Human neutrophil peptides 1-3 protect the murine urinary tract from uropathogenic Escherichia coli challenge.

Antimicrobial peptides (AMPs) are critical to the protection of the urinary tract of humans and other animals from pathogenic microbial invasion. AMPs rapidly destroy pathogens by disrupting microbial membranes and/or augmenting or inhibiting the host immune system through a variety of signaling pathways. We have previously demonstrated that alpha-defensins 1-3 (DEFA1A3) are AMPs expressed in the epithelial cells of the human kidney collecting duct in response to uropathogens. We also demonstrated that DNA copy number variations in the DEFA1A3 locus are associated with UTI and pyelonephritis risk. Because DEFA1A3 is not expressed in mice, we utilized human DEFA1A3 gene transgenic mice (DEFA4/4) to further elucidate the biological relevance of this locus in the murine urinary tract. We demonstrate that the kidney transcriptional and translational expression pattern is similar in humans and the human gene transgenic mouse upon uropathogenic Escherichia coli (UPEC) stimulus in vitro and in vivo. We also demonstrate transgenic human DEFA4/4 gene mice are protected from UTI and pyelonephritis under various UPEC challenges. This study serves as the foundation to start the exploration of manipulating the DEFA1A3 locus and alpha-defensins 1-3 expression as a potential therapeutic target for UTIs and other infectious diseases.

Intercalated cell function, kidney innate immunity, and urinary tract infections.

Intercalated cells (ICs) in the kidney collecting duct have a versatile role in acid-base and electrolyte regulation along with the host immune defense. Located in the terminal kidney tubule segment, ICs are among the first kidney cells to encounter bacteria when bacteria ascend from the bladder into the kidney. ICs have developed several mechanisms to combat bacterial infections of the kidneys. For example, ICs produce antimicrobial peptides (AMPs), which have direct bactericidal activity, and in many cases are upregulated in response to infections. Some AMP genes with IC-specific kidney expression are multiallelic, and having more copies of the gene confers increased resistance to bacterial infections of the kidney and urinary tract. Similarly, studies in human children demonstrate that those with history of UTIs are more likely to have single-nucleotide polymorphisms in IC-expressed AMP genes that impair the AMP's bactericidal activity. In murine models, depleted or impaired ICs result in decreased clearance of bacterial load following transurethral challenge with uropathogenic E. coli. A 2021 study demonstrated that ICs even act as phagocytes and acidify bacteria within phagolysosomes. Several immune signaling pathways have been identified in ICs which may represent future therapeutic targets in managing kidney infections or inflammation. This review's objective is to highlight IC structure and function with an emphasis on current knowledge of IC's diverse innate immune capabilities.

Generation of Atp6v1g3-Cre mice for investigation of intercalated cells and the collecting duct.

Kidney intercalated cells (ICs) maintain acid-base homeostasis and recent studies have demonstrated that they function in the kidney's innate defense. To study kidney innate immune function, ICs have been enriched using vacuolar ATPase (V-ATPase) B1 subunit (Atp6v1b1)-Cre (B1-Cre) mice. Although Atp6v1b1 is considered kidney specific, it is expressed in multiple organ systems, both in mice and humans, raising the possibility of off-target effects when using the Cre-lox system. We have recently shown using single-cell RNA sequencing that the gene that codes for the V-ATPase G3 subunit (mouse gene: Atp6v1g3; human gene: ATP6V1G3; protein abbreviation: G3) mRNA is selectively enriched in human kidney ICs. In this study, we generated Atp6v1g3-Cre (G3-Cre) reporter mice using CRISPR/CAS technology and crossed them with Tdtomatoflox/flox mice. The resultant G3-Cre+Tdt+ progeny was evaluated for kidney specificity in multiple tissues and found to be highly specific to kidney cells with minimal or no expression in other organs evaluated compared with B1-Cre mice. Tdt+ cells were flow sorted and were enriched for IC marker genes on RT-PCR analysis. Next, we crossed these mice to ihCD59 mice to generate an IC depletion mouse model (G3-Cre+ihCD59+/+). ICs were depleted in these mice using intermedilysin, which resulted in lower blood pH, suggestive of a distal renal tubular acidosis phenotype. The G3-Cre mice were healthy, bred normally, and produce regular-sized litter. Thus, this new "IC reporter" mice can be a useful tool to study ICs.NEW & NOTEWORTHY This study details the development, validation, and experimental use of a new mouse model to study the collecting duct and intercalated cells. Kidney intercalated cells are a cell type increasingly recognized to be important in several human diseases including kidney infections, acid-base disorders, and acute kidney injury.

