Person: León Luis, Juan Antonio
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First Name
Juan Antonio
Last Name
León Luis
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Salud Pública y Materno-Infantil
Area
Obstetricia y Ginecología
Identifiers
11 results
Search Results
Now showing 1 - 10 of 11
- PublicationConsidering the Effects and Maternofoetal Implications of Vascular Disorders and the Umbilical Cord(MDPI, 2022-11-29) Sanchez Trujillo, Lara; García Montero, Cielo; Fraile Martínez, Oscar; Guijarro, Luis G.; Bravo Arribas, Coral; León Luis, Juan Antonio; Saez, Jose V.; Bujan, Julia; Álvarez Mon, Melchor; García Honduvilla, Natalio; Saez, Miguel A.; Ortega, Miguel A.The umbilical cord is a critical anatomical structure connecting the placenta with the foetus, fulfilling multiple functions during pregnancy and hence influencing foetal development, programming and survival. Histologically, the umbilical cord is composed of three blood vessels: two arteries and one vein, integrated in a mucous connective tissue (Wharton’s jelly) upholstered by a layer of amniotic coating. Vascular alterations in the umbilical cord or damage in this tissue because of other vascular disorders during pregnancy are worryingly related with detrimental maternofoetal consequences. In the present work, we will describe the main vascular alterations presented in the umbilical cord, both in the arteries (Single umbilical artery, hypoplastic umbilical artery or aneurysms in umbilical arteries) and the vein (Vascular thrombosis, aneurysms or varicose veins in the umbilical vein), together with other possible complications (Velamentous insertion, vasa praevia, hypercoiled or hypocoiled cord, angiomyxoma and haematomas). Likewise, the effect of the main obstetric vascular disorders like hypertensive disorders of pregnancy (specially pre-eclampsia) and chronic venous disease on the umbilical cord will also be summarized herein.
- PublicationTrasplante de células madre hematopoyéticas a embriones preinmunes vía celocentesis(Universidad Complutense de Madrid, 2017-01-20) León Luis, Juan Antonio; Clavero Núñez, José Antonio; Muñoz Fernández, María Ángeles; Santolaya-Forgás, JoaquínLa terapia celular mediante la introducción de células madre hematopoyéticas en un paciente afecto de una enfermedad susceptible de tratamiento, es una forma de terapia génica. El alo-trasplante de células madre hematopoyéticas ocurre de forma natural en embarazos gemelares dicigóticos, que establecen comunicaciones placentarias en útero. Esto se debe a que diversas características del embrión en desarrollo, brindan la oportunidad de tolerar sangre de un donante durante este periodo. Si se perfeccionan los métodos de introducción de las células madre en el embrión, este tipo de tratamiento genético en útero, podría convertirse en una alternativa viable, sobre todo para tratar enfermedades metabólicas, inmunológicas y hematopoyéticas, de origen hereditario, antes de que el déficit genético haya comprometido significativamente a distintos órganos fetales. Además, la existencia de una "ventana inmunológica" en el desarrollo embrionario, previa al inicio de los procesos de capacitación tímica, con presencia de células T maduras, permite la tolerancia a antígenos extraños. En condiciones ideales, la transferencia génica iniciada durante este periodo daría lugar a una tolerancia prolongada, quizás permanente, si estos antígenos se mantienen de forma persistente, lo que evitaría cualquier respuesta inmune celular del huésped contra las células donadas y facilitaría el trasplante de otros órganos en un período postnatal. Nuestra hipótesis se basa en demostrar, mediante el trasplante de células madre hematopoyéticas humanas CD34+ a embriones babuinos, entre los días 36 y 46 postfecundación vía celocentesis, ecoguiada, la posibilidad de crear xenoquimeras hematopoyéticas humano-babuino. Con este fin, se aislaron por métodos inmunomagnéticos, células madre CD34+ procedentes de las sangre del cordón umbilical de recién nacidos a término y sin complicaciones intraparto...
