Markers of microbial translocation during pregnancy: differences among HIV+ women of African and European provenance

Introduction: Microbial translocation (MT) markers are indicators of HIV-related immune activation, but reference values are mostly derived from European or North American populations and could be substantially different in populations living in developing countries. Here we evaluate possible differences in MT markers levels in HIV+ pregnant women of different geographical provenance. Methodology: This study is nested within an observational study of pregnant women with HIV in Italy. Women were dichotomized on the basis of provenance in two groups of European (n = 14) and African (n = 26) origin. Soluble CD14, lipopolysaccharide-binding protein (LBP) and intestinal-fatty acid binding protein (I-FABP) were measured in plasma samples collected between the first and second trimester of pregnancy. Results: Demographic and viroimmunological characteristics were similar between groups, although European women were more commonly smokers and HCV-coinfected. Irrespective of origin, LBP plasma levels were positively correlated with I-FABP (r = 0.467, p = 0.004) and sCD14 levels (r = 0.312 p = 0.060). Significantly higher levels of sCD14 (1885 vs. 1208 ng/mL, p = 0.005) LBP (28.5 vs. 25.3 µg/mL, p = 0.050) and I-FABP (573.4 vs. 358.2 pg/mL, p = 0.002) were observed in European compared with African women. A multivariable linear regression analysis, adjusted for smoking and HCV coinfection confirmed the association between sCD14 levels and women provenance (p = 0.03). Conclusions: Our observations indicate significant differences in soluble markers among women of different provenance. In the design and analysis of studies evaluating MT markers, population-specific reference values should be considered.

Download Full-text

Persistent Systemic Microbial Translocation, Inflammation, and Intestinal Damage During Clostridioides difficile Infection

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz507 ◽

2019 ◽

Vol 7 (1) ◽

Cited By ~ 1

Author(s):

Alessandra Oliva ◽

Lucia Aversano ◽

Massimiliano De Angelis ◽

Maria Teresa Mascellino ◽

Maria Claudia Miele ◽

...

Keyword(s):

Fecal Microbiota Transplantation ◽

Cell Damage ◽

Binding Protein ◽

Fecal Microbiota ◽

Microbial Translocation ◽

Intestinal Cell ◽

Intestinal Damage ◽

Fatty Acid Binding ◽

Clostridioides Difficile ◽

Clostridioides Difficile Infection

Abstract Background Clostridioides difficile infection (CDI) might be complicated by the development of nosocomial bloodstream infection (n-BSI). Based on the hypothesis that alteration of the normal gut integrity is present during CDI, we evaluated markers of microbial translocation, inflammation, and intestinal damage in patients with CDI. Methods Patients with documented CDI were enrolled in the study. For each subject, plasma samples were collected at T0 and T1 (before and after CDI therapy, respectively), and the following markers were evaluated: lipopolysaccharide-binding protein (LPB), EndoCab IgM, interleukin-6, intestinal fatty acid binding protein (I-FABP). Samples from nonhospitalized healthy controls were also included. The study population was divided into BSI+/BSI- and fecal microbiota transplantation (FMT) +/FMT- groups, according to the development of n-BSI and the receipt of FMT, respectively. Results Overall, 45 subjects were included; 8 (17.7%) developed primary n-BSI. Markers of microbial translocation and intestinal damage significantly decreased between T0 and T1, however, without reaching values similar to controls (P < .0001). Compared with BSI-, a persistent high level of microbial translocation in the BSI+ group was observed. In the FMT+ group, markers of microbial translocation and inflammation at T1 tended to reach control values. Conclusions CDI is associated with high levels of microbial translocation, inflammation, and intestinal damage, which are still present at clinical resolution of CDI. The role of residual mucosal perturbation and persistence of intestinal cell damage in the development of n-BSI following CDI, as well as the possible effect of FMT in the restoration of mucosal integrity, should be further investigated.

Download Full-text

Gestational age-specific reference values of placental thickness in normal pregnant women

Women & Health ◽

10.1080/03630242.2018.1553816 ◽

2019 ◽

Vol 59 (7) ◽

pp. 718-729 ◽

Cited By ~ 1

Author(s):

E. Keshavarz ◽

M. Motevasselian ◽

B. Amirnazeri ◽

S. Bahramzadeh ◽

H. Mohammadkhani ◽

...