Platelet transfusions in a murine model of neonatal polymicrobial sepsis: Divergent effects on inflammation and mortality.

BACKGROUND: Platelet transfusions (PTxs) are often given to septic preterm neonates at high platelet count thresholds in an attempt to reduce bleeding risk. However, the largest randomized controlled trial (RCT) of neonatal transfusion thresholds found higher mortality and/or major bleeding in infants transfused at higher thresholds. Using a murine model, we investigated the effects of adult PTx on neonatal sepsis-induced mortality, systemic inflammation, and platelet consumption. STUDY DESIGN AND METHODS: Polymicrobial sepsis was induced via intraperitoneal injection of cecal slurry preparations (CS1, 2, 3) into P10 pups. Two hours after infection, pups were transfused with washed adult Green Flourescent Protein (GFP+) platelets or control. Weights, platelet counts, and GFP% were measured before 4 and 24 h post-infection. At 24 h, blood was collected for quantification of plasma cytokines. RESULTS: The CS batches varied in 24 h mortality (11%, 73%, and 30% in CS1, 2, and 3, respectively), due to differences in bacterial composition. PTx had differential effects on sepsis-induced mortality and systemic inflammatory cytokines, increasing both in mice infected with CS1 (low mortality) and decreasing both in mice infected with CS2 and 3. In a mathematical model of platelet kinetics, the consumption of transfused adult platelets was higher than that of endogenous neonatal platelets, regardless of CS batch. DISCUSSION: Our findings support the hypothesis that transfused adult platelets are consumed faster than endogenous neonatal platelets in sepsis and demonstrate that PTx can enhance or attenuate neonatal inflammation and mortality in a model of murine polymicrobial sepsis, depending on the composition of the inoculum and/or the severity of sepsis.

[Unselective single embryo transfer: chances of pregnancy related to operator experience]. / Transferencia no selectiva de embrón único: posibilidades de embarazo relacionadas con la experiencia del operador.

BACKGROUND: Selection of best quality embryo aims to achieve higher success rate, the pregnancy is unique and therefore obstetric risks are reduced. OBJECTIVE: To evaluate the pregnancy rate with no transfer of selected single embryo (TSSE) three days versus the experience of the physician performing the embryo transfer. PATIENTS AND METHODS: A retrospective, cross-sectional observational study in 159 patients Mexican Fertility Center in CEPAM protocol in vitro fertilization any indication, other ovulatory disorders and who was only possible obtain an embryo to be transferred in three day. For the analysis were grouped according to age, number of cells of the embryo transfer day and the doctor performed. Continuous variables are reported as means and standard deviations and univariate logistic regression was performed to determine statistical significance. Categorical variables were evaluated in frequencies and percentages. The calculations were performed with the software JMP. RESULTS: Protocol of single-embryo transfer not selected in three day pregnancy rate of 17% was obtained, with lower rates in women over 40 years of age and older embryos of more than 9 cells but also higher rate abortion. More experienced doctors achieved better pregnancy rates. CONCLUSION: This is the first study in Mexican population to assess the possibility of pregnancy with single embryo transfer in selected post-harvest with a three day success rate of 17% and first-order variables: number of cells on the day of transfer and experience of the physician who performed the procedure.

DEFA1A3 DNA gene-dosage regulates the kidney innate immune response during upper urinary tract infection.