- PublicationChronic Venous Disease in Pregnant Women Causes an Increase in ILK in the Placental Villi Associated with a Decrease in E-Cadherin(MDPI, 2022-02-14) Ortega, Miguel A.; Chaowen, Chen; Fraile Martínez, Oscar; García Montero, Cielo; Sáez García, Miguel Ángel; Cruza, Iris; Pereda Cerquella, Claude; Álvarez Mon, Miguel Ángel; Guijarro, Luis G.; Fatych, Yuliia; Menor Salván, César; Álvarez Mon, Melchor; León Luis, Juan Antonio; Buján, Julia; García Honduvilla, Natalio; Bravo Arribas, Coral; Asúnsolo del Barco, AngelChronic venous disease (CVD) is a multifactorial vascular disorder frequently manifested in lower limbs in the form of varicose veins (VVs). Women are a vulnerable population for suffering from CVD, especially during pregnancy, when a plethora of changes occur in their cardiovascular system. Previous studies have indicated a worrisome association between CVD in pregnancy with the placental structure and function. Findings include an altered cellular behavior and extracellular matrix (ECM) composition. Integrin-linked kinase (ILK) is a critical molecule involved in multiple physiological and pathological conditions, and together with cadherins, is essential to mediate cell to ECM and cell to cell interplay, respectively. Thus, the aim of this study was to evaluate the implication of ILK and a set of cadherins (e-cadherin, cadherin-6 and cadherin-17) in placentas of women with CVD in order to unravel the possible pathophysiological role of these components. Gene expression (RT-qPCR) and protein expression (immunohistochemistry) studies were performed. Our results show a significant increase in the gene and protein expression of ILK, cadherin-6 and cadherin-17 and a decrease of e-cadherin in the placenta of women with CVD. Overall, this work shows that an abnormal expression of ILK, e-cadherin, cadherin-6 and cadherin-17 may be implicated in the pathological changes occurring in the placental tissue. Further studies should be conducted to determine the possible associations of these changes with maternal and fetal well-being.
- PublicationThe Pivotal Role of the Placenta in Normal and Pathological Pregnancies: A Focus on Preeclampsia, Fetal Growth Restriction, and Maternal Chronic Venous Disease(MDPI, 2022-02-06) Ortega, Miguel A.; Fraile Martínez, Oscar; García Montero, Cielo; Sáez García, Miguel Ángel; Álvarez Mon, Miguel Ángel; Torres Carranza, Diego; Álvarez Mon, Melchor; Bujan, Julia; García Honduvilla, Natalio; Bravo Arribas, Coral; Guijarro, Luis G.; León Luis, Juan AntonioThe placenta is a central structure in pregnancy and has pleiotropic functions. This organ grows incredibly rapidly during this period, acting as a mastermind behind different fetal and maternal processes. The relevance of the placenta extends far beyond the pregnancy, being crucial for fetal programming before birth. Having integrative knowledge of this maternofetal structure helps significantly in understanding the development of pregnancy either in a proper or pathophysiological context. Thus, the aim of this review is to summarize the main features of the placenta, with a special focus on its early development, cytoarchitecture, immunology, and functions in non-pathological conditions. In contraposition, the role of the placenta is examined in preeclampsia, a worrisome hypertensive disorder of pregnancy, in order to describe the pathophysiological implications of the placenta in this disease. Likewise, dysfunction of the placenta in fetal growth restriction, a major consequence of preeclampsia, is also discussed, emphasizing the potential clinical strategies derived. Finally, the emerging role of the placenta in maternal chronic venous disease either as a causative agent or as a consequence of the disease is equally treated.
- PublicationUterine Artery Embolization of Uterine Arteriovenous Malformation: A Systematic Review of Success Rate, Complications, and Posterior Pregnancy Outcomes(MDPI, 2022-07-01) Ruiz Labarta, Francisco Javier; Pintado Recarte, Maria Pilar; González Leyte, Manuel; Bravo Bravo, Coral; Álvarez Luque, Arturo; Cuñarro López, Yolanda; García Montero, Cielo; Fraile Martínez, Oscar; Ortega, Miguel A.; León Luis, Juan AntonioUterine Arteriovenous Malformation (UAVM) is a rare but life-threating cause of uterine bleeding. The clinical management of this condition is challenging, and there is a need to describe the most adequate approach for these patients. Uterine artery embolization (UAE) is the most widely-published treatment in the literature in recent years, although there is a need to update the evidence on this treatment and to compare it with other available therapies. Thus, the objective of this systematic review is to quantify the efficacy of UAE of UAVM. In addition, we evaluated the clinical context of the patients included, the treatment complications, and the pregnancy outcomes after UAE. With this goal in mind, we finally included 371 patients spread over all continents who were included in 95 studies. Our results show that, similar to other medical therapies, the global success rate after embolization treatment was 88.4%, presenting a low risk of adverse outcomes (1.8%), even in women with later pregnancy (77% had no complications). To date, this is the largest systematic review conducted in this field, although there are still some points to address in future studies. The results obtained in our study should be outlined in UAE protocols and guidelines to aid in clinical decision-making in patients with UAVM.
