Multi-omics and machine learning for the prevention and management of female reproductive health

Females typically carry most of the burden of reproduction in mammals. In humans, this burden is exacerbated further, as the evolutionary advantage of a large and complex human brain came at a great cost of women’s reproductive health. Pregnancy thus became a highly demanding phase in a woman’s life cycle both physically and emotionally and therefore needs monitoring to assure an optimal outcome. Moreover, an increasing societal trend towards reproductive complications partly due to the increasing maternal age and global obesity pandemic demands closer monitoring of female reproductive health. This review first provides an overview of female reproductive biology and further explores utilization of large-scale data analysis and -omics techniques (genomics, transcriptomics, proteomics, and metabolomics) towards diagnosis, prognosis, and management of female reproductive disorders. In addition, we explore machine learning approaches for predictive models towards prevention and management. Furthermore, mobile apps and wearable devices provide a promise of continuous monitoring of health. These complementary technologies can be combined towards monitoring female (fertility-related) health and detection of any early complications to provide intervention solutions. In summary, technological advances (e.g., omics and wearables) have shown a promise towards diagnosis, prognosis, and management of female reproductive disorders. Systematic integration of these technologies is needed urgently in female reproductive healthcare to be further implemented in the national healthcare systems for societal benefit.publishedVersio

Role of Vitamin D in Preeclampsia

Pathogenesis of preeclampsia involves immune dysfunction, placental implantation, abnormal angiogenesis, excessive inflammation, hypertension that may be affected by vitamin D. Human placenta expresses all the components for vitamin D signaling: Vitamin D receptor (VDR), retinoid X receptor (RXR), 1-alpha- hydroxylase (CYP27B1) and 24- hydroxylase (CYP24A1). Vitamin D binding protein plays a role in binding and transportation of 25 hydroxyvitamin D [25(OH)D] and 1,25(OH)2D3. Vitamin D is activated by 25-hydroxylase (CYP2R1) and 1-alpha -hydroxylase (CYP27B1) and is degraded by 24-hydroxylase (CYP24A1). Vitamin D supplementation is not recommended by WHO for pregnant women and allows recommended nutrient intake (RNI) of 200 IU (5 μg) per day. Further research requires serum 25(OH)D analysis and assessment of maternal and infant outcomes; pre-conceptional vitamin D status

Relationship between gestational age and endoglin levels in maternal and cord blood

Background: Poor placentation at early gestational age is an important predisposing condition for the development of preeclampsia. The present study was designed to study the relationship of gestational age with endoglin levels in maternal and cord blood of normal and pre-eclamptic women.Methods: The present study was conducted in fifty pregnant women that were grouped as: group 1 (control, n=25) comprising of normotensive women immediately after delivery, group 2 (study group, n=25) comprising of age -and sex- matched pre-eclamptic women. Study samples were drawn (maternal venous blood and umbilical cord blood). Endoglin was analyzed by competitive enzyme linked immunosorbent assay.Results: Maternal serum endoglin levels were decreased in group II as compared to group I. Maternal endoglin showed a positive correlation with gestational age in both normotensive and preeclamptic women. Cord blood endoglin showed negative correlation with gestational age in both normotensive women and preeclamptics. A significant positive correlation was found between maternal and cord blood endoglin levels with birth weight in preeclamptic mothers. Pre-eclamptics with birth weight less than 2.5 kg had lower maternal blood endoglin levels as compared to controls.Conclusions: These finding suggest that endoglin levels may responsible for the pathogenesis of PE and/or IUGR

