Browsing by Author "Renu Bala"

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Comparison of expression of chemokine receptor 4 in maternal decidua and chorionic villi in women with spontaneous miscarriages and women opting for termination of viable pregnancies
(Wolters Kluwer Medknow Publications, 2021) Anamika Das; Nisha Agrawal; Rinchen Zangmo; Kallol Roy; Kiran Singh; Renu Bala
Background: Early pregnancy losses can be a distressing experience both for the parents and the treating clinician. We aim to explore the role of chemokine receptor 4 (CXCR4) in early pregnancy losses by comparing its expression among patients with spontaneous miscarriages and patients undergoing termination of viable pregnancies for unwanted pregnancies. Aim: The aim of the study was to investigate the expression of CXCR4 in early pregnancy losses and correlate the various clinical parameters with differential expression of the above receptor in the chorionic villi and maternal decidua. Study and Setting: The present study is a case-'control study done in a tertiary care center. Methodology: Fifty patients attending outdoor and antenatal clinic of the hospital aged 18-'40 years with spontaneous miscarriage under 20 weeks of gestational age were included as cases and compared with fifty females of comparable age group (18-'40 years) seeking medical termination of pregnancy as controls. Chorionic villi and decidua obtained from the cases and controls were analyzed for CXCR4 expression. Statistical Analysis: The results were analyzed using mean ± standard deviation, percentiles values, Chi-square test, and P value to determine the association of CXCR4 expression in decidua and chorionic villi of cases versus controls. Results: CXCR4 expression was significantly downregulated in cases as compared to the controls with P < 0.001. The mean normalized ratio of CXCR4 expression to housekeeping gene (β Actin) expression in the case group was 1.607 ± 1.108 and in the control group, it was 2.506 ± 1.457. There was a strong correlation between the expression of CXCR4 and maternal age. With increasing age, the expression of CXCR4 was more downregulated in both the cases and control groups (P < 0.001). The expression of CXCR4 was elevated in controls as compared to cases in <30 years age group (P = 0.009). CXCR4 expression was higher in primigravida than in multigravida (P = 0.001), and as the number of previous miscarriages increased, the expression of CXCR4 was found to be decreased (P = 0.021). Conclusion: CXCR4 expression is significantly reduced in women with spontaneous miscarriages in comparison with viable pregnancies. and possibly, therapies targeted at increasing the expression of CXCR4 can be used as a treatment modality for management of spontaneous miscarriages. © 2021 Wolters Kluwer Medknow Publications. All rights reserved.
Duplications in 19p13.3 are associated with male infertility
(Springer New York LLC, 2019) Vertika Singh; Renu Bala; Arijit Chakraborty; Singh Rajender; Sameer Trivedi; Kiran Singh
Purpose: To identify genomic imbalances and candidate loci in idiopathic male infertility. Methods: Affymetrix CytoScan 750K Array was used to analyze genomic imbalances and candidate loci in 34 idiopathic infertile cases of different phenotypes (hypo-spermatogenesis, n = 8; maturation arrest, n = 7; and Sertoli cell-only syndrome, n = 13, severe oligozoospermia, n = 6, and 10 normozoospermic fertile men). Ten ethnically matched controls were screened for comparison. Results: The cytogenetic array analysis detected a genomic gain at the 19p13.3 region in 9 (26.47%) cases, with the highest frequency in patients with Sertoli cell-only syndrome (SCOS) (38%). Its complete absence in the control group suggests its likely pathogenic nature. In addition to Y-classical, micro, and partial deletions, the duplication in 19p13.3 could serve as a unique biomarker for evaluation of infertility risk. The common region across the individuals harboring the duplication identified STK11, ATP5D, MIDN, CIRBP, and EFNA2 genes which make them strong candidates for further investigations. The largest duplicated region identified in this study displayed a major network of 7 genes, viz., CIRBP, FSTL3, GPX4, GAMT, KISS1R, STK11, and PCSK4, associated with reproductive system development and function. The role of chance was ruled out by screening of ethnically matched controls. Conclusion: The result clearly indicates the significance of 19p13.3 duplication in infertile men with severe testicular phenotypes. The present study underlines the utility and significance of whole genomic analysis in the cases of male infertility which goes undiagnosed due to limitations in the conventional cytogenetic techniques and for identifying genes that are essential for spermatogenesis. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.
