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Varagic J, Desvigne-Nickens P, Gamble-George J, Hollier L, Maric-Bilkan C, Mitchell M, Pemberton VL, Redmond N. Maternal Morbidity and Mortality: Are We Getting to the "Heart" of the Matter? J Womens Health (Larchmt) 2020; 30:178-186. [PMID: 33259740 PMCID: PMC8020498 DOI: 10.1089/jwh.2020.8852] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Cardiovascular disease (CVD), including hypertensive disorders of pregnancy (HDP) and peripartum cardiomyopathy, is a leading cause of pregnancy-related death in the United States. Women who are African American or American Indian/Alaskan Native, have HDP, are medically underserved, are older, or are obese have a major risk for the onset and/or progression of CVD during and after pregnancy. Paradoxically, women with no preexisting chronic conditions or risk factors also experience significant pregnancy-related cardiovascular (CV) complications. The question remains whether substantial physiologic stress on the CV system during pregnancy reflected in hemodynamic, hematological, and metabolic changes uncovers subclinical prepregnancy CVD in these otherwise healthy women. Equally important and similarly understudied is the concept that women's long-term CV health could be detrimentally affected by adverse pregnancy outcomes, such as preeclampsia, gestational hypertension, and diabetes, and preterm birth. Thus, a critical life span perspective in the assessment of women's CV risk factors is needed to help women and health care providers recognize and appreciate not only optimal CV health but also risk factors present before, during, and after pregnancy. In this review article, we highlight new advancements in understanding adverse, pregnancy-related CV conditions and will discuss promising strategies or interventions for their prevention, diagnosis, and treatment.
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Affiliation(s)
- Jasmina Varagic
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Patrice Desvigne-Nickens
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Joyonna Gamble-George
- Center for Translational Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Lisa Hollier
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Christine Maric-Bilkan
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Megan Mitchell
- Division of Extramural Research Activities, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Victoria L Pemberton
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Nicole Redmond
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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102
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Getaneh T, Negesse A, Dessie G, Desta M. The impact of pregnancy induced hypertension on low birth weight in Ethiopia: systematic review and meta-analysis. Ital J Pediatr 2020; 46:174. [PMID: 33243285 PMCID: PMC7690116 DOI: 10.1186/s13052-020-00926-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/26/2020] [Indexed: 02/07/2023] Open
Abstract
Background Even though neonatal mortality reduction is the major goal needed to be achieved by 2030, it is still unacceptably high especially in Ethiopia. In the other hand, low birth weight is the major cause of neonatal mortality and morbidity. More than 10 millions of low birth weight infants occurred as a result of pregnancy induced hypertension. However, in Ethiopia the association between low birth weight and pregnancy induced hypertension was represented with un-updated, inconclusive and different studies. Therefore, this review aimed to estimate the overall pooled impact of pregnancy induced hypertension on low birth weight and its association in Ethiopia. Methods articles searched on PubMed/Medline, EMBASE, CINAHL, Cochrane library, Google, Google Scholar and local shelves. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was applied for critical appraisal. The I2 statistic was computed to check the presence of heterogeneity. Publication bias was evaluated using funnel plot asymmetry and Egger’s test. A random effect model was used to estimate the pooled prevalence of low birth weight. Result From the total 131 identified original articles, 25 were eligible and included for the final analysis. The overall pooled prevalence of low birth weight among women who had pregnancy induced hypertension in Ethiopia was 39.7% (95% CI: 33.3, 46.2). But, I2 statistic estimation evidenced significant heterogeneity across included studies (I2 = 89.4, p < 0.001). In addition, the odds of having low birth weight newborns among women who had pregnancy induced hypertension was 3.89 times higher compared to their counterparts (OR = 3.89, 95% CI: 2.66, 5.69). Conclusion The pooled prevalence of low birth weight among women who had pregnancy induced hypertension was more than two times higher than the pooled estimate of low birth weight among all reproductive aged women. The odds of low birth weight also increased nearly four times among women with pregnancy induced hypertension than normotensive women. Therefore, health policies which provide better and quality antenatal care with more oriented on importance of early detection and management of pregnancy induced hypertension should be implemented.
