ABSTRACT
Visfatin/NAMPT (VIS), the hormone exerting a pleiotropic effect, is also perceived as an important factor in the regulation of reproductive processes and pregnancy maintenance. Previous studies confirmed its involvement in the control of porcine pituitary and ovary function. In this study, we hypothesized that VIS may affect the global transcriptome of luteal cells and thus regulate the functioning of the ovaries. Illumina's NovaSeq 6000 RNA sequencing was performed to investigate the differentially expressed genes (DEGs) and long non-coding RNAs (DELs) as well as the occurrence of differential alternative splicing events (DASs) in the porcine luteal cells exposed to VIS (100 ng/mL) during the implantation period. The obtained results revealed 170 DEGs (99 up- and 71 downregulated) assigned to 45 functional annotations. Moreover, we revealed 40 DELs, of which 3 were known and 37 were described for the first time. We identified 169 DASs events. The obtained results confirmed a significant effect of VIS on the transcriptome and spliceosome of luteal cells, including the genes involved in the processes crucial for successful implantation and pregnancy maintenance as angiogenesis, steroidogenesis, inflammation, cell development, migration, and proliferation.
Subject(s)
Luteal Cells , Nicotinamide Phosphoribosyltransferase , Animals , Female , Pregnancy , Nicotinamide Phosphoribosyltransferase/genetics , Ovary , Pregnancy Maintenance , Swine , TranscriptomeABSTRACT
Maintenance of pregnancy is highly dependent on the maternal immune system. High levels of regulatory T cells (Tregs) accumulate in the maternal placenta to suppress immunoreactivity against fetal antigens. We assessed whether Astragalus root (AsR) and AsR-containing Kampo medicines modulate immunoreactivity and thereby increase mouse litter size. AsR-exposed murine splenocytes exhibited significantly increased IL-2 secretion. In AsR-exposed mice, total Tregs were significantly increased, whereas cytotoxic T lymphocyte antigen 4 (CTLA-4)-positive Tregs were decreased in AsR-exposed mice. Tregs express IL-2 receptor subunit alpha and are activated by IL-2. CTLA-4 interacts with B7 expressed in antigen-presenting cells (APCs) with high affinity, and CTLA-4/B7 signaling plays a critical role in inhibiting APC activity, thereby suppressing CD4+ T cell proliferation and activation. The decrease in CTLA-4+ Tregs in AsR-exposed mice is thought to induce an increase in CD4+ T cells, leading to increased IL-2 secretion from CD4+ T cells followed by Treg activation. Th17 cells prevent trophoblast apoptosis, resulting in trophoblast invasion into the decidua. AsR increases Th17 cells, thereby inducing dose-dependent increases in litter size. Although Keishikaogito (KO)- and Ogikenchuto (OK)-exposed mice exhibited increased IL-2 secretion and splenic Tregs, KO also increased CTLA-4+ Tregs. Therefore, KO promoted immunosuppression by increasing CTLA-4+ Tregs, which induced a decrease in Th17 and exerted little effect on litter size. Therefore, an increase in both Tregs and Th17 cells can be considered necessary for embryo implantation and pregnancy maintenance.
Subject(s)
Interleukin-2 , T-Lymphocytes, Regulatory , Pregnancy , Female , Mice , Animals , CTLA-4 Antigen , Interleukin-2/pharmacology , Th17 Cells , Embryo Implantation , Pregnancy MaintenanceABSTRACT
Spontaneous abortion is a pregnancy complication characterized by complex and multifactorial etiology. About 5% of childbearing women are globally affected by early pregnancy loss (EPL) and most of them experience recurrence (RPL). Epigenetic mechanisms and controlled inflammation are crucial for pregnancy maintenance and genetic predispositions may increase the risk affecting the maternal-fetal crosstalk. Combined analyses of global methylation, inflammation and inherited predispositions may contribute to define pregnancy loss etiopathogenesis. LINE-1 epigenetic regulation plays crucial roles during embryo implantation, and its hypomethylation has been associated with senescence and several complex diseases. By analysing a group of 230 women who have gone through pregnancy interruption and comparing those experiencing spontaneous EPL (n = 123; RPL, 54.5%) with a group of normal pregnant who underwent to voluntary interruption (VPI, n = 107), the single statistical analysis revealed significant lower (P < 0.00001) LINE-1 methylation and higher (P < 0.0001) mean cytokine levels (CKs: IL6, IL10, IL17A, IL23) in EPL. Genotyping of the following SNPs accounted for different EPL/RPL risk odds ratio: F13A1 rs5985 (OR = 0.24; 0.06-0.90); F13B rs6003 (OR = 0.23; 0.047-1.1); FGA rs6050 (OR = 0.58; 0.33-1.0); CRP rs2808635/rs876538 (OR = 0.15; 0.014-0.81); ABO rs657152 (OR = 0.48; 0.22-1.08); TP53 rs1042522 (OR = 0.54; 0.32-0.92); MTHFR rs1801133/rs1801131 (OR = 2.03; 1.2-3.47) and FGB rs1800790 (OR = 1.97; 1.01-3.87), although Bonferroni correction did not reach significant outputs. Principal Component Analysis (PCA) and logistic regression disclosed further SNPs positive/negative associations (e.g. APOE rs7412/rs429358; FGB rs1800790; CFH rs1061170) differently arranged and sorted in four significant PCs: PC1 (F13A, methylation, CKs); PC3 (CRP, MTHFR, age, methylation); PC4 (F13B, FGA, FGB, APOE, TP53, age, methylation); PC6 (F13A, CFH, ABO, MTHFR, TP53, age), yielding further statistical power to the association models. In detail, positive EPL risk association was with PC1 (OR = 1.81; 1.33-2.45; P < 0.0001) and negative associations with PC3 (OR = 0.489; 0.37-0.66; P < 0.0001); PC4 (OR = 0.72; 0.55-0.94; P = 0.018) and PC6 (OR = 0.61; 0.46-0.81; P = 0.001). Moreover, significant inverse associations were detected between methylation and CKs levels in the whole group (rIL10 = - 0.22; rIL17A = - 0.25; rIL23 = - 0.19; rIL6 = - 0.22), and methylation with age in the whole group, EPL and RPL subgroups (r2TOT = 0.147; r2EPL = 0.136; r2 RPL = 0.248), while VPI controls lost significance (r2VPI = 0.011). This study provides a valuable multilayer approach for investigating epigenetic abnormalities in pregnancy loss suggesting genetic-driven dysregulations and anomalous epigenetic mechanisms potentially mediated by LINE-1 hypomethylation. Women with unexplained EPL might benefit of such investigations, providing new insights for predicting the pregnancy outcome and for treating at risk women with novel targeted epidrugs.
