Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 28.933
Filtrar
1.
Orv Hetil ; 161(10): 389-395, 2020 Mar.
Artículo en Húngaro | MEDLINE | ID: mdl-32115993

RESUMEN

Introduction: The treatment of preeclampsia, which occurs in 3-8% of pregnancies, is not yet resolved. In preeclampsia, NO synthesis is insufficient, which can contribute to hypertension, proteinuria and abnormal vascularization of the placenta. Decreased NO synthesis in the preeclamptic placenta may also be due to a decrease in the affinity of NO synthase for tetrahydrobiopterin (BH4), resulting in BH4 resistance. In recent years, pravastatin has been shown to prevent preeclampsia in animal models and in human studies. One of the known pleiotropic effects of pravastatin is that it increases NO synthase activity. Aim: Description of the effect of pravastatin on BH4-resistant NO synthase activity in the preeclamptic placenta. Method: NO synthase activity in the placental microsome was measured with C14 arginine substrate using healthy (n = 9) and preeclamptic (n = 9) samples. NO synthase activity was measured at 0.02 µM, physiological at 0.20 µM and pharmacological at 50 µM BH4. Results: One of the 9 preeclamptic patients was BH4-resistant; physiologic BH4 concentration did not significantly increase NO synthase activity, whereas healthy placental microsomes showed a mean increase of 60% (p<0.01), and BH4-sensitive preeclamptic specimen showed a 67% (p<0.01) increase. 10 µM pravastatin increased NO synthase activity by 32-38% at each BH4 concentration in healthy, BH4-sensitive and BH4-resistant preeclampsia samples. Conclusion: 10 µM pravastatin increased BH4-resistant placental NO synthase activity to a similar extent as placental physiological BH4 concentration (0.06-0.20 µM) to BH4-sensitive NO synthase activity. The NO synthase activity of BH4-resistant preeclamptic placenta can be increased by pravastatin to physiological level. Orv Hetil. 2020; 161(10): 389-395.


Asunto(s)
Biopterina/análogos & derivados , Óxido Nítrico Sintasa/efectos de los fármacos , Placenta/metabolismo , Pravastatina/farmacología , Preeclampsia/metabolismo , Femenino , Humanos , Embarazo
2.
Wiad Lek ; 73(1): 99-103, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32124816

RESUMEN

OBJECTIVE: The aim: to study and compare the features of the interleukins levels and morphological changes of placenta at various stages of preeclampsia. PATIENTS AND METHODS: Materials and methods: 109 pregnant women with preeclampsia of varying severity (study group) and 30 pregnant women with uncomplicated pregnancy (control group) were examined. Immunohistochemical method, proinflammatory interleukins levels, morphological and morphometric analysis of peripheral and central placental areas biopsies on the optical and electron-microscopic level have been used. RESULTS: Results: Morphofunctional changes in the placenta in case of preeclampsia and the increase in the expression level of the transforming growth factor have a series of regular stages from the formation, strain and disruption of adaptive mechanisms with more pronounced signs of morphological immaturity of parenchymal and stromal elements of the placenta, especially in the area of syncytiotrophoblast and spiral vessels. The degree of clinical manifestation of preeclampsia has a correlation relationship with IL-10 deficiency and with the increase in TNF-α, stimulation of macrophage-protein production that contributes to the change in the ratio of Thl / Th2, which are antagonists and inhibit each other's development. CONCLUSION: Conclusions: The severity of the preeclampsia course correlates with the state of morphofunctional changes in the placenta and changes in the ratio of the pro- and anti-inflammatory interleukins.


Asunto(s)
Preeclampsia , Complejo Antígeno-Anticuerpo , Femenino , Humanos , Interleucinas , Placenta , Embarazo , Factor de Necrosis Tumoral alfa
3.
Wiad Lek ; 73(1): 151-155, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32124826

