growth factors

生长因子
  • 文章类型: Journal Article
    背景:半月板修复应该是黄金标准。然而,半月板血管化不良,即使是出色的半月板修复也可能无法愈合。因此,已经对富血小板血浆(PRP)进行了大量研究和系统评价,间充质干细胞(MSCs)和纤维蛋白凝块用于半月板增强,但结果仍有争议。本系统综述旨在确定半月板修复增强的其他新兴策略,并评估该领域是否有不同的探索途径。
    方法:于2022年8月进行了系统文献综述。PubMed,OvidMEDLINE(R)全部,Ovid所有EBM评论,搜索了OvidEmbase和ISIWebofScience数据库。在体内动物和人体研究中,有关PRP以外的因素对半月板病变的生物学增强,包括MSC或纤维蛋白凝块。仅软骨研究,以前的系统评价和专家意见被排除在外.所有数据均由两名独立的审阅者进行分析。
    结果:在8965项研究中,只有19项涵盖12个不同因素的研究符合纳入标准。八项研究调查了使用生长因子进行半月板生物学增强,如血管内皮生长因子或骨形态发生蛋白7。五项研究报道了细胞疗法,六项研究集中在其他因素,如透明质酸,辛伐他汀或去胶原。大多数研究(n=18)是在动物模型上进行的,以粗略观察和组织学评估作为结果。聚合酶链反应和免疫组织化学也很常见。生物力学测试仅是两项研究的对象。
    结论:尽管已经尝试了几种增强策略,没有产生决定性的结果,证明对半月板愈合缺乏了解。需要更多的研究来更好地了解调节半月板修复的途径以及如何对它们采取积极的行动。
    方法:病例对照和动物实验室研究的系统评价。
    BACKGROUND: Meniscal repair should be the gold standard. However, the meniscus is poorly vascularized and even an excellent meniscus repair may not heal. Therefore, numerous studies and systematic reviews have been carried out on platelet-rich plasma (PRP), mesenchymal stem cells (MSCs) and fibrin clots for meniscal augmentation, but the results remain controversial. This systematic review aimed to identify other emerging strategies for meniscal repair augmentation and to assess whether there are different avenues to explore in this field.
    METHODS: A systematic literature review was conducted in August 2022. PubMed, Ovid MEDLINE(R) all, Ovid All EBM Reviews, Ovid Embase and ISI Web of Science databases were searched. In Vivo animal and human studies concerning the biological augmentation of meniscal lesions by factors other than PRP, MSCs or fibrin clots were included. Cartilage-only studies, previous systematic reviews and expert opinions were excluded. All data were analyzed by two independent reviewers.
    RESULTS: Of 8965 studies only nineteen studies covering 12 different factors met the inclusion criteria. Eight studies investigated the use of growth factors for meniscal biologic augmentation, such as vascular endothelial growth factor or bone morphogenic protein 7. Five studies reported on cell therapy and six studies focused on other factors such as hyaluronic acid, simvastatin or atelocollagen. Most studies (n = 18) were performed on animal models with gross observation and histological evaluation as outcomes. Polymerase chain reaction and immunohistochemistry were also common. Biomechanical testing was the object of only two studies.
    CONCLUSIONS: Although several augmentation strategies have been attempted, none has yielded conclusive results, testifying to a lack of understanding with regard to meniscal healing. More research is needed to better understand the pathways that regulate meniscus repair and how to act positively on them.
    METHODS: Systematic review of case-control and animal laboratory studies.
