Article
Immunology
Marwa Ben Ali Gannoun, Meriem Mehdi, Hedia Zitouni, Manel Boussabah, Ines Zouari, Ali Jlali, Wassim Y. Almawi
Summary: This study tested the link between altered PlGF and sFLT-1 levels, and their ratio with PE and PE-associated features, and found that increased sFlt-1 levels and sFlt-1/PlGF ratio are independent risk factors for PE.
AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY
(2023)
Article
Cell Biology
Evangeline Deer, Jalisa Jones, Denise C. Cornelius, Kyleigh Comley, Owen Herrock, Nathan Campbell, Sarah Fitzgerald, Tarek Ibrahim, Babbette LaMarca, Lorena M. Amaral
Summary: Preeclampsia (PE) is characterized by new onset hypertension in association with placental ischemia, reduced fetal weight, elevated soluble fms-like tyrosine kinase-1 (sFlt-1), and placental mitochondrial (mt) dysfunction and oxidative stress. This study demonstrates that sFlt-1 induced hypertension during pregnancy reduces placental mitochondrial function, but treatment with PIBF improves placental mitochondrial function and hypertension, suggesting the efficacy of enhanced progesterone signaling as a potential therapy for PE.
Review
Biochemistry & Molecular Biology
Lucile Yart, Edith Roset Bahmanyar, Marie Cohen, Begona Martinez de Tejada
Summary: Placental development and function are crucial for efficient maternal-fetal exchanges, pregnancy-specific hormone secretion, and immune modulation. Incorrect placental development can lead to serious pregnancy disorders, such as preeclampsia, endangering both the mother and the infant. The role of the uteroplacental renin-angiotensin system in placental development and function may have been underestimated.
Review
Medicine, General & Internal
Courtney Bisson, Sydney Dautel, Easha Patel, Sunitha Suresh, Patricia Dauer, Sarosh Rana
Summary: Preeclampsia is a disease that has wide-ranging effects on the body's organ systems, with consequences lasting beyond the immediate postpartum period. Current research aims to understand the pathophysiology of preeclampsia for accurate screening and treatment. Preeclampsia impacts maternal morbidity and mortality in the cardiovascular system and other organs, with effects persisting after pregnancy. This review discusses the current understanding of preeclampsia's pathophysiology and ways to improve overall outcomes.
FRONTIERS IN MEDICINE
(2023)
Review
Physiology
Tlili Barhoumi, Stephen Todryk
Summary: The renin-angiotensin system (RAS) is a central regulator of cardiovascular physiology, and its hyper-activation is common in hypertension. Recent studies have highlighted the crucial role of the immune system, particularly monocyte/macrophage cells, in hypertension and its related pathology. Targeting RAS components in these cells may present an innovative strategy for the treatment of hypertension.
FRONTIERS IN PHYSIOLOGY
(2023)
Article
Public, Environmental & Occupational Health
Alexa Campbell, Kaitlyn K. Stanhope, Marissa Platner, Naima T. Joseph, Denise J. Jamieson, Sheree L. Boulet
Summary: The study found that the postpartum blood pressure screening attendance rate was low among women with hypertensive disorders of pregnancy, highlighting the need for further research and creative solutions to address barriers at the individual, provider, and system levels.
JOURNAL OF WOMENS HEALTH
(2022)
Article
Obstetrics & Gynecology
Sunitha C. Suresh, Colleen Duncan, Harjot Kaur, Ariel Mueller, Avery Tung, Joana L. Perdigao, Kavia Khosla, Rohin Dhir, Karie Stewart, Kedra Wallace, Roy Ahn, Sarosh Rana
Summary: The hospital-wide, bundled quality-improvement initiative implemented for patients with hypertensive disorders of pregnancy successfully improved postpartum visit adherence and blood pressure control, showing positive effects on postpartum management.
OBSTETRICS AND GYNECOLOGY
(2021)
Review
Obstetrics & Gynecology
Caio Ribeiro Vieira Leal, Larissa Braga Costa, Guilherme Costa Ferreira, Alexandre de Melo Ferreira, Fernando M. Reis, Ana Cristina Simoes e Silva
Summary: The activation and dysfunction of the Renin Angiotensin System (RAS) play important roles in normal pregnancy and in the development of preeclampsia (PE). PE is characterized by altered placental physiology and increased sensitivity to the vasoconstrictor effects of Angiotensin II (Ang II). Further research is needed to understand the role of circulating RAS, uteroplacental RAS, and local RAS molecules in the pathogenesis of PE.
