Changes in inhibins and activin secretion in healthy and pathological pregnancies

Florio, Pasquale; Cobellis, Luigi; Luisi, Stefano; Ciarmela, Pasquapina; Severi, Filiberto Maria; Bocchi, Caterina

doi:10.1016/s0303-7207(01)00503-2

Cited by 85 publications

(54 citation statements)

References 57 publications

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“…While the studies are contradictory, elevated levels of inhibin-A and activin-A may be useful markers related to fetal well-being during preeclampsia, trisomy 21, preterm delivery, and intrauterine growth restriction. 39 More research in this area is needed. A recent review of evaluation of AF S100B protein concentration as an early marker for brain injuries and/or brain maturation also merits further study.…”

Section: Af As a Diagnostic Mediummentioning

confidence: 99%

Amniotic Fluid: Not Just Fetal Urine Anymore

2005

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Section: Af As a Diagnostic Mediummentioning

confidence: 99%

Amniotic Fluid: Not Just Fetal Urine Anymore

2005

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“…During pregnancy, monitoring changes in serum concentration of these proteins is performed for detection of fetal aberrations like Down's syndrome, the risk of miscarriage, fetal demise, intrauterine growth restriction or non-cancerous disorders, e.g. preeclampsia of the mother and preterm delivery [12,13]. Secondary to the secretion of tumor-and/or pregnancy-associated proteins several aberrations in serum chemistry and protein concentration in the maternal serum can occur.…”

Section: Role Of Tumor Marker Determination For Evaluation Of Suspicimentioning

confidence: 99%

Adnexal Masses in Pregnancy

et al. 2003

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With the widespread use of routine abdominal ultrasound examination during pregnancy, adnexal masses are observed with increasing frequency. Most patients are clinically asymptomatic at the time of presentation, and most of the adnexal masses detected during early pregnancy disappear during the first 16 weeks of pregnancy. Ovarian tumors are estimated to occur in about 1 in 1,000 pregnancies and of these 3% are malignant. Here we present an overview about frequency, diagnostic procedures and pathological characteristics of these ovarian tumors. Moreover, current modalities for treatment during pregnancy are summarized. Surgical treatment of the adnexal masses has to be performed with adequate staging and debulking equal to the treatment of non-pregnant women. However, whereas during organogenesis abortion has to be considered prior to chemotherapy, later in pregnancy surgical debulking as complete as possible, followed by taxol-platinum chemotherapy is indicated. If the fetus is not viable at the time of primary surgery, neoadjuvant chemotherapy and complementation of surgery after delivery of the baby should be performed. It should be stressed that chemotherapy for ovarian cancer applied during pregnancy appears to be safe. However, no studies have evaluated the long-term consequences for children exposed to intra-uterine chemotherapy. Aspiration of cysts should be avoided, as the correlation between the histological evaluation of an ovarian malignancy and the cytological evaluation of aspirates is poor. Moreover, spillage of malignant cysts is hazardous for the patient.

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“…Inhibin A and Activin A have been reported to regulate various physiologic functions, including ACTH and GH secretion, neuronal survival, hypothalamic oxytocin secretion, erythropoiesis, early embryonic development and gonad function (8 -11). Activin A concentrations significantly increase in maternal serum with advancing gestation (12), whereas umbilical cord blood serum do not significantly differ from midpregnancy to term gestation (7) and are significantly lower than in maternal serum (6,7). Disorders of pregnancy due to reduced placental perfusion and various degrees of feto-placental hypoxemia, such as preeclampsia and fetal growth restriction (13) are characterized by increased levels of maternal and umbilical cord activin A (12), and feto-placental and/or maternal isocapnic hypoxemia are specific triggers for an increase in activin A.…”