Subject(s)
Abortion, Spontaneous , Epigenesis, Genetic , Pregnancy , Humans , Female , Interleukin-10/genetics , Interleukin-6/genetics , Abortion, Spontaneous/genetics , Genetic Predisposition to Disease , DNA Methylation , Pregnancy Maintenance , Inflammation/genetics , Apolipoproteins E/geneticsABSTRACT
Fetal loss (FL) from the 45th day of gestation until calving can impose a significant economic burden on dairy farmers, resulting in lost profits and increased production costs. Pregnancy-associated glycoprotein (PAG) is commonly used for detecting pregnancy in cows. PAG is secreted by binucleated trophoblast cells of the placenta and regulated by more than 24 genes. The purpose of this study was to determine the PAG threshold for FL and a probability of pregnancy maintenance until calving based on milk PAG levels. Our results reveal that primiparous and multiparous cows that maintained pregnancy until the 40th week exhibited higher PAG sample-negative (SN) values in their milk in the 6th week of gestation than did those that experienced FL later in gestation. Pregnant cows with higher PAG SN values in the 6th week of gestation were more likely to maintain their pregnancies. The area under the receiver operating characteristic curve for predicting the probability of pregnancy maintenance was 0.722 for our prediction model. On the other hand, a milk PAG SN value of <0.192 indicated 95 % confidence that FL would occur between the 7th and 40th weeks of gestation. Milk PAG testing is a noninvasive sampling technique that does not induce additional stress in lactating cows. The study reveals that PAG SN values increase significantly in Holstein cows during the 6th week of gestation. The predictive model developed was effective in forecasting pregnancy outcomes up to the 40th week of gestation or calving. The model's performance is moderately good for field application and could be a useful tool for dairy producers.
Subject(s)
Lactation , Milk , Humans , Pregnancy , Female , Cattle , Animals , Pregnancy Outcome , Pregnancy Maintenance , GlycoproteinsABSTRACT
We tested in the present study the hypothesis that supplementation with long-acting P4 (iP4) at different times of the initial dioestrus improves pregnancy rates in dairy and beef recipients submitted to fixed-time embryo transfer (FTET). Recipients from commercial farms had their oestrous cycle synchronized with an E2/P4-based protocol in three experiments (Exp. 1 to 3). In Exp. 1, dairy heifers (n = 76) and cows (n = 104) were randomly assigned to two experimental groups: the control group (n = 89) and the iP4D4 group (n = 91). For Exps. 2 and 3, suckled beef recipients were used. In Exp. 2, recipients were assigned to two experimental groups: Control group (n = 147) and iP4D7 group (n = 144); whereas in Exp. 3, recipients were randomly assigned to three experimental groups: Control group (n = 85), iP4-D4 group (n = 86) and iP4D7 group (n = 81). Recipients in the iP4D4 and iP4-D7 groups received an i.m. administration of 150 mg iP4, on D4 or D7 (D0 was the day of expected oestrus). On D7, all recipients were evaluated by transrectal ultrasonography and those that had a CL received a fresh or vitrified in vitro-produced embryo. In Exp. 2 and 3, the CL area was also determined by ultrasonography at the time of FTET. The pregnancy diagnosis was performed at 30 days in Exp. 1, 57 days in Exp. 2, and between 40 and 72 days of pregnancy in Exp. 3. In Exp. 1, the pregnancy rate did not differ (p > .1) between the Control group (38.2% [34/89]) and iP4D4 group (49.5% [45/91]); yet, a parity effect indicated a greater (p < .05) pregnancy rate in heifers (57.9% [44/76]) than cows (30.8% [32/104]). In Exp. 2, the pregnancy rate was greater (p < .05) in the iP4D7 group (45.0% [65/144]) than in the Control group (34.0% [50/147]). Also, a greater (p = .08) pregnancy rate was observed for recipients with a small CL (≤2.75 cm2 ) that were treated with iP4 on the day of FTET than the control recipients (46.4% [32/69] vs. 32.6% [28/86]). In Exp. 3, no significant effects (p > .1) of the treatment group or CL size were detected on pregnancy rates at days 30 and 60. In conclusion, the beneficial effects of iP4 supplementation at early dioestrus on pregnancy maintenance may vary according to the experimental conditions, but its use at the time of FTET can be used as an alternative to enhance the fertility of beef recipients in challenging conditions in commercial herds.
Subject(s)
Insemination, Artificial , Progesterone , Pregnancy , Cattle , Animals , Female , Progesterone/pharmacology , Insemination, Artificial/veterinary , Pregnancy Rate , Pregnancy Maintenance , Dietary Supplements , Estrus Synchronization/methodsABSTRACT
Este trabalho tem o objetivo de analisar as concepções de maternidade para mulheres inférteis de diferentes níveis socioeconômicos que estão em tratamento de reprodução assistida. Trata-se de um estudo qualitativo, descritivo, que utilizou como instrumento uma entrevista semiestruturada e contemplou temas como o significado de família, desejo/expectativas sobre filho e gestação e expectativas sobre a maternidade. Participaram da pesquisa 48 mulheres inférteis acima de 35 anos que usam tecnologias de reprodução assistida de alta complexidade em instituições privada e pública. Os dados foram tratados pela análise de conteúdo em que emergiram os temas: representações sociais da família; representações sociais da maternidade; expectativas com a gestação e os modelos maternos; e o filho imaginado. As participantes representaram a família de forma positiva, como um sistema de suporte, de fundação e origem de amor, configurando-a como um laço social. Por outro lado, as concepções de família com base na consanguinidade também estiveram presentes, representando a família pela perpetuação da espécie e pela importância do laço biológico. A maternidade foi marcada por significativa idealização, sendo vista como um papel gratificante e de realização da feminilidade. O peso da cobrança social para procriar também foi sentido como um dever a cumprir e que, na impossibilidade de se realizar, gera sentimentos de inferioridade, menos-valia, impotência e inadequação perante a sociedade, o que reforça o estigma da infertilidade. Tais resultados apontam a importância de reflexões sobre o papel da mulher na nossa cultura, visto que a maternidade é ainda utilizada como medida para o sucesso ou fracasso feminino. Faz-se necessário também refletir sobre a possibilidade da maior inserção do trabalho psicológico na reprodução assistida, visto a carga emocional e social envolvidas nesse processo.(AU)
This study aimed to analyze the conceptions of motherhood for infertile women from different socioeconomic levels who are undergoing assisted reproduction treatment. This is a qualitative and descriptive study that used a semi-structured interview as an instrument and included topics such as the meaning of family and desires/expectations about the child, pregnancy, and motherhood. A total of 48 infertile women over 35 years of ages using high-complexity assisted reproductive technologies in private and public institutions participated in this research. The data were treated by content analysis in which the following themes emerged: family social representations; social representations of motherhood; expectations with pregnancy and maternal models; and the imagined son. Participants represented the family in a positive way as a support system and the foundation and origin of love, embracing the family as a social bond. On the other hand, the family concepts based on inbreeding were also present, representing the family by perpetuation of the species and the importance of biological bonds. Motherhood was marked by significant idealization, being seen as a gratifying role and the fulfillment of femininity. The weight of the social demand to procreate was also felt as a duty to be fulfilled that, in the impossibility of carrying it out, generates feelings of inferiority, worthlessness, impotence, and inadequacy toward society, which reinforce the stigma of infertility. Results point to the necessary reflections on the role of women and our culture since Motherhood is still used as a measure of female success or failure. They also point to a reflection on the possibility of greater inclusion of psychological work in assisted reproduction given the emotional and social burden involved in this process.(AU)
