Browsing by Author "Espinoza, Jimmy"

Now showing 1 - 14 of 14
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    A longitudinal study of angiogenic (placental growth factor) and anti-angiogenic (soluble endoglin and soluble vascular endothelial growth factor receptor-1) factors in normal pregnancy and patients destined to develop preeclampsia and deliver a small for gestational age neonate
    (TAYLOR & FRANCIS LTD, 2008) Romero, Roberto; Nien, Jyh Kae; Espinoza, Jimmy; Todem, David; Fu, Wenjiang; Chung, Hwan; Kusanovic, Juan Pedro; Gotsch, Francesca; Erez, Offer; Mazaki Tovi, Shali; Gomez, Ricardo; Edwin, Sam; Chaiworapongsa, Tinnakorn; Levine, Richard J.; Karumanchi, S. Ananth
    Introduction. Accumulating evidence suggests that an imbalance between pro-angiogenic (i.e., vascular endothelial growth factor (VEGF) and placental growth factor (PlGF)) and anti-angiogenic factors (i.e., soluble VEGF receptor-1 (sVEGFR-1, also referred to as sFlt1)) is involved in the pathophysiology of preeclampsia (PE). Endoglin is a protein that regulates the pro-angiogenic effects of transforming growth factor , and its soluble form has recently been implicated in the pathophysiology of PE. The objective of this study was to determine if changes in maternal plasma concentration of these angiogenic and anti-angiogenic factors differ prior to development of disease among patients with normal pregnancies and those destined to develop PE (preterm and term) or to deliver a small for gestational age (SGA) neonate.
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    A role for CXCL13 in the host response to intra-amniotic infection
    (2007) Nhan-Chang, Chia-Ling; Romero, Roberto; Kusanovic, Juan Pedro; Gotsch, Francesca; Edwin, Samuel S.; Erez, Offer; Mittal, Pooja; Espinoza, Jimmy; Friel, Lara; Vaisbuch, Edi; Than, Nandor Gabor; Mazaki-Tovi, Shali; Hassan, Sonia
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    A role for microRNAs - Key regulators of gene expression - In chorioamnionitis and parturition
    (2006) Montenegro, Daniel; Romero, Roberto; Pineles, Beth L.; Tarca, Adi L.; Kim, Yeon Mee; Draghici, Sorin; Kusanovic, Juan Pedro; Erez, Offer; Mazakitovi, Shali; Hassan, Sonia; Espinoza, Jimmy; Kim, Chong Jai
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    Early Rapid Growth, Early Birth: Accelerated Fetal Growth and Spontaneous Late Preterm Birth
    (2009) Lampl, Michelle; Kusanovic, Juan Pedro; Erez, Offer; Espinoza, Jimmy; Gotsch, Francesca; Goncalves, Luis; Hassa, Sonia; Gómez Mora, Ricardo Alberto; Nien Shy, Jyh-Kae; Edward A. Frongillo; Romero, Roberto
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    Evidence for a polarized Th1 response in the maternal circulation in women with preterm labor and intra-amniotic inflammation/infection
    (2006) Espinoza, Jimmy; Kusanovic, Juan Pedro; Hassan, Sonia; Edwin, Samuel S.; Gotsch, Francesca; Kim, Chong Jai; Than, Nandor Gabor; Erez, Offer; Nien, Jyh Kae; Gómez Mora, Ricardo Alberto; Yoon, Bo Hyun; Romer, Roberto
    OBJECTIVE: Most work examining the immune response to intra-amniotic infection has focused on the study of amniotic fluid (AF) cytokines. An adequate characterization of the full range of maternal pro- and antiinflammatory cytokines is lacking. This is important, because of emerging evidence that complications of infection result from an anti-inflammatory response. The purpose of this study was to characterize the maternal cytokine response in women with preterm labor with and without intra-amniotic infection/inflammation (IAI). STUDY DESIGN: This study focused on patients with preterm