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“…Activin A concentrations significantly increase in maternal serum with advancing gestation (12), whereas umbilical cord blood serum do not significantly differ from midpregnancy to term gestation (7) and are significantly lower than in maternal serum (6,7). Disorders of pregnancy due to reduced placental perfusion and various degrees of feto-placental hypoxemia, such as preeclampsia and fetal growth restriction (13) are characterized by increased levels of maternal and umbilical cord activin A (12), and feto-placental and/or maternal isocapnic hypoxemia are specific triggers for an increase in activin A. Indeed, cord blood Activin A levels increase in the sheep after induction of hypoxia, remain elevated throughout hypoxia and return to control values when normal blood flow is restored (14).…”

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Activin A Plasma Levels at Birth: An Index of Fetal Hypoxia in Preterm Newborn

et al. 2003

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Activin-A is a growth factor involved in cell growth and differentiation, neuronal survival, early embrionic development and erythropoiesis. Hypoxemia is a specific trigger for increasing activin-A in fetal lamb circulation. We tested the hypothesis that fetal hypoxia induces activin-A secretion in preterm newborn infants. Fifty newborn infants with gestational ages ranging from 26 to 36 wk were enrolled in a prospective study performed at the Pediatrics, Obstetrics and Reproductive Medicine Department, University of Siena, Italy. Heparinized blood samples were obtained from the umbilical vein after cord clamping, immediately after delivery. Activin A, hypoxanthine (Hx), xanthine (Xa) plasma levels and absolute nucleated red blood cell (NRBC) count were measured. Activin-A levels (p Ͻ 0.0001) and NRBC (p Ͻ 0.0001) were significantly higher in hypoxic than in non hypoxic preterm newborns. Cord activin A levels were significantly related with Hx ( a ϭ0.64, b ϭ0.64, p Ͻ 0.0001) and Xa Activin A is a growth factor (␤A/␤A dimer) mainly produced by the placenta, decidua and fetal membranes and secreted in large amounts in maternal circulation (1-7). Inhibin/activin subunits are expressed in a variety of tissues, including ovary, testis, placenta, adrenal, kidney, brain and pituitary gland. Inhibin A and Activin A have been reported to regulate various physiologic functions, including ACTH and GH secretion, neuronal survival, hypothalamic oxytocin secretion, erythropoiesis, early embryonic development and gonad function (8 -11). Activin A concentrations significantly increase in maternal serum with advancing gestation (12), whereas umbilical cord blood serum do not significantly differ from midpregnancy to term gestation (7) and are significantly lower than in maternal serum (6, 7). Disorders of pregnancy due to reduced placental perfusion and various degrees of feto-placental hypoxemia, such as preeclampsia and fetal growth restriction (13) are characterized by increased levels of maternal and umbilical cord activin A (12), and feto-placental and/or maternal isocapnic hypoxemia are specific triggers for an increase in activin A. Indeed, cord blood Activin A levels increase in the sheep after induction of hypoxia, remain elevated throughout hypoxia and return to control values when normal blood flow is restored (14). Activin A subunit mRNA expression is up-regulated during hypoxic ischemia in the adult brain and cerebral hypoxia stimulates Activin A secretion in rat newborns as well as in adult animals (15,16). No human study to date has determined whether this protein is altered in babies with clinical signs of hypoxia at birth. Perinatal hypoxia set in motion a cascade of biochemical events commencing with a shift from oxidative to anaerobic metabolism, which leads to a rapid rise in the levels of lactic acid and of oxygen free radicals (17). During hypoxia the cutback in oxidative phosphorilation rapidly diminishes reservers of high-energy phopshate. High levels of adenosine and hypoxanthine accumulate in a few minu...

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Changes in inhibins and activin secretion in healthy and pathological pregnancies

Cited by 85 publications

References 57 publications

Amniotic Fluid: Not Just Fetal Urine Anymore

Amniotic Fluid: Not Just Fetal Urine Anymore

Adnexal Masses in Pregnancy

Activin A Plasma Levels at Birth: An Index of Fetal Hypoxia in Preterm Newborn

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