Antimicrobial peptides (AMPs) are host defense effectors with potent neutralizing and immunomodulatory functions against invasive pathogens. The AMPs α-Defensin 1-3/DEFA1A3 participate in innate immune responses and influence patient outcomes in various diseases. DNA copy-number variations in DEFA1A3 have been associated with severity and outcomes in infectious diseases including urinary tract infections (UTIs). Specifically, children with lower DNA copy numbers were more susceptible to UTIs. The mechanism of action by which α-Defensin 1-3/DEFA1A3 copy-number variations lead to UTI susceptibility remains to be explored. In this study, we use a previously characterized transgenic knock-in of the human DEFA1A3 gene mouse to dissect α-Defensin 1-3 gene dose-dependent antimicrobial and immunomodulatory roles during uropathogenic Escherichia coli (UPEC) UTI. We elucidate the relationship between kidney neutrophil- and collecting duct intercalated cell-derived α-Defensin 1-3/DEFA1A3 expression and UTI. We further describe cooperative effects between α-Defensin 1-3 and other AMPs that potentiate the neutralizing activity against UPEC. Cumulatively, we demonstrate that DEFA1A3 directly protects against UPEC meanwhile impacting pro-inflammatory innate immune responses in a gene dosage-dependent manner.

[Report of the seminal characteristics in patients with consecutive pregnancy to intrauterine insemination and his perinatal complications]. / Influencia del estudio seminal en el éxito de la inseminación intrauterina y en las complicaciones perinatales.

BACKGROUND: It is reported that pregnancies achieved through assisted reproductive techniques have increased risk of complications. There is doubt as to whether this increase is attributable to the underlying infertility or to the assisted reproduction techniques. Postcapacitation seminal parameters have been mentioned as determinants of success. OBJECTIVES: To describe semen parameters of patients at the Mexican Fertility Center (CEPAM) who achieved pregnancy with intrauterine insemination and compare the causes of perinatal morbidity and mortality with those of the general population. PATIENTS AND METHODS: A descriptive, retrospective (2004-2009), analytical and longitudinal study based on analysis of intrauterine insemination cycles that achieved pregnancy with prenatal care and childbirth. The variables studied were: pregnancy, obstetric complications and postcapacitation semen parameters. For the analysis the data was divided according to sperm morphology. The results were analyzed using SPSS-20. Continuous variables were reported as means, and their standard deviations and logistic regression as univariate to determine the statistical significance. The categorical variables were evaluated in frequencies and percentages. RESULTS: 133 cases were analyzed, 78% with normal morphology over 4%, mean semen parameters: 0.63 mL volume, density 82.72 million/mL, progressive motility 88.5% and normal morphology over 4% of 5.93%. The 16.6% of pregnancies were twins. 18.5% was abortion, 69% was cesarean section and 30% vaginal delivery. No differences were found in any of the variables when comparing normal sperm morphology groups lower and higher than 4%, except in patients with abortion. There was no increased incidence of perinatal complications than in the general population. CONCLUSIONS: Perinatal complications incidence is similar to the general population, except in multiple pregnancy. There is more success in intrauterine insemination when the postcapacitation morphology is over 4%.

[Assisted hatching following embryo implantation failure]. / Eclosión asistida en pacientes con falla previa en la implantación embrionaria.

BACKGROUND: Assisted hatching in reproduction techniques has improved the successful implantation rates in certain groups of patients with poor prognosis. This study focuses on its effect in groups of patients with previous implantation failure and according to age groups. OBJECTIVE: Compare the pregnancy rates of patients who turned to this technique following an implantation failure using in vitro fertilization with those of patients who did not use assisted hatching before another attempt of in vitro fertilization and according to specific age groups. MATERIAL AND METHOD: Cases of patients using assisted hatching in our Center between January 2008 and December 2009 were studied. The results were compared in terms of age in three groups: group I, >35 years; group II, 35-39 years, and group III, > 40 years. RESULTS: Patients in group II had better pregnancy rate (30%) than those in groups I and III (16.98 and 20.83%, respectively). When comparing the results of the group of patients using assisted hatching with those of the group that did not, the first reported a 20% pregnancy rate versus no pregnancy in the other group.

[Intrauterine insemination results in the Specialized Center for Women's Care]. / Resultados de inseminación intrauterina en el centro especializado para la atención de la mujer.

