尿路の胎盤成長因子と妊娠前出血症のリスク
Richard J Levine1, Ravi Thadhani, Cong Qian
1Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development, Department of Health and Human Services, Bethesda, Md, USA.
JAMA
|January 6, 2005
まとめ
妊娠中期の小便性胎盤成長因子 (PlGF) の減少は,子宮内閉塞前症の発症の強い予測因子である. この発見は,この妊娠合併症の早期発見に役立ちます.
科学分野:
- 産婦人科と産婦人科を担当しています.
- 妊産婦・胎児医学について
- ネフロロジーはネフロロジーを用います.
背景:
- 妊産前不妊症は,血管新生因子の不均衡,特に高溶性fms類型チロシンキナーゼ1 (sFlt1) と低胎盤成長因子 (PlGF) と関連しています.
- 尿中のPlGFは,sFlt1.1.のようなより大きな分子とは異なり,腎臓で濾過されるため,潜在的なバイオマーカーです.
研究 の 目的:
- 尿中のPlGFの減少が高血圧と白血病前症候群におけるタンパク質尿に先行するかどうかを調査する.
- 尿中のPlGF濃度が,妊娠前出血症の発症を予測できるかどうかを判断する.
主な方法:
- 妊娠前出血症予防のためのカルシウム試験の中で,ネストされた症例対照試験が行われました.
- 120組の女性 (子閉塞前症患者と正規血圧対照群) が,場所,妊娠年齢,サンプル保存の観点からマッチングが行われました.
- 尿中のPLGF濃度が測定され,尿中のクレアチニンに正常化されました.
主要な成果:
- 尿中のPlGF濃度は両グループで同様のパターンをたどったが,妊娠25~28週から始まる妊娠前出血症の症例では有意に低下した.
- 尿中のPlGFの有意な減少は,早期発症の妊娠前出血症の症例や,妊娠年齢に適した幼児を産んだ症例で観察されました.
- 妊娠21~32週間の尿PlGFの最低四分位 (<118 pg/mL) は,妊娠37週前に妊娠前出血症のリスクが22.5倍増加した.
結論:
- 妊娠中期の尿中のPlGFの減少は,妊娠前出血症の早期発症と強く関連しています.
- 尿中のPlGFは,妊娠前出血症の早期発見のための貴重な予測バイオマーカーとして役立つ可能性があります.
関連する概念動画
01:33Hormonal Regulation
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
01:07Teratogenicity
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
01:24Gonadal and Placental Hormones
The gonads, namely the testes in males and the ovaries in females, are pivotal in producing gonadal hormones that orchestrate the intricate processes of sexual development and reproduction.
In males, testosterone is the primary gonadal androgen. It plays a central role in the maturation of male reproductive organs — the penis and testes. Additionally, testosterone is instrumental in the development of secondary sexual characteristics — a deep voice as well as facial and pubic hair growth — and...
In males, testosterone is the primary gonadal androgen. It plays a central role in the maturation of male reproductive organs — the penis and testes. Additionally, testosterone is instrumental in the development of secondary sexual characteristics — a deep voice as well as facial and pubic hair growth — and...
01:14Fetal Circulation
Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...