Este estudio tuvo como objetivo analizar las concepciones de maternidad de mujeres infértiles, de diferentes niveles socioeconómicos, que se encuentran en tratamiento de reproducción asistida. Se trata de un estudio cualitativo, descriptivo, que utilizó como instrumento una entrevista semiestructurada e incluyó temas como el sentido de la familia, deseos/expectativas sobre el hijo y el embarazo y expectativas sobre la maternidad. Participaron en la investigación un total de 48 mujeres infértiles, mayores de 35 años, usuarias de tecnologías de reproducción asistida de alta complejidad en instituciones públicas y privadas. Los datos se sometieron a análisis de contenido del cual surgieron los temas: representaciones sociales familiares; representaciones sociales de la maternidad; expectativas con el embarazo y modelos maternos; hijo imaginado. Las participantes representaron a la familia de manera positiva, como sistema de apoyo, fundamento y origen del amor, configurándola como vínculo social. Por otro lado, también estuvieron presentes las concepciones familiares basadas en la consanguinidad, representando a la familia para la perpetuación de la especie y la importancia del vínculo biológico. La maternidad estuvo marcada por una importante idealización, vista como un rol gratificante y de realización de la feminidad. También se sintió el peso de la demanda social de procrear como un deber que cumplir y que, ante la imposibilidad de realizarlo, genera sentimientos de inferioridad, desvalorización, impotencia e inadecuación en la sociedad, lo que refuerza el estigma de la infertilidad. Por tanto, son necesarias reflexiones sobre el papel de la mujer en nuestra cultura, ya que la maternidad se sigue utilizando como medida del éxito o fracaso femenino. También se reflexiona sobre la posibilidad de una mayor inclusión del trabajo psicológico en la reproducción asistida dada la carga emocional y social que implica este proceso.(AU)
Subject(s)
Humans , Female , Pregnancy , Reproduction , Family , Parenting , Social Representation , Infertility, Female , Anxiety , Ovulation Detection , Ovulation Induction , Ovum , Ovum Transport , Parent-Child Relations , Patient Care Team , Patients , Pregnancy Maintenance , Pregnancy, Multiple , Prejudice , Psychology , Quality of Life , Self Concept , Sex , Sexual Abstinence , Shame , Achievement , Social Identification , Sperm Transport , Spermatozoa , Taboo , Time , Tobacco Use Disorder , Urogenital System , Uterus , Population Characteristics , National Health Strategies , Labor, Obstetric , Pregnancy , Pregnancy Outcome , Pharmaceutical Preparations , Adoption , Divorce , Marriage , Fertilization in Vitro , Sexually Transmitted Diseases , Child Rearing , Family Characteristics , Risk Factors , Pelvic Inflammatory Disease , Reproductive Techniques , Gestational Age , Coitus , Pregnancy, High-Risk , Oocyte Donation , Consanguinity , Contraception , Sexuality , Couples Therapy , Affect , Abortion, Threatened , Pelvic Infection , Heredity , Inheritance Patterns , Ovulation Prediction , Depression , Reproductive Rights , Diagnosis , Dreams , Alcoholism , Embryo Transfer , Endometriosis , Conjugal Status , Job Market , Fallopian Tube Patency Tests , Family Conflict , Family Relations , Fantasy , Fear , Female Urogenital Diseases and Pregnancy Complications , Masculinity , Sedentary Behavior , Binge Drinking , Hope , Social Norms , Delay Discounting , Contraceptive Prevalence Surveys , Psychological Trauma , Donor Conception , Healthy Lifestyle , Contraceptive Effectiveness , Long-Acting Reversible Contraception , Social Construction of Gender , Gender Expression , Gender-Specific Needs , Frustration , Embarrassment , Sadness , Emotional Regulation , Psychological Distress , Empowerment , Varicocele , Belonging , Family Support , Emotional Exhaustion , Guilt , Happiness , Imagination , Infertility, Male , Insemination, Artificial, Homologous , Laboratories , Life Style , Loneliness , Maternal-Fetal Exchange , Medicine , ObesityABSTRACT
Objetivo: Avaliar o desejo de gestantes, vítimas de violência sexual, em manter ou interromper a gravidez. Métodos: Estudo transversal retrospectivo que avaliou o desejo da gestante vítima de violência sexual pela manutenção ou interrupção da gravidez, no Programa de Atendimento às Vítimas de Violência Sexual, no período de janeiro de 2019 a setembro de 2022. Resultados: Foram acolhidas 67 gestantes vítimas de violência sexual que procuraram atendimento com vistas a orientação, manutenção ou interrupção da gestação. Entre elas, 56 (83,6%) pacientes solici- taram a interrupção da gestação e para 32 (57,2%) a solicitação foi aceita; 9 (16%) não tiveram a solicitação de interrupção autorizada por equipe multidisciplinar e mantiveram a gestação; 11 (16,4%) não solicitaram a interrupção e também optaram pela manutenção da gestação. A média das idades foi de 26 anos. Em sua maio- ria, eram solteiras, brancas e procedentes de munícipios do entorno de Caxias do Sul. O agressor era quase sempre desconhecido, e a agressão teria ocorrido pre- dominantemente na residência da vítima ou do agressor. Conclusão: No período estudado, foram avaliadas 67 gestações decorrentes de violência sexual. Dessas, 56 pacientes solicitaram a interrupção da gestação e 32 tiveram a solicitação aceita; nove não tiveram a solicitação de interrupção autorizada e mantiveram a gestação; 11 não solicitaram a interrupção e também optaram pela manutenção da gestação. Não cabe ao médico julgar a decisão da vítima, mas, sim, acolher e ofertar o seu direito de escolha.
Objective: To evaluate the desire of pregnant women, victims of sexual violence, to maintain or terminate pregnancy. Methods: Retrospective cross-sectional study that evaluated the desire of pregnant women victims of sexual violence for the mainte- nance or interruption of pregnancy in Program to Assist Victims of Sexual Assault, from January 2019 to September 2022. Results: Sixty-seven pregnant women who were victim of sexual assault and who sought care for maintenance or interruption of pregnancy were received. Among these, 56 (83.6%) patients requested the interruption of pregnancy and in 32 (57.2%) cases the request was accepted; 9 (16%) didn't have the interruption request authorized by the multidisciplinary team and have kept the pregnancy; 11 (16.4%) didn't request the interruption and have chosen to keep the pregnancy. The average age was 26 years. They were single, white, and mostly from cities around Caxias do Sul. The aggressor was almost always unknown, and the assault occurred mostly at the victim's or aggressor's home. Conclusion: Sixty-seven pregnancies resulting from sexual assault were evaluated during the period of the study. Fifty-sixth patients of those have requested pregnancy termination and 32 had their request accepted; nine didn't have their request for termination authorized and have kept their pregnancy; eleven didn't request termination and have chosen to keep their pregnancy. It isn't up to the physician to judge the victim's decision, but to welcome and offer her the right to choose.
