Low Dose Aspirin in high-risk pregnancies: The volatile effect of acetylsalicylic acid on the inhibition of platelets uncovered by G. Born’s light transmission aggregometry

Stern, C; Mayer-Pickel, K; Weiss, Eva-Christine; Kutllovci-Hasani, K; Nanda, M; Eberhard, Katharina; Cervar-Zivkovic, M; Prüller, Florian

doi:10.1016/j.jri.2021.103320

Cited by 5 publications

(6 citation statements)

References 42 publications

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“…For pregnancies with a high-risk of developing PE, the administration of low-dose aspirin from very early stages of gestation onwards is commonly advised. [ 112 ], leading to the assumption that anti-platelet therapy has a protective effect on pathological blood coagulation in the placenta [ 113 ]. However, the action of aspirin to prevent PE is poorly understood, and mechanisms such as “aspirin resistance” have to be considered [ 112 ].…”

Section: Platelet Activation In Pregnancy Complicationsmentioning

confidence: 99%

“…[ 112 ], leading to the assumption that anti-platelet therapy has a protective effect on pathological blood coagulation in the placenta [ 113 ]. However, the action of aspirin to prevent PE is poorly understood, and mechanisms such as “aspirin resistance” have to be considered [ 112 ].…”

Section: Platelet Activation In Pregnancy Complicationsmentioning

confidence: 99%

“…A study from Roberge et al described a significant reduction in the prevalence of PE, and a dose-response effect for the prevention of PE, when low dose aspirin (50–150 mg/day) was administered before the 16th week of gestation [ 114 ]. However, a study from Stern et al showed an inhibitory effect of aspirin on platelet aggregation in a proportion of pregnant women, but also demonstrated that patients respond in an individual and dose-dependent manner [ 112 ].…”

Section: Platelet Activation In Pregnancy Complicationsmentioning

confidence: 99%

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Changes in Maternal Platelet Physiology during Gestation and Their Interaction with Trophoblasts

Forstner

Guettler

Gauster

2021

IJMS

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Upon activation, maternal platelets provide a source of proinflammatory mediators in the intervillous space of the placenta. Therefore, platelet-derived factors may interfere with different trophoblast subtypes of the developing human placenta and might cause altered hormone secretion and placental dysfunction later on in pregnancy. Increased platelet activation, and the subsequent occurrence of placental fibrinoid deposition, are linked to placenta pathologies such as preeclampsia. The composition and release of platelet-derived factors change over gestation and provide a potential source of predicting biomarkers for the developing fetus and the mother. This review indicates possible mechanisms of platelet-trophoblast interactions and discusses the effect of increased platelet activation on placenta development.

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Section: Platelet Activation In Pregnancy Complicationsmentioning

confidence: 99%

Section: Platelet Activation In Pregnancy Complicationsmentioning

confidence: 99%

Section: Platelet Activation In Pregnancy Complicationsmentioning

confidence: 99%

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Changes in Maternal Platelet Physiology during Gestation and Their Interaction with Trophoblasts

Forstner

Guettler

Gauster

2021

IJMS

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“…Em relação a função plaquetária no uso da aspirina, existem relatos de que até 30% das gestantes são resistentes ao tratamento com doses baixas. Além da dose, o horário que a administração da aspirina deve ser feita é um fator bastante questionado, porém estudos mostram que há maior eficácia quando ingeridos à noite (STERN C, et al, 2021;PARK F, et al, 2015).…”

Section: Discussionunclassified

O uso de baixas doses de aspirina na prevenção da pré-eclâmpsia: uma revisão de literatura