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  • 文章类型: Journal Article
    背景:本研究旨在评估浓缩生长因子(CGF)注射如何影响兔正畸牙齿移动的速度。
    方法:这项实验研究采用了裂口构型。在上颌第一磨牙正畸化之前,在一个随机分配的象限中,在上颌第一磨牙的颊侧和腭侧使用粘膜下注射制备并施用CGF。使用相反的象限作为对照。该研究检查了四个时间点:1、2、3和4周。使用数字卡尺在每个随访点进行牙齿移动的测量。兔子被安乐死,和他们的上颌段,特别是上颌第一磨牙,进行组织学研究,以确定拉伸和压缩侧发生的任何变化。
    结果:在实验侧观察到明显的牙齿移动,第三,随访第4周(p≤0.05)。组织学上,在压缩方面,CGF组从第一周开始出现骨吸收和牙周膜活性反应,并持续到接下来的三周.此外,在紧张的一面,CGF组描述了从第一周开始的骨水泥和成骨细胞活动,然后从第二周开始的成纤维细胞活动,所有活动一直持续到第四周。
    结论:CGF具有有效增强正畸牙齿移动的潜力,而不会产生不良的临床或组织学影响。
    BACKGROUND: The present study aimed to assess how a concentrated growth factor (CGF) injection affects the rate of orthodontic tooth movement in rabbits.
    METHODS: This experimental investigation employed a split-mouth configuration. Before orthodontic mesialization of the maxillary first molars, CGF was prepared and administered using submucosal injections on the buccal and palatal sides of the maxillary first molars in one randomly assigned quadrant. The opposite quadrant was used as a control. The study examined four time points:1, 2, 3, and 4 weeks. The measurement of tooth movement was conducted at each follow-up point using a digital caliper. The rabbits were euthanized, and their maxillary segments, specifically the maxillary first molars, were studied histologically to identify any alterations occurring on both the tension and compression sides.
    RESULTS: Significant tooth movement was observed in the experimental sides versus control sides in the second, third, and fourth week of follow-up periods (p ≤ 0.05). Histologically, on the compression side, the CGF group showed bone resorption and periodontal ligament active reactions from the first week and continued throughout the next three weeks. Also, on the tension side, the CGF group depicted cementoblastic and osteoblastic activities from the first week followed by fibroblastic activities from the second week and all activities continued till the fourth week.
    CONCLUSIONS: CGF has the potential to effectively enhance orthodontic tooth movement without adverse clinical or histological effects.
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  • 文章类型: Journal Article
    由于细胞增殖和血管生成不足而导致的伤口愈合受损是全世界患者的重大生理和心理负担。用于伤口修复的高剂量的外源性生长因子(GF)的治疗性递送是不理想的,因为GF在蛋白水解伤口环境中具有差的稳定性。这里,我们提出了一种两阶段策略,使用基于硫糖铝的生物活性微针(SUC-MN)递送白细胞介素-4(IL-4)以加速伤口愈合.在第一阶段,SUC-MN通过经由JAK-STAT途径更有效地重编程促再生M2样巨噬细胞以增加内源性GF产生来协同地增强IL-4的作用。在第二阶段,硫糖铝与GFs结合,并在空间上不利于蛋白酶降解,以增加GFs的生物利用度。与各自未处理的对照相比,IL-4/SUC-MN技术在糖尿病小鼠伤口和猪伤口中加速伤口愈合56.6%和46.5%。总的来说,我们的研究结果强调了创新使用分子模拟来识别生物活性成分,并将其掺入微针中,通过多种协同机制促进伤口愈合.
    Impaired wound healing due to insufficient cell proliferation and angiogenesis is a significant physical and psychological burden to patients worldwide. Therapeutic delivery of exogenous growth factors (GFs) at high doses for wound repair is non-ideal as GFs have poor stability in proteolytic wound environments. Here, we present a two-stage strategy using bioactive sucralfate-based microneedle (SUC-MN) for delivering interleukin-4 (IL-4) to accelerate wound healing. In the first stage, SUC-MN synergistically enhanced the effect of IL-4 through more potent reprogramming of pro-regenerative M2-like macrophages via the JAK-STAT pathway to increase endogenous GF production. In the second stage, sucralfate binds to GFs and sterically disfavors protease degradation to increase bioavailability of GFs. The IL-4/SUC-MN technology accelerated wound healing by 56.6 % and 46.5 % in diabetic mice wounds and porcine wounds compared to their respective untreated controls. Overall, our findings highlight the innovative use of molecular simulations to identify bioactive ingredients and their incorporation into microneedles for promoting wound healing through multiple synergistic mechanisms.
