Browsing by Author "Kusanovic, Juan Pedro"

Now showing 1 - 12 of 12
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    Clinical chorioamnionitis at term II : the intra-amniotic inflammatory response
    (2016) Romero, Roberto; Chaemsaithong, Piya; Steven J. Korzeniewski; Tarca, Adi L.; Bhatti, Gaurav; Xu, Zhonghui; Kusanovic, Juan Pedro
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    Clinical chorioamnionitis at term IX : in vivo evidence of intra-amniotic inflammasome activation
    (2019) Gomez-López, Nardhy; Romero, Roberto; Maymon, Ely; Kusanovic, Juan Pedro; Panaitescu, Bogdan; Miller, Derek; Pacora, Percy; Tarca, Adi L.; Motomura, Kenichiro; Erez, Offer; Jung, Eunjung J.; Hassan, Sonia S.; Hsu, Chaur Dong
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    Clinical chorioamnionitis at term VI : acute chorioamnionitis and funisitis according to the presence or absence of microorganisms and inflammation in the amniotic cavity
    (2016) Romero, R.; Chaemsaithong, P.; Docheva, N.; Korzeniewski, S.; Kusanovic, Juan Pedro; Yoon, B.; Kim, J.; Chaiyasit, N.; Ahmed, A.; Qureshi, F.; Jacques, S.; Kim, C.; Hassan, S.; Chaiworapongsa, T.; Yeo, L.; Kim Y.
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    Evidence for a polarized Th1 response in the maternal circulation in women with preterm labor and intra-amniotic inflammation/infection
    (2006) Espinoza, Jimmy; Kusanovic, Juan Pedro; Hassan, Sonia; Edwin, Samuel S.; Gotsch, Francesca; Kim, Chong Jai; Than, Nandor Gabor; Erez, Offer; Nien, Jyh Kae; Gómez Mora, Ricardo Alberto; Yoon, Bo Hyun; Romer, Roberto
    OBJECTIVE: Most work examining the immune response to intra-amniotic infection has focused on the study of amniotic fluid (AF) cytokines. An adequate characterization of the full range of maternal pro- and antiinflammatory cytokines is lacking. This is important, because of emerging evidence that complications of infection result from an anti-inflammatory response. The purpose of this study was to characterize the maternal cytokine response in women with preterm labor with and without intra-amniotic infection/inflammation (IAI). STUDY DESIGN: This study focused on patients with preterm labor in the following groups: 1) term delivery (n = 157); 2) preterm delivery without IAI (n = 126); and 3) IAI (n = 50). IAI was defined as a positive AF culture or an elevated AF WBC count. Maternal plasma concentrations of interleukin (IL)-1b, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12p70, IL-13, interferon gamma, granulocyte-macrophage colony-stimulating factor, and tumor necrosis factor alpha were determined. A p!0.05 was considered significant. RESULTS: 1) Patients with IAI had higher plasma concentrations of IL-6 than those without IAI who delivered preterm [median: 12.5 pg/ml, range: 0-355.5 vs.7.4 pg/ml, range: 0.74-179.3; p = 0.04), and those who delivered at term (median: 5 pg/ml, range: 0-541.4; p = 0.01); 2) Patients with IAI had higher plasma concentrations of IL-8 than those who delivered at term (median:11.1 pg/ml, range: 0.29-82 vs. median: 6 pg/ml, range: 0.4-84.3; p = 0.02) but not than those without IAI who delivered preterm (median: 7.9, range: 1.3-90.2; pO0.05); and 3) There were no significant differences in the plasma concentrations of the rest of the cytokines (11 of 13) among groups. CONCLUSION: IL6 and IL8 are increased in the maternal circulation in cases of intra-amniotic infection/inflammation. The lack of a demonstrable anti-inflammatory response is in sharp contrast to what has been reported in non-pregnant patients
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    Gestational weight gain recommendations for Chilean women : a mathematical optimization approach
    (2018) Garmendia, M.L.; Matus, O.; Mondschein, S.; Kusanovic, Juan Pedro
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    Maternal and neonatal circulating visfatin concentrations in patients with pre-eclampsia and a small-for-gestational age neonate
    (TAYLOR & FRANCIS LTD, 2010) Mazaki Tovi, Shali; Vaisbuch, Edi; Romero, Roberto; Kusanovic, Juan Pedro; Chaiworapongsa, Tinnakorn; Kim, Sun Kwon; Nhan Chang, Chia Ling; Gomez, Ricardo; Savasan, Zeynep Alpay; Madan, Ichchha; Yoon, Bo Hyun; Yeo, Lami; Mittal, Pooja; Ogge, Giovanna; Gonzalez, Juan M.; Hassan, Sonia S.