RESUMEN

OBJECTIVE: The aim: To find out typical pathomorphological differences in placenta of women with early and late preeclampsia. PATIENTS AND METHODS: Materials and methods: Investigation includes 40 placentas from deliveries in women with preeclampsia (main group) and 40 placentas from physiological delivery in somatically healthy women, who had no complications during pregnancy (control group). Placentas in the main group were devided into two sub-groups (20 in each) - with early and late preeclampsia. Specialties of the blood vessels in normal pregnancy were investigated, and their structural transformation with the developement of preeclampsia, according to the appearence of perinatal pathology. Morphometrical data of the blood stream was investigated with the help of eyepiece and program Image Tools 3,6. RESULTS: Results: Significant decrease of weight (p<0,05), square and volume of placenta was common to early preeclampsia, comparing to the same characteristics in late Preeclampsia (PE). Specific gravity of villi without vessels, hardened blood vessels, hardened villi and fibrinoid altered vessels was increased statistically significantly (p<0,05) in placenta of women with early PE, comparing to women with late PE. The number of effective blood vessels crossings was determined mostly in late PE, comparing to the early form (p<0,05). Found out significant defferences (p<0,05) in changes of hystovasoarchitecture of placenta in early preeclampsia, according to the number of immature villi and villi with no signs of compensatory angiomatosis. CONCLUSION: Conclusions: Increased number of hypoplasia of placenta, breach of effective placental blood stream and significant decrease of compensatory and adaptive changes in placenta are more common to early PE, comparing to late PE.


Asunto(s)
Preeclampsia , Estudios de Casos y Controles , Femenino , Humanos , Placenta , Embarazo
4.
Medicine (Baltimore) ; 99(11): e19349, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32176056

RESUMEN

The visual system was reported to be affected in over half of patients with preeclampsia (PE), though fundus examination was performed only among patients complaining of visual symptoms. Delayed diagnosis and treatment of PE-related retinopathy may lead to permanent visual impairment. Therefore, we hypothesize that some clinical or laboratory parameters could predict severity of retinal damage.The aim of the study was to explore the risk factors for retinopathy in severe preeclampsia (sPE) and investigate pregnancy outcomes with different degrees of retinopathy.This retrospective cohort study included women with sPE who underwent ophthalmoscopy and delivered after admission to West China Second University Hospital, between June 2013 and December 2016. Clinical and laboratory characteristics were retrieved from medical records. Patients confirmed with retinopathy were followed up with telephones. Multiple logistic regression analysis was performed to identify risk factors of PE-related retinopathy.Five hundred thirty-four patients were included, of which 17.6% having stage-1/2 retinopathy, 14.6% having stage-3/4 retinopathy, and 67.8% having normal retina. Compared with patients without retinopathy, patients with stage 3/4 retinopathy were more likely to have preterm-birth and low-birth-weight babies. Significant risk factors for stage 3/4 retinopathy in sPE included severe hypertension (odds ratio [OR] 2.24, 95% confidence interval [CI]: 1.10-4.56), elevated white blood cell (WBC) counts (OR 1.88, 95% CI: 1.05-3.35), decreased platelet counts (OR 2.12, 95% CI: 1.07-4.48), lactate dehydrogenase (LDH) concentration of >800 IU/L (OR 2.31, 95% CI: 1.05-5.06), low hemoglobin (HGB) concentrations of <110 g/L (OR 3.73, 95% CI: 1.21-11.47), 24-hour proteinuria of 2 to 5 g (OR 6.39, 95% CI: 2.84-14.39), and >5 g (OR 8.66, 95% CI: 3.67-20.44).This study confirms the association between retinopathy and preterm-birth and low-birth weight in sPE. The risk factors for severe PE-related retinopathy, including severe hypertension, platelet and WBC count, HGB and LDH concentration, and proteinuria, are associated with the development of retinopathy. Routine and repeated fundus examination is recommended for maternal monitoring in sPE.


Asunto(s)
Preeclampsia/epidemiología , Resultado del Embarazo , Embarazo de Alto Riesgo , Enfermedades de la Retina/epidemiología , Retinoscopía/métodos , China , Estudios de Cohortes , Femenino , Edad Gestacional , Hospitales Universitarios , Humanos , Recién Nacido , Modelos Logísticos , Análisis Multivariante , Preeclampsia/diagnóstico , Embarazo , Nacimiento Prematuro , Enfermedades de la Retina/diagnóstico , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la Enfermedad
5.
Isr Med Assoc J ; 22(3): 137-141, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32147976