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  • 文章类型: Journal Article
    成纤维细胞是在整个身体中发现的间充质来源的细胞。虽然这些细胞有几个功能,它们不可或缺的作用包括通过产生关键的细胞外基质成分来维持组织结构,并参与受伤后的伤口愈合。成纤维细胞也是纤维化过程中疾病进展的关键介质,癌症,和其他炎症性疾病。在这些混乱的状态下,成纤维细胞可以激活为炎性成纤维细胞或收缩肌成纤维细胞。成纤维细胞需要各种生长因子和促有丝分裂分子才能存活,扩散,和差异化。虽然促有丝分裂生长因子在体外对成纤维细胞的活性早在20世纪70年代就被表征,生长因子在体内对这些细胞的增殖和分化作用尚不清楚。最近探索成纤维细胞异质性的工作提出了是否所有成纤维细胞状态都表现出相同的生长因子需求的问题。这里,我们将检查和回顾关于成纤维细胞生长因子受体(FGFRs)影响的现有研究,血小板衍生生长因子受体(PDGFR),和转化生长因子β受体(TGFβR)对成纤维细胞状态的影响。
    Fibroblasts are cells of mesenchymal origin that are found throughout the body. While these cells have several functions, their integral roles include maintaining tissue architecture through the production of key extracellular matrix components, and participation in wound healing after injury. Fibroblasts are also key mediators in disease progression during fibrosis, cancer, and other inflammatory diseases. Under these perturbed states, fibroblasts can activate into inflammatory fibroblasts or contractile myofibroblasts. Fibroblasts require various growth factors and mitogenic molecules for survival, proliferation, and differentiation. While the activity of mitogenic growth factors on fibroblasts in vitro was characterized as early as the 1970s, the proliferation and differentiation effects of growth factors on these cells in vivo are unclear. Recent work exploring the heterogeneity of fibroblasts raises questions as to whether all fibroblast cell states exhibit the same growth factor requirements. Here, we will examine and review existing studies on the influence of fibroblast growth factor receptors (FGFRs), platelet-derived growth factor receptors (PDGFRs), and transforming growth factor β receptor (TGFβR) on fibroblast cell states.
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  • 文章类型: Journal Article
    评估局部使用同种异体富血小板血浆(PRP)滴眼液治疗严重干眼症患者的症状和临床体征的有效性。
    案例系列和文献综述。
    对3例SS严重干眼连续患者的6只眼进行了评估。用同种异体局部PRP滴眼液治疗眼睛,一滴,每天6次,持续3个月。治疗暂停后3个月进行治疗后随访评估。我们评估了主观症状,视敏度,眼泪破裂时间,Schirmer\我测试的结果,荧光素角膜和结膜染色,和角膜敏感性。
    所有患者的症状和视力均有明显改善。角膜敏感性显着改善,荧光素角膜染色减少或消失。
    使用同种异体PRP滴眼液治疗SS相关严重干眼症患者已被证明非常有效,症状和主要临床体征有所改善。
    UNASSIGNED: To assess the effectiveness of topical allogeneic platelet-rich plasma (PRP) eye drops for the treatment of symptoms and clinical signs in patients with severe dry eye disease as a secondary condition caused by Sjögren\'s syndrome (SS).
    UNASSIGNED: Case series and literature review.
    UNASSIGNED: Six eyes from three consecutive patients with severe dry eye from SS were evaluated. The eyes were treated with allogeneic topical PRP eye drops, with one drop applied six times daily for 3 months. A post-treatment follow-up evaluation was conducted 3 months after treatment suspension. We evaluated subjective symptoms, visual acuity, tear breakup time, the results of Schirmer\'s I test, fluorescein corneal and conjunctival staining, and corneal sensitivity.
    UNASSIGNED: The symptoms and visual acuity improved significantly in all patients. There was a significant improvement in corneal sensitivity and a decrease or disappearance of fluorescein corneal staining.
    UNASSIGNED: The treatment with allogenic PRP eye drops of patients with SS-related severe dry eye disease has proven to be very effective, with an improvement in symptoms and main clinical signs.
