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Wind M, Dekker L, van den Akker-van Marle ME, Ballieux BEPB, Cobbaert CM, Rabelink TJ, van Lith JMM, Teng YKO, Sueters M. The addition of the sFlt-1/PlGF ratio to the protein/creatinine ratio in multiple pregnancy: Post-hoc analysis of the PREPARE cohort study. Pregnancy Hypertens 2024; 36:101111. [PMID: 38387424 DOI: 10.1016/j.preghy.2024.101111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/14/2024] [Accepted: 02/11/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE To assess the predictive accuracy of the sFlt-1/PlGF ratio cut-off 38 in addition to the standard-of-care spot urine protein/creatinine ratio (PCr) for multiple pregnancies in women with suspected pre-eclampsia. STUDY DESIGN Post-hoc analysis of a prospective cohort study. MAIN OUTCOME MEASURES Primary outcome was the occurrence of pre-eclampsia in one and four weeks after presentation with suspected pre-eclampsia. Test characteristics with 95% confidence intervals (CI) were calculated on pre-eclampsia development in one and four weeks. RESULTS Twenty-three multiple pregnancies with suspected pre-eclampsia between 20 and 37 weeks gestation were included for analysis. Women who eventually developed pre-eclampsia had a significantly higher PCr (34.0 vs. 16.5, p = 0.015), sFlt-1 (17033 vs. 5270 pg/ml, p = 0.047) and sFlt-1/PlGF ratio (99 vs. 25, p = 0.033) at baseline. Furthermore, PCr ≥ 30 and sFlt-1/PlGF ratio > 38 was respectively seen in 1/16 (6.3 %) and 3/16 (18.8 %) of the women who did not develop pre-eclampsia. For predicting pre-eclampsia within one week the sFlt-1/PlGF ratio sensitivity was 75.0 % [95 % CI 19.4-99.4] and the negative predictive value 93.8 % [73.0-98.8], while no pre-eclampsia developed when PCr was < 30. Consequently, the combination of these tests did not lead to an improvement in test characteristics, with non-significant differences in positive predictive value (50.0 % [29.5-70.5] versus 80.0 % [37.3-96.4]) compared to PCr alone for pre-eclampsia development in one week. CONCLUSIONS In addition to standard-of-care spot urine PCr measurements, this study has not been able to demonstrate that the sFlt-1/PlGF ratio cut-off 38 is of added value in the prediction of pre-eclampsia in multiple pregnancy. TRIAL REGISTRATION Netherlands Trial Register (NL8308).
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Affiliation(s)
- M Wind
- Department of Obstetrics, Leiden University Medical Centre, Leiden, the Netherlands.
| | - L Dekker
- Department of Obstetrics, Leiden University Medical Centre, Leiden, the Netherlands
| | | | - B E P B Ballieux
- Department of Clinical Chemistry, Leiden University Medical Centre, Leiden, the Netherlands
| | - C M Cobbaert
- Department of Clinical Chemistry, Leiden University Medical Centre, Leiden, the Netherlands
| | - T J Rabelink
- Department of Nephrology, Leiden University Medical Centre, Leiden, the Netherlands
| | - J M M van Lith
- Department of Obstetrics, Leiden University Medical Centre, Leiden, the Netherlands
| | - Y K O Teng
- Department of Nephrology, Leiden University Medical Centre, Leiden, the Netherlands
| | - M Sueters
- Department of Obstetrics, Leiden University Medical Centre, Leiden, the Netherlands
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2
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Kumar M, Balyan K, Debnath E, Himtsoe B, Sapna S, Kumar A. Antenatal risk stratification for preeclampsia with sFlt-1/PlGF ratio: Which is the best time to test? Pregnancy Hypertens 2023; 34:39-46. [PMID: 37801800 DOI: 10.1016/j.preghy.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 07/15/2023] [Accepted: 09/21/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVE To find out the predictive value of sFlt-1/PlGF ratio for antenatal risk stratification (ARS) of women at high risk of preeclampsia (PE). METHODS Antenatal women at high risk of PE underwent sFlt-1/PlGF ratio at 20-22, 28-30 and 34-36 weeks and were followed till delivery. Those who developed PE were cases those who had normal outcome were controls, the cases and controls were compared. RESULTS Hypertension in pregnancy was seen in 116/287 (40.4 %), 46/287(16.0 %) had PE and 21(7.3 %) had early onset PE. Mean arterial pressure at 20-22 weeks was the high in those who developed early onset PE (109.08 ± 9.74 mmHg). The sFlt-1/PlGF ratio of 38 or more at 20-22 weeks resulted in either PE or adverse fetal outcome in all cases. Whereas, the ratio of less than 38 ruled out PE in all cases up to 29 + 6 weeks. At 28-30 weeks, the ratio less than 38 predicted no PE up to 34 weeks and no complication up to 29+6 weeks. The sensitivity for the detection at later gestation further decreased as the gestation advanced however the specificity was above 98 % at all gestations. The positive predictive value of the test increased with the advancing gestation, the negative predictive value was 93 % or higher at all gestations. CONCLUSION The usefulness of sFlt-1/PlGF ratio ≥38 for risk stratification was validated in the study, the testing at 28-30 weeks appeared to be the best time to test for PE prediction in high risk women.