- Publication3D Ultrasound in Pelvic Floor: Is It Useful as a Prognostic Tool in Type of Labor Development and Subsequent Pelvic Floor Diseases?(MDPI, 2022-09-13) Barca, Juan Antonio; Bravo Arribas, Coral; García Tizón, Santiago; Aracil Rodriguez, Rocio; Pina Moreno, Juan Manuel; Cueto Hernandez, Ignacio; Pintado Recarte, María Del Pilar; Álvarez Mon, Melchor; Ortega, Miguel A.; León Luis, Juan AntonioThe objective of our study is to determine the thickness of the pubovisceral fasciculus of the levator ani muscle and the area of the genital hiatus by means of three-dimensional perineal ultrasound, in pregnant women in the 2nd trimester, and to analyze the related maternal, perinatal and postpartum clinical variables. Furthermore, to compare the results of our study with two similar series previously published. An observational, prospective study of pelvic floor ultrasound was carried out, performed at week 20, whose delivery was attended in the obstetrics service of the Hospital General Universitario Gregorio Marañón de Madrid (HGUGM), during the period of August from 2021 to June 2022. Maternal, ultrasound, perinatal and postpartum clinical variables were collected from each participant. During the study period, a total of 54 patients were included in it. The mean gestational age at which the ultrasound was performed was 19.81 ± 0.91 weeks. In relation to the ultrasound variables, the mean thickness of the pubovisceral muscle was 0.87 ± 0.13 cm (95% CI, 0.64–1.38 cm), while, in the plane of minimum dimension of the genital hiatus, the hiatal area at rest was 13.41 ± 3.22 (95% CI, 4.60–18.78) cm2. There is a significant correlation between the age of pregnant women (over 35 years of age) and the increase in the area of the genital hiatus (r = 0.295, p = 0.031). 3D ultrasound of the pelvic floor performed at week 20 of gestation can to be an effective, non-invasive, reproducible and cheap tool in the prognosis of the development of labor and of possible subsequent perineal dysfunctions.
- PublicationIrregular Expression of Cellular Stress Response Markers in the Placenta of Women with Chronic Venous Disease(MDPI, 2022-11-17) García Montero, Cielo; Fraile Martínez, Oscar; Rodriguez Martín, Sonia; Funes Moñux, Rosa M.; Saz, Jose V.; Bravo Arribas, Coral; León Luis, Juan Antonio; Ruiz Minaya, Maria; Pekarek, Leonel; Saez, Miguel A.; García Lledó, Alberto; Álvarez Mon, Melchor; Bujan, Julia; García Honduvilla, Natalio; Ortega, Miguel A.Pregnancy comprises a period in a woman’s life in which the circulatory system is subjected to hemodynamical and biochemical changes. During this period, while restructuring blood vessels and exchanging maternal-fetal products there is an increased risk of developing chronic venous disease (CVD), which may have an echo in life after childbirth for both mother and child. Previously, we investigated that pregnancy-associated CVD involves changes in placental architecture at angiogenesis, lymphangiogenesis and villi morphology compared with healthy controls (HC) with no history of CVD. We aimed to more deeply investigate the oxidative stress response in placenta from women with CVD versus HC through several markers (NRF2, KEAP1, CUL3, GSK-3β). An observational, analytical, and prospective cohort study was conducted on 114 women in their third trimester of pregnancy (32 weeks). A total of 62 participants were clinically diagnosed with CVD. In parallel, 52 controls with no history of CVD (HC) were studied. Gene and protein expressions of NRF2, KEAP1, CUL3, GSK-3β were analyzed by real-time polymerase chain reaction (RT-qPCR) and immunohistochemistry. Nrf2 gene and protein expression was significantly greater in placental villi of women with CVD, while Keap1, CUL-3 and GSK-3β gene and protein expressions were significantly lower. Our results defined an aberrant gene and protein expression of Nrf2 and some of their main regulators Keap1, CUL-3 and GSK-3 β in the placenta of women with CVD, which could be an indicator of an oxidative environment observed in this tissue.
