scholarly journals Effect of esomeprazole on maternal serum soluble fms-like tyrosine kinase-1 and endoglin in patients with early-onset preeclampsia

2021 ◽  
Vol 99 (1) ◽  
Author(s):  
Ahmed M Abbas ◽  
Yousra M Othman ◽  
Mohamad M Abdallah ◽  
Noura H. Abd Ellah ◽  
Hanan G. Abdel Azim ◽  
...  

Objective: This study evaluates the effect of esomeprazole on the maternal serum levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng) in patients with early-onset preeclampsia.Methods: A randomized, double-blind, placebo-controlled trial was carried out in a tertiary University hospital between March 2018, and September 2019 (Clinical Trials.Gov: NCT03213639). The study included women between 28 and 31+6 weeks gestational age who had been diagnosed as preeclampsia without severe features. They were randomly assigned in a 1:1 ratio into an esomeprazole group, which received esomeprazole 40 mg orally once a day, and a placebo group, which received one placebo tablet daily. Blood samples were obtained to assess levels of serum sFlt-1and sEng using ELISA testing. The primary outcome was the difference between the mean serum level of sFlt-1 and sEng at the start of treatment and at the termination of pregnancy in both groups.Results: Eighty-eight patients were randomly assigned into both groups (44 in each). No statistically significant difference was found in the levels of sFlt-1 between both groups at admission and termination of pregnancy. The number of days of treatment for the esomeprazole group was slightly longer than the placebo group (11.4±9.4 vs. 10.3±6.3 days, P=0.515). No statistically significant difference in the rate of maternal and fetal complications occurred between the two groups. No side effects from the study medications were reported.Conclusions: Esomeprazole, at the dosage used in this study did not effectively lower the serum levels of sFlt-1 and sEng in patients with early-onset preeclampsia. Furthermore, it did not prolong the duration of pregnancy, nor did it decrease maternal or fetal complications.

2019 ◽  
Vol 7 (13) ◽  
pp. 2133-2137 ◽  
Author(s):  
Roza Sriyanti ◽  
Johanes C. Mose ◽  
Masrul Masrul ◽  
Netti Suharti

BACKGROUND: Preeclampsia can be divided into early (EOPE) and late (LOPE) onset preeclampsia. Preeclampsia is related to the failure of placentation. Accumulation of hypoxia-inducible factors (HIF)-1α is commonly an acute and beneficial respond to hypoxia, while chronically elevated is associated with preeclampsia. AIM: This study aims to evaluate the serum levels of HIF-1α in preeclampsia and normal pregnancy, and to compare the difference between early-onset and late-onset preeclampsia. METHODS: A cross-sectional comparative study was conducted among a total of 69 pregnant women at ≥ 20 weeks of gestation, were recruited at obstetrics and gynaecology department at Dr M. Djamil Padang Hospital, network hospitals, health centres. They were divided into three groups early-onset preeclampsia, late-onset preeclampsia, and normal pregnancy. Preeclampsia was diagnosed using International Guidelines. Data were analysed by SPSS 24 program; data are presented as median and range or as mean ± standard deviation. One-way ANOVA test was used to determine the relationship between HIF-1α levels with the onset of preeclampsia. RESULTS: The results showed that the mean maternal serum HIF-1α levels in early-onset preeclampsia (EOPE), late-onset preeclampsia (LOPE), and normal pregnancy were 1366.96 ± 733.40 pg/ml, 916.87 ± 466.06 pg/ml, and 716.77 ± 541.08 pg/ml. Serum HIF-1α levels were higher in early-onset preeclampsia (EOPE), and late-onset preeclampsia (LOPE) compared to normal pregnancy. Among preeclampsia patients, serum HIF-1α was higher in EOPE than LOPE women. Statistical analysis revealed a significant difference in mean maternal serum HIF-1α between early-onset preeclampsia, late-onset preeclampsia, and normal pregnancy (p < 0.05). CONCLUSION: This study concluded that there is a significantly different level of HIF-1α between in early-onset preeclampsia, late-onset preeclampsia and normal pregnancy. Early-onset preeclampsia is the highest levels of serum HIF-1α.


