Salivarni i inflamatorni medijatori plazme i sekretorni status prevremeno porođenih žena sa periodontitisom – studija preseka

Bacground/Aim. Preterm birth is defined as a delivery prior to the completed 37th week of gestation. Literature data suggested that periodontal processes may influence to the feto-placental unit and induce preterm delivery. The degree of the periodontal disease is influenced by secretor status. Pro-inflammatory cytokines are involved in periodontitis as well as in delivery. The combined influence of these factors on the risk of preterm birth has not been explored. The aim of our study was to investigate the associations between periodontal diseases, secretor status, and interleukin-1-β (IL1-ß) and prostaglandine E2 (PGE2) levels in women delivered preterm. Methods. The study included 56 preterm delivery women and 56 women delivered at term as a control group, aged between 17 and 41 years. Periodontal examination, blood and saliva sampling were performed within 48 hours following delivery. Secretor phenotype was determined by hemagglutination inhibition method. The concentrations of IL1-ß and PGE2 were measured by high sensitivity Enzyme-linked Immunosorbent Assay (ELISA). Results. In the pre-term birth group there were 66.1% of women with periodontitis, while in the control one there were 12.5% (p < 0.01). Concentrations of IL1-ß and PGE2 in plasma were significantly higher in the non-secretor group of women who gave birth pre-term and had periodontitis comparing to other groups. There was a significant correlation between salivary and plasma levels of PGE2 and IL1-ß in the preterm birth group (R = 0.416, p = 0.017 and R = -0.592, p < 0.001, respectively). There were no such correlations in women who delivered at term. Conclusion. Our results support the hypothesis that non-secretor phenotype and periodontitis are at least in part responsible for pathogenesis of preterm birth. This probability of negative impact of non-secretor status cannot be ignored. These findings support the need for additional research into the biology of human parturition. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.Uvod/Cilj. Prevremeni porođaj se definiše kao porođaj pre navršene 37 nedelje gestacije. Podaci iz literature govore u prilog tome da periodontalni procesi mogu uticati na fetoplacentalnu jedinicu i indukovati preterminski porođaj. Sekretorni status može uticati na stepen periodontalne bolesti. Proinflamatorni citokini imaju uticaj na periodontitis kao i na porođaj. Kombinovani uticaj ovih faktora rizika za prevremeni porođaj nije dovoljno istražen. Cilj ove studije je bio da istraži povezanost između periodontalne bolesti, sekretornog statusa, nivoa interleukina 1-b (IL1-b) i prostaglandina E2 (PGE2) kod žena koje su imale prevremeni porođaj. Metode. Studijom je bilo obuhvaćeno 56 žena, koje su imale prevremen porođaj i 56 žena u kontrolnoj grupi koje su se porodile u terminu, starosti između 17 i 41 godine. Periodontalni pregled, uzorkovanje krvi i salive je izvršeno u prvih 48 sati po porođaju. Sekretorni status je određen metodom inhibicije hemaglutinacije. Koncentracije IL1-b i PGE2 su merene visoko senzitivnim Enzyme-linked Immunosorbent Assay (ELISA) testom. Rezultati. U grupi prevremenih porođaja bilo je 66,1% žena sa periodontitisom, a u kontrolnoj grupi 12,5% (p < 0.01). Prevremeno porođene žena, nesekretori sa periodontitisom imale su u plazmi značajno više vrednosti IL 1-b i PGE 2 u odnosu na ostale grupe (p < 0,01). U grupi prevremeno porođenih žena postojala je značajna korelacija između salivarnih i plazmatskih koncentracija PGE2 i IL1-b (R = 0.416, p = 0.017 i R = -0,592, p < 0,001, redom). Ove korelacije nisu postojale kod žena koje su imale terminski porođaj. Zaključak. Naši rezultati podržavaju hipotezu da su sekretorni status i periodontitis, bar delimično, odgovorni za patogenezu preterminskog porođaja. Verovatnoća negativnog uticaja nesekretornog statusa se ne sme ignorisati. Ovi zaključci ukazuju na potrebu za dodatnim istraživanjima porođaja

Transient bacteremia caused by Atopobium vaginae after caesarean delivery: Case report

