Department of Women's and Children's Health, Section of Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden.
Department of Medicinal Chemistry, Analytical Pharmaceutical Chemistry, Uppsala University, Uppsala, Sweden.
Am J Reprod Immunol. 2024 Jun;91(6):e13889. doi: 10.1111/aji.13889.
Preterm birth (PTB) is a leading cause of infant mortality and morbidity. The pathogenesis of PTB is complex and involves many factors, including socioeconomy, inflammation and infection. Asymmetric dimethylarginine, ADMA and symmetric dimethylarginine, SDMA are involved in labor as inhibitors of nitric oxide, a known relaxant of the uterine smooth muscles. Arginines are scarcely studied in relation to PTB and we aimed to investigate arginines (ADMA, SDMA and L-arginine) in women with spontaneous PTB and term birth.
The study was based on data from the population-based, prospective cohort BASIC study conducted in Uppsala County, Sweden, between September 2009 and November 2018. Arginines were analyzed by Ultra-High Performance Liquid Chromatography using plasma samples taken at the onset of labor from women with spontaneous PTB (n = 34) and term birth (n = 45). We also analyzed the inflammation markers CRP, TNF-R1 and TNF-R2 and GDF-15.
Women with spontaneous PTB had higher plasma levels of ADMA (p < 0.001), and L-Arginine (p = 0.03). In addition, inflammation marker, TNF-R1 (p = 0.01) was higher in spontaneous PTB compared to term birth. Further, in spontaneous PTB, no significant correlations could be observed when comparing levels of arginines with inflammation markers, except ADMA versus CRP.
These findings provide novel evidence for the potential involvement of arginines in the pathogenesis of spontaneous PTB and it seems that arginine levels at labor vary independently of several inflammatory markers. Further research is warranted to investigate the potential of arginines as therapeutic targets in the prevention and management of spontaneous PTB.
早产 (PTB) 是婴儿死亡和发病的主要原因。PTB 的发病机制复杂，涉及许多因素，包括社会经济状况、炎症和感染。不对称二甲基精氨酸 (ADMA) 和对称二甲基精氨酸 (SDMA) 作为已知的子宫平滑肌松弛剂一氧化氮的抑制剂，参与分娩。精氨酸在与 PTB 的关系方面研究甚少，我们旨在研究自发性 PTB 和足月分娩妇女的精氨酸（ADMA、SDMA 和 L-精氨酸）。
该研究基于瑞典乌普萨拉县进行的基于人群的前瞻性队列 BASIC 研究的数据，该研究于 2009 年 9 月至 2018 年 11 月进行。在自发性 PTB（n = 34）和足月分娩（n = 45）妇女分娩开始时使用超高效液相色谱法分析血浆样本中的精氨酸。我们还分析了炎症标志物 CRP、TNF-R1 和 TNF-R2 和 GDF-15。
自发性 PTB 妇女的 ADMA（p < 0.001）和 L-精氨酸（p = 0.03）血浆水平更高。此外，与足月分娩相比，自发性 PTB 中的炎症标志物 TNF-R1 （p = 0.01）更高。此外，在自发性 PTB 中，除了 ADMA 与 CRP 之间，当比较精氨酸与炎症标志物的水平时，无法观察到任何显著相关性。
这些发现为精氨酸在自发性 PTB 发病机制中的潜在作用提供了新的证据，并且似乎分娩时精氨酸水平的变化独立于几种炎症标志物。需要进一步研究以探讨精氨酸作为预防和管理自发性 PTB 的治疗靶点的潜力。
