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母体微生物组与妊娠高血压疾病,子痫前期。

Maternal microbiome and the hypertensive disorder of pregnancy, preeclampsia.

机构信息

Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana.

出版信息

Am J Physiol Heart Circ Physiol. 2020 Jan 1;318(1):H1-H10. doi: 10.1152/ajpheart.00469.2019. Epub 2019 Oct 18.

Abstract

Preeclampsia (PE) is a pregnancy-specific disorder that can be life threatening for both mother and baby. It is characterized by a new onset hypertension during the second half of pregnancy and affects ~300,000 women in the United States every year. There is no cure for PE, and the only effective treatment is delivery of the placenta and the fetus, which is often preterm. PE is believed to be a severe manifestation of placental dysfunction due to early angiogenic imbalances and inflammatory disturbances; however, the cause of this is unknown. The once thought "sterile" placenta now has been proposed to have a unique microbiome of its own. Under ideal conditions, the microbiome represents a balanced bacterial community that is important to the maintenance of a healthy environment. Dysbiosis of these communities may lead to inflammation that potentially contributes to adverse pregnancy outcomes, such as preterm birth and PE. Thus far, the female reproductive tract microbiome has been found to be influenced by periodontal disease, cardiometabolic complications, and maternal obesity, all of which have been identified as contributors to PE. This review will look at the maternal reproductive tract microbiome, evidence for and against, and its role in pregnancy and PE-related events as well as data from relevant mouse models that could be useful for further investigating the influence of the reproductive tract microbiome on the pathogenesis of PE.

摘要

子痫前期 (PE) 是一种妊娠特有的疾病,可对母婴生命造成威胁。它的特征是在妊娠后半期新出现的高血压,并影响美国每年约 30 万名妇女。PE 无法治愈,唯一有效的治疗方法是分娩胎盘和胎儿,这通常是早产。PE 被认为是由于早期血管生成失衡和炎症紊乱导致的胎盘功能障碍的严重表现;然而,其原因尚不清楚。曾经被认为“无菌”的胎盘现在被认为有自己独特的微生物组。在理想条件下,微生物组代表着一个平衡的细菌群落,对维持健康的环境很重要。这些群落的失调可能导致炎症,从而可能导致不良的妊娠结局,如早产和 PE。到目前为止,已经发现女性生殖道微生物组受牙周病、心血管代谢并发症和母体肥胖的影响,这些都被认为是 PE 的促成因素。这篇综述将探讨生殖道微生物组,包括其在妊娠和 PE 相关事件中的证据以及作用,以及来自相关小鼠模型的数据,这些数据可能有助于进一步研究生殖道微生物组对 PE 发病机制的影响。

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