Henriques

Nunes²,

Brito³

et al. 2022

Acervo Médico

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Objetivo: Analisar o uso profilático de baixas doses de aspirina, importância do diagnóstico precoce e seu desfecho ao final da gestação atrelada a prevenção da pré-eclâmpsia. Métodos: A abordagem metodológica se propõe a descrever por meio de uma revisão integrativa. As bases de dados utilizadas foram National Library of Medicine, Biblioteca Virtual em Saúde e Cochrane Library. Os descritores utilizados foram: “pre-eclampsia”, “aspirin”, “pregnancy” e “risk factors”. Os critérios de inclusão foram artigos de journal article, clinical trial, ensaios clínicos, randomizados ou não randomizados, estudos de caso-controle, estudo de coorte, livre acesso, publicados em inglês, português, espanhol, no intervalo de 2012 a 2022. Resultados: O estudo analisou mulheres de acordo com o alto grau de risco para o desenvolvimento da pré-eclâmpsia e avaliaram a profilaxia com aspirina em baixas doses. Os fatores de risco que determinavam se a gestante apresentava alto grau para a Pré-Eclâmpsia (PE) variavam entre os artigos, porém, os mais citados: hipertensão crônica, idade avançada, história prévia de pré-eclâmpsia, obesidade, diabetes, trombofilia, natimorto prévio, nuliparidade, gestação multifetal, doença autoimune e doença renal crônica. Considerações finais: Dessa forma, atualmente é realizado o tratamento profilático com baixas doses de aspirina, porém ainda necessita de mais estudos.

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“…Currently, diagnoses are made based on clinical signs which appear when PE has progressed, late in pregnancy, to a point that maternal and fetal morbidity is often already irreversible 2, 14 Specific, reliable early first trimester screening methods are lacking 2, 15 . The only pharmacological intervention known to reduce risk, low-dose aspirin, is accompanied by challenges such as insufficient effects in up to 60% of high-risk pregnancies 16 . PE is also associated with a reduction of the lifespan of both mother and child due to complications from cardiovascular disease later in life 2, 10, 11 .…”

Section: Mainmentioning

confidence: 99%

Disturbed trophoblast transition links preeclampsia progression from placenta to the maternal syndrome

Nonn

Debnath

Valdes

et al. 2022

Preprint

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Pre-eclampsia (PE) is a syndrome that affects multiple organ systems and is the most severe hypertensive disorder in pregnancy. It frequently leads to preterm delivery, maternal and fetal morbidity and mortality and life-long complications1. We currently lack efficient screening tools2,3 and early therapies4,5 to address PE. To investigate the early stages of early onset PE, and identify candidate markers and pathways, we performed spatio-temporal multi-omics profiling of human PE placentae and healthy controls and validated targets in early gestation in a longitudinal clinical cohort. We used a single-nuclei RNA-seq approach combined with spatial proteo- and transcriptomics and mechanistic in vitro signalling analyses to bridge the gap from late pregnancy disease to early pregnancy pathomechanisms. We discovered a key disruption in villous trophoblast differentiation, which is driven by the increase of transcriptional coactivator p300, that ultimately ends with a senescence-associated secretory phenotype (SASP) of trophoblasts. We found a significant increase in the senescence marker activin A in preeclamptic maternal serum in early gestation, before the development of clinical symptoms, indicating a translation of the placental syndrome to the maternal side. Our work describes a new disease progression, starting with a disturbed transition in villous trophoblast differentiation. Our study identifies potential pathophysiology-relevant biomarkers for the early diagnosis of the disease as well as possible targets for interventions, which would be crucial steps toward protecting the mother and child from gestational mortality and morbidity and an increased risk of cardiovascular disease later in life.

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Low Dose Aspirin in high-risk pregnancies: The volatile effect of acetylsalicylic acid on the inhibition of platelets uncovered by G. Born’s light transmission aggregometry

Cited by 5 publications

References 42 publications

Changes in Maternal Platelet Physiology during Gestation and Their Interaction with Trophoblasts

Changes in Maternal Platelet Physiology during Gestation and Their Interaction with Trophoblasts

O uso de baixas doses de aspirina na prevenção da pré-eclâmpsia: uma revisão de literatura

Disturbed trophoblast transition links preeclampsia progression from placenta to the maternal syndrome

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