OC15.07: Distinctive endothelial and angiogenic signature of pre‐eclampsia versus COVID‐19 in pregnancy
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ABSTRACT:
SUBMITTER: Youssef L
PROVIDER: S-EPMC8662066 | biostudies-literature | 2021 Oct
REPOSITORIES: biostudies-literature
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| S-EPMC8661710 | biostudies-literature
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| S-EPMC8662279 | biostudies-literature
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| S-EPMC7361765 | biostudies-literature
Project description:BackgroundPre-eclampsia (PE) is related to an impaired endothelial function. Endothelial dysfunction accounts for altered vascular reactivity, activation of the coagulation cascade and loss of vascular integrity. Impaired endothelial function originates from production of inflammatory and cytotoxic factors by the ischemic placenta and results in systemic oxidative stress (OS) and an altered bioavailability of nitric oxide (•NO). The free radical •NO, is an endogenous endothelium-derived relaxing factor influencing endothelial function. In placental circulation, endothelial release of •NO dilates the fetal placental vascular bed, ensuring feto-maternal exchange. The Endopreg study was designed to evaluate in vivo endothelial function and to quantify in vitro OS in normal and pre-eclamptic pregnancies.Methods/designThe study is divided into two arms, a prospective longitudinal study and a matched case control study. In the longitudinal study, pregnant patients ≥18 years old with a singleton pregnancy will be followed throughout pregnancy and until 6 months post-partum. In the case control study, cases with PE will be compared to matched normotensive pregnant women. Maternal blood concentration of superoxide (O2•) and placental concentration of •NO will be determined using EPR (electron paramagnetic resonance). Endothelial function and arterial stiffness will be evaluated using respectively Peripheral Arterial Tonometry (PAT), Flow-Mediated Dilatation (FMD) and applanation tonometry. Placental expression of eNOS (endothelial NOS) will be determined using immune-histochemical staining. Target recruitment will be 110 patients for the longitudinal study and 90 patients in the case-control study.DiscussionThe results of Endopreg will provide longitudinal information on in vivo endothelial function and in vitro OS during normal pregnancy and PE. Adoption of these vascular tests in clinical practice potentially predicts patients at risk to develop cardiovascular events later in life after PE pregnancies. •NO, O2•- and eNOS measurements provide further inside in the pathophysiology of PE.Trial registrationThis trial has been registered on clinicaltrials.gov. ClinicalTrials.gov Identifier: NCT02603913 . Registered October 2015.
| S-EPMC5827979 | biostudies-literature
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| S-EPMC8957356 | biostudies-literature
Project description:Pre-eclampsia is a complex disease with significant maternal and fetal morbidity and mortality. Its syndromic nature makes diagnosis and management difficult. The field is rapidly evolving with the definition of pre-eclampsia being challenged by some organisations, with proteinuria no longer being essential in the presence of other features. In the last decade, angiogenic factors, in particular soluble fms-like tyrosine kinase 1 (sFlt-1), have emerged as important molecules in the pathogenesis of pre-eclampsia. Here we review the most recent evidence regarding the potential of these factors as biomarkers and therapeutic targets for pre-eclampsia.Tweetable abstractA review of angiogenic factors, sFlt-1 and PlGF, in the diagnosis, prediction and management of pre-eclampsia.
| S-EPMC6175139 | biostudies-literature
Project description:Oxidative and inflammatory stress, angiogenic imbalance, and endothelial dysfunction are pathophysiological mechanisms occurring in pre-eclampsia (PE) that may persist over time and predispose women to a higher risk of cardiovascular disease (CVD) in the future. However, there is little evidence on the vascular function of women at risk of PE who have not developed the disease. The main objective of this research is to study factors and biomarkers involved in endothelial dysfunction related to oxidative stress, angiogenic disbalance, and inflammation in women at high risk of term PE who do not develop the disease. An observational, analytical, retrospective, and descriptive study was carried out in a selected sample of 68 high-risk and 57 non-risk of term PE participants in the STATIN study (FFIS/2016/02/ST EUDRACT No: 2016-005206-19). A significant increase in mean arterial pressure (MAP) levels and oxidative stress biomarkers (uric acid, homocysteine, and total serum antioxidant capacity) was found. Biomarkers of inflammation (interleukin-6 and growth differentiation factor 15) and endothelial function (asymmetric dimethylarginine) were significantly elevated in the group at risk of pre-eclampsia. A significative dependence relationship was also established between MAP and interleukin-6 and uric acid. These results suggest that women at high risk of term PE may represent pregnancies with pre-existing maternal risk factors for CVD, manifested by the own cardiovascular overload of pregnancy. A better understanding of maternal cardiovascular function in pregnancy would allow the improved prediction of CVD late in life in women.
