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1.
Nutrients ; 13(7)2021 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-34371873

RESUMO

Menopause, probably the most important natural change in a woman's life and a major component of female senescence, is characterized, inter alia, by cessation of ovarian estrogen and progesterone production, resulting in a gradual deterioration of the female immune system. Hormone replacement therapy (HRT) is used in postmenopausal women to relieve some of the peri- and postmenopausal symptoms, while there is also evidence that the therapy may additionally partially reverse menopausal immune senescence. Flavonoids, and especially isoflavones, are widely used for the treatment of menopausal symptoms, although it is not at present clear whether they can reverse or alleviate other menopausal changes. HRT reverses the menopausal CD4/CD8 ratio and also limits the general peri- and postmenopausal inflammatory state. Moreover, the increased levels of interleukins (IL)-1ß, IL-6, and IL-8, as well as of tumor necrosis factor-α (TNF-α) are decreased after the initiation of HRT. However, some reports show no effect of HRT on IL-4, IL-10, and IL-12. It is thus evident that the molecular pathways connecting HRT and female immune senescence need to be clarified. Interestingly, recent studies have suggested that the anti-inflammatory properties of isoflavones possibly interact with inflammatory cytokines when applied in menopause treatments, thereby potentially reversing immune senescence. This narrative review presents the latest data on the effect of menopausal therapies, including administration of flavonoid-rich products, on age-associated immune senescence reversal with the aim of revealing possible directions for future research and treatment development.


Assuntos
Anti-Inflamatórios/uso terapêutico , Flavonoides/uso terapêutico , Terapia de Reposição Hormonal , Sistema Imunitário/efeitos dos fármacos , Imunossenescência/efeitos dos fármacos , Menopausa/efeitos dos fármacos , Fitoestrógenos/uso terapêutico , Fatores Etários , Animais , Anti-Inflamatórios/efeitos adversos , Citocinas/metabolismo , Feminino , Flavonoides/efeitos adversos , Terapia de Reposição Hormonal/efeitos adversos , Humanos , Sistema Imunitário/imunologia , Sistema Imunitário/metabolismo , Mediadores da Inflamação/metabolismo , Menopausa/imunologia , Menopausa/metabolismo , Fitoestrógenos/efeitos adversos , Fatores Sexuais
2.
Nutrients ; 13(7)2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34371934

RESUMO

Bisphenol A (BPA), a ubiquitous endocrine-disrupting chemical (EDC), is increasingly hypothesized to be a factor contributing to changes in fetal growth velocity. BPA exposure may be environmental, occupational, and/or dietary, with canned foods and plastic bottles contributing significantly. Our systematic review aims to evaluate the current literature and to investigate the role of BPA in abnormal fetal growth patterns. A search was conducted in the PubMed and Cochrane databases. A total of 25 articles met the eligibility criteria and were included in this systematic review. Eleven of them failed to show a clear relationship between BPA and abnormal fetal growth. The majority of the remaining studies (9/14) found an inverse association of BPA with indicators of fetal growth, whereas three studies suggested increased fetal growth, and two studies produced contradictory findings. Of note, both of the studies that collected a sample (amniotic fluid) directly reflecting BPA concentration in the fetus during the first half of pregnancy revealed an inverse association with birth weight. In conclusion, there is mounting evidence that combined exposure to BPA from dietary and non-dietary sources during pregnancy may contribute to abnormal fetal growth; a tendency towards fetal growth restriction was shown, especially when exposure occurs during the first half.


Assuntos
Compostos Benzidrílicos/efeitos adversos , Disruptores Endócrinos/efeitos adversos , Exposição Ambiental/efeitos adversos , Desenvolvimento Fetal/efeitos dos fármacos , Retardo do Crescimento Fetal/induzido quimicamente , Fenóis/efeitos adversos , Animais , Peso ao Nascer/efeitos dos fármacos , Exposição Dietética/efeitos adversos , Feminino , Retardo do Crescimento Fetal/fisiopatologia , Contaminação de Alimentos , Embalagem de Alimentos , Idade Gestacional , Humanos , Recém-Nascido , Gravidez , Medição de Risco , Fatores de Risco
3.
J Matern Fetal Neonatal Med ; : 1-14, 2021 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-33467971