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Affiliation(s)
- Manisha Kumar
- Department of Obstetrics and Gynecology, LHMC, New Delhi, India.
| | - Kirti Balyan
- Department of Obstetrics and Gynecology, LHMC, New Delhi, India
| | - Ekta Debnath
- Department of Biochemistry, LHMC, New Delhi, India
| | - Ben Himtsoe
- Department of Obstetrics and Gynecology, LHMC, New Delhi, India
| | - Surbhi Sapna
- Department of Obstetrics and Gynecology, LHMC, New Delhi, India
| | - Arunav Kumar
- Kasturba Medical College, Manipal, Karnataka, India
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Karpova NS, Dmitrenko OP, Budykina TS. Literature Review: The sFlt1/PlGF Ratio and Pregestational Maternal Comorbidities: New Risk Factors to Predict Pre-Eclampsia. Int J Mol Sci 2023; 24:ijms24076744. [PMID: 37047717 PMCID: PMC10095124 DOI: 10.3390/ijms24076744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/13/2023] [Accepted: 03/24/2023] [Indexed: 04/08/2023] Open
Abstract
One of the main causes of maternal and neonatal morbidity and mortality is pre-eclampsia. It is characterized by a high sFlt1/PlGF ratio, according to prior research. Pregestational diseases in mothers may increase the risk of developing pre-eclampsia. Only a few studies have looked at the connection between maternal comorbidities before conception and the sFlt1/PlGF ratio. The most recent information regarding the association between maternal pregestational diseases and the ratio of sFlt1/PlGF is described in this review. The paper also examines current research suggesting that changes in pregnancy hormones and metabolites are related to a high sFlt1/PlGF ratio. Certain maternal disorders have been found to dramatically raise sFlt-1 and sFlt1/PlGF levels, according to an analysis of the literature. There is still debate about the data on the association between the sFlt1/PlGF ratio and maternal disorders such as HIV, acute coronary syndromes, cardiovascular function in the mother between 19 and 23 weeks of pregnancy, thyroid hormones, diabetes, and cancer. Additional research is needed to confirm these findings.
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Affiliation(s)
- Nataliia Sergeevna Karpova
- Federal State Budgetary Institution “Research Institute of Pathology and Pathophysiology”, St. Baltiyskaya, House 8, Moscow 125315, Russia
| | - Olga Pavlovna Dmitrenko
- Federal State Budgetary Institution “Research Institute of Pathology and Pathophysiology”, St. Baltiyskaya, House 8, Moscow 125315, Russia
| | - Tatyana Sergeevna Budykina
- State Budgetary Health Institution of the Moscow Region “Moscow Regional Research Institute of Obstetrics and Gynecology”, St. Pokrovka, d.22a, Moscow 101000, Russia
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Sroka D, Lorenz-Meyer LA, Scherfeld V, Thoma J, Busjahn A, Henrich W, Verlohren S. Comparison of the Soluble fms-Like Tyrosine Kinase 1/Placental Growth Factor Ratio Alone versus a Multi-Marker Regression Model for the Prediction of Preeclampsia-Related Adverse Outcomes after 34 Weeks of Gestation. Fetal Diagn Ther 2023; 50:215-224. [PMID: 36809755 DOI: 10.1159/000529781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 02/03/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION The objective of this retrospective study was to compare the predictive performance of the soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio alone or in a multi-marker regression model for preeclampsia-related maternal and/or fetal adverse outcomes in women >34 weeks of gestation. METHODS We analyzed the data collected from 655 women with suspected preeclampsia. Adverse outcomes were predicted by multivariable and univariable logistic regression models. The outcome of patients was evaluated within 14 days after presentation with signs and symptoms of preeclampsia or diagnosed preeclampsia. RESULTS The full model integrating available, standard clinical information and the sFlt-1/PlGF ratio had the best predictive performance for adverse outcomes with an AUC of 72.6%, which corresponds to a sensitivity of 73.3% and specificity of 66.0%. The positive predictive value of the full model was 51.4%, and the negative predictive value was 83.5%. 24.5% of patients, who did not experience adverse outcomes but were classified as high risk by sFlt-1/PlGF ratio (≥38), were correctly classified by the regression model. The sFlt-1/PlGF ratio alone had a significantly lower AUC of 65.6%. CONCLUSIONS Integrating angiogenic biomarkers in a regression model improved the prediction of preeclampsia-related adverse outcomes in women at risk after 34 weeks of gestation.
