Iphigenia Phocas

Inflammatory cytokines in newborn infants

Serum levels of IL-1beta, IL-6 and TNF-alpha were measured in 48 healthy, termed neonates on the 1st (N1), 5th (N5) and 40th (N40) day after birth, compared with those in maternal serum (MS), umbilical cord (UC) and adult controls. Cytokine values in N1 and N5 were significantly elevated, than those in UC and in controls (P<0.0001). IL-1beta and IL-6 declined significantly from N1 to N40 (P<0.0001), while TNF-alpha increased significantly from N1 to N5 and declined thereafter. MS infinity IL-1beta and IL-6, but not MS infinity TNF-alpha, were significantly higher than those of controls (P<0.0001). IL-1beta values depended on the mode of delivery. In conclusion, the increased concentrations of IL-1beta, IL-6 and TNF-alpha during the perinatal period might suggest their involvement in an inflammation-like process during normal parturition, and reflect also a newborn immune response to the stress of delivery and environmental changes.

Hormonal and ultrasound characteristics of menstrual function during chronic hemodialysis and after successful renal transplantation

The cycles of 11 renal transplant recipients (RTR), at least 24 months after stabilization of graft function and four hemodialyzed (HD) patients, menstruating regularly, were evaluated by concurrent and systematic determinations throughout the cycle of LH, FSH, estradiol, progesterone, testosterone, prolactin and SHBG and in the case of RTR also by ultrasound follow‐up. Biphasic estradiol secretion, midcycle LH and FSH surge, duration of luteal phase, midluteal progesterone values and in the case of RTR, ultrasonic parameters were consistent with: (1) normal ovulatory cycles in five RTR; (2) ovulatory cycles with luteal phase deficiency in five RTR and two HD patients; (3) anovulatory cycles in one RTR and two HD patients. Thus, in HD patients only abnormal cycles of central etiology were found, while in RTR, luteal phase deficiency was a very common syndrome, in equal percentage with normal ovulatory cycles.

A Comparative Study of Serum Soluble Vascular Cell Adhesion Molecule-1 and Soluble Intercellular Adhesion Molecule-1 in Preeclampsia

OBJECTIVES:Maternal serum soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecule-1 (sICAM-1) were evaluated in preeclampsia to investigate whether these molecules could be helpful with regard to this pregnancy complication.STUDY DESIGN:The study population was composed of 30 preeclamptic patients with a mean gestational age of 35.5 ± 4.6 weeks and 20 age-matched and gestational age-matched normotensive uncomplicated pregnancies (controls). Blood samples from 7 of the 30 preeclamptic patients and 15 of the 20 controls in the second trimester were also analyzed. Data were analyzed by parametric methods.RESULTS:Significantly higher maternal serum sVCAM-1 levels were found in both groups of preeclamptic patients with and without fetal growth restriction (981 ± 145 ng/ml; n = 13; p < 0.0005 and 846 ± 84 ng/ml; p < 0.02, respectively) compared with controls (668 ± 186 ng/ml). In contrast, no significant difference was found in maternal serum sICAM-1 levels between preeclamptic and normotensive pregnancies, or in both adhesion molecules (1) in the controls between second and third trimester samples and (2) in the second trimester between pregnant women who developed preeclampsia later and gestational age-matched controls.CONCLUSION: These findings show a selective significant elevation of maternal serum sVCAM-1 in preeclampsia, with the highest values in cases complicated with fetal growth restriction, perhaps reflecting its angiogenic function. Hence, sVCAM-1 could be helpful in the diagnosis of this fetal complication in preeclampsia.

Discordant secretion of pregnancy specific β1-glycoprotein and human chorionic gonadotropin by human pre-embryos cultured in vitro