BACKGROUND: intrauterine insemination should be offered to couples with unexplained infertility, given its effectiveness and compared to in vitro fertilization and embryo transfer, is less invasive and requires less resources. It also should be offered to couples with male factor infertility in selected patients with induction of ovulation to increase the chances of pregnancy. OBJECTIVE: to determine the rate of pregnancy with intrauterine insemination in couples with infertility. MATERIAL AND METHODS: descriptive and retrospective study of 500 couples with female, male and combined infertility, primary or secondary, managed with homologous insemination, with controlled ovarian stimulation and programmed ovulation, in patients with at least one permeable salpinx, FSH <12 IU/L and > 5 x 10(6) mobile and normal sperm. Ultrasonografic follicular follow-up and ovulation triggering according to findings, performing insemination 36 hours after the shooting, with luteal phase support with progesterone. RESULTS: 1.6 cycles on average, female infertility 65.8%, 21% male and combined 13.2%, age average 32 years of women and 36 years of man, average ovarian stimulation 8 days. Pregnancy in 19.5% of the patients, of these, 65.1% under the age of 35 years, 33.3% from 35 to 40 years and 1.5% older than 40 years. Pregnancy at term 77.08%, miscarriage 11.45% and unknown resolution at 11.45%. Twin pregnancy 14.61% and high fetal order 5.7%. Pregnancy with female infertility 64%, male 22.3% and combined 13.5%. Pregnancy with endometrial <8 mm 9.8%, 8-15 mm 86.4% >15 mm 3.6%. With trilaminar endometrium 72.3%, dense 12.5%, linear 0.5%. CONCLUSION: The rate of pregnancy in intrauterine insemination hardly exceeds 20%. The determinants for this are the women age, type of infertility and endometrial characteristics. It was also noted high twin pregnancy and high fetal order.

[Evaluation of two transfer embryo systems performed by six physicians]. / Evaluación de dos sistemas de transferencia de embriones.

BACKGROUND: Embryo transfer is a critical point for success in IVF cycles. Many factors should be considered when performing an embryo transfer such as: embryo quality and number, soft versus rigid catheter, easy of the transfer, physician technique, ultrasound guide during transfer, among others. OBJECTIVE: Evaluate two different embryo transfer systems performed by six physicians with the same protocol. MATERIAL AND METHODS: We evaluated 308 embryo transfers performed from January 2006 to December 2008 by six physicians with two different systems. We only included patients with good quality in embryos and endometrium. Both systems were analyzed in each of the six physicians. RESULTS: Similar characteristics in number of transferred embryos, number of cells in each embryo and quality of them, were found in both groups. There were no significant differences between both systems in the characteristics of the couple nor the mentioned above. Most of the transfers n = 252 (81.81%), were realized by two of the six physicians, however, the pregnancy rate did not show significant differences between these physicians and the less experienced ones. CONCLUSIONS: With the obtained results, it could be supposed that the most influential factor in the outcome is the operator experience in the use of each system and not the system itself.

Placement on COVID-19 Units Does Not Increase Seroconversion Rate of Pediatric Graduate Medical Residents.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated disease COVID-19 (coronavirus disease 2019) has presented graduate medical education (GME) training programs with a unique set of challenges. One of the most pressing is how should hospital systems that rely on graduate medical residents provide appropriate care for patients while protecting trainees. This question is of particular concern as healthcare workers are at high risk of SARS-CoV-2 exposure. Objective: This cross-sectional study sought to assess the impact of hospital COVID-19 patient placement on pediatric graduate medical residents by comparing rates of SARS-CoV-2 seroconversion rates of residents who worked on designated COVID-19 teams and those who did not. Methods: Forty-four pediatric and medicine-pediatric residents at Riley Children's Hospital (Indianapolis, IN) were tested for SARS-CoV-2 immunoglobulin M (IgM) and IgG seroconversion in May 2020 using enzyme-linked immunosorbent assays (Abnova catalog no. KA5826), 2 months after the first known COVID-19 case in Indiana. These residents were divided into two groups: those residents who worked on designated COVID-19 teams, and those who did not. Groups were compared using χ2 or Fisher exact test for categorical variables, and continuous variables were compared using Student t testing. Results: Forty-four of 104 eligible residents participated in this study. Despite high rates of seroconversion, there was no difference in the risk of SARS-CoV-2 seroconversion between residents who worked on designated COVID-19 teams (26% or 8/31) and those who did not (31% or 4/13). Eleven of 44 residents (25%) tested positive for SARS-CoV-2 IgG, whereas only 5/44 (11.4%) tested positive for SARS-CoV-2 IgM, without a detectable difference between exposure groups. Conclusion: We did not observe a difference in SARS-CoV-2 seroconversion between different exposure groups. These data are consistent with growing evidence supporting the efficacy of personal protective equipment. Further population-based research on the role of children in transmitting the SARS-CoV-2 virus is needed to allow for a more evidence-based approach toward managing the COVID-19 pandemic.

