ON THE ISSUE OF THE RELATIONSHIP BETWEEN THE LEVEL OF HYPOXEMIA IN THE MOTHER AND THE EXPRESSION OF PROHIBITIN IN THE PLACENTA OF PREGNANT WOMEN WITH COVID-19 INFECTION
DOI:
https://doi.org/10.11603/24116-4944.2024.1.14752Keywords:
COVID-19, hypoxemia in a pregnant woman, placental dysfunction, prohibitin, mitochondrial dysfunctionAbstract
The aim of the study – to study the relationship between the oxygen saturation of pregnant women (SpO2) and the expression of the marker of mitochondrial/placental dysfunction prohibitin (PHB) in the placenta during COVID-19 infection.
Materials and Methods. Analysis of 58 histories of pregnancy and childbirth of women with a diagnosis of COVID-19 was carried out according to the data of the "Maternity House No. 2" of Odesa during the period from 01.11.2021 to 31.12.2022. Clinical and laboratory data on the course of pregnancy were analyzed, as well as perinatal outcomes for mother and fetus. PHB expression was studied by immunohistochemistry in 25 placentas of pregnant women with "covid" anamnesis and 20 placentas of healthy women. Statistical processing of the results was carried out using the Social Science Statistics online platform.
Results and Discussion. A significant percentage of women became ill in the 3rd trimester of pregnancy – 65.51%, in the 2nd trimester – 25.86%, and in the 1st – 8.62% (f=148.38358, p<0.00001). 53.4 % of women were diagnosed with bilateral polysegmental pneumonia, 6.9 % with left/right-sided pneumonia, 1.7 % with pneumonitis, and 6.9 % with hydropericardium. The SрO2 level was 95 % or more in 87.9 % of women; the SpO2 level within 90–94 % - in 2.06 %. 10.3 % of pregnant women needed oxygen support in ICU. Hyperexpression of PHB was detected in "post-covid" placentas (1.52±1.12 vs. 0.25±0.5; Uemp = 87.5, z=3.63182, p=0.00028); which was significantly associated with "covid" anamnesis (H=12.2933 (1, N=45); p=0.00045, RR=3.04, OR=9.5, 95 % CI 2.423–37.249) with a sensitivity of 79.2 % and specificity 71.4 %. A direct relationship was established between the level of SрO2 and the expression of PHB (r(23)=0.057; t=0.272; r2=0.003).
Conclusions. COVID-19 infection in pregnant women is accompanied by changes in the functional state of the placenta: overexpression of PHB probably indicates the "stress" of mitochondrial respiration and placental dysfunction like reflection of hypoxemia in the mother. The limited sample size requires further research.
References
Wang, C., Horby, P.W., Hayden, F.G., Gao, G.F. (2020) A novel coronavirus outbreak of global health concern. Lancet, 395(10223), 470-473. DOI: 10.1016/S0140-6736(20)30 185-9
Allotey, J., Stallings, E., Bonet, M., Yap, M., Chatterjee, S., Kew, T., Debenham, L., Llavall, A.C., Dixit, A., Zhou, D., Balaji, R., Lee, S.I., Qiu, X., Yuan, M., Coomar, D., Sheikh, J., Lawson, H., Ansari, K., van Wely, M., van Leeuwen, E., Kostova, E., Kunst, H., Khalil, A., Tiberi, S., Brizuela, V., Broutet, N., Kara, E., Kim, C.R., Thorson, A., Oladapo, O.T., Mofenson, L., Zamora, J., Thangaratinam, S (2020). Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ, 370:m3320. DOI: 10.1136/bmj.m3320
Djusad, S., Irwinda, R., Harzif, A.K., Surya, R., Wibowo, N., Saroyo, Y.B., Adjie, J.S. (2022) Determining laboratory parameters in pregnant women with severe COVID-19. SAGE Open Medicine, 10. DOI: 10.1177/20503121221132168.
Del Rio, C., Malani, P.N., Omer, S.B. (2021) Confronting the delta variant of SARS-CoV-2. JAMA, 326(11), 1001-1002. DOI: 10.1001/jama.2021.14811.
Wang, A.M., Berry, M., Moutos, C.P., Omere, C., Clark, S.M., Harirah, H.M., Jain, S., Olson, G.L., Pacheco, L.D., Saade, G.R., Saad, A.F. (2021. Association of the delta (B.1.617.2) variant of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) with pregnancy outcomes. Obstet Gynecol., 138(6), 838-841. DOI: 10.1097/AOG.0000000000004595.
Mahajan, N.N., Gajbhiye, R.K. (2023). Oxygen saturation in pregnant women with COVID-19: challenges in low-income and middle-income countries. AJOG, 228, 356-35. DOI: 10.1016/j.ajog.2022.10.017
Society for Maternal-Fetal Medicine. (2020). Management considerations for pregnant patients with COVID-19.2020. Retrieved from https://s3.amazonaws.com/cdn.smfm.org/media/2734/SMFM_COVID_Management_of_COVID_pos_preg_patients_2-2-21_(final).pdf .
Poon, L.C., Yang, H., Kapur, A., Melamed, N., Dao, B., Divakar, H., McIntyre, H.D., Kihara, A.B., Ayres-de-Campos, D., Ferrazzi, E.M., Di Renzo, G.C., Hod, M. (2021) Global interim guidance on coronavirus disease 2019 (COVID-19) during pregnancy and puerperium from FIGO and allied partners: information for healthcare professionals. Obstetric Anesthesia Digest, 41(1), 39-40. DOI: 10.1097/01.aoa.0000732512.61342.76
Eid, J., Stahl, D., Costantine, M.M., Rood, K.M. (2022) Oxygen saturation in pregnant individuals with COVID-19: time for re-appraisal? AJOG, 226, 813-816. DOI: 10.1016/j.ajog.2021.12.023.
Li, J., Wang, L., Ding, J., Cheng, Y., Diao, L., Li, L., Zhang, Y., Yin, T. (2022) Multiomics studies investigating recurrent pregnancy loss: an effective tool for mechanism exploration. Front. Immunol., 13, 1-12. DOI: 10.3389/fimmu.2022.826198.
Sferruzzi-Perri, A.N., Higgins, J.S., Vaughan, O.R., Murray, A.J., Fowden, A.L. (2019) Placental mitochondria adapt developmentally and in response to hypoxia to support fetal growth. PNAS, 116(5), 621-1626. DOI: 10.1073/pnas.1816056116.
Yoshinaka, T., Kosako, H., Yoshizumi, T., Furukawa, R., Hirano, Y., Kuge, O., Tamada, T., Koshiba, T. (2019) Structural basis of mitochondrial scaffolds by prohibitin complexes: insight into a role of the coiled-coil region. iScience., 19, 1065-1078. DOI: 10.1016/ j.isci.2019.08.056.
Huo, R., Zimmerman, K., Weiss R. M., Bowdler, N.C., Anderson, E. J. (2020) Cardiac-specific deletion of prohibitin-1 leads to fetal demise, gross mitochondrial abnormalities and heart failure in adolescent mice. Circulation Research, 127:A359. DOI: 10.1161/res.127.suppl_1.359
Youyang Qu, Csaba Konrad, C. Corey Anderson, Liping Qian, Tina Yin, Giovanni Manfredi, Costantino Iadecola, Ping Zhou (2020, April 15). Prohibitin S-nitrosylation is required for the neuroprotective effect of nitric oxide. Neuronal Cultures Journal of Neuroscience, 40(16), 3142-3151. DOI: 10.1523/JNEUROSCI.1804-19.2020.
Yoshimoto, F.K. (2020) The proteins of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2 or n-COV19), the cause of COVID-19. Protein J., 39(3), 198-216. DOI: 10.1007/s10930-020-09901-4.
Andersen, K.G., Rambaut, A., Lipkin, W.I., Holmes, E. C., and Garry, R. F. (2020). The proximal origin of SARS-CoV-2. Nature Medicine, 26, 450–452. DOI: 10.1038/s41591-020-0820-9.
Oyang, L., Li, J., Jiang, X., Lin, J., Xia, L. Yang, L. Tan, S., Wu, N., Han, Y., Yang, Y., Luo, X., Li, J., Liao, Q., Shi, Y., & Zhou, Y. (2022) The function of prohibitins in mitochondria and the clinical potentials. Cancer Cell International, 22, A:343. DOI: 10.1186/s12935-022-02765-x.
Khong, T.Y., Mooney, E.E., Ariel, L., Balmus, N.C., Boyd, T.K., Brundler, M.A., Derricott, H., Evans, M.J., Faye-Petersen, O.M., Gillan, J.E., Heazell, A.E., Heller, D.S., Jacques, S.M., Keating, S., Kelehan, P., Maes, A., McKay, E.M., Morgan, T.K, Nikkels, P.G., Parks, W.T., Redline, R.W., Scheimberg, I., Schoots, M.H., Sebire, N.J., Timmer, A., Turowski, G., Vander Voorn, J.P., van Lijnschoten, I., Gordijn, S.J. (2016) Sampling and definitions of placental lesions: Amsterdam placental workshop group consensus statement. Arch Pathol Lab Med., 140(7), 698-713. DOI: 10.5858/arpa.2015-0225-CC.
Informer Technologies Inc. LUCIA G version 4.7 by Laboratory Imaging.
Social Science Statistics. Retrieved from https://www.socscistatistics.com/tests/.
Raeisi, T., Mozaffari, H., Sepehri, N., Darand, M., Razi, B., Garousi, N., Alizadeh, M., Alizadeh, S. (2022) The negative impact of obesity on the occurrence and prognosis of the 2019 novel coronavirus (COVID-19) disease: a systematic review and meta-analysis. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 27, 893-911. DOI: 10.1007/s40519-021-01269-3.
Zheng, C., Huang, W.Y., Sun, F.H., Wong, M.C., Siu, P.M., Chen, X.K., Wong, S.H. (2023). Association of sedentary lifestyle with risk of acute and post-acute COVID-19 sequelae: a retrospective cohort study. The American Journal of Medicine, DOI: 10.1016/j.amjmed.2023.12.002.
Daskalakis, G., Psarris, A., Koutras, A., Fasoulakis, Z., Prokopakis, I., Varthaliti, A., Karasmani, C., Ntounis, T., Domali, E., Theodora, M., Antsaklis P., Pappa K.I., Papapanagiotou A. (2023). Maternal infection and preterm birth: from molecular basis to clinical implications. Children, 10(5), 907. DOI: 10.3390/children10050907.
Holland, O.J., Hickey, A.J.R., Alvsaker, A., Moran, S., Hedges, C., Chamley, L.W., Perkins, A.V. (2017) Changes in mitochondrial respiration in the human placenta over gestation. Placenta, 57, 102-112. DOI: 10.1016/j.placenta.2017.06.011.
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