Introduction: Genital microbiome of woman is still a puzzle to this day. It consists of a large number of different bacterial species and phenotypes that make up the normal genital flora, while in the cases of its change there is a predominance of certain, especially anaerobic species, which is the case with bacterial vaginosis. These types are mostly rare causing invasive infections, but under certain conditions can lead to severe infections, such as multiple parts of the genital tract, and to an unwanted outcome in the pregnancy. Case report: This paper presents an extremely rare case of transient bacteremia caused by Atopobium vaginae type in a patient following a cesarean section where empirical therapy gave a positive effect and the patient recovered and released home with healthy newborn. Conclusions: During the clinical work it is important to be aware of the different anaerobic species present in the genital tract of women microbiome like Atopobium vaginae and should adjust the empirical therapy, which was the case here

Oxidative stress and platelet activation during on-pump and off-pump coronary artery bypass grafting in patients with double grafted vessels

This study aimed to evaluate the oxidative stress status and two markers of platelet activation and reactivity in off-pump versus on-pump coronary artery bypass surgery. Study groups of 65 patients with double coronary artery bypass grafting were divided into cardiopulmonary bypass (CPB) and off-pump coronary artery bypass groups. In serial blood samples, lipid hydroperoxides (LOOH), serum paraoxonase (PON1), advanced oxidation protein products (AOPP), total sulfhydryl groups (tSHG) and red blood cell distribution width (RDW) to platelet (Plt) ratio (RPR) and mean platelet volume (MPV) to platelet (Plt) ratio (MPR) index were determined to compare the extent of oxidative stress and platelet activation. The MPR and RPR rose significantly in the post-operative period (P lt 0.001) in both groups. The increase was higher in the CPB group, but this difference reached borderline significance at 48 h post-operatively. The AOPP/tSHG index increased 6 h after surgery, preceded by a significant fall of the PON1/LOOH ratio, more evident in the CPB group. Multiple linear regression analysis showed explicit connection between these markers and surgery-related clinical conditions. Receiver operating characteristic analysis enabled estimation of the clinical accuracy of oxidative plus platelet-related indices in prediction of surgery caused complications (area under the curve for the model consisted of oxidative stress parameters and platelet activation indices was above 0.9, P lt 0.001). Results showed higher oxidative stress and undesirable platelet activation in the CPB group. Oxidative status markers and platelet activity indices showed good clinical accuracy to predict the development of possible surgical complications

Inflammatory response in preterm delivery women with inflammatory diseases of periodontium

Prevremeni porođaj je onaj porođaj koji se dogodi pre navršene 37. nedelje trudnoće. Prevalenca prevremenog porođaja u svetu se kreće od 5% do 13.3%. Prevremeni porođaj može biti uzrokovan mnogobrojnim patološkim procesima kao i bolestima majke ili fetusa. Jedan od prepoznatih uzroka prevremenog porođaja je intraamnionska infekcija. Intraamnionska infekcija indukuje produkciju proinflamatornih citokina karakterističnih za terminski porođaj uključujući factor nekroze tumora alfa (TNF)-α, IL-8, IL-6, IL-1β i PGE2. U nekim slučajevima prevremenog porođaja u amnionskoj tečnosti se ne mogu detektovati mikrobiološki agensi ni gajenjem u kulturi ni drugim osetljivijim mikrobiološkim tehnikama uprkos povećanim nivoima citokina u amnionskoj tečnosti. Literaturni podaci ukazuju da se, u slučajevima prevremenog porođaja sa sterilnom antramnionskom inflamacijom, citokini produkuju u procesu infekcije ili inflamacije na udaljenom mestu u organizmu. Na taj način stvoreni citokini cirkulacijom dospevaju do feto-placentarne jedinice, prolaze placentarnu barijeru i u momentu kada dostižu kritičnu koncentraciju stimulišu porođaj. Ova zapažanja su u skladu sa Miller-ovom (Miller) teorijom žarišta iz 1891. Godine. Mikrobiološka i imunološka istraživanja kao i studije na animalnom modelu ukazuju da periodontalni procesi mogu uticati na fetoplacentarnu jedinicu I indukovati prevremeni porođaj. Perodontalna oboljenja su infektivna oboljenja čiji je ishod inflamacija specifičnih tkiva koja okružuju zub i predstavljaju njegovu potporu. Postoje dve glavne kategorije periodalnog oboljenja: a) gingivitis-nedestruktivna i reverzibilna inflamacija gingival i b) periodontitis-destruktivna inflamacija potpornog tkiva zuba. Gingivitis je reverzibilna i nedestruktivna inflamacija gingiva prouzrokovana nespecifičnim bakterijama. Ako gingivitis perzistira kasnije može dovesti do periodontitisa...Preterm birth (PTB) is defined as a delivery prior to the completed 37th week of gestation. The global prevalence rate of preterm birth is ranging from 5% to 13.3%. PTB is associated with multiple pathological processes such as medical conditions of the mother or fetus.Intra-amniotic infection has been causally linked to PTB. Intra-amniotic infection induces the production of pro-inflammatory cytokines, involved in term delivery, including tumor necrosis factor (TNF)-α, IL-8, IL-6, IL-1β, and PGE2. In some cases of PTB microorganisms cannot be detected by cultivation and other microbiology techniques despite high levels of cytokines in amniotic fluid. Literature data suggest that in cases of PTB with sterile intra-amniotic inflammation, cytokines are produced in distant part of the body due to infection and inflammation, cross the placental barrier, and when they reach appropriate quantities stimulate labor. This statement is in accordance with Miller’s focal infection theory published in 1891. Microbiological, immunological and animal model studies suggested that periodontal processes may influence to the feto-placental unit and induce preterm delivery. Periodontal diseases are infectious diseases that result in the inflammation of the specialized tissues that both surround and support the teeth. There are two major categories of periodontal diseases: a) Gingivitis – non-destructive and reversible gingival inflammation and b) Periodontitis – destructive inflammation of teeth supporting tissues. Gingivitis is a mainly reversible and nondestructive gingival inflammation related to a non-specific bacterial challenge. When gingivitis is persistent, it can further lead to periodontitis. Periodontitis is a destructive inflammatory disease of the supporting tissues of the teeth. Pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α) and prostaglandins (PGE1 and PGE2) are produced in response to infection. Vascular permeability is also increased – allowing the diffusion of cytokines into the blood flow which may have systemic effects on the host. During the second and third trimester of pregnancy, the gingival/periodontal inflammation often becomes more severe. Analysis of amniotic fluid obtained at the time of preterm birth without chorio- amnionitis shows elevated levels of inflammatory cytokines..

