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The human microbiota comprises all microorganisms, such as bacteria, fungi, and viruses, found within a specific environment that live on our bodies and inside us. The last few years have witnessed an explosion of information related to the role of microbiota changes in health and disease. Even though the gut microbiota is considered the most important in maintaining our health, other regions of the human body, such as the oral cavity, lungs, vagina, and skin, possess their own microbiota. Recent work suggests a correlation between the microbiota present during pregnancy and pregnancy complications. The aim of our literature review was to provide a broad overview of this growing and important topic. We focused on the most significant changes in the microbiota in the four more common obstetric diseases affecting women's health. Thus, our attention will be focused on hypertensive disorders, gestational diabetes mellitus, preterm birth, and recurrent miscarriage. Pregnancy is a unique period in a woman's life since the body undergoes different adaptations to provide an optimal environment for fetal growth. Such changes also involve all the microorganisms, which vary in composition and quantity during the three trimesters of gestation. In addition, special attention will be devoted to the potential and fundamental advances in developing clinical applications to prevent and treat those disorders by modulating the microbiota to develop personalized therapies for disease prevention and tailored treatments.
RESUMO
BACKGROUND: To study the frequency of inherited thrombophilia in monochorionic twin pregnancies with twin-twin transfusion syndrome (TTTS). METHODS: At the Department of Obstetrics of the Polytechnic University of Marche (Ancona, Italy) a population of monochorionic diamniotic pregnant women was selected retrospectively. After termination of the pregnancy, genotyping for Factor I, Factor V Leiden, Factor II and Methylenetetrahydrofolate Reductase (MTHFR), as well as activities of the plasma proteins C and S, was performed. RESULTS: Regarding the 32 patients with TTTS, from a cohort of 104 monochorionic pregnancies recruited, at least one thrombophilic defect was more frequent (OR: 3.24), and the allele polymorphism frequency was higher for Factor I (OR: 4.4) and for Factor V Leiden (OR: 11.66). CONCLUSIONS: Maternal inherited thrombophilia, possibly also inherited from monochorial fetuses, may result in impaired development of the placental vascular architecture. This inheritance hypothesis may explain why only a fraction of monochorionic diamniotic twins develop TTTS.
RESUMO
PROBLEM: A threefold higher prevalence of antinuclear antibodies (ANA) has been reported in patients with recurrent pregnancy loss (RPL). Nevertheless, the role of ANA in reproductive failure is still unclear. The aim of this study was to investigate the role of ANA during early pregnancy in vivo. METHOD OF STUDY: We used pregnant mice treated with immunoglobulin G (IgG) obtained from normal healthy subjects (NHS); ANA(+) sera of patients with RPL; and ANA(+) sera from women with uncomplicated pregnancies (HW). Placental immunohistochemical/immunofluorescence staining was performed to detect complement and immune complex deposition. ELISA was performed to evaluate complement levels. RESULTS: ANA(+) IgG from RPL women significantly increased embryo resorption rate, reduced C3, and increased C3a serum levels compared to NHS IgG or ANA(+) -HW IgG. Increased C3 deposition and increased immune complex staining in placental tissues from mice treated with ANA(+) -RPL IgG fraction compared to NHS- and ANA(+) -HW-IgG-treated mice were found. CONCLUSION: ANA(+) IgG injection in mice is able to induce fetal resorption and complement activation. The presence on placental tissues of immune complexes and complement fragments suggests the complement activation as a possible mechanism of placental damage.