The ADA*2 allele of the adenosine deaminase gene (20q13.11) and recurrent spontaneous abortions: an age-dependent association

OBJECTIVE: Adenosine deaminase acts on adenosine and deoxyadenosine metabolism and modulates the immune response. The adenosine deaminase G22A polymorphism (20q.11.33) influences the level of adenosine deaminase enzyme expression, which seems to play a key role in maintaining pregnancy. The adenosine deaminase 2 phenotype has been associated with a protective effect against recurrent spontaneous abortions in European Caucasian women. The aim of this study was to investigate whether the G22A polymorphism of the adenosine deaminase gene is associated with recurrent spontaneous abortions in Brazilian women. METHODS: A total of 311 women were recruited to form two groups: G1, with a history of recurrent spontaneous abortions (N = 129), and G2, without a history of abortions (N = 182). Genomic DNA was extracted from peripheral blood with a commercial kit and PCR-RFLP analysis was used to identify the G22A genetic polymorphism. Fisher's exact test and odds ratio values were used to compare the proportions of adenosine deaminase genotypes and alleles between women with and without a history of recurrent spontaneous abortion (p<0.05). The differences between mean values for categorical data were calculated using unpaired t tests. The Hardy-Weinberg equilibrium was assessed with a chi-square test. RESULTS: Statistically significant differences were identified for the frequencies of adenosine deaminase genotypes and alleles between the G1 and G2 groups when adjusted for maternal age. CONCLUSIONS:The results suggest that the adenosine deaminase *2 allele is associated with a low risk for recurrent spontaneous abortions, but this association is dependent on older age

Intrauterine thrombosis of umbilical artery - case report

ABSTRACT: CONTEXT: Umbilical cord thrombosis is related to greater fetal and perinatal morbidity and mortality. It is usually associated with umbilical cord abnormalities that lead to mechanical compression with consequent vascular ectasia. Its correct diagnosis and clinical management remains a challenge that has not yet been resolved. CASE REPORT: This study reports a case of umbilical artery thrombosis that occurred in the second half of a pregnancy. The umbilical cord was long, thin and overly twisted and the fetus presented severe intrauterine growth restriction. The clinical and histopathological findings from this case are described. CONCLUSIONS: This case report emphasizes the difficulty in diagnosing and clinically managing abnormalities of intrauterine life with a high chance of perinatal complications

The intricate role of mast cell proteases and the annexin A1-FPR1 system in abdominal wall endometriosis

Endometriosis is a continuous and progressive disease with a poorly understood aetiology, pathophysiology and natural history. This study evaluated the histological differences between eutopic and ectopic endometria (abdominal wall endometriosis) and the expression of mast cell proteases (tryptase and chymase), annexin A1 (ANXA1) and formyl peptide receptor 1 (FPR1). Ectopic endometrium from 18 women with abdominal wall endometriosis and eutopic endometrium from 10 women without endometriosis were obtained. The endometrial samples were analysed by histopathology, immunohistochemistry and ultrastructural immunogold labeling to determine mast cell heterogeneity (tryptase and chymase positive cells) and the expression levels of ANXA1 and FPR1. Histopathological analysis of the endometriotic lesions showed a glandular pattern of mixed differentiation and an undifferentiated morphology with a significant influx of inflammatory cells and a change in mast cell heterogeneity, as evidenced by a significant increase in the number of chymase-positive cells and endogenous chymase expression. The undifferentiated glandular pattern of endometriotic lesions was positively associated with a marked increase and co-localization of ANXA1 and FPR1 in the epithelial cells. In conclusion, the co-upregulated expression of mast cell chymase and ANXA1–FPR1 system in ectopic endometrium suggests their involvement in the development of endometriotic lesions

Biomarcadores de suscetibilidade à endometriose

OBJETIVOS: verificar as freqüências dos genótipos nulos para os genes GSTT1 e GSTM1, assim como as freqüências do alelo polimórfico do gene CYP1A1 em um grupo de mulheres com endometriose, e comparar essas freqüências com aquelas observadas em um grupo que não apresenta a doença (controle), visando uma possível identificação de biomarcadores de suscetibilidade à endometriose. MÉTODOS: foram incluídas 50 mulheres com sinais clínicos sugestivos de endometriose e que foram submetidas à videolaparoscopia e biópsia das lesões avaliadas histologicamente. A endometriose foi confirmada em 25 mulheres, consideradas como o grupo caso, e resultado negativo foi observado nas outras 25 (grupo controle). Os genótipos nulos para os genes GSTT1 e GSTM1 foram avaliados pela reação em cadeia da polimerase (PCR) multiplex. A investigação do alelo polimórfico do gene CYP1A1 foi realizada por meio da técnica de PCR-RFLP (polimorfismos de comprimento de fragmentos de restrição). Para a análise estatística utilizou-se o teste exato de Fisher. RESULTADOS: em ambos os grupos, as freqüências dos polimorfismos de deleção apresentaram valores de 16% para o gene GSTT1 e de 44% para o gene GSTM1. Portanto, os resultados não mostraram diferenças na distribuição dos genótipos nulos GSTT1 e GSTM1 entre os grupos estudados. A diferença da freqüência alélica para o alelo m1 do gene CYP1A1, embora não significante, foi mais elevada nas mulheres com endometriose (0,22) quando comparada àquelas do grupo controle (0,14). CONCLUSÃO: os resultados não mostraram uma associação entre os polimorfismos avaliados e o diagnóstico de endometriose