RESUMO

Fetuses that have not achieved their full growth potential are associated with adverse perinatal and long-term outcomes; thus, it is essential to identify environmental factors that can potentially impair normal intrauterine development. Endocrine disrupting compounds (EDCs), substances capable of altering the homeostasis of the endocrine system, are thought to play a role in restriction of growth velocity, with phthalates being among the most common EDCs to which pregnant women are exposed. Such exposure can potentially lead to changes to the epigenome, placental structure, and hormone function and trigger oxidative stress. Given that these pathways have been linked to fetal growth restriction, we reviewed the literature on the relationship between phthalates and fetal growth. The majority of the studies, which used birth weight as an indicator of intrauterine development, showed contradictory results, the main reason being the EDCs' rapid metabolism. However, we can draw more consistent conclusions when phthalates are quantified at more than one time point during pregnancy. In this narrative review, we present current data indicating the role of phthalates, and especially di-(2-ethylhexyl) phthalate (DEHP), in abnormal fetal growth velocity.

5.
J Clin Med ; 9(5)2020 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-32397539

RESUMO

This study aims to evaluate the natural history, disease progression, and outcomes in dichorionic twins with selective fetal growth restriction (sFGR) according to different diagnostic criteria and time of onset. Dichorionic twins seen from the first trimester were included. sFGR was classified according to the Delphi consensus, and was compared to the outcomes of those classified by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) diagnostic criteria. Early sFGR occurred before 32-weeks, and late sFGR after 32-weeks. Disease progression, neonatal outcomes such as gestation at delivery, birthweight, neonatal unit (NNU) admission, and morbidities were compared. One-hundred twenty-three of 1053 dichorionic twins had sFGR, where 8.4% were classified as early sFGR, and 3.3% were late sFGR. Disease progression was seen in 36%, with a longer progression time (5 vs. 1 week) and higher progression rate (40% vs. 26%) in early sFGR. Perinatal death was significantly higher in the sFGR than the non-sFGR group (24 vs. 16 per 1000 births, p = 0.018), and those with early sFGR had more NNU admissions than late sFGR (p = 0.005). The ISUOG diagnostic criteria yielded a higher number of sFGR than the Delphi criteria, but similar outcomes. sFGR have worse perinatal outcomes, with early onset being more prevalent. Use of the Delphi diagnostic criteria can reduce over-diagnosis of sFGR and avoid unnecessary intervention.

6.
Mediators Inflamm ; 2018: 8476217, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30622436

RESUMO

The development of the fetal nervous system mirrors general fetal development, comprising a combination of genetic resources and effects of the intrauterine environment. Our aim was to assess the 2nd trimester amniotic fluid levels of brain-derived neurotrophic factor (BDNF) and to investigate its association with fetal growth. In accordance with our study design, samples of amniotic fluid were collected from women who had undergone amniocentesis early in the 2nd trimester. All pregnancies were followed up until delivery and fetal growth patterns and birth weights were recorded, following which pregnancies were divided into three groups based on fetal weight: (1) AGA (appropriate for gestational age), (2) SGA (small for gestational age), and (3) LGA (large for gestational age). We focused on these three groups representing a reflection of the intrauterine growth spectrum. Our results revealed the presence of notably higher BDNF levels in the amniotic fluid of impaired growth fetuses by comparison with those of normal growth. Both SGA and macrosomic fetuses are characterized by notably higher amniotic fluid levels of BDNF (mean values of 36,300 pg/ml and 35,700 pg/ml, respectively) compared to normal-growth fetuses (mean value of 32,700 pg/ml). Though apparently small, this difference is, nevertheless, statistically significant (p value < 0.05) in SGA fetuses in the extremes of the distribution, i.e., below the 3rd centile. In conclusion, there is clear evidence that severe impairment of fetal growth induces the increased production of fetal brain growth factor as an adaptive mechanism in reaction to a hostile intrauterine environment, thereby accelerating fetal brain development and maturation.


