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HIV 感染合并妊娠高血压疾病的血管生成失衡研究述评

A Review of Angiogenic Imbalance in HIV-Infected Hypertensive Disorders of Pregnancy.

机构信息

Optics and Imaging Centre, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Private Bag 7, Congella, Durban, KwaZulu-Natal, 4013, South Africa.

Women's Health and HIV Research Group, Department of Obstetrics and Gynecology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.

出版信息

Curr Hypertens Rep. 2019 Jul 24;21(9):69. doi: 10.1007/s11906-019-0970-7.

Abstract

PURPOSE OF REVIEW

This review provides a comprehensive insight into the angiogenic profile of hypertensive and normotensive pregnancies compromised by HIV infection. Furthermore, we evaluate the economic implementation of the sFlt-1/PlGF ratio and review the reports on therapeutic apheresis in limiting sFlt-1 production.

RECENT FINDINGS

In preeclampsia, an increased expression of sFlt-1 triggers angiogenic imbalance. Women of African ancestry have high levels of angiogenic factors than other racial groups. The sFlt-1/PlGF ratio shows promise in the early assessment of preeclampsia, while sFlt-1 apheresis restores angiogenic imbalance. Studies suggest antiretroviral therapy does not impact the angiogenic shift in preeclampsia development. The angiogenic profile in pregnant women of different races influences preeclampsia development. Despite the opposing immune response in HIV infection and preeclampsia, the HIV tat protein strongly mimics vascular endothelial growth factor (VEGF); hence, it is plausible to assume that HIV infection may ameliorate the angiogenic imbalance in preeclampsia.

摘要

目的综述

本综述全面探讨了 HIV 感染致高血压和正常血压妊娠的血管生成特征。此外,我们评估了可溶性 fms 样酪氨酸激酶 1/胎盘生长因子(sFlt-1/PlGF)比值的经济实施情况,并综述了关于治疗性血浆去除术在限制 sFlt-1 产生方面的报告。

最近的发现

在子痫前期中,sFlt-1 的过度表达引发了血管生成失衡。与其他种族群体相比,非洲裔女性的血管生成因子水平较高。sFlt-1/PlGF 比值在子痫前期的早期评估中有一定的应用前景,而 sFlt-1 血浆去除术可恢复血管生成失衡。研究表明,抗逆转录病毒疗法并不影响子痫前期发展中的血管生成改变。不同种族孕妇的血管生成特征影响子痫前期的发生。尽管 HIV 感染和子痫前期的免疫反应相反,但 HIV tat 蛋白强烈模拟血管内皮生长因子(VEGF);因此,可以假设 HIV 感染可能改善子痫前期的血管生成失衡。

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