- PublicationChronic Venous Disease during Pregnancy Causes a Systematic Increase in Maternal and Fetal Proinflammatory Markers(MDPI, 2022-08-11) Ortega, Miguel A.; Gómez Lahoz, Ana M.; Sanchez Trujillo, Lara; Fraile Martínez, Oscar; García Montero, Cielo; Guijarro, Luis G.; Bravo Arribas, Coral; León Luis, Juan Antonio; Saz, Jose V.; Bujan, Julia; García Honduvilla, Natalio; Monserrat, Jorge; Álvarez Mon, MelchorChronic venous disease (CVD) is a common vascular disorder characterized by increased venous hypertension and insufficient venous return from the lower limbs. Pregnancy is a high-risk situation for developing CVD. Approximately a third of the women will develop this condition during pregnancy, and similarly to arterial hypertensive disorders, previous evidence has described a plethora of alterations in placental structure and function in women with pregnancy-induced CVD. It is widely known that arterial-induced placenta dysfunction is accompanied by an important immune system alteration along with increased inflammatory markers, which may provide detrimental consequences for the women and their offspring. However, to our knowledge, there are still no data collected regarding cytokine profiling in women with pregnancy-induced CVD. Thus, the aim of the present work was to examine cytokine signatures in the serum of pregnant women (PW) with CVD and their newborns (NB). This study was conducted through a multiplex technique in 62 PW with pregnancy-induced CVD in comparison to 52 PW without CVD (HC) as well as their NB. Our results show significant alterations in a broad spectrum of inflammatory cytokines (IL-6, IL-12, TNF-α, IL-10, IL-13, IL-2, IL-7, IFN-γ, IL-4, IL-5, IL-21, IL-23, GM-CSF, chemokines (fractalkine), MIP-3α, and MIP-1β). Overall, we demonstrate that pregnancy-induced CVD is associated with a proinflammatory environment, therefore highlighting the potentially alarming consequences of this condition for maternal and fetal wellbeing.
- PublicationThe Placentas of Women Who Suffer an Episode of Psychosis during Pregnancy Have Increased Lipid Peroxidation with Evidence of Ferroptosis(MDPI, 2023-01-06) Ortega, Miguel A.; Fraile Martínez, Oscar; García Montero, Cielo; Funes Moñux, Rosa M.; Rodriguez Martín, Sonia; Bravo Arribas, Coral; León Luis, Juan Antonio; Saz, Jose V.; Saez, Miguel A.; Guijarro, Luis G.; Lahera, Guillermo; Mora, Fernando; Fernandez Rojo, Sonia; Quintero, Javier; Monserrat, Jorge; García Honduvilla, Natalio; Bujan, Julia; Álvarez Mon, Melchor; Alvarez Mon, Miguel ÁngelPsychosis is a complex entity characterized by psychological, behavioral, and motor alterations resulting in a loss of contact with reality. Although it is not common, pregnancy can be a period in which a first episode of psychosis can manifest, entailing detrimental consequences for both the fetus and the mother. The pathophysiological basis and study of maternofetal wellbeing need to be further elucidated. Lipid peroxidation and ferroptosis are two phenomena that are tightly linked to the placental dysfunction commonly observed in different complications of pregnancy. In the present study, we aim to explore the histopathological and gene expression of different markers of lipid peroxidation and ferroptosis in the placentas of women who underwent a first episode of psychosis during their pregnancy (n = 22). The aim is to then compare them with healthy pregnant women (n = 20). In order to achieve this goal, iron deposits were studied using Prussian Blue staining. In addition, the protein/gene expression of a transferrin receptor (TFRC), as well as an acyl-CoA synthetase long-chain family member 4 (ACSL-4), arachidonate lipoxygenase-5 (ALOX-5), malondialdehyde (MDA), and glutathione peroxidase 4 (GPX4) were all analyzed through gene expression (RT-qPCR) and immunohistochemical procedures. Our results demonstrate an increased presence of iron deposits that are accompanied by a further expression of TFRC, ACSL-4, ALOX-5, MDA, and GPX4—all of which are observed in the placenta tissue of women who have suffered from a first episode of psychosis. Therefore, in our study, a histopathological increase in lipid peroxidation and ferroptosis markers in the affected women is suggested. However, further studies are needed in order to validate our results and to establish possible consequences for the reported alterations.
- PublicationUso de los modelos 3D de los corazones fetales en la docencia multidisciplinar del diagnóstico tratamiento y pronóstico de las cardiopatías congénitas(2022-01-11) León Luis, Juan Antonio; Bravo Arribas, Coral; Álvarez Martín, Teresa; Perez Caballero, Ramón; Fernández Aceñero, María Jesús; Calvo Haro, José Antonio; Perez Mañanes, Ruben; Gonzalez Martín, Agustina Eliana; Caamiña Alvarez, Sara; Rodeño Fernández, Haizea; Gamez Alderete, Francisco de Asis