The global epidemic of obesity is rapidly becoming a major public health problem in many parts of the world. Unhealthy diets and physical inactivity are two modifiable risk factors for prevention of obesity and its associated chronic diseases. Their influence on muscle energy metabolism and fat mass is not completely elucidated. A decreased capacity for fatty acid oxidation (FAO) may be a metabolic risk factor for weight gain and is found to be depressed in obese individuals; and exercise training may promote an increased capacity for FAO. In addition to the interest in whole-body FAO, the role of site specific lipid accumulation including visceral adipose tissue (VAT), intrahepatic lipids (IHL) and intramyocellular lipids (IMCL) has become a focus of interest because of their reported association with insulin resistance (IR), a key metabolic defect associated with obesity and type 2 diabetes mellitus (T2DM). However, ambiguity persists regarding the importance of IMCL as a metabolic substrate for energy production in obesity. A better understanding of the factors regulating FAO, body fat distribution and IMCL mobilisation is important for the development of interventions allowing effective treatment of conditions in which these are disturbed. The study of individuals with metabolic myopathies can give more information about the energy metabolism of muscle. McArdle disease (MD) affects glucose availability to muscle for energy production. Investigations into IMCL storage and mobilisation in MD have not been reported. The aims of this thesis are to investigate 1) the effects of weight-loss via dietary restriction plus modest but clinically-relevant exercise training on FAO, body fat distribution and mobilisation of IMCL during exercise in obese non-diabetic adults; 2) the effect of an exercise training intervention on IMCL storage and mobilisation in a subject with MD. All obese subjects underwent a 4 month lifestyle intervention with weekly meetings with a dietitian and an exercise physiologist. Of the 92 subjects, 73 completed the intervention. They showed significant decreases in body weight (8%), fat mass (14%) and total cholesterol (5%). The exercise prescription of 1500 kcal.week-1 resulted in variable compliance with the prescription (1224 ± 1085 kcal.week-1) measured by heart rate monitor. Those who did most exercise and also those who had less weekly variability in their exercise, had greater reductions in body weight and fat mass. The total activity energy expenditure measured by accelerometry did not change post-intervention but there was a reduction in low intensity activity and an increase in moderate and high intensity activity. A submaximal treadmill test and resting metabolic rate (RMR) using indirect calorimetry was measured before and after the intervention to investigate factors regulating FAO and energy expenditure. Subjects showed increases in FAO without change in energy expenditure for the same walking speed post intervention, but the volume of exercise completed during the intervention was not associated with these changes. To investigate body fat distribution in obesity, VAT, IHL and soleus muscle IMCL was measured in a sub-group of 18 males by magnetic resonance imaging (MRI) and spectroscopy (MRS) along with measurement of maximal aerobic capacity. Fitness increased significantly with significant decreases in VAT (29%) and IHL (54%), without significant change in IMCL. Subjects who had the greatest decrease in VAT were those who exercised for longer durations during the intervention. IHL was the only measure of excess lipid that correlated with IR. The measurement of IMCL before and after 1-hour of cycle ergometer exercise showed no significant mobilisation of IMCL either at baseline or after the lifestyle intervention. The intensity of the acute exercise was adjusted to correspond to each individual’s maximal fatty acid oxidation (MFAO) which increased by over 60% post intervention. In the subject with MD, an 8 week exercise training intervention without dietary intervention increased IMCL stores by 27%, but there was no marked change in IMCL with acute exercise at both time points. The findings of this thesis demonstrate that a clinically relevant and achievable lifestyle intervention incorporating weight loss through diet and objectively measured exercise can achieve improvements in blood lipid profile, body composition and FAO. The differential effects of the intervention on the various fat depots and their associations to metabolic markers suggest that individualised strategies may be required dependent upon body fat distribution. The non detection of mobilisation of IMCL by MRS suggests that these lipids may not be present as a substrate source in this population but rather an ectopic lipid depot related to increased energy consumption in diet. The relatively low capacity for FAO in both the obese and MD subjects may have affected the results. This thesis discusses implications for clinical practice, discusses novel findings related to the energy metabolism in obesity and MD and informs clinical and basic science about important future directions.