Assuntos
Líquido Amniótico/metabolismo , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Trimestres da Gravidez/metabolismo , Peso ao Nascer/genética , Peso ao Nascer/fisiologia , Feminino , Desenvolvimento Fetal/genética , Desenvolvimento Fetal/fisiologia , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Gravidez
7.
Mol Syndromol ; 9(1): 52-57, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29456484

RESUMO

Holoprosencephaly (HPE) spectrum disorder is the most common congenital malformation of the human brain with absence of or incomplete midline cleavage. Its cause is heterogenic, making genetic counseling a challenge. In this case report, a pregnancy affected by alobar HPE is described. Using aCGH, an 8.9-Mb deletion at 7q36.1q36.3 together with a 4.9-Mb duplication at 12q24.32q24.33 is assumed to be the possible reason for this alobar HPE case. It is discussed that disruption of key elements of the developing brain, taking environmental factors into account, contributes to the HPE spectrum. The use of aCGH for invasive prenatal testing is starting to become the standard technique, providing accurate information about the cause of congenital diseases for couples receiving genetic counseling.

8.
Int J Gynaecol Obstet ; 125(2): 146-9, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24556088

RESUMO

OBJECTIVE: To determine whether the risk of hypertensive complications differs among low-risk women who undergo prenatal diagnosis via chorionic villus sampling (CVS) and amniocentesis. METHODS: In a retrospective study, data were analyzed from women who underwent prenatal diagnosis by CVS or amniocentesis at Alexandra Maternity Hospital, Athens, Greece, between 1998 and 2011. All women had either transabdominal CVS at 10-13 weeks of pregnancy with a 20-gauge needle, or amniocentesis at 17-21 weeks with a 22-gauge needle, both under direct ultrasound guidance. Only women who had cytogenetically normal pregnancies and delivered at the study hospital were included. The main outcome measure was the development of hypertensive complications. RESULTS: Overall, 3243 women who underwent CVS and 6875 woman who underwent amniocentesis met the inclusion criteria, and their outcomes were analyzed. In total, 237 women (2.3%) developed hypertensive disorders during their pregnancy. The incidence of pre-eclampsia (2.4% vs. 0.8%) and total hypertensive disorders (3.8% vs. 1.7%) was significantly higher (P<0.001) in the CVS group than in the amniocentesis group. CONCLUSION: Women who underwent CVS had a significantly higher risk of developing hypertensive disorders in comparison to those who underwent amniocentesis. This finding warrants further investigation via a well-designed prospective randomized trial.


Assuntos
Amniocentese/efeitos adversos , Amostra da Vilosidade Coriônica/efeitos adversos , Pré-Eclâmpsia/epidemiologia , Adulto , Feminino , Grécia/epidemiologia , Humanos , Incidência , Pré-Eclâmpsia/etiologia , Gravidez , Estudos Retrospectivos , Fatores de Risco
9.
Clin Infect Dis ; 57(11): 1520-6, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24046313

RESUMO

BACKGROUND: Influenza is associated with an increased risk for serious illness, hospitalization, and mortality in infants aged <6 months. However, influenza vaccines are not licensed for administration in this age group. The study evaluated the effectiveness of postpartum influenza vaccination of mothers and household members in infants. METHODS: The influenza vaccine was offered to mothers and household members of neonates born or hospitalized in 3 hospitals prior to the 2012-2013 season. Mothers were contacted every 2 weeks during the influenza season, and data regarding the onset of fever and/or respiratory symptoms in infants, healthcare seeking, hospitalization, and administration of antibiotics were collected. RESULTS: The study group consisted of 553 mothers who delivered 573 neonates. The influenza vaccine was administered to 841 of 1844 (45.6%) household contacts. Vaccination coverage rates ranged between 41.9% for neonates siblings and 49% for mothers. Five hundred thirty infants were analyzed for vaccine effectiveness. For outcomes in the infant, postpartum maternal vaccination had 37.7% effectiveness against acute respiratory illness (ARI), 50.3% against a febrile episode, 53.5% against influenza-like illness (ILI), 41.8% against related healthcare seeking, and 45.4% against administration of antibiotics. Multiple logistic regression analyses showed that maternal influenza vaccination was significantly associated with a decreased probability for febrile episodes, ARIs, and/or ILIs in infants, related healthcare seeking, and/or administration of antibiotics during the influenza season. Vaccination of other household contacts had no impact. CONCLUSIONS: Maternal postpartum vaccination against influenza was associated with a significant reduction of influenza-related morbidity, healthcare seeking, and antibiotic prescription in infants during the influenza season.