Cord blood angiogenic profile in normotensive pregnancies

Human placenta undergoes both angiogenesis and vasculogenesis during fetal development. An imbalance in proangiogenic [placental growth factor (PlGF) and vascular endothelial growth factor] and antiangiogenic factors [soluble fms like tyrosine kinase-1 (sFlt-1), soluble endoglin (sEng)] has been reported to have a role in pathophysiology of preeclampsia. Hence the present study was designed to analyze heme oxygenase-1 and endoglin levels in maternal and cord blood of normotensive women. The study comprised of twenty five normotensive pregnant women immediately after delivery Study samples were drawn (maternal venous blood and umbilical cord blood) and heme oxygenase-1 (HO-1) and endoglin levels were analyzed by competitive enzyme linked immunosorbent assay. Heme oxygenase-1 levels were elevated in maternal blood as compared to cord blood of normotensive pregnant women. Also, serum blood endoglin levels were higher in maternal blood compared to cord blood of normotensive pregnant women. These findings indicate that there is angiogenic balance during normotensive pregnancy and dysbalance might occur during pathological pregnancy. These markers of angiogenic balance may serve as diagnostic marker and may help in explaining future risk of cardiovascular disease in these women.Keywords: Vasculogenesis; Proangiogenic and antiangiogenic factors; Pregnanc

Birth Weight, Cord Blood Lipoprotein and Apolipoprotein Levels in Indian Newborns

Objectives: Primordial prevention of chronic disease is of clinical and public health importance. Considering the fetal onset of atherosclerosis, we aimed to determine the cord blood level of lipoproteins and apolipoproteins as well as their correlation with birth weight and gestational age. Methods: This cross-sectional study comprised 100 healthy Indian newborns. Ten ml. of cord blood was collected from placental end of umbilical vein. Serum was separated by centrifugation and ana-lyzed on the same day for lipid profile including total cholesterol (TC), triglycerides (TG), high density lipoprotein- cholesterol (HDL-C), very low density lipoproteincholesterol (VLDL) and low density lipoprotein-cholesterol (LDL-C), apolipoproteins A-I and B (ApoA-I, ApoB). Atherogenic index (AI) was calculated as the ratio of ApoB to ApoA-I. Results: Cord blood of female newborns had higher TC, HDL-C, LDL-C, Apo A-I, Apo B and AI as compared to male newborns, whereas TG and VLDL-C were higher in male than in female newborns. Significant positive correlation was observed between cord blood Apo A-I and HDL-C (r= 0.45, p<0.01), and between cord blood Apo-B and LDL-C (r= 0.44, p<0.01). Non-significant inverse correlation was observed between Apo A-I and ApoB with gestational age. There was a significant inverse correlation be-tween TG and gestational age (r= -0.197, p <0.05). Positive non-significant correlation was observed between AI and birth weight (r=0.046, p>0.05). Conclusions: These findings are another confirmatory evidence for the association of prenatal factors with cord blood lipid pro-file, and can serve as starting point for studying lipid transport system changes during early life

Lactate dehydrogenase levels in preeclampsia and its correlation with maternal and perinatal outcome

Background: Hypertensive disorder of pregnancy occurs in approximately 6-8% of all pregnancies. The most serious consequences for the mother and the baby are the result of preeclampsia and eclampsia. Lactate Dehydrogenase (LDH) is an intracellular enzyme. Recently LDH has been suggested as potential marker to predict severity of pre-eclampsia. The objective of the present study was to compare the serum lactate dehydrogenase levels in women with preeclampsia and normal pregnant women and to correlate lactate dehydrogenase levels with maternal and perinatal outcome in preeclampsia.Methods: An observational prospective study was conducted on 200 antenatal women attending the labour room emergency. Women with singleton pregnancy and cephalic presentation, from 28 weeks onwards were enrolled in the study. Out of 200, 100 were normal pregnant women and 100 were preeclamptic women. Serum LDH levels were measured in all women and maternal and perinatal outcome was assessed in terms of LDH levels.Results: Higher levels of LDH was observed in pregnant women with preeclampsia (627.38±230.04 IU/l) as compared to normal pregnant women (224.43±116.61 IU/l). The maternal complications were found to be maximum in women with LDH > 800 IU/l.  Abruption was the most common complication. The perinatal mortality and neonatal deaths were found to have significant correlation with high LDH levels.Conclusions: Maternal and perinatal complications were associated with higher LDH levels in preeclampsia patients. Serum LDH levels can be offered to all patients of preeclampsia and can be used to predict the prognosis of preeclampsia

