Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Understanding the mechanisms of disease responsible for the syndrome of pre-eclampsia (PE) as well as early risk assessment is still a major challenge. Risk factors for PE are nulliparity, a family or own history of PE, pre-existing diabetes or increased body mass index, multiple pregnancy, maternal age, renal disease, hypertension or raised blood pressure at booking and chronic autoimmune disease. Other factors are thrombophilias and insulin resistance together with obesity. On the other hand identification of predictors of the development of pre-eclampsia would enhance the ability to diagnose women likely to develop pre-eclampsia before the onset of the disease and would improve their monitoring and enable to convey them to randomized trials for evaluating prophylactic treatment. A number of biochemical agents have been assessed as markers for predicting pre-eclampsia. None of them has been proved to be of clinical value yet. Much effort has been put into evaluating novel potential markers and their combination with other screening methods such as Doppler sonography. The most promising biochemical markers, to date, are placenta protein 13 (PP-13) as well as soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng). These markers allow screening at a relatively early stage and, most importantly, show relatively high predictive values and improved diagnostic performance if combined with first trimester Doppler sonography. However, until now, too little data are available to justify the clinical use of these markers. Large-scale prospective studies, assessing these markers, are important to advance progress in reducing maternal and perinatal morbidity and relieving the heavy burden of pre-eclampsia.
 ...
PMID:Predictors and risk factors of pre-eclampsia. 1885 8

Galectins regulate cell growth, proliferation, differentiation, apoptosis, signal transduction, mRNA splicing, and interactions with the extracellular matrix. Here we focus on the galectins in the reproductive system, particularly on a group of six galectins that first appears in anthropoid primates in conjunction with the evolution of highly invasive placentation and long gestation. Of these six, placental protein 13 (PP13, galectin 13) interacts with glycoproteins and glycolipids to enable successful pregnancy. PP13 is related to the development of a major obstetric syndrome, preeclampsia, a life-threatening complication of pregnancy which affects ten million pregnant women globally. Preeclampsia is characterized by hypertension, proteinuria, and organ failure, and is often accompanied by fetal loss and major newborn disabilities. PP13 facilitates the expansion of uterine arteries and veins during pregnancy in an endothelial cell-dependent manner, via the eNOS and prostaglandin signaling pathways. PP13 acts through its carbohydrate recognition domain that binds to sugar residues of extracellular and connective tissue molecules, thus inducing structural stabilization of vessel expansion. Further, decidual PP13 aggregates may serve as a decoy that induces white blood cell apoptosis, contributing to the mother's immune tolerance to pregnancy. Lower first trimester PP13 level is one of the biomarkers to predict the subsequent risk to develop preeclampsia, while its molecular mutations/polymorphisms that are associated with reduced PP13 expression are accompanied by higher rates of preeclampsia We propose a targeted PP13 replenishing therapy to fight preeclampsia in carriers of these mutations.
 ...
PMID:Galectin 13 (PP13) Facilitates Remodeling and Structural Stabilization of Maternal Vessels during Pregnancy. 3126 64

Objective: Preeclampsia (PE) is a multi-systemic complication of pregnancy often characterised with the onset of hypertension and proteinuria after 20 weeks of gestation. Today, PE is the leading cause of maternal and perinatal morbidity and mortality worldwide. An early detection of PE would allow a chance to plan the appropriate monitoring and for clinical management to be immediately done following early detection thus making prophylactic strategies much more effective. Materials and methods: This systematic review aims to evaluate the potential of the various serum biomarkers and diagnostic modalities (uterine artery Doppler, MAP, and maternal history) available for early prediction of PE with articles included and obtained through MEDLINE Full Text, Pubmed, Science Direct, ProQuest, SAGE, Taylor and Francis Online, Google Scholar, HighWire and Elsevier ClinicalKey. Results: Ninety-five articles were found that fulfilled all of our inclusion criteria. Placental growth factor (PlGF), pregnancy associated plasma protein A (PAPP-A), soluble fms-like tyrosine kinase (sFLT) and placental protein 13 (PP-13) were the most commonly studied biomarkers. Whereas uterine Doppler scanning and Mean Arterial Pressure (MAP) were the most commonly studied out of other modalities. Conclusion: Current evidence shows serum biomarkers such as PIGF, PP-13 and sFlt yielded the best results for a single biomarker with others having conflicting results. However, a combination model with other diagnostic modalities performed better than a single biomarker. In the future, new techniques will hopefully provide sets of multiple markers, which will lead to a screening program with clinically relevant performance. However further studies are required to improve current methods.
 ...
PMID:Evaluation of Serum Biomarkers and Other Diagnostic Modalities for Early Diagnosis of Preeclampsia. 3198 41