2018 ◽  
Vol 3 (2) ◽  
pp. 11
Author(s):  
Lita Nafratilova ◽  
Yusrawati Yusrawati ◽  
Irza Wahi

Early Onset Preeclampsia (EO-PE) is preeclampsia that develops before 34 weeks 'gestation, caused by intrinsic factors, while Late Onset Preeclampsia (LO-PE) is preeclampsia that develops after 34 weeks' gestation due to extrinsic and maternal factors. There is an increased production of antiangiogenic factors (sFlt-1, s-Eng and PIGF) contribute to pathophysiology of preeclampsia.This study aims to measure the difference of sFlt-1, sEng, PIGF levels between EO-PE and LO-PE. This was an observational study with cross sectional design conducted at Dr. M. Djamil, TK Hospital. III dr. Reksodiwiryo and Biomedical Laboratory FK Unand Padang from August 2017 to August 2018. The sample of this study were 26 severe preeclampsia women : 13 (EO-PE)  and 13 (LO-PE), selected using consecutive sampling. Levels of sFlt-1, sEng, PIGF were examined using the enzyme-linked immunosorbent assay (ELISA) method. Statistical analysis was performed using unpaired t test and Mann-Whitney Test. Results shown that serum levels of sFlt-1 and sEng in (EO-PE)  were 9.51 ± 0.71 ng / L, 1.44 ± 0.06 ng / mL, 5.79 ± 0.42 ng / mL while in PEAL it was 8, 89 ± 0.78 ng / mL, 1.35 ± 0.14 ng / mL, 6.72 ± 0.76. There were a significant difference with a value of p <0.05. The conclusion of this study is that the levels of sFlt-1 and sEng are higher in (EO-PE)  than(LO-PE)and PIGF levels was lower in (EO-PE) compared to (LO-PE)


2021 ◽  
Vol 81 (11) ◽  
pp. 1247-1255
Author(s):  
Mariz Kasoha ◽  
Zoltan Takacs ◽  
Lena Fackiner ◽  
Christoph Gerlinger ◽  
Panagiotis Sklavounos ◽  
...  

Abstract Background Preeclampsia remains a major cause of perinatal and maternal mortality and morbidity worldwide. Wnt/β-catenin signaling is known to be critically involved in placenta development processes. Dickkopf-1 (DKK1) is a key regulator of this transduction pathway. The aim of this study is to compare maternal serum DKK1 levels and placental mRNA levels of DKK1 and β-catenin in preeclamptic and normal pregnant women at delivery. Methods The present study included 30 women with preeclampsia and 30 women with normal pregnancy. Maternal serum DKK1 levels were measured by ELISA. Placental mRNA levels of DKK1 and β-catenin were detected using RT-PCR. Results Decreased maternal serum DKK1 levels were associated with worse maternal and fetal complications including HELLP syndrome, determination of one or more pathological symptom and IUGR diagnosis. No significant difference in maternal serum DKK1 levels was reported between preeclamptic women and women with normal pregnancy. Placental mRNA DKK1 levels were lower in preeclamptic women compared with normal pregnant women. Placental mRNA β-catenin levels showed no significant difference between two groups. Conclusions Our findings reported the aberrant placental mRNA DKK1 levels in patients with preeclampsia. In addition, worse preeclampsia features were associated with decreased maternal serum DKK1 levels. Hence, aberrant Wnt/β-catenin signaling might present a plausible mechanism in preeclampsia pathogenicity. Dysregulated expression of DKK1 at gene level in the placenta but not at protein level in the maternal serum might confirm the notion that preeclampsia is a type of placenta-derived disease.