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Affiliation(s)
- Temesgen Getaneh
- Department of Midwifery, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
| | - Ayenew Negesse
- Department of Human Nutrition and Food Sciences, College of Health Science, Debre Markos University, Debre Markos, Ethiopia.,Center of excellence in Human Nutrition, School of Human Nutrition, Food Science and Technology, Hawassa University, Hawasa, Ethiopia
| | - Getenet Dessie
- Department of Nursing, School of Health science, College of Medicine and Health Science, Bahr Dar University, Bahir Dar, Ethiopia
| | - Melaku Desta
- Department of Midwifery, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
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103
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Chen Y, Huang P, Han C, Li J, Liu L, Zhao Z, Gao Y, Qin Y, Xu Q, Yan Y, Wang Y, Ren J, Men J, Dong J, Zhang J, Xue F. Association of placenta-derived extracellular vesicles with pre-eclampsia and associated hypercoagulability: a clinical observational study. BJOG 2020; 128:1037-1046. [PMID: 33010098 DOI: 10.1111/1471-0528.16552] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Pre-eclampsia (PE) is a pregnancy-associated condition initiated by placental factors. We have demonstrated that placental extracellular vesicles (pcEVs) cause hypertension and proteinuria in pregnant and non-pregnant mice. STUDY DESIGN An observational study with both case-control and longitudinal designs. SETTING A single centre at the Department of Obstetrics and Gynaecology, Tianjin Medical University. POPULATION We collected blood samples and clinical information from 54 PE patients, 33 normally pregnant women at 30-36 gestational weeks and on postpartum days 1 and 4 for the cross-sectional study, and at 22-31, 32-35 and 36-40 weeks for the longitudinal study. Non-pregnant women were also recruited. METHODS Blood samples were analysed using flow cytometry, coagulation tests and ELISA. MAIN OUTCOME MEASURES The primary outcome was plasma pcEV and other extracellular vesicles (EVs), and their expressions of anionic phospholipids and von Willebrand factor (VWF). Secondary variables included coagulation, ADAMTS-13 and the anionic phospholipid-binding proteins. RESULTS Plasma pcEVs progressively increased from pregnant women during non-menstrual period (NW) to PE patients (interquartile range [IQR] for NW: 206/microlitre [116-255], normal pregnancy [NP]: 1108/microlitre [789-1969] and PE: 8487/microlitre [4991-16 752]) and predicted PE. EVs from endothelial cells, platelets and erythrocytes accounted for <10% of pcEVs. VWF became hyper-adhesive in PE patients and contributed to the pregnancy-associated hypercoagulability. CONCLUSION Placental, platelet- and endothelial cell-derived EVs were significantly elevated in PE patients, but only pcEVs predicted PE. These EVs played a causal role in the pregnancy-induced hypercoagulability. TWEETABLE ABSTRACT Placenta-derived extracellular vesicles predict pre-eclampsia and the associated hypercoagulability.
