Amir Hossein Norooznezhad; Alireza A Shamshirsaz; Sedigheh Hantoushzadeh
Abstract
Pregnant women with coronavirus disease 2019 (COVID-19) have a higher risk of morbidity and mortality compared with the general population. Possible pathways are: I) in patients with COVID-19, cytokine storm defined as the excess release of pro-inflammatory cytokines such as interleukin 1β (IL-1β), ...
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Pregnant women with coronavirus disease 2019 (COVID-19) have a higher risk of morbidity and mortality compared with the general population. Possible pathways are: I) in patients with COVID-19, cytokine storm defined as the excess release of pro-inflammatory cytokines such as interleukin 1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) has been associated with morbidities and an even higher rate of mortality. II) Labor, despite being a term/preterm, has an inflammatory nature, although, inflammation is more prominent in preterm delivery. During labor, different pro-inflammatory cytokines such as IL-1β, IL-6, and TNF-α are involved which as mentioned, all are crucial role players in the cytokine storm. III) Tissue injury, and during labor, (especially cesarean section) is shown to cause inflammation via pro-inflammatory cytokines release including those involved in the cytokine storm through the activation of nuclear factor κB (NFκB). IV) post-partum hemorrhage with a notable amount of blood loss which can cause significant hypoxemia. In this condition, hypoxia-inducible factor 1α which has a cross-talk with NFκB, leads to the expression of IL-1β, IL-6, and TNF-α as both angiogenic and pro-inflammatory factors. Considering all the mentioned issues and pathways, we suggest that clinicians be careful about the escalation of the inflammatory status in their pregnant COVID-19 patients during/following labor.
Behrouz Gharesi-Fard; Maryam Zare; Eskandar Kamali-Sarvestani
Volume 14, Issue 4 , December 2017, , Pages 306-315
Abstract
Background: Multiple Sclerosis (MS) with four different types is one of the well studied autoimmune diseases of the central nervous system. Generally, two-thirds of MS patients are females who are at risk of pregnancy-related complications. Inappropriate responses of mother’s immune system, ...
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Background: Multiple Sclerosis (MS) with four different types is one of the well studied autoimmune diseases of the central nervous system. Generally, two-thirds of MS patients are females who are at risk of pregnancy-related complications. Inappropriate responses of mother’s immune system, such as antibody production against placental proteins, may lead to pregnancy-related disorders. The association between pregnancy complications and some autoantibodies including anti-phospholipid and anti-angiotensin II type-1 receptor antibodies are clear examples in this regard. Objective: To investigate the probable placental antigens that might be targeted by the antibodies in the sera of MS patients. Methods: Total placental proteins were extracted from normal fresh placentas and were separated using two-dimensional gel electrophoresis (2-DE) technique. The separated proteins were transferred onto a Polyvinylidene Fluoride (PVDF) membrane and blotted with the pooled sera of MS women or healthy controls (20 individuals in each group). The differentially blotted spot was identified by mass spectrometry and confirmed by western blot technique. Results: The results indicated that the women afflicted with MS had an antibody against placental HSP70kDa protein 5 (GRP78). Conclusion: In the present study, a new placental autoantigen candidate, which was targeted by antibody present in MS women sera, was found. The clinical importance of this finding regarding pregnancy complications in MS patients should be investigated by further experiments.
Mohammed Said Al-Balushi; Elias Anthony Said; Sidgi Syed Hasson; Juma Zaid Al-Busaidi; Iman Al-Reesi; Mohammed Idris; Wadha Al-Ghafri; Moza Al-Kalbani; Ali Abdullah Al-Jabri
Volume 13, Issue 2 , June 2016, , Pages 114-123
Abstract
Background: Helicobacter pylori (H. pylori), is a common infection in pregnant women accompanied by variations in the levels of the IgM, IgA and IgG antibody isotypes. The variations of anti-H. pylori antibodies during and after pregnancy, and the extent of protection they provide to the mother and the ...