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  • 文章类型: Journal Article
    精原干细胞(SSC)是精子发生的基础,因此在保护稀有或濒危物种的生育力以及开发转基因动物和鸟类方面具有巨大的潜力。然而,开发隔离的最佳条件,文化,在体外维持SSC仍然具有挑战性,尤其是鸡肉。本研究的目的是(1)找到怀乡鸡SSC分离的最佳年龄,(2)制定高效的隔离协议,(3)富集,和(4)分离的SSC的培养。在本研究中,我们首先比较了11个不同年龄组(8-79日龄)淮乡鸡的SSC分离效率。我们发现21日龄鸡的睾丸产生最高的细胞活力。接下来,我们比较了两种不同的酶组合来分离SSC,发现0.125%胰蛋白酶和0.02g/LEDTA支持最高的SSC数量和活力。随后是研究富集SSC的最佳条件,其中我们观察到,与Percoll梯度和磁激活细胞分选方法相比,差异铺板具有最高的富集效率。最后,为了找到SSC的最佳培养条件,我们比较了添加不同浓度的胎牛血清(FBS;2%,5%,7%,和10%)和不同浓度的GDNF,bFGF,或LIF(5、10、20或30ng/mL)。我们发现,2%的FBS和个体生长因子的组合,包括GDNF(20ng/mL),bFGF(30ng/mL),或LIF(5ng/mL),最好地支持了SSC的增殖和集落形成。总之,SSC可以通过酶消化从21天大的鸡的睾丸中最佳地分离,然后使用差异电镀进行富集。此外,添加2%FBS和优化浓度的GFNF,bFGF,或培养物中的LIF促进鸡SSC的增殖。
    Spermatogonial stem cells (SSCs) comprise the foundation of spermatogenesis and hence have great potential for fertility preservation of rare or endangered species and the development of transgenic animals and birds. Yet, developing optimal conditions for the isolation, culture, and maintenance of SSCs in vitro remains challenging, especially for chicken. The objectives of this study were to (1) find the optimal age for SSC isolation in Huaixiang chicken, (2) develop efficient protocols for the isolation, (3) enrichment, and (4) culture of isolated SSCs. In the present study, we first compared the efficiency of SSC isolation using 11 different age groups (8-79 days of age) of Huaixiang chicken. We found that the testes of 21-day-old chicken yielded the highest cell viability. Next, we compared two different enzymatic combinations for isolating SSCs and found that 0.125% trypsin and 0.02 g/L EDTA supported the highest number and viability of SSCs. This was followed by investigating optimal conditions for the enrichment of SSCs, where we observed that differential plating had the highest enrichment efficiency compared to the Percoll gradient and magnetic-activated cell sorting methods. Lastly, to find the optimal culture conditions of SSCs, we compared adding different concentrations of foetal bovine serum (FBS; 2%, 5%, 7%, and 10%) and different concentrations of GDNF, bFGF, or LIF (5, 10, 20, or 30 ng/mL). We found that a combination of 2% FBS and individual growth factors, including GDNF (20 ng/mL), bFGF (30 ng/mL), or LIF (5 ng/mL), best supported the proliferation and colony formation of SSCs. In conclusion, SSCs can be optimally isolated through enzymatic digestion from testes of 21-day-old chicken, followed by enrichment using differential plating. Furthermore, adding 2% FBS and optimized concentrations of GFNF, bFGF, or LIF in the culture promotes the proliferation of chicken SSCs.
