[Use of hydroxychloroquine in recurrent immune-mediated obstetric diseases (excluding systemic lupus): Scientific basis and evidence].

Rev Med Interne

Service de médecine interne et inflammation, département inflammation-immunopathologie-biothérapie (DMU I3), CEREMAIAA, hôpital Saint-Antoine, AP-HP, Sorbonne université, Paris, France.

Published: December 2024

Hydroxychloroquine (HCQ), a synthetic antimalarial, is recognized for its immunomodulatory, anti-inflammatory and vascular-protective effects. In 20-30% of cases of primary obstetrical antiphospholipid syndrome (APS), the combination of antiplatelet aggregation and prophylactic anticoagulation fails to prevent obstetrical complications, a situation referred to as refractory obstetrical APS. This is partly due to the pro-inflammatory effects of antiphospholipid antibodies (aPL) binding to decidual and trophoblastic cells, which compromise embryonic implantation and placentation. Experimental studies in vitro and in mouse models have shown that HCQ can inhibit the detrimental effect of aPLs on trophoblastic invasion, findings corroborated by retrospective observational clinical studies. However, no randomized controlled trial has evaluated the addition of HCQ to conventional therapy for refractory obstetric APS. The hypothesis of allo-immune and/or autoimmune mechanisms involved in cases of recurrent pregnancy loss (RPL) with no identified cause and in chronic intervillositis of unknown etiology (CIUE) has led to the empirical use of HCQ in these indications. However, current evidence does not support its use in unexplained RPL. A few clinical studies of low scientific evidence suggest a benefit of HCQ in CIUE, but further data are needed. Finally, pre-eclampsia (PE) is another pregnancy-related condition at risk of recurrence, and its pathogenesis also seems to involve an imbalance in immune responses. HCQ's antioxidant properties could have a positive effect on endothelial dysfunction, a key component of PE.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.revmed.2024.12.004DOI Listing

Publication Analysis

Top Keywords

clinical studies
8
hcq
5
[use hydroxychloroquine
4
hydroxychloroquine recurrent
4
recurrent immune-mediated
4
immune-mediated obstetric
4
obstetric diseases
4
diseases excluding
4
excluding systemic
4
systemic lupus
4

Similar Publications

This study aimed to evaluate the effects of different dietary supplementation levels with jujube fruit powder on the performance, biochemical parameters, and egg quality characteristics of laying quails. A total of 60 quails (45 days old) were randomly assigned to treatments with different levels of jujube fruit powder: a basal diet (control) and diets supplemented with 5 g/kg (T1), 10 g/kg (T2), with five replicates per treatment (20 quails/treatment and four quails/replicate). The differences between 1-15 and 16-30 days for feed intake (p<0.

View Article and Find Full Text PDF

The present study was conducted to evaluate the effect of humic substances on performance and selected blood biochemical parameters in turkeys. A total of twenty 6-week-old turkey hybrids (Big 6) were divided into two groups. The first group of turkeys was fed the basal diet without any supplementation of humic substances as a control group.

View Article and Find Full Text PDF

Current clinical practice guidelines were established by several organizations to guide the diagnosis and treatment of hypertension in men and women in a similar manner despite data demonstrating differences in underlying mechanisms. Few publications have provided a contemporary and comprehensive review focused on characteristics of hypertension that are unique to women across their life spectrum. We performed a computerized search using PubMed, OVID, EMBASE, and Cochrane library databases between 1995 and 2023 that highlighted relevant clinical studies, challenges to the management of hypertension in women, and multidisciplinary approaches to hypertension control in women, including issues unique to racial and ethnic minority groups.

View Article and Find Full Text PDF

Effect of commercial prescription diets containing prebiotics on clinical signs and fecal microbiome in dogs with intestinal disease.

Pol J Vet Sci

December 2024

School of Veterinary Nursing and Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonancho, Musashino, Tokyo 180-8602, Japan.

Diet has emerged as a key modulator of the gut microbiota, offering a potential strategy for disease prevention and management. This study investigated the effects of the Prescription Diet Gastrointestinal Biome (GB) on 7 healthy dogs and 16 dogs with chronic gastrointestinal diseases (GI dogs). Our investigation monitored changes in body weight and the Canine Inflammatory Bowel Disease Activity Index (CIBDAI) in 16 GI dogs fed a GB diet.

View Article and Find Full Text PDF

Background: Recently, there has been a surge in virtual reality (VR)-based training for upper limb (UL) rehabilitation, which has yielded mixed results. Therefore, we aimed to explore the effects of conventional therapy combined with VR-based training on UL dysfunction during post-stroke rehabilitation.

Methods: Studies published in English before May 2023 were retrieved from PubMed, Embase, and the Cochrane Library.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!