RESUMEN

BACKGROUND: Pregestational diabetes mellitus (PGDM) carries a significantly elevated risk of adverse maternal and fetal outcomes. There is evidence that certain interventions reduce the risk for adverse outcomes. Studies have shown that a multi-disciplinary approach improves pregnancy outcomes in women with PGDM. OBJECTIVES: To determine pregnancy outcomes in women with PGDM using a multi-disciplinary approach. METHODS: We retrospectively reviewed consecutive women with pregestational type 1 and type 2 diabetes who were monitored at a high-risk pregnancy clinic at the Sheba Medical Center. Clinical data were obtained from the medical records. All data related to maternal glucose control and insulin pump function were prospectively recorded on Medtronic CareLink® pro software (Medtronic MiniMed, Northridge, CA). RESULTS: This study comprised 121 neonates from 116 pregnancies of 94 women. In 83% of the pregnancies continuous glucose monitoring (CGM) sensors were applied during a part or all of the pregnancy. Pregnancy outcomes among women who were followed by a multi-disciplinary team before and during pregnancy, and during labor and puerperium resulted in better glucose control (hemoglobin A1c 6.4% vs. 7.8%), lower risk for pregnancy induced hypertension/preeclampsia (7.7% vs. 15.6%), lower birth weight (3212 g vs. 3684 g), and lower rate of large size for gestational age and macrosomia (23.1% vs. 54.2% and 3.3% vs. 28.4%, respectively), compared to data from European cohorts. CONCLUSIONS: The multi-disciplinary approach for treating women with PGDM practiced in the high-risk pregnancy clinic at the Sheba Medical Center resulted in lower rates of macrosomia, LGA, and pregnancy induced hypertension compared to rates reported in the literature.


Asunto(s)
Diabetes Mellitus/terapia , Complicaciones del Embarazo/terapia , Atención Prenatal/métodos , Adulto , Glucemia , Femenino , Macrosomía Fetal/prevención & control , Humanos , Hipertensión/prevención & control , Recién Nacido de Bajo Peso , Recién Nacido , Insulina/uso terapéutico , Israel , Preeclampsia/prevención & control , Embarazo , Estudios Prospectivos , Estudios Retrospectivos
6.
Zhonghua Fu Chan Ke Za Zhi ; 55(1): 29-35, 2020 Jan 25.
Artículo en Chino | MEDLINE | ID: mdl-32074770

RESUMEN

Objective: To observe the dynamic changes of human serum albumin (HSA) level during pregnancy and study the early warning significance of HSA level on the onset of preeclampsia (PE) . Methods: Totally 369 PE pregnant women (PE group) and 309 normal pregnant women (control group) without PE who admitted in Haidian Maternal and Child Health Hospital from January 2013 to December 2017 were selected. HSA levels were tested before meeting the criterion of PE in the first trimester, the early-third trimester and the late-third trimester, the difference between the two groups were compared. The relationship between the HSA level and the incidence of complications in PE patients was analyzed. Results: (1)The mean values of HSA level in PE group and control group were (41.9±3.1) versus (40.0±2.2) g/L, (34.2±2.7) versus (35.4±2.7) g/L and (33.7±2.9) versus (36.7±3.3) g/L in the first trimester,the early-third trimester and the late-third trimester respectively,the difference in the first trimester was no significance (P>0.05), while the differences in the early-third trimester and the late-third trimester were both significant (all P<0.05). (2) The HSA level during pregnancy of PE group showed a continuous downward trend, while the control group was V-shaped trend. The receiver operating characteristic (ROC) curve analysis showed that PE could be early warned by the decrease of HSA level in PE group [area under curve (AUC)=0.742, cut-off value=5.97 g/L, sensitivity 70.8%, specificity 62.8%], the same result was in severe PE (AUC=0.756, cut-off value=6.85 g/L, sensitivity 70.8%, specificity 72.0%). The level of HSA was negatively correlated with the incidence of complications (r=-0.19, P<0.01). Conclusions: Excessive decrease of HSA level is an early warning factor for PE onset. The higher the baseline of HSA level and the greater the extent of pregnancy decline, the risk of PE in pregnant women is higher. The lower of HSA level in PE, the incidence of complications is higher. The excessive decrease of HSA level may be the first clinical manifestation before the onset of clinical symptoms of PE, so it may be the warning factor and one of the laboratory indicators in the PE sub-clinical stage.


