ORIGINAL ARTICLE: Maternal Plasma Concentration of the Pro‐Inflammatory Adipokine Pre‐B‐Cell‐Enhancing Factor (PBEF)/Visfatin Is Elevated In Pregnant Patients with Acute Pyelonephritis

Citation Mazaki‐Tovi S, Vaisbuch E, Romero R, Kusanovic JP, Chaiworapongsa T, Kim SK, Nhan‐Chang C‐L, Gomez R, Yoon BH, Yeo L, Mittal P, Ogge G, Gonzalez JM, Hassan SS. Maternal plasma concentration of the pro‐inflammatory adipokine pre‐B‐cell‐enhancing factor (PBEF)/visfatin is elevated in pregnant patients with acute pyelonephritis. Am J Reprod Immunol 2010; 63: 252–262 Problem Visfatin/pre‐B‐cell‐enhancing factor (PBEF) has been implicated in the regulation of the innate immune system, as well as in glucose metabolism. Specifically, visfatin plays a requisite role in delayed neutrophil apoptosis in patients with sepsis. The aim of this study was to determine whether pyelonephritis during pregnancy is associated with changes in maternal plasma visfatin concentration in normal weight and overweight/obese patients. Method of study This cross‐sectional study included the following groups: (1) normal pregnant women (n = 200) and (2) pregnant women with pyelonephritis (n = 40). Maternal plasma visfatin concentrations were determined by ELISA. Non‐parametric statistics was used for analyses. Results (1) The median maternal plasma visfatin concentration was significantly higher in patients with pyelonephritis than in those with a normal pregnancy; (2) among overweight/obese pregnant women, those with pyelonephritis had a significantly higher median plasma visfatin concentration than women with a normal pregnancy; and (3) pyelonephritis was independently associated with higher maternal plasma visfatin concentrations after adjustment for maternal age, pre‐gestational body mass index, smoking status, gestational age at sampling, and birthweight. Conclusion Acute pyelonephritis during pregnancy is associated with a high circulating maternal visfatin concentration. These findings suggest that visfatin/PBEF may play a role in the regulation of the complex and dynamic crosstalk between inflammation and metabolism during pregnancy.     

Impact of early feeding on childhood eczema: development after nutritional intervention compared with the natural course – the GINIplus study up to the age of 6 years

Background Nutritional intervention with hydrolysed infant formulas has been shown efficacious in preventing eczema in children predisposed to allergy. However, this preventive effect has never been related to the natural course of eczema in children with or without a family history of allergy. The aim of this study therefore was to compare the course of eczema in predisposed children after nutritional intervention to the natural course of eczema. Method The prospective German birth cohort study GINIplus includes a total of 5991 children, subdivided into interventional and non‐interventional groups. Children with a familial predisposition for allergy whose parents agreed to participate in the prospective, double‐blind intervention trial (N=2252) were randomly assigned at birth to one of four formulas: partially or extensively hydrolysed whey, extensively hydrolysed casein (eHF‐C) or standard cow's milk formula. Children with or without familial predisposition represented the non‐interventional group (N=3739). Follow‐up data were taken from yearly self‐administered questionnaires from 1 up to 6 years. The outcome was physician‐diagnosed eczema and its symptoms. The cumulative incidence of eczema in predisposed children with or without nutritional intervention was compared with that of non‐predisposed children who did not receive intervention. Cox regression was used to adjust for confounding. Results Predisposed children without nutritional intervention had a 2.1 times higher risk for eczema [95% confidence interval (CI) 1.6–2.7] than children without a familial predisposition. The risk was smaller with nutritional intervention even levelling out to 1.3 (95% CI 0.9–1.9) in children fed eHF‐C formula. Conclusion Although direct comparability is somewhat restricted, the data demonstrate that early intervention with hydrolysed infant formulas can substantially compensate up until the age of 6 years for an enhanced risk of childhood eczema due to familial predisposition to allergy. Cite this as: A. v. Berg, U. Krämer, E. Link, C. Bollrath, J. Heinrich, I. Brockow, S. Koletzko, A. Grübl, B. Filipiak‐Pittroff, H.‐E. Wichmann, C.‐P. Bauer, D. Reinhardt, D. Berdel and the GINIplus study group, Clinical & Experimental Allergy, 2010 (40) 627–636.     

