Introduction
Hydatidiform mole (HM) is a gestational trophoblastic disease, which is
characterized by abnormal trophoblastic proliferation and hydrophic
degeneration in the placenta [1]. HM may lead to several
complications, such as massive bleeding during pregnancy, uterine
rupture when performing evacuation, and transforming to gestational
trophoblastic neoplasia, so it negatively affects a woman’s health both
during pregnancy and for rest of her life [2]. Although several
studies have identified interesting pathogenetic pathways that might
contribute to the development of HM, such as genetic defects in
fertilization phase, NLRP7 gene mutations, and dietary changes, the
exact ethiology is still not fully elucidated [3-5].
Carnitine (L-3-hydroxy-4-N-N-N-trimethylaminobutyrate) is an essential
compound, that is synthesized in only a few organs, such as brain,
liver, and kidney. It has a functional role in the intracellular
transport of long-chain fatty acids for β-oxidation process [6,7].
Fatty acids are energy substrates that provide the energy necessary for
growth, maturation, and transport functions of placenta. Since carnitine
biosynthesis in the fetus is insufficient, transport of maternal
carnitine through the placenta plays an important role for fetal
development [8].
Amino acids are biologically important organic molecules, which play
central roles both in building of proteins and as intermediates in
metabolism of cells and tissues. The free amino acids (FAAs) are
distributed throughout the body to participate the active metabolic
system [9]. Previous studies have determined that metabolomics
analysis, a new method measuring the metabolites in all tissue or
biofluid samples, could usable in several diseases which has
uncontrolled cell growth [10-12]. In a study in normal pregnant
women, the elevated levels of FAAs were found compatible with
syncytiotrophoblast activity in the intervillous space [13]. Since
it is well known that there are hyperactivity and excess proliferation
in trophoblastic cells of molar
pregnancies, we hypothesized that FAA levels would be lower in plasma of
HM patients than in normal pregnants due to the enhanced metabolism of
trophoblastic cells. To the best of our knowledge, this is the first
study in the literature which compares plasma FAA and carnitine levels
in HM patients with those of healthy pregnant women.