labor in the following groups: 1) term delivery (n = 157); 2) preterm delivery without IAI (n = 126); and 3) IAI (n = 50). IAI was defined as a positive AF culture or an elevated AF WBC count. Maternal plasma concentrations of interleukin (IL)-1b, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12p70, IL-13, interferon gamma, granulocyte-macrophage colony-stimulating factor, and tumor necrosis factor alpha were determined. A p!0.05 was considered significant. RESULTS: 1) Patients with IAI had higher plasma concentrations of IL-6 than those without IAI who delivered preterm [median: 12.5 pg/ml, range: 0-355.5 vs.7.4 pg/ml, range: 0.74-179.3; p = 0.04), and those who delivered at term (median: 5 pg/ml, range: 0-541.4; p = 0.01); 2) Patients with IAI had higher plasma concentrations of IL-8 than those who delivered at term (median:11.1 pg/ml, range: 0.29-82 vs. median: 6 pg/ml, range: 0.4-84.3; p = 0.02) but not than those without IAI who delivered preterm (median: 7.9, range: 1.3-90.2; pO0.05); and 3) There were no significant differences in the plasma concentrations of the rest of the cytokines (11 of 13) among groups. CONCLUSION: IL6 and IL8 are increased in the maternal circulation in cases of intra-amniotic infection/inflammation. The lack of a demonstrable anti-inflammatory response is in sharp contrast to what has been reported in non-pregnant patients
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    Growth Perturbations in a Phenotype with Rapid Fetal Growth Preceding Preterm Labor and Term Birth
    (WILEY, 2009) Lampl, Michelle; Kusanovic, Juan Pedro; Erez, Offer; Gotsch, Francesca; Espinoza, Jimmy; Goncalves, Luis; Lee, Wesley; Gomez, Ricardo; Kae Nien, Jyh; Frongillo, Edward A.; Romero, Roberto
    The variability in fetal growth rates and gestation duration in humans is not well understood. Of interest are women presenting with an episode of preterm labor and subsequently delivering a term neonate, who is small relative to peers of similar gestational age. To further understand these relationships, fetal growth patterns predating an episode of preterm labor were investigated. Retrospective analysis of fetal biometry assessed by serial ultrasound in a prospectively studied sample of pregnancies in Santiago, Chile, tested the hypothesis that fetal growth patterns among uncomplicated pregnancies (n = 3,706) and those with an episode of preterm labor followed by term delivery (n = 184) were identical across the time intervals 16-22 weeks, 22-28 weeks, and 28-34 weeks in a multilevel mixed-effects regression. The hypothesis was not supported. Fetal weight growth rate was faster from 16 weeks among pregnancies with an episode of preterm labor (P < 0.05), declined across midgestation (22-28 weeks, P < 0.05), and rebounded between 28 and 34 weeks (P = 0.06). This was associated with perturbations in abdominal circumference growth and proportionately larger biparietal diameter from 22 gestational weeks (P = 0.03), greater femur (P = 0.01), biparietal diameter (P = 0.001) and head circumference (P = 0.02) dimensions relative to abdominal circumference across midgestation (22-28 weeks), followed by proportionately smaller femur diaphyseal length (P = 0.02) and biparietal diameter (P = 0.03) subsequently. A distinctive rapid growth phenotype characterized fetal growth preceding an episode of preterm labor among this sample of term-delivered neonates. Perturbations in abdominal circumference growth and patterns of proportionality suggest an altered growth strategy pre-dating the preterm labor episode. Am. J. Hum. Biol. 21:782-792, 2009. (C) 2009 Wiley-Liss, Inc.