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  • 文章类型: Journal Article
    间充质脂肪基质细胞(ASCs)被认为是转化医学最有希望和最容易获得的材料。ASC可以独立使用或在基于支架的构建体的结构内使用,因为这些不仅确保机械支撑,但也可以优化细胞活动的条件,因为支架结构的特定特征对细胞的重要活动有影响。该手稿提出了对在与之接触的这种部分皮肤等效物的结构中培养人ASC期间在条件培养基中发生的分泌和积累的研究。已证明,ASC在该部分皮肤等效结构内的培养过程中保留了其功能活性,分开,在塑料基质上:它们增殖并分泌各种蛋白质,然后可以在条件培养基中积累。我们对ASC在塑料上和部分皮肤等效结构内培养过程中条件培养基变化的比较研究揭示了在各种细胞功能条件下,此类分泌因子在培养基中释放和积累的不同动力学。还证明了在所研究的部分皮肤等效结构中评估ASC分泌功能的最佳标记是营养因子VEGF-A,HGF,MCP,SDF-1α,IL-6和IL-8。结果将有助于开发用于这种皮肤等效体外临床前研究的算法,并且可能有助于研究包括ASC在内的各种其他复杂构建体。
    Mesenchymal adipose stromal cells (ASCs) are considered the most promising and accessible material for translational medicine. ASCs can be used independently or within the structure of scaffold-based constructs, as these not only ensure mechanical support, but can also optimize conditions for cell activity, as specific features of the scaffold structure have an impact on the vital activity of the cells. This manuscript presents a study of the secretion and accumulation that occur in a conditioned medium during the cultivation of human ASCs within the structure of such a partial skin-equivalent that is in contact with it. It is demonstrated that the ASCs retain their functional activity during cultivation both within this partial skin-equivalent structure and, separately, on plastic substrates: they proliferate and secrete various proteins that can then accumulate in the conditioned media. Our comparative study of changes in the conditioned media during cultivation of ASCs on plastic and within the partial skin-equivalent structure reveals the different dynamics of the release and accumulation of such secretory factors in the media under a variety of conditions of cell functioning. It is also demonstrated that the optimal markers for assessment of the ASCs\' secretory functions in the studied partial skin-equivalent structure are the trophic factors VEGF-A, HGF, MCP, SDF-1α, IL-6 and IL-8. The results will help with the development of an algorithm for preclinical studies of this skin-equivalent in vitro and may be useful in studying various other complex constructs that include ASCs.
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  • 文章类型: Journal Article
    (1)背景:单剂量COX-2选择性非甾体抗炎药(NSAIDs)如何影响犬富含血小板凝胶(PRGs)和其他血液成分中生长因子(GF)和细胞因子的释放,目前尚缺乏相关知识。(2)方法:对6只成年杂种犬进行了交叉研究。将动物随机分配接受单剂量的卡洛芬或菲洛昔布。PRG,温度诱导的血小板裂解液(TIPL),化学诱导PL(CIPL),在处理之前(1小时)和之后(6小时)从每只狗获得血浆血液成分。血小板和白细胞计数以及血小板衍生生长因子-BB浓度的测定,(PDGF-BB),转化生长因子β-1(TGF-β1),白细胞介素1β(IL-1β),通过ELISA测定所有血液成分中的肿瘤坏死因子-α(TNF-α)和IL-10的浓度。(3)结果:血小板和白细胞计数以及PDGF-BB浓度均不受NSAIDs和时间的影响。TGF-β1的总浓度不受NSAIDs的影响;然而,在6h时,PRG上清液(PRGS)中这种GF的释放增加。在6h时,费洛昔布PRGS和血浆中的IL-1β和TNF-α浓度显着降低(p<0.001),分别。在用两种NSAID处理的所有血液成分中,IL-10浓度在6h时显著降低(p<0.001)。(4)结论:我们的发现的临床意义可能表明,这些药物应该从患者中撤出,以便在临床使用PRP/PRG之前清除。另一方面,为避免某些患者在PRP/PRG治疗后可能发生的炎症反应,应预防性使用NSAIDs,仅适用于对治疗有严重反应性炎症的动物.