Assuntos
Febre/prevenção & controle , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde , Adolescente , Adulto , Antibacterianos/administração & dosagem , Características da Família , Feminino , Febre/virologia , Grécia/epidemiologia , Humanos , Recém-Nascido , Influenza Humana/epidemiologia , Pessoa de Meia-Idade , Mães/estatística & dados numéricos , Análise Multivariada , Período Pós-Parto , Estudos Prospectivos , Inquéritos e Questionários , Vacinação/psicologia , Adulto Jovem
10.
Exp Diabetes Res ; 2012: 538474, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23227034

RESUMO

Gestational diabetes, occurring during the hyperglycemic period of pregnancy in maternal life, is a pathologic state that increases the incidence of complications in both mother and fetus. Offspring thus exposed to an adverse fetal and early postnatal environment may manifest increased susceptibility to a number of chronic diseases later in life. Compelling evidence for the role of epigenetic transmission in these complications has come from comparison of siblings born before and after the development of maternal diabetes, exposure to this intrauterine diabetic environment being shown to cause alterations in fetal growth patterns which predispose these infants to developing overweight and obesity later in life. Diabetes of the offspring is also mainly the consequence of exposure to the diabetic intrauterine environment, in addition to genetic susceptibility. Since obesity and diabetes are known to increase the risk of cardiovascular disease, cardiovascular sequelae in the offspring of diabetic mothers are virtually inevitable. Research data also suggest that exposure to a diabetic intrauterine environment during pregnancy is associated with an increase in dyslipidemia, subclinical vascular inflammation, and endothelial dysfunction processes in the offspring, all of which are linked with development of cardiovascular disease later in life. The main underlying mechanisms involve persistent hyperglycemia hyperinsulinemia and leptin resistance.


Assuntos
Doenças Cardiovasculares/genética , Diabetes Mellitus Tipo 2/genética , Diabetes Gestacional/genética , Epigênese Genética , Obesidade/genética , Efeitos Tardios da Exposição Pré-Natal , Animais , Glicemia/metabolismo , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/fisiopatologia , Doença Crônica , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/fisiopatologia , Diabetes Gestacional/sangue , Diabetes Gestacional/fisiopatologia , Feminino , Feto/metabolismo , Predisposição Genética para Doença , Humanos , Obesidade/sangue , Fenótipo , Gravidez , Fatores de Risco
11.
Hormones (Athens) ; 11(4): 397-409, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23422762

RESUMO

Considering that preterm birth accounts for about 6-10% of all births in Western countries and of more than 65% of all perinatal deaths, elucidation of the particularly complicated mechanisms of labor is essential for determination of appropriate and effective therapeutic interventions. Labor in humans results from a complex interplay of fetal and maternal factors, which act upon the uterus to trigger pathways leading gradually to a coordinated cervical ripening and myometrial contractility. Although the exact mechanism of labor still remains uncertain, several components have been identified and described in detail. Based on the major role played by the human placenta in pregnancy and the cascade of labor processes activated via placental mediators exerting endocrine, paracrine, and autocrine actions, this review article has aimed at presenting the role of these mediators in term and preterm labor and the molecular pathways of their actions. Some of the aforementioned mediators are involved in myometrial activation and preparation and others in myometrial stimulation leading to delivery. In the early stages of pregnancy, myometrial molecules, like progesterone, nitric oxide, and relaxin, contribute to the retention of pregnancy. At late stages of gestation, fetal hypothalamus maturation signals act on the placenta causing the production of hormones, including CRH, in an endocrine manner; the signals then enhance paracrinically the production of more hormones, such as estrogens and neuropeptides, that contribute to cervical ripening and uterine contractility. These molecules act directly on the myometrium through specific receptors, while cytokines and multiple growth factors are also produced, additionally contributing to labor. In situations leading to preterm labor, as in maternal stress and fetal infection, cytokines trigger placental signaling sooner, thus leading to preterm birth.