Development of gates to measure the immature platelet fraction in C57BL/6J mice using the Sysmex XN-V series multispecies hematology analyzer.

The immature platelet fraction (IPF) is a measure of newly released platelets, which has been used as a marker of platelet production in multiple human studies but is not widely available in multispecies analyzers. We developed gates to measure the IPF in diluted and undiluted murine blood samples on the Sysmex XN-1000V multispecies hematology analyzer. IPF gates were created using undiluted and diluted (1/10) blood samples obtained from adult and newborn (postnatal day 10, P10) C57BL/6J wild-type (WT) mice, and from 3 murine models of thrombocytopenia: c-MPL-/- mice, which lack the thrombopoietin receptor (hyporegenerative); antibody-mediated thrombocytopenia; and acute inflammation-induced thrombocytopenia. P10 mice were chosen because, at their size, we could consistently obtain (by terminal phlebotomy) the blood volume needed to run an undiluted sample. The undiluted blood IPF gate successfully differentiated between mechanisms of thrombocytopenia in both adult and P10 mice. For diluted samples, 2 IPF gates were generated: a thrombocytopenic (T) gate, which performed well in samples with platelet counts (PCs) <800 × 109/L in adult mice and <500 × 109/L in newborn mice, and a non-thrombocytopenic (NT) gate, which performed well in samples with PCs above these thresholds. PCs and IPFs measured in diluted blood using these gates agreed well with those measured in undiluted blood and had good reproducibility. These diluted gates allow for the accurate measurement of PCs and IPFs in small (10 µL) blood volumes, which can be obtained easily from adult and newborn mice as small as P1 to assess platelet production serially.

Assessment of Seroconversion to SARS-CoV-2 in a Cohort of Pediatric Kidney Transplant Recipients.

Background: The occurrence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated coronavirus disease 2019 (COVID-19) have profoundly affected adult kidney disease patients. In contrast, pediatric solid organ transplant recipients, including pediatric kidney transplant (KT) recipients, do not seem to be at particularly higher risk for SARS-CoV-2 infection or for severe COVID-19 disease. This patient population might be protected by certain mechanisms, such as the immunosuppressive medications with their anti-inflammatory properties or simply being well-versed in self-protection techniques. Assessing SARS-CoV-2 antibody serologies could potentially help understand why this patient population is apparently spared from severe SARS-CoV-2 clinical courses. Objective: To examine SARS-CoV-2 serologic status in a cohort of pediatric KT recipients. Methods: SARS-CoV-2 anti-spike IgG and IgM antibodies were measured by three different methods in pediatric KT recipients coming for routine clinic visits immediately post-confinement in May-June of 2020. The patients were considered seroconverted if SARS-CoV-2 antibodies were positive by 2/3 methods and weak positive/indeterminate if positive by 1/3. Results: Thirty-one patients were evaluated (about 1/3 of our institution's pediatric KT population). One patient seroconverted, while three were considered weak positive/indeterminate. None were symptomatic and none had nasopharyngeal PCR confirmed SARS-CoV-2 disease. Conclusions: Seroconversion to SARS-CoV-2 was rare in this population and likely reflects the social distancing practiced by these patients. The results will serve as a foundation for a future longitudinal study to evaluate the long-term emergence and persistence of antibodies in this population and may inform studies of response to a future vaccine.