    (1) Background: There is a lack of knowledge about how a single dose of COX-2 selective non-steroidal anti-inflammatory drugs (NSAIDs) might affect the release of growth factors (GFs) and cytokines from canine platelet-rich gels (PRGs) and other hemocomponents. (2) Methods: A crossover study was conducted in six adult mongrel dogs. Animals were randomized to receive a single dose of either carprofen or firocoxib. PRG, temperature-induced platelet lysate (TIPL), chemically induced PL (CIPL), and plasma hemocomponents were obtained from each dog before (1 h) and after (6 h) the treatments. Platelet and leukocyte counts and determination of the concentrations of platelet-derived growth factor-BB, (PDGF-BB), transforming growth factor beta-1 (TGF-β1), interleukin 1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α) and IL-10 concentrations were assayed by ELISA in all hemocomponents. (3) Results: Both platelet and leukocyte counts and PDGF-BB concentrations were not affected by NSAIDs and time. Total TGF-β1 concentrations were not affected by NSAIDs; however, the release of this GF was increased in PRG supernatants (PRGS) at 6 h. IL-1β and TNF-α concentrations were significantly (p < 0.001) lower in both firocoxib PRGS and plasma at 6 h, respectively. IL-10 concentrations were significantly (p < 0.001) lower at 6 h in all hemocomponents treated with both NSAIDs. (4) Conclusions: The clinical implications of our findings could indicate that these drugs should be withdrawn from patients to allow their clearance before the clinical use of PRP/PRG. On the other hand, the prophylactic use of NSAIDs to avoid the inflammatory reactions that some patients might have after PRP/PRG treatment should be performed only in those animals with severe reactive inflammation to the treatment.
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  • 文章类型: Journal Article
    骨再生是一个复杂的病理生理过程,细胞,和生物力学因素,包括免疫细胞和生长因子。骨折愈合通常需要几周到几个月,在此期间,患者经常被固定,无法工作。由于固定与负面的健康和社会经济影响有关,如果可以加速骨折愈合并缩短愈合时间将是可取的。然而,为此目的的干预措施还不是当前临床治疗指南的一部分,从来没有专门针对这个主题的全面审查。因此,这篇叙述性综述概述了加速骨折愈合的方法的现有临床证据,重点是在没有骨骼疾病的健康患者中的临床适用性。确定的最有前途的方法是轴向微运动的应用,电磁场和直流电流的电磁刺激,以及生长因子和甲状旁腺激素的管理。一些干预措施已被证明可以将治愈时间减少多达20%至30%,可能相当于几个星期。由于方法的组合可以比单独的一种方法更进一步地减少愈合时间,特别是如果它们的作用机制不同,需要在人类患者中进行临床研究,以评估个体和联合对愈合进展的影响.还需要研究以确定干预措施的理想设置,即,最佳频率,强度,和暴露时间在整个单独的愈合阶段。还需要更多的临床研究来为临床指南创建证据基础。为了更容易进行这些调查,需要开发能够更好地量化人类患者骨折愈合进展和速度的新方法.
    Bone regeneration is a complex pathophysiological process determined by molecular, cellular, and biomechanical factors, including immune cells and growth factors. Fracture healing usually takes several weeks to months, during which patients are frequently immobilized and unable to work. As immobilization is associated with negative health and socioeconomic effects, it would be desirable if fracture healing could be accelerated and the healing time shortened. However, interventions for this purpose are not yet part of current clinical treatment guidelines, and there has never been a comprehensive review specifically on this topic. Therefore, this narrative review provides an overview of the available clinical evidence on methods that accelerate fracture healing, with a focus on clinical applicability in healthy patients without bone disease. The most promising methods identified are the application of axial micromovement, electromagnetic stimulation with electromagnetic fields and direct electric currents, as well as the administration of growth factors and parathyroid hormone. Some interventions have been shown to reduce the healing time by up to 20 to 30%, potentially equivalent to several weeks. As a combination of methods could decrease the healing time even further than one method alone, especially if their mechanisms of action differ, clinical studies in human patients are needed to assess the individual and combined effects on healing progress. Studies are also necessary to determine the ideal settings for the interventions, i.e., optimal frequencies, intensities, and exposure times throughout the separate healing phases. More clinical research is also desirable to create an evidence base for clinical guidelines. To make it easier to conduct these investigations, the development of new methods that allow better quantification of fracture-healing progress and speed in human patients is needed.