The global epidemic of obesity is rapidly becoming a major public health problem in many parts of the world. Unhealthy diets and physical inactivity are two modifiable risk factors for prevention of obesity and its associated chronic diseases. Their influence on muscle energy metabolism and fat mass is not completely elucidated. A decreased capacity for fatty acid oxidation (FAO) may be a metabolic risk factor for weight gain and is found to be depressed in obese individuals; and exercise training may promote an increased capacity for FAO. In addition to the interest in whole-body FAO, the role of site specific lipid accumulation including visceral adipose tissue (VAT), intrahepatic lipids (IHL) and intramyocellular lipids (IMCL) has become a focus of interest because of their reported association with insulin resistance (IR), a key metabolic defect associated with obesity and type 2 diabetes mellitus (T2DM). However, ambiguity persists regarding the importance of IMCL as a metabolic substrate for energy production in obesity. A better understanding of the factors regulating FAO, body fat distribution and IMCL mobilisation is important for the development of interventions allowing effective treatment of conditions in which these are disturbed. The study of individuals with metabolic myopathies can give more information about the energy metabolism of muscle. McArdle disease (MD) affects glucose availability to muscle for energy production. Investigations into IMCL storage and mobilisation in MD have not been reported. The aims of this thesis are to investigate 1) the effects of weight-loss via dietary restriction plus modest but clinically-relevant exercise training on FAO, body fat distribution and mobilisation of IMCL during exercise in obese non-diabetic adults; 2) the effect of an exercise training intervention on IMCL storage and mobilisation in a subject with MD. All obese subjects underwent a 4 month lifestyle intervention with weekly meetings with a dietitian and an exercise physiologist. Of the 92 subjects, 73 completed the intervention. They showed significant decreases in body weight (8%), fat mass (14%) and total cholesterol (5%). The exercise prescription of 1500 kcal.week-1 resulted in variable compliance with the prescription (1224 ± 1085 kcal.week-1) measured by heart rate monitor. Those who did most exercise and also those who had less weekly variability in their exercise, had greater reductions in body weight and fat mass. The total activity energy expenditure measured by accelerometry did not change post-intervention but there was a reduction in low intensity activity and an increase in moderate and high intensity activity. A submaximal treadmill test and resting metabolic rate (RMR) using indirect calorimetry was measured before and after the intervention to investigate factors regulating FAO and energy expenditure. Subjects showed increases in FAO without change in energy expenditure for the same walking speed post intervention, but the volume of exercise completed during the intervention was not associated with these changes. To investigate body fat distribution in obesity, VAT, IHL and soleus muscle IMCL was measured in a sub-group of 18 males by magnetic resonance imaging (MRI) and spectroscopy (MRS) along with measurement of maximal aerobic capacity. Fitness increased significantly with significant decreases in VAT (29%) and IHL (54%), without significant change in IMCL. Subjects who had the greatest decrease in VAT were those who exercised for longer durations during the intervention. IHL was the only measure of excess lipid that correlated with IR. The measurement of IMCL before and after 1-hour of cycle ergometer exercise showed no significant mobilisation of IMCL either at baseline or after the lifestyle intervention. The intensity of the acute exercise was adjusted to correspond to each individual’s maximal fatty acid oxidation (MFAO) which increased by over 60% post intervention. In the subject with MD, an 8 week exercise training intervention without dietary intervention increased IMCL stores by 27%, but there was no marked change in IMCL with acute exercise at both time points. The findings of this thesis demonstrate that a clinically relevant and achievable lifestyle intervention incorporating weight loss through diet and objectively measured exercise can achieve improvements in blood lipid profile, body composition and FAO. The differential effects of the intervention on the various fat depots and their associations to metabolic markers suggest that individualised strategies may be required dependent upon body fat distribution. The non detection of mobilisation of IMCL by MRS suggests that these lipids may not be present as a substrate source in this population but rather an ectopic lipid depot related to increased energy consumption in diet. The relatively low capacity for FAO in both the obese and MD subjects may have affected the results. This thesis discusses implications for clinical practice, discusses novel findings related to the energy metabolism in obesity and MD and informs clinical and basic science about important future directions.

No description available.