Asunto(s)
Preeclampsia/diagnóstico , Albúmina Sérica Humana/análisis , Biomarcadores/sangre , Estudios de Casos y Controles , Femenino , Humanos , Preeclampsia/sangre , Embarazo , Primer Trimestre del Embarazo , Tercer Trimestre del Embarazo , Curva ROC
7.
West Afr J Med ; 37(1): 246-252, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32030711

RESUMEN

BACKGROUND: Clinical evidence had suggested that hyperhomocysteinaemia features in hypertensive disorders of pregnancy. However, there is still conflicting evidence on the extent to which elevated maternal homocysteine contributes to this deadly complication of pregnancy. OBJECTIVES: This study investigated the impact of elevated maternal homocysteine levels in early pregnancy on preeclampsia and its severity among Nigerian women in Lagos. METHODS: This was a prospective cohort study conducted at the Lagos University Teaching Hospital. Participants were enrolled in the first trimester of pregnancy following which their sociodemographic data were obtained by interview. Venous blood samples were collected for measurement of homocysteine concentration using the ELISA method. Data on the occurrence of preeclampsia was obtained from the delivery records. Binary logistic regression model was used to study the effects of the major baseline characteristics on the development of preeclampsia. RESULTS: The final analysis included 167 patients; hyperhomocysteinaemia was recorded in 24 (24.6%) patients. Women with hyperhomocysteinaemia had no statistically significant risk of developing preeclampsia or severe preeclampsia, compared with women with a normal homocysteine concentration. CONCLUSION: The prevalence of hyperhomocysteinaemia in the study was relatively low. The absence of a significant association between maternal hyperhomocysteinaemia and preeclampsia reported in this study could create room for the conduct of a more robust, adequately powered longitudinal research needed to answer some of the major reservations that remain from the present study.


Asunto(s)
Homocisteína/sangre , Hiperhomocisteinemia/complicaciones , Preeclampsia/diagnóstico , Adulto , Biomarcadores/sangre , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Hiperhomocisteinemia/epidemiología , Nigeria/epidemiología , Preeclampsia/sangre , Preeclampsia/epidemiología , Embarazo , Prevalencia , Estudios Prospectivos , Índice de Severidad de la Enfermedad
9.
Nat Rev Neurol ; 16(3): 154-170, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32080393

RESUMEN

Neuromyelitis optica spectrum disorders (NMOSD) are a type of neurological autoimmune disease characterized by attacks of CNS inflammation that are often severe and predominantly affect the spinal cord and optic nerve. The majority of individuals with NMOSD are women, many of whom are of childbearing age. Although NMOSD are rare, several small retrospective studies and case reports have indicated that pregnancy can worsen disease activity and might contribute to disease onset. NMOSD disease activity seems to negatively affect pregnancy outcomes. Moreover, some of the current NMOSD treatments are known to pose risks to the developing fetus and only limited safety data are available for others. Here, we review published studies regarding the relationship between pregnancy outcomes and NMOSD disease activity. We also assess the risks associated with using disease-modifying therapies for NMOSD during the course of pregnancy and breastfeeding. On the basis of the available evidence, we offer recommendations regarding the use of these therapies in the course of pregnancy planning in individuals with NMOSD.


Asunto(s)
Anomalías Inducidas por Medicamentos , Aborto Espontáneo/inducido químicamente , Factores Inmunológicos/efectos adversos , Neuromielitis Óptica/tratamiento farmacológico , Neuromielitis Óptica/inmunología , Complicaciones del Trabajo de Parto/inducido químicamente , Preeclampsia/inducido químicamente , Adulto , Femenino , Humanos , Embarazo
10.
Medicine (Baltimore) ; 99(3): e18740, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011454

