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Tuesday, 6 March 2018

HLA-G 14 bp Polymorphism and Risk of Pre-Eclampsia




HLA-G:Human Leukocyte Antigen G; PE: Pre-Eclampsia; IUGR: Intrauterine Growth Restriction; HELLP: Hemolytic Elevated Liver Enzymes and Low Platelets; TGF: Transforming Growth Factor; ILT: Immunoglobulin-Like Transcript Receptor; APC: Antigen- Presenting Cell; KIR: Killer-Immunoglobulin Like Receptors; NK: Natural Killer; CD: Cluster of Designation; UTR: Untranslated Region; BP: Base Pair; Snp: Single Nucleotide Polymorphism; PCR: Polymerase Chain Reaction; OR: Odds Ratio; 95%CI: Confidence Interval; Ins: Insertion; Del: Deletion; CVD: Cardiovascular Disease.
Pre-eclampsia belongs to one of very serious complication during pregnancy. It is a multisystem disorder that is manifested by hypertension, proteinuria and abnormal blood clotting. Advanced clinical symptoms include seizures, renal failure, IUGR (Intrauterine Growth Restriction) and/or HELLP (Hemolysis, Elevated Liver Enzymes and Low Platelets) syndrome. Finally the generalized damage of the maternal endothelium, kidneys and liver can develop leading to increased mortality of mother as well as foetus. The clinical symptoms of pre-eclampsia can be observed in the second or the third trimester in pregnancy and are the most common in primiparas. Clinical features of PE are studied by Doppler flowmetry not only in foetal and foetoplacental circulation as well as in maternal organs, i.e. uterine cerebral ophtalmic and renal vessels. Stiffness metabolic syndrome and risk of CVD  are other clinical research topics.
Despite many research studies, the pathology of pre-eclampsia is not fully understood. One cause may originate in an insufficiently developed placenta, referred to as poor placentation. It is characterized by impaired remodeling of spiral arteries of the uterus (endothelial dysfunction) caused by an imbalance of circulating angiogenic factors. High circulating levels of soluble Fms like tyrosine kinase 1 (sFlt1) and soluble endoglin (sEng), a circulating receptor or TGFbeta, (both anti-angiogenic factors) and low levels of circulating Vascular Endothelial Growth Factor (VEGF) and Placental Growth Factor (PlGF) (both pro-angiogenic factors) have been described.



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