direct relation among the genotype, the level of metabolite and the clinical manifestations. In this regard, we recommend the administration of folic acid in women in search of pregnancy due to the high frequency of heterozygous and homozygous for MTHFR C677T mutation in our population.

Nuevas opciones en anticoncepción: posible uso espermicida de plantas colombianas

Currently there exists increasing preoccupation concerning sexual and reproductive health among teenagers; in spite of the availability of different contraceptive methods, the number of undesired pregnancies is steadily increasing. Among the products presently available for birth control, spermicides are a means that can be totally controlled by the woman and are very reliable compared to other contraceptives in common use. However, they cause irritation in the vaginal epithelium due to their tensoactive effect on cellular membranes which might enhance the risk of acquiring sexually transmissible diseases. In searching for new alternatives, it was observed that a wide variety of plants have spermicidal activity. Hence it is interesting to consider potential contraceptives of vegetable origin, as they may constitute a key tool to prevent undesired pregnancies in general, and in particular in vulnerable groups such as teenagers and young women.

Inherited thrombophilia is associated with deep vein thrombosis in a Colombian population

The development of venous thromboembolism is influenced by a variety of genetic and environmental risk factors. A few studies have ascertained whether thrombophilic defects are risk factors for venous thromboembolism in Latin American populations with a variable degree of admixture, such as the Colombian population. To address this issue, we conducted a case-control study involving 100 consecutive patients with deep vein thrombosis and 114 healthy controls from the Hospital Universitario San Vicente de Paúl, Medellín, Colombia. Activated protein C resistance (APC resistance) was detected in 25/99 patients vs. 6/114 controls (OR = 6.08, 95% CI = 2.23-17.47). Ten of 100 patients carried the factor V Leiden mutation vs. 1/114 controls (OR = 12.56, 95% CI = 1.61-267). APC resistance was associated with the factor V Leiden mutation in only 10/25 patients. The prothrombin G20210A mutation was found in 4/100 patients, but none of the controls (P < 0.05). There was no significant difference in the proportion of homozygous carriers of methylenetetrahydrofolate reductase C677T variant among patients and controls. In conclusion, in our studied population, factor V Leiden, APC resistance, and prothrombin G20210A were associated with an increased risk of deep vein thrombosis. However, the frequencies of these thrombophilic defects and of APC resistance associated with factor V Leiden was lower than the corresponding frequencies previously reported for Caucasian populations. Further study is required to assess the influence of ethnicity on thrombophilia.

Heparin plus aspirin as a "single" therapy for recurrent spontaneous abortion associated with both allo- and autoimmunity

PROBLEM

The aim of this study was to contribute to the study of the pathogenesis and the treatment of recurrent spontaneous abortion (RSA) associated with immune alterations.

METHOD OF STUDY

This is a prospective clinical trial with 11 patients with RSA associated with allo- and autoimmunity not receiving lymphocyte immunizations but only heparin and aspirin preconceptionally and through pregnancy. A concurrent group of 8 patients receiving a complete therapy (lymphocyte immunizations, heparin, and aspirin) but not receiving heparin and aspirin preconceptionally is also included in this report.

RESULTS

The rate of pregnancy success in these patients was 90.9% (10/11), and the rate of success of the concurrent group was 75.0% (6/8).

CONCLUSIONS

The results are in agreement with the working hypothesis regarding the possible final common mechanism in the pathogenesis of abortion associated with allo- and autoimmunity. The "single" therapy with heparin and aspirin was effective, less costly, and logistically simpler to provide than a complete therapy including lymphocyte immunizations.

[Inflammatory pseudotumor of the spleen]

A case of inflammatory pseudotumor of the spleen in a 69-year-old woman who was studied for elevated globular sedimentation rate is presented. The lesion was observed on echography as a mixed solid-cystic mass. Magnetic resonance showed a slight decrease in signal intensity in potentiated T1 sequences and a heterogenic mass with high signal areas in T2 images and protonic density. Splenectomy was performed and histopathologic study demonstrated an inflammatory pseudotumor of 10 cm in its greatest size. Two year follow up was satisfactory. On review of the literature only 34 cases of inflammatory pseudotumors have been previously published. Half of the cases presented during the 6th and 7th decades of life, with women being the most frequently affected. Inflammatory pseudotumors of the spleen are benign lesions which should be considered in the differential diagnosis of splenic masses. Since diagnosis cannot be made preoperatively, and a malignant tumor is almost always suspected, splenectomy should be performed.

Cell microchimerism in patients with recurrent spontaneous abortion: preliminary results

The goal of this study was to determine the prevalence of non-host male cell microchimerism in a group of women with a history of recurrent spontaneous abortion (RSA). The detection of male cell microchimerism was based upon amplification of a fragment of Y chromosome DNA obtained from peripheral blood mononuclear cells from the mother. The amplification products were electrophoresed, transferred onto nylon membranes and hybridized with a specific 32P-labelled probe. The products were visualized by autoradiography. Seventy-seven patients with RSA were studied. Some patients (42.8%) had received immunotherapy for RSA using live mononuclear cells from male donors. Of the 77 patients 46 (59.7%) were positive for the selected Y chromosome sequence, 22 (28.6%) had no evidence of Y chromosome DNA and in nine (11.7%) cases the chimeric status could not be defined since the amplified band was too faint to be clearly assigned as positive. Twenty patients were pregnant at the time of sampling. There were no statistically significant differences among the different variables studied: age of the mother, number of previous pregnancies, number of previous immunotherapeutic inoculations or period of time between the last inoculation and sampling. Male cell microchimerism has been reported in some but not all women who have given birth to male children. The dynamics for the establishment of this chimeric status and its persistence have not been defined. We found that most patients with RSA (59.7%) were positive for microchimerism but that this could not be correlated with abortion, current pregnancy or leukocyte immunotherapy. A prospective study is being undertaken to determine if there is a subset of patients negative for chimerism who become positive after alloimmunotherapy with male lymphocytes and have an improved prognosis for successful pregnancy.

Prevalence of asthma in a tropical city of Colombia

Four thousand subjects from Cartagena, Colombia were surveyed in order to establish the prevalence of asthma in this city. They were considered to have asthma when they had consulted their physicians for shortness of breath accompanied with wheezing during the last year and had received asthma medications. Point and cumulative prevalence were 8.8% and 12.2%, respectively. Seventy percent of the affected population was less than 15 years old. There were no significant differences in the prevalence of asthma between sexes. Forty-five percent of asthmatic subjects had family histories of asthma. The prevalence of rhinitis was 16.4% and 30.6% of the patients with asthma. The asthma prevalence of this study is high, indicating that this respiratory disease is a significant health problem in this tropical city.