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    Low circulating maternal adiponectin in patients with pyelonephritis: adiponectin at the crossroads of pregnancy and infection
    (2010) Mazaki-Tovi, Shali; Romero, Roberto; Vaisbuch, Edi; Chaiworapongsa, Tinnakorn; Erez, Offer; Mittal, Pooja; Kwon Kim, Sun; Gotsch, Francesca; Lamont, Ronald; Ogge, Giovanna; Pacora, Percy; Goncalves, Luis; Jai Kim, Chong; Gómez Mora, Ricardo Alberto; Espinoza, Jimmy; Hassan, Sonia S.; Kusanovic, Juan Pedro
    Objective: An emerging theme in modern biology is that adipose tissue can respond to metabolic stress, and to inflammatory stimuli, by regulating the secretion of a complex network of soluble mediators, termed adipokines. Adiponectin, the most prevalent circulating adipokine in human, has profound insulin-sensitizing and anti-inflammatory properties. Indeed, the notion that adiponectin plays an important role in the interactions between the metabolic and the immune systems has been strongly suggested. Thus, the aim of this study was to determine if pyelonephritis during pregnancy is associated with changes in maternal serum adiponectin concentrations. Study design: This cross-sectional study included women in the following groups: 1) normal pregnant women (ns200); and 2) pregnant women with pyelonephritis (ns50). Maternal plasma adiponectin concentrations were determined by ELISA. Non-parametric statistics were used for analyses. Results: 1) The median maternal plasma adiponectin concentration was lower in patients with pyelonephritis than in those with a normal pregnancy (P-0.001); 2) among pregnant women with a normal weight, patients with pyelonephritis had a lower median plasma adiponectin concentration than those with a normal pregnancy (P-0.001); 3) similarly, among overweight/obese patients, those with pyelonephritis had a lower median plasma adiponectin concentration than those with a normal pregnancy (P-0.001); and 4) the presence of pyelonephritis was independently associated with maternal plasma adiponectin concentrations after adjustment for maternal age, smoking, gestational age at sampling, and pregestational body mass index (BMI). Conclusion: 1) The findings that acute pyelonephritis in pregnancy is characterized by low maternal plasma concentrations of adiponectin in both lean and overweight/obese patients are novel and concur with the antiinflammatory properties of adiponectin; and 2) the results of this study support the notion that adiponectin may play a role in the intricate interface between inflammation and metabolism during pregnancy
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    Plasma protein Z concentrations in pregnant women with idiopathic intrauterine bleeding and in women with spontaneous preterm labor
    (TAYLOR & FRANCIS LTD, 2007) Kusanovic, Juan Pedro; Espinoza, Jimmy; Romero, Roberto; Hoppensteadt, Debra; Nien, Jyh Kae; Kim, Chong Jai; Erez, Offer; Soto, Eleazar; Fareed, Jawed; Edwin, Sam; Chaiworapongsa, Tinnakorn; Than, Nador G.; Yoon, Bo Hyun; Gomez, Ricardo; Papp, Zoltan; Hassan, Sonia S.
    Objectives. Preterm parturition has been associated with decidual vascular disorders and excessive thrombin generation. The objective of this study was to examine maternal plasma concentrations of protein Z in normal pregnancies, as well as in those presenting with spontaneous preterm labor (PTL) and intrauterine bleeding during pregnancy.
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    Preeclampsia is characterized by a large number of neutrophils displaying a high amplitude of NAD(P)H metabolic oscillations: A link between intravascular inflammation, endothelial cell dysfunction and preeclampsia
    (2006) Espinoza, Jimmy; Kindzelski, Andrei; Kusanovic, Juan Pedro; Chaiworapongsa, Tinnakorn; Hassan, Sonia; Yoon, Bo Hyun; Petty, Howard; Romero, Roberto
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    Should Bilateral Uterine Artery Notching Be Used in the Risk Assessment for Preeclampsia, Small-for-Gestational-Age, and Gestational Hypertension?
    (WILEY, 2010) Espinoza, Jimmy; Kusanovic, Juan Pedro; Bahado Singh, Ray; Gervasi, Maria Teresa; Romero, Roberto; Lee, Wesley; Vaisbuch, Edi; Mazaki Tovi, Shali; Mittal, Pooja; Gotsch, Francesca; Erez, Offer; Gomez, Ricardo; Yeo, Lami; Hassan, Sonia S.