Environment, Lifestyle, and Female Infertility
(Springer Science and Business Media Deutschland GmbH, 2021) Renu Bala; Vertika Singh; Singh Rajender; Kiran Singh
Lifestyle factors, which include the practices we adopt in our daily life, have a significant role in shaping our overall health. These lifestyle choices are mainly centered on personal preferences and our surrounding social environment. In addition to lifestyle factors, we continuously interact with our environment, which impacts physiology. Several factors have been claimed to affect women’s fertility; lifestyle-related factors, in particular, have received great attention in the last decade. Due to societal and professional pressure, childbearing age in women has gradually shifted to the 30s. Delayed age of childbearing along with modern lifestyle offers a wider window of opportunity for various lifestyle and genetic perturbations to penetrate to affect fertility. While clinical studies have strengthened a direct correlation between lifestyle, environment, and female reproductive health; experimental studies on animal models have investigated their mechanism of action. In most instances, these factors target the neuroendocrine pathways, resulting in metabolic derangements. This review aims to dissect the plausible interconnection of lifestyle and environmental factors with various neuroendocrine pathways and to discuss how it can affect the female physiology in the long-term, resulting in reproductive incompetence. © 2020, Society for Reproductive Investigation.
Estradiol correlates with the accumulation of Monocytic Myeloid-Derived Suppressor Cells in Pre-term birth: A possible explanation of immune suppression in pre-term babies
(Elsevier Ireland Ltd, 2021) Snehil Budhwar; Rachna Verma; Priyanka Verma; Renu Bala; Sangeeta Rai; Kiran Singh
Synergistic interplay of immune endocrine interaction is prerequisite for an effective maternal fetal tolerance. Pre-term birth (PTB) may be a consequence of altered immune-endocrine crosstalk during third trimester resulting in early breakdown of this tolerance. Myeloid derived suppressor cells (MDSCs), a heterogenous population of immature immune cells are increased in pregnant women and healthy newborns, but their role in PTB still remains obscure. We now report that granulocytic MDSCs (G-MDSCs) is decreased in women delivering prematurely, suggesting their potential role in maintaining maternal fetal tolerance. Interestingly, in contrast statistically significant increase in MDSCs and monocytic MDSCs (M-MDSCs) along with positive correlation with cord serum estradiol (E2), and overexpressed ER-α in placental tissue suggested E2 mediated accumulation of M-MDSCs in PTB babies. MDSCs mediated immune suppression is accompanied with subsequent decline in total T cells and its subtypes: Th and Tc in PTB babies, which signifies their potential contribution towards the impaired immune system of PTB babies. © 2021 Elsevier B.V.