La cholestase intrahépatique de la grossesse (CIG) est la maladie du foie la plus répandue au cours de la grossesse. Elle est caractérisée par un prurit et est associée à une augmentation de la concentration des acides biliaires dans le sang, ce qui peut mener à un risque accru de conséquences périnatales indésirables, y compris un accouchement prématuré spontané et une augmentation des risques de mort de l’enfant à l’accouchement, entre autres. Le traitement médical de cette maladie repose actuellement sur l’acide ursodésoxycholique (UDCA) qui diminue le prurit et les anomalies biochimiques maternelles dans certains cas. Actuellement, le diagnostic de la CIG est posé suite à un test de quantification des acides biliaires sériques totaux par une méthode enzymatique. Nous émettons l'hypothèse que certains profils d’acides biliaires permettraient d’évaluer le risque de complications chez les femmes atteintes de CIG. En analysant les profilages, il pourrait être possible de déterminer la ou les espèces responsables de ces complications et ainsi déterminer des sous-groupes de patientes plus à risque de complications ou qui répondraient mieux au traitement. De plus, nous pensons que le traitement à l’UDCA, étant lui-même un acide biliaire, pourrait interférer lors de la quantification des acides biliaires totaux sériques, particulièrement dans les cas les plus problématiques de CIG où de fortes doses de ce composé sont administrées. Si c’était le cas, cela ferait en sorte que les valeurs de référence pourraient être modifiées en fonction du traitement administré. Le projet de recherche présenté vise au développement d’une méthode de quantification des acides biliaires sériques par la chromatographie liquide couplée à un spectromètre de masse en tandem (LC-MS/MS), qui permettrait un profilage des acides biliaires sériques chez les femmes enceintes atteintes de la CIG et qui permettrait également d’évaluer l’effet du traitement à l’UDCA sur ce profilage. Une méthode de quantification des acides biliaires par chromatographie liquide couplée à un spectromètre de masse en tandem a été développée et validée. Les surnageants obtenus par précipitation de protéines avec le méthanol ont été injectés sur le LC-MS/MS. La séparation est réalisée par chromatographie en phase inverse sur une colonne C18 de type interactions hydrophobes. Les transitions ioniques sur le spectromètre de masse ont été déterminées pour toutes les espèces d’acides biliaires au préalable et l’acide cholique deutéré, l’acide chénodésoxycholique deutéré ainsi que l’acide désoxycholique deutéré ont été utilisés comme standards internes. Quinze acides biliaires, y compris les acides biliaires conjugués et libres, ont été séparés et quantifiés par LC–MS/MS en utilisant l’ionisation par électro nébulisation (ESI) en mode ion négatif. La quantification a été réalisée en mode de surveillance de réactions multiples (MRM) avec des méthodes de courbes d'étalonnage externes. Les coefficients de corrélation des courbes standards pour tous les acides biliaires étaient supérieurs à 0,9966. La méthode développée a démontré une précision acceptable, avec une imprécision intra analyse inférieure à 3,2% pour toutes les espèces d’acide biliaire étudiées (pour des échantillons à 0,8 et 5 μg/mL) et une imprécision inter analyse inférieure à 15%. Une suppression d’ion moyenne de 8,2% a été observée, qui a été jugée acceptable. Une bonne corrélation a été obtenue entre la méthode LC-MS/MS et une méthode enzymatique (r=0,964). En conclusion, une méthode fonctionnelle, efficace et rapide a été développée pour quantifier les acides biliaires sériques individuels et différents profils d’acides biliaires représentant une large gamme de concentrations ont été comparés. La comparaison des profilages d’acides biliaires suggère que les acides biliaires principaux responsables de l’augmentation de la concentration des acides biliaires totaux dans le sang pour des échantillons à une concentration de plus de 10 μmol/L sont l’acide cholique glyco-conjugué (GCA), l’acide cholique tauro-conjugué (TCA) ainsi que l’acide ursodésoxycholique glyco- conjugué (GUDCA). Cette nouvelle méthode validée, et les données préliminaires sur les profils d’acides biliaires dans les échantillons cliniques, permettront de lancer des analyses cliniques prospectives pour évaluer l’effet du traitement par l’UDCA sur les concentrations totales d’acides biliaires sériques et sur les profils d’acides biliaires individuels chez les patientes atteintes de la CIG. / Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease during pregnancy. It is characterized by pruritus and is associated with an increased