Subject(s)
Humans , Female , Pregnancy , Pregnancy Maintenance , Rape , Abortion, Legal/statistics & numerical data , Pregnant Women/psychology , Pregnancy/statistics & numerical data , Cross-Sectional Studies/methods , Abortion, Induced/statistics & numerical data , Violence Against WomenABSTRACT
En 2021 entró en vigencia en Argentina la Ley N.º 27.610. El objetivo es describir características de afiliadas a OSEP que solicitaron interrupción del embarazo (SIE).Trabajo observacional descriptivo. Se analizaron las variables del 0800 del Ministerio de Salud de la Nación de todas las personas que SIE con OSEP, entre el 24/01 y 31/12/2021. Los datos fueron analizados con SPSS Statistics. Se utilizaron moda, mediana, porcentaje, tasa y el chi2. Se recibieron 427 SIE, se concretaron 330 (77,3%). Solicitaron ive: media 28,59 años. Modo 19 y 33 años. Concretaron ive: modo 22 años. 84,5% se realizó ambulatorio con misoprostol. De las SIE, 50,4% eran solteras, 43,4% trabajaba, 59,1% tenía secundario completo. Se desconoce 32,8%. De las SIE, 52,7% refirió haber estado utilizando MAC (54,2% preservativo; 37,4% anticonceptivos orales; 2,8% métodos "naturales"; 2,2% DIU). La mayor cantidad fue de zonas urbanas del Gran Mendoza. Sin embargo, se observan tasas elevadas en zonas rurales respecto de algunas zonas urbanas y más pobladas. Se observó progresión de SIE a lo largo del año. Un 11% después de SIE decidió continuar con el embarazo. Aparentemente ninguna de las variables tuvo relación con esa decisión. El MAC utilizado fue mayormente preservativo y anticonceptivos orales. Esto podría indicar falta de educación y poco acceso a métodos de larga duración. La problemática de interrupción es transversal. En base a los resultados de este trabajo, las personas sin pareja conviviente, ante un embarazo no planificado serían las que SIE. Ninguna otra variable parece actuar como determinante. Tampoco del paso de la solicitud a la interrupción efectiva o a la continuación del embarazo. Hay que aumentar la accesibilidad a MAC en zonas rurales (AU)
In 2021, Law No. 27610 entered into force in Argentina. The objective is to describe characteristics of people with OSEP who requested termination of pregnancy (PWRTP). Descriptive observational work. The variables of the 0800 of the Ministry of Health of Argentina of all the PWRTP with OSEP, between 01/24 and 12/31/2021, were analyzed. Data were analyzed with SPSS Statistics. Mode, median, percentage, rate and chi2 were used. PWRTP: 427 requests were received, 330 (77.3%) were completed. PWRTP: mean 28.59 years. Mode 19 and 33 years. People who had an abortion: mode 22 years. 84.5% were performed on an outpatient basis with misoprostol. 50.4% of the PWRTP were single, 43.4% worked, 59.1% had completed high school, 32.8% unknown, 52.7% reported having been using contraceptive methods (CM): 54.2% condoms; 37.4% oral contraceptives; 2.8% "natural" methods; 2.2% IUDs. The largest amount was from urban areas of Mendoza. However, high rates are observed in rural areas. A progression of the amount of PWRTP was observed throughout the year. 11% after requesting an abortion decided to continue with the pregnancy. Apparently none of the variables was related to that decision. The CM used were mostly condoms and oral contraceptives. This may indicate a lack of education and poor access to long-acting CM. The problem of interruption is transversal. People without a cohabiting partner, faced with an unplanned pregnancy, are the ones who RTP. No other variable seems to act as a determinant. Nor from the transition from the request to the effective interruption or continuation of the pregnancy. We must increase the accessibility to CM in rural areas (AU)
Subject(s)
Humans , Female , Pregnancy , Adult , Pregnancy, Unwanted , Abortion, Legal/statistics & numerical data , Contraception/statistics & numerical data , Pregnancy, Unplanned , Pregnancy Maintenance , Pregnancy/statistics & numerical data , Rural AreasABSTRACT
So far, few signals involved in embryo-maternal dialogue have been identified in pregnant she-camel. Our objective was to investigate expression profiles of genes relevant to uterine extracellular matrix remodeling (ITGB4, SLCO2A1, FOS, and JUN), uterine tissue vascularization, and placental formation (VEGFA, PGF, and PDGFA), embryonic growth and development (IGF1 and PTEN), plus cell death of uterine tissue (BCL2) in early pregnant versus non-pregnant she-camels. Forty genital tracts (20 pregnant and 20 non-pregnant) and blood samples were collected from abattoirs. Total RNA was extracted from uterine tissues and qRT-PCR was conducted for candidate genes. Serum concentrations of progesterone (P4) and estradiol17-ß (E2) were measured. Expression of ITGB4, FOS, and PGF genes increased (P < 0.001) in the right uterine horn of pregnant versus non-pregnant she-camels. Moreover, JUN, SLCO2A1, VEGFA, and PTEN mRNAs were up-regulated (P < 0.001) in various segments of uterine tissues in pregnant groups. The PDGFA transcript was over-expressed (P < 0.001) in both uterine horns of pregnant groups. Additionally, IGF1 was higher (P < 0.001) in the right horn and the uterine body of pregnant groups, and expression of BCL2 was increased (P < 0.001) in the pregnant uterine body. Moreover, serum concentrations of P4 were higher (P < 0.001) and E2 lower (P < 0.05) in pregnant she-camels. Taken together, the fine-tuning of genes related to implantation, matrix formation, vascularization, and placental formation is highly required for successful pregnancy in she-camels.
Subject(s)
Camelus , Organic Anion Transporters , Pregnancy , Female , Animals , Humans , Camelus/genetics , Placenta/metabolism , China , Ethnicity , Progesterone , Uterus/metabolism , Pregnancy Maintenance , Proto-Oncogene Proteins c-bcl-2/metabolism , Estradiol , Organic Anion Transporters/metabolismABSTRACT
T-cell immunoglobulin mucin-3 (Tim-3) is an important checkpoint that induces maternal-fetal tolerance in pregnancy. Macrophages (Mφs) play essential roles in maintaining maternal-fetal tolerance, remodeling spiral arteries, and regulating trophoblast biological behaviors. In the present study, the formation of the labyrinth zone showed striking defects in pregnant mice treated with Tim-3 neutralizing antibodies. The adoptive transfer of Tim-3+Mφs, rather than Tim-3-Mφs, reversed the murine placental dysplasia resulting from Mφ depletion. With the higher production of angiogenic growth factors (AGFs, including PDGF-AA, TGF-α, and VEGF), Tim-3+dMφs were more beneficial in promoting the invasion and tube formation ability of trophoblasts. The blockade of AGFs in Tim-3+Mφs led to the narrowing of the labyrinthine layer of the placenta, compromising maternal-fetal tolerance, and increasing the risk of fetal loss. Meanwhile, the AGFs-treated Tim-3-Mφs could resolve the placental dysplasia and fetal loss resulting from Mφ depletion. These findings emphasized the vital roles of Tim-3 in coordinating Mφs-extravillous trophoblasts interaction via AGFs to promote pregnancy maintenance and in extending the role of checkpoint signaling in placental development. The results obtained in our study also firmly demonstrated that careful consideration of reproductive safety should be taken when selecting immune checkpoint and AGF blockade therapies in real-world clinical care.