Keyword(s):

Pregnant Women ◽

Reference Values ◽

Gestational Age ◽

Specific Reference ◽

Placental Thickness

Download Full-text

Immune Activation and Microbial Translocation Markers in HIV-Exposed Uninfected Malawian Infants in the First Year of Life

Journal of Tropical Pediatrics ◽

10.1093/tropej/fmz022 ◽

2019 ◽

Vol 65 (6) ◽

pp. 617-625 ◽

Cited By ~ 1

Author(s):

Silvia Baroncelli ◽

Clementina Maria Galluzzo ◽

Giuseppe Liotta ◽

Mauro Andreotti ◽

Sandro Mancinelli ◽

...

Keyword(s):

Immune Activation ◽

Binding Protein ◽

Microbial Translocation ◽

First Year ◽

Gastrointestinal Infections ◽

Fatty Acid Binding ◽

Hiv Exposed ◽

First Year Of Life ◽

The Impact ◽

Exposed Uninfected

Abstract Background HIV-exposed uninfected (HEU) infants show a high rate of morbidity. We aimed to investigate on biomarkers of immune activation/microbial translocation in HEU infants, evaluating the impact that infections/malnutrition can have on biomarker levels during the first year of life. Methods Clinical data of 72 Malawian infants were recorded monthly and correlated with levels of soluble CD14 (sCD14), lipopolysaccharide-binding protein (LBP) and intestinal fatty acid-binding protein (I-FABP), analyzed longitudinally. Results Levels of sCD14 and LBP showed a significant age-related increase. Higher levels of LBP (19.4 vs. 15.2 μg/ml) were associated with stunting, affecting 30% of the infants. The association remained statistically significant after adjusting for cytomegalovirus acquisition, malaria and respiratory infections (p = 0.031). I-FABP levels were significantly increased in infants experiencing gastrointestinal infections (1442.8 vs. 860.0 pg/ml, p = 0.018). Conclusion We provide evidence that stunting is associated with an enhanced inflammatory response to microbial products in HEU children, suggesting that malnutrition status should be taken into consideration to better understand the alteration of the immune profile of HEU infants living in poor socioeconomic settings.

Download Full-text

Changes in serum adipocyte fatty acid‐binding protein in women with gestational diabetes mellitus and normal pregnant women during mid‐ and late pregnancy

Journal of Diabetes Investigation ◽

10.1111/jdi.12484 ◽

2016 ◽

Vol 7 (5) ◽

pp. 797-804 ◽

Cited By ~ 24

Author(s):

Ying Zhang ◽

Hao‐hang Zhang ◽

Jia‐hui Lu ◽

Si‐yuan zheng ◽

Tao Long ◽

...

Keyword(s):

Diabetes Mellitus ◽

Fatty Acid ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Fatty Acid Binding Protein ◽

Binding Protein ◽

Late Pregnancy ◽

Fatty Acid Binding ◽

Acid Binding Protein

Download Full-text

First trimester thyroid function in pregnant women residing in Saint Petersburg (Russia): reference values and risk of gestational diabetes

Diabetes Mellitus ◽

10.14341/dm9283 ◽

2018 ◽

Vol 21 (1) ◽

pp. 34-41

Author(s):

Polina V. Popova ◽

Ekaterina S. Shilova ◽

Alexandra S. Tkachuk ◽

Alexandra V. Dronova ◽

Anna D. Anopova ◽

...

Keyword(s):