RESUMEN

To investigate the interaction between the single nucleotide polymorphism of the 3' untranslated region (3'UTR) of the pentraxin 3 (PTX3) gene, as well as environmental factors and the preeclampsia risk in a Chinese Han population.Sanger sequencing was used to analyze rs5853783 and rs73158510 loci of the PTX3 gene 3'UTR from 235 patients with preeclampsia and 235 control subjects. The plasma PTX3 protein level was measured by enzyme-linked immunosorbent assay (ELISA).The risk of preeclampsia in the PTX3 gene rs5853783 locus D allele carriers was 0.72 times higher than that of the I allele carriers (95% CI: 0.60-0.84, P < .001). The risk of preeclampsia in the PTX3 gene rs73158510 locus A allele carriers was 1.36 times higher than in the G allele carriers (95% CI: 1.16-1.55, P < .001). The area under the ROC curve (AUC) for the diagnosis of preeclampsia by plasma PTX3 protein levels was 0.906 (P < .001). The PTX3 gene rs5853783 and rs73158510 single nucleotide polymorphisms (SNPs) were associated with plasma PTX3 protein levels. The AUC of plasma PTX3 protein level diagnosis of preeclampsia in PTX3 gene rs5853783 locus II genotype subjects was up to 0.9371, followed by the ID genotype (AUC = 0.8586); the DD genotype was the lowest (AUC = 0.8154). The AUC of plasma PTX3 protein level diagnosis of preeclampsia in rs73158510 locus GG genotype subjects was 0.9102, GA genotype was 0.8766, and AA genotype was 0.8750.The rs5853783 and rs73158510 SNPs in the 3'UTR region of the PTX3 gene are associated with the risk of preeclampsia in a Chinese Han population.


Asunto(s)
Regiones no Traducidas 3'/genética , Proteína C-Reactiva/genética , Polimorfismo de Nucleótido Simple , Preeclampsia/genética , Componente Amiloide P Sérico/genética , Adolescente , Adulto , Alelos , Grupo de Ascendencia Continental Asiática , China/etnología , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Preeclampsia/etnología , Embarazo , Factores de Riesgo
13.
Lancet ; 395(10221): 335, 2020 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-32007161
14.
Lancet ; 395(10221): 335-336, 2020 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-32007162
15.
BMJ ; 368: m237, 2020 02 19.
Artículo en Inglés | MEDLINE | ID: mdl-32075794

RESUMEN

OBJECTIVE: To evaluate the risk of adverse maternal and infant outcomes following in utero exposure to duloxetine. DESIGN: Cohort study nested in the Medicaid Analytic eXtract for 2004-13. SETTING: Publicly insured pregnancies in the United States. PARTICIPANTS: Pregnant women 18 to 55 years of age and their liveborn infants. INTERVENTIONS: Duloxetine exposure during the etiologically relevant time window, compared with no exposure to duloxetine, exposure to selective serotonin reuptake inhibitors, exposure to venlafaxine, and exposure to duloxetine before but not during pregnancy. MAIN OUTCOME MEASURES: Congenital malformations overall, cardiac malformations, preterm birth, small for gestational age infant, pre-eclampsia, and postpartum hemorrhage. RESULTS: Cohort sizes ranged from 1.3 to 4.1 million, depending on the outcome. The number of women exposed to duloxetine varied by cohort and exposure contrast and was around 2500-3000 for early pregnancy exposure and 900-950 for late pregnancy exposure. The base risk per 1000 unexposed women was 36.6 (95% confidence interval 36.3 to 36.9) for congenital malformations overall, 13.7 (13.5 to 13.9) for cardiovascular malformations, 107.8 (107.3 to 108.3) for preterm birth, 20.4 (20.1 to 20.6) for small for gestational age infant, 33.6 (33.3 to 33.9) for pre-eclampsia, and 23.3 (23.1 to 23.4) for postpartum hemorrhage. After adjustment for measured potential confounding variables, all baseline characteristics were well balanced for all exposure contrasts. In propensity score adjusted analyses versus unexposed pregnancies, the relative risk was 1.11 (95% confidence interval 0.93 to 1.33) for congenital malformations overall and 1.29 (0.99 to 1.68) for cardiovascular malformations. For preterm birth, the relative risk was 1.01 (0.92 to 1.10) for early exposure and 1.19 (1.04 to 1.37) for late exposure. For small for gestational age infants the relative risks were 1.14 (0.92 to 1.41) and 1.20 (0.83 to 1.72) for early and late pregnancy exposure, respectively, and for pre-eclampsia they were 1.12 (0.96 to 1.31) and 1.04 (0.80 to 1.35). The relative risk for postpartum hemorrhage was 1.53 (1.08 to 2.18). Results from sensitivity analyses were generally consistent with the findings from the main analyses. CONCLUSIONS: On the basis of the evidence available to date, duloxetine is unlikely to be a major teratogen but may be associated with an increased risk of postpartum hemorrhage and a small increased risk of cardiac malformations. While continuing to monitor the safety of duloxetine as data accumulate over time, these potential small increases in risk of relatively uncommon outcomes must be weighed against the benefits of treating depression and pain during pregnancy in a given patient. TRIAL REGISTRATION: EUPAS 15946.