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Affiliation(s)
- Dorota Sroka
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany,
| | | | - Valerie Scherfeld
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Julie Thoma
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Wolfgang Henrich
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Verlohren
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Jing M, Chen X, Qiu H, He W, Zhou Y, Li D, Wang D, Jiao Y, Liu A. Insights into the immunomodulatory regulation of matrix metalloproteinase at the maternal-fetal interface during early pregnancy and pregnancy-related diseases. Front Immunol 2023; 13:1067661. [PMID: 36700222 PMCID: PMC9869165 DOI: 10.3389/fimmu.2022.1067661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
Trophoblast immune cell interactions are central events in the immune microenvironment at the maternal-fetal interface. Their abnormalities are potential causes of various pregnancy complications, including pre-eclampsia and recurrent spontaneous abortion. Matrix metalloproteinase (MMP) is highly homologous, zinc(II)-containing metalloproteinase involved in altered uterine hemodynamics, closely associated with uterine vascular remodeling. However, the interactions between MMP and the immune microenvironment remain unclear. Here we discuss the key roles and potential interplay of MMP with the immune microenvironment in the embryo implantation process and pregnancy-related diseases, which may contribute to understanding the establishment and maintenance of normal pregnancy and providing new therapeutic strategies. Recent studies have shown that several tissue inhibitors of metalloproteinases (TIMPs) effectively prevent invasive vascular disease by modulating the activity of MMP. We summarize the main findings of these studies and suggest the possibility of TIMPs as emerging biomarkers and potential therapeutic targets for a range of complications induced by abnormalities in the immune microenvironment at the maternal-fetal interface. MMP and TIMPs are promising targets for developing new immunotherapies to treat pregnancy-related diseases caused by immune imbalance.
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Affiliation(s)
- Mengyu Jing
- Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China,Key Laboratory of reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
| | - Xi Chen
- Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China,Key Laboratory of reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
| | - Hongxia Qiu
- Department of Obstetrics, Hangzhou Fuyang Women And Children Hospital, Fuyang, China
| | - Weihua He
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China
| | - Ying Zhou
- Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China,Key Laboratory of reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
| | - Dan Li
- Department of Reproduction, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Dimin Wang
- Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China,Key Laboratory of reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China,*Correspondence: Yonghui Jiao, ; Dimin Wang, ; Aixia Liu,
| | - Yonghui Jiao
- Department of Reproduction, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China,*Correspondence: Yonghui Jiao, ; Dimin Wang, ; Aixia Liu,
| | - Aixia Liu
- Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China,Key Laboratory of reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China,Department of Reproduction, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China,*Correspondence: Yonghui Jiao, ; Dimin Wang, ; Aixia Liu,
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Hurrell A, Sparkes J, Duhig K, Seed PT, Myers J, Battersby C, Clark K, Green M, Hunter RM, Shennan AH, Chappell LC, Webster L. Placental growth fActor Repeat sampling for Reduction of adverse perinatal Outcomes in women with suspecTed pre-eclampsia: study protocol for a randomised controlled trial (PARROT-2). Trials 2022; 23:722. [PMID: 36056408 PMCID: PMC9437393 DOI: 10.1186/s13063-022-06652-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/07/2022] [Indexed: 12/04/2022] Open
Abstract
Background Pre-eclampsia is a complex pregnancy disorder, characterised by new or worsening hypertension associated with multi-organ dysfunction. Adverse outcomes include eclampsia, liver rupture, stroke, pulmonary oedema, and acute kidney injury in the mother, and stillbirth, foetal growth restriction, and iatrogenic preterm delivery for the foetus. Angiogenic biomarkers, including placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt-1), have been identified as valuable biomarkers for preterm pre-eclampsia, accelerating diagnosis and reducing maternal adverse outcomes by risk stratification, with enhanced surveillance for high-risk women. PlGF-based testing for suspected preterm pre-eclampsia has been incorporated into national guidance. The role of repeat PlGF-based testing and its effect on maternal and perinatal adverse outcomes have yet to be evaluated. Methods The PARROT-2 trial is a multi-centre randomised controlled trial of repeat revealed PlGF-based testing compared to repeat concealed testing, in women presenting with suspected pre-eclampsia between 22+0 and 35+6 weeks’ gestation. The primary objective is to establish whether repeat PlGF-based testing decreases a composite of perinatal severe adverse outcomes (stillbirth, early neonatal death, or neonatal unit admission). All women prior to enrolment in the trial will have an initial revealed PlGF-based test. Repeat PlGF-based tests will be performed weekly or two-weekly, depending on the initial PlGF-based test result, with results randomised to revealed or concealed. Discussion National guidance recommends that all women presenting with suspected preterm pre-eclampsia should have a single PlGF-based test when disease is first suspected, to help rule out pre-eclampsia. Clinical and cost-effectiveness of repeat PlGF-based testing has yet to be investigated. This trial aims to address whether repeat PlGF-based testing reduces severe maternal and perinatal adverse outcomes and whether repeat testing is cost-effective. Trial registration ISRCTN 85912420. Registered on 25 November 2019 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06652-8.