Gestational Diabetes ◽

Pregnant Women ◽

Reference Values ◽

Subclinical Hypothyroidism ◽

Reference Interval ◽

First Trimester ◽

Specific Reference ◽

Thyroid Status ◽

Saint Petersburg ◽

Increased Risk

Background. Subclinical hypothyroidism during pregnancy and gestational diabetes mellitus (GDM) is known to be associated with maternal and child morbidity. The concept of subclinical dysfunction of the thyroid gland in pregnant women depends on the population-specific and trimester-specific reference values so fixed universal cutoff concentrations for thyroid-stimulating hormone (TSH) that were recommended earlier now are put under the question. Population-specific and trimester-specific reference values have not been defined for pregnant women residing in Saint Petersburg. The data concerning the association of maternal thyroid status with GDM development are controversial. Aims. The aim of the study was to determine the reference values of TSH and free thyroxin (fT4) in the first trimester of pregnancy in women living in St. Petersburg, and to assess the relationship between thyroid status and the risk of subsequent development of GDM. Materials and methods. The levels of TSH, fT4 and thyroid peroxidase antibodies (TPO-Ab) were analyzed in 503 pregnant women before the 14th week of gestation. The women underwent oral glucose tolerance test (OGTT) at 2428 weeks to find out those with GDM. The association between thyroid function, thyroid autoimmunity and the risk of GDM we estimated. Results. The reference values for TSH were 0.07 4.40 mU /L, and for fT4 11.7 20.3 pmol/L. The prevalence of subclinical hypothyroidism in the 503 pregnant women was 16.9% according to the diagnostic criteria of TSH 2.5 mIU / L and 3.8% using our calculated reference interval. Hypothyroxinemia was registered in 5,3% using reference values recommended by diagnostic tests manufacturer and in 2,8% according to our calculated reference interval for fT4. GDM was diagnosed in 23% of women. Logistic regression analysis showed associations of hypothyroxinemia and TPO-Ab-positivity with the increased risk of GDM that remained significant after adjustments on age and body mass index (BMI) [adjusted OR (95% CI) = 7.39 (1.2742.93) for hypothyroxinemia, p=0.026; and adjusted OR (95% CI) = 2.02 (1.014.04) for TPO-Ab-positivity, p=0.047). Conclusions. Reference intervals for first trimester TSH and fT4 have been established for pregnant women living in St. Petersburg. Hypothyroxinemia and TPO-Ab-positivity were associated with the increased risk of GDM.

Download Full-text

MON-283 IGF-1 Levels During Normal Pregnancy

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1152 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Guillermo Javier Thomas ◽

Agustina Peverini ◽

Fernando Smithuis ◽

Dolores Fabbro ◽

Julieta Tkatch ◽

...

Keyword(s):

Pregnant Women ◽

Reference Values ◽

Metabolic Diseases ◽

Clinical Endocrinology ◽

Normal Pregnancy ◽

Specific Reference ◽

Serum Samples ◽

Estrogen Regulation ◽

Growth Hormone Action

Abstract Pregnancy is associated with a physiological GH excess, where maternal pituitary GH is suppressed by effect of placental GH on the hepatic receptor, increasing IGF-1 serum levels1. However, it is also described that estrogens and progesterone are responsible for reduction in IGF-1 by direct hepatic action through the inhibition of the JAK-STAT pathway that results in GH resistance, being more clear at the beginning of pregnancy.2 Acromegaly is a rare disorder in which GH axis is deregulated and IGF-1 is the most reliable biochemical marker for diagnosis and monitoring. It is know that secondary hypogonadism associated with these pathology decreases fertility rates. Nonetheless, improvement of acromegaly treatment and greater access to assisted reproductive technology increase pregnancy rates in this population. The follow-up of pregnant acromegalic women acquires relevance for the comorbidities of this association and depends on the adequate interpretation of the IGF-1 values. Then, due to changes in concentration and action of IGF-1 during pregnancy3, it is important that each laboratory establish their specific reference values. For that reason we analyzed serum samples from 80 healthy pregnant women living in the Metropolitan Area of Buenos Aires (AMBA): 22 were in the 1st trimester (1T), 29 in the 2nd (2T) and 29 in the 3rd (3T). All women were between 30 and 40 years old, had no endocrinopathies or metabolic diseases. Serum IGF-1 was measured by Immulite 2000 Siemens, and Prism8 GraphPad was used for statistical analysis, calculating ranges for each trimester defined as 2,5 and 97,5 percentiles. Ranges obtained were: 64,5-165,0 ng/ml, 78,9-201,0 ng/ml and 96,1-344,0 ng/ml for 1T, 2T and 3T, respectively. Significant differences were observed between 3T and the other trimesters (1T and 2T). We also compared these ranges with our reference values from healthy non-pregnant women in the same age, and found that 3T has significantly higher values of IGF-1 (55,8-188,4 ng/ml vs. 96,1-344,0 ng/ml respectively). In conclusion, IGF-1 levels during the first two trimesters of pregnancy remain within the normal range, and there is a significant increase during the third trimester. Given that IGF-1 plays an essential role during pregnancy, it is important to report ranges in healthy pregnant women to contribute in the follow-up of patients with acromegaly who get pregnant. Although our results are in agree with the available literature, it is necessary to increase the number of healthy pregnant women to establish reference values of IGF-1. 1Frankenne et al (1988). The physiology of growth hormones in pregnant women and partial characterization of the placental GH variant. Journal of Clinical Endocrinology and Metabolism 66:1171-1180 2Leung et al (2004). Estrogen regulation of growth hormone action. Endocrine Reviews 25:693-72 3Muhammad et al (2017). Pregnancy and acromegaly. Pituitary 20:179-184

Download Full-text

Urinary liver-type fatty acid-binding protein as a Marker for Early Diagnosis of Diabetic Nephropathy in Type 1 Diabetic Children.