Asunto(s)
Clorhidrato de Duloxetina/efectos adversos , Complicaciones del Embarazo/tratamiento farmacológico , Resultado del Embarazo/epidemiología , Inhibidores de Captación de Serotonina y Norepinefrina/efectos adversos , Anomalías Inducidas por Medicamentos/epidemiología , Anomalías Inducidas por Medicamentos/etiología , Adolescente , Adulto , Estudios de Cohortes , Clorhidrato de Duloxetina/uso terapéutico , Femenino , Cardiopatías Congénitas/inducido químicamente , Cardiopatías Congénitas/epidemiología , Humanos , Recién Nacido Pequeño para la Edad Gestacional , Persona de Mediana Edad , Hemorragia Posparto/inducido químicamente , Hemorragia Posparto/epidemiología , Preeclampsia/inducido químicamente , Embarazo , Complicaciones del Embarazo/epidemiología , Nacimiento Prematuro/inducido químicamente , Nacimiento Prematuro/epidemiología , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , Efectos Tardíos de la Exposición Prenatal/epidemiología , Inhibidores de Captación de Serotonina y Norepinefrina/uso terapéutico , Estados Unidos/epidemiología , Adulto Joven
16.
Life Sci ; 244: 117306, 2020 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-31953159

RESUMEN

AIMS: Accumulated evidence indicates that the dysregulation of circular RNAs (circRNAs) plays pivotal roles in many human diseases including preeclampsia (PE). Circ_0063517 has been verified to be down-regulated in PE. But the role of circ_0063517 in PE is still unclear. This research aims to probe into the effect of circ_0063517 on angiogenesis in PE development. MAIN METHODS: The expression of circ_0063517, endothelin receptor type B (ETBR) and miR-31-5p was assessed by quantitative reverse transcription polymerase chain reaction (RT-qPCR). MTT assay, colony formation assay, scratch assay, transwell assay, and tube formation assay were performed to detect proliferation, migration, and angiogenesis, respectively. Dual luciferase reporter system and RNA immunoprecipitation (RIP) assay were carried out to determine the interaction between miR-31-5p and circ_0063517(or ETBR). ETBR, VEGFRA, and VEGFR2 levels were detected by western blot analysis. The effect of circ_0063517 and ETBR on angiogenesis was evaluated in N-nitro-L-arginine methyl ester hydrochloride (L-NAME)-induced PE in vivo. KEY FINDINGS: The levels of circ_0063517 and ETBR were down-regulated in the placenta tissue of PE patients. Conversely, the level of miR-31-5p was up-regulated in PE. Overexpression of circ_0063517 or knockdown of miR-31-5p facilitated growth, migration, and angiogenesis of vascular endothelial cells. Circ_0063517 knockdown-induced repression of the expression of ETBR, VEGFA, and VEGFR2 was partly counteracted by ETBR overexpression. Mechanistically, circ_0063517 sponged miR-31-5p to regulate ETBR expression. Finally, circ_0063517 promoted angiogenesis via enhancing ETBR expression in PE in vivo. SIGNIFICANCE: Our findings suggest that circ_0063517-miR-31-5p-ETBR axis regulates angiogenesis during the pathological process of PE.


Asunto(s)
MicroARNs/metabolismo , Preeclampsia/metabolismo , Receptor de Endotelina B/metabolismo , Animales , Línea Celular , Proliferación Celular/fisiología , Células Endoteliales/metabolismo , Femenino , Células Endoteliales de la Vena Umbilical Humana , Humanos , MicroARNs/genética , Neovascularización Patológica/genética , Preeclampsia/genética , Embarazo , Ratas , Ratas Sprague-Dawley
17.
Clin Sci (Lond) ; 134(2): 289-302, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-31961431