    Objective. Maternal circulating visfatin concentrations are higher in patients with a small-for-gestational-age (SGA) neonate than in those who delivered an appropriate-for-gestational age (AGA) neonate or in those with pre-eclampsia. It has been proposed that enhanced transfer of visfatin from the foetal to maternal circulation may account for the high concentrations of maternal visfatin observed in patients with an SGA neonate. The aims of this study were: (1) to determine whether cord blood visfatin concentrations differ between normal neonates, SGA neonates and newborns of pre-eclamptic mothers; and (2) to assess the relationship between maternal and foetal circulating visfatin concentrations in patients with an SGA neonate and those with pre-eclampsia.
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    Maternal plasma concentrations of angiogenic/anti-angiogenic factors are of prognostic value in patients presenting to the obstetrical triage area with the suspicion of preeclampsia
    (TAYLOR & FRANCIS LTD, 2011) Chaiworapongsa, Tinnakorn; Romero, Roberto; Savasan, Zeynep Alpay; Kusanovic, Juan Pedro; Ogge, Giovanna; Soto, Eleazar; Dong, Zhong; Tarca, Adi; Gaurav, Bhatti; Hassan, Sonia S.
    Objective: To determine whether maternal plasma concentrations of placental growth factor (PlGF), soluble endoglin (sEng), soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and -2 could identify patients at risk for developing preeclampsia (PE) requiring preterm delivery. Study design: Patients presenting with the diagnosis "rule out PE" to the obstetrical triage area of our hospital at <37 weeks of gestation (n = 87) were included in this study. Delivery outcomes were used to classify patients into four groups: I) patients without PE or those with gestational hypertension (GHTN) or chronic hypertension (CHTN) who subsequently developed PE at term (n = 19); II): mild PE who delivered at term (n = 15); III): mild disease (mild PE, GHTN, CHTN) who subsequently developed severe PE requiring preterm delivery (n = 26); and IV): diagnosis of severe PE (n = 27). Plasma concentrations of PlGF, sEng, sVEGFR-1 and -2 were determined at the time of presentation by ELISA. Reference ranges for analytes were constructed by quantile regression in our laboratory (n = 180; 1046 samples). Comparisons among groups were performed using multiples of the median (MoM) and parametric statistics after log transformation. Receiver operating characteristic curves, logistic regression and survival analysis were employed for analysis. Results: The mean MoM plasma concentration of PlGF/sVEGFR-1, PlGF/sEng, PlGF, sVEGFR-1 and -2, and sEng in Group III was significantly different from Group II (all p<0.05). A plasma concentration of PlGF/sVEGFR-1 <= 0.05 MoM or PlGF/sEng <= 0.07 MoM had the highest likelihood ratio of a positive test (8.3, 95% CI 2.8-25 and 8.6, 95% CI 2.9-25, respectively), while that of PlGF <= 0.396 MoM had the lowest likelihood ratio of a negative test (0.08, 95% CI 0.03-0.25). The association between low plasma concentrations of PlGF/sVEGFR-1 (= 0.05 MoM) as well as that of PlGF/sEng (= 0.07 MoM) and the development of severe PE remained significant after adjusting for gestational age at presentation, average systolic and diastolic blood pressure, and a history of chronic hypertension [ adjusted odds ratio (OR) = 27 (95% CI 6.4-109) and adjusted OR 30 (95% CI 6.9-126), respectively]. Among patients who presented < 34 weeks gestation (n = 59), a plasma concentration of PlGF/sVEGFR-1 < 0.033 MoM identified patients who delivered within 2 weeks because of PE with a sensitivity of 93% (25/27) and a specificity of 78% (25/32). This cut-off was associated with a shorter interval-to-delivery due to PE [ hazard ratio = 6 (95% CI 2.5-14.6)]. Conclusions: Plasma concentrations of angiogenic/anti-angiogenic factors are of prognostic value in the obstetrical triage area. These observations support the value of these biomarkers in the clinical setting for the identification of the patient at risk for disease progression requiring preterm delivery.