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Affiliation(s)
- Alice Hurrell
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, Westminster Bridge Road, London, SE1 7EH, UK.
| | - Jenie Sparkes
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, Westminster Bridge Road, London, SE1 7EH, UK
| | - Kate Duhig
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, Westminster Bridge Road, London, SE1 7EH, UK
| | - Paul T Seed
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, Westminster Bridge Road, London, SE1 7EH, UK
| | - Jenny Myers
- Maternal & Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
| | - Cheryl Battersby
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London Chelsea and Westminster Hospital Campus, 369 Fulham Road, London, SW10 9NH, UK
| | - Katherine Clark
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, Westminster Bridge Road, London, SE1 7EH, UK
| | | | - Rachael M Hunter
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Andrew H Shennan
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, Westminster Bridge Road, London, SE1 7EH, UK
| | - Lucy C Chappell
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, Westminster Bridge Road, London, SE1 7EH, UK
| | - Louise Webster
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, Westminster Bridge Road, London, SE1 7EH, UK
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Scurt FG, Morgenroth R, Bose K, Mertens PR, Chatzikyrkou C. Pr-AKI: Acute Kidney Injury in Pregnancy – Etiology, Diagnostic Workup, Management. Geburtshilfe Frauenheilkd 2022; 82:297-316. [PMID: 35250379 PMCID: PMC8893985 DOI: 10.1055/a-1666-0483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 10/09/2021] [Indexed: 10/29/2022] Open
Abstract
AbstractDespite significant improvements in inpatient and outpatient management, pregnancy-related acute kidney injury (Pr-AKI) remains an important risk factor for early and late maternal and
fetal morbidity and mortality. There is a discrepancy between the incidence of Pr-AKI in developing and in developed countries, with the former experiencing a decrease and the latter an
increase in Pr-AKI in recent decades. Whereas septic and hemorrhagic complications predominated in the past, nowadays hypertensive disorders and thrombotic microangiopathy are the leading
causes of Pr-AKI. Modern lifestyles and the availability and widespread use of in-vitro fertilization techniques in industrialized countries have allowed more women of advanced age to become
pregnant. This has led to a rise in the percentage of high-risk pregnancies due to the disorders and comorbidities inherent to or accompanying aging, such as diabetes, arterial hypertension
and preexisting chronic kidney disease. Last but not least, the heterogeneity of symptoms, the often overlapping clinical and laboratory characteristics and the pathophysiological changes
related to pregnancy make the diagnosis and management of Pr-AKI a difficult and challenging task for the treating physician. In addition to general supportive management strategies such as
volume substitution, blood pressure control, prevention of seizures or immediate delivery, each disease entity requires a specific therapy to reduce maternal and fetal complications. In this
review, we used the current literature to provide a summary of the physiologic and pathophysiologic changes in renal physiology which occur during pregnancy. In the second part, we present
common and rare disorders which lead to Pr-AKI and provide an overview of the available treatment options.
