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Molecular Mechanisms Underlying Twin-to-Twin Transfusion Syndrome

Twin-to-twin transfusion syndrome is a unique disease and a serious complication occurring in 10–15% of monochorionic multiple pregnancies with various placental complications, including hypoxia, anemia, increased oxidative stress, and ischemia-reperfusion injury. Fetoscopic laser photocoagulation,...

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Autores principales: Kajiwara, Kazuhiro, Ozawa, Katsusuke, Wada, Seiji, Samura, Osamu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600593/
https://www.ncbi.nlm.nih.gov/pubmed/36291133
http://dx.doi.org/10.3390/cells11203268
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author Kajiwara, Kazuhiro
Ozawa, Katsusuke
Wada, Seiji
Samura, Osamu
author_facet Kajiwara, Kazuhiro
Ozawa, Katsusuke
Wada, Seiji
Samura, Osamu
author_sort Kajiwara, Kazuhiro
collection PubMed
description Twin-to-twin transfusion syndrome is a unique disease and a serious complication occurring in 10–15% of monochorionic multiple pregnancies with various placental complications, including hypoxia, anemia, increased oxidative stress, and ischemia-reperfusion injury. Fetoscopic laser photocoagulation, a minimally invasive surgical procedure, seals the placental vascular anastomoses between twins and dramatically improves the survival rates in twin-to-twin transfusion syndrome. However, fetal demise still occurs, suggesting the presence of causes other than placental vascular anastomoses. Placental insufficiency is considered as the main cause of fetal demise in such cases; however, little is known about its underlying molecular mechanisms. Indeed, the further association of the pathogenic mechanisms involved in twin-to-twin transfusion syndrome placenta with several molecules and pathways, such as vascular endothelial growth factor and the renin–angiotensin system, makes it difficult to understand the underlying pathological conditions. Currently, there are no effective strategies focusing on these mechanisms in clinical practice. Certain types of cell death due to oxidative stress might be occurring in the placenta, and elucidation of the molecular mechanism underlying this cell death can help manage and prevent it. This review reports on the molecular mechanisms underlying the development of twin-to-twin transfusion syndrome for effective management and prevention of fetal demise after fetoscopic laser photocoagulation.
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spelling pubmed-96005932022-10-27 Molecular Mechanisms Underlying Twin-to-Twin Transfusion Syndrome Kajiwara, Kazuhiro Ozawa, Katsusuke Wada, Seiji Samura, Osamu Cells Review Twin-to-twin transfusion syndrome is a unique disease and a serious complication occurring in 10–15% of monochorionic multiple pregnancies with various placental complications, including hypoxia, anemia, increased oxidative stress, and ischemia-reperfusion injury. Fetoscopic laser photocoagulation, a minimally invasive surgical procedure, seals the placental vascular anastomoses between twins and dramatically improves the survival rates in twin-to-twin transfusion syndrome. However, fetal demise still occurs, suggesting the presence of causes other than placental vascular anastomoses. Placental insufficiency is considered as the main cause of fetal demise in such cases; however, little is known about its underlying molecular mechanisms. Indeed, the further association of the pathogenic mechanisms involved in twin-to-twin transfusion syndrome placenta with several molecules and pathways, such as vascular endothelial growth factor and the renin–angiotensin system, makes it difficult to understand the underlying pathological conditions. Currently, there are no effective strategies focusing on these mechanisms in clinical practice. Certain types of cell death due to oxidative stress might be occurring in the placenta, and elucidation of the molecular mechanism underlying this cell death can help manage and prevent it. This review reports on the molecular mechanisms underlying the development of twin-to-twin transfusion syndrome for effective management and prevention of fetal demise after fetoscopic laser photocoagulation. MDPI 2022-10-17 /pmc/articles/PMC9600593/ /pubmed/36291133 http://dx.doi.org/10.3390/cells11203268 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Kajiwara, Kazuhiro
Ozawa, Katsusuke
Wada, Seiji
Samura, Osamu
Molecular Mechanisms Underlying Twin-to-Twin Transfusion Syndrome
title Molecular Mechanisms Underlying Twin-to-Twin Transfusion Syndrome
title_full Molecular Mechanisms Underlying Twin-to-Twin Transfusion Syndrome
title_fullStr Molecular Mechanisms Underlying Twin-to-Twin Transfusion Syndrome
title_full_unstemmed Molecular Mechanisms Underlying Twin-to-Twin Transfusion Syndrome
title_short Molecular Mechanisms Underlying Twin-to-Twin Transfusion Syndrome
title_sort molecular mechanisms underlying twin-to-twin transfusion syndrome
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600593/
https://www.ncbi.nlm.nih.gov/pubmed/36291133
http://dx.doi.org/10.3390/cells11203268
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