Severe preeclampsia: Are hemostatic and inflammatory parameters associated?

Pinheiro, Melina de Barros; Carvalho, Maria G.; Martins‐Filho, Olindo Assis; Freitas, Luís Carlos Bastos; Godói, Lara Carvalho; Alpoim, Patrícia Nessralla; Gomes, Karina Braga; Dusse, Luci Maria Sant’Ana

doi:10.1016/j.cca.2013.09.050

Cited by 26 publications

(25 citation statements)

References 44 publications

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“…46 PAI-1 levels are also increased in severe preeclampsia, 23 and polymorphisms in the PAI-1 gene (SERPINE2) have been associated with increased risk of preeclampsia in a meta-analysis. 47 It is not clear whether PAI-1 regulates blood pressure or vice versa; however, one study suggests that inhibition of PAI-1 can reduce hypertension caused by inhibition of nitric oxide synthase.…”

Section: Gomez-arango Et Al Blood Pressure and Gut Microbiome Butyratmentioning

confidence: 98%

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Increased Systolic and Diastolic Blood Pressure Is Associated With Altered Gut Microbiota Composition and Butyrate Production in Early Pregnancy

et al. 2016

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Abstract-The risk of developing pregnancy-induced hypertension and preeclampsia is higher in obese pregnant women.In obesity, the composition of the gut microbiota is altered. Obesity is also associated with low-grade inflammation.Metabolites from the gut microbiota may contribute to both hypertension and inflammation. The aim of this study is to investigate whether the composition of the gut microbiota in overweight and obese pregnant women is associated with blood pressure and levels of plasminogen activator inhibitor-1. The composition of the gut microbiota was determined with 16S ribosomal RNA sequencing in 205 women at 16 weeks gestation from the SPRING study (the Study of Probiotics in Gestational Diabetes). Expression of butyrate-producing genes in the gut microbiota was assessed by realtime polymerase chain reaction. Plasminogen activator inhibitor-1 levels were measured in fasting serum of a subset of 70 women. Blood pressure was slightly but significantly higher in obese compared with overweight women. The abundance of the butyrate-producing genus Odoribacter was inversely correlated with systolic blood pressure. Butyrate production capacity was decreased, but plasminogen activator inhibitor-1 concentrations increased in obese pregnant women. Plasminogen activator inhibitor-1 levels were inversely correlated with expression of butyrate kinase and Odoribacter abundance. This study shows that in overweight and obese pregnant women at 16 weeks gestation, the abundance of butyrate-producing bacteria and butyrate production in the gut microbiota is significantly negatively associated with blood pressure and with plasminogen activator inhibitor-1 levels. Increasing butyrate-producing capacity may contribute to maintenance of normal blood pressure in obese pregnant women. Gomez-Arango et al Blood Pressure and Gut Microbiome Butyrate Production 975The SCFA butyrate is produced from dietary fiber by bacteria in the gastrointestinal lumen. There are 2 main enzymes catalyzing butyrate production: butyrate kinase (Buk) and butyryl-CoA:acetate CoA-transferase (But), which are often used as biomarkers for the detection of butyrate-producing bacteria.11 Buk catalyzes the formation of butyrate from butyryl-CoA, releasing ATP in the process. 12,13 But catalyzes the reaction of butyryl-CoA with exogenous acetate to form butyrate and acetyl-CoA.13,14 Some butyrate-producing bacteria only express But or Buk, whereas others express both. 12The main butyrate producers in the human gut belong to the Firmicutes phylum (Coprococci, Eubacterium, Roseburia, and Faecalibacterium genera), 14 but members of other phyla, especially Bacteroidetes (Odoribacter and Alistipes genera), often contribute to the overall butyrogenic pool. SCFAproducing bacteria may affect blood pressure by direct effects of SCFA on vasodilation or through plasminogen activator inhibitor-1 (PAI-1). n-Butyrate increases PAI-1 mRNA in cultured hepatocytes, 15 and SCFA enemas stimulate rectal microcirculation and PAI-1 after aortic graft surgery. 16 It is uncl...