RESUMEN

Preeclampsia (PE) is regarded as a pregnancy-associated hypertension disorder that is related to excessive inflammatory responses. Although the gut microbiota (GM) and short-chain fatty acids (SCFAs) have been related to hypertension, their effects on PE remain unknown. We determined the GM abundance and faecal SCFA levels by 16S ribosomal RNA (rRNA) sequencing and gas chromatography, respectively, using faecal samples from 27 patients with severe PE and 36 healthy, pregnant control subjects. We found that patients with PE had significantly decreased GM diversity and altered GM abundance. At the phylum level, patients with PE exhibited decreased abundance of Firmicutes albeit increased abundance of Proteobacteria; at the genus level, patients with PE had lower abundance of Blautia, Eubacterium_rectale, Eubacterium_hallii, Streptococcus, Bifidobacterium, Collinsella, Alistipes, and Subdoligranulum, albeit higher abundance of Enterobacter and Escherichia_Shigella. The faecal levels of butyric and valeric acids were significantly decreased in patients with PE and significantly correlated with the above-mentioned differential GM abundance. We predicted significantly increased abundance of the lipopolysaccharide (LPS)-synthesis pathway and significantly decreased abundance of the G protein-coupled receptor (GPCR) pathway in patients with PE, based on phylogenetic reconstruction of unobserved states (PICRUSt). Finally, we evaluated the effects of oral butyrate on LPS-induced hypertension in pregnant rats. We found that butyrate significantly reduced the blood pressure (BP) in these rats. In summary, we provide the first evidence linking GM dysbiosis and reduced faecal SCFA to PE and demonstrate that butyrate can directly regulate BP in vivo, suggesting its potential as a therapeutic agent for PE.


Asunto(s)
Ácidos Grasos Volátiles/análisis , Microbioma Gastrointestinal/fisiología , Hipertensión/fisiopatología , Preeclampsia/fisiopatología , Adulto , Animales , Bacterias/clasificación , Bacterias/genética , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Butiratos/administración & dosificación , Butiratos/análisis , Butiratos/metabolismo , Ácidos Grasos Volátiles/metabolismo , Heces/química , Heces/microbiología , Femenino , Microbioma Gastrointestinal/efectos de los fármacos , Microbioma Gastrointestinal/genética , Humanos , Hipertensión/metabolismo , Hipertensión/microbiología , Ácidos Pentanoicos/análisis , Ácidos Pentanoicos/metabolismo , Dinámica Poblacional , Preeclampsia/metabolismo , Preeclampsia/microbiología , Embarazo , ARN Ribosómico 16S/genética , Ratas Sprague-Dawley
18.
Gene ; 733: 144358, 2020 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-31935507

RESUMEN

PURPOSE: Identification the genetic factors in preeclampsia (PE) are useful to increase the current knowledge of the pathophysiology of the disorder. The genetic factors implicated for all cases of PE remain to be determined. This study was aimed to investigate association between ADD1 1378G > T, AGTR2 1675G > A, AGTR1 1166A > C, NOS3 894 G > T and CYP11B2 -344C > T gene polymorphisms in Iranian women with PE. MATERIAL AND METHODS: 117 pregnant women with PE and 103 healthy women without affected previous pregnancy by PE were selected. Genomic DNA was extracted from peripheral blood and real-time PCR was performed to investigate the polymorphisms using a commercial kit. RESULTS: There was a significant difference in CYP11B2 -344C > T gene polymorphism between case and control groups (P = 0.025). The odds ratio was 0.71 (CI 95% = 0.28-1.79). There were no statistical significant differences between other genetic polymorphisms. CONCLUSION: Our results showed a significant association between CYP11B2 -344C > T gene polymorphism with PE. This finding suggests that mentioned polymorphism may be associated with susceptibility to PE at least in IRAN.


Asunto(s)
Citocromo P-450 CYP11B2/genética , Preeclampsia/genética , Adulto , Alelos , Estudios de Casos y Controles , Citocromo P-450 CYP11B2/metabolismo , Femenino , Frecuencia de los Genes/genética , Estudios de Asociación Genética/métodos , Predisposición Genética a la Enfermedad/genética , Genotipo , Humanos , Irán/epidemiología , Oportunidad Relativa , Polimorfismo Genético/genética , Preeclampsia/fisiopatología , Embarazo
19.
Lancet ; 395(10220): 285-293, 2020 01 25.
Artículo en Inglés | MEDLINE | ID: mdl-31982074