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Affiliation(s)
- Florian G. Scurt
- Klinik für Nieren- und Hochdruckerkrankungen, Diabetologie und Endokrinologie, Medizinische Fakultät der Otto-von-Guericke-Universität, Magdeburg, Germany
| | - Ronnie Morgenroth
- Klinik für Nieren- und Hochdruckerkrankungen, Diabetologie und Endokrinologie, Medizinische Fakultät der Otto-von-Guericke-Universität, Magdeburg, Germany
| | - Katrin Bose
- Universitätsklinik für Gastroenterologie, Hepatologie und Infektiologie, Medizinische Fakultät der Otto-von-Guericke-Universität, Magdeburg, Germany
| | - Peter R. Mertens
- Klinik für Nieren- und Hochdruckerkrankungen, Diabetologie und Endokrinologie, Medizinische Fakultät der Otto-von-Guericke-Universität, Magdeburg, Germany
| | - Christos Chatzikyrkou
- PHV-Dialysezentrum, Halberstadt, Germany
- Klinik für Nephrologie, Medizinische Hochschule Hannover, Hannover, Germany
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Gubensek J, Ponikvar R, Premru Srsen T, Fabjan Vodusek V, Moertl MG, Lucovnik M. Therapeutic plasma exchange and dextran-sulfate plasma adsorption as extracorporeal treatments of extremely preterm preeclampsia with fetal growth restriction. J Clin Apher 2021; 36:595-605. [PMID: 33847403 DOI: 10.1002/jca.21899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 02/26/2021] [Accepted: 03/29/2021] [Indexed: 11/07/2022]
Abstract
AIM To evaluate effectiveness and safety of therapeutic plasma exchange (TPE) and dextran-sulfate plasma adsorption (DSA) for extracorporeal removal of soluble Fms-like tyrosine kinase-1 (sFlt-1) as part of expectant management of preeclampsia at extremely preterm gestational age. METHODS Retrospective case series of six patients with preeclampsia at <28 weeks of gestation, treated with DSA or TPE. Laboratory results, clinical characteristics and neonatal outcomes were collected from charts and National Perinatal Information System. RESULTS Fetal growth restriction (FGR) was diagnosed in all cases. Pregnancy was prolonged for a median of 14 (range 5-74) days from admission and 10 (3-73) days from first apheresis. A mixed effects model showed a decrease in sFlt-1 and sFlt-1/PlGF ratio during DSA/TPE (significant effect of time [before/after]), which was comparable between DSA and TPE (no effect of procedure type). Median absolute reduction in sFlt-1 was 42% (inter-quartile range [IQR] 13%-57%) during DSA and 34% (16%-40%) during TPE; for sFlt-1/PlGF ratio it was 29% (22%-36%) and 38% (29%-42%), respectively. All procedures were well tolerated by fetuses. Anaphylactoid reaction, often with angioedema, occurred in 4/6 patients undergoing DSA and was attributed to bradykinin activation. One patient developed wound hematoma after cesarean section, possibly attributed to depletion coagulopathy. CONCLUSIONS As potential novel treatment of early preeclampsia, a non-selective and widely available TPE was comparable to DSA regarding sFlt-1 reduction but was associated with fewer side-effects. Both seem to allow maternal stabilization and pregnancy prolongation even when early preeclampsia is complicated by FGR.
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Affiliation(s)
- Jakob Gubensek
- Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Rafael Ponikvar
- Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tanja Premru Srsen
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Vesna Fabjan Vodusek
- Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | - Miha Lucovnik
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Xu Q, Sun G, Zhang S, Liu G, Yang L, Meng Y, Chen A, Yang Y, Li X, Hao D, Liu X, Shao J. Prediction of hypertensive disorders in pregnancy based on placental growth factor. Technol Health Care 2021; 29:165-170. [PMID: 33682756 PMCID: PMC8150549 DOI: 10.3233/thc-218017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The prediction of hypertensive disorders in pregnancy (HDP) mainly involves various aspects such as maternal characteristics and biomarkers. OBJECTIVE: We aimed to study the effect of the HDP prediction model with or without placental growth factor (PlGF). METHODS: This study used maternal factors and PlGF, and standardized the data uniformly. At 12–20 weeks, the comprehensive comparison of model quality with or without PlGF was conducted by logistic regression. RESULTS: The area under curve and the model accuracy of the model with PlGF were higher than those of the model without PlGF. The accuracy of the model with PlGF was above 90%. CONCLUSIONS: Adding PlGF to the model for predicting HDP improved the accuracy and effectiveness of the model. This study confirmed the predictive performance of PlGF.