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  • 文章类型: Journal Article
    背景:据估计,全世界每年发生超过200万例胎儿死亡病例,但是,尽管发病率很高,该疾病的一些基本和临床特征仍不清楚。建议胎盘在胎儿死亡中起核心作用。胎盘产生激素,调节胎盘-母体单位功能的细胞因子和生长因子。胎儿死亡与这些调节因子中的一些分泌受损有关。
    目的:本研究的目的是评估,从胎儿死亡中收集的胎盘,炎症的基因表达,增殖和保护因素。
    方法:回顾性选择单胎妊娠死胎病例,排除妊娠合并胎儿异常,妊娠期糖尿病,宫内生长受限和中度至重度孕产妇疾病。从健康的单胎足月妊娠中收集的一组胎盘用作对照。比较两组产妇和胎龄,胎儿性别和出生体重。炎症的胎盘mRNA表达(IL-6),增殖性(激活素A,TGF-β1)和调节性(VEGF,使用实时PCR进行VEGFR2、ATP结合盒(ABC)转运蛋白ABCB1和ABCG2、鞘氨醇1-磷酸(S1P)信号通路)标记。使用GraphPadPrism5软件进行数据的统计分析和图形表示。对于统计分析,使用学生的t检验,P值<0.05被认为是显著的。
    结果:胎死组胎盘IL-6和VEGFR2mRNA表达明显高于对照组(P<0.01),而激活素A,ABCB1和ABCG2表达显著降低(P<0.01)。在胎儿死亡组中发现S1P信号通路的显著改变,随着特异性受体同种型鞘氨醇1-磷酸受体1、3和4(S1P1、S1P3、S1P4)和鞘氨醇激酶2(SK2)的表达增加,负责S1P合成的酶同工型之一(P<0.01)。
    结论:(s):本研究证实胎盘IL-6和VEGFR2mRNA的表达显着增加,并且首次显示S1P受体和SK2的表达增加,以及激活素A和选定的ATP结合盒转运蛋白的表达减少,提示胎儿死亡胎盘中多种炎症和保护因素紊乱。
    BACKGROUND: It is estimated that over 2 million cases of fetal death occur worldwide every year, but, despite the high incidence, several basic and clinical characteristics of this disorder are still unclear. Placenta is suggested to play a central role in fetal death. Placenta produces hormones, cytokines and growth factors that modulate functions of the placental-maternal unit. Fetal death has been correlated with impaired secretion of some of these regulatory factors.
    OBJECTIVE: The aim of the present study was to evaluate, in placentas collected from fetal death, the gene expression of inflammatory, proliferative and protective factors.
    METHODS: Cases of fetal death in singleton pregnancy were retrospectively selected, excluding pregnancies complicated by fetal anomalies, gestational diabetes, intrauterine growth restriction and moderate to severe maternal diseases. A group of placentas collected from healthy singleton term pregnancies were used as controls. Groups were compared regarding maternal and gestational age, fetal sex and birth weight. Placental mRNA expression of inflammatory (IL-6), proliferative (Activin A, TGF-β1) and regulatory (VEGF, VEGFR2, ATP-binding cassette (ABC) transporters ABCB1 and ABCG2, sphingosine 1-phosphate (S1P) signaling pathway) markers was conducted using real-time PCR. Statistical analysis and graphical representation of the data were performed using the GraphPad Prism 5 software. For the statistical analysis, Student\'s t-test was used, and P values < 0.05 were considered significant.
    RESULTS: Placental mRNA expression of IL-6 and VEGFR2 resulted significantly higher in the fetal death group compared to controls (P<0.01), while activin A, ABCB1 and ABCG2 expression resulted significantly lower (P<0.01). A significant alteration in the S1P signaling pathway was found in the fetal death group, with an increased expression of the specific receptor isoforms sphingosine 1-phosphate receptor 1, 3 and 4 (S1P1, S1P3, S1P4) and of sphingosine kinase 2 (SK2), one of the enzyme isoforms responsible for S1P synthesis (P<0.01).
    CONCLUSIONS: (s): The present study confirmed a significantly increased expression of placental IL-6 and VEGFR2 mRNA, and for the first time showed an increased expression of S1P receptors and SK2 as well as a decreased expression of activin A and of selected ATP-binding cassette transporters, suggesting that multiple inflammatory and protective factors are deranged in placenta of fetal death.
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