Fetal hyperhomocysteinemia is associated with placental inflammation and early breakdown of maternal-fetal tolerance in pre-term birth
(John Wiley and Sons Inc, 2022) Renu Bala; Rachna Verma; Snehil Budhwar; Nikita Prakash; Shikha Sachan
Problem: Hyperhomocysteinemia (hypHcy) due to impaired folate metabolism is shown to be a risk factor for preterm birth (PTB) and low birth weight (LBW) in mothers. However, the relationship of fetal hypHcy with adverse pregnancy outcomes is under-represented. The present study aims to investigate the association of fetal hypHcy with oxidative stress and placental inflammation that can contribute to an early breakdown of maternal-fetal tolerance in pre-term birth (PTB). Methods: Cord blood and placenta tissue were collected from PTB and term infant group. Levels of homocysteine, folic acid, vitamin B12 and oxidative stress markers (MDA, T-AOC, 8-OHdG) were measured in cord blood serum using ELISA and respective standard assay kits. Relative expression of candidate genes (TNF-α, IL-6, IL1-β, VEGF-A, MMP2 and MMP9) was also checked using RT-PCR and immunoblotting/immunohistochemistry. Results: PTB infants showed significantly higher levels of homocysteine (P =.02) and lower levels of vitamin B12 (P =.005) as compared to term infants. We also found that PTB infants with hypHcy had lower T-AOC (P =.003) and higher MDA (P =.04) levels as compared to term infants with normal homocysteine levels. The mRNA and protein levels of TNF-α, VEGF-A, MMP2 and MMP9 were significantly higher in hypHcy PTB infants. Conclusion: Our results show that fetal hypHcy is associated with oxidative stress and an increase in inflammatory markers in the placenta. Thus, in conclusion, our study demonstrates that fetal hypHcy during pregnancy is a potential risk factor that may initiate an early breakdown of uterine quiescence due to activation of inflammatory processes leading to PTB. © 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Genetic Testing in Pregnancy to Assess the Risk of Preterm Birth
(Springer Nature, 2024) Renu Bala; Rajender Singh
Preterm birth (PTB) is one of the leading causes of infant and child mortality under 5 years of age. PTB infants have long-term health consequences and usually suffer from sepsis, respiratory distress syndrome, feeding difficulties, and the risk of adult metabolic diseases. Various studies have highlighted the role of a complex interplay between genetic (maternal and fetal) and environmen-tal factors in controlling birth timing in humans. However, the molecular mechanisms involved in the pathophysiology of PTB are still poorly understood. In recent years, studies have suggested a significant contribution of genetic variations to the etiology of PTB. The obstetric/familial history of women with PTB and twin studies also emphasizes the role of genetic factors. In this chapter, we illustrate the plausible genetic factors associated with PTB risk and their suitability to assessing the risk of PTB. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.
Hyperhomocysteinemia and low vitamin B12 are associated with the risk of early pregnancy loss: A clinical study and meta-analyses
(Elsevier Inc., 2021) Renu Bala; Rachna Verma; Priyanka Verma; Vertika Singh; Namrata Yadav; Singh Rajender; Nisha Rani Agrawal; Kiran Singh
One-carbon metabolism is crucial for the maintenance of healthy pregnancy and alterations in this pathway have been associated with various pregnancy-related complications. Therefore, the present study was conducted to test the hypothesis that the altered folic acid, vitamin B12 and homocysteine levels are associated with the risk of early pregnancy loss (EPL). Plasma folic acid, vitamin B12 and homocysteine levels were analyzed in 83 females with EPL and 70 healthy pregnant females in their first trimester. Further, meta-analyses of folic acid, vitamin B12 and homocysteine were also performed involving various eligible studies. Results from our case-control study and meta-analysis showed that folic acid deficiency is not associated with the risk of EPL. On the other hand, low vitamin B12 and hyperhomocysteinemia were individually found to be significant risk factors for EPL in the present study (P < .01, P < .05, respectively) and meta-analysis as well (P < .001, P < .05, respectively). Vitamin B12 deficiency in combination with hyperhomocysteinemia was a more serious risk factor for EPL (Odds Ratio = 4.98, P = 0.002). Therefore, we conclude that vitamin B12 deficiency and elevated homocysteine levels are independent risk factors for EPL, and of higher risk when combined. The assessment of vitamin B12 and homocysteine levels may serve as a good screening marker for EPL risk. © 2021 Elsevier Inc.