Inflammatory response in preterm delivery women with inflammatory diseases of periodontium

Prevremeni porođaj je onaj porođaj koji se dogodi pre navršene 37. nedelje trudnoće. Prevalenca prevremenog porođaja u svetu se kreće od 5% do 13.3%. Prevremeni porođaj može biti uzrokovan mnogobrojnim patološkim procesima kao i bolestima majke ili fetusa. Jedan od prepoznatih uzroka prevremenog porođaja je intraamnionska infekcija. Intraamnionska infekcija indukuje produkciju proinflamatornih citokina karakterističnih za terminski porođaj uključujući factor nekroze tumora alfa (TNF)-α, IL-8, IL-6, IL-1β i PGE2. U nekim slučajevima prevremenog porođaja u amnionskoj tečnosti se ne mogu detektovati mikrobiološki agensi ni gajenjem u kulturi ni drugim osetljivijim mikrobiološkim tehnikama uprkos povećanim nivoima citokina u amnionskoj tečnosti. Literaturni podaci ukazuju da se, u slučajevima prevremenog porođaja sa sterilnom antramnionskom inflamacijom, citokini produkuju u procesu infekcije ili inflamacije na udaljenom mestu u organizmu. Na taj način stvoreni citokini cirkulacijom dospevaju do feto-placentarne jedinice, prolaze placentarnu barijeru i u momentu kada dostižu kritičnu koncentraciju stimulišu porođaj. Ova zapažanja su u skladu sa Miller-ovom (Miller) teorijom žarišta iz 1891. Godine. Mikrobiološka i imunološka istraživanja kao i studije na animalnom modelu ukazuju da periodontalni procesi mogu uticati na fetoplacentarnu jedinicu I indukovati prevremeni porođaj. Perodontalna oboljenja su infektivna oboljenja čiji je ishod inflamacija specifičnih tkiva koja okružuju zub i predstavljaju njegovu potporu. Postoje dve glavne kategorije periodalnog oboljenja: a) gingivitis-nedestruktivna i reverzibilna inflamacija gingival i b) periodontitis-destruktivna inflamacija potpornog tkiva zuba. Gingivitis je reverzibilna i nedestruktivna inflamacija gingiva prouzrokovana nespecifičnim bakterijama. Ako gingivitis perzistira kasnije može dovesti do periodontitisa...Preterm birth (PTB) is defined as a delivery prior to the completed 37th week of gestation. The global prevalence rate of preterm birth is ranging from 5% to 13.3%. PTB is associated with multiple pathological processes such as medical conditions of the mother or fetus.Intra-amniotic infection has been causally linked to PTB. Intra-amniotic infection induces the production of pro-inflammatory cytokines, involved in term delivery, including tumor necrosis factor (TNF)-α, IL-8, IL-6, IL-1β, and PGE2. In some cases of PTB microorganisms cannot be detected by cultivation and other microbiology techniques despite high levels of cytokines in amniotic fluid. Literature data suggest that in cases of PTB with sterile intra-amniotic inflammation, cytokines are produced in distant part of the body due to infection and inflammation, cross the placental barrier, and when they reach appropriate quantities stimulate labor. This statement is in accordance with Miller’s focal infection theory published in 1891. Microbiological, immunological and animal model studies suggested that periodontal processes may influence to the feto-placental unit and induce preterm delivery. Periodontal diseases are infectious diseases that result in the inflammation of the specialized tissues that both surround and support the teeth. There are two major categories of periodontal diseases: a) Gingivitis – non-destructive and reversible gingival inflammation and b) Periodontitis – destructive inflammation of teeth supporting tissues. Gingivitis is a mainly reversible and nondestructive gingival inflammation related to a non-specific bacterial challenge. When gingivitis is persistent, it can further lead to periodontitis. Periodontitis is a destructive inflammatory disease of the supporting tissues of the teeth. Pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α) and prostaglandins (PGE1 and PGE2) are produced in response to infection. Vascular permeability is also increased – allowing the diffusion of cytokines into the blood flow which may have systemic effects on the host. During the second and third trimester of pregnancy, the gingival/periodontal inflammation often becomes more severe. Analysis of amniotic fluid obtained at the time of preterm birth without chorio- amnionitis shows elevated levels of inflammatory cytokines..