OBJECTIVE To study and compare the secretion of pregnancy specific beta 1-glycoprotein (SP1) and human chorionic gonadotropin (hCG) by human pre-embryos, cultured in vitro, with their respective morphological development. DESIGN Spare human pre-embryos from randomly selected women participating in a program of in vitro fertilization (IVF) were studied prospectively. SETTING Pre-embryos were cultured, and hormone release was determined in academic research laboratories. PATIENTS, PARTICIPANTS Pre-embryos (n = 108) cultured for 14 days after fertilization in Hams F-10 medium (GIBCO Ltd., Paisley, Scotland) were observed, and hCG and SP1 were measured in the culture media at regular intervals. MAIN OUTCOME MEASURES Discordant secretion of SP1 and hCG. RESULTS Of the 98 bipronucleate pre-embryos, 53.6% formed blastocysts, 17.3% of which hatched. Human chorionic gonadotropin was detected from day 7 after fertilization concomitantly with blastocyst formation, thereafter showing a logarithmic increase (maximum 10,650 mIU) until the first signs of embryonic disintegration. Pregnancy-specific beta 1-glycoprotein release started 3 to 4 days after fertilization independently of the morphological development and the future production of hCG, thereafter displaying a nonlogarithmic increase (maximum 41 ng). CONCLUSIONS Hormone secretion and morphological development are unique for each pre-embryo. Human chorionic gonadotropin and SP1 seem to have different biochemical and physiological regulation.

Patterns of inflammatory cytokine serum concentrations during the perinatal period

Inflammatory cytokines interleukin-1beta (IL-1beta), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were measured in the serum of healthy, term neonates on the first (N1), fifth (N5) and 40th (N40) day after birth, compared with those in maternal serum (MS), umbilical cord (UC) and in adult controls. All three cytokines were significantly elevated in N1 and N5, compared with those in UC and adults (P < 0.0001). IL-1beta and IL-6 declined significantly from N1 to N40 (P < 0.0001), while TNF-alpha increased significantly from N1 to N5 and declined thereafter. TNF-alpha values in UC were significantly higher than in adults, but lower than in N40 (P < 0.0001), while IL-1beta and IL-6 values in UC did not differ from those in N40 and in adults. IL-1beta and IL-6, but not TNF-alpha values in MS were significantly higher than those in controls (P < 0.0001). IL-1beta values in MS were significantly higher than those in N1 (P < 0.0001), while those of IL-6 and TNF-alpha were significantly lower (P < 0.0001). Moreover, IL- 1beta values were dependent on the mode of delivery in N1 (P < 0.001), in MS (P < 0.02) and in UC (0.03), while IL-1beta and TNF-alpha values in N1 were strongly interrelated (r = 0.7; P < 0.01). In conclusion, the increased values of IL-1beta, IL-6 and TNF-alpha during the perinatal period might reflect a newborn immune response to the stress of delivery and to environmental changes after birth.

Homocysteine and folate levels in postmenopausal women

OBJECTIVES To assess total homocysteine (tHcy) and folate levels in postmenopausal women and investigate whether age, menopause duration, kind of menopause and tobacco use had an effect on these levels. METHODS Total homocysteine and folate levels were measured in fasting blood samples of 200 postmenopausal women with normal thyroid and renal function tests. Patients were not receiving vitamins or hormone replacement therapy. RESULTS Total homocysteine levels increased significantly after 60 years while folate levels showed a decrease trend after 65 years. Menopause duration had no effect on folate levels and increased significantly tHcy levels after >180 months duration. The kind of menopause did not influence tHcy and folate levels. Tobacco use reduced significantly folate levels. CONCLUSIONS Age seems to be the principal factor influencing tHcy levels. We believe that decreased folate levels also reflect an age-associated inadequate dietary intake. Tobacco use did not alter tHcy levels; however, we found smoking to lower folate levels.

Changes of angiogenin serum concentrations in the perinatal period

The polypeptide angiogenin, a normal constituent of human plasma, might be involved in endothelium homeostasis, angiogenesis, and neovascularization accompanying various diseases. This study aimed at determining angiogenin serum concentrations in the perinatal period of healthy newborns and at forming a baseline for this protein, which in the future may serve as a diagnostic index in developmental errors of the placenta and/or newborn. One milliliter of blood was drawn on d 1 and 4 of life from 30 healthy full-term neonates, and angiogenin serum concentrations were measured by an enzyme immunoassay using a commercially available kit. In 10 cases angiogenin serum concentrations were also measured in the maternal serum before delivery and in the umbilical vein serum. Angiogenin serum concentrations (μg/L) were significantly higher in maternal serum (225.7 ± 49.6) compared with umbilical vein serum (119.0 ± 34.2) (p < 0.0002), as well as that compared with day 1 (166.4 ± 44.9) (p < 0.01) but not to d 4 neonatal serum (240.8 ± 52.6). Angiogenin serum concentrations showed a statistically significant increase from d 1 to 4(p < 10-7), as well as from umbilical cord serum to d 1 neonatal serum (p < 0.0002). A statistically significant correlation existed between values in umbilical cord serum and d 1 neonatal serum (r = 0.84, n = 10, p < 0.002) and between those in d 1 and 4 neonatal serum (r = 0.37, n = 30, p < 0.04). Sex, birth weight, or mode of delivery did not influence angiogenin serum concentrations. We conclude that a rapid increase of angiogenin serum concentrations to maternal levels takes place during the first four postnatal days in healthy full-term neonates.