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Affiliation(s)
- Qi Xu
- Peking University People's Hospital, Beijing 100044, China
| | - Ge Sun
- Faculty of Environment and Life Sciences, Beijing University of Technology, Beijing 100124, China.,Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing 100124, China
| | - Song Zhang
- Faculty of Environment and Life Sciences, Beijing University of Technology, Beijing 100124, China.,Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing 100124, China
| | - Guoli Liu
- Peking University People's Hospital, Beijing 100044, China
| | - Lin Yang
- Faculty of Environment and Life Sciences, Beijing University of Technology, Beijing 100124, China.,Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing 100124, China
| | - Yu Meng
- Faculty of Environment and Life Sciences, Beijing University of Technology, Beijing 100124, China.,Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing 100124, China
| | - Aiqing Chen
- Beijing Yes Medical Devices Co. Ltd., Beijing 100152, China
| | - Yimin Yang
- Faculty of Environment and Life Sciences, Beijing University of Technology, Beijing 100124, China.,Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing 100124, China
| | - Xuwen Li
- Faculty of Environment and Life Sciences, Beijing University of Technology, Beijing 100124, China.,Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing 100124, China
| | - Dongmei Hao
- Faculty of Environment and Life Sciences, Beijing University of Technology, Beijing 100124, China.,Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing 100124, China
| | - Xiaohong Liu
- Beijing Yes Medical Devices Co. Ltd., Beijing 100152, China
| | - Jing Shao
- Beijing Yes Medical Devices Co. Ltd., Beijing 100152, China
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Han X, Ghaemi MS, Ando K, Peterson LS, Ganio EA, Tsai AS, Gaudilliere DK, Stelzer IA, Einhaus J, Bertrand B, Stanley N, Culos A, Tanada A, Hedou J, Tsai ES, Fallahzadeh R, Wong RJ, Judy AE, Winn VD, Druzin ML, Blumenfeld YJ, Hlatky MA, Quaintance CC, Gibbs RS, Carvalho B, Shaw GM, Stevenson DK, Angst MS, Aghaeepour N, Gaudilliere B. Differential Dynamics of the Maternal Immune System in Healthy Pregnancy and Preeclampsia. Front Immunol 2019; 10:1305. [PMID: 31263463 PMCID: PMC6584811 DOI: 10.3389/fimmu.2019.01305] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 05/22/2019] [Indexed: 12/11/2022] Open
Abstract
Preeclampsia is one of the most severe pregnancy complications and a leading cause of maternal death. However, early diagnosis of preeclampsia remains a clinical challenge. Alterations in the normal immune adaptations necessary for the maintenance of a healthy pregnancy are central features of preeclampsia. However, prior analyses primarily focused on the static assessment of select immune cell subsets have provided limited information for the prediction of preeclampsia. Here, we used a high-dimensional mass cytometry immunoassay to characterize the dynamic changes of over 370 immune cell features (including cell distribution and functional responses) in maternal blood during healthy and preeclamptic pregnancies. We found a set of eight cell-specific immune features that accurately identified patients well before the clinical diagnosis of preeclampsia (median area under the curve (AUC) 0.91, interquartile range [0.82-0.92]). Several features recapitulated previously known immune dysfunctions in preeclampsia, such as elevated pro-inflammatory innate immune responses early in pregnancy and impaired regulatory T (Treg) cell signaling. The analysis revealed additional novel immune responses that were strongly associated with, and preceded the onset of preeclampsia, notably abnormal STAT5ab signaling dynamics in CD4+T cell subsets (AUC 0.92, p = 8.0E-5). These results provide a global readout of the dynamics of the maternal immune system early in pregnancy and lay the groundwork for identifying clinically-relevant immune dysfunctions for the prediction and prevention of preeclampsia.
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Affiliation(s)
- Xiaoyuan Han
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Mohammad S Ghaemi
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Kazuo Ando
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Laura S Peterson
- Department of Pediatrics, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Edward A Ganio
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Amy S Tsai
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Dyani K Gaudilliere
- Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Ina A Stelzer
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Jakob Einhaus
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Basile Bertrand
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Natalie Stanley
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Anthony Culos
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Athena Tanada
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Julien Hedou
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Eileen S Tsai
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Ramin Fallahzadeh
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Ronald J Wong
- Department of Pediatrics, School of Medicine, Stanford University, Palo Alto, CA, United States.,March of Dimes Prematurity Research Center, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Amy E Judy
- Department of Obstetrics and Gynecology, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Virginia D Winn
- Department of Obstetrics and Gynecology, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Maurice L Druzin
- Department of Obstetrics and Gynecology, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Yair J Blumenfeld
- Department of Obstetrics and Gynecology, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Mark A Hlatky
- Department of Health Research and Policy, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Cecele C Quaintance
- March of Dimes Prematurity Research Center, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Ronald S Gibbs
- Department of Obstetrics and Gynecology, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Brendan Carvalho
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Gary M Shaw
- Department of Pediatrics, School of Medicine, Stanford University, Palo Alto, CA, United States.,March of Dimes Prematurity Research Center, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - David K Stevenson
- Department of Pediatrics, School of Medicine, Stanford University, Palo Alto, CA, United States.,March of Dimes Prematurity Research Center, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Martin S Angst
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Nima Aghaeepour
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Brice Gaudilliere
- Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, United States
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11
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Bouchard J, Mehta RL. Angiogenesis Markers and Recovery From Acute Kidney Injury: A Piece of the Puzzle? Am J Kidney Dis 2019; 74:12-14. [PMID: 31103333 DOI: 10.1053/j.ajkd.2019.03.421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 03/10/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Josée Bouchard
- Hôpital Sacré-Coeur de Montréal, Université de Montréal, Montréal, Canada
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12
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Hamza A, Gerlinger C, Radosa J, Solomayer EF, Hagmann J, Sester U, Bohle R, Stroeder R, Takacs Z, Meyberg-Solomayer G, Juhasz-Boess I, Kasoha M. Pilot study: placental biomarker predictive capability (sFlt-1, PlGF and their ratio) of postpartum maternal outcome. Arch Gynecol Obstet 2019; 299:1557-1566. [PMID: 30953183 DOI: 10.1007/s00404-019-05128-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 03/25/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prenatal measurement of placental biomarkers was able to improve screening and diagnosis of preeclampsia. Little is known about the clinical role of placental biomarkers in the postpartum period. METHODS This study is a prospective monocentric trial that included a total of 30 women with preeclamptic pregnancies. Serum placental biomarkers including soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) were measured before and 2 h after delivery by Enzyme-Linked Immunosorbent Assay (ELISA) using commercially available kits according to manufacturer's instructions and correlated with the postpartum outcome. RESULTS Postpartum higher serum PlGF level was associated with postpartum elevation of the systolic blood pressure. Yet, the placental biomarkers were not able to predict general worsening of postpartum preeclampsia or other individual clinical or laboratory parameters. CONCLUSION Serum concentrations of sFlt-1 and PlGF or their ratio in our study cohort did not completely predict the occurrence of postpartum preeclampsia. Yet, postpartum higher serum PlGF level was associated with postpartum elevation of the systolic blood pressure.