Impact of socio-demographic variables on antenatal services in eastern Uttar Pradesh, India
(Taylor and Francis Ltd., 2021) Renu Bala; Ajay Singh; Vertika Singh; Priyanka Verma; Snehil Budhwar; Om Prakash Shukla; Gyan Prakash Singh; Kiran Singh
We investigated the impact of socio-demographic variables on antenatal care (ANC) utilization and the low birth weight of a child. Data were collected from 300 pregnant females. Only 22.5% of females received full antenatal care (≥4 visits). Our results showed that female’s age at marriage and education plays a significant role in improving ANC. We observed an overall decrease in the utilization of services provided during each antenatal visit. ANC visits from the first trimester decrease the risk of having a baby with low birth weight. Awareness programs and educating families about pregnancy care are recommended to improve ANC utilization. © 2020 Taylor & Francis Group, LLC.
Interleukin-17 gene polymorphisms and the risk of early miscarriage: A case-control study and meta-analysis
(Elsevier B.V., 2018) Priyanka Verma; Rohini R. Nair; Snehil Budhwar; Vertika Singh; Renu Bala; Anuradha Khanna; Nisha R. Agarwal; Punam Rai; Singh Rajender; Kiran Singh
Previous reports clearly suggest that IL-17 have important role in development of systemic and peripheral inflammation in early miscarriage (EM). In the present study, we have investigated the association between genetic variants in IL-17A, IL-17F and susceptibility to EM. We recruited 135 EM patients and 150 controls and used PCR-RFLP method for genotyping the polymorphisms of IL-17A, rs4711998 (−832 A/G), rs8193036 (−692C/T) and IL-17F rs763780 (7488 T/C). No significant difference was observed for all the three polymorphic sites between the EM patients and control group in terms of genotypic (rs4711998, χ2 = 1.95, p = 0.37; rs8193036, χ2 = 1.91, p = 0.38; rs763780, χ2 = 2.45, p = 0.29), and allelic frequencies (rs4711998, OR = 1.19, 95% CI = 0.84 to 1.67, p = 0.35; rs8193036,OR = 1.18, 95% CI = 0.58 to 2.06, p = 0.75; rs763780, OR = 1.5, 95% CI = 0.93 to 2.71, p = 0.11). Further, meta-analysis of IL-17F (rs763780) variant with EM also revealed non-significant association of IL-17F (rs763780) variant with EM in the presence of mutant genotype (CC) via random effect model (p = 0.70, OR = 1.30, 95% CI =0.33–5.11). © 2018
Opportunities and challenges in industrial production of biofuels
(Elsevier, 2022) Renu Bala; Monoj Kumar Mondal
Biomass-derived fuels are emerging as an excellent alternative to fossil fuels due to several associated benefits such as diversification of biomass and renewable and environmentally friendly nature. However, the various challenges associated with the conversion process limit their production. Biomass yield, its storage, and transportation to the energy generation location are the essential parameters for biofuel commercialization. The physicochemical properties and structural variations of biomass significantly influence the production yield. The evolution of biofuel from different feedstock can be classified into four generations. Pretreatment is one of the crucial steps when dealing with complex biomass to improve their utilization. Pretreatment may cause an enhancement in biomass crystallinity, degradation of sugars, formation of inhibitory compounds, and so on, resulting in poor production yields. Enzymatic hydrolysis is essential when the biomass is directed to a fermentation process in deriving liquid biofuel such as bioethanol, biobutanol, and so on. However, the cost, activity, and enzyme contact time are the crucial aspects that need to be considered. Biomass can be converted to liquid or gaseous fuel through different routes of biochemical and thermochemical processes such as fermentation, anaerobic digestion, pyrolysis, gasification, transesterification, and so on. The challenges not only are limited to the production of biofuel but also include their downstream processing, purification steps, and coproduct formation. Water availability and recycling is also an important factor for biofuel production. The impact of biofuel on the environment and economy of the overall process also influences the commercialization of biofuels. In this chapter, the opportunities and challenges associated with biofuel production and their commercialization are discussed. © 2022 Elsevier Inc. All rights reserved.