Subject(s)
Cell Communication , Macrophages , Placenta , Pregnancy Maintenance , Trophoblasts , Animals , Female , Mice , Pregnancy , Decidua/metabolism , Hepatitis A Virus Cellular Receptor 2/genetics , Hepatitis A Virus Cellular Receptor 2/metabolism , Intercellular Signaling Peptides and Proteins/metabolism , Macrophages/metabolism , Placenta/metabolism , Pregnancy Maintenance/genetics , Pregnancy Maintenance/physiology , Trophoblasts/metabolism , Cell Communication/genetics , Cell Communication/physiologyABSTRACT
Com os avanços tecnológicos e o aprimoramento da prática médica via ultrassonografia, já é possível detectar possíveis problemas no feto desde a gestação. O objetivo deste estudo foi analisar a prática do psicólogo no contexto de gestações que envolvem riscos fetais. Trata-se de um estudo qualitativo sob formato de relato de experiência como psicólogo residente no Serviço de Medicina Fetal da Maternidade Escola da Universidade Federal do Rio de Janeiro (UFRJ). Os registros, feitos por observação participante e diário de campo, foram analisados em dois eixos temáticos: 1) intervenções psicológicas no trabalho em equipe em consulta de pré-natal, exame de ultrassonografia e procedimento de amniocentese; e 2) intervenções psicológicas em casos de bebês incompatíveis com a vida. Os resultados indicaram que o psicólogo nesse serviço é essencial para atuar de forma multiprofissional na assistência pré-natal para gravidezes de alto risco fetal. Ademais, a preceptoria do residente é relevante para sua formação e treinamento para atuação profissional no campo da psicologia perinatal.(AU)
Face to the technological advances and the improvement of medical practice via ultrasound, it is already possible to detect possible problems in the fetus since pregnancy. The objective of this study was to analyze the psychologist's practice in the context of pregnancies which involve fetal risks. It is a qualitative study based on an experience report as a psychologist trainee at the Fetal Medicine Service of the Maternity School of UFRJ. The records, based on the participant observation and field diary, were analyzed in two thematic axes: 1) psychological interventions in the teamwork in the prenatal attendance, ultrasound examination and amniocentesis procedure; and 2) psychological interventions in cases of babies incompatible to the life. The results indicated that the psychologist in this service is essential to work in a multidisciplinary way at the prenatal care for high fetal risk pregnancies. Furthermore, the resident's preceptorship is relevant to their education and training for professional performance in the field of Perinatal Psychology.(AU)
Con los avances tecnológicos y la mejora de la práctica médica a través de la ecografía, ya se puede detectar posibles problemas en el feto desde el embarazo. El objetivo de este estudio fue analizar la práctica del psicólogo en el contexto de embarazos de riesgos fetal. Es un estudio cualitativo basado en un relato de experiencia como residente de psicología en el Servicio de Medicina Fetal de la Escuela de Maternidad de la Universidade Federal do Rio de Janeiro (UFRJ). Los registros, realizados en la observación participante y el diario de campo, se analizaron en dos ejes temáticos: 1) intervenciones psicológicas en el trabajo en equipo, en la consulta prenatal, ecografía y los procedimientos de amniocentesis; y 2) intervenciones psicológicas en casos de bebés incompatibles con la vida. Los resultados señalaron como fundamental la presencia del psicólogo en este servicio trabajando de forma multidisciplinar en la atención prenatal en el contexto de embarazos de alto riesgo fetal. Además, la tutela del residente es relevante para su educación y formación para el desempeño profesional en el campo de la Psicología Perinatal.(AU)
Subject(s)
Humans , Female , Pregnancy , Prenatal Care , Pregnancy, High-Risk , Psychosocial Intervention , Heart Defects, Congenital , Anxiety , Orientation , Pain , Parent-Child Relations , Parents , Paternity , Patient Care Team , Patients , Pediatrics , Placenta , Placentation , Pregnancy Complications , Pregnancy Maintenance , Prognosis , Psychoanalytic Theory , Psychology , Puerperal Disorders , Quality of Life , Radiation , Religion , Reproduction , Reproductive and Urinary Physiological Phenomena , General Surgery , Syndrome , Congenital Abnormalities , Temperance , Therapeutics , Urogenital System , Bioethics , Physicians' Offices , Infant, Premature , Labor, Obstetric , Pregnancy , Pregnancy, Animal , Pregnancy Outcome , Adaptation, Psychological , Pharmaceutical Preparations , Echocardiography , Magnetic Resonance Spectroscopy , Family , Abortion, Spontaneous , Child Rearing , Child Welfare , Mental Health , Family Health , Survival Rate , Life Expectancy , Cause of Death , Ultrasonography, Prenatal , Chromosome Mapping , Parental Leave , Mental Competency , Polycystic Kidney, Autosomal Recessive , Down Syndrome , Perinatal Care , Comprehensive Health Care , Chemical Compounds , Depression, Postpartum , Neurobehavioral Manifestations , Disabled Children , Diagnostic Techniques and Procedures , Gravidity , Crisis Intervention , Affect , Cytogenetic Analysis , Spirituality , Complicity , Value of Life , Humanizing Delivery , Death , Decision Making , Defense Mechanisms , Abortion, Threatened , Delivery of Health Care , Dementia , Uncertainty , Organogenesis , Qualitative Research , Pregnant Women , Early Diagnosis , Premature Birth , Nuchal Translucency Measurement , Child Mortality , Depression , Depressive Disorder , Postpartum Period , Diagnosis , Diagnostic Techniques, Obstetrical and Gynecological , Ethanol , Ego , Emotions , Empathy , Environment , Humanization of Assistance , User Embracement , Ethics, Professional , Cell Nucleus Shape , Prenatal Nutrition , Cervical Length Measurement , Family Conflict , Family Therapy , Resilience, Psychological , Reproductive Physiological Phenomena , Female Urogenital Diseases and Pregnancy Complications , Gestational Sac , Brief, Resolved, Unexplained Event , Fetal Death , Embryonic and Fetal Development , Multimodal Imaging , Mortality, Premature , Clinical Decision-Making , Pediatric Emergency Medicine , Child, Foster , Freedom , Burnout, Psychological , Birth Setting , Frustration , Sadness , Respect , Psychological Distress , Genetics , Psychological Well-Being , Obstetricians , Guilt , Happiness , Health Occupations , Hospitalization , Hospitals, Maternity , Hospitals, University , Human Development , Human Rights , Imagination , Infections , Infertility , Anencephaly , Jurisprudence , Obstetric Labor Complications , Licensure , Life Change Events , Life Support Care , Loneliness , Love , Medical Staff, Hospital , Intellectual Disability , Morals , Mothers , Narcissism , Congenital, Hereditary, and Neonatal Diseases and Abnormalities , Neonatology , Nervous System Malformations , Object AttachmentABSTRACT
A violência sexual e o aborto legal são temas tabus em nossa sociedade. No campo da saúde, a(o) psicóloga(o) atua em fases distintas, seja na avaliação psicológica do pedido pelo aborto legal, que culminará ou não em sua aquiescência; seja no momento posterior à solicitação, no atendimento em enfermarias ou ambulatorial. Partindo de relato de experiência, este artigo tem como objetivo refletir sobre as possibilidades e desafios da atuação psicológica no atendimento em saúde para pessoas em situação de gestação decorrente de violência sexual e que buscam pelo aborto legal. Para tanto, dividimos o artigo em três momentos. No primeiro deles, será possível encontrar dados conceituais, estatísticos e históricos sobre ambos os temas, trazendo recortes nacionais e internacionais. No segundo, trazemos apontamentos sobre o que chamamos de "eixos norteadores", ou seja, dialogamos com aspectos fundamentais para o trabalho nesta seara, sendo eles gênero, família, sexualidade e trauma. Por fim, no terceiro, aprofundamos a reflexão sobre o atendimento psicológico atrelado aos conceitos já discutidos, analisando de forma crítica principalmente um dos pontos mais espinhosos da atuação: a avaliação para aprovação (ou recusa) do pedido pelo aborto. Apoiamo-nos no referencial psicanalítico e defendemos que esta atuação psicológica é primordialmente uma oferta de cuidado, comprometido com as demandas das pessoas atendidas e com a promoção de saúde mental, e consideramos que o papel da psicologia é essencial para o reconhecimento do sofrimento e dos efeitos do abandono socioinstitucional na vida do público atendido.(AU)