Expression of CEA, CA-125 and SCC antigen by biological fluids associated with pregnancy

Carcinoembryonic antigen (CEA), cancer antigen 125 (CA-125) and squamous cell carcinoma (SCC) antigen were measured in 56 full-termed pregnancies by enzyme-immunoassays (EIA-MEIA). The measurements were done in maternal serum (MS), umbilical cord blood (UCB) and amniotic fluid (AF) samples, during delivery. Very high antigen levels were found in AF samples (median: CEA = 124 ng/ml; CA-125 = 710 U/ml; SCC = 710 ng/ml) compared to UCB and MS. CEA and SCC showed significantly lower values in MS (0.6 and 1.7 ng/ml, respectively) than in UCB (1.6 ng/ml, P = 7.7 x 10(-9); 3.55 ng/ml, P = 6.5 x 10(-6), respectively), while CA-125 had significantly higher values in MS (6 U/ml) than in UCB (0.0 U/ml, P = 17 x 10(-6); Wilcoxon paired test). All CEA values in MS were below cut-off (less than or equal to 5 ng/ml), while 10% of CA-125 and 30% of SCC values were above cut-off (less than or equal to 35 U/ml and less than or equal to 2.5 ng/ml, respectively). Amniotic fluid CEA with meconium had higher values (P = 0.0002), while the highest CA-125 values in AF samples were found in primiparae (P = 0.02). Moreover SCC in AF samples from vaginal delivered pregnancies showed significantly higher values, compared to those from cesarean section (P = 4.2 x 10(-7); Mann-Whitney U-test). Thus, our findings suggest that pregnancy has an influence on maternal serum SCC and CA-125 values, while CEA is independent of gestation and seems to conserve its diagnostic value during pregnancy as well.

Soluble form of ICAM-1, VCAM-1, E- and L-selectin in human milk

In breast milk and paired serum from 70 lactating women and 40 of their term, infection-free neonates, on the 2nd and 5th day postpartum slCAM-1, sVCAM-1, sE- and sL-selectin were measured by ELISA and compared with those in 26 healthy adults (controls). Seven infant formulas and fresh milk from five cows were also analyzed. Human colostrum values of slCAM-1, sVCAM-1 (similar to those in maternal and control serum), sE-selectin and sL-selectin (-10 and -100 times lower than in maternal and control serum) were significantly higher than those in milk, while they varied widely. None of the adhesion molecules was detected in fresh cows milk or infant formulas. Exclusively breast-fed infants showed significantly higher values of slCAM-1 and sL-selectin on the 2nd day of life than those supplemented also with formula. Only slCAM-1 values correlated positively between colostrum and time-matched maternal serum. These findings show in human milk important amounts of slCAM-1 and sVCAM-1 but minimal amounts of sE- and sL-selectin, which could affect the immune system of the neonate.

Comparison between steroid hormones and Cortisol in serum and follicular fluid in stimulated and unstimulated cycles of in vitro fertilization patients

The present study was undertaken to evaluate the effects of the concentrations of serum and follicular fluid steroids and cortisol levels on the establishment of pregnancies in in vitro fertilization (IVF). Our study group consisted of 42 women (group A) who received gonadotropins for induction of ovulation for IVF. The control group included 23 women (group B) who underwent in vitro fertilization without stimulation. Serum estradiol and progesterone levels were significantly higher in group A than in group B. Serum and follicular fluid cortisol levels were similar in both groups A and B. There was no significant difference in the fertilization rates of the stimulated or unstimulated cycles. However, there were no pregnancies in group B whereas there was a 28.5% pregnancy rate in group A. There were no correlations between the estradiol, progesterone and cortisol levels when compared to the oocyte maturity and the fertilization rates in both groups of patients.