The Role of Oxidative Stress in the Onset and Development of Age-Related Macular Degeneration

Age-related macular degeneration (AMD) is a complex, degenerative and progressive chronic disease that leads to severe visual loss. The prevalence of early AMD accounts for 18% in the population between 65 and 74 years of age and even 30% in subjects older than 74 years. The articles published in the last decade point out to a significant role of oxidative stress in the onset and development of age-related macular degeneration. Generally, reactive oxygen species (ROS) are produced in the eye during light absorption and physiological metabolic processes. The level of oxidative stress is kept under control by the action of antioxidants and reparative enzymes. Excessive synthesis of ROS leads to increased oxidative modification of lipids, proteins and DNA, causing oxidative damage of cytoplasmic and nuclear cell elements and changes of the extracellular matrix. The accumulation of oxidatively modified compounds in drusen deposits will initiate the onset and development of AMD. The objective of this review was to highlight the mechanisms of oxidative stress in order to elucidate their significance and association with the pathogenesis of AMD

Pseudotrombocytopenia caused by EDTA in obstetrics and perinatology: Case report

Introduction: Clinically, the most important pseudothrombocytopenia is described in pregnant women and also in their newborns if blood sample is taken using EDTA. Case report: Patient, 35 years old pregnant woman, 36 weeks of gestation, was admitted to Gynecological and Obstetrics Clinic in the CCS because of pregnancy monitoring. The EDTA thrombocytes result was 34.0 x 10e9/L and patient was without any symptoms of bleeding tendency. Pseudothrombocytopenia was suspected. We decided to check it by examination of blood smear and incubating EDTA sample on 37°C degrees for an hour. The platelets value on 37°C degrees was 32.0 x 10e9/L. Blood smear showed a platelet aggregation. The platelet count with the Sodium Citrate was 253.0 x 10e9/L, with the Ammonium oxalate 266.0 x 10e9/L and with Mg-sulphate 284.0 x 10e9/L. Newborn was healthy. The Complete Blood Count of newborn revealed normal parameters apart from a low platelet count 49.0 x 10e9/L. A blood smear was ordered and it revealed platelet aggregations. Platelet count of newborn blood sample taken on sodium-citrate was 189.0 x 10e9/L which clearly indicated pseudothrombocytopenia. Conclusions: Although PTP does not require clinical-therapeutic intervention, undiagnosed PTP can lead to therapeutic intervention (unnecessary administration of platelet concentrate) and seriously deteriorate both mother's and child's health. Therefore, the authors suggest examination of blood smear in every case when thrombocytopenia is diagnosed

