Reduced glutathione in hepatitis E infection and pregnancy outcome

Bhatnagar, Gunjan; Sharma, Sneha; Kumar, Ashok; Prasad, Sudha; Agarwal, Sarita; Kar, Premashish

doi:10.1111/jog.12986

Cited by 21 publications

(27 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Overall, there is a paucity of knowledge in regard to risk factors that affect prevalence or predispose to HEV infection in individuals with HIV . Recent studies have described novel factors implicated in infection and mortality of HEV infection during pregnancy . In this regard, a mutation in the progesterone receptor (PR) has been reported to be associated with acute viral hepatitis and liver failure from HEV in pregnant women .…”

Section: Introductionmentioning

confidence: 99%

“…9,10 Recent studies have described novel factors implicated in infection and mortality of HEV infection during pregnancy. 3,15 In this regard, a mutation in the progesterone receptor (PR) has been reported to be associated with acute viral hepatitis and liver failure from HEV in pregnant women. 4 This mutation, called PROGINS (progesterone receptor G insert), consists of two single nucleotide polymorphisms and a G-intron insert, and it has been reported to render the PR less functional.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A mutation in the progesterone receptor predisposes to HEV infection in HIV‐positive patients

Debes

Pas

Groothuismink

et al. 2018

Liver International

View full text Add to dashboard Cite

Background and AimsInfection with Hepatitis E virus (HEV) can cause chronic liver disease in immunocompromised hosts. In transplant recipients, the use of certain immunosuppressants and food habits has been proposed as risk factors for HEV. In individuals infected with the human immunodeficiency virus (HIV), risk factors for HEV infection are less clear. We aimed to study the association between a mutation in the progesterone receptor (PR) named PROGINS and HEV‐infected in HIV‐positive individuals.MethodsWe evaluated the presence of the SNP PROGINS via KASP in serum samples of 64 HIV‐positive individuals and 187 healthy controls. We performed ELISA tests to address the serum levels of IL‐10 and IL‐12, as well as T‐cell stimulation assays in peripheral blood to address immune response in individuals with PROGINS.ResultsWe found a significant association between the presence of PROGINS mutation and HEV seroprevalence in individuals infected with HIV (30% in HIV+/HEV+ versus 2% in HIV+/HEV, respectively, P = .009). Moreover, we found that HIV+/HEV+ individuals expressing the PROGINS mutation had lower serum levels of IL‐10 and higher levels of IL‐12. The presence of the mutation led to a reduced response upon stimulation of CD4+ and CD8+ T cells compared to those without the mutation, suggesting an immune modulation associated with PROGINS.ConclusionsOur study identified a mutation in the PR that provides significant insights into mechanisms of HEV infection in immunosuppressed individuals.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A mutation in the progesterone receptor predisposes to HEV infection in HIV‐positive patients

Debes

Pas

Groothuismink

et al. 2018

Liver International

View full text Add to dashboard Cite

show abstract

“…During pregnancy, the immune system is altered to protect the fetus from attacks by the mother's immune system; however, these changes also affect the way the immune system responds to infectious agents. Several studies (Table ).have shown significant differences in the immune and hormonal responses in pregnant women with FHF caused by hepatitis E …”

Section: Pathogenesismentioning

confidence: 99%

“…Published data on oxidative stress in HEV infection are very scarce. There is a study that evaluates the level of GSH in HEV‐infected pregnant patients concluding that HEV infection aggravates oxidative stress during pregnancy. These authors also suggest that GSH may play an important role in mediating a series of pregnancy events.…”

Section: Pathogenesismentioning

confidence: 99%

“…Several studies ( Table 2).have shown significant differences in the immune and hormonal responses in pregnant women with FHF caused by hepatitis E. [45][46][47][48][49][50][51][52][53][54][55][56][57] One of the main changes during pregnancy is the decrease in cellular immunity, which presents itself as a decrease of CD4, an increase of CD8, and, therefore, a decrease in the CD4/CD8 ratio. Moreover, the changes in the maternal immune response are partially due to significant variations in hormone levels, with an increase in progesterone, estrogen, and human chronic gonadotropin.…”

