23 - Lipoxin concentration in high-risk participants taking Aspirin: a potential mechanism of action

Friday, February 10, 2023

9:30 AM – 9:45 AM

Location: Room 3009, Moscone West, Level 3

Objective:

Lipoxins are endogenous inflammatory mediators that are shown to be upregulated with aspirin (ASA) exposure in several populations. Our objective was to describe lipoxin levels in high-risk women at baseline and with ASA exposure.

Study Design:

This open-label randomized trial recruited participants defined as high risk for pre-eclampsia per the USPSTF major criteria. Participants were randomized to 81mg or 162mg of ASA prophylaxis and analyzed based on dose exposure or grouped as high-risk ASA-exposed. A separate cohort recruited simultaneously of low-risk patients without major criteria served as controls. Serum samples were obtained at 11-16 and 28-32 weeks’ gestation. Lipoxin (LXA₄) and C-reactive protein (CRP) in maternal plasma were quantified using Cayman Lipoxin A₄ ELISA and hsCRP protein enzyme immunoassay. We utilized t-tests and simple linear regression.

Results:

56 low risk and 104 high-risk participants were included (47 taking 81mg; 57 taking 162mg ASA). Demographic characteristics differed between groups as expected (Table 1). CRP was significantly correlated with LXA₄ concentration at enrollment for the total population (P=0.03) and was higher in high risk participants (P=.04). LXA₄ concentrations were significantly lower in high-risk vs. low-risk participants at enrollment (P < 0.0001, Table 2). Over the midtrimester, Lipoxin concentrations decreased for both low and high-risk groups, but this decline was significantly lower in the aspirin-exposed patients, P=.007. This change in LXA₄ concentration, termed delta, was not correlated with CRP concentration in the third trimester or with a change in CRP between enrollment and the third trimester suggesting an independent action related to aspirin exposure.

Conclusion:

In pregnancy, aspirin exposure appears to preserve lipoxin concentration suggesting a possible mechanism of action for prophylaxis. This observation is consistent with other populations treated with this medication outside of obstetrics.

Primary & Presenting Author(s)

Katherine Vignes, MD

MFM Faculty
Ochsner Clinic Foundation
Lafayette, Louisiana, United States

Slides

Coauthor(s)

Pranaya Chilukuri, MD (she/her/hers)

Resident Physician
University of Kentucky
Lexington, KY, United States
AS

Aarthi Srinivasan, MD, MS

University of Kentucky
Lawrenceville, New Jersey, United States
CC

Cynthia Cockerham, BS, RN

Department of OBGYN, Division of Maternal Fetal Medicine, University of Kentucky
Lexington, Kentucky, United States
WW

Wendy Whitley, RN

University of Kentucky
Lexington, Kentucky, United States
HH

Hong Huang, MD, PhD

Department of Pediatrics, University of Kentucky College of Medicine
Lexington, Kentucky, United States
BS

Brandon Schanbacher, MS

Department of Pediatrics, University of Kentucky College of Medicine
Lexington, Kentucky, United States
LS

Leon Su, BS

Department of Statistics, University of Kentucky
Lexington, Kentucky, United States
AS

Arnold J. Stromberg, MS, PhD

Department of Statistics, University of Kentucky
Lexington, Kentucky, United States
Zachary D. Stanley, MD (he/him/his)

Fellow Physician
Saint Louis University/St. Mary's SSM Heatlh
St. Louis, Missouri, United States
BM

Brittany McKinley, MD, MPH

Bronxcare
Bronx, New York, United States
JB

John A. Bauer, PhD

Department of Pediatrics, University of Kentucky College of Medicine
Lexington, Kentucky, United States
JO

John O'Brien, MD

Chandler Medical Center, University of Kentucky
Lexington, Kentucky, United States