Navegando por Palavras-chave "pré-eclâmpsia"
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- ItemSomente MetadadadosCaracterização do perfil lipídico em plasma e placenta de gestantes com pré-eclâmpsia(Universidade Federal de São Paulo (UNIFESP), 2013-06-26) Korkes, Henri Augusto [UNIFESP]; Sass, Nelson Sass [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)As síndromes hipertensivas na gravidez representam importante causa de morbidade e mortalidade, contribuindo com mais de 50.000 mortes maternas ao redor do mundo a cada ano. Entre elas a préeclâmpsia (PE) ocupa um papel de destaque. A obesidade representa um dos fatores de risco mais importantes para a PE e, embora os mecanismos envolvidos nesta associação ainda não sejam totalmente elucidados, seria possível o envolvimento de classes específicas de lipídeos neste processo. Objetivo: Caracterizar o perfil lipídico em plasma e placenta de pacientes com PE. Metodologia: Foram colhidas amostras de plasma e placenta de 20 pacientes, sendo 10 controles (CO) e 10 pacientes com PE. Estas foram submetidas à extração lipídica e análise lipidômica por espectrometria de massas. Resultados: Encontramos uma composição lipídica bem distintas entre os grupos estudados. Quando comparadas com os CO, as análises plasmáticas de pacientes com PE apresentam um aumento na quantidade de Phosphatidylserines (52,3% em PE) e (15,53% em CO), Phosphatidylcholines (9,47% em PE) e (0,41% em CO) e Flavanoids (8,39% em PE) e (1,33% em CO), assim como uma redução na quantidade de Phosphatidylethonolamines (24,03% em PE) e (77,38% em CO). Nas amostras placentárias nota-se aumento de Phosphatidylserines (56,28% em PE) e (34,85% em CO), Polyketide Macrolides (32,77% em PE) e (3,86% em CO), redução de Flavanoids (2,98% em PE) e (11,68% em CO), Phosphatidylinositols (4,39% em PE) e (13,28% em CO) Phosphatidylethonolamines (0% em PE) e (9,69% em CO). Conclusão: Foi possível identificar, nos perfis lipídicos plasmático e placentário de pacientes com pré-eclâmpsia, a presença de concentrações diferenciadas de alguns componentes lipídicos, exibindo no plasma maiores concentrações de Phosphatidylserines, Phosphatidylcholines e Flavanoids, além de menores de Phosphatidylethonolamines. Na placenta foram identificadas maiores concentrações de Phosphatidylserines e Polyketide Macrolides e redução de Flavanoids e Phosphatidylethonolamines.
- ItemSomente MetadadadosPapel dos micrornas 135-a e 210 na fisiopatologia da pre-eclâmpsia(Universidade Federal de São Paulo (UNIFESP), 2016) Korkes, Henri Augusto [UNIFESP]; Oliveira, Leandro Gustavo de Oliveira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Preeclampsia affects 3 to 5% of all pregnancies. The disease is characterized by endothelial dysfunction and systemic inflammatory response. Recent researches on microRNAs suggest important roles for these molecules on several biological processes, including preeclampsia. Objectives: To evaluate the participation of miR-135-a and miR-210 in the pathophysiology of preeclampsia. Methods: This is a case-control study, involving in vitro and in vivo experimental models to evaluate the role of miR-135-a and miR-210 on trophoblastic invasion and hypoxia and angiogenic imbalance in placentas of women with preeclampsia. Results: miR-135-a increased trophoblastic invasion in vitro and its mechanism of action was affected by hypoxia (p<0.05). miR-135-a was able to promote spiral artery remodeling in pregnant mice (p<0.05). Preeclamptic placentas expressed higher amount of mir-210 and it was positively correlated with higher expression of total Flt (p<0.05). These results demonstrated correlation between miR-210 and the angiogenic imbalance found in preeclampsia. Conclusion: Either miR-135-a or miR-210 seem to be involved in the pathophysiology of preeclampsia. Additional functional studies must be developed in order to elucidate the role of these molecules as cause or consequence of preeclampsia and to identify specific target genes.
- ItemSomente MetadadadosPredição da pré-eclâmpsia pela dopplervelocimetria das artérias uterinas e pelos biomarcadores papp-a e plgf, entre 11 e 14 semanas de gestação(Universidade Federal de São Paulo (UNIFESP), 2015-11-27) Lobo, Guilherme Antonio Rago [UNIFESP]; Pares, David Baptista da Silva Pares [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: 1) To examine predictive value of uterine artery doppler, PAPP-A and PLGF, between 11-14 weeks gestation, in the prediction of preeclampsia (PE). 2) To validate first trimester FMF algorithm which combines maternal characteristics, mean arterial pressure (MAP), uterine artery doppler and biochemical markers in a Brazilian population. Method: Prospective observational study. 701 patients were recruited by the time of 11-14 weeks anomaly scan. 617 pregnant women comprised final sample (84 were excluded). In all of them demographic characteristics were recorded, MAP and mean pulsatility index (PI) obtained and PAPP-A and PLGF measured. Biophysical and biochemical markers were converted into MoM. All data was inserted on FMF software in order to calculate PE risk for each participant. Groups were formed on the basis of gestational age at delivery. Group 1 (n=7); delivery before 34 weeks. Group 2 (n=18); delivery before 37 weeks (includes group 1 patients plus delivery between 34-37 weeks). Group 3 (n=34); delivery before 42 weeks (includes group 2 patients plus delivery after 37 weeks). Control group (no PE / no GH) was composed by 517 women. Results: Mean PI MoM, PAPP-A MoM and PLGF MoM isolated performed equally in group 1 achieving a detection rate (DR) of 28,6%, for a 10% false positive rate (FPR). Markers performance in group 2 was 22,2%, 16,7% and 38,9%, respectively (10% FPR). Markers performance in group 3 was 20,6%, 11,8% and 26,5%, respectively (10% FPR). Combination markers that yelded highest area under the curve (AUC) for group 1 was mean PI MoM + PAPP-A MoM (AUC = 0,757) with a DR of 42,9% for 10% FPR. The combination of mean PI MoM + PAPP-A MoM + PLGF MoM had the best performance in group 2 and 3 (AUC = 0,711 and 0,682, respectively) with a DR of 38,9% and 35,3%, respectively, for 10% FPR. Detection rate achieved by FMF algorithm was 85,7%, 66,7% and 52,9% for groups 1,2 and 3, respectively, for a 10% FPR. Conclusion: First trimester mean PI, PAPP-A and PLGF performs poorly both isolated or in combination in the prediction of PE. FMF algorithm performance is quite good, particularly for the early onset subtype, comparable to the one obtained in the reference population.
- ItemAcesso aberto (Open Access)Preeclampsia(Federacao Brasileira Soc Ginecologia & Obstetricia-Febrasgo, 2017) Lopes Ramos, Jose Geraldo; Sass, Nelson [UNIFESP]; Martins Costa, Sergio HofmeisterThe authors review hypertensive disease during pregnancy with an academic and practical view, and using the best evidence available. This disease, which is the most important clinical disease in Brazilian pregnant women, may have its incidence reduced with prevention through the use of calcium and aspirin in pregnant women at risk. Previously, it was a disease that presented with hypertension with proteinuria, but it has now been classified with new clinical parameters besides proteinuria. Morbidity and mortality should be reduced in a continental country such as Brazil using protocols for the early treatment of complications by calculating severe outcomes in preeclampsia. The early treatment of acute hypertension, use of magnesium sulfate and early hospitalization in cases of preeclampsia are concepts to pursue the reduction of our pregnant women's mortality.