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i5.23518 ◽

2018 ◽

Vol 11 (5) ◽

pp. 329

Author(s):

Mones M Abushady ◽

Gihan A Fathy ◽

Inas R El-alameey ◽

Abbas Ma ◽

Essam M Galal ◽

...

Keyword(s):

Diabetic Nephropathy ◽

Fatty Acid ◽

Early Diagnosis ◽

Fatty Acid Binding Protein ◽

Binding Protein ◽

Linear Regression Analysis ◽

Fatty Acid Binding ◽

Acid Binding Protein ◽

The Mean

Objectives: Renal failure and premature mortality are fatal prognosis of diabetic nephropathy. To improve patient outcome, early diagnosis of diabetic nephropathy is necessary. The study was designed to evaluate urinary liver-type fatty acid binding protein (L-FABP), as an early biomarker of tubulointerstitial injury, and its association with the clinical characteristics of type 1 diabetic children.Methods: Fifty randomly selected patients with type 1 diabetes mellitus (DM) attending the diabetes outpatient clinic of Ain Shams University Children’s Hospital were included in the study. 50 age and sex-matched healthy subjects were enrolled as controls. Urinary L-FABP, 24 h urine albumin, hemoglobin A1c (HbA1c), serum creatinine, and lipid profile were measured.Results: Diabetic subjects had higher mean urinary L-FABP than controls (p<0.05). In microalbuminuric diabetic subjects, the mean urinary L-FABP was detected to be significantly higher than that in normoalbuminuric diabetic subjects, and significantly higher values of the mean urinary L-FABP were detected in the microalbuminuric and the normoalbuminuric subjects than the controls (p<0.05). Multiple linear regression analysis showed that duration of DM and HbA1c was the main predictors of urinary L-FABP in diabetic subjects.Conclusion: In patients with childhood-onset T1D, urinary L-FABP may be used as an indicator of renal injury in early stages of nephropathy, even in the normoalbuminuric state.

Download Full-text

Persistent Systemic Microbial Translocation and Intestinal Damage During Coronavirus Disease-19

Frontiers in Immunology ◽

10.3389/fimmu.2021.708149 ◽

2021 ◽

Vol 12 ◽

Author(s):

Alessandra Oliva ◽

Maria Claudia Miele ◽

Federica Di Timoteo ◽

Massimiliano De Angelis ◽

Vera Mauro ◽

...

Keyword(s):

Binding Protein ◽

Microbial Translocation ◽

Control Group ◽

Intestinal Damage ◽

Cell Integrity ◽

Gut Permeability ◽

Fatty Acid Binding ◽

And Gender ◽

High Level ◽

High Degree

Microbial translocation (MT) and intestinal damage (ID) are poorly explored in COVID-19. Aims were to assess whether alteration of gut permeability and cell integrity characterize COVID-19 patients, whether it is more pronounced in severe infections and whether it influences the development of subsequent bloodstream infection (BSI). Furthermore, we looked at the potential predictive role of TM and ID markers on Intensive Care Unit (ICU) admission and in-hospital mortality. Over March–July 2020, 45 COVID-19 patients were enrolled. Markers of MT [LPB (Lipopolysacharide Binding Protein) and EndoCab IgM] and ID [I-FABP (Intestinal Fatty Acid Binding Protein)] were evaluated at COVID-19 diagnosis and after 7 days. As a control group, age- and gender-matched healthy donors (HDs) enrolled during the same study period were included. Median age was 66 (56-71) years. Twenty-one (46.6%) were admitted to ICU and mortality was 22% (10/45). Compared to HD, a high degree of MT and ID was observed. ICU patients had higher levels of MT, but not of ID, than non-ICU ones. Likewise, patients with BSI had lower EndoCab IgM than non-BSI. Interestingly, patients with high degree of MT and low ID were likely to be admitted to ICU (AUC 0.822). Patients with COVID-19 exhibited high level of MT, especially subjects admitted to ICU. COVID-19 is associated with gut permeability.

