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Purpose: Follistatin levels increase during the course of pregnancy and may play a role in ovarian arrest, reflected by the simultaneous decrease of anti-mullerian-hormone (AMH) levels. The aim of the study was to investigate AMH and follistatin levels during the hormonal window at the beginning of pregnancy. Since both parameters are described as deregulated in polycystic ovarian syndrome (PCOS), subgroup analysis of PCOS patients may additionally elucidate their interplay and effects on ovarian activity., Methods: Serum samples were retrospectively analyzed using the AMH Gen II ELISA and the Human Follistatin Quantikine ELISA Kit. Samples were collected longitudinally from 57 patients (32 with PCOS and 25 controls) before conception and during the first trimester. In 18 patients, measurements from the early and the late first trimester were available. Potential associations of AMH and follistatin levels with PCOS-related parameters were compared between the subgroups as well as longitudinally before and in the first trimester of pregnancy. For statistical analysis, the Spearman's correlation, Wilcoxon test, t test, Friedman test and multiple linear regression analysis was performed., Results: In contrast to AMH, follistatin levels differed not between controls and PCOS patients before and in pregnancy. In both subgroups, AMH levels significantly decreased and follistatin levels significantly increased in longitudinally performed measurements before conceiving and in the first trimester of pregnancy., Conclusion: Follistatin levels are not suited as a biomarker for PCOS, but could be involved in suppressing ovarian activity, as reflected by AMH levels at the beginning of pregnancy.

Problem: CEACAM1 and CEACAM6 belong to the carcinoembryonic antigen (CEA) family and may play an immune-modulatory role during pregnancy. The aim of the study was to determine the blood serum levels of soluble CEACAM1 and CEACAM6 over the course of pregnancy and postpartum., Method of Study: CEACAM1 and CEACAM6 levels were determined with customized in-house Sandwich-enzyme-linked immunosorbent assay (ELISA) systems. The study population (n=125) was divided into four groups according to the pregnancy trimester and postpartum. Additionally, samples of non-pregnant women (n=14) were analyzed., Results: Serum levels of CEACAM1 in healthy pregnant women were much lower than in non-pregnant women, a difference not seen for CEACAM6. Comparison between the trimesters and postpartum revealed a significant difference in CEACAM1 serum levels. The highest CEACAM1 levels were detected in third trimester. These levels were statistically significantly different from the CEACAM1 levels in first trimester and second trimester. The lowest levels were observed in the second trimester. Postpartum CEACAM1 serum concentrations were slightly lower than in the third trimester, but higher than in the first trimester and significantly higher compared to levels in the second trimester., Conclusion: Decreased concentration of CEACAM1 during the pregnancy suggests its regulatory role in the immune tolerance during the course of pregnancy., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Problem: T‐cells are key players in fighting the coronavirus disease 2019 (COVID‐19). The checkpoint molecule B7‐H4, a member of the B7 family, can inhibit T‐cell activation and proliferation by inhibiting NF‐kb expression. We aimed to elucidate the immunological role of soluble B7‐H4 (sB7‐H4) and B7‐H4 in pregnant women suffered from an acute Sars‐Cov2 infection. Methods: Expression levels of sB7‐H4 and cytokines were detected by enzyme linked immunosorbent assay. B7‐H4 and cytokines mRNA expression was analyzed by qPCR, and B7‐H4 and NF‐κb (p65) protein levels were investigated by western blot and immunofluorescence staining in placenta chorionic villous and decidual basalis tissues of COVID‐19 affected women and healthy controls. Results: Fibrinoid necrosis in the periphery of placental villi was increased in the COVID‐19‐affected patients. sB7‐H4 protein in maternal and cord blood serum and IL‐6/IL‐10 were increased while leukocytes were decreased during SARS‐CoV‐2 infection. Serum sB7‐H4 level was increased according to the severity of SARS‐Cov‐2 infection. Cytokines (IL‐6, IL‐18, IL‐1β, TNF‐α), B7‐H4 mRNA and protein in the decidual basalis tissues of COVID‐19‐infected pregnant women were significantly increased compared to healthy controls. IL‐18 and IL‐1β were significantly increased in the placenta chorionic villous samples of COVID‐19 affected patients, while NF‐κb (p65) expression was decreased. Conclusions: The expression of the immunological marker sB7‐H4 correlated with the severity of COVID‐19 disease in pregnant women. sB7‐H4 and B7‐H4 can be used to monitor the progression of COVID‐19 infection during pregnancy, and for evaluating of the maternal immune status. [ABSTRACT FROM AUTHOR]

Problem: The aim of this study was to evaluate the soluble programmed death‐ligand (sPD‐L1) and soluble B7‐H4 (sB7‐H4) serum concentration levels longitudinal throughout the three trimesters of uncomplicated pregnancies. Method of the study: sPD‐L1 and sB7‐H4 levels were determined with enzyme‐linked immunosorbent assay (ELISA). The patients (n = 26) were divided into three groups according to the pregnancy trimester. Among 26 women involved in the study 14 had longitudinal sB7‐H4 and sPD‐L1 measurements in each trimester of pregnancy. Results: During the course of pregnancy, the sB7‐H4 blood serum levels were significant higher in second trimester than in first and third trimester, whereas sPD‐L1 levels increased significantly over the course of pregnancy. Conclusion: The highest serum levels of sPD‐L1 in the third trimester suggest increasing suppression of maternal immunity throughout pregnancy, whereas elevated sB7‐H4 concentration levels in second trimester suggests different profile of T‐cell regulation in physiological pregnancy. [ABSTRACT FROM AUTHOR]