concentration of bile acids in blood, which may lead to an increased risk of perinatal consequences, including spontaneous preterm delivery and an increased risk of death at birth, among others. The medical treatment of this disease currently relies on ursodeoxycholic acid (UDCA) which reduces pruritus and maternal biochemical abnormalities in some cases. Currently, the diagnosis of ICP is made using an enzymatic assay to measure total serum bile acids. We hypothesize that profiling of the individual bile acids would make it possible to assess the risk of complications in women with ICP. By analyzing the bile acid profiles, it could be possible to determine which specie(s) is responsible for these complications and thus to distinguish subgroups of patients at higher risk of complications or who would respond better to treatment. In addition, we believe that UDCA treatment, being a bile acid itself, could interfere with the quantification of total serum bile acids, particularly in the most problematic cases of CIG where high doses of this compound are administered. If this was the case, it would mean that the reference values would need to be changed depending on the administered treatment. The research project aims to develop and validate a method for quantifying bile acids in serum by liquid chromatography coupled to a tandem mass spectrometer (LC-MS/MS), which would allow profiling of serum bile acids in affected women and which would also make it possible later to evaluate the effects of UDCA treatment on this profiling. A method for the quantification of bile acids by liquid chromatography coupled to tandem mass spectrometry has been developed and validated. The supernatants obtained by precipitation of proteins with methanol were injected onto the LC-MS/MS. The separation was carried out using reversed-phase chromatography on a C18 hydrophobic interactions type column. Ionic transitions on the mass spectrometer were determined for all bile acids species beforehand and deuterated cholic acid, deuterated chenodeoxycholic acid and deuterated deoxycholic acid were used as internal standards. Fifteen bile acids, including conjugated and free bile acids, were separated and quantified by LC–MS/MS using electrospray ionization (ESI) in negative ion mode. Quantification was performed in multiple reaction monitoring (MRM) mode with external calibration curve methods. Correlation coefficients for standard curves for all bile acids were greater than 0.9966. The method developed showed acceptable precision, with intra-assay imprecision of less than 3.2% for all the bile acid species studied (for samples at 0.8 and 5 μg/mL) and inter-assay imprecision under 15%. An average ion suppression of 8.2% was observed, which was judged acceptable. Finally, a good correlation was obtained between the LC-MS/MS method and an enzymatic method (r = 0.964). In conclusion, a functional, efficient and rapid method was developed to quantify the individual serum bile acids and different bile acids profiles representing a wide range of concentrations were compared. The comparison of the bile acid profiles suggests that the main bile acids responsible for the increase in total bile acids concentration in blood for samples at a concentration of more than 10 μmol/L are glycocholic acid (GCA), taurocholic acid (TCA), glycoursodeoxycholic acid (GUDCA). This new validated method, and the preliminary data on bile acid profiles in clinical samples, will allow us to initiate prospective clinical analyses to assess the effect of UDCA treatment on total bile acid concentrations and profiles in patients with intrahepatic cholestasis of pregnancy.

L'utilisation du pentobarbital de sodium (PB), injecté par voie intrapéritonéale (IP), est décrite comme une technique acceptable par les directives d'euthanasie de l'AVMA et du CCPA pour tuer les rongeurs. Cependant, de plus en plus de preuves contestent l'acceptabilité de l'IP PB. Celle-ci a été décrite comme inconsistante et il existe des données suggérant que cette technique pourrait induire de la douleur et du stress. L'objectif de cette thèse était donc de développer et d'évaluer des méthodes alternatives d'euthanasie. Au cours de l'étude pilote, nous avons développé un protocole d'injection pour les injections intrahépatiques (IH) de PB. Ensuite, nous avons testé cette injection sur des souris et des rats. Comme objectif secondaire, nous avons évalué l'utilisation de l'éthanol (ET) comme alternative au PB pour l’euthanasie des souris. Pour les souris, quatre-vingts souris CD1 adultes (mâles et femelles- 26,8 g [23-34 g], moyenne [intervalle]) ont été assignées au hasard à 6 groupes de traitement