2015 ◽  
Vol 9 ◽  
pp. CMRH.S21865 ◽  
Author(s):  
Anna Yliniemi ◽  
Kaarin Makikallio ◽  
Teemu Korpimaki ◽  
Heikki Kouru ◽  
Jaana Marttala ◽  
...  

Objective To evaluate the efficacy of first-trimester markers–-pregnancy-associated plasma protein A (PAPPA), free human chorionic gonadotropin β (fhCGβ), alpha-fetoprotein (AFP), placental growth factor (PlGF), and soluble tumor necrosis factor receptor-1 (sTNFR1) together with maternal characteristics (MC) for prediction of early-onset preeclampsia (EOPE). Methods During 2005-2010, the abovementioned biomarkers were analyzed with logistic regression analysis in 64 EOPE and 752 control subjects to determine whether these biomarkers separately and in combination with MC would predict development of EOPE. Results PAPPA, fhCGβ, and PlGF levels were lower, whereas AFP and sTNFR1 levels were higher in mothers with EOPE compared to controls. The combination of all markers with MC (age, weight, and smoking status) detected 48% of the mothers with EOPE, with a 10% false-positive rate (FPR). Conclusions First-trimester maternal serum levels of PAPPA, fhCGβ, AFP, PlGF, and sTNFR1, together with MC, are predictive of development of subsequent EOPE. These markers, along with MC, form a suitable panel for predicting EOPE.


2020 ◽  
Vol 86 ◽  
pp. 01004
Author(s):  
H Sumawan ◽  
Sutrisno

Matrix Metalloproteinases 14 presumably play for cytotrophoblast migration and invasion of the uterine wall and in the remodeling of the spiral arteries in pregnancy. Inadequate trophoblastic invasion leads to an inappropriate vascular remodeling, which generates conditions of hypoxia and increased oxidative stress in the placenta early onset preeclampsia. Therefore, it is particularly important to investigating whether MMP14 altered and can be used as biomarker of preeclampsia. There have been no studies done to measure MMP14 in serum maternal between early onset preeclampsia and normal pregnancy The purpose of this study was to analyse whether maternal serum matrix metalloproteinases 14 levels differ in early onset preeclampsia and uncomplicated pregnancies. This crosssectional study was carried out in 20 subjects with early onset preeclampsia and 20 subjects of normotensive pregnant women range 24 up to 34 weeks of gestation. The study was conducted in Margono Hospital Purwokerto, Indonesia. Level of MMP 14 was measured in maternal serum using an enzyme-linked immunosorbent assay (ELISA). The mean difference was statically analysed by independent samples T-test and ROC curve to determine sensitivity and specificity of MMP 14.Women age, gestational age, parity and body mass index showed a non significant difference between both groups. In this study level MMP 14 in serum was higher in pregnant women with preeclampsia compared to the normotensive ( 266.41 vs 46.80 pg/dl ; p<0.00). Moreover, the area under curve of serum MMP 14 was 0.936, standard error 0.043, p<0.00. The optimal cut-off value of serum MMP at 110.73 pg/dl showed a high diagnostic value in preeclampsia with a sensitivity of 90 % and a specificity of 90%. Maternal serum MMP 14 was higher in preeclampsia and the important finding is the MMP 14 probably become a marker to predict early onset preeclampsia.


2021 ◽  
Vol 5 (1) ◽  
pp. 82-89
Author(s):  
David Perdana ◽  
Defrin Defrin ◽  
Firdawati Firdawati