PREGNANCY HYPERTENSION-AN INTERNATIONAL JOURNAL OF WOMENS CARDIOVASCULAR HEALTH
(2022)
Review
Medicine, Research & Experimental
Chuanxin Su, Jinhua Xue, Chao Ye, Aidong Chen
Summary: Hypertension, present in over one billion adults, is closely related to the disruption of the renin-angiotensin system (RAS). The AT1R receptor is the most important angiotensin II receptor, playing a critical role in vasoconstriction and being associated with multiple signaling pathways, including AT1R/JAK/STAT and Ras/Raf/MAPK pathways.
INTERNATIONAL JOURNAL OF MOLECULAR MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Victoria A. deMartelly, John Dreixler, Avery Tung, Ariel Mueller, Sarah Heimberger, Abid A. Fazal, Heba Naseem, Roberto Lang, Eric Kruse, Megan Yamat, Joey P. Granger, Bhavisha A. Bakrania, Javier Rodriguez-Kovacs, Sarosh Rana, Sajid Shahul
Summary: The study found that in women with a history of preeclampsia, levels of activin A and global longitudinal strain remained elevated 10 years postpartum, and were associated with the deterioration of cardiac structure and function.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Review
Obstetrics & Gynecology
Alisse Hauspurg, Arun Jeyabalan
Summary: High blood pressure in the postpartum period can occur in women with antenatal hypertensive disorders or develop de novo. The distinction between postpartum preeclampsia or eclampsia and those with antepartum onset is unclear. The diagnosis of postpartum preeclampsia should be considered in women with new-onset hypertension 48 hours to 6 weeks after delivery. There are limited evidence-based guidelines for the diagnosis and management of this condition. Risk factors for postpartum preeclampsia include older maternal age, black race, maternal obesity, and cesarean delivery. Prompt recognition and treatment are important, as delayed-onset postpartum preeclampsia can lead to maternal morbidity. Further research is needed to better understand the pathophysiology and specific risk factors. Improved understanding of postpartum preeclampsia is crucial for patient care, counseling, and reducing maternal morbidity and mortality in the postpartum period.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2022)
Review
Medicine, General & Internal
Jarawee Sukmanee, Tippawan Liabsuetrakul
Summary: Women with a history of hypertensive disorders of pregnancy (HDP) have an increased risk of cardiovascular diseases (CVDs) in later life, especially within the first 5 years postpartum. Preeclamptic women have a higher risk of CVDs compared to women with normotensive pregnancies.
Review
Cell Biology
Maksymilian Ziaja, Kinga Anna Urbanek, Karolina Kowalska, Agnieszka Wanda Piastowska-Ciesielska
Summary: The renin-angiotensin system (RAS) is not only involved in regulating cardiovascular function, but also plays a complex role in various processes such as memory and cancer. Maintaining the balance between individual elements of the RAS system is crucial for achieving homeostasis, and any disturbance in their expression or activity can lead to pathological processes.
Article
Cardiac & Cardiovascular Systems
Nirupama Ramkumar, Deborah Stuart, Caitlin S. Peterson, Chunyan Hu, William Wheatley, Jae Min Cho, J. David Symons, Donald E. Kohan
Summary: Loss of sPRR reduces baseline blood pressure, decreases Ang II-induced hypertension and renal injury, and is associated with greater endothelium-dependent vasorelaxation of resistance-sized arteries.
CIRCULATION RESEARCH
(2021)
Article
Medicine, General & Internal
Szymon Kozlowski, Anna Stelmaszczyk-Emmel, Iwona Szymusik, Aleksandra Saletra-Bielinska, Robert Brawura-Biskupski-Samaha, Pawel Pietruski, Agnieszka Osinska, Katarzyna Kosinska-Kaczynska
Summary: In this study, it was found that the concentration of sFlt-1 is higher in dichorionic twin pregnancies compared to monochorionic pregnancies. PlGF and sEng levels did not significantly differ between mono- and dichorionic gestation. Additionally, the concentrations of PlGF, sFlt-1 and sEng increased significantly during gestation and were much higher in the third trimester compared to the first trimester.