The Association Between Periodontal Inflammation and Labor Triggers (Elevated Cytokine Levels) in Preterm Birth: A Cross-Sectional Study

Background: Periodontitis is considered to be a risk factor for preterm birth. Mechanisms have been proposed for this pathologic relation, but the exact pathologic pattern remains unclear. Therefore, the objective of the present study is to evaluate levels of four major labor triggers, prostaglandin E-2 (PGE(2)), interleukin (IL)-1 beta, IL-6, and tumor necrosis factor (TNF)-alpha, in gingival crevicular fluid (GCF) and serum samples between women with preterm birth (PTB) and full-term birth (FTB) and correlate them with periodontal parameters. Methods: PGE(2), IL-1 beta, IL-6, and TNF-alpha levels were estimated using enzyme-linked immunosorbent assays in GCF and serum samples collected 24 to 48 hours after labor from 120 women (60 FTB, 60 PTB). Results: Women with PTB exhibited significantly more periodontitis, worse periodontal parameters, and increased GCF levels of IL-6 and PGE(2) compared with the FTB group; there were no significant differences in serum levels of measured markers. GCF levels of IL-1 beta, IL-6, and PGE(2) and serum levels of TNF-alpha and PGE(2) were significantly higher in women with periodontitis compared with periodontally healthy women. Serum levels of PGE(2) were positively correlated with probing depth (PD) and clinical attachment level (CAL) as well as with GCF levels of TNF-alpha in women with PTB. Conclusions: Women with PTB demonstrated worse periodontal parameters and significantly increased GCF levels of IL-6 and PGE(2) compared with those with FTB. Based on significant correlations among serum PGE(2) and PD, CAL, and GCF TNF-alpha in PTB, periodontitis may cause an overall increase of labor triggers and hence contribute to preterm labor onset

Chromosomes aberations and enviromental factors

Explanation the topic: Changes in genetic material can lead to aberrant cell in the direction of disorders of cellular regulation, malignant transformation, cell death, or if the adjustment was made at the level of the reproductive cells, to genetic changes in some of the consequent off spring. The topic position in scientific/professional public: Breaking of chromosomes can occur spontaneously or can be induced. Chromatid/chromosome breakings can be induced by different environmental factors: chemicals, biological clastogenic agents, accidentally or intentionally. Conclusions: The authors suggest: - making conditions for strong respect of environmental regulations; - to use higher plants for the early detection of environmental mutagens; - create and orderly update National radionuclide database

Anthocyanins protect hepatocytes against CCl4_4-induced acute liver injury in rats by inhibiting pro-inflammatory mediators, polyamine catabolism, lipocalin-2, and excessive proliferation of Kupffer cells

This study examined the hepatoprotective and anti-inflammatory effects of anthocyanins from Vaccinim myrtillus (bilberry) fruit extract on the acute liver failure caused by carbon tetrachloride-CCl$_4$ (3 mL/kg, i.p.). The preventive treatment of the bilberry extract (200 mg anthocyanins/kg, orally, 7 days) prior to the exposure to the CCl$_4$ resulted in an evident decrease in markers of liver damage (glutamate dehydrogenase, sorbitol dehydrogenase, malate dehydrogenase), and reduced pro-oxidative (conjugated dienes, lipid hydroperoxide, thiobarbituric acid reactive substances, advanced oxidation protein products, NADPH oxidase, hydrogen peroxide, oxidized glutathione), and pro-inflammatory markers (tumor necrosis factor-alpha, interleukin-6, nitrite, myeloperoxidase, inducible nitric oxide synthase, cyclooxygenase-2, CD68, lipocalin-2), and also caused a significant decrease in the dissipation of the liver antioxidative defence capacities (reduced glutathione, glutathione S-transferase, and quinone reductase) in comparison to the results detected in the animals treated with CCl$_4$ exclusively. The administration of the anthocyanins prevented the arginine metabolism’s diversion towards the citrulline, decreased the catabolism of polyamines (the activity of putrescine oxidase and spermine oxidase), and significantly reduced the excessive activation and hyperplasia of the Kupffer cells. There was also an absence of necrosis, in regard to the toxic effect of CCl$_4$ alone. The hepatoprotective mechanisms of bilberry extract are based on the inhibition of pro-oxidative mediators, strong anti-inflammatory properties, inducing of hepatic phase II antioxidant enzymes (glutathione S-transferase, quinone reductase) and reduced glutathione, hypoplasia of Kupffer cells, and a decrease in the catabolism of polyamines