Background. Asthma airway remodeling is closely related to the abnormal migration of human airway smooth muscle cells (ASMCs), and vascular endothelial growth factor (VEGF) is involved in the pathophysiological process of asthma. This study aimed to investigate the effect of VEGF on ASMC migration through in vitro cell experiments and to intervene in ASMC migration with different asthma drugs and signaling pathway inhibitors to provide a basis for screening effective drugs for airway remodeling. Methods. The effect of VEGF on the proliferation of ASMCs was detected by the CCK-8 method, and the effect of VEGF on the migration of ASMCs was proven by scratch and transwell assays. Different asthma drugs and signaling pathway inhibitors were used to interfere with the migration of ASMCs. The number of migrating cells was compared between the intervention and nonintervention groups. Results. Our results showed that VEGF induction enhanced ASMC migration; pretreatment with the commonly used asthma drugs (salbutamol, budesonide, and ipratropium bromide) significantly attenuated VEGF-induced ASMC migration; and inhibitors SB203580, LY294002, and Y27632 blocked the VEGF-induced activation of p38 MAPK, PI3K, and ROCK signaling pathway targets in ASMCs and inhibited migration. Conclusion. This study shows that the current commonly used asthma drugs salbutamol, budesonide, and ipratropium have potential value in the treatment of airway remodeling, and the p38 MAPK, PI3K, and ROCK signaling pathway targets are involved in the VEGF-induced ASMC migration process. Signaling pathway inhibitor drugs may be a new way to treat asthma-induced airway remodeling in asthma patients in the future. However, the related mechanism and safety profile still need further research.
Background In recent years, with the development of monitoring conditions and the application of pulmonary vascular-targeted drugs, pregnancy outcomes in women with pulmonary hypertension (PH) have improved, but the maternal mortality rate is still high. The purpose of this study was to describe the maternal-foetal outcomes in pregnant women with PH. Methods The clinical data of 154 pregnant women with PH who were admitted to the Third Affiliated Hospital of Guangzhou Medical University from January 2011 to December 2020 were collected and descriptively analysed. Results Among the 154 pregnant women with PH, 6 (3.9%) had idiopathic pulmonary arterial hypertension (iPAH), 41 (26.6%) had pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD-PAH), 45 (29.2%) had PAH related to other diseases (oPAH), and 62 (40.3%) had PH related to left heart disease (LHD-PH). The systolic pulmonary artery pressure (sPAP) was 36–49 mmHg in 53.2% of the patients, 50–69 mmHg in 22.1% of the patients and ≥ 70 mmHg in 24.7% of the patients. Five (3.2%) pregnant women died within 1 week after delivery; iPAH patients had the highest mortality rate (3/6, 50%). Fifty-four patients (35.1%) were admitted to the intensive care unit (ICU), and the incidence of heart failure during pregnancy was 14.9%. A total of 70.1% of the patients underwent caesarean section; 42.9% had premature infants; 28.6% had low-birth-weight (LBW) infants; 13.0% had very-low-birth-weight (VLBW) infants; 3.2% had extremely-low-birth-weight (ELBW) infants; 61% had small for gestational age (SGA) infants; and 1.9% experienced neonatal mortality. Conclusion There were significant differences in the maternal-foetal outcomes in the iPAH, CHD-PAH, oPAH and LHD-PH groups. Maternal mortality was highest in the iPAH group; therefore, iPAH patients should be advised to prevent pregnancy. Standardized and multidiscipline-assisted maternal management is the key to improving maternal-foetal outcomes.
Background: In recent years, with the development of monitoring conditions and the promotion and application of pulmonary vascular targeted drugs, the adverse pregnancy outcomes in women with pulmonary hypertension (PH) have been improved, but the rate of maternal mortality is still high. The purpose of this study was to describe the Maternal-fetal outcomes in pulmonary artery hypertensive pregnant women.Methods: The clinical data of 154 pregnant women with PH, who were admitted to the Third Affiliated Hospital of Guangzhou Medical University from January 2011 to December 2020 were collected and analyzed comprehensively.Results: Among patients diagnosed as PH with transcardiac color Doppler ultrasonography, 6 (3.9%) had idiopathic pulmonary hypertension (iPAH), 41 patients (26.6%) of pulmonary arterial hypertension associated with congenital heart disease (CHD-PAH) , 45 patients (45.2%) of pulmonary arterial hypertension (oPAH) related to other diseases, and 62 patients (40.3%) of pulmonary arterial hypertension (LHD-PH) related to left heart disease. Systolic pulmonary artery pressure (sPAP) was 36-49mmHg in 53.2% of patients, 50-69mmHg in 22.1% and ≥70mmHg in 24.7%. Five (3.2%) pregnant women died within 1 week after delivery; iPAH had the highest mortality rate (3/6, 50%); the incidence of heart failure during pregnancy was 14.9%, the incidence of postpartum hemorrhage was 10.4%, and cesarean section accounted for 70.1%, iatrogenic abortion 14.3%, premature infants 42.9%, low birth weight infants 44.8%, birth asphyxia infants 14.9%, fetal mortality 5.2%, neonatal mortality 1.9%. The average birth weight of perinatal infants was 2334.9±814.6g.Conclusion: There are significant differences in adverse pregnancy outcomes among pregnant women with pulmonary hypertension caused by different etiologies (iPAH, CHD-PAH, oPAH and LHD-PH). In general, iPAH got the worst prognosis, LHD-PH got the second, and then oPAH. CHD-PAH has the best prognosis relatively. Therefore, PH patients will be advised to avoid pregnancy; standardized, whole-process, and multidisciplinary assisted maternal management is the key to improving the maternal and fetal outcomes of such high-risk pregnancies.
ObjectivesTo investigate whether platelet counts are associated with clinical outcomes in patients with acute fatty liver of pregnancy (AFLP).MethodsWe retrospectively analyzed 140 patients with AFLP admitted to the Third Affiliated Hospital of Guangzhou Medical University between January 2010 and August 2022. In this cohort study, we used smooth curve fitting, Kaplan–Meier analysis, and multivariable logistic regression analysis to examine the independent relationship between platelet counts and 42‐day postpartum mortality in AFLP.ResultsThere were 140 patients with AFLP, of which 15 died and 53 (37.86%) had thrombocytopenia. The overall 42‐day postpartum maternal mortality was 10.7%. We observed a U‐shaped relationship between the platelet counts and 42‐day postpartum mortality. Two different slopes were observed below and above the inflection point at approximately 220 × 109/L. After adjusting for some confounders, patients with thrombocytopenia (<100 × 109/L) were found to have increased 42‐day postpartum mortality compared with middle‐tertile and highest‐tertile patients. Patients with thrombocytopenia had a higher 42‐day postpartum mortality, and higher proportions of intensive care unit admissions, postpartum hemorrhage, and multiple organ failure (P < 0.05).ConclusionsA U‐shaped association between platelet counts and 42‐day postpartum mortality was observed in patients with AFLP. Thrombocytopenia is associated with poorer adverse clinical outcomes in women with AFLP.
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