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Affiliation(s)
- Y Chen
- Department of Obstetrics and Gynaecology, Tianjin Medical University General Hospital and Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - P Huang
- Department of Obstetrics and Gynaecology, Tianjin Medical University General Hospital and Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - C Han
- Department of Obstetrics and Gynaecology, Tianjin Medical University General Hospital and Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - J Li
- Department of Obstetrics and Gynaecology, Tianjin Medical University General Hospital and Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - L Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital and Tianjin Neurological Institute, Tianjin, China
| | - Z Zhao
- Department of Neurosurgery, Tianjin Medical University General Hospital and Tianjin Neurological Institute, Tianjin, China
| | - Y Gao
- Department of Neurosurgery, Tianjin Medical University General Hospital and Tianjin Neurological Institute, Tianjin, China
| | - Y Qin
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Q Xu
- Department of Obstetrics and Gynaecology, Tianjin Medical University General Hospital and Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - Y Yan
- Department of Obstetrics and Gynaecology, Tianjin Medical University General Hospital and Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - Y Wang
- Department of Obstetrics and Gynaecology, Tianjin Medical University General Hospital and Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - J Ren
- Centre of Precision Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - J Men
- Centre of Precision Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - J Dong
- Bloodworks Research Institute, Seattle, WA, USA.,Division of Hematology, Department of Medicine, University of Washington, School of Medicine, Seattle, WA, USA
| | - J Zhang
- Department of Neurosurgery, Tianjin Medical University General Hospital and Tianjin Neurological Institute, Tianjin, China
| | - F Xue
- Department of Obstetrics and Gynaecology, Tianjin Medical University General Hospital and Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
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104
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Wang X, Liang G, Guo Q, Cai W, Zhang X, Ni J, Tao Y, Niu X, Chen S. ELABELA improves endothelial cell function via the ELA-APJ axis by activating the PI3K/Akt signalling pathway in HUVECs and EA.hy926 cells. Clin Exp Pharmacol Physiol 2020; 47:1953-1964. [PMID: 32687618 DOI: 10.1111/1440-1681.13382] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/11/2020] [Accepted: 07/13/2020] [Indexed: 01/26/2023]
Abstract
Destruction of endothelial cells (ECs) function is involved in the structural and functional pathophysiological processes of preeclampsia (PE). Vascular endothelial injury may pre-exist for several years in women that develop PE and may pose increased risks for hypertension, coronary artery disease, and type-2 diabetes mellitus. Previous findings showed that Elabela (ELA), the endogenous ligand of the apelin (APJ) receptor expressed mainly on ECs, may play a protective role in early pregnancy and prevent PE. However, the exact functional role and molecular mechanisms of ELA are unclear. Here, we aimed to classify whether and how ELA improves EC function via the ELA-APJ axis. Two human umbilical vein endothelial cell (HUVEC) lines, namely HUVECs and EA.hy926, were treated with ELA, and then their cellular activities were studied by performing CCK-8 tests, scratch-wound analysis, and tube-formation assays. Doses of ELA exceeding 0.01 μmol/L markedly improved the cell viability, migration, and tube formation ability of HUVECs and EA.hy926 cells. Western blot analysis indicated that the above effects caused by ELA were related to upregulation of the APJ receptor and activation of PI3K/Akt signalling. Further verification tests were performed using the PI3K inhibitor wortmannin, and the results illustrated that inhibiting PI3K/Akt signalling blocked the positive effects of ELA on EC function and APJ receptor expression. Taken together, our findings indicate that ELA may alter EC function via the ELA-APJ axis and PI3K/Akt signalling and that ELA shows promise for use in endothelial dysfunction therapy for preventing and treating PE.
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Affiliation(s)
- Xiujuan Wang
- Institute of Prevention and Treatment of Cardiovascular Diseases in Alpine Environment of Plateau, Characteristic Medical Center of the Chinese People's Armed Police Force, Tianjin, China
| | - Guoqing Liang
- Institute of Prevention and Treatment of Cardiovascular Diseases in Alpine Environment of Plateau, Characteristic Medical Center of the Chinese People's Armed Police Force, Tianjin, China
| | - Qing Guo
- Institute of Prevention and Treatment of Cardiovascular Diseases in Alpine Environment of Plateau, Characteristic Medical Center of the Chinese People's Armed Police Force, Tianjin, China
| | - Wei Cai
- Institute of Prevention and Treatment of Cardiovascular Diseases in Alpine Environment of Plateau, Characteristic Medical Center of the Chinese People's Armed Police Force, Tianjin, China
