Changes of lipoxin levels during pregnancy and the monthly-cycle, condition the normal course of pregnancy or pathology

Abstract

Objective and Design The purpose of the review was to gather information on the role and possibilities of using lipoxin in the treatment of infertility and maintaining a normal pregnancy. Ovulation, menstruation, embryo implantation, and childbirth are reactions representing short-term inflammatory events involving lipoxin activities. Lipoxin A4 (LXA4) is an arachidonic acid metabolite, and in cooperation with its positional isomer lipoxin B4 (LXB4), it is a major lipoxin in mammals. Biosynthesis process occurs in two stages: in the first step, the donor cell releases the eicosanoid intermediate; secondarily, the acceptor cell gets and converts the intermediate product into LXA4 (leukocyte/platelet interaction). Results Generating lipoxin synthesis may also be triggered by salicylic acid, which acetylates cyclooxygenase-2. Lipoxin A4 and its analogues are considered as specialized pro-resolving mediators. LXA4 is an important component for a proper menstrual cycle, embryo implantation, pregnancy, and delivery. Its level in the luteal phase is high, while in the follicular phase, it decreases, which coincides with an increase in estradiol concentration with which it competes for the receptor. LXA4 inhibits the progression of endometriosis. However, during the peri-implantation period, before pregnancy is confirmed clinically, high levels of LXA4 can contribute to early pregnancy loss and may cause miscarriage. After implantation, insufficient LXA4 levels contribute to incorrect maternal vessel remodeling; decreased, shallow trophoblastic invasion; and the immuno-energetic abnormality of the placenta, which negatively affects fetal growth and the maintenance of pregnancy. Moreover, the level of LXA4 increases in the final stages of pregnancy, allowing vessel remodeling and placental separation. Methods The review evaluates the literature published in the PubMed and Embase database up to 31 December 2019. The passwords were checked on terms: lipoxin and pregnancy with combined endometriosis, menstrual cycle, implantation, pre-eclampsia, fetal growth restriction, and preterm labor. Conclusions Although no human studies have been performed so far, the cell and animal model study results suggest that LXA4 will be used in obstetrics and gynecology soon.

Long-chain polyunsaturated fatty acid (LC-PUFA) status in severe preeclampsia and preterm birth: a cross sectional study

“…Previous studies have suggested that AA/EPA have positive correlation with inflammatory rate of eicosanoids 47 , 48 , particularly due to AA eicosanoid metabolites 30 , 49 . On the other hand, AA is also found to generate lipoxins, particularly lipoxin (LXA4), which acts as an anti-inflammatory properties that related to obstetrical complications such as preterm and preeclampsia 50 , 51 . Here we showed that the value of ≥ 35 AA/EPA has increased the risk for preeclampsia with sensitivity 83.3% and 84.1%, with significant differences compared to control ( p < 0.001) and high adjusted odds ratio (OR 24.78).…”

Relationship between Platelet-to-Lymphocyte Ratio and Lymphocyte-to-Monocyte Ratio with Spontaneous Preterm Birth: A Systematic Review and Meta-analysis

“…According to its definition, preterm labor refers to pregnancy termination before 37 weeks of gestation. It is one of a common complication in obstetrics [ 1 ]. The incidence of preterm birth exceeds 10% worldwide, affecting more than 15 million births each year [ 2 , 3 ].…”

Factors associated with fertility intention among women with systemic lupus erythematosus in China: A cross‐sectional study

“…A normal menstrual cycle is another important affect factor in fertility intention, which is also consistent with our surveys in China. 35 Reproductive concerns covered fear of infertility, the negative impact of infertility on family relationships, caring for a child in poor health, and concerns about the risks of the child giving birth, which is common among lupus patients. 12 In our study, we have found that reproductive concerns scale was related to fertility intention and included the fertility potential, child's health, personal health, and becoming pregnant which changed fertility intention.…”