HBxAg suppresses cell apoptosis and promotes the secretion of placental hormones in human placental trophoblasts via activation of the EGFR/Akt pathway.

The aim of this study is to investigate the role of Hepatitis B virus x (HBx) in the growth and secretion of human placental trophoblasts. Firstly, placenta tissues were collected from pregnant HBV carriers with various viral loads. The results of immunohistochemical technique showed that the HBx protein and pEGFR protein levels were both markedly increased with the viral load elevation. Then, a placental trophoblast cell strain (JEG-3-HBx), which stably expressed HBx mRNA and protein, was established with the pcDNA-HBx transfection followed by the G418 selection. The JEG-3-HBx strain displayed distinct activation of the EGFR/AKT pathway, a lower level of cell apoptosis, and higher secretion levels of placental hormones, including human chorionic gonadotropin (hCG), progesterone, estrogen and ß-endorphin. Subsequently, HBx siRNA was used to silence the HBx gene in the JEG-3-HBx strain. Our data showed that the HBx siRNA transfection markedly suppressed the activation of the EGFR/AKT pathway, promoted cell apoptosis, and reduced the secretion of the placental hormones. Finally, EGF was applied to simulate the JEG-3-HBx strain with or without the HBx siRNA transfection. EGF treatment counteracted the reduction of cell apoptosis and the suppression of hormone secretion caused by HBx siRNA in the cell strain. In conclusion, the pEGFR protein was robustly upregulated in HBx-infected human placenta tissues and trophoblast cells. HBx reduces cell apoptosis and promotes the secretion of placental hormones in human placental trophoblast cells via activation of the EGFR/Akt pathway.

HBxAg suppresses apoptosis of human placental trophoblastic cell lines via activation of the PI3K/Akt pathway.

The aim of this study is to investigate the effect of hepatitis B virus X (HBx) protein on the apoptosis of placental trophoblastic cells and its potential mechanism. A pcDNA3.1 expression vector of HBx gene was built and transfected into JEG-3 and HTR-8 human placental trophoblastic cell lines, respectively. After transfection for 48 h, RT-PCR and immunofluorescence analyses showed that HBx mRNA and protein expression was detected in JEG-3 and HTR-8 cells. Flow cytometry revealed that early apoptosis of JEG-3 and HTR-8 cells was reduced by pcDNA-HBx transfection. Immunofluorescence and Western blotting showed that PI3K and p-Akt were significantly upregulated in HTR-8 cells. HBx ectopic expression did not change the viability of JEG-3 and HTR-8 cells when the PI3K/Akt pathway was blocked by its specific inhibitor LY294002. Moreover, the pcDNA-PI3K expression vector and pcDNA-HBx were transfected individually or co-transfected into the cells. The results showed that pcDNA-PI3K/pcDNA-HBx co-transfection promoted the expression of PI3K protein compared with the pcDNA-PI3K transfection group but did not increase the expression of HBx protein compared with pcDNA-HBx transfection group. In conclusion, HBx gene can be transferred into JEG-3 and HTR-8 human placental trophoblastic cell lines and cause inhibition of cell apoptosis. Its effect of apoptosis inhibition is related to the activation of the PI3K/Akt signaling pathway.

A systematic review and meta-analysis of the efficacy and safety of hysteroscopic electric resection versus vaginal surgery in the treatment of uterine scar defects after cesarean section.

Background: Cesarean sections are increasingly likely to be applied; however, uterine scar defects (USD) often remain after delivery. The two existing treatment methods, hysteroscopic electric resection and vaginal surgery, are still controversial in terms of efficacy and safety. So, this paper to compares the effectiveness and safety of hysteroscopic electric resection and vaginal surgery in the treatment of USD after cesarean section. Methods: We performed a related literature search from main databases. According to the PICOS principles inclusion criteria were adult female USD patients to evaluate the efficacy of hysteroscopic resection and vaginal surgery for the treatment of USD, outcome data could be extracted to compare the efficacy and safety of the two procedures. Subsequently, according to the titles, abstracts, and full texts of the retrieved articles, studies that did not meet the inclusion criteria were eliminated. The RevMan 5.20 software was used for meta-analysis and Cochrane Risk of Bias 2 (RoB 2.0) was used to assess the risk of bias. The effectiveness and safety of hysteroscopic resection and vaginal surgery in the treatment of USD patients after cesarean section were compared. Results: Eight articles were finally included, with a total of 191 patients in the hysteroscopic electric resection group and 212 patients in the vaginal surgery group. Compared with hysteroscopic resection and vaginal surgery, there is less intraoperative blood loss [mean difference (MD) is -25.23, P<0.00001], shorter operation time (MD is -29.45, P<0.00001), and shorter hospital stay (MD is -1.87, P<0.00001), but menstrual improvement risk ratio (RR) is 0.71 (P=0.51) and diverticulum recovery RR is 0.60 (P=0.43) there were no significant differences. Discussion: Hysteroscopic electric resection provides a more satisfactory outcome than vaginal surgery in terms of intraoperative blood loss, operation time, and hospital stay. However, the sample size of the study was not large enough and some studies had high risk of bias, more large-sample multi-center high quality studies are needed for further comprehensive comparative analysis.

Endometrial sampling devices for early diagnosis of endometrial lesions.

PURPOSE: Endometrial carcinoma is the most common gynecologic malignancy in both developed and some developing countries. Unlike cervical cancer, for which there is routine screening, only patients symptomatic for endometrial carcinoma typically seek medical help for its diagnosis and treatment. Dilatation and curettage (D&C) has been the standard procedure for evaluating suspicious endometrial lesions. The discomfort and injury caused by the D&C procedure, however, restrict its use as a screening method for early diagnosis of endometrial lesions. High-risk endometrial cancer patients would benefit from an effective and low-cost screening test. In recent years, several endometrial devices have been developed and proposed as screening tools. METHODS: We have reviewed and evaluated the literature relating to the endometrial sampling devices in clinical use or clinical trials, with the goal of comparing devices and identifying the most appropriate ones for screening for endometrial lesions. Eligible literature was identified from systematic PubMed searches, and the relevant data were extracted. Comments, letters, unpublished data, conference proceedings, and case reports were excluded from our search. Seventy-four articles on endometrial sampling devices were obtained for this review. RESULTS: The main screening devices for endometrial carcinoma are aspiration devices (such as the Vabra aspirator), Pipelle, Tao Brush, and SAP-1 device. Among these devices, the Tao Brush is the most promising endometrial sampler for screening for endometrial lesions. However, its sampling insufficiency, cost, and unsuccessful insertion rate (20 % in nulliparous and 8 % in parous women) are problematic. CONCLUSIONS: A more accurate and low-cost endometrial sampler, with improved specimen sufficiency and higher sensitivity for endometrial lesions, needs tobe developed and clinically verified.