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   Table of Contents - Current issue
Coverpage
July-September 2021
Volume 5 | Issue 3
Page Nos. 129-192

Online since Saturday, September 18, 2021

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ORIGINAL ARTICLES  

A defective CXCL16/CXCR6 axis increases the risk of pregnancy loss via the abnormal crosstalk between decidual γδ t cells and trophoblasts p. 129
Deng-Xuan Fan, Ming-Qing Li, Wen-Jie Zhou, Hong-Lan Huang, Hui-Li Yang, Cong-Jian Xu
DOI:10.4103/2096-2924.324878  
Objective: The maternal–fetal interface undergoes dynamic changes to allow the fetus to grow and develop in the uterus. The interaction between decidual γδ Τ cells and trophoblasts plays a pivotal role during successful pregnancy; however, their physiological functions in early-term human pregnancy are still not completely illustrated. This study was undertaken to illustrate the functional roles of CXCL16/CXCR6 to prevent pregnancy loss via the crosstalk between decidual γδ T cells and HTR8/SVneo trophoblast cells. Methods: The percentile of CXCR6+ γδ T cells in the peripheral blood from normal female and recurrent spontaneous abortion (RSA) patients was analyzed by flow cytometry. The expression of CXCR6 was detected in decidual immune cells via flow cytometry, and the expression of CXCL16 was analyzed in HTR8/SVneo trophoblast cells and lentivirus (LV)-HTR8/SVneo trophoblast cells via enzyme-linked immunosorbent assay. Reverse transcriptase-polymerase chain reaction was used to verify the expression of the CXCL16 gene in LV-HTR8/SVneo trophoblast cells. Expression of granzyme B and cytokines and proliferation of decidual γδ T cocultured with HTR8/SVneo trophoblast cells were analyzed by flow cytometry. Invasion of HTR8/SVneo trophoblast cells was assessed via Matrigel transwell assay. Adoptive transfer was induced in vivo further to illustrate that the normal expression of CXCL16/CXCR6 could prevent pregnancy loss. Results: The percentile of CXCR6+ γδ T cells in the peripheral blood from RSA patients was lower than normal pregnancies. The expression of CXCR6 was highest in the decidual γδ T cells among decidual immune cells, and the expression of CXCL16 increased as the amount of HTR8/SVneo trophoblast cells increased. Expression of granzyme B in the decidual γδ T cells was downregulated by cocultured with HTR8/SVneo cells dependent of CXCL16, and HTR8/SVneo trophoblast cells induced the Th2 cytokines production in the decidual γδ T cells. Both the expression of CXCR6 in the decidual γδ T cells and proliferation of the decidual γδ T cells were promoted by HTR8/SVneo trophoblast cells. On the other hand, decidual γδ T cells enhanced the invasion of HTR8/SVneo trophoblast cells and thus promoted embryo implantation. In vivo study was taken further and shown that low expression of CXCL16/CXCR6 results in pregnancy loss because of dialog disorder between decidual γδ Τ cells and trophoblasts. Conclusions: Low expression of CXCL16/CXCR6 results in pregnancy loss because of the dialog disorder between decidual γδ Τ cells and trophoblasts, and it showed a light on the effective strategy of adoptive transfer of CXCR6+ γδ T cells on the treatment of RSA. This observation provides a scientific basis on which a potential strategy can be applied to the early-detect and treatment of RSA.