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Background: Helicobacter pylori (H. pylori), is a common infection in pregnant women accompanied by variations in the levels of the IgM, IgA and IgG antibody isotypes. The variations of anti-H. pylori antibodies during and after pregnancy, and the extent of protection they provide to the mother and the fetus are not completely understood. Objectives: To investigate the changes of the anti-H. pylori IgM, IgA and IgG levels in healthy Omani pregnant women during pregnancy and 3 months after delivery. Methods: Serum samples obtained from 70 Omani healthy pregnant women, with no history of autoimmune diseases, were tested for anti-H. pylori IgM, IgA and IgG in the first trimester of pregnancy and 3 months after delivery. In parallel and as a control group, sera obtained from a group of 70 healthy non-pregnant Omani women were tested. The levels of anti-H. pylori IgM, IgA and IgG were measured using standard Enzyme Linked Immunosorbent Assays (ELISAs). Results: Anti-H. pylori IgA levels were found to be significantly higher during pregnancy (p=0.046) and after delivery (p=0.02) when compared to the control group. Moreover, a significant increase in the levels of anti-H. pylori IgM, IgA and IgG was detected after delivery (p=0.002) when compared to the levels during pregnancy. Conclusion: Pregnancy is associated with an increase in the levels of anti-H. pylori IgA antibodies. In addition, anti-H. pylori IgM, IgG and IgA antibody levels increase after delivery.
Feryal Dabagh-Gorjani; Fahimeh Anvari; Jaleh Zolghadri; Eskandar KamaliSarvestani; Behrouz Gharesi-Fard
Volume 11, Issue 4 , December 2014, , Pages 233-245
Abstract
Background: Preeclampsia (PE) is one of the most complex and life-threatening pregnancy disorders and is considered as a major cause of mortality among mothers and fetuses worldwide. Although the exact etiology of PE is not well known several lines of evidence support an immunological etiology for PE. ...
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Background: Preeclampsia (PE) is one of the most complex and life-threatening pregnancy disorders and is considered as a major cause of mortality among mothers and fetuses worldwide. Although the exact etiology of PE is not well known several lines of evidence support an immunological etiology for PE. Objective: To investigate the differences in the expression of TLRs 2, 4, 5, and 6 and a group of inflammatory cytokines including IL-1, IL-6, TNF-α and IFN-γ in placentas from PE and healthy pregnant women in their third trimester of pregnancy. Methods: This case-control study was performed on fifteen PE and fifteen age and gestational matched healthy pregnant women in the third trimester of pregnancy. Real time PCR (RT-PCR) technique was used to determine the expression of TLRs 2, 4, 5, and 6 in the maternal and fetal parts of the placenta. Moreover, the expressions of IL-1, IL-6, TNF-α and IFN-γ at RNA level in placental samples, peripheral, and cord blood were investigated. Results: The results of the present study indicated that the expressions of TLRs 4, 5 and 6 were significantly increased in both maternal part (p<0.001 and p<0.003 for TLRs 4, 6 and TLR 5, respectively) and fetal part (p<0.001), while TLR2 showed significant increase only in the fetal part of PE placentas (p<0.002). The levels of all studied cytokines showed over-expression within peripheral and cord blood samples from PE patients (p<0.001 for IL-1, IL-6, and IFN-γ and p<0.004 for TNF-α in both cord and peripheral blood samples). Conclusion: The finding of the present study indicated that the expression of the studied TLRs and inflammatory cytokines are generally suppressed in normal pregnancy, but are up regulated in preeclamptic women. Moreover, it seems that the maternal and fetal parts of the placenta may play different roles in the induction of the inflammatory status within the placenta.
Leila Rezanezhad; Jaleh Zolghadri; Behrouz Gharesi-Fard
Volume 10, Issue 4 , December 2013, , Pages 238-246
Abstract
Background: Preeclampsia (PE) is a pregnancy specific syndrome that is associated with high maternal and fetal morbidity and mortality. Glucose regulated protein78 (GRP78) is an Endoplasmic Reticulum (ER) protein which is expressed on the cell surfaces of trophoblast cells under stress or hypoxic condition. ...
