Evidence map›Paper›PMID 42794639›Full record

ArticleInternational journal of molecular sciences2026

Dysregulation of the Heparanase/TFPI-2/Heparan Sulfate Axis in Recurrent Pregnancy Loss.

Chen Yanovich, Nadin Sabbah, Keren Asayag, Yonatan Crispel, Haim Cohen, Anat Keren-Politansky, Yona Nadir

Abstract read
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Article in International journal of molecular sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Chen YanovichThrombosis and Hemostasis Unit, Rambam Health Care Campus, Haifa 31096, Israel.
Nadin SabbahThrombosis and Hemostasis Unit, Rambam Health Care Campus, Haifa 31096, Israel.
Keren AsayagThrombosis and Hemostasis Unit, Rambam Health Care Campus, Haifa 31096, Israel.ORCID 0000-0001-7024-8667
Yonatan CrispelThrombosis and Hemostasis Unit, Rambam Health Care Campus, Haifa 31096, Israel.
Haim CohenThrombosis and Hemostasis Unit, Rambam Health Care Campus, Haifa 31096, Israel.
Anat Keren-PolitanskyThrombosis and Hemostasis Unit, Rambam Health Care Campus, Haifa 31096, Israel.
Yona NadirThrombosis and Hemostasis Unit, Rambam Health Care Campus, Haifa 31096, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Recurrent pregnancy loss (RPL) is a clinically heterogeneous reproductive disorder, and in many women the underlying mechanism remains unexplained by standard thrombophilia evaluation. Pregnancy is characterized by a tightly regulated hemostatic balance at the maternal-placental interface. Heparanase, tissue factor pathway inhibitor 2 (TFPI-2), and heparan sulfate (HS) are expressed in placental and hemostatic pathways and may contribute to coagulation-related pregnancy complications. We investigated whether the heparanase/TFPI-2/HS axis is altered in women with RPL. Blood samples were obtained from 69 women with RPL and 47 control women with at least two normal deliveries and no history of pregnancy-related vascular complications. Samples were collected at least three months after pregnancy and in the absence of hormonal therapy. Plasma and white blood cell samples were analyzed using an enzyme-linked immunosorbent assay, Western blotting, real-time polymerase chain reaction, co-immunoprecipitation, and Sanger sequencing. Mechanistic experiments using heparanase-derived peptide 16 and TFPI-2-derived peptide 6 were performed in MCF-7 and JAR cells. We found that women with RPL had increased plasma heparanase levels, heparanase procoagulant activity, HS levels, and heparanase mRNA expression compared with controls. TFPI-2 protein and mRNA expression were also elevated. The heparanase rs4693608 AA genotype was more frequent in women with RPL and, together with rs4364254 TT, was associated with increased heparanase expression and procoagulant activity. Although TFPI-2 levels were higher in RPL, co-immunoprecipitation showed reduced heparanase/TFPI-2 complex formation, suggesting impaired inhibitory regulation. HS modulated heparanase binding to TF and TFPI-2 in a concentration-dependent, bell-shaped manner. Heparanase-derived peptide 16 increased TFPI-2 expression, supporting a regulatory feedback loop. In conclusion, RPL is associated with dysregulation of the heparanase/TFPI-2/HS axis, including increased heparanase expression and activity, altered heparanase/TFPI-2 interaction, and heparanase-related genetic variation. These findings suggest a coagulation-related reproductive mechanism that may contribute to pregnancy loss and warrants validation in larger prospective studies.

Indexed as

Abortion, HabitualGlucuronidaseGlycoproteinsHeparan SulfateLipoproteinsAdultFemaleHeparanaseHumansPregnancyGlucuronidaseGlycoproteinsHeparanaseHeparan SulfateLipoproteinstissue-factor-pathway inhibitor 2heparanaseheparan sulfaterecurrent pregnancy lossthrombophiliatissue factor pathway inhibitor 2

Identifiers

PMID42794639
PMCPMC13607651

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.