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Vitamin d-binding protein is involved in the pathogenesis of preeclampsia by inhibiting the tyrosine phosphorylation of vascular endothelial growth factor receptor-2 in endothelial cells p. 140
Ting-Feng Lu, Yun-Zhen Ye, Xiao-Tian Li, Ying Zhang
DOI:10.4103/2096-2924.322839  
Objective: The role of Vitamin D-binding protein (DBP) in preeclampsia (PE) pathogenesis is unknown. In this study, we compared the expression of DBP in the placentas of PE patients with the placentas of normotensive pregnant women with placenta previa controls, and aimed to explore the effect of DBP on endothelial cells (ECs) and the underlying mechanism. Methods: DBP expression in placental tissues collected from PE patients and controls was evaluated by immunohistochemistry. The downregulation and upregulation of DBP expression in HTR-8/SVneo cells were examined using DBP-targeting small interfering RNA (siRNA) and DBP-expression vector, respectively. The conditioned media of these DBP-overexpressing and DBP-siRNA HTR-8/SVneo cells were collected and added to human umbilical vein EC (HUVEC) cultures. Angiogenic effects on HUVECs were assessed by tube formation assays, and the proliferation and migration of HUVECs were examined using the Real-Time Cell Analyzer. The expression of vascular endothelial growth factor (VEGF) and VEGF receptor (VEGFR)-2, as well as the phosphorylation of different residues of VEGFR-2 in HUVECs, were determined by western blotting. Results: DBP expression was significantly increased in the placental tissues collected from PE patients. The conditioned medium of DBP-overexpressing HTR-8/SVneo cells potently inhibited tube formation by HUVECs, in addition to their proliferation and migration. Furthermore, treatment of HUVECs with the conditioned medium of DBP-overexpressing HTR-8/SVneo cells decreased the phosphorylation of VEGFR-2 at tyrosine 996, whereas the treatment of these cells with the conditioned medium of DBP-siRNA HTR-8/SVneo cells increased the phosphorylation of VEGFR-2 at tyrosine 951, 996, and 1,175. Conclusions: The expression of DBP is increased in the placentas of PE patients. DBP plays potential roles in endothelial dysfunction, which contributes to PE development, by inhibiting tyrosine phosphorylation of VEGFR-2 in ECs.
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Impact of early versus late amniotomy on induction of labor in nulliparous women after vaginally administered misoprostol: A randomized clinical trial p. 148
Mohamed Elsibai Anter, Ayman Abd Elkader Shabbana, Alaa Eldin Fatahlla Elhalaby, Hager Abd Elshafy Abd Elfattah Youssif, Nabih Ibrahim Elkhouly
DOI:10.4103/2096-2924.324223  
Objective: To investigate the effect of early versus late amniotomy after induction of labor (IOL) with vaginally administered misoprostol. Methods: This randomized clinical trial was conducted at the Department of Obstetrics and Gynecology, Menoufia University, from May 2019 to March 2020, and included 120 nulliparous women at term (≥ 37 weeks' gestation) undergoing IOL. Computer-generated randomization was used to randomize the participants into either the early amniotomy group (3 cm cervical dilatation; n = 60) or the late amniotomy group (7 cm cervical dilatation; n = 60). All participants received misoprostol (25 μg) vaginally to induce labor. The primary outcome was the induction-to-delivery interval, defined as the time from the initiation of IOL to the time of delivery. Results: Women in the early amniotomy group had a shorter duration of labor (12.60 ± 5.36 h) than those in the late amniotomy group (16.67 ± 7.26 h). The mean time from rupture of the fetal membrane to delivery was significantly shorter in the late (2.51 ± 0.36 h) than in the early amniotomy group (3.1 ± 0.89 h). There was no statistically significant difference between the groups in terms of maternal complications (fever, nausea, vomiting, and uterine hyperstimulation) or neonatal complications (meconium-stained liquor, APGAR score <7 at 1 and 5 min, and neonatal intensive care unit admission). Conclusions: IOL using vaginally administered misoprostol followed by early amniotomy was accompanied by a shorter duration of labor and decreased use of oxytocin. There was no significant difference between the early and late amniotomy groups in terms of the rate of cesarean section or maternal and neonatal complications.