Depletion of CD4+CD25+ regulatory T cells enhances natural killer T cell‐mediated anti‐tumour immunity in a murine mammary breast cancer model

Both invariant natural killer T (NK T) cells and CD4⁺CD25⁺ T regulatory cells (T_regs) regulate the immune system to maintain homeostasis. In a tumour setting, NK T cells activated by α‐galactosylceramide (α‐GalCer) execute anti‐tumour activity by secreting cytokines. By contrast, T_regs intrinsically suppress antigen‐specific immune responses and are often found to be elevated in tumour patients. In this study, we have shown that T_regs regulate NK T cell function negatively in vitro, suggesting a direct interaction between these cell types. In a murine mammary tumour model, we demonstrated that administration of either α‐GalCer or anti‐CD25 antibody alone markedly suppressed tumour formation and pulmonary metastasis, and resulted in an increase in the survival rate up to 44% (from a baseline of 0%). When treatments were combined, depletion of T_regs boosted the anti‐tumour effect of α‐GalCer, and the survival rate jumped to 85%. Our results imply a potential application of combining T_reg cell depletion with α‐GalCer to stimulate NK T cells for cancer therapy.     

妊娠期高血压病患者血清NO、NOS水平与脂质过氧化物关系

目的：探讨妊娠期高血压病患者血清NO、NOS水平与脂质过氧化物关系。方法：应用生化法对31例妊娠期高血压病患者进行了血清NO、NOS测定和化学比色法测定血清丙二醛（MDA）、超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-PX）含量,并与35名正常孕妇作比较。结果：妊娠期高血压病患者血清NO、NOS、GSH-PX水平非常显著地低于正常孕妇组（P〈0.01）,而NOS、MDA水平又非常显著地高于正常孕妇组（P〈0.01）,相关分析显示,血清NO、SOD、GSH-PX水平呈负相关（r=-0.4172、-0.4215、-0.4022,P〈0.05）。结论：妊娠期高血压病患者血清NO、NOS、GSH-PX水平的降低与活性代谢紊乱密切相关。     

宫颈癌患者手术前后血清SCC、CYFRA21-1和CA125检测的临床意义

本文对宫颈癌患者手术治疗前后血清鳞状细胞癌抗原（SCC）、细胞角蛋白片段19（CYFRA21-1）和CA125进行检测,现将结果报告如下。     

辅助生殖技术后发生宫内外同时妊娠的相关因素分析

目的探讨辅助生殖技术后发生宫内外同时妊娠的高危因素、诊断、治疗及预后。方法对2005年1月～2008年10在广州医学院第三附属医院生殖科进行辅助生殖治疗后发生的7例宫内外同时妊娠病例进行回顾性分析。结果宫内外妊娠的发生率为0.6%,5例为输卵管因素不孕,其中1例有既往异位妊娠史。6例经B超确诊,1例经手术确诊。1例行阴道B超引导下异位孕囊穿刺抽吸胚芽术,1例行输卵管切开取胚术,5例行输卵管切除术,其中3例在异位病灶去除后继续宫内妊娠并分娩活婴。结论既往输卵管盆腔疾病或手术、异位妊娠史是辅助生殖技术后发生宫内外同时妊娠的高危因素。对有高危因素的患者早期加强B超检测有助于早期诊断、早期治疗,将对宫内妊娠的影响减到最小。     

宫腔镜输卵管妊娠插管注射MTX治疗宫外孕24例

目的利用宫腔镜插管对输卵管妊娠保守治疗,探讨其临床价值。方法2006～2008年24例宫外孕患者行患侧输卵管插管注入MTX 20～40mg,成功杀死胚胎。结果方法简便可行,费用少,值得推广。结论采用宫腔镜输卵管妊娠插管保守治疗成功率高,消除了手术的痛苦,保存了完整输卵管,减少并发症。     

早期诊断输卵管外异位妊娠的临床初探

目的探讨临床上提高输卵管外异位妊娠早期诊断准确率的途径。方法回顾分析近年经手术后病理证实的输卵管以外部位的异位妊娠的术前超声诊断情况。结果 33例患者22例在术前确诊,9例误诊,2例漏诊。结论经阴道超声结合彩色多普勒超声可提高异位妊娠的诊断准确率。     

孕前女性生殖道感染状况分析

目的 了解孕前女性生殖道感染发病情况。方法 对2008年9-12月进行孕前体检的1 254例孕前妇女进行生殖道感染的相关检查,包括阴道炎、急性宫颈炎、盆腔炎、性传播性疾病,并对检查结果进行分析。结果 孕前妇女生殖道感染发病率达23.76%,年龄大、怀孕次数多、丈夫有性伴（≥2人）及有生殖道感染（RTI）自觉症状是危险因素,文化程度高和卫生习惯好则是保护因素。结论 RTI是孕前妇女的常见及多发病,与不良妊娠结局的发生关系密切,应通过宣教提高孕前女性的自我保健能力,改善不良卫生习惯和不洁性行为,从而促进生殖健康。