| S-EPMC9311926 | biostudies-literature
Project description:T helper 17 (TH17) cells have been identified as a new lineage of helper T cells and have been shown to be important in host defense against extracellular infectious agents, autoimmune disease and chronic inflammatory diseases. Recently, TH17 cells have also been shown to participate in successful pregnancy, as well as in the pathogenesis of diseases of pregnancy, such as recurrent spontaneous abortion (RSA) and pre-eclampsia (PE). Here, we review our current knowledge of TH17 cells in human RSA and PE. We also discuss how the local uterine microenvironment affects the differentiation of TH17 cells and the mechanisms that regulate TH17 cells during pregnancy. Research into TH17 cells will not only advance our understanding of TH17-related pregnancy complications, but will also facilitate the design of novel therapies for reproductive diseases.
| S-EPMC4220838 | biostudies-other
Project description:ObjectivesTo investigate the incidence of clinical, ultrasonographic and biochemical findings related to pre-eclampsia (PE) in pregnancies with COVID-19, and to assess their accuracy to differentiate between PE and the PE-like features associated with COVID-19.DesignA prospective, observational study.SettingTertiary referral hospital.ParticipantsSingleton pregnancies with COVID-19 at >20+0 weeks.MethodsForty-two consecutive pregnancies were recruited and classified into two groups: severe and non-severe COVID-19, according to the occurrence of severe pneumonia. Uterine artery pulsatility index (UtAPI) and angiogenic factors (soluble fms-like tyrosine kinase-1/placental growth factor [sFlt-1/PlGF]) were assessed in women with suspected PE.Main outcome measuresIncidence of signs and symptoms related to PE, such as hypertension, proteinuria, thrombocytopenia, elevated liver enzymes, abnormal UtAPI and increased sFlt-1/PlGF.ResultsThirty-four cases were classified as non-severe and 8 as severe COVID-19. Five (11.9%) women presented signs and symptoms of PE, all five being among the severe COVID-19 cases (62.5%). However, abnormal sFlt-1/PlGF and UtAPI could only be demonstrated in one case. One case remained pregnant after recovery from severe pneumonia and had a spontaneous resolution of the PE-like syndrome.ConclusionsPregnant women with severe COVID-19 can develop a PE-like syndrome that might be distinguished from actual PE by sFlt-1/PlGF, LDH and UtAPI assessment. Healthcare providers should be aware of its existence and monitor pregnancies with suspected pre-eclampsia with caution.Tweetable abstractThis study shows that a pre-eclampsia-like syndrome could be present in some pregnancies with severe COVID-19.
| S-EPMC7300912 | biostudies-literature
Project description:Background and objectivesDuring the COVID-19 pandemic, a possible overlap of obesity and COVID-19 infection has raised concerns among patients and healthcare professionals about protecting pregnant women from developing a severe infection and unwanted pregnancy outcomes. The aim of this study was to evaluate the associations of body mass index with clinical, laboratory, and radiology diagnostic parameters as well as pregnancy complications and maternal outcomes in pregnant patients with COVID-19.Materials and methodsClinical status, laboratory, and radiology diagnostic parameters and pregnancy outcomes were analyzed for pregnant women hospitalized between March 2020 and November 2021 in one tertiary-level university clinic in Belgrade, Serbia, due to infection with SARS-CoV-2. Pregnant women were divided into the three sub-groups according to their pre-pregnancy body mass index. For testing the differences between groups, a two-sided p-value <0.05 (the Kruskal-Wallis and ANOVA tests) was considered statistically significant.ResultsOut of 192 hospitalized pregnant women, obese pregnant women had extended hospitalizations, including ICU duration, and they were more likely to develop multi-organ failure, pulmonary embolism, and drug-resistant nosocomial infection. Higher maternal mortality rates, as well as poor pregnancy outcomes, were also more likely to occur in the obese group of pregnant women. Overweight and obese pregnant women were more likely to develop gestational hypertension, and they had a higher grade of placental maturity.ConclusionsObese pregnant women hospitalized due to COVID-19 infection were more likely to develop severe complications.
| S-EPMC10144693 | biostudies-literature