The purpose of this study is to know the difference average of maternal serum levels of HIF-1α between early-onset and late-onset severe preeclampsia. This study used a cross sectional comparative study design that conducted in Februari 2020 - Agustus 2020 in the SMF / Obstetrics and Gynecology department of RSUP dr. M. Djamil Padang, RSUD Achmad Mochtar, RSUD Pariaman, RSUD M Zein Painan. We used consecutive sampling method which consists of 60 pregnant women who fulfill the inclusion and exclusion criteria. They were divided into two groups early-onset severe preeclampsia and late-onset severe preeclampsia. HIF-1α tests were done using ELISA method. The average of maternal serum levels of HIF-1α in late-onset severe preeclampsia is found to be the highest when compared to the early-onset severe preeclampsia, 1,37 ± 1,08 ng/ml vs 0,69 ± 0,11 ng/ml. This difference is significant with the Mann-whitney non parametrical statistical test (p <0.05). There is a significant difference average of maternal serum levels of HIF-1α between early-onset and late-onset severe preeclampsiaKeywords: early onset severe preeclampsia, late onset preeclampsia late onset, maternal serum levels of  HIF-1α


2020 ◽  
Vol 9 (1) ◽  
pp. 183 ◽  
Author(s):  
Katarzyna Kosinska-Kaczynska ◽  
Magdalena Zgliczynska ◽  
Szymon Kozlowski ◽  
Lukasz Wicherek

Multiple gestation is one of the key risk factors for the occurrence of preeclampsia (PE). Soluble fms-like tyrosine kinase-1, placental growth factor, and soluble endoglin are molecules involved in the process of angiogenesis with a proven role in the pathogenesis of PE. The aim of the review was to summarize available data on maternal serum levels of the above-mentioned factors and their usefulness in predicting PE in twin pregnancies. Only original research articles written in English were considered eligible. Reviews, chapters, case studies, conference papers, experts’ opinions, editorials, and letters were excluded from the analysis. No publication date limitations were imposed. The systematic literature search using PubMed/MEDLINE, Scopus, Embase, and Cochrane Library databases identified 338 articles, 10 of which were included in the final qualitative analyses. The included studies showed significant differences in maternal serum levels of the discussed factors between women with twin pregnancies with PE and those who did not develop PE, and their promising performance in predicting PE, alone or in combination with other factors. The identification of the most effective algorithms, their prompt introduction to the clinical practice, and further assessment of the real-life performance should become a priority.


Author(s):  
Poornima Shankar ◽  
Kavitha Karthikeyan ◽  
Amrita Priscilla Nalini ◽  
Sindhura M. ◽  
Gowtham Kim

Background: Preeclampsia is being increasingly recognized as two different entities: early-onset preeclampsia occurring at less than 34 weeks of gestation, and late-onset disease occurring at 34 or more weeks of gestation. Early-onset and late-onset pre-eclampsia are found to have different implications for the mother and neonate. The aim of this study is to compare the risk factors, maternal and fetal outcomes in early (<34 weeks) versus late (≥34weeks) onset preeclampsia.Methods: 208 patients diagnosed with pre-eclampsia in Chettinad Academy of Research and Education over a period of three years (From January 2014 to December 2016) were retrospectively studied. Patients were classified as early onset and late onset pre-eclampsia based on the gestational age of onset. Data on risk factors, maternal and fetal outcomes were collected and analyzed using Chi Square and Fisher’s test and compared.Results: The overall preeclampsia rate was 6.3%. Early onset and late onset were 34.6% and 65.3% respectively and the rate increased with increasing gestational age.35.3% of patients with late onset preeclampsia and 55.6% patients of early onset type required more than one drug which is a statistically significant difference. Proteinuria more than 3gm/l/day was significantly more in late onset preeclampsia than in early onset preeclampsia. 55.5% of patients with early onset pre-eclampsia required MgSO4 when compared to 17.4%. There was no statistically significant difference in the rate of caesarean section (61.1% vs 73.5%). Altered coagulation profile was significantly more in early onset preeclampsia (11.1%). The incidence of oligohydramnios, SGA and low APGAR at 5 minutes of birth were significantly high in early onset pre-eclampsia when compared to late onset type.Conclusions: Patients with early onset pre-eclampsia are found to have significantly higher rates of specific maternal and fetal morbidity when compared to the late onset type.


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