RESUMEN

BACKGROUND: Preterm birth remains a common cause of neonatal mortality, with a disproportionately high burden in low-income and middle-income countries. Meta-analyses of low-dose aspirin to prevent pre-eclampsia suggest that the incidence of preterm birth might also be decreased, particularly if initiated before 16 weeks of gestation. METHODS: ASPIRIN was a randomised, multicountry, double-masked, placebo-controlled trial of low-dose aspirin (81 mg daily) initiated between 6 weeks and 0 days of pregnancy, and 13 weeks and 6 days of pregnancy, in nulliparous women with an ultrasound confirming gestational age and a singleton viable pregnancy. Participants were enrolled at seven community sites in six countries (two sites in India and one site each in the Democratic Republic of the Congo, Guatemala, Kenya, Pakistan, and Zambia). Participants were randomly assigned (1:1, stratified by site) to receive aspirin or placebo tablets of identical appearance, via a sequence generated centrally by the data coordinating centre at Research Triangle Institute International (Research Triangle Park, NC, USA). Treatment was masked to research staff, health providers, and patients, and continued until 36 weeks and 7 days of gestation or delivery. The primary outcome of incidence of preterm birth, defined as the number of deliveries before 37 weeks' gestational age, was analysed in randomly assigned women with pregnancy outcomes at or after 20 weeks, according to a modified intention-to-treat (mITT) protocol. Analyses of our binary primary outcome involved a Cochran-Mantel-Haenszel test stratified by site, and generalised linear models to obtain relative risk (RR) estimates and associated confidence intervals. Serious adverse events were assessed in all women who received at least one dose of drug or placebo. This study is registered with ClinicalTrials.gov, NCT02409680, and the Clinical Trial Registry-India, CTRI/2016/05/006970. FINDINGS: From March 23, 2016 to June 30, 2018, 14 361 women were screened for inclusion and 11 976 women aged 14-40 years were randomly assigned to receive low-dose aspirin (5990 women) or placebo (5986 women). 5780 women in the aspirin group and 5764 in the placebo group were evaluable for the primary outcome. Preterm birth before 37 weeks occurred in 668 (11·6%) of the women who took aspirin and 754 (13·1%) of those who took placebo (RR 0·89 [95% CI 0·81 to 0·98], p=0·012). In women taking aspirin, we also observed significant reductions in perinatal mortality (0·86 [0·73-1·00], p=0·048), fetal loss (infant death after 16 weeks' gestation and before 7 days post partum; 0·86 [0·74-1·00], p=0·039), early preterm delivery (<34 weeks; 0·75 [0·61-0·93], p=0·039), and the incidence of women who delivered before 34 weeks with hypertensive disorders of pregnancy (0·38 [0·17-0·85], p=0·015). Other adverse maternal and neonatal events were similar between the two groups. INTERPRETATION: In populations of nulliparous women with singleton pregnancies from low-income and middle-income countries, low-dose aspirin initiated between 6 weeks and 0 days of gestation and 13 weeks and 6 days of gestation resulted in a reduced incidence of preterm delivery before 37 weeks, and reduced perinatal mortality. FUNDING: Eunice Kennedy Shriver National Institute of Child Health and Human Development.


Asunto(s)
Aspirina/administración & dosificación , Preeclampsia/epidemiología , Nacimiento Prematuro/epidemiología , Adolescente , Adulto , Aspirina/efectos adversos , Presión Sanguínea , Parto Obstétrico/estadística & datos numéricos , Países en Desarrollo , Método Doble Ciego , Femenino , Humanos , Preeclampsia/prevención & control , Embarazo , Resultado del Embarazo/epidemiología , Nacimiento Prematuro/prevención & control , Adulto Joven
20.
BMJ ; 368: l6779, 2020 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-31941696

RESUMEN

The studyChappell LC, Brocklehurst P, Green ME, et al. Planned early delivery or expectant management for late preterm pre-eclampsia (PHOENIX): a randomised controlled trial. Lancet 2019;394:1181-90.This project was funded by the NIHR Health Technology Assessment Programme (project number 12/25/03).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000838/mothers-benefit-from-a-planned-earlier-delivery-for-late-pre-eclampsia.


Asunto(s)
Preeclampsia , Nacimiento Prematuro , Femenino , Humanos , Recién Nacido , Madres , Embarazo , Evaluación de la Tecnología Biomédica , Espera Vigilante
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA