Corticotrophin-releasing hormone and CRH-binding protein - Differences between patients at risk for preterm birth and hypertension
Corticotrophin-releasing hormone and CRH-binding protein - Differences between patients at risk for preterm birth and hypertension
复制标题
DOI：
10.1111/j.1749-6632.1999.tb07878.x
复制
发表时间：
1999-01-01
期刊：
影响因子：
--
通讯作者：
Korst, LM
中科院分区：
文献类型：
--
作者：
Hobel, CJ;Arora, CP;Korst, LM
背景资料：在妊娠中期和晚期，血浆CRH（被认为是由胎盘分泌的）逐渐升高，血浆CRH-BP使CRH失活，这可能阻止其对母体垂体和子宫肌层的外周作用。在妊娠的最后几周，CRH-BP降低，从而引起游离CRH或CRH/CRHBP复合物的增加，从而在分娩的开始中发挥作用，目的：我们测试了以下假设，即处于早产（PTB）和高血压（HYP）风险的患者中CRH、CRH-BP或CRH/CRH-BP复合物的差异解释了分娩时间的差异。从妊娠期行为研究数据库中，我们确定了18例自发性PTB患者和23例发生HYP的患者。两组均为足月分娩（正常）孕妇，分别于孕18-20、28-30、35-36周采集孕妇血浆，用双抗体RU试剂盒测定CRH水平，用免疫放射法测定CRH-BP，计算CRH-BP/CRH二聚体复合物指数，使用Kruskal-Wallis检验对两例病例进行统计分析，结果：与HYP病例相比，PTB病例中的母体CRH（pg/ml）在所有三个时间段均显著升高。与HYP病例相比，PTB病例中的母体CRH-BP（pg/ml）在所有三个时间段均显著降低，PTB组产妇CRH-BP/CRH二聚体复合物指数在所有三个时间段均显著低于对照组或HYP组，提示CRH过度。PTB组分娩时平均GA显著低于对照组或HYP组。这些结果表明，有PTB风险的患者CRH显著升高，CRH-BP降低，和CRH-BP/CRH二聚体复合物指数降低。
Background: During pregnancy in the second and third trimester there is a progressive rise in plasma CRH thought to be secreted by the placenta, plasma CRH-BP inactivates CRH, which may prevent its peripheral action on the maternal pituitary and myometrium. Zn the last few weeks of pregnancy CRH-BP decreases, thereby causing an increase In free CRH or a CRH/CRHBP complex available to play a role in the onset of parturition,Objective: We tested the hypothesis that differences In CRH, CRH-BP, or a CRH/CRH-BP complex in patients at risk for preterm birth (PTB) and hypertension (HYP) account for the differences in the timing of parturition,Methods: From a Behavior in Pregnancy Study database, we identified 18 patients a ho had spontaneous PTB and 23 patients who developed HYP. Both groups were case controlled and matched with patients who delivered at term (Normal), Maternal plasma samples had been appropriately collected from these patients at 18-20, 28-30, and 35-36 weeks gestational age, CRH levels were measured by double antibody RU kit and the CRH-BP by a immunoradiometric technique, ti CRH-BP/CRH dimer complex index was calculated, Statistical analysis was done using Kruskal-Wallis test for two cases,Results: Maternal CRH (pg/ml) in the PTB cases compared to the HYP cases was significantly elevated at all three time periods, Maternal CRH-BP (pg/ml) In the PTB versus HYP cases was significantly lower at all three time periods in the PTB cases compared to the HYP cases, Maternal CRH-BP/CRH dimer complex index was significantly lower in the PTB cases at all three time periods than either the controls or the HYP cases, suggesting excessive CRH, The mean GA at delivery for the PTB eases was significantly lower than the control or HYP cases,Conclusions: These results suggest that those patients at risk for PTB have significantly elevated CRH, lower CRH-BP, and a reduced CRH-BP/CRH dimer complex index at all three time periods of assessment.