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Background: Preeclampsia (PE) is a pregnancy specific syndrome that is associated with high maternal and fetal morbidity and mortality. Glucose regulated protein78 (GRP78) is an Endoplasmic Reticulum (ER) protein which is expressed on the cell surfaces of trophoblast cells under stress or hypoxic condition. GRP78 has a role in aggressive behavior of invasive cells and may play a role in normal placentation. Objectives: To investigate the autoantibody against GRP78 in the sera of patients with PE and to assess the correlation between antibody and severity of the disease. Methods: We evaluated the anti-GRP78 antibody within the sera of fifty pre-eclamptic (12 severe and 38 mild PE) and fifty healthy pregnant women using a home-made ELISA assay. Furthermore, western blot technique was used to assess the expression of GRP78 in placenta of healthy and pre-eclamptic women in their third trimester. The presence of anti-GRP78 antibody in the serum samples from pre-eclamptic and healthy women was also assessed. Results: GRP78 was expressed by placenta, and both healthy and preeclamptic women produced anti-GRP78 antibody. Although no significant difference was found between the pre-eclamptic and healthy women regarding the level of anti-GRP78 antibody, the difference between severe pre-eclamptic and healthy control women was statistically significant (p<0.003). Conclusion: The findings of the present study indicated that measurement of anti-GRP78 antibody may provide a new marker for severe pre-eclampsia. Yet, future studies are required to confirm this notion.
Shabnam Pour Abolghasem; Mohammad Reza Bonyadi; Zohre Babaloo; Abolfazl Porhasan; Behroz Nagili; Omid Ali Gardashkhani; Parviz Salehi; Mohammad Hashemi; Mojtaba Varshoghi; Gafar Olade Gaffari
Volume 8, Issue 4 , December 2011, , Pages 251-255
Abstract
Background: Toxoplasmosis is well known as an important infection in pregnant women. Although many serologic methods are available, diagnosis of early Toxoplasmosis may be extremely difficult. Objective: To detect the Toxoplasma IgG antibodies developed at the early stage of infection in pregnant women. ...
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Background: Toxoplasmosis is well known as an important infection in pregnant women. Although many serologic methods are available, diagnosis of early Toxoplasmosis may be extremely difficult. Objective: To detect the Toxoplasma IgG antibodies developed at the early stage of infection in pregnant women. Methods: 225 pregnant women, who were in the 2nd to 4th month of their pregnancy, enrolled in this study. Anti-toxoplasma IgG, IgM and IgG avidity were evaluated by ELISA method. Results: The patients were categorized into three groups as follows: Group A, 124 cases; IgG+, IgM+, 55.1%; group B, 99 cases; IgG+, IgM-, 44%; and group C, 2 cases; IgG -, IgM +, 0.9%. Fifty five percent of the pregnant women had positive IgG and IgM among which 7.1% had low avidity which revealed an active infection in the pregnant women. In the current study, 44% of pregnant women had positive IgG and negative IgM, all of which had high avidity, which is an indication that in our population the level of toxoplasmosis infection is high and most women have had contacts with this parasite before pregnancy. Conclusion: In this study, the low avidity test was 7.1% showing that the occurrence of toxoplasmosis infection is still a serious issue. Observation of 45.8% high avidity among group A suggests that either IgM has a high half-life or there is a false positive IgM as a result of rheumatologic disorders. Therefore, avidity test is important in predicting maternal toxoplasmosis which is of value in disease treatment.
Zahra Alinejad; Reza Jafari Shakib; Kambiz Forghan-parast; Ziba Zahiri; Hossein Sadri; Farangis Nagafi; Zahra Roushan
Volume 6, Issue 4 , December 2009, , Pages 195-201
Abstract
Background: Pregnancy is a successful transplantation. The factors evading rejection of the fetus are poorly understood. Recently an interest has grown, in HLA-G molecules as one of these factors. Since these antigens are mainly expressed on the surface of cytotro-phoblasts that are in direct contact ...
