Innate and Adaptive Immune Responses in HELLP Syndrome

Stojanovska, Violeta; Zenclussen, Ana Claudia

doi:10.3389/fimmu.2020.00667

Cited by 21 publications

(20 citation statements)

References 148 publications

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“…Therefore, additional and more specific/sensitive detection criteria are needed for improving PE and HELLP screening, diagnosis and treatment. In recent years, various studies have shown that insufficient adaptations of the maternal immune system are implicated in the pathophysiology of PE and HELLP, including alterations in levels and function of regulatory T cells 17–19 . The B7 homolog 4, B7‐H4, is a member of the B7 family that was independently discovered by a number of scientists in 2003 20–22 .…”

Section: Introductionmentioning

confidence: 99%

Abnormal expression of the costimulatory molecule B7‐H4 in placental chorionic villous and decidual basalis tissues of patients with preeclampsia and HELLP syndrome

Duan

Reisch

Iannaccone

et al. 2021

American J Rep Immunol

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Background B7‐H4, a checkpoint molecule of the B7 family, regulates a broad spectrum such as T‐cell activation, cytokine secretion, tumour progression, and invasion capacities. Our previous data revealed that soluble B7‐H4 (sB7‐H4) blood serum levels are elevated in women at high risk for the hypertensive pregnancy disorder preeclampsia (PE) in the first trimester, as well as in patients with confirmed early/late‐onset PE. Aim We here aim to investigate the expression pattern of B7‐H4 in placental tissues of PE and HELLP Syndrome versus control group. Methods B7‐H4 protein expression and localization were investigated by immunoblotting and co‐immunohistochemistry in placental chorionic villous and decidual basalis tissues. Results B7‐H4 protein was prominently expressed at the cell membrane, in the cytoplasm of the syncytiotrophoblast (STB) and interstitial extravillous trophoblast (EVT). B7‐H4 protein levels in placental chorionic villous tissue were significantly higher in women with early‐onset/late‐onset PE and HELLP, while it was decreased in decidual basalis tissues of early‐onset PE and HELLP compared with controls. Conclusion B7‐H4 was inversely expressed in placental chorionic villous and decidual basalis tissues of PE and HELLP patients. The increase in B7‐H4 in the STB in PE and HELLP may lead to excessive apical expression and release of soluble B7‐H4 in the maternal circulation. In contrast, the decrease in B7‐H4 in decidual basalis tissues could be related to the decrease in invasion ability of the EVT in PE. Thus, the current results strongly suggest that B7‐H4 is involved in the pathogenesis of PE and HELLP.

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Section: Introductionmentioning

confidence: 99%

Abnormal expression of the costimulatory molecule B7‐H4 in placental chorionic villous and decidual basalis tissues of patients with preeclampsia and HELLP syndrome

Duan

Reisch

Iannaccone

et al. 2021

American J Rep Immunol

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“…Nesse contexto, estudos genéticos sobre a hereditariedade da predisposição para préeclâmpsia e/ou síndrome HELLP na gravidez, provaram que fatores genéticos e imunológicos desempenham um papel importante na patogênese dessas afecções (STOJANOVSKA;ZENCLUSSEN, 2020).…”

Section: Desenvolvimentounclassified

Abdome agudo hemorrágico por síndrome HELLP : relato de caso / Acute hemorrhagic abdomen due to HELLP syndrome: case report

Martins¹,

Melo²,

Borges³

et al. 2021

Braz. J. Hea. Rev.

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“…HELLP syndrome occurs mostly in the second and third trimesters of pregnancy (usually between 27 and 7 weeks antenatally), and 15–30% of women present in the puerperium (usually within 7 days after delivery) ( 4 ). The pathological mechanism of the disease is not yet very clear, which may be related to placental origin ( 5 ), autoimmunity ( 6 ), mutations in coagulation factor V gene ( 7 ), fatty acid oxidation disorder symptoms ( 8 ) and so on. The incidence of HELLP syndrome is relatively low, accounting for only 0.5–0.9% of the pregnant population (the incidence in China can be about 2.5%), but the clinical manifestations are diverse, the disease develops rapidly, and poses a greater risk to maternal and child health, and the lives of mothers and children are often endangered by delayed treatment, with a high rate of maternal and child complications and death ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical Classification, Pregnancy Outcomes and Risk Factors Analysis of Severe Preeclampsia Complicated With HELLP Syndrome

et al. 2022

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PurposeTo investigate the clinical classification, pregnancy outcomes and risk factors of pregnant women with severe preeclampsia (SPE) complicated with HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome.MethodsThe clinical data of 50 pregnant women diagnosed with SPE complicated with HELLP syndrome in our hospital from January 2014 to January 2021 were retrospectively analyzed, and they were selected as the observation group. An additional 50 maternities diagnosed with preeclampsia (PE) during the same period were selected as the control group. The clinical classification and pregnancy outcomes of pregnant women in the observation group were recorded. The age and gestational age of onset of pregnancy were recorded and compared between the two groups. Univariate analysis and multivariate logistic regression model were used to analyze the risk factors for its occurrence.ResultsAmong the 50 maternities in the observation group, there were 10 cases of type I, accounting for 20.00%; 35 cases of type II, accounting for 70.00%; 5 cases of type III, accounting for 10.00%. Partial 33 cases, the composition ratio of 66.00%; complete 17 cases, the composition ratio of 34.00%. Among the fetuses of 50 maternities in the observation group, 35 were premature, accounting for 70.00%; 13 had fetal growth restriction, accounting for 26.00%; and 2 died during perinatal period, accounting for 4.00%. Among the 50 maternities in the observation group, 48 cases were cesarean section, the composition ratio was 96.00%; 2 cases were induced labor, the composition ratio was 4.00%; there was no natural birth, the composition ratio was 0.00%. Univariate analysis showed that age, gestational age at onset, gestational age at termination of pregnancy, HGB, LDH, ALT, AST, TBIL, PLT, PT, and FIB were all associated with the occurrence of SPE complicated with HELLP syndrome (P < 0.05). Multivariate logistic analysis showed that gestational age at onset, gestational age at termination of pregnancy, HGB, LDH, ALT, AST, TBIL, PLT, and FIB were independent risk factors for SPE complicated with HELLP syndrome (P < 0.05).ConclusionSPE complicated with HELLP syndrome has significantly increased adverse pregnancy outcomes. Understanding its clinical classification is of great significance for the preventive application of platelet transfusion therapy and the selection of transfusion timing. Gestational age at onset and gestational age at termination of pregnancy are independent risk factors for its occurrence. Fully understanding the high-risk factors of HELLP syndrome, taking preventive measures in time, and carrying out targeted nursing can effectively improve the prognosis of pregnant women and reduce the risk of HELLP syndrome.

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Innate and Adaptive Immune Responses in HELLP Syndrome

Cited by 21 publications

References 148 publications

Abnormal expression of the costimulatory molecule B7‐H4 in placental chorionic villous and decidual basalis tissues of patients with preeclampsia and HELLP syndrome

Abnormal expression of the costimulatory molecule B7‐H4 in placental chorionic villous and decidual basalis tissues of patients with preeclampsia and HELLP syndrome

Abdome agudo hemorrágico por síndrome HELLP : relato de caso / Acute hemorrhagic abdomen due to HELLP syndrome: case report

Clinical Classification, Pregnancy Outcomes and Risk Factors Analysis of Severe Preeclampsia Complicated With HELLP Syndrome

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