3 research outputs found
New Opportunities for Endometrial Health by Modifying Uterine Microbial Composition: Present or Future?
We acknowledge the research support by Copan Italia S.p.A Inc., and Clearblue, SPD Swiss
Precision Diagnostics GmbH. This study is part of a PhD Thesis conducted at the Official Doctoral Programme in
Biomedicine of the University of Granada, Spain. We are grateful to Ana Yara Postigo-Fuentes for her assistance
with English language.Current knowledge suggests that the uterus harbours its own microbiota, where the
microbes could influence the uterine functions in health and disease; however, the core uterine
microbial composition and the host-microbial relationships remain to be fully elucidated. Different
studies are indicating, based on next-generation sequencing techniques, that microbial dysbiosis could
be associated with several gynaecological disorders, such as endometriosis, chronic endometritis,
dysfunctional menstrual bleeding, endometrial cancer, and infertility. Treatments using antibiotics
and probiotics and/or prebiotics for endometrial microbial dysbiosis are being applied. Nevertheless
there is no unified protocol for assessing the endometrial dysbiosis and no optimal treatment protocol
for the established dysbiosis. With this review we outline the microbes (mostly bacteria) identified
in the endometrial microbiome studies, the current treatments offered for bacterial dysbiosis in the
clinical setting, and the future possibilities such as pro- and prebiotics and microbial transplants for
modifying uterine microbial composition.This work is supported by the Spanish Ministry of Economy, Industry and Competitiveness (MINECO)
and European Regional Development Fund (FEDER): grants RYC-2016-21199 and ENDORE SAF2017-87526-R;
Programa Operativo FEDER Andalucía (B-CTS-500-UGR18) and by the University of Granada Plan Propio de
Investigación 2016—Excellence actions: Unit of Excellence on Exercise and Health (UCEES)—and Plan Propio
de Investigación 2018—Programa Contratos-Puente, and the Junta de Andalucía, Consejería de Conocimiento,
Investigación y Universidades, European Regional Development Funds (ref. SOMM17/6107/UGR). A.S.-L. is
funded by the Spanish Ministry of Science, Innovation and Universities (PRE2018-0854409)
THROMBOPHILIA IN PREGNANCY – CURRENT ISSUE OF MODERN PERINATOLOGY
Pregnancy is a condition of increased affinity to blood clotting. The most important changes of coagulation system in pregnancy involve the increase of the following coagulation factors: fibrinogen production, level of numerous blood coagulation factors- FII, FVII, FVIII, FX, FXII, acquired activated protein C resistance, and the decrease of: fibrinolysis due to the increase of a large number of fibrinolytic activator inhibitors PAI-1 and PAI-2, thrombin activatable fibrinolysis inhibitor TAFI, and levels of proteins S and C. This disease is not a disease on its own, but a group of inherited and acquired coagulation disorders that increase the predisposition to thrombosis. The treatment of choice in pregnancy are low-molecular-weight heparins (LMWHs) which are derived from standard heparin by controlled hydrolysis, thus obtaining heparins of a lower molecular mass. The most commonly used LMWHs are: dalteparin sodium, enoxaparin, nadroparin-calcium, reviparin. LMWH is given in prophylactic doses – low and medium doses in therapeutic doses. Thromboprophylaxis in pregnancy is implemented as: intrapartal, intra- and postpartum according to the official recommendations of the American Association of Obstetricians and Gynecologists (ACOG). Specific recommendations of ACOG refer to the treatment of hereditary thrombophilia in pregnancy
Insulin Resistance and C-reactive Protein in Preeclampsia
Preeclampsia is referred to as the “disease of the theories” because of the multiple hypotheses proposed to explain is occurrence. Despite considerable research, the causes of preeclampsia remain unclear. Preeclampsia is likely to be multifactorial in origin, and recent research has focused on endothelial dysfunction as a central abnormality in preeclampsia. Insulin resistance and inflammation may contribute to the onset of preeclampsia. They could also be correlated. The aim of the study was to evaluate the presence and relationship between insulin resistance and its markers and C-reactive protein as a marker of inflammation. During their third trimester, 17 preeclamptic women and 20 normotensive controls underwent oral glucose tolerance test, basic biochemical analyses and SHBG. Preeclamptic women were more insulin resistant (p=0,004), and they had higher triglycerides levels (p=0,006), uric acid (p=0,002). However, the study groups did not differ in C-reactive protein (CRP), sex hormone-binding globulin (SHBG), high and low-density lipoproteins (HDL-cholesterol and LDL-cholesterol). In multiple regression analysis only SHBG (p=0,014) and triglycer-ides (p=0,003) were associated with insulin sensitivity independently of the body mass index (BMI), weight gain, HDL and LDL, and CRP. Preeclampsia is a state of increased insulin re- sistance, and CRP as the marker of inflammation was not increased in our research, and not associated with established preeclampsia