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Background: Pregnancy is a successful transplantation. The factors evading rejection of the fetus are poorly understood. Recently an interest has grown, in HLA-G molecules as one of these factors. Since these antigens are mainly expressed on the surface of cytotro-phoblasts that are in direct contact with maternal tissues, it has been suggested that these molecules may have a role in induction of immune tolerance in mothers. Objective: to find the association of soluble HLA-G (sHLA-G) and the success of pregnancy with intracyto-plasmic sperm injection (ICSI) procedure. Methods: In this study, the supernatant of 287 individually cultured embryos corresponding to 96 women under ICSI procedure were as-sayed for soluble HLA-G1 and G5 by a sandwich ELISA. Results: Clinical pregnancy suc-cessfully occurred in 30 of candidates. No differences in clinical parameters (age, infertility duration, stimulation regimen) were observed between pregnant and nonpregnant women under ICSI procedure. None of the embryo supernatants in either group showed any detect-able sHLA-G molecules. Conclusion: Our results showed that detectable level of sHLA-G is not produced by day 2 embryos and such a measurement may not provide reliable infor-mation for embryo selection and estimation of pregnancy success.
Vijay Kumar; Bikash Medhi
Abstract
Normal pregnancy has been considered as a controlled state of inflammation at an early stage of blastocyst implantation that subsequently develops systemically. Till recent past most popular hypotheses regarding status of immune system in pregnancy were dominated by the Th1 and Th2 hypothesis, in which ...
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Normal pregnancy has been considered as a controlled state of inflammation at an early stage of blastocyst implantation that subsequently develops systemically. Till recent past most popular hypotheses regarding status of immune system in pregnancy were dominated by the Th1 and Th2 hypothesis, in which the fetus avoids maternal rejection through a bias towards T-helper (Th2) cytokine production. Recent findings have shown that predominant immune interactions in the human deciduas are between the placental trophoblast and maternal uterine natural killer (uNK) cells rather than the T cells. Thus NK cells are emerging as important players in the uterine immune response to invasive forms of placenta, as in cases of hemochorial placenta. In humans there is a lack of evidence for T-cell responses to trophoblast cells; therefore it was thought that uterine NK cells are the key factors by which the maternal immune system recognizes trophoblast cells. In this review we are trying to summarize the role of uNK cells in the maintenance of normal pregnancy in humans.
Amir Hassan Zarnani; Pouneh Dokouhaki; Mahmood Jeddi-Tehrani
Volume 1, Issue 3 , December 2004, , Pages 143-153
Abstract
Indoleamine 2,3-dioxygenase (IDO), an enzyme involved in the catabolism of tryptophan, is expressed by a variety of cells and tissues such as macrophages, dendritic cells, cells of the endocrine system and by the placenta. IFN- γ is the main inducer of this enzyme. IDO acts as an important defense ...
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Indoleamine 2,3-dioxygenase (IDO), an enzyme involved in the catabolism of tryptophan, is expressed by a variety of cells and tissues such as macrophages, dendritic cells, cells of the endocrine system and by the placenta. IFN- γ is the main inducer of this enzyme. IDO acts as an important defense mechanism of innate immunity against pathogens. It also has tumor suppressive activity and prolongs the survival of allograft. One of the interesting functions of IDO is prevention of the allogenic fetus rejection during pregnancy by inhibiting alloreactive T cells. It was shown that inhibition of IDO activity by IDO inhibitor, 1-methyl tryptophan, during mouse pregnancy causes fetal rejection. The main mechanism by which IDO protects fetus is through reducing the tryptophan level and suppressing the T cell activity in the feto-maternal interface. In this review the biological functions of IDO with emphasis on its role in allogeneic fetus protection have been discussed.