TY  - JOUR
A1  - Neuhaus, Winfried
A1  - Schlundt, Marian
A1  - Fehrholz, Markus
A1  - Ehrke, Alexander
A1  - Kunzmann, Steffen
A1  - Liebner, Stefan
A1  - Speer, Christian P.
A1  - Förster, Carola Y.
T1  - Multiple Antenatal Dexamethasone Treatment Alters Brain Vessel Differentiation in Newborn Mouse Pups
JF  - PLoS One
N2  - Antenatal steroid treatment decreases morbidity and mortality in premature infants through the maturation of lung tissue, which enables sufficient breathing performance. However, clinical and animal studies have shown that repeated doses of glucocorticoids such as dexamethasone and betamethasone lead to long-term adverse effects on brain development. Therefore, we established a mouse model for antenatal dexamethasone treatment to investigate the effects of dexamethasone on brain vessel differentiation towards the blood-brain barrier (BBB) phenotype, focusing on molecular marker analysis. The major findings were that in total brains on postnatal day (PN) 4 triple antenatal dexamethasone treatment significantly downregulated the tight junction protein claudin-5, the endothelial marker Pecam-1/CD31, the glucocorticoid receptor, the NR1 subunit of the N-methyl-D-aspartate receptor, and Abc transporters (Abcb1a, Abcg2 Abcc4). Less pronounced effects were found after single antenatal dexamethasone treatment and in PN10 samples. Comparisons of total brain samples with isolated brain endothelial cells together with the stainings for Pecam-1/CD31 and claudin-5 led to the assumption that the morphology of brain vessels is affected by antenatal dexamethasone treatment at PN4. On the mRNA level markers for angiogenesis, the sonic hedgehog and the Wnt pathway were downregulated in PN4 samples, suggesting fundamental changes in brain vascularization and/or differentiation. In conclusion, we provided a first comprehensive molecular basis for the adverse effects of multiple antenatal dexamethasone treatment on brain vessel differentiation.
KW  - endothelial cells
KW  - protein expression
KW  - central nervous system
KW  - mouse models
KW  - pregnancy
KW  - tight junctions
KW  - sheep
KW  - angiogenesis
Y1  - 2015
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-125471
VL  - 10
IS  - 8
ER  - 
TY  - JOUR
A1  - Sitter, Magdalena
A1  - Pecks, Ulrich
A1  - Rüdiger, Mario
A1  - Friedrich, Sabine
A1  - Fill Malfertheiner, Sara
A1  - Hein, Alexander
A1  - Königbauer, Josefine T.
A1  - Becke-Jakob, Karin
A1  - Zöllkau, Janine
A1  - Ramsauer, Babett
A1  - Rathberger, Katharina
A1  - Pontones, Constanza A.
A1  - Kraft, Katrina
A1  - Meybohm, Patrick
A1  - Härtel, Christoph
A1  - Kranke, Peter
T1  - Pregnant and postpartum women requiring intensive care treatment for COVID-19 — first data from the CRONOS-registry
JF  - Journal of Clinical Medicine
N2  - (1) Background: Data on coronavirus 2 infection during pregnancy vary. We aimed to describe maternal characteristics and clinical presentation of SARS-CoV-2 positive women requiring intensive care treatment for COVID-19 during pregnancy and postpartum period based on data of a comprehensive German surveillance system in obstetric patients. (2) Methods: Data from COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS), a prospective multicenter registry for SARS-CoV-2 positive pregnant women, was analyzed with respect to ICU treatment. All women requiring intensive care treatment for COVID-19 were included and compared regarding maternal characteristics, course of disease, as well as maternal and neonatal outcomes. (3) Results: Of 2650 cases in CRONOS, 101 women (4%) had a documented ICU stay. Median maternal age was 33 (IQR, 30–36) years. COVID-19 was diagnosed at a median gestational age of 33 (IQR, 28–35) weeks. As the most invasive form of COVID-19 treatment interventions, patients received either continuous monitoring of vital signs without further treatment requirement (n = 6), insufflation of oxygen (n = 30), non-invasive ventilation (n = 22), invasive ventilation (n = 28), or escalation to extracorporeal membrane oxygenation (n = 15). No significant clinical differences were identified between patients receiving different forms of ventilatory support for COVID-19. Prevalence of preterm delivery was significantly higher in women receiving invasive respiratory treatments. Four women died of COVID-19 and six fetuses were stillborn. (4) Conclusions: Our cohort shows that progression of COVID-19 is rare in pregnant and postpartum women treated in the ICU. Preterm birth rate is high and COVID-19 requiring respiratory support increases the risk of poor maternal and neonatal outcome.
KW  - maternal critical care
KW  - COVID-19
KW  - ARDS
KW  - SARS-CoV-2
KW  - pregnancy
KW  - obstetrics
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-255257
SN  - 2077-0383
VL  - 11
IS  - 3
ER  -