et ont été tuées par des injections IH ou des injections IP, en utilisant soit ET ou PB. Le taux de mauvaise injection (mauvais placement du contenu de l'injection) pour les essais IH était de 93% (28/30), y compris 14% intrathoracique (4/28), le reste ayant abouti dans la cavité péritonéale telle une injection IP. Ainsi, seulement 7% (2/30) des injections ont donné lieu à une administration hépatique (selon l’évaluation d'autopsie). Les injections IH ayant abouti dans le foie ont entraîné des décès quasi instantanés. Ces données montrent que les injections IH ne sont pas réalisables chez la souris étant donné la difficulté à frapper le foie et le risque d'injections intrathoraciques. D'autre part, l'IP ET a produit des temps significativement (p = 0.010; Mann-Whitney) plus courts de l'injection à l'arrêt du rythme cardiaque (CHB) (115s [88-185] médian [intervalle]) par rapport à l'IP PB (176s [123-260]), confirmant que l'ET est une alternative viable et potentiellement supérieure à la PB. Pour les rats, 66 injections IH et 14 injections IP ont été tentées sur des rats Sprague-Dawley mâles et femelles adultes (poids médian 371g, plage 170-730g), et ont entraîné un délai significativement plus rapide pour la perte du réflexe de redressement (LORR) (p < 0.0001, 95%CI 68 to 88s, Mann-Whitney) et temps de CHB (p < 0.0001, 95%CI 82 to 234s, Mann-Whitney) par rapport aux injections IP. Le temps médian de LORR et CHB après les injections IH était de 4s [1 to 96] et 142.5s [2 to 330] respectivement; alors que le temps médian de LORR et CHB après les injections IP était de 89.5s [73 to 110] et 275s [237 to 423], respectivement. Le taux de mauvaise injection, basé sur les évaluations d’autopsie, était plus élevé avec les injections IH qu'avec les injections IP (IH: 59%, IP: 29%); cependant, 97% des mauvaises injections IH ont tout de même produit une euthanasie réussie et rapide (LORR: 29s [1 to 96], CHB: 216s [12 to 330]. Les injections IH sont donc une alternative efficace aux injections IP pour l'euthanasie chez le rat, et présentent moins de risques d'échec des tentatives d'euthanasie. / The use of sodium pentobarbital (PB), injected intraperitoneally (IP), for killing rodents is described as an acceptable technique by the American Veterinary Medical Association (AVMA) and Canadian Council on Animal Care (CCAC) euthanasia guidelines. However, there is a growing body of evidence challenging the acceptability of IP PB. It has been described as inconsistent and there is evidence that it may induce pain and stress. The objective of this thesis was to develop and evaluate alternative methods of euthanasia. During the pilot study, an injection protocol for intrahepatic (IH) injections of PB was developed and then tested on both mice and rats. As a secondary objective, the use of ethanol (ET) was evaluated as an alternative to PB for mice. For mice, eighty adult (male and female) CD1 mice (26.8g [23-34g], mean [range]) were randomly assigned to 6 treatment groups and were killed by IH injections or IP injections, using either ET or PB. the misinjection rate (misplacement of injectate) for IH injections was 93% (28/30), including 14% intrathoracic (4/28), and the remainder were IP delivery. Only 7% (2/30) of IH attempts resulted in successful IH delivery, per necropsy evaluation. These yielded quasi-instantaneous deaths. These data show that IH injections are not feasible in mice given the difficulty in hitting the liver and the risk of intrathoracic injections. On the other hand, IP ET produced significantly (p = 0.010; Mann-Whitney) shorter time from injection to cessation of heartbeat (CHB) (115s [88-185] median [range]) compared with IP PB (176s [123-260]), confirming that ET is a viable and potentially superior alternative to PB. For rats, 66 IH injections and 14 IP injections were attempted on adult male and female Sprague-Dawley rats (median weight 371g, range 170-730g), and resulted in significantly faster time to loss of righting reflex (LORR) (p < 0.0001, 95%CI 68 to 88s, Mann-Whitney) and time to CHB (p < 0.0001, 95%CI 82 to 234s, Mann-Whitney) compared with IP injections. Time to LORR and CHB following IH injections were: LORR of 4s [1 to 96], CHB of 142.5s [2 to 330]; compared with IP injections: LORR of 89.5s [73 to 110], CHB of 275s [237 to 423). The misinjection rate was higher with IH injections than with IP injections (IH: 59%, IP: 29%); however, 97 % of IH misinjections resulted in fast and successful euthanasia (LORR: 29s [1 to 96], CHB: 216s [12 to 330]. IH injections are thus an efficacious alternative to IP injections for rat euthanasia and pose less risk of failed euthanasia attempts.

