Placenta derived factors involved in the pathogenesis of the liver in the syndrome of haemolysis, elevated liver enzymes and low platelets (HELLP): A review

Lieshout, L.C.E.W. van; Koek, Ger H.; Spaanderman, Marc E. A.; Heimel, Pieter J. van Runnard

doi:10.1016/j.preghy.2019.08.004

Cited by 23 publications

(49 citation statements)

References 54 publications

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“…Recent exploration provided possible evidence for the concept that several placental derived factors are involved in hepatic injury and cause increased apoptosis of the liver sinusoidal endothelial cells (LSECs) 9 . Insulin-like growth factor-binding protein (IGFBP), containing IGFBP-1 to -6, is a super family of proteins that bind highly specifically to insulin-like growth factors (IGFs).…”

Section: Discussionmentioning

confidence: 99%

Identification of Differential Expression Cytokines in Hemolysis, Elevated Liver Enzymes, and Low Platelet Syndrome by Proteome Microarray Analysis and Further Verification

et al. 2021

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To screen the differential expression cytokines (DECs) in hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome, establish its differential cytokines spectra, and provide the clues for its diagnosis and pathogenic mechanism researches. Sera from four HELLP syndrome patients and four healthy controls were detected by proteome microarray. Then the analysis of Gene Ontology (GO) enrichment, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway, and protein–protein interaction (PPI) network were performed and possible hub proteins were selected out, further verified by Enzyme Linked Immunosorbent Assay (ELISA) in sera from 21 HELLP syndrome patients and 21 healthy controls. Thirty DECs were defined according to P-value and fold change between HELLP group and control group. GO enrichment analysis showed that DECs were mainly involved in the regulation of inflammatory response and have relationship to growth factor binding, transmembrane receptor protein kinase, and cytokine receptor activity. Seven possible hub proteins were defined by PPI analysis, including IGFBP-3/Follistatin-like 1/FLRG/Fetuin A and MMP-13/Thrombospondin-5/Aggrecan. ELISA showed higher serum levels of Fetuin A/IGFBP-3/FLGR/MMP-13/Thrombospondin-5 in HELLP group than those in controls, while the levels of Follistatin-like 1 and Aggrecan were lower in HELLP patients (all P < 0.05 or <0.01).The serological DECs spectra of HELLP syndrome was established and seven possible hub proteins that may be more closely related to the disease have been verified, providing new clues for its pathogenesis, diagnosis, and clinical treatment.

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Section: Discussionmentioning

confidence: 99%

Identification of Differential Expression Cytokines in Hemolysis, Elevated Liver Enzymes, and Low Platelet Syndrome by Proteome Microarray Analysis and Further Verification

et al. 2021

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“…Hemolysis, elevated liver enzymes, and low platelet count syndrome, otherwise known as HELLP syndrome, is considered a severe complication of pregnancy that coexists in 70-80% of cases with preeclampsia [1]. The risk of developing HELLP syndrome within a pregnancy ranges between 0.2% and 0.8%, with a 0-24% mortality rate [2][3][4]. The perinatal death rate goes up to 37% [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…The perinatal death rate goes up to 37% [2,3]. It is associated with an increased risk of severe complications for both mother and offspring [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

HELLP Syndrome—Holistic Insight into Pathophysiology

et al. 2022

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HELLP syndrome, also known as the syndrome of hemolysis, elevated liver enzymes, and low platelets, represents a severe pregnancy complication typically associated with hypertension. It is associated with increased risks of adverse complications for both mother and fetus. HELLP occurs in 0.2–0.8% of pregnancies, and, in 70–80% of cases, it coexists with preeclampsia (PE). Both of these conditions show a familial tendency. A woman with a history of HELLP pregnancy is at high risk for developing this entity in subsequent pregnancies. We cannot nominate a single worldwide genetic cause for the increased risk of HELLP. Combinations of multiple gene variants, each with a moderate risk, with concurrent maternal and environmental factors are thought to be the etiological mechanisms. This review highlights the significant role of understanding the underlying pathophysiological mechanism of HELLP syndrome. A better knowledge of the disease’s course supports early detection, an accurate diagnosis, and proper management of this life-threatening condition.

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“…Multiparous women older than 30 years have an increased risk of developing HELLP during pregnancy ( 2 ). The mortality rate among women with HELLP syndrome is 0–24% and perinatal death rises up to 37% ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…While the most frequent complication of HELLP Syndrome is acute kidney injury, surgical complications are weighted by the high rate of maternal and foetal death. Indeed, subcapsular liver haematoma could occur in patients affected by HELLP ( 3 ). This rare but potentially life-threatening condition is reported in 1:40,000 to 1:25,000 pregnancies ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Liver Bleeding Due to HELLP Syndrome Treated With Embolization and Liver Transplantation: A Case Report and Review of the Literature

et al. 2021

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Background: Liver bleeding secondary to haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is uncommon, but a life-threatening peripartum condition that needs a prompt multidisciplinary approach.Case Presentation: In this study, we presented a case of 28-year-old pregnant woman, who was presented to the obstetrics department with signs of preeclampsia and foetal growth restriction. An emergency caesarean section was performed, and the patient developed a HELLP syndrome complicated by spontaneous liver rupture. After radiological and surgical procedures, liver failure became evident and liver transplantation was successfully performed. The patient and her daughter are now alive.Conclusions: Despite the rarity of this disease, liver complications due to HELLP syndrome must be properly diagnosed and treated given the gravity of the possible evolution in young women. After diagnosis, the patients must be treated in specialised centres with gynaecological, liver surgery, and transplant skills.

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Placenta derived factors involved in the pathogenesis of the liver in the syndrome of haemolysis, elevated liver enzymes and low platelets (HELLP): A review

Cited by 23 publications

References 54 publications

Identification of Differential Expression Cytokines in Hemolysis, Elevated Liver Enzymes, and Low Platelet Syndrome by Proteome Microarray Analysis and Further Verification

Identification of Differential Expression Cytokines in Hemolysis, Elevated Liver Enzymes, and Low Platelet Syndrome by Proteome Microarray Analysis and Further Verification

HELLP Syndrome—Holistic Insight into Pathophysiology

Liver Bleeding Due to HELLP Syndrome Treated With Embolization and Liver Transplantation: A Case Report and Review of the Literature

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