Florio P, Severi F M, Luisi S, Ignacchiti E, Calonaci G, Bocchi C, Petraglia F
Chair of Obstetrics and Gynecology, Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy.
Biol Neonate. 2003;84(4):281-6. doi: 10.1159/000073635.
Inhibin A and inhibin B are glycoprotein hormones produced by human placenta and by several fetal organs during pregnancy. They are secreted in maternal circulation in increasing amounts from early until term pregnancy, and in umbilical cord blood levels are significantly lower than in maternal serum and do not differ from mid-pregnancy to term gestation. In the present study, we aimed to determine whether secretion of inhibin A and inhibin B into the fetal circulation is increased in pregnancies complicated by umbilical-placental vascular insufficiency. A group of women (n = 13) with abnormal Doppler umbilical artery flow velocimetry and a group of control women (n = 11) with uncomplicated term pregnancies and normal umbilical artery flow velocity waveforms were studied. In each woman, inhibin A and inhibin B concentrations were estimated in umbilical cord artery and vein. In the two groups of women, mean inhibin A levels did not differ between umbilical cord artery and vein. In addition, no difference was retrieved both in umbilical cord artery and vein values between healthy controls and patients with abnormal Doppler umbilical artery flow velocimetry. On the contrary, inhibin B levels were significantly higher in samples from umbilical cord vein than artery, in both groups of pregnant women (both p < 0.001). However, women with abnormal Doppler umbilical artery flow velocimetry had inhibin B levels significantly higher than healthy controls (p = 0.005) only in the umbilical cord artery, but not in the vein. In the presence of abnormal Doppler umbilical artery flow velocity, the concentrations of inhibin B are increased in the arterial umbilical circulation, suggesting that inhibin B is released from multiple fetal sources as a response to hypoxemic stress. As inhibins may affect the hypothalamus-pituitary-adrenal axis which plays an important role in the mechanisms of adaptations to the post-natal life, inhibin B in fetal circulation might then be beneficial to a fetus whose intrauterine survival is threatened by impaired umbilical-placental blood flow.
抑制素A和抑制素B是由人胎盘以及孕期的几个胎儿器官产生的糖蛋白激素。从妊娠早期到足月，它们在母体循环中的分泌量不断增加，而在脐带血中的水平显著低于母体血清，且从妊娠中期到足月并无差异。在本研究中，我们旨在确定在合并脐-胎盘血管功能不全的妊娠中，抑制素A和抑制素B向胎儿循环中的分泌是否增加。研究了一组多普勒脐动脉血流速度测定异常的女性（n = 13）和一组足月妊娠无并发症且脐动脉血流速度波形正常的对照女性（n = 11）。在每位女性中，估计了脐动脉和脐静脉中抑制素A和抑制素B的浓度。在两组女性中，脐动脉和脐静脉中的平均抑制素A水平并无差异。此外，健康对照组和多普勒脐动脉血流速度测定异常的患者在脐动脉和脐静脉的值上均未发现差异。相反，在两组孕妇中，脐静脉样本中的抑制素B水平均显著高于动脉样本（均p < 0.001）。然而，多普勒脐动脉血流速度测定异常的女性仅在脐动脉中抑制素B水平显著高于健康对照组（p = 0.005），而在静脉中并非如此。在存在多普勒脐动脉血流速度异常的情况下，脐动脉循环中抑制素B的浓度增加，这表明抑制素B是作为对低氧应激的反应从多个胎儿来源释放的。由于抑制素可能影响下丘脑-垂体-肾上腺轴，而该轴在适应产后生活的机制中起重要作用，那么胎儿循环中的抑制素B可能对其宫内生存受到脐-胎盘血流受损威胁的胎儿有益。