DCHS1 DNA copy number loss associated with pediatric urinary tract infection risk.

Urinary tract infections (UTI), associated with vesicoureteral reflux (VUR), can lead to chronic kidney disease. Genetic alterations in the innate immune defenses contribute to UTI risk. We investigated a novel gene, Dachsous Cadherin-Related 1 (DCHS1), in children with UTI. We determined absolute DNA copy number (CN) of DCHS1 in children with UTI. In this case-control study, we utilized multiple complementary methods to determine the genomic CN of DCHS1. Children with (n = 370) and without (n = 71) VUR from two well-phenotyped clinical trials of UTI were copy-typed and compared to 491 healthy controls with no known history of VUR or UTI. Less than 1% of controls had a single copy of DCHS1, while 31% of children with UTI and no VUR and 7% of children with UTI and VUR had a single copy of the DCHS1 gene. Using immunostaining, we localized expression postnatally to the bladder and renal epithelia. Mice were also challenged with two uropathogenic Escherichia coli strains, and Dchs1 mRNA was quantified. This study represents the first report of DCHS1 in association with pediatric UTI. We hypothesize that its role in innate immunity is critical to lower urinary tract defense. Further investigation is required to determine the role of DCHS1 in innate immunity.

Platelet-derived extracellular vesicles infiltrate and modify the bone marrow during inflammation.

During inflammation, steady-state hematopoiesis switches to emergency hematopoiesis to repopulate myeloid cells, with a bias toward the megakaryocytic lineage. Soluble inflammatory cues are thought to be largely responsible for these alterations. However, how these plasma factors rapidly alter the bone marrow (BM) is not understood. Inflammation also drives platelet activation, causing the release of platelet-derived extracellular vesicles (PEVs), which package diverse cargo and reprogram target cells. We hypothesized that PEVs infiltrate the BM, providing a direct mode of communication between the plasma and BM environments. We transfused fluorescent, wild-type (MPL+) platelets into recipient cMpl-/-mice before triggering systemic inflammation. Twenty hours postinfusion, we observed significant infiltration of donor platelet-derived particles in the BM, which we tracked immunophenotypically (MPL+ immunohistochemistry staining) and quantified by flow cytometry. To determine if this phenomenon relates to humans, we extensively characterized both megakaryocyte-derived and PEVs generated in vitro and in vivo, and found enrichment of extracellular vesicles in bone marrow compared with autologous peripheral blood. Last, BM from cMpl-/- mice was cultured in the presence or absence of wild-type (MPL+) PEVs. After 72 hours, flow cytometry revealed increased megakaryocytes only in cultures with added PEVs. The majority of CD41+ cells were bound to PEVs, suggesting a PEV-mediated rescue of megakaryopoiesis. In conclusion, we report for the first time that plasma-residing PEVs infiltrate the BM. Further, PEVs interact with BM cells in vivo and in vitro, causing functional reprogramming that may represent a novel model of inflammation-induced hematopoiesis.

Thrombocytopenia is associated with severe retinopathy of prematurity.

Retinopathy of prematurity (ROP) is characterized by abnormal retinal neovascularization in response to vessel loss. Platelets regulate angiogenesis and may influence ROP progression. In preterm infants, we assessed ROP and correlated with longitudinal postnatal platelet counts (n = 202). Any episode of thrombocytopenia (<100 × 109/l) at ≥30 weeks postmenstrual age (at onset of ROP) was independently associated with severe ROP, requiring treatment. Infants with severe ROP also had a lower weekly median platelet count compared with infants with less severe ROP. In a mouse oxygen-induced retinopathy model of ROP, platelet counts were lower at P17 (peak neovascularization) versus controls. Platelet transfusions at P15 and P16 suppressed neovascularization, and platelet depletion increased neovascularization. Platelet transfusion decreased retinal of vascular endothelial growth factor A (VEGFA) mRNA and protein expression; platelet depletion increased retinal VEGFA mRNA and protein expression. Resting platelets with intact granules reduced neovascularization, while thrombin-activated degranulated platelets did not. These data suggest that platelet releasate has a local antiangiogenic effect on endothelial cells to exert a downstream suppression of VEGFA in neural retina. Low platelet counts during the neovascularization phase in ROP is significantly associated with the development of severe ROP in preterm infants. In a murine model of retinopathy, platelet transfusion during the period of neovascularization suppressed retinopathy.

