Untersuchungen zur Expression und Funktion des Glykoproteins Progranulin an der Humanplazenta sowie Evaluation neuer Marker in der Prädiktion und Diagnostik der Präeklampsie

In der vorliegenden Arbeit wurde die Expression von Progranulin in humanem Plazentagewebe unter physiologischen und pathologischen (Präeklampsie, fetale Wachstumsrestriktion) Bedingungen analysiert. Bei starker Expression in villösen Trophoblastzellen folgten Untersuchungen zur Bedeutung des Progranulins bezüglich grundlegender vitaler Funktionen humaner villöser Trophoblastzellen. Darüber hinaus wurden Untersuchungen zur Prädiktion einer Präeklampsie und zur Diagnostik eines HELLP-Syndroms unter Verwendung neuer maternaler Serummarker (sFlt-1/PlGF; microRNA-Analysen) durchgeführt

Isoflavones - Mechanism of Action and Impact on Breast Cancer Risk

Isoflavones are plant-derived substances with weak es-trogenic effects. Asian populations are high consumers of soy products which are rich in isoflavones. The lower breast cancer incidence in Asian women compared with Western women has been associated with the possibility of a preventive isoflavone effect on cancer risk. The aim of this review is to give an overview of current research data on the influence of isoflavones on the risk of primary breast cancer development as well as the risk of recurrence in breast cancer patients. Despite inconsistencies in the available data, an inverse correlation between isoflavone intake and risk of breast cancer is likely. However, a negative impact on breast cancer disease, especially on hormone receptor-positive tumors, cannot be excluded at present

Prediction of spontaneous preterm birth using CCL2 and CXCL10 in maternal serum of symptomatic high-risk pregnant women: a prospective cohort study

Abstract Introduction CCL2 and CXCL10 are putative biomarkers for the prediction of spontaneous preterm birth. This study evaluates these markers in a cohort of pregnant high-risk women. Material and methods In our prospective study, we included 109 women with signs of preterm labor between 20 + 0 and 31 + 6 weeks of gestation. Inclusion criteria were regular (< 3/30 min) or painful contractions, cervical length < 25 mm or a history of previous preterm birth (PTB). Blood samples were obtained upon first admission to our clinic. Biomarker concentrations were measured using pre-coated sandwich immunoassays (ELISA). Primary study outcome was spontaneous preterm birth < 34 weeks, secondary outcome was delivery < 37 weeks or within seven days after study inclusion. Results Sixteen women (14.7%) delivered < 34 weeks and twenty women between 34 + 0 and 36 + 6 weeks (18.4%). Six patients (5.5%) gave birth within seven days after study admission. CXCL10 showed higher medium serum levels in women with PTB < 34 weeks (115 pg/ml compared to 61 pg/ml ≥ 34 weeks; p < 0.001) and < 37 weeks (103 pg/ml vs. 53 pg/ml; p < 0.001). In contrary, lower CCL2 serum levels were associated with PTB < 34 weeks (46 pg/ml vs. 73 pg/ml; p = 0.032) and birth within 7 days (25 pg/ml vs. 73 pg/ml; p = 0.008). The CXCL10/CCL2-ratio further improved the predictive model with a ROC-AUC of 0.83 (95% CI 0.73–0.93, p < 0.001) for delivery < 34 weeks. These corresponds to a sensitivity, specificity and positive predictive value of 0.67, 0.86 and 0.43 at a cut-off of 2.2. Conclusion Low maternal serum CCL2 levels are associated with a higher risk of preterm delivery within seven days. High CXCL10 serum levels are more associated with a high risk for preterm birth < 34 weeks. Elevated CXCL10/CCL2-ratio is showing the best predictive performance. Trial registration number (DRKS-ID) DRKS00010763, Registration date: September 02, 2016

Accuracy of immediate antepartum ultrasound estimated fetal weight and its impact on mode of delivery and outcome - a cohort analysis

Abstract Background The aim of the study was to investigate the accuracy of ultrasound-derived estimated fetal weight (EFW) and to determine its impact on management and outcome of delivery. Methods In this single-center cohort analysis, women with a singleton term pregnancy in the beginning stages of labor were included. Women with immediately antepartum EFW (N = 492) were compared to women without ultrasound (N = 515). Results EFW was correct (deviation from birth weight ≤ 10%) in 72.2% (355/492) of patients with fetal biometry; 19.7% (97/492) were underestimated, and 8.1% (40/492) were overestimated. Newborns with a lower birth weight were more frequently overestimated, and newborns with higher birth weight were more frequently underestimated. The mean difference between EFW and real birth weight was − 114.5 g (standard deviation ±313 g, 95% confidence interval 87.1–142.0). The rate of non-reassuring fetal heart tracing (9.8% vs. 1.9%, P < 0.001) and of caesarean delivery (9.1% vs. 5.0%, P = 0.013) was higher in women with EFW. Overestimation was associated with an increased risk for delivery by caesarean section (odds ratio 2.80; 95% confidence interval 1.2–6.5, P = 0.017). After adjustment, EFW remained associated with increased non-reassuring fetal heart tracing (odds ratio 4.73; 95% confidence interval 2.3–9.6) and caesarean delivery (odds ratio 1.86; 95% confidence interval 1.1–3.1). The incidence of perineal tears of grade 3/4, shoulder dystocia, postnatal depression and neonatal acidosis did not differ between groups. Conclusions Antepartum ultrasound-derived EFW does not improve maternal and fetal outcome and is therefore not recommended

Additional file 1 of Prediction of spontaneous preterm birth using CCL2 and CXCL10 in maternal serum of symptomatic high-risk pregnant women: a prospective cohort study

Additional file 1: Figure S1. Impact of multiple gestation and interaction with the CXCL10 / CCL 2 ratio. A Boxplot comparing the CXCL10 / CCL2 ratio in dependence of gestational age at delivery (grouped) in dependence of multiple gestation. Similar correlation appeared in both subgroups. B Profile plot of marginal means of CXCL10 / CCL2 ratio by multiple gestation. The relative values of the mean CXCL10 / CCL2 ratio between groups defined according to multiple gestation are the same for all groups of gestational age at delivery (main effect multiple gestation P=0.781). Differences of the CXCL10 / CCL2 mainly results from gestational age at delivery (main effect gestational age P<0.001). There is no interaction between multiple gestation (yes/no) and gestational age at delivery (effect of interaction P=0.864). Analysis by two-factorial ANOVA. Figure S2. Boxplot of CXCL10 / CCL 2 ratio in dependence of gestational age at delivery (grouped) and singleton pregnancies. Kruskal-Wallis analysis revealed significant differences between groups (p< 0.001). Figure S3. Receiver operating characteristics (ROC) curves for the prediction of spontaneous preterm birth <34 weeks in symptomatic women. Comparison of CXCL10 / CCL 2 ratio alone (blue line, AUC 0.83) and the combination with cervical length (predictive probability by logistic regression, green line, AUC 0.84) with an AUC-difference of -0.015 (-0.103-0.73), p = 0.734. Table S1. Characteristics of the used ELISAs