Hypoxia-induced Autophagy in the Pathogenesis of MAP

Status Not yet recruiting

Clinical Trial Summary

To investigate the role of HIF 1α and LC3B in the pathogenesis of MAP, to evaluate the role of MMP-9 in the antenatal prediction of MAP, and to compare the expression of HIF1α, LC3B, and level MMP-9 between patients of placenta previa with MAP and patients with normal placentation.

Clinical Trial Description

Cesarean section (CS) rate has been rising rapidly in the recent years.One of the complications of repeated CS is placenta previa, an implantation of placenta on or near internal os. Morbidly adherent placenta (MAP), known also as placenta accreta spectrum, has histopathologic and clinical types. The placenta becomes abnormally adherent to the uterine wall, fails to separate leading to massive blood loss and possible hysterectomy. The risk of MAP in patient with placenta previa increases with repeated CS. Theories for development of MAP include abnormal trophoblastic invasion of myometrium, abnormal decidualization, neovascularization and reduction of apoptosis of trophobalsts. In early pregnancy: the trophoblasts invade spiral arteries and reduce blood flow to the placenta 00leading to hypoxia. Hypoxia inducible factor 1 alpha (HIF-1α), a protein involved in cellular adaptation to hypoxia, increases throughout pregnancy and contributes in the invasion of trophoblasts. Excessive invasion in MAP might prolong the hypoxia, increasing the expression of HIF1α. Autophagy is a process for managing and removing the damaged organelles and cellular proteins in hypoxia. It supports the trophoblasts. Hypoxia induced autophagy markers such as LC3B might be enhanced by MAP. Matrix metalloproteinase-9 (MMP-9) plays an important role in cell invasion and placental implantation. Disturbance of MMP-9 might alter the trophobalsts invasion resulting in MAP . The investigators hypothesize that hypoxia, autophagy and invasiveness are linked to the pathophysiology of MAP, so we will assess the expression of HIF1α, LC3B to estimate their role beside MMP-9. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT05817448
Study type	Observational
Source	Assiut University
Contact	Nermeen Bahaa ElDien Mohamed Ahmed, dr
Phone	01011126294
Email	nermeenbahaa11@gmail.com
Status	Not yet recruiting
Phase
Start date	September 2023
Completion date	November 2024

View Details

See also
Status	Clinical Trial	Phase
Recruiting	`NCT04498598` - Structural Modification In Supraglottic Airway Device	N/A
Completed	`NCT05532670` - N600X Low Saturation Accuracy Validation
Enrolling by invitation	`NCT04106401` - Intravascular Volumes in Hypoxia During Antarctic Confinement	N/A
Recruiting	`NCT05883137` - High-flow Nasal Oxygenation for Apnoeic Oxygenation During Intubation of the Critically Ill
Recruiting	`NCT02661152` - DAHANCA 30: A Randomized Non-inferiority Trial of Hypoxia-profile Guided Hypoxic Modification of Radiotherapy of HNSCC.	Phase 3
Terminated	`NCT02801162` - Evaluation of Accuracy and Precision of a New Arterial Blood Gas Analysis System Blood in Comparison With the Reference Standard	N/A
Not yet recruiting	`NCT02201875` - Intrinsic Periodic Pattern of Breathing	N/A
Completed	`NCT02943863` - Regional Ventilation During High Flow Nasal Cannula and Conventional Nasal Cannula in Patients With Hypoxia	N/A
Completed	`NCT01922401` - Inverse Ratio Ventilation on Bariatric Operation	N/A
Completed	`NCT02105298` - Effect of Volume and Type of Fluid on Postoperative Incidence of Respiratory Complications and Outcome (CRC-Study)	N/A
Active, not recruiting	`NCT01681238` - Goal-directed Therapy in High-risk Surgery	N/A
Completed	`NCT01463527` - Using Capnography to Reduce Hypoxia During Pediatric Sedation	N/A
Completed	`NCT01507623` - Value of Capnography During Nurse Administered Propofol Sedation (NAPS)	N/A
Withdrawn	`NCT00638040` - The Gene Expression Studies of the Role of Tumor Microenvironments in Tumor Progression	N/A
Active, not recruiting	`NCT06097754` - Intermittent Exogenous Ketosis (IEK) at High Altitude	N/A
Completed	`NCT04589923` - The VISION-Acute Study
Completed	`NCT05044585` - Evaluation of RDS MultiSense® in Desaturation Analysis in Healthy Volunteers	N/A
Completed	`NCT03659513` - The Effect of ECMO on the Pharmacokinetics of the Drugs and Their Clinical Efficacy
Completed	`NCT03221387` - Sleep and Daytime Use of Humidified Nasal High-flow Oxygen in COPD Outpatients	N/A
Not yet recruiting	`NCT05914324` - Outpatient Pediatric Pulse Oximeters in Africa	N/A

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.