The relationship between the onset of labor mechanisms and the hemostatic system

Golgi Reassembly Stacking Protein 2 Modulates Myometrial Contractility during Labor by Affecting ATP Production

The mechanism of maintaining myometrial contractions during labor remains unclear. Autophagy has been reported to be activated in laboring myometrium, along with the high expression of Golgi reassembly stacking protein 2 (GORASP2), a protein capable of regulating autophagy activation. This study aimed to investigate the role and mechanism of GORASP2 in uterine contractions during labor. Western blot confirmed the increased expression of GORASP2 in laboring myometrium. Furthermore, the knockdown of GORASP2 in primary human myometrial smooth muscle cells (hMSMCs) using siRNA resulted in reduced cell contractility. This phenomenon was independent of the contraction-associated protein and autophagy. Differential mRNAs were analyzed using RNA sequencing. Subsequently, KEGG pathway analysis identified that GORASP2 knockdown suppressed several energy metabolism pathways. Furthermore, reduced ATP levels and aerobic respiration impairment were observed in measuring the oxygen consumption rate (OCR). These findings suggest that GORASP2 is up-regulated in the myometrium during labor and modulates myometrial contractility mainly by maintaining ATP production.

Neonatal DNA methylation patterns associate with gestational age

Risk for adverse neonatal outcome increases with declining gestational age (GA), and changes in DNA methylation may contribute to the relationship between GA and adverse health outcomes in offspring. To test this hypothesis, we evaluated the association between GA and more than 27,000 CpG sites in neonatal DNA extracted from umbilical cord blood from two prospectively-characterized cohorts: (1) a discovery cohort consisting of 259 neonates from women with a history of neuropsychiatric disorders and (2) a replication cohort consisting of 194 neonates of uncomplicated mothers. GA was determined by obstetrician report and maternal last menstrual period. The associations between proportion of DNA methylated and GA were evaluated by fitting a separate linear mixed effects model for each CpG site, adjusting for relevant covariates including neonatal sex, race, parity, birth weight percentile and chip effects. CpG sites in 39 genes were associated with GA (false discovery rate < 0.05) in the discovery cohort. The same CpG sites in 25 of these genes replicated in the replication cohort, with each association replicating in the same direction. Notably, these CpG sites were located in genes previously implicated in labor and delivery (e.g., AVP, OXT, CRHBP and ESR1) or that may influence the risk for adverse health outcomes later in life (e.g., DUOX2, TMEM176A and CASP8). All associations were independent of method of delivery or induction of labor. These results suggest neonatal DNA methylation varies with GA even in term deliveries. The potential contribution of these changes to clinically significant postnatal outcomes warrants further investigation.

Clinical application of the PFA-100

The PFA-100 (platelet function analyzer) is a relatively new tool for the investigation of primary hemostasis. Recent studies have shown its utility as a screening tool for investigating possible von Willebrand disorder (VWD) and various platelet disorders. More recently, the PFA-100 has been shown to be valuable in monitoring desmopressin acetate (DDAVP) therapy in both VWD and platelet disorders. The PFA-100 has also been evaluated in many other studies for its utility in assessing drug effects, for potential monitoring of antiplatelet medication (including aspirin), or for evaluation of overall primary hemostasis in various clinical disorders or during surgical procedures. This article reviews current findings and highlights the benefits and limitations of the clinical utility of the PFA-100. Ultimately, the greatest strengths of the PFA-100 are its simplicity of use and excellent sensitivity to particular hemostatic disturbances such as VWD, platelet disorders, and platelet-affecting medication. However, because it is thus a global test system, this also creates a significant limitation because the PFA-100 is not specific for, nor predictive of, any particular disorder. However, used appropriately, the PFA-100 can be considered a worthwhile addition to any hemostasis laboratory involved in the diagnosis or therapeutic monitoring of bleeding disorders and potentially of antiplatelet medication. This review should be valuable to both hemostasis scientists and clinical specialists.

Utility of the PFA-100 for assessing bleeding disorders and monitoring therapy: a review of analytical variables, benefits and limitations

The PFA-100 (platelet function analyser) is a relatively new tool for the investigation of primary haemostasis. Recent studies have shown its utility in monitoring antiplatelet therapy (including aspirin) and as a screening tool for investigating possible von Willebrand disease (vWD) and various platelet disorders. More recently, the PFA-100 has been shown to be of value in monitoring DDAVP therapy in both vWD and platelet disorders. This paper reviews current findings, details the utility of the PFA-100 for some of these purposes, as well as reviewing analytical variables that may complicate the interpretation of results. The author highlights the benefits, as well as noting the limitations, of its use. Ultimately, the greatest strengths of the PFA-100 are its simplicity in use and excellent sensitivity to particular haemostatic disturbances such as vWD, platelet disorders and platelet-affecting medication. However, because it is thus a 'global' test system, this also creates a significant limitation, as the PFA-100 is not specific for, nor predictive of, any particular disorder. However, utilized appropriately, the PFA-100 can be considered a worthwhile addition to any haemostasis laboratory involved in the diagnosis or therapeutic-monitoring of bleeding disorders including vWD and platelet-dysfunctions. This review should be of value to both haemostasis scientists and clinical specialists.