Assuntos
Trabalho de Parto/fisiologia , Placenta/fisiologia , Descolamento Prematuro da Placenta/fisiopatologia , Gonadotropina Coriônica/fisiologia , Citocinas/fisiologia , Sistema Endócrino/fisiologia , Feminino , Humanos , Inflamação/fisiopatologia , Peptídeos e Proteínas de Sinalização Intercelular/fisiologia , Neurocinina B/fisiologia , Neuropeptídeo Y/fisiologia , Trabalho de Parto Prematuro/fisiopatologia , Ocitócicos/farmacologia , Gravidez , Prostaglandinas/fisiologia , Contração Uterina/efeitos dos fármacos
12.
Hepatogastroenterology ; 54(78): 1694-700, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18019697

RESUMO

Experiments in animals and population-based studies have shown the efficacy of nonsteroidal antiinflammatory drugs in colorectal cancer prevention. COX-2 is overexpressed in dysplastic and neoplastic epithelium. COX-2 is a key-enzyme in several tumorigenic pathways, such as promotion of tumor angiogenesis. Non-selective inhibition of COX enzyme demonstrates a protective effect as well, suggesting that more than one mechanism takes place in neoplastic transformation. Blockade of COX enzyme by NSAIDs down-regulates its metabolic product prostaglandin E2. Inhibition of PGE2 seems to have a negative effect in cancer occurrence. Induction of apoptosis is another mechanism that explains the protective effect of NSAIDs. The recently discovered PPARdelta factor, is also overexpressed in neoplastic tissue, and may be a mediator through which COX-2 exerts its oncogenic effect.


Assuntos
Anti-Inflamatórios não Esteroides/farmacologia , Anticarcinógenos/farmacologia , Neoplasias do Colo/prevenção & controle , Apoptose , Neoplasias do Colo/epidemiologia , Ciclo-Oxigenase 2/biossíntese , Dinoprostona/metabolismo , Regulação Enzimológica da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Humanos , Neovascularização Patológica , PPAR delta/metabolismo
13.
Hepatogastroenterology ; 54(75): 799-802, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17591066

RESUMO

BACKGROUND/AIMS: The detection of Helicobacter pylori (H. pylori) antigen in stool by conventional ELISA is a reliable non-invasive method for the diagnosis of H. pylori infection in untreated patients. Recently, rapid in-office stool tests have been developed for the same purpose. METHODOLOGY: We have prospectively evaluated the performances of a commercially available enzyme-linked immunoassay (Novitec EIA) and a rapid near-patient immunochromatographic stool test (Stick H. pyl) for the detection of H. pylori stool antigen. Fifty H. pylori positive and 50 negative patients were included. H. pylori infection was diagnosed by using histology, rapid urease test and urea breath test. Patients were classified as positive if two of the three tests were positive and negative if all the three tests were negative. Testing was carried out according to the manufacturer's instructions. RESULTS: Novitec EIA had 8% equivocal results. If they were interpreted as negative the sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy were 82%, 86%, 86%, 83% and 84% and if as positive 88%, 76%, 79%, 86% and 82% respectively. ROC curve analysis showed a cut-off value of 0.144 for our population. The corresponding numbers for this cut-off value were: 82%, 94%, 93%, 84% and 88%. The respective numbers for Stick H. pyl were 78%, 78%, 76%, 78% and 79%. CONCLUSIONS: Novitec EIA performed well in this cohort of Greek patients and demonstrated a high specificity and positive predictive value when we adjusted the cut-off at 0.144. Performance of Stick H. pyl was sub-optimal.


Assuntos
Antígenos de Bactérias/análise , Cromatografia/métodos , Ensaio de Imunoadsorção Enzimática , Fezes/química , Infecções por Helicobacter/diagnóstico , Helicobacter pylori/isolamento & purificação , Feminino , Humanos , Masculino , Sensibilidade e Especificidade
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