Inverse Correlation between Insulin‑like Growth Factor‑1 and Leptin Levels in Preeclampsia

Background: Preeclampsia is the major cause of maternofetal and neonatal morbidity and mortality. Insulin‑like growth factor (IGF) system has a crucial role in correct embryonic and placental development and growth. Conflicting data are available regarding IGF‑1 in preeclamptic mothers. The extent to which leptin per se mediates the fetal growth and developmental abnormalities associated with preeclampsia remains to be clarified.Aim: Hence, the present study was planned to assess IGF‑1 and leptin levels in maternal and cord blood of preeclamptics and to compare them with normotensive pregnant women.Subjects and Methods: The present study was conducted in the Department of Biochemistry in collaboration with the Department of Obstetrics and Gynaecology, Pt. B.D. Sharma, PGIMS, Rohtak. Totally, 25 normotensive pregnant and 25 preeclamptic women were enrolled, and serum leptin and IGF‑1 levels were analyzed in maternal and cord blood of women by enzyme‑linked immunosorbent assay.Results: IGF‑I levels were lowered in maternal blood of preeclamptic as compared to normotensive mothers (P &lt; 0.001). Leptin levels were significantly increased in preeclamptic mothers as compared to normotensive mothers (P &lt; 0.001). Leptin had a positive correlation with IGF in both groups and it is highly statistically significant in preeclamptic mothers. Conclusion: Findings of the present study suggest that IGF‑1 and leptin play a central role in controlling fetal growth.KEY WORDS: Cord blood, insulin‑like growth factor‑1, leptin, preeclamptics, pregnanc

Low blood glutathione levels in acute myocardial infarction

Background: Although experimental studies have demonstrated that reduced glutathione (GSH) is involved in cellular protection from deleterious effects of oxygen free radicals in ischaemia and reperfusion, there are controversial data on the correlation between levels of GSH and the ischaemic process. Aim: The present study was planned to evaluate erythrocyte GSH levels in patients with acute myocardial infarction (AMI). Setting &amp; Design: Erythrocyte GSH levels were determined in 22 patients with AMI and 15 age matched healthy volunteers served as control. Material &amp; Methods: Erythrocyte GSH levels were measured by using Bentler in AMI and control patients. Also lipid profile was analyzed enzymatically in these subject. Statistics: The values were expressed as means ± standard deviation (SD) and data from patients and controls was compared using student's 't'-test. Results &amp; Conclusion: GSH levels were significantly decreased in AMI as compared to control (p&lt;0.001). Also, total cholesterol and triglycerides were higher is AMI subjects (p&lt;0.05). These finding suggest that depressed GSH levels may be associated with enhanced protective mechanism to oxidative stress in AMI

Lipid Peroxidation and Lipid Profile in Type II Diabetes Mellitus Lipid Peroxidation and Lipid Profile in Type II Diabetes Mellitus

Abstract The study was designed to find out the relation between lipid peroxidation, lipoprotein levels to severity and complication of diabetes mellitus. Degree of lipid peroxidation was measured in terms of malondialdehyde (MDA) along with antioxidants, lipid profile and blood glucose in diabetes mellitus. Total 100 human subjects, out of which 50 healthy individuals of age group (50-70years) were taken as control &amp; 50 elderly diabetic subjects of age group (50-70years) were taken as cases. There was significant increase in the lipid profile except HDL cholesterol, which is decreased, Also significant decrease in antioxidant enzymes such as Reduced glutathione, glutathione peroxidase, glutathione reductase, superoxide dismutase except catalase was seen as compared to the control subjects. Other findings observed was that the level of lipid peroxide (MDA) increased as per the increase in concentration of blood glucose. Our findings indicate that the increase in the lipid peroxidation product MDA and decline in glutathione-dependent antioxidant defences may appear early in non insulin dependent type 2diabetes mellitus patients