Review
Obstetrics & Gynecology
Sarosh Rana, Suzanne D. Burke, S. Ananth Karumanchi
Summary: Preeclampsia is a serious complication of pregnancy that can lead to morbidity and mortality for both the mother and fetus. Abnormal levels of circulating angiogenic factors released from the placenta are believed to be responsible for the symptoms of preeclampsia. Measuring these angiogenic biomarkers in the blood can help clinicians diagnose and predict preeclampsia. Additionally, these biomarkers are useful in studying the mechanisms of related disorders of placental implantation.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2022)
Article
Transplantation
Sahir Kalim, Anders H. Berg, Subbian Ananth Karumanchi, Ravi Thadhani, Andrew S. Allegretti, Sagar Nigwekar, Sophia Zhao, Anand Srivastava, Dominic Raj, Rajat Deo, Anne Frydrych, Jing Chen, James Sondheimer, Tariq Shafi, Matthew Weir, James P. Lash
Summary: The study suggests that protein carbamylation is a predictor of CKD progression beyond traditional risk factors like eGFR and proteinuria. However, the association of carbamylation with mortality was weaker in this limited sample size.
NEPHROLOGY DIALYSIS TRANSPLANTATION
(2022)
Letter
Obstetrics & Gynecology
S. Ananth Karumanchi, Towia Libermann
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2022)
Article
Peripheral Vascular Disease
Vesna D. Garovic, Ralf Dechend, Thomas Easterling, Ananth Karumanchi, Suzanne McMurtry Baird, Laura A. Magee, Sarosh Rana, Jane V. Vermunt, Phyllis August, Vice Chair
Summary: Hypertensive disorders of pregnancy (HDP) are a major cause of morbidity and mortality for both mothers and fetuses worldwide. This report reviews the current literature on HDP, including epidemiology, pathophysiology, treatment guidelines, and associated complications.
Editorial Material
Medical Laboratory Technology
Kathryn J. Gray, Martin Hemberg, S. Ananth Karumanchi
CLINICAL CHEMISTRY
(2022)
Article
Medicine, Research & Experimental
Sarah M. Davis, Vignesh N. Hariharan, Agnes Lo, Anton A. Turanov, Dimas Echeverria, Jacquelyn Sousa, Nicholas McHugh, Annabelle Biscans, Julia F. Alterman, S. Ananth Karumanchi, Melissa J. Moore, Anastasia Khvorova
Summary: Preeclampsia is a potentially lethal pregnancy complication driven by overexpression of placental soluble fms-like tyrosine kinase 1 (sFLT1). Researchers have found that injecting specific siRNA can reduce placental sFLT1 and improve symptoms. They also discovered that modifying siRNA chemically can enhance its effectiveness and safety, providing a framework for further development of this therapeutic approach.
MOLECULAR THERAPY-NUCLEIC ACIDS
(2022)
Article
Endocrinology & Metabolism
Mengyao Tang, Anders Berg, Eugene P. Rhee, Andrew S. Allegretti, Sagar Nigwekar, S. Ananth Karumanchi, James P. Lash, Sahir Kalim
Summary: The impact of glycated hemoglobin (HbA(1c)) on renal outcomes in patients with diabetes and chronic kidney disease (CKD) is modified by carbamylation and anemia.
Review
Peripheral Vascular Disease
Takahiko Nakagawa, Ana Andres-Hernando, Tomoki G. Kosugi, Laura Sanchez-Lozada, Peter Stenvinkel, Karolina Kublickiene, S. Ananth Karumanchi, Duk-Hee Kang, Hideto Kojima, Bernardo R. Rodriguez-Iturbe, Dean A. Tolan, Miguel J. Lanaspa, Richard Johnson
Summary: Preeclampsia is a hypertensive disorder of pregnancy caused by abnormal placentation. Fructose, which plays a critical role in fetal growth, is produced in the placenta during early pregnancy to assist fetal survival in a hypoxic environment. Impaired placentation leads to excessive fructose production, which drives various pathological features of preeclampsia. In addition, dietary fructose intake has been identified as an independent risk factor for preeclampsia.
HYPERTENSION RESEARCH
(2023)
Article
Urology & Nephrology
Sahir Kalim, Sophia Zhao, Mengyao Tang, Eugene P. Rhee, Andrew S. Allegretti, Sagar Nigwekar, S. Ananth Karumanchi, James P. Lash, Anders H. Berg
Summary: Protein carbamylation, driven by elevated blood urea levels, is associated with adverse outcomes in ESKD. However, its relationship to clinical outcomes in earlier stages of CKD is not well understood.
