Hemangi Chaudhari

Differential Expression of Collectins in Human Placenta and Role in Inflammation during Spontaneous Labor

Collectins, collagen-containing Ca2+ dependent C-type lectins and a class of secretory proteins including SP-A, SP-D and MBL, are integral to immunomodulation and innate immune defense. In the present study, we aimed to investigate their placental transcript synthesis, labor associated differential expression and localization at feto-maternal interface, and their functional implication in spontaneous labor. The study involved using feto-maternal interface (placental/decidual tissues) from two groups of healthy pregnant women at term (≥37 weeks of gestation), undergoing either elective C-section with no labor (‘NLc’ group, n = 5), or normal vaginal delivery with spontaneous labor (‘SLv’ group, n = 5). The immune function of SP-D, on term placental explants, was analyzed for cytokine profile using multiplexed cytokine array. SP-A, SP-D and MBL transcripts were observed in the term placenta. The ‘SLv’ group showed significant up-regulation of SP-D (p = 0.001), and down-regulation of SP-A (p = 0.005), transcripts and protein compared to the ‘NLc’ group. Significant increase in 43 kDa and 50 kDa SP-D forms in placental and decidual tissues was associated with the spontaneous labor (p<0.05). In addition, the MMP-9-cleaved form of SP-D (25 kDa) was significantly higher in the placentae of ‘SLv’ group compared to the ‘NLc’ group (p = 0.002). Labor associated cytokines IL-1α, IL-1β, IL-6, IL-8, IL-10, TNF-α and MCP-1 showed significant increase (p<0.05) in a dose dependent manner in the placental explants treated with nSP-D and rhSP-D. In conclusion, the study emphasizes that SP-A and SP-D proteins associate with the spontaneous labor and SP-D plausibly contributes to the pro-inflammatory immune milieu of feto-maternal tissues.

Cervical cancer in Indian women reveals contrasting association among common sub-family of HLA class I alleles.

We studied the relationship between human leukocyte antigen (HLA) class I alleles and cervical cancer among Indian women. Seventy-five cervical cancer cases were compared with 175 noncancer controls. Cervical biopsy tissue specimen from cancer cases and cervical swab specimen from controls were collected for HPV detection and typing. Blood was taken for HLA typing by PCR-SSOP method. The impact of HLA class I alleles on cervical cancer risk was evaluated using StatCalc program (Epi Info version 6.0.4. CDC Atlanta, GA, USA), and confirmed with Bonferroni correction. Results revealed HLA-B*37, HLA-B*58 were associated significantly with increased risk while HLA-B*40 with decreased risk for cervical cancer. At high-resolution analysis after Bonferroni correction, HLA-B*37:01 allele was associated with increased risk, whereas HLA-B*40:06 was with decreased risk for cervical cancer. HLA-B*37:01 and HLA-B*40:06 belong to the same superfamily of HLA-B44. In silico analysis revealed different binding affinities of HLA-B*37:01 and HLA-B*40:06 for the epitopes predicted for E6 and L1 proteins of HPV16. The higher binding affinity of epitopes to B*40:06, as revealed by docking studies, supports the hypothesis that this allele is able to present the antigenic peptides more efficiently than B*37:01 and thereby can protect the carriers from the risk of cervical cancer. Thus, there is a clear indication that HLA plays an important role in the development of cervical cancer in HPV-infected women. Identification of these factors in high-risk HPV-infected women may help in reducing the cervical cancer burden in India.

To study and compare the obstetric and neonatal outcome of pregnancies complicated with hypothyroidism amongst antenatally detected and treated hypothyroid patients and patients found to be hypothyroid at the time of labor

Background: To evaluate pregnancy outcome in women with elevated serum thyroid stimulating hormone (TSH) values as compared to those in whom hypothyroidism was treated. Methods: A prospective interventional comparative study was conducted in the department of obstetrics and gynaecology in King Edward Memorial Hospital, Mumbai, India from 2014 to 2015. A cohort of 60 hypothyroid patients was divided into two groups of 30 each. Group 1, euthyroid (treated hypothyroid) and group 2, hypothyroid at the time of labor and pregnancy outcomes were compared. Results: All patients in group 1 delivered at term; whereas in group 2, 9 (30%) patients had preterm deliveries and 21 (70%) delivered at term, amongst which 5 patients delivered babies with severe intrauterine growth restriction (IUGR). Neonatal intensive-care unit (NICU) admission were required for 3 neonates in group 1 and 11 (36.67%) neonates in group 2. Group 1 delivered 5 (16.67%) low birth weight babies (weight <2.5 kg) whereas 16 (53.34%) babies had low birth weight in group 2. Conclusions: Treatment of patients diagnosed with hypothyroidism during pregnancy significantly (p value <0.05) reduced the risk of preterm labor, low birth weight, need for NICU admission.