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    Periodontitis and placental growth factor in oral fluids are early pregnancy predictors of gestational diabetes mellitus
    (2018) Chaparro, Alejandra; Zúñiga, Edgardo; Varas‐Godoy, Manuel; Albers, Daniela; Ramírez, Valeria; Hernández, Marcela; Kusanovic, Juan Pedro; Acuña‐Gallardo, Stephanie; Rice, Gregory; Illanes, Sebastián E.
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    Polymorphisms in maternal and fetal genes encoding for proteins involved in extracellular matrix metabolism alter the risk for small-for-gestational-age
    (TAYLOR & FRANCIS LTD, 2011) Edwards, Digna R. Velez; Romero, Roberto; Kusanovic, Juan Pedro; Hassan, Sonia S.; Mazaki Tovi, Shali; Vaisbuch, Edi; Kim, Chong Jai; Erez, Offer; Chaiworapongsa, Tinnakorn; Pearce, Brad D.; Bartlett, Jacquelaine; Friel, Lara A.; Salisbury, Benjamin A.; Anant, Madan Kumar; Vovis, Gerald F.; Lee, Min Seob; Gomez, Ricardo; Behnke, Ernesto; Oyarzun, Enrique; Tromp, Gerard; Menon, Ramkumar; Williams, Scott M.
    Objective. To examine the association between maternal and fetal genetic variants and small-for-gestational-age (SGA).
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    Preeclampsia is characterized by a large number of neutrophils displaying a high amplitude of NAD(P)H metabolic oscillations: A link between intravascular inflammation, endothelial cell dysfunction and preeclampsia
    (2006) Espinoza, Jimmy; Kindzelski, Andrei; Kusanovic, Juan Pedro; Chaiworapongsa, Tinnakorn; Hassan, Sonia; Yoon, Bo Hyun; Petty, Howard; Romero, Roberto
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    Spontaneous labor at term is characterized by specific differential expression of micrornas: A novel mechanism for post-transcriptional gene expression regulation in human parturition
    (2006) Pineles, Beth L.; Romero, Roberto; Montenegro, Daniel; Kim, Jung-Sun; Tarca, Adi L.; Kusanovic, Juan Pedro; Mittal, Pooja; Hassan, Sonia; Espinoza, Jimmy; Kim, Chong Jai
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    The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age
    (TAYLOR & FRANCIS LTD, 2008) Erez, Offer; Romero, Roberto; Espinoza, Jimmy; Fu, Wenjiang; Todem, David; Kusanovic, Juan Pedro; Gotsch, Francesca; Edwin, Samuel; Nien, Jyh Kae; Chaiworapongsa, Tinnakorn; Mittal, Pooja; Mazaki Tovi, Shali; Than, Nandor Gabor; Gomez, Ricardo; Hassan, Sonia S.
    Introduction. An imbalance between angiogenic and anti-angiogenic factors has been proposed as central to the pathophysiology of preeclampsia (PE). Indeed, patients with PE and those delivering small-for-gestational age (SGA) neonates have higher plasma concentrations of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and the soluble form of endoglin (s-Eng), as well as lower plasma concentrations of vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) than do patients with normal pregnancies. Of note, this imbalance has been observed before the clinical presentation of PE or the delivery of an SGA neonate. The objective of this study was to determine if changes in the profile of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters are associated with a high risk for the subsequent development of PE and/or delivery of an SGA neonate.