Sexual abuse and legal abortion are taboo subjects in our society. On the health area, the psychologist works on different fields, such as psychological evaluation from the request of legal abortion, that will end or not on its approval, and also in a further moment, either the care on wards or ambulatorial treatment. Relying on a case report, this article aims to contemplate the possibilities and challenges from psychological work on healthcare to pregnant women from sexual violence and seek legal abortion. For this purpose, we divide this article in three moments. On the first, it will find definitions, statistics, and historical data about both issues, including national and international information. On the second, we bring notes called 'guiding pillar,' that is, we interact with fundamental aspects from this area, such as gender, family, sexuality, and trauma. On the third one, in-depth discussions we dwell on psychological care tied to the concepts previously addressed, critically analyzing one of the hardest moments of working in this area: the evaluation to approve (or refuse) the request for abortion. We lean over psychoanalytic thoughts and argue that this psychological work is primarily an offer of care, committed to the needs from those who seek us and to promoting good mental health and, also, we consider that psychology is essential to acknowledge the suffering and the effects of social and institutional neglect on the lives of the people seen.(AU)
La violencia sexual y el aborto son temas tabús en nuestra sociedad. En el campo de la salud, el(la) psicólogo(a) actúa en diferentes fases: en la evaluación psicológica de la solicitud del aborto legal, que culminará o no en su obtención, y/o en el momento posterior a la solicitud en la atención en enfermería o ambulatorio. Desde un reporte de experiencia, este artículo pretende reflexionar sobre las posibilidades y los desafíos de la Psicología en la atención en salud para personas en estado de embarazo producto de violencia sexual y que buscan un aborto legal. Para ello, este artículo está dividido en tres momentos. En el primer, presenta datos conceptuales, estadísticos e históricos sobre los dos temas, trayendo recortes nacionales e internacionales. En el segundo, comenta los llamados "ejes temáticos", es decir, se establece un diálogo con aspectos fundamentales para el trabajo en este ámbito, como género, familia, sexualidad y trauma. Por último, en el tercer, profundiza en la reflexión sobre la atención psicológica asociada a los conceptos discutidos, analizando de forma crítica uno de los puntos más espinosos de la actuación: la evaluación para la aprobación (o negativa) de la solicitud de aborto. Se utilizó el referencial psicoanalítico y se argumenta que esta atención psicológica es sobre todo una forma de cuidado, comprometida con las demandas de las personas atendidas y la promoción de la salud mental, y el papel de la Psicología es esencial para reconocer el sufrimiento y los efectos del abandono socioinstitucional en la vida del público atendido.(AU)
Subject(s)
Humans , Female , Pregnancy , Psychology , Sex Offenses , Health , Abortion, Legal , Patient Care Team , Pedophilia , Pleasure-Pain Principle , Poverty , Pregnancy Maintenance , Prejudice , Prisons , Psychoanalysis , Public Policy , Punishment , Rape , Rehabilitation , Religion , Reproduction , Safety , Sexual Behavior , Sex Education , Social Class , Social Environment , Social Identification , Social Problems , Social Sciences , Stress Disorders, Post-Traumatic , Obstetric Surgical Procedures , Surgical Procedures, Operative , Taboo , Violence , Unified Health System , Risk Groups , Brazil , Pregnancy , Sex Counseling , Sexually Transmitted Diseases , Abortion, Criminal , Residence Characteristics , Maternal Mortality , Mental Health , Health Education , Vital Statistics , Women's Health , Acquired Immunodeficiency Syndrome , Gestational Age , HIV , Intersectoral Collaboration , Practice Guideline , Coronavirus , Battered Women , Confidentiality , Sexuality , Feminism , Crime Victims , Crime , Criminology , Hazards , Disaster Vulnerability , Cultural Characteristics , Personal Autonomy , Dangerous Behavior , Judiciary , Criminal Liability , Public Defender Legal Services , Public Attorneys , Death , Stress Disorders, Traumatic, Acute , Prenatal Nutritional Physiological Phenomena , Parturition , Vulnerable Populations , Aggression , Sexology , Human Rights Abuses , Racial Groups , Fetal Mortality , Pregnancy, Unplanned , Reproductive Rights , Erotica , PAHO Ethics Review Committee , Violence Against Women , Fear , Pleasure , Embryonic and Fetal Development , Human Trafficking , Psychological Trauma , Psychosocial Support Systems , Social Construction of Ethnic Identity , Social Construction of Gender , Androcentrism , Embarrassment , Sexual Trauma , Developmental Disability Nursing , Emotional Abuse , Gender Equity , Homicide , Interpersonal Relations , Anencephaly , Jurisprudence , Life Change Events , Men , Age GroupsABSTRACT
AIMS: Molecular hydrogen (H2) has attracted growing interest because of its implications in various diseases. However, the molecular mechanisms underlying the remarkable effect of a small amount of H2 remain elusive. No knowledge has been available on the role of H2 in the etiology of pregnancy disorders or its direct influence on human immune cells. Since maternal immunity, T cells in particular, plays a critical role in pregnancy maintenance. We investigated the effects of H2 on T cells and its relation to preterm birth (PTB). MAIN METHODS: Exhaled H2 concentrations in pregnant women were measured and correlated with cytokine concentrations in maternal and umbilical cord blood. H2 was added to T cells collected from healthy donors, and differentiation and proliferation were examined. Energy metabolism was also examined. H2 was administered to mice and cytokine expression was compared. KEY FINDINGS: Our prospective observational study revealed that maternal production of H2 is significantly lower in pregnant women with PTB, suggesting its potential as a biomarker for predicting PTB. We found that H2 has clear associations with several maternal cytokines, and acts as an immunomodulator by exerting mitochondrial function in human T cells. Moreover, in vivo administration of H2 to pregnant mice regulated inflammatory responses and reduced PTB caused by T cell activation, which further supports the notion that H2 may contribute to prolonged gestation through its immunomodulatory effect. SIGNIFICANCE: Measuring maternal H2-production could be a potential clinical tool in the management of PTB, and H2 may have positive impact on pregnancy maintenance.
Subject(s)
Premature Birth , Animals , Biomarkers , Cytokines , Female , Humans , Hydrogen/pharmacology , Infant, Newborn , Mice , Mitochondria , Pregnancy , Pregnancy Maintenance , T-LymphocytesABSTRACT
T-cell immunoglobulin mucin-3 (Tim-3) plays roles in the functional regulation of both adaptive and innate immune cells and is greatly involved in many diseases. However, the precise roles of Tim-3 on macrophages (Mφs) in pregnancy remain unstated. In the current study, we found the higher frequency of Tim-3+ decidual Mφs (dMφs) in response to trophoblasts. The reduced abundance of Tim-3 on Mφs was accompanied by disordered anti- and pro-inflammatory cytokine profiles in miscarriage. Adoptive transfer of Tim-3+Mφs, but not Tim-3-Mφs, relieved murine embryo absorption induced by Mφ depletion. Our flow cytometry results and the extensive microarray analysis confirmed that Tim-3+ and Tim-3-dMφs were neither precisely pro-inflammatory (M1) nor anti-inflammatory (M2) Mφs. However, with higher CD132 expression, Tim-3+dMφs subset induced Th2 and Treg bias in decidual CD4+T cells and promoted pregnancy maintenance. Blockade of Tim-3 or CD132 pathways leaded to the dysfunction of maternal-fetal tolerance and increased fetal loss. These findings underscored the important roles of Tim-3 in regulating dMφ function and maintaining normal pregnancy, and suggested that Tim-3 on Mφs is a potential biomarker for diagnosis of miscarriage. Our study also emphasized the importance of careful consideration of reproductive safety when choosing immune checkpoint blockade therapies in real world clinical care. Though IL-4 treated Tim-3-Mφs could rescue the fetal resorption induced by Mφ depletion, whether IL-4 represent novel therapeutic strategy to prevent pregnancy loss induced by checkpoint inhibition still needs further research.