Purpose: Oxidative stress is involved in the pathogenesis of hypertensive disorders such as preeclampsia (PE) and associated with the human vitamin E-binding protein afamin. The aim of this study was, therefore, to analyse afamin in the first trimester of patients developing PE later in pregnancy and in control subjects without pregnancy complications.Methods: In this retrospective study, 137 serum samples from the first trimester of pregnancy were analysed in a case-control study design. 39 patients developed PE (10 patients with early-onset and 29 patients with late onset disease) and 98 women had an uncomplicated pregnancy. Mann-Whitney U test, t test, logistic regression and ROC analyses were performed for statistical evaluation.Results: Pregnant women developing PE presented with higher afamin concentrations in the first trimester [median 101.81 mg/L; interquartile range (IQR) 88.94-113.26] compared to subjects with uncomplicated pregnancy (median 86.40; IQR 75.26-96.92; p < 0.001). After adjusting for confounders, the odds ratio per afamin standard deviation was 1.60 (95% CI: 1.04-2.58; p = 0.04). An afamin threshold concentration of 87.8 mg/L exhibited the best sensitivity (79.5%) and specificity (57.1%) in predicting PE. Subgroup analysis of early- and late-onset disease resulted in substantially higher afamin concentrations in women with developing late-onset PE compared to controls (p < 0.001) with an odds ratio per afamin standard deviation of 1.62 (95% CI: 0.98-2.70; p = 0.06).Conclusions: Serum afamin concentrations are elevated in the first trimester among patients developing PE compared to controls. Substantial differences were observed mainly among patients with late-onset PE. [ABSTRACT FROM AUTHOR]

Problem To determine the association between maternal soluble B7-H4 (sB7-H4) and the preterm premature rupture of the amniotic membranes (pPROM), the blood serum concentration levels of sB7-H4 were studied. Method of study Maternal serum levels of sB7-H4 were determined with enzyme-linked immunosorbent assay (ELISA) in patients between 11 and 13 weeks' gestation who later on in the pregnancy developed pPROM (n=21), premature rupture of the amniotic membranes at term (n=18), and in control group (n=27). Results The highest serum levels of sB7-H4 were found in patients who developed pPROM. An OR of 1.39 (95%-CI: 1.17-1.77; P=.002) per ng/mL sB7-H4 indicated an increased risk for developing pPROM, with some predictive ability to discriminate between pPROM cases and controls (AUC=.81). Conclusion Increased serum levels of sB7-H4 in early pregnancy in pPROM cases may indicate the dynamics of the immune response at the feto-maternal interface and, thus, may serve as a predictive marker for this pregnancy complication. [ABSTRACT FROM AUTHOR]

Problem B7-H4, a transmembrane protein that negatively regulates T lymphocytes, seems to play a role in the suppression of the im\mune response at the maternal-fetal interface. The aim of this study was to compare the blood serum concentration levels of soluble B7-H4 ( sB7-H4) prepartal and postpartal in both women who experienced spontaneous onset of labor and those who underwent elective cesarian section. Method of study Blood was obtained from 30 prepartal and postpartal women who delivered at the University Hospital of Essen between 2011 and 2012. These patients were further divided into two subgroups depending on the advancement of labor. The sB7-H4 blood serum concentration levels of the women in the groups were then determined by ELISA ( BIOZOL, Eching, Germany). Results In women who underwent elective cesarian section, a significant increase in sB7-H4 blood serum concentration levels occurred postpartal, while in women who experienced spontaneous onset of labor, no differences between prepartal and postpartal concentration levels were observed. The sB7-H4 blood serum concentration levels on the day after delivery in the women who experienced spontaneous labor and those who underwent elective cesarian section were comparable; however, higher blood serum concentration levels of sB7-H4 were observed prepartal in women with spontaneous onset of labor compared to those found in the women about to undergo elective cesarian section. Conclusion These changes in sB7-H4 blood serum concentration levels suggest that this protein is involved in immunological changes associated with the spontaneous onset of labor and post-delivery homeostasis. [ABSTRACT FROM AUTHOR]

Abstract Research question What are the trends in anti-Müllerian hormone (AMH) concentrations from pre-conception to the third trimester of pregnancy in women with polycystic ovary syndrome (PCOS)? Design Observational study including cross-sectional and longitudinal data analysis. The Beckman Coulter AMH Gen II Assay was used to determine AMH levels longitudinally before pregnancy from 52 women with PCOS and 51 controls during all trimesters. Differences in AMH levels across successive stages of pregnancy were examined with the Wilcoxon signed-rank test for paired values. Linear regression models, adjusted for body-mass index (BMI), gestational and maternal age were used to compare AMH levels of PCOS and controls. Results AMH levels decreased significantly (all P < 0.05) from pre-pregnancy level throughout each trimester in women with PCOS and healthy controls. After adjusting for maternal age, gestational age and maternal BMI, AMH levels before pregnancy were 1.89 (95% CI 1.46 to 2.44; P < 0.0001) times higher among women with PCOS compared with controls (median 7.66 versus 2.67 ng/ml). During the first trimester, AMH levels were 1.61 (95% CI 1.22 to 2.13; P = 0.001) times higher among women with PCOS compared with controls (median 5.33 versus 2.48 ng/ml). Differences in AMH levels between women with PCOS and controls in the second trimester (1.68 times higher; 95% CI 0.94 to 3.01; median: 5.50 versus 2.20 ng/ml) and the third trimester (1.45 times higher; 95% CI 1.01 to 2.07; median: 1.36 versus 1.06 ng/ml) were not statistically significant. Conclusion These findings indicate a pregnancy-associated AMH-decline independent of pre-pregnancy elevated AMH levels. [ABSTRACT FROM AUTHOR]