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Affiliation(s)
- Amr Hamza
- Department of Obstetrics and Gynecology, Saarland University, Homburg, Saar, Germany.
| | - Ch Gerlinger
- Department of Obstetrics and Gynecology, Saarland University, Homburg, Saar, Germany
| | - J Radosa
- Department of Obstetrics and Gynecology, Saarland University, Homburg, Saar, Germany
| | - E F Solomayer
- Department of Obstetrics and Gynecology, Saarland University, Homburg, Saar, Germany
| | - J Hagmann
- Department of Obstetrics and Gynecology, Saarland University, Homburg, Saar, Germany
| | - U Sester
- Department of Internal Medicine IV, Saarland University, Homburg, Saar, Germany
| | - R Bohle
- Department of Pathology, Saarland University, Homburg, Saar, Germany
| | - R Stroeder
- Department of Obstetrics and Gynecology, Saarland University, Homburg, Saar, Germany
| | - Z Takacs
- Department of Obstetrics and Gynecology, Saarland University, Homburg, Saar, Germany
| | - G Meyberg-Solomayer
- Department of Obstetrics and Gynecology, Saarland University, Homburg, Saar, Germany
| | - I Juhasz-Boess
- Department of Obstetrics and Gynecology, Saarland University, Homburg, Saar, Germany
| | - M Kasoha
- Department of Obstetrics and Gynecology, Saarland University, Homburg, Saar, Germany
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13
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Shu W, Li H, Gong H, Zhang M, Niu X, Ma Y, Zhang X, Cai W, Yang G, Wei M, Yang N, Li Y. Evaluation of blood vessel injury, oxidative stress and circulating inflammatory factors in an L-NAME-induced preeclampsia-like rat model. Exp Ther Med 2018; 16:585-594. [PMID: 30112025 PMCID: PMC6090470 DOI: 10.3892/etm.2018.6217] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 04/13/2018] [Indexed: 01/07/2023] Open
Abstract
Preeclampsia is a pregnancy-specific disease characterized by hypertension as well as proteinuria after the 20th week of pregnancy. Animal models are effective tools for studying the pathogenesis, diagnostic criteria and treatment methods of preeclampsia. The present study sought to establish and evaluate a preeclampsia-like Sprague Dawley (SD) rat model using N-nitro-L-arginine methyl ester (L-NAME). Rats were randomly assigned to 7 groups (n=10 in each): Control rats and rats treated with low-dose L-NAME (40 mg/kg body weight/day) starting from gestational day (GD) 9, medium-L-NAME (75 mg/kg body weight/day) starting from GD 9 (9D ML group), high-dose L-NAME (125 mg/kg body weight/day) starting from GD 9, low-dose L-NAME starting from GD 10, medium-dose L-NAME starting from GD 10 and high-dose L-NAME starting from GD 10. Blood pressure (BP), 24-h proteinuria, fetal intrauterine growth, histopathological changes, the plasma soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PLGF) ratio and cytokine levels were evaluated. Elevated BP, increased urinary albumin excretion, severe endotheliosis, mesangial expansion and increased sFlt-1/PLGF ratios were observed in the experimental groups compared with the control group (P<0.05), particularly in the 9D ML group. The results of the present study may optimize the conditions of the previously established L-NAME-induced preeclampsia SD rat model and aid further study into the pathogenesis of preeclampsia.