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
(2023)
Article
Multidisciplinary Sciences
Gena Guidry, Nicklaus A. Sparrow, Hyyat S. Marshall, Roberta De Souza Santos, Suman P. Bharath, Michael M. Gezalian, Margareta D. Pisarska, Jean-Philippe Vit, Scott A. Kelly, S. Ananth Karumanchi, Shouri Lahiri
Summary: Urinary tract infections (UTIs) can lead to delirium-like states, and postmenopausal females are more susceptible to delirium following UTIs. It has been found that 17 beta-estradiol can reduce neuronal injury and improve delirium-like behaviors caused by UTIs, possibly by suppressing the expression of interleukin-6 (IL-6).
SCIENTIFIC REPORTS
(2022)
Article
Medicine, General & Internal
Nicklaus A. A. Sparrow, Gena Guidry, Faizan Anwar, Sonja Darwish, Scott A. A. Kelly, S. Ananth Karumanchi, Shouri Lahiri
Summary: Prone positioning can alleviate neuronal injury and inflammation by reducing interleukin 6 (IL-6) in a model of mechanical ventilation-induced acute lung injury. Further studies are needed to investigate the relationship between prone positioning and delirium, and to develop novel diagnostic or therapeutic approaches to reduce systemic and cerebral IL-6 expression.
FRONTIERS IN MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Lauren A. Biwer, Qing Lu, Jaime Ibarrola, Alec Stepanian, Joshua J. Man, Brigett V. Carvajal, Nicholas D. Camarda, Zsuzsanna Zsengeller, Geraldine Skurnik, Ellen W. Seely, S. Ananth Karumanchi, Iris Z. Jaffe
Summary: Preeclampsia is associated with hypertension and end organ damage, and women exposed to preeclampsia have an increased risk of hypertension after pregnancy. This study found that exposure to sFlt1 during pregnancy leads to enhanced responsiveness of smooth muscle cell mineralocorticoid receptors (SMC-MR) to hypertensive stimuli, contributing to postpartum hypertension. These findings suggest that targeting SMC-MR could be a potential intervention to mitigate cardiovascular risk in women after preeclampsia.
CIRCULATION RESEARCH
(2023)
Article
Obstetrics & Gynecology
Eynav Accortt, James Mirocha, Dongsheng Zhang, Sarah J. Kilpatrick, Towia Libermann, S. Ananth Karumanchi
Summary: This study aimed to determine if a panel of novel third-trimester plasma protein biomarkers in pregnant women can be used to identify those who have a high predisposed risk for perinatal mood and anxiety disorders. The results showed that participants with perinatal mood and anxiety disorders had a unique and distinct plasma protein signature that regulated a variety of neuronal signaling and proinflammatory pathways. Further validation studies with larger sample sizes are needed to determine the potential use of these molecules for early detection of perinatal mood and anxiety disorders when combined with traditional risk factors.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2023)
Article
Medicine, Research & Experimental
Vincent Dupont, Anders H. Berg, Michifumi Yamashita, Chengqun Huang, Ambart E. Covarrubias, Shafat Ali, Aleksandr Stotland, Jennifer E. Van Eyk, Belinda Jim, Ravi Thadhani, S. Ananth Karumanchi
Summary: Kidney donation increases the risk of preeclampsia by impairing renal reserve and preventing the upregulation of l-kynurenine, resulting in impaired placentation, placental hypoperfusion, and an antiangiogenic state.
JOURNAL OF CLINICAL INVESTIGATION
(2022)
Article
Critical Care Medicine
Faizan Anwar, Nicklaus A. Sparrow, Mohammad Harun Rashid, Gena Guidry, Michael M. Gezalian, Eric J. Ley, Maya Koronyo-Hamaoui, Itai Danovitch, E. Wesley Ely, S. Ananth Karumanchi, Shouri Lahiri
Summary: This study demonstrates the pathogenic role of systemic IL-6 in mediating structural and functional acute neuropsychiatric symptoms in VILI. The researchers found that inhibiting IL-6 can reduce neural injury and improve acute neuropsychiatric behaviors in mice with VILI.