Subject(s)
Abortion, Spontaneous , Hepatitis A Virus Cellular Receptor 2 , Macrophages , T-Lymphocytes, Regulatory , Th2 Cells , Animals , Decidua , Female , Hepatitis A Virus Cellular Receptor 2/immunology , Interleukin-4/immunology , Macrophages/immunology , Mice , Pregnancy , Pregnancy Maintenance , T-Lymphocytes, Regulatory/immunology , Th2 Cells/immunologyABSTRACT
The relationship between the maternal endocrine environment and late embryonic mortality (> 28 d of gestation) in cattle is poorly defined. A definitive rise and alterations in secretion patterns of prostaglandin F2α (PGF2α) concentration without luteal regression is a trademark of this period. The objective was to evaluate whether consecutively induced PGF2α pulses would alter steroid hormone production and luteal blood perfusion potentially influencing pregnancy success. Pregnant beef cows (n = 12) were selected to receive either an oxytocin injection (OT, n = 8) or saline injection (CON, n = 4) on d 30 and 31 of gestation to stimulate sequential prostaglandin releases 24 h apart. Blood samples were collected every 30 min for 1 h before and continuing for 4 h post oxytocin administration. Luteal blood perfusion was measured via Doppler ultrasound at the beginning and end of the OT challenge. Concentrations of prostaglandin F2α metabolite (PGFM) were quantified to show effectiveness of the treatment while concentrations of progesterone, estradiol and pregnancy-associated glycoproteins (PAG) were measured to examine the effect of PGF2α release. Control animals exhibited no changes in any quantified hormone and an expected numerical increase in circulating PAG concentrations. Peak concentrations of PGFM in OT cows were observed 2 h post OT administration and concentrations returned to basal levels by the end of the sampling period. Peak concentrations of PGFM were decreased on d 31 compared to d 30. Following OT administration, progesterone and estradiol concentrations did not change in response to PGF2α release but were decreased on d 31 compared to d 30. There were no changes in luteal blood perfusion in response to PGF release on d 30 or d 31. Repeated PGF2α release may alter steroid hormone production; however, it does not negatively affect pregnancy status during the transition between early and late embryonic development.
Subject(s)
Dinoprost , Progesterone , Animals , Cattle , Estradiol , Female , Oxytocin/pharmacology , Pregnancy , Pregnancy Maintenance , ProstaglandinsABSTRACT
La preeclampsia es una patología con una importante incidencia a nivel mundial que se encuentra asociada directamente con el 15% de las muertes maternas. Esta se caracteriza usualmente por la presencia de hipertensión y proteinuria, que se manifiestan desde la mitad de la gestación. Los microARN son moléculas de ARN monocatenario que actúan principalmente degradando el ARN mensajero transcrito o inhibiendo la traducción de microARN. Los microARN placentarios ejercen un papel en el crecimiento y función de la placenta, se considera factible su uso potencial como biomarcadores de diagnóstico debido a la capacidad de entrar en la circulación materna y ser detectables en el plasma materno.
Preeclampsia is a disease with a significant incidence worldwide that is directly associated with 15% of maternal deaths. This is usually characterized by the presence of hypertension and proteinuria, which manifests itself from the middle of pregnancy. MicroRNAs are single-stranded RNA molecules that act primarily by degrading transcribed messenger RNA or inhibiting microRNA translation. Placental microRNAs play a role in the growth and function of the placenta, their potential use as diagnostic biomarkers is considered feasible due to the ability to enter the maternal circulation and be detectable in maternal plasma.
Subject(s)
Humans , Female , Pregnancy , Health Sciences , MicroRNAs , Pre-Eclampsia , Molecular Biology , Pregnancy Maintenance , Pregnancy, High-Risk , Obstetrics , Hypertension, Pregnancy-InducedABSTRACT
Maternal immunotolerance towards the semi-allogeneic foetus is critical for normal pregnancy (NP). As a secretory protein, growth arrest-specific factor 6 (GAS6) promotes cancer progression by inducing the conversion of tumour-associated macrophages to an immunosuppressive M2-like phenotype. However, little is known about whether GAS6 regulates decidual macrophages (dMφs) in the early maternal-foetal interface. In this study, first-trimester decidual tissues were obtained from normal pregnant women undergoing elective terminations and patients with miscarriages. The expression of GAS6 and its receptors (AXL, TYRO3 and MERTK) in decidua and GAS6 secretion by decidual stromal cells (DSCs) was measured. Then, we investigated the effect of recombinant human GAS6 (rhGAS6) on dMφs isolated from NP and THP-1 cells, and revealed the underlying mechanism. Both the expression of GAS6 in DSCs and MERTK in dMφs, in addition to GAS6 secretion by DSCs, was found to be significantly decreased in miscarriage patients compared to that in NPs. Additionally, we observed that rhGAS6 polarized dMφs and THP-1 cells towards an M2-like phenotype, as evidenced by the up-regulated CD163 expression. Moreover, rhGAS6 enhanced the clearance of toxic cell-free haemoglobin by dMφs by up-regulating CD163 expression, and rhGAS6 also boosted cell proliferation of dMφs and THP-1 cells. Finally, we demonstrated that rhGAS6 stimulated CD163 expression and cell proliferation by activating the PI3K/Akt signalling pathway. Collectively, these findings suggest that GAS6-mediated dialogue between DSCs and dMφs is crucial for the establishment and maintenance of maternal-foetal immunotolerance, and decreased GAS6 secretion by DSCs may lead to the occurrence of miscarriage in the first trimester.
Subject(s)
Abortion, Spontaneous , Decidua , Intercellular Signaling Peptides and Proteins/metabolism , Abortion, Spontaneous/metabolism , Cell Proliferation , Decidua/metabolism , Female , Humans , Intercellular Signaling Peptides and Proteins/genetics , Intercellular Signaling Peptides and Proteins/pharmacology , Macrophages/metabolism , Phosphatidylinositol 3-Kinases/metabolism , Pregnancy , Pregnancy Maintenance , Stromal Cells/metabolism , c-Mer Tyrosine Kinase/genetics , c-Mer Tyrosine Kinase/metabolismABSTRACT
INTRODUCTION: This study aimed to investigate amniotic fluid (AF) proteins that were differentially expressed between patients with cervical insufficiency (CI) and asymptomatic short cervix (SCX, ≤ 25 mm), and whether these proteins could be predictive of spontaneous preterm birth (SPTB) in these patients. METHOD: This was a retrospective cohort study of 129 singleton pregnant women with CI (n = 80) or SCX (n = 49) at 17 to 26 weeks who underwent amniocentesis. An antibody microarray was used to perform comparative proteomic profiling of AF from matched CI (n = 20) and SCX (n = 20) pregnancies. In the total cohort, an ELISA validation study was performed for 15 candidate proteins of interest. Subgroup analyses of patients with CI and SCX were conducted to evaluate the association between the 15 proteins and SPTB at < 32 weeks of gestation. RESULTS: Eighty-six proteins showed intergroup differences. ELISA validation confirmed significantly higher levels of AF EN-RAGE, IL-8, lipocalin-2, MMP-9, S100A8/A9, thrombospondin-2, and TNFR2 in patients with CI than in those with SCX. Multivariable analysis showed that increased AF levels of EN-RAGE, S100A8/A9, and uPA were independently associated with SPTB at < 32 weeks in patients with CI; whereas in patients with SCX, high AF levels of APRIL, EN-RAGE, LBP, and TNFR2 were independently associated with SPTB at < 32 weeks. CONCLUSIONS: Multiple AF proteins show altered expression in patients with CI compared with SCX controls. Moreover, several novel mediators involved in inflammation were identified as potential biomarkers for predicting SPTB after the diagnosis of CI and SCX. These results provide new insights into target-specific molecules for targeted therapies to prevent SPTB in patients with CI/SCX.