An imbalance in the production of proinflammatory and anti-inflammatory cytokines is observed in whole blood cultures of preeclamptic women in comparison with healthy pregnant women.

OBJECTIVE: To compare the production of pro- and anti-inflammatory cytokines by whole blood samples stimulated with lipopolysaccharide from normotensive and preeclamptic women. METHODS: The synthesis of tumor necrosis factor-α, interleukyn-1ß, interleukin-6 and interleukin-10 were assayed by immunosorbent assays in 56 and 50 preeclamptic and normotensive women, respectively. RESULTS: Preeclamptic women showed a higher synthesis (p < 0.05) of interleukin-1ß and interleukin-6 versus normotensive group. Interleukin-10 synthesis from samples of normotensive women showed a higher production versus preeclamptic group (p < 0.05). CONCLUSION: Preeclamptic women showed an imbalance in the production of pro and anti-inflammatory cytokines in comparison with normotensive women.

Valor de la cuenta folicular antral como predictor de éxito en ciclos de fertilización in vitro / Value of the antral follicular count as a predictor of success in in vitro fertilization cycles

Resumen ANTECEDENTES: La asociación entre pruebas de reserva ovárica y respuesta a la estimulación está debidamente establecida aunque su capacidad para predecir embarazo clínico y recién nacido vivo es limitada. OBJETIVO: Evaluar la utilidad clínica de la cuenta folicular antral para predecir embarazo clínico y recién nacido vivo. MATERIALES Y MÉTODOS: Estudio de cohorte, retrospectivo, efectuado en el Instituto Nacional de Perinatología, entre 2011 y 2016 en ciclos de fertilización in vitro en fresco. Se incluyeron pacientes con diagnóstico de infertilidad a quienes se efectuó, in vitro, transferencia de embriones en fresco. Variables de estudio: edad, cuenta folicular antral, concentración basal de FSH y cantidad de ovocitos capturados. Se elaboró un modelo de regresión logística. Para el análisis estadístico se utilizó el programa Statistic Package for Social Sciences (SPSS). Se consideró significativa la probabilidad de error alfa menor de 5%. RESULTADOS: Se analizaron 923 ciclos de fertilización in vitro. La cuenta folicular antral tiene predicción para detectar embarazo clínico con un área bajo la curva ROC de 0.59 y para recién nacido vivo de 0.57. El número óptimo con mayor porcentaje de embarazo clínico (9%) y recién nacido vivo (10.4%) tuvo cuenta folicular antral ≥ 8. CONCLUSIONES: Cuando la cuenta folicular antral es más o menos mayor de 8 folículos se espera mayor cantidad de embarazos clínicos y de recién nacidos.

Abstract BACKGROUND: The association between ovarian reserve test and ovarian response is well established, however, its ability to predict clinical pregnancy and the live birth is limited. OBJETIVE: Evaluate the clinical usefulness of the antral follicle count (AFC) to predict clinical pregnancy and live newborn. MATERIALS AND METHODS: Retrospective cohort study was made. In fresh IVF cycles, performed at INPer between 2011-2016. Including patients diagnosed with infertility, who underwent in vitro fertilization with fresh embryo transfer. The study variables were age, antral follicle count, basal FSH concentration and number of oocytes captured. A binary logistic regression model was performed. Statistical Package for Social Sciences (SPSS) was used for the statistical analysis. The probability of error alpha <5% was considered significant. RESULTS: A total of 923 in vitro fertilization cycles were included. The antral follicle count has a prediction for clinical pregnancy (ABC 0.59) and live birth (ABC 0.57). The optimal cut-off value with the highest percentage of clinical pregnancy (9%) and live birth (10.4%) was presented with a CFA ≥ 8. A higher pregnancy rate is reported when there is a follicular count above ≥8 follicles. CONCLUSIONS: It is expected the highest number of clinical pregnancy and live birth when the antral follicle count is for ≥8 follicles.