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The role of soluble e-selectin and thrombospondin-2 in HIV associated preeclampsia.

dc.contributor.advisorNaicker, Thajasvarie.
dc.contributor.authorNaidoo, Girija.
dc.date.accessioned2020-09-10T16:33:05Z
dc.date.available2020-09-10T16:33:05Z
dc.date.created2019
dc.date.issued2019
dc.descriptionMasters Degree. University of KwaZulu-Natal, Durban.en_US
dc.description.abstractObjective: HIV infection and hypertensive disorders of pregnancy are common causes of maternal mortality in South Africa. Preeclampsia (PE) is a pregnancy-specific disorder that contributes to the majority of maternal deaths caused by hypertension in pregnancy. Reduced placentation, endothelial dysfunction of multiple organs and inflammation occur during PE. Endothelial cells express the adhesion molecule soluble E-selectin (sE-selectin) in response to inflammation. This molecule facilitates the cohesion of leukocytes to endothelial cells. In PE, endothelial cell activation and dysfunction cause endothelial cells to secrete the glycoprotein thrombospondin-2 (TSP-2). TSP-2 affects cellular functions, plays a regulatory role in the extracellular matrix and is an inhibitor of angiogenesis. In PE, an imbalance of angiogenic and anti-angiogenic factors result in dysregulation of angiogenesis. Considering the high rate of maternal mortality in South Africa due to HIV infection and PE, the aim of this study was to investigate the role of sE-selectin and TSP-2 in HIV-associated preeclamptic and normotensive pregnancies. Method: The study population (n = 72) comprised of normotensive pregnant (n = 36) and preeclamptic (n = 36) groups. These groups were further stratified by HIV status (negative vs. positive). The Bio-Plex immunoassay technique was used to measure serum concentrations of sE-selectin and TSP-2. Results: There was a statistical difference observed in gestational age, systolic blood pressure, diastolic blood pressure and baby weight across the study groups (p < 0.0001). sE-selectin: Based on pregnancy type and HIV status, levels of serum sE-selectin were significantly increased in preeclamptic HIV-negative compared to normotensive HIV-negative groups (p = 0.0070). TSP-2: Regardless of HIV status and based on pregnancy type, TSP-2 levels were significantly elevated (p = 0.0429) in preeclamptic compared to normotensive groups. Based on HIV status, a significant upregulation (p = 0.0095) of TSP-2 was noted in HIV-positive compared to HIV-negative groups. Furthermore, based on pregnancy type and HIV status, levels of TSP-2 were statistically significant across all study groups (p = 0.0229). Conclusion: This study highlights the role of sE-selectin and TSP-2 in preeclamptic women compromised by HIV infection and demonstrates the potential biomarker value of sE-selectin and TSP-2 in the early diagnosis of preeclampsia.en_US
dc.description.notesisiZulu Abstract Inhloso: Ukungenwa yigcinwane leSandulela-ngculazi nezinkinga zempilo ezihlobene nephika kubantu abakhulelwe yizona eziyimbangela evamile yokushona kwabesifazane uma bebeletha eNingizimu Afrika. I-Preeclampsia (PE) wuhlobo lokugula oluhambisana nokukhulelwa okuyilona oluvame ukuba yimbangela yokushona kwababelethayo okudalwa yiphika ngesikhathi bekhulelwe. Uma umuntu ene-PE inhliziyo ishaya kancane, amaphaphu akhe nezinye izingxenye ezingaphakathi emzimbeni zingasebenzi kahle futhi abe nezinhlungu. Ngenxa yezinhlungu, izicubu zamaphaphu azibe zisavuma ukudonsa kalula umoya emaphashini okuyisimo semolekhyuli esibizwa nge-sE-selectin. Le molekhyuli isiza ukudluliseleni umoya onempilo ezicutshini zamphaphu. Uma une-PE, ukusebenza nokungasebenzi kwezicubu zamaphaphu kwenza ukuthi lezi zicubu zikhiqize uketshezi olulimaza amaphrotheni i-thrombospondin-2 (TSP-2). I-TSP-2 iphazamisa ukusebenza kwezicubu zamaphaphu, idlale indima ekuphazamisekeni kokwakheka kwezicubu zamaphaphu futhi icindezela uketshezi olusiza ukuvuselela izicubu zamaphaphu, i-angiogenesis. Uma une-PE, ukungahambisani ngendlela kokwakhela nokungakheki kwezicubu ezintsha emaphashini kuholela ekutheni i-angiogenesis ingabe isasebenza ngendlela. Ngokubona amazinga aphezulu okushona kwabantu bebeletha eNingizimu Afrika ngenxa yokuhaqwa yiHIV nePE, inhloso yalolu cwaningo bekungukuphenya iqhaza le-sE-selectin ne-TSP-2 kubantu abakhulelwe abanomfutho wegazi ophezulu nabangenawo umfutho wegazi ophezulu. Uhlelo Olulandeliwe: Abantu ababambe iqhaza ocwaningweni (n = 72) bahlanganise amaqoqo abantu abakhulelwe abangenawo umfutho wegazi ophezulu (n = 36) nabanomfutho wegazi ophezulu (n = 36). Lawa maqoqo aphinde ahlukaniswa ngesimo sawo seHIV (abahaqekile nabangahaqekile). Kusetshenziswe uhlelo lokubheka isibalo samasosha omzimba lwe-Bio-Plex ukuze kubhekwe ubungako be-sE-selectin ne-TSP-2 egazini kwababambe iqhaza. Imiphumela: Ngokwemininingwane eqoqiwe ubonakele umehluko uma kuqhathaniswa izikhathi zokukhulelwa, umfutho wegazi odalwa yizicubu nalowo odalwa wukusebenza kwemithambo kanjalo nesisindo sengane kuwona wonke amaqoqo abeyingxenye yocwaningo (p < 0.0001).en_US
dc.identifier.urihttps://researchspace.ukzn.ac.za/handle/10413/18661
dc.language.isoenen_US
dc.subject.otherPreeclampsia (PE).en_US
dc.subject.otherHIV infection.en_US
dc.subject.otherHypertensive disorders.en_US
dc.subject.otherE-selectin.en_US
dc.subject.otherGlycoprotein thrombospondin-2 (TSP-2).en_US
dc.titleThe role of soluble e-selectin and thrombospondin-2 in HIV associated preeclampsia.en_US
dc.typeThesisen_US

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