    Objective. The purpose of this study was to determine the value of bilateral uterine artery notching in the second trimester in the risk assessment for preeclampsia, gestational hypertension, and small-for-gestational-age (SGA) without preeclampsia. Methods. This prospective cohort study included 4190 singleton pregnancies that underwent ultrasound examination between 23 and 25 weeks' gestation. The 95th percentiles of the mean pulsatility index (PI) and resistive index (RI) of both uterine arteries were calculated. Multivariable logistic regression analyses were performed to determine if bilateral uterine artery notching is an independent explanatory variable for the occurrence of preeclampsia, early-onset preeclampsia (<= 34 weeks), late-onset preeclampsia (>34 weeks), gestational hypertension, and delivery of an SGA neonate without preeclampsia, while controlling for confounding factors. Results. (1) The prevalence of preeclampsia, early-onset preeclampsia, late-onset preeclampsia, SGA, and gestational hypertension were 3.4%, 0.5%, 2.9%, 10%, and 7.9%, respectively; (2) 7.2% of the study population had bilateral uterine artery notching; and (3) bilateral uterine artery notching was an independent explanatory variable for the development of preeclampsia (odds ratio [OR] 2.1; 95% confidence interval [CI], 1.28-3.36), early-onset preeclampsia (OR, 4.47; 95% CI, 1.50-13.35), and gestational hypertension (OR, 1.50; 95% CI, 1.02-2.26), but not for late-onset preeclampsia or SGA. Conclusions. Bilateral uterine notching between 23 and 25 weeks' gestation is an independent risk factor for the development of early-onset preeclampsia and gestational hypertension. Thus, bilateral uterine artery notching should be considered in the assessment of risk for the development of these pregnancy complications.
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    Spontaneous labor at term is characterized by specific differential expression of microRNAs: A novel mechanism for post-transcriptional gene expression regulation in human parturition
    (2006) Pineles, Beth L.; Romero, Roberto; Montenegro, Daniel; Kim, Jung-Sun; Tarca, Adi L.; Kusanovic, Juan Pedro; Mittal, Pooja; Hassan, Sonia; Espinoza, Jimmy; Kim, Chong Jai
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    The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age
    (TAYLOR & FRANCIS LTD, 2008) Erez, Offer; Romero, Roberto; Espinoza, Jimmy; Fu, Wenjiang; Todem, David; Kusanovic, Juan Pedro; Gotsch, Francesca; Edwin, Samuel; Nien, Jyh Kae; Chaiworapongsa, Tinnakorn; Mittal, Pooja; Mazaki Tovi, Shali; Than, Nandor Gabor; Gomez, Ricardo; Hassan, Sonia S.
    Introduction. An imbalance between angiogenic and anti-angiogenic factors has been proposed as central to the pathophysiology of preeclampsia (PE). Indeed, patients with PE and those delivering small-for-gestational age (SGA) neonates have higher plasma concentrations of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and the soluble form of endoglin (s-Eng), as well as lower plasma concentrations of vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) than do patients with normal pregnancies. Of note, this imbalance has been observed before the clinical presentation of PE or the delivery of an SGA neonate. The objective of this study was to determine if changes in the profile of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters are associated with a high risk for the subsequent development of PE and/or delivery of an SGA neonate.
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    Tissue factor and tissue pathway inhibitor: A link between a hemostatic disorder and preterm PROM?
    (2006) Erez, Offer; Espinoza, Jimmy; Chatworapongsa, Tinnakorn; Gotsch, Francesca; Kusanovic, Juan Pedro; Than, Nandor Gabor; Mazaki-Tovi, Shali; Papp, Zoltan; Yoon, Bo Hyun; Hoppensteadt, Debra; Fareed, Jawed; Hassan, Sonia; Romero, Roberto
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    Villitis of unknown etiology: The pathophysiologic equivalent of graft-versus-host disease in human pregnancy
    (2006) Kim, Chong Jai; Kim, Jung-Sun; Kim, Yeon Mee; Mazaki-Tovi, Shali; Friel, Lara; Kusanovic, Juan Pedro; Espinoza, Jimmy; Hassan, Sonia; Romero, Roberto