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Affiliation(s)
- Wen Shu
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin 300162, P.R. China
| | - Hanying Li
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin 300162, P.R. China.,Graduate School of Medicine, Tianjin Medical University, Tianjin 300070, P.R. China
| | - Hao Gong
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin 300162, P.R. China.,Jinzhou Medical University, Jinzhou, Liaoning 121001, P.R. China
| | - Mei Zhang
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin 300162, P.R. China
| | - Xiulong Niu
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin 300162, P.R. China
| | - Yongqiang Ma
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin 300162, P.R. China
| | - Xin Zhang
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin 300162, P.R. China
| | - Wei Cai
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin 300162, P.R. China
| | - Guohong Yang
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin 300162, P.R. China
| | - Maoti Wei
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin 300162, P.R. China
| | - Ning Yang
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin 300162, P.R. China
| | - Yuming Li
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin 300162, P.R. China
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14
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Yusuf AM, Kahane A, Ray JG. First and Second Trimester Serum sFlt-1/PlGF Ratio and Subsequent Preeclampsia: A Systematic Review. Journal of Obstetrics and Gynaecology Canada 2018; 40:618-26. [DOI: 10.1016/j.jogc.2017.07.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/13/2017] [Accepted: 07/16/2017] [Indexed: 12/29/2022]
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15
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Abstract
Preeclampsia is a relatively common pregnancy-related condition associated with serious maternal and fetal morbidity and mortality. It is now well established that anti-angiogenic sFlt1 is upregulated in preeclampsia and binds PlGF and VEGF, causing an imbalance in angiogenic factors with subsequent endothelial injury and dysfunction. Measurement of placental growth factor (PlGF) and the sFlt1/PlGF ratio have both been validated in other countries for screening and diagnosis of preeclampsia and the differentiation of preeclampsia from other hypertensive disorders of pregnancy. There are several automated, commercially available immunoassays capable of measuring PlGF and the sFlt1/PlGF ratio for preeclampsia diagnosis. Here we outline the methodology for using the Roche Cobas ® e 411 immunoassay platform to determine the sFlt1/PlGF ratio.
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Affiliation(s)
- Carin Black
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia.
| | - Fabricio da Silva Costa
- Monash Ultrasound for Women, 252-256 Clayton Road, Clayton, VIC, 3168, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
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16
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Rhee C, Edwards M, Dang C, Harris J, Brown M, Kim J, Tucker HO. ARID3A is required for mammalian placenta development. Dev Biol 2017; 422:83-91. [PMID: 27965054 PMCID: PMC5540318 DOI: 10.1016/j.ydbio.2016.12.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 11/29/2016] [Accepted: 12/01/2016] [Indexed: 11/17/2022]
Abstract
Previous studies in the mouse indicated that ARID3A plays a critical role in the first cell fate decision required for generation of trophectoderm (TE). Here, we demonstrate that ARID3A is widely expressed during mouse and human placentation and essential for early embryonic viability. ARID3A localizes to trophoblast giant cells and other trophoblast-derived cell subtypes in the junctional and labyrinth zones of the placenta. Conventional Arid3a knockout embryos suffer restricted intrauterine growth with severe defects in placental structural organization. Arid3a null placentas show aberrant expression of subtype-specific markers as well as significant alteration in cytokines, chemokines and inflammatory response-related genes, including previously established markers of human placentation disorders. BMP4-mediated induction of trophoblast stem (TS)-like cells from human induced pluripotent stem cells results in ARID3A up-regulation and cytoplasmic to nuclear translocation. Overexpression of ARID3A in BMP4-mediated TS-like cells up-regulates TE markers, whereas pluripotency markers are down-regulated. Our results reveal an essential, conserved function for ARID3A in mammalian placental development through regulation of both intrinsic and extrinsic developmental programs.
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Affiliation(s)
- Catherine Rhee
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX 78712, United States; Institute for Cellular and Molecular Biology, The University of Texas at Austin, Austin, TX 78712, United States
| | - Melissa Edwards
- Institute for Cellular and Molecular Biology, The University of Texas at Austin, Austin, TX 78712, United States; Cell and Molecular Biology, Colorado State University, Fort Collins, CO 80523, United States
| | - Christine Dang
- Institute for Cellular and Molecular Biology, The University of Texas at Austin, Austin, TX 78712, United States
| | - June Harris
- Institute for Cellular and Molecular Biology, The University of Texas at Austin, Austin, TX 78712, United States
| | - Mark Brown
- Cell and Molecular Biology, Colorado State University, Fort Collins, CO 80523, United States
| | - Jonghwan Kim
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX 78712, United States; Institute for Cellular and Molecular Biology, The University of Texas at Austin, Austin, TX 78712, United States
| | - Haley O Tucker
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX 78712, United States; Institute for Cellular and Molecular Biology, The University of Texas at Austin, Austin, TX 78712, United States.
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