Amniotic membrane-derived mesenchymal cells (AMCs) are considered suitable candidates for a variety of cell-based applications. In view of cell therapy application in uterine pathologies, we studied AMCs in comparison to cells isolated from the endometrium of mares at diestrus (EDCs) being the endometrium during diestrus and early pregnancy similar from a hormonal standpoint. In particular, we demonstrated that amnion tissue fragments (AM) shares the same transcriptional profile with endometrial tissue fragments (ED), expressing genes involved in early pregnancy (AbdB-like Hoxa genes), pre-implantantion conceptus development (Erα, PR, PGRMC1 and mPR) and their regulators (Wnt7a, Wnt4a). Soon after the isolation, only AMCs express Wnt4a and Wnt7a. Interestingly, the expression levels of prostaglandin-endoperoxide synthase 2 (PTGS2) were found greater in AM and AMCs than their endometrial counterparts thus confirming the role of AMCs as mediators of inflammation. The expression of nuclear progesterone receptor (PR), membrane-bound intracellular progesterone receptor component 1 (PGRMC1) and membrane-bound intracellular progesterone receptor (mPR), known to lead to improved endometrial receptivity, was maintained in AMCs over 5 passages in vitro when the media was supplemented with progesterone. To further explore the potential of AMCs in endometrial regeneration, their capacity to support resident cell proliferation was assessed by co-culturing them with EDCs in a transwell system or culturing in the presence of AMC-conditioned medium (AMC-CM). A significant increase in EDC proliferation rate exhibited the crucial role of soluble factors as mediators of stem cells action. The present investigation revealed that AMCs, as well as their derived conditioned media, have the potential to improve endometrial cell replenishment when low proliferation is associated to pregnancy failure. These findings make AMCs suitable candidates for the treatment of endometrosis in mares.
Objective: To assess oxygen diffusion at 36 weeks' post-menstrual age in preterm infants by means of the non-invasive oxygen saturation/fraction of inspired oxygen ratio (36w-SFR) and to identify factors associated with 36w-SFR
Background
Early continuous positive airway pressure (CPAP) and surfactant replacement are effective treatments for neonatal respiratory distress syndrome (RDS). CPAP is the first line in preterm infants needing respiratory support, with surfactant replacement in case of CPAP failure (CPAP‐F).
Objectives
To analyze incidence and factors associated with CPAP‐F in preterm infants with RDS.
Design, Setting and Patients
Single‐center retrospective database analysis (2004–2017) of inborn infants, gestational age (GA) 24 + 0/7–31 + 6/7 weeks, not intubated on admission to the neonatal intensive care unit, managed with CPAP. CPAP‐F was defined as intubation and surfactant administration in the first 72 h of life; CPAP success (CPAP‐S) was CPAP alone without need for additional RDS treatments. Demographic, respiratory, and clinical data associated with CPAP‐F were studied using logistic regression analysis.
Results
A total of 562 infants met the inclusion criteria: 252 (44.8%) were CPAP‐F and 310 (55.2%) were CPAP‐S. The CPAP‐F, compared to CPAP‐S group, had lower GA and birth weight, and were less likely to receive antenatal steroids or to be vaginal births. Logistic regression showed that the fraction of inspired oxygen (FiO2) ≥ 0.23 between 180 and 240 min of life (FiO2 180–240 min) was the strongest factor associated with CPAP‐F (odds ratio: 16.01 [95% confidence interval: 10.34–24.81]).
Conclusion
FiO2 180–240 min was highly predictive of CPAP‐F in preterm infants. With this model for surfactant administration/CPAP‐F, 11.2% of infants would have unnecessarily received treatment, but importantly, 27.7% would have been treated much earlier, with a potential reduction in air leaks and duration of mechanical ventilation.
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