Section: Pathogenesismentioning

confidence: 99%

See 1 more Smart Citation

Hepatitis E and pregnancy: current state

Pérez‐Gracia

Suay-García

Mateos-Lindemann

2017

Reviews in Medical Virology

189

162

View full text Add to dashboard Cite

Hepatitis E virus (HEV) is responsible for more than 50% of acute viral hepatitis cases in endemic countries. Approximately 2 billion individuals live in hepatitis E-endemic areas and, therefore, are at risk of infection. According to World Health Organization, HEV causes about 20.1 million infections and 70 000 deaths every year. In developing countries with poor sanitation, this disease is transmitted through contaminated water and is associated with large outbreaks, affecting hundreds or thousands of people. In developed countries, autochthonous cases of HEV have been increasingly recognized in the past several years. Hepatitis E virus typically causes an acute, self-limiting illness similar to other acute viral hepatitis, such as hepatitis A or B, with about 0.2% to 1% mortality rate in the general population. However, the course of hepatitis E in pregnancy is different than the mild self-constraining infection described in other populations. During pregnancy, HEV infection can take a fulminant course, resulting in fulminant hepatic failure, membrane rupture, spontaneous abortions, and stillbirths. Studies from various developing countries have shown a high incidence of HEV infection in pregnancy with a significant proportion of pregnant women progressing to fulminant hepatitis with a fatality rate of up to 30%. The present review will highlight new aspects of the HEV infection and pregnancy.

show abstract

Oxidative stress—A key determinant of complications and negative outcome in hepatitis E virus infected pregnancies: A comprehensive account involving cases from northeast India

Kashyap

Islam

Kaur

et al. 2023

Journal of Medical Virology

View full text Add to dashboard Cite

Regulated oxidative stress (OS) is important during pregnancy. Sporadic studies suggest the significance of deregulated OS in hepatitis E virus (HEV) infected pregnancy, but with limited reactive oxygen species (ROS) or antioxidant markers. The present novel study, therefore, aimed to evaluate the significance of ROS‐antioxidant imbalance and resulting altered OS in HEV infected pregnancy complications like preterm delivery (PTD) and outcome. Difference in serum levels of ROS and antioxidant panel of markers were evaluated by ELISA for HEV immunoglobulin M RNA positive genotype 1 cases (including acute [acute viral hepatitis, AVH] and fulminant [fulminant hepatic failure, FHF] cases) and healthy term delivery subjects, and analyzed statistically. Direct ROS marker H2O2 levels and indirect OS marker for DNA damage 8‐hydroxy‐2′‐deoxyguanosine was significantly increased in HEV‐cases compared to controls, and was associated and prognostic factor for PTD and fetal death in HEV cases. A comparatively lower total serum antioxidant capacity was observed in the FHF cases compared to the control subjects and the AVH cases. Glutathione (GSH) levels and superoxide dismutase (SOD) activity were significantly associated with PTD in the FHF sub‐cohorts (p = 0.017) and AVH sub‐cohorts (p < 0.001), respectively, and was associated with poor prognosis in HEV cases. The serum H2O2 levels were found to be negatively correlated with SOD activity (p = 0.016) and GSH levels (p = 0.001) in the HEV‐AVH cases; and positively correlated with the viral load in HEV cases (p = 0.023). The ROS‐antioxidant imbalance resulting OS plays a detrimental associative role in HEV infected pregnancy complications like PTD and adverse pregnancy outcomes; and holds therapeutic significance.

show abstract

Reduced glutathione in hepatitis E infection and pregnancy outcome

Abstract: Oxidative stress is present in HEV infection during pregnancy, as shown by low GSH, and is associated with adverse pregnancy outcomes. Serum GSH ≤10.88 ng/mL during pregnancy can be used for risk stratification for HEV infection.

Cited by 21 publications

References 32 publications

A mutation in the progesterone receptor predisposes to HEV infection in HIV‐positive patients

A mutation in the progesterone receptor predisposes to HEV infection in HIV‐positive patients

Hepatitis E and pregnancy: current state

Oxidative stress—A key determinant of complications and negative outcome in hepatitis E virus infected pregnancies: A comprehensive account involving cases from northeast India

Contact Info

Product

Resources

About