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Section: Gomez-arango Et Al Blood Pressure and Gut Microbiome Butyratmentioning

confidence: 98%

“…17 PAI-1 is expressed in adipose tissue, and its levels are increased in obesity. 18 In pregnancies affected by hypertension, including preeclampsia and HELLP syndrome (hemolysis elevated liver enzymes and low platelet), placental PAI-1 expression 19 and circulating PAI-1 levels [20][21][22][23][24] are increased.…”

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confidence: 99%

Increased Systolic and Diastolic Blood Pressure Is Associated With Altered Gut Microbiota Composition and Butyrate Production in Early Pregnancy

et al. 2016

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“…44,45 As a result, various inflammatory cytokines have been demonstrated to be related to PE, 20,30 and numerous studies investigated the association of IL-18 and IFN-c with PE. 20,23,40 Nevertheless, current evidence is conflict-ing on the direction of change in circulating levels of these two cytokines, 14,[16][17][18]22,41 highlighting the need for a systematic review including studies that display data not only with mean and S.D. but also with median and percentile range.…”

Section: Discussionmentioning

confidence: 99%

“…All the 11 studies for IL-18 were conducted during the third trimester (28+ weeks). In 16 studies for IFN-c, the assessment occurred during the second trimester (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) weeks) was in one study, 18 during the third trimester in 13 studies, 19,20,26,30,31,[35][36][37][38][39][40][41][42] and blood collection time period overlapping the second and third trimester was in one study. 43 There was also one study which measured the IFN-c levels at four different points during pregnancy.…”

Section: Description Of Systematic Literature Review Studiesmentioning

confidence: 99%

“…Nine of the 11 studies used serum specimens to examine the IL-18 levels, [14][15][16]23,24,26,[28][29][30] and two studies were with plasma. 22,28 Eight of the 16 studies reported the use of plasma in the IFN-c assay, 17,19,20,31,36,37,40,42 while eight studies conducted in serum. 18,26,30,35,38,39,41,43 Variables that can affect the cytokine levels were reported in most of the 25 selected studies (Table S1).…”

Section: Description Of Systematic Literature Review Studiesmentioning

confidence: 99%

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Interleukin-18 and Interferon Gamma Levels in Preeclampsia: A Systematic Review and Meta-analysis

Yang

et al. 2014

Am J Reprod Immunol

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Elevated levels of D‐dimer tested by immunoturbidimetry are associated with the extent of severity of pre‐eclampsia

Rodríguez-Peña

Ibáñez-Pinilla

2020

Intl J Gynecology & Obste

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Objective To establish the association between increased levels of D‐dimer and severity of pre‐eclampsia. Methods A nested, prospective cohort, analytical case–control study was conducted among women with pre‐eclampsia between March 2017 and March 2018. Inclusion criteria were age over 18 years, gestational age of more than 20 weeks, a single pregnancy with a living fetus, and a diagnosis of pre‐eclampsia. D‐dimer was measured by immunoturbidimetry at the time of diagnosis of pre‐eclampsia, applying cut‐off points adjusted for gestational age. Statistical analysis involved unconditional logistic regression for the association of elevated D‐dimer with severe pre‐eclampsia adjusted by confounding variables. Results There were 132 patients with pre‐eclampsia, of which 44 were classed as controls and 88 were classed as having severe pre‐eclampsia (case group). Cohort characteristics included: age between 18 and 45 years (mean 28.0 ± 6.3 years); presence of gestational hypertension (10.6%), chronic arterial hypertension (9.0%); and gestational diabetes (5.3%). In the case group, levels of D‐dimer were significantly higher than in controls (19.3% vs 2.3%, odds ratio [OR] 10.30, 95% confidence interval [CI] 1.32–80.14, P=0.004) as well as significant in the unconditional logistic regression model adjusted for maternal age, parity, gestational age, and comorbidities (OR 10.02, 95% CI 1.28–78.68, P=0.028). Conclusion Elevated levels of D‐dimer and severe pre‐eclampsia are strongly associated, reinforcing evidence that one of the physiopathologic bases of the condition is the activation of fibrinolysis and the coagulation system.

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Severe preeclampsia: Are hemostatic and inflammatory parameters associated?

Cited by 26 publications

References 44 publications

Increased Systolic and Diastolic Blood Pressure Is Associated With Altered Gut Microbiota Composition and Butyrate Production in Early Pregnancy

Increased Systolic and Diastolic Blood Pressure Is Associated With Altered Gut Microbiota Composition and Butyrate Production in Early Pregnancy

Interleukin-18 and Interferon Gamma Levels in Preeclampsia: A Systematic Review and Meta-analysis

Elevated levels of D‐dimer tested by immunoturbidimetry are associated with the extent of severity of pre‐eclampsia

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