Subject(s)
Amniotic Fluid/immunology , Antibodies/analysis , Premature Birth/immunology , Urogenital Abnormalities/immunology , Uterine Cervical Incompetence/immunology , Adult , Amniotic Fluid/chemistry , Amniotic Fluid/metabolism , Antibodies/metabolism , Asymptomatic Diseases , Case-Control Studies , Cerclage, Cervical/statistics & numerical data , Cervical Length Measurement , Cervix Uteri/abnormalities , Cervix Uteri/pathology , Cervix Uteri/surgery , Cohort Studies , Female , Humans , Infant, Newborn , Microarray Analysis/methods , Pregnancy , Pregnancy Maintenance/physiology , Pregnancy Outcome/epidemiology , Premature Birth/epidemiology , Premature Birth/etiology , Proteome/analysis , Proteome/metabolism , Proteomics/methods , Republic of Korea/epidemiology , Retrospective Studies , Risk Factors , Time Factors , Urogenital Abnormalities/complications , Urogenital Abnormalities/epidemiology , Urogenital Abnormalities/surgery , Uterine Cervical Incompetence/epidemiology , Uterine Cervical Incompetence/etiology , Uterine Cervical Incompetence/surgeryABSTRACT
Antecedentes: El embarazo es una etapa plagada de cambios fisiológicos y mentales. El ejercicio físico es saludable y beneficioso, a pesar de ello, durante el embarazo se constata una disminución de la actividad física de las gestantes. Objetivo: Evaluar los efectos del ejercicio físico acuático en las mujeres embarazadas. Estrategia de búsqueda: Se llevó a cabo una búsqueda sistemática que se extendió desde enero a abril de 2020, en las bases de datos: Pubmed, Web of Science, Medline, Cinalh, Scopus y Cochrane. Selección de estudios: Tras la aplicación de los criterios de inclusión (ensayos clínicos aleatorizados publicados entre 01/01/2015 y el 31/04/2020 e idioma castellano o inglés y exclusión (artículos duplicados, revisiones bibliográficas y que no se ajustasen al tema de estudio), se obtuvieron 11 artículos válidos. Síntesis de resultados: La calidad de la metodología se evaluó mediante la escala Jadad, obteniendo una puntuación de 3, y el riesgo de sesgo siguiendo las indicaciones del Manual Cochrane de revisiones sistemáticas, adquiriendo un bajo riesgo de sesgo. Las variables evaluadas fueron calidad de sueño, peso del bebé, peso gestacional y posparto, dolor lumbopélvico, depresión posparto, estado del perineo, duración del parto, constantes hemodinámicas y la calidad de vida, obteniendo en algunos casos resultados dispares. Conclusión: El ejercicio físico acuático produce cambios beneficiosos en las gestantes manteniendo la duración de la gestación, disminuyendo el peso de la madre sin alterar el del bebé y mejorando la calidad de vida.(AU)
Background: Pregnancy is a stage that involves physiological and mental changes. Physical exercise is healthy and beneficial, however, during pregnancy there is a decrease in physical activity in pregnant women. Objective: To evaluate the effects of aquatic physical exercise in pregnant women. Search strategy: A systematic search was carried out from January to April 2020 in the databases: Pubmed, Web of Science, Medline, Cinalh, Scopus and Cochrane. Study selection: After application of the inclusion criteria (randomized clinical trials published between 01/01/2015 and 04/31/2020 and Spanish or English language and the exclusion criteria (duplicate articles, bibliographic reviews and those that did not fit the study topic), 11 valid articles were obtained. Synthesis of results: The quality of the methodology was evaluated using the Jadad scale, obtaining a score of 3, and the risk of bias following the indications of the Cochrane Manual of systematic reviews, acquiring a low risk of bias. The variables evaluated were quality of sleep, baby's weight, gestational and postpartum weight, lumbo-pelvic pain, postpartum depression, perineal status, duration of labour, haemodynamic constants, and quality of life, obtaining mixed results in some cases. Conclusion: Aquatic physical exercise produces beneficial changes in pregnant women, maintaining the duration of gestation, reducing the weight of the mother without altering that of the baby and improving quality of life.(AU)
Subject(s)
Humans , Pregnancy , Exercise , Exercise Therapy , Swimming , Pregnancy Maintenance , Gestational Weight Gain , Systematic Reviews as TopicABSTRACT
A gestação heterotópica é uma entidade rara, principalmente se resultante de concepção natural. O diagnóstico é ultrassonográfico, porém a gestação intrauterina concomitante contribui para a dificuldade propedêutica. Neste relato de caso, a detecção foi tardia, a ultrassonografia não identificou a gestação heterotópica e apenas durante a avaliação intraoperatória, por meio de uma cirurgia de emergência devido a choque hemorrágico, houve o reconhecimento. A suspeita de uma gestação heterotópica deve ser sempre aventada quando sinais clínicos típicos (sangramento, dor abdominal) estão presentes, mesmo na ausência de fatores de risco ou imagens anômalas na ecografia. Assim, uma intervenção precoce menos invasiva pode ser realizada, reduzindo a morbimortalidade materna e do feto intrauterino. Este relato de caso destaca uma situação incomum dentro dessa patologia rara: diagnóstico tardio, apenas no segundo trimestre de gestação, sem evidência prévia ultrassonográfica, certificada apenas durante o intraoperatório. O manejo cirúrgico preciso permitiu a manutenção da gravidez intrauterina.(AU)
Heterotopic pregnancy is a rare entity, especially if it is resulted from natural conception. The diagnosis is ultrasonographic, but the concomitant intrauterine pregnancy contributes to the propaedeutic difficulty. In this case report, the detection was late, the ultrasonography did not identify heterotopic pregnancy and, only during intraoperative evaluation through emergency surgery, exploratory laparotomy, there was recognition. The suspicion of a heterotopic pregnancy should always be raised when typical clinical signs (bleeding, abdominal pain) are present, even in absentia of risk factors or anomalous images on ultrasound. Thus, a less invasive early intervention can be performed, reducing maternal and intrauterine fetus morbimortality. This case report highlights an unusual situation within this rare pathology: late diagnosis, only in the second trimester of pregnancy, without previous ultrasound evidence, certified only during the intraoperative period. Precise surgical management allowed the maintenance of intrauterine pregnancy.(AU)