ABCB11/BSEP est le transporteur des acides biliaires, localisé au niveau du pôle canaliculaire des hépatocytes. Les mutations de ce gène sont responsables de la cholestase familiale intrahépatique progressive de type 2.Au cours de ma thèse, j’ai évalué la capacité des aminoglycosides et du PTC124 à induire la translecture de codons stop prématurés, l’adressage et la fonction de mutants non-sens et faux sens de Bsep ainsi que l’effet d’une bithérapie (translecture+chaperone).Dans nos modèles cellulaires, la gentamicine était capable d’induire la translecture du codon-stop prématuré du mutant non-sens BsepR1090X dans les lignées NIH3T3, HEK293 et Can 10. La protéine entière générée était partiellement détectée aux membranes plasmiques des cellules HEK293 et canaliculaires des cellules Can 10 et était partiellement fonctionnelle puisqu’elle était responsable d’une augmentation de l’activité de transport de 3H-taurocholate (3H-TC) dans les clones MDCK. Ces effets étaient potentialisés par l’addition de drogues chaperones telles que le 4-phenylbutyrate (4-PB).J’ai également mis en évidence la capacité de nouveaux composés dérivés du 4-PB (MHMPB, OTNC et HMPB) à corriger l’adressage et à augmenter le transport de 3H-TC du mutant faux sens BsepR1128C à des concentrations plus faibles que le 4-PB. Enfin, j’ai pu montrer que d'autres drogues chaperones (GPB, PA, SAHA et C18), pouvaient corriger l’adressage canaliculaire de BsepR1128C et augmenter son activité de transport de 3H-TC dans les clones MDCK. / ABCB11/BSEP is the main bile acids transporter located at the canalicular pole of hepatocytes. Mutations of ABCB11 are responsible for progressive familial intrahepatic cholestasis type 2.During my phD, I evaluated the ability of aminoglycosides and PTC124 to induce readthrough of premature termination codons, targeting and function of nonsense and missense mutants of Bsep and also the effect of combined therapy (readthrough + chaperone).In our expermental models, gentamicin increased readthrough of p.R1090X mutation NIH3T3, HEK293 and Can 10 lines. The resulting full-length protein was detected at the plasma membrane of HEK293 and at the canalicular membrane of Can 10 cells; and was partially functional since it was responsible for increasing the transport activity of 3H-taurocholate (3H-TC) in MDCK clones. These effects were potentiated by the addition of chaperone drugs such as 4-phenylbutyrate (4-PB).I have also demonstrated the ability of new 4-PB derived compounds (MHMPB, OTNC and HMPB) to correct mistrafficking and to increase 3H-TC transport of BsepR1128C missense mutant at lower concentrations than 4-PB. Finally, I showed that other chaperone drugs (GPB, PA, SAHA, and C18) were able to correct mistrafiking of BsepR1128C and to increase its 3H-TC transport activity in MDCK clones.

No description available.

The aim of this thesis was to establish methods for selected PAPP-A (Pregnancy- Associated Plasma Protein A) gene polymorphisms analysis and to study genetic background of PAPP-A and biochemical background of PAPP-A and PlGF (Placental Growth Factor) in relation to risk pregnancy. Secondly, the aim was to establish method for two-dimensional (2D) electrophoresis of amniotic fluid. Methods for analysis of ten PAPP-A gene polymorphisms were established. These polymorphisms, PAPP-A and PlGF levels were studied in together 165 women in third trimester pregnancies complicated with threatening preterm labor (n=98), preeclampsia (n=35), IUGR (Intrauterine Growth Restriction) (n=34) and ICP (Intrahepatic Cholestasis of Pregnancy) (n=15). 114 healthy pregnant women served as controls. The method for 2D electrophoresis of amniotic fluid was established. Preeclamptic patients had significantly higher frequency of TT genotype of Cys327Cys (C/T) PAPP-A gene polymorphism compared to controls. Patients with ICP had increased serum levels of PAPP-A compared to controls, in patients with threatening preterm labor PAPP-A levels were rather decreased. PlGF levels did not differ from control group in patients with ICP and threatening preterm labor. Positive correlation was found between PAPP-A and PlGF in group of...

The aim of this thesis was to establish methods for selected PAPP-A (Pregnancy- Associated Plasma Protein A) gene polymorphisms analysis and to study genetic background of PAPP-A and biochemical background of PAPP-A and PlGF (Placental Growth Factor) in relation to risk pregnancy. Secondly, the aim was to establish method for two-dimensional (2D) electrophoresis of amniotic fluid. Methods for analysis of ten PAPP-A gene polymorphisms were established. These polymorphisms, PAPP-A and PlGF levels were studied in together 165 women in third trimester pregnancies complicated with threatening preterm labor (n=98), preeclampsia (n=35), IUGR (Intrauterine Growth Restriction) (n=34) and ICP (Intrahepatic Cholestasis of Pregnancy) (n=15). 114 healthy pregnant women served as controls. The method for 2D electrophoresis of amniotic fluid was established. Preeclamptic patients had significantly higher frequency of TT genotype of Cys327Cys (C/T) PAPP-A gene polymorphism compared to controls. Patients with ICP had increased serum levels of PAPP-A compared to controls, in patients with threatening preterm labor PAPP-A levels were rather decreased. PlGF levels did not differ from control group in patients with ICP and threatening preterm labor. Positive correlation was found between PAPP-A and PlGF in group of...