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REVIEW ARTICLES Top

Comparison of risks of thromboembolism of drospirenone-containing and nondrospirenone -containing combined oral contraceptive use: A meta-analysis p. 154
Wan-Lin Zhang, Zhe Dong, Jun-Yan Zhang, Min-Zhi Lyu, Wei Zhang, Jian-Lei Huang, Xin Yang
DOI:10.4103/2096-2924.324822  
This study aimed to estimate the risk of venous thromboembolism (VTE), arterial thromboembolism (ATE), and other side effects following the use of drospirenone (DRSP)-containing combined oral contraceptives (COCs). When compared with non-DRSP-containing COCs, DRSP-containing COCs decreased the risk of VTE by 15% in the overall study population, although this was not statistically significant (adjusted hazard ratio/risk ratio [95% confidence interval] 0.85 [0.69, 1.04]). DRSP-containing COCs also showed significant benefits in terms of ATE risk. The body mass index of the subjects significantly decreased by 0.64 kg/m2 after taking the DRSP-containing COCs for 6 months. We concluded that DRSP-containing COCs were safe for use and could be broadly recommended.
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Role of autoantibodies in infertility, miscarriage, and assisted reproductive technology outcomes p. 161
Hui-Hui Shen, Zhen-Zhen Lai, Hui-Li Yang, Jia-Wei Shi, Ming-Qing Li
DOI:10.4103/2096-2924.322829  
Although considerable advances have been made in the field of assisted reproductive technology (ART), millions of couples still suffer from infertility and miscarriage. In a large number of cases, the etiology of these common reproductive failures remains unknown. However, the significance of autoantibodies in infertility and miscarriage has sparked extensive interest because of their pleiotropic roles in disrupting normal pregnancy. This review discusses the pleiotropic roles of a series of autoantibodies in infertility and miscarriage. A brief recapitulation of how the autoantibodies interfere with ART outcomes and treatments for this type of idiopathic infertility or miscarriage is also provided. While several disputes remain to be resolved, further studies employing better designs and larger sample sizes are required in view of the therapeutic potential of autoantibody inhibitors and the future of contraceptive vaccines.
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Progress in the application of ovarian and fallopian tube organoids p. 174
Yi-Lin Dai, Jin-Song Wei, Jing Xu, Ke Li, Jing Wang, Ran-Ran Cha, Yu Kang
DOI:10.4103/2096-2924.322840  
As an innovative in vitro culture model, organoids have been established by cell sorting and subsequent culture in three-dimensional culture systems. Organoids can be derived from induced pluripotent stem cells or organ-restricted adult stem cells. Compared with traditional two-dimensional cell culture models and patient-derived xenograft models, organoids possess long-term genetic stability and can better retain the characteristics of source tissues or organs. These advantages have led to the increased use of ovarian and fallopian tube organoids in various fields of research, including cell differentiation and development, establishment of disease occurrence and progression models, tissue regeneration and reconstruction, individual drug screening, immune cell co-culture, and maternal–fetal medicine. This review briefly summarizes the recent progress in the application of ovarian and fallopian tube organoids in the field of obstetrics and gynecology.
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Research Progress of In vitro Oocyte Maturation p. 183
Yuan-Xue Jing, Yi-Qing Wang, Hong-Xing Li, Feng Yue, Shi-Long Xue, Xue-Hong Zhang
DOI:10.4103/2096-2924.325827  
In vitro maturation (IVM) has been used in clinical settings for 30 years. The merits of IVM include that it needs a relatively small amount of hormones and short treatment period. However, because the effectiveness of IVM is lower than that of controlled ovarian hyperstimulation, there are few centers routinely use IVM, and it is only applicable to a few special populations. In this article, several oocyte sources related to IVM have been discussed and the effects of gonadotropin priming and triggering on IVM are described. Furthermore, we have reviewed the optimization of IVM culture conditions in recent years along with the effects of IVM on genes of oocytes and cumulus cells and the obstetric and neonatal outcomes. We aim to provide indications for future improvement of IVM technology so that the success rates of IVM technology in special populations can be improved. We hope that this mild and natural protocol can be applied to more populations, including individuals with normal ovulation.
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