Download Full-text

Positive Associations between Adipocyte Fatty Acid-Binding Protein Level and Central Arterial Stiffness in Peritoneal Dialysis Patients

International Journal of Hypertension ◽

10.1155/2021/8849115 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Cheng-Hao Sung ◽

Bang-Gee Hsu ◽

Jen-Pi Tasi ◽

Chih-Hsien Wang ◽

Chiu-Huang Kuo

Keyword(s):

Regression Analysis ◽

Peritoneal Dialysis ◽

Fatty Acid ◽

Arterial Stiffness ◽

Fatty Acid Binding Protein ◽

Binding Protein ◽

Linear Regression Analysis ◽

Enzyme Linked Immunosorbent Assay ◽

Fatty Acid Binding ◽

Acid Binding Protein

Background. Adipocyte fatty acid-binding protein (A-FABP) plays essential roles in lipolysis, insulin resistance, and atherosclerosis. This study aimed to evaluate the relationship between serum A-FABP levels and carotid-femoral pulse wave velocity (cfPWV) in peritoneal dialysis (PD) patients. Methods. This study obtained fasting blood samples from 76 PD patients. A validated tonometry system was used to measure cfPWV. Patients with cfPWV values >10 m/s were classified into the high arterial stiffness group, whereas patients with values ≤10 m/s were classified into the low arterial stiffness group, according to the ESH-ESC 2013 guidelines. Serum A-FABP levels were measured using a commercial enzyme-linked immunosorbent assay kit. Results. Twenty-five (32.9%) of the 76 PD patients were classified in the high arterial stiffness group. Compared with the patients in the low arterial stiffness group, the high arterial stiffness group was older ( P = 0.002) and had a longer PD vintage ( P = 0.011), higher diastolic blood pressure (DBP, P = 0.036), higher fasting glucose levels ( P = 0.012), higher serum C reactive protein levels ( P = 0.001), and higher serum A-FABP levels ( P < 0.001). A multivariate logistic regression analysis of the factors significantly associated with central arterial stiffness revealed that A-FABP (odds ratio (OR): 1.165, 95% confidence interval (CI): 1.056–1.284, P = 0.002), age (OR: 1.423, 95% CI: 1.153–1.757, P = 0.001), PD vintage (OR: 1.049, 95% CI: 1.015–1.085, P = 0.005), and DBP (OR: 1.152, 95% CI: 1.033–1.285, P = 0.011) were independent predictors of central arterial stiffness in PD patients. Furthermore, serum A-FABP levels (β = 0.476, adjusted R2 change: 0.197, P < 0.001) were significantly positively correlated with cfPWV according to the multivariable forward stepwise linear regression analysis. Conclusions. A-FABP levels are an independent marker of central arterial stiffness in PD patients.

Download Full-text

High Serum Adipocyte Fatty Acid Binding Protein Is Associated with Metabolic Syndrome in Patients with Type 2 Diabetes

Journal of Diabetes Research ◽

10.1155/2016/8380279 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Jer-Chuan Li ◽

Du-An Wu ◽

Jia-Sian Hou ◽

Yi-Maun Subeq ◽

Hsin-Dean Chen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Metabolic Syndrome ◽

Fatty Acid ◽

Fatty Acid Binding Protein ◽

Binding Protein ◽

Linear Regression Analysis ◽

Fatty Acid Binding ◽

Acid Binding Protein ◽

Type 2 Dm

Adipocyte fatty acid binding protein (A-FABP) is a key mediator of obesity-related metabolic syndrome (MetS). The aim of this study was to evaluate the relationship between A-FABP concentration and MetS in type 2 diabetes mellitus (DM) patients. Fasting blood samples were obtained from 165 type 2 DM volunteers. MetS and its components were defined using diagnostic criteria from the International Diabetes Federation. Among 165 DM patients, 113 patients (68.5%) had MetS. Diabetic persons who had MetS had significantly higher A-FABP levels (P<0.001) than those without MetS. Female DM persons had higher A-FABP level than man (P<0.001). No statistically significant differences in A-FABP levels were found in use of statin, fibrate, or antidiabetic drugs. Multivariate forward stepwise linear regression analysis revealed that body fat mass (P<0.001), logarithmically transformed creatinine (log-creatinine;P<0.001), female DM patients (P<0.001), and logarithmically transformed high sensitive C-reactive protein (log-hs-CRP;P=0.013) were positively correlated, while albumin (P=0.004) and glomerular filtration rate (GFR;P=0.043) were negatively correlated with serum A-FABP levels in type 2 DM patients. In this study, higher serum A-FABP level was positively associated with MetS in type 2 DM patients.

Download Full-text