| | - Xin Zhang
- Institute of Prevention and Treatment of Cardiovascular Diseases in Alpine Environment of Plateau, Characteristic Medical Center of the Chinese People's Armed Police Force, Tianjin, China
| | - Jianmei Ni
- Institute of Prevention and Treatment of Cardiovascular Diseases in Alpine Environment of Plateau, Characteristic Medical Center of the Chinese People's Armed Police Force, Tianjin, China
| | - Yanyan Tao
- Institute of Prevention and Treatment of Cardiovascular Diseases in Alpine Environment of Plateau, Characteristic Medical Center of the Chinese People's Armed Police Force, Tianjin, China
| | - Xiulong Niu
- Institute of Prevention and Treatment of Dermatosis in Alpine Environment of Plateau, Characteristic Medical Center of the Chinese People's Armed Police Force, Tianjin, China
| | - Shaobo Chen
- Institute of Prevention and Treatment of Cardiovascular Diseases in Alpine Environment of Plateau, Characteristic Medical Center of the Chinese People's Armed Police Force, Tianjin, China
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105
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Wu D, Shi L, Hong L, Chen X, Cen H. MiR-135a-5p promotes the migration and invasion of trophoblast cells in preeclampsia by targeting β-TrCP. Placenta 2020; 99:63-69. [PMID: 32758717 DOI: 10.1016/j.placenta.2020.07.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/02/2020] [Accepted: 07/26/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND MiR-135a-5p is an important regulator of cell migration and invasion in several diseases. However, the biological functions and mechanisms of miR-135a-5p in women with preeclampsia (PE) remain unclear. METHODS The levels of miR-135a-5p and beta-transducin repeat containing E3 ubiquitin protein ligase (β-TrCP) expression in samples of placenta tissue from PE patients and healthy control subjects were determined by quantitative real-time PCR. The effects of miR-135a-5p and β-TrCP on cell migration, invasion, and epithelial-mesenchymal transition (EMT) in two trophoblast cell lines (HTR-8/SVneo and TEV-1) were examined using wound healing, Transwell, and western blot assays, respectively. A luciferase reporter assay was performed to confirm the association between miR-135a-5p and β-TrCP, and an in vivo mouse model was established and used to analyze the effect of β-TrCP on PE clinical phenotypes. RESULTS We found that miR-135a-5p expression was significantly decreased and negatively correlated with β-TrCP expression in the placental tissues of pregnant women with PE. Cellular function experiments showed that overexpression of miR-135a5p promoted the migration and invasion of trophoblast cells in vitro. Furthermore, β-TrCP was confirmed as a target gene of miR-135a-5p in trophoblast cells. Notably, overexpression of β-TrCP significantly reversed the effect of miR-135a-5p on migration and invasion of trophoblast cells. At the molecular level, decreases in E-cadherin levels and increases in N-cadherin, Vimentin, and β-catenin levels that were induced by miR-135a-5p overexpression were attenuated by β-TrCP overexpression. CONCLUSIONS Our findings demonstrate that miR-135a-5p promotes the migration and invasion of trophoblast cells by targeting β-TrCP.
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Affiliation(s)
- Dongcai Wu
- Department of Obstetrics, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China.
| | - Li Shi
- Department of Medical Ultrasonics, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Lan Hong
- Department of Gynecology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Xiaoju Chen
- Department of Obstetrics, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Hui Cen
- Department of Obstetrics, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
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106
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Huai J, Li GL, Lin L, Ma JM, Yang HX. Phosphoproteomics reveals the apoptotic regulation of aspirin in the placenta of preeclampsia-like mice. Am J Transl Res 2020; 12:3361-3375. [PMID: 32774705 PMCID: PMC7407703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 06/03/2020] [Indexed: 06/11/2023]
Abstract
Preeclampsia (PE) is a severe gestational complication, and dysfunctional placenta plays an essential role in PE pathogenesis. Although low-dose aspirin is currently the most promising prophylactic drug for PE prevention, the exact mechanism of aspirin remains unclear. A previous study reported that treatment with low-dose aspirin could ameliorate PE-like symptoms in lipopolysaccharide (LPS)-induced PE-like mouse model. This study aimed to uncover the potential mechanism of aspirin action in PE through quantitative phosphoproteomics comparison. We established the following four groups: a control (CTRL) group, an LPS-treated (L) group, an LPS + aspirin co-treatment (LA) group, and an aspirin-treated (A) group. A total of 4350 phosphosites and 4170 phosphopeptides from 1866 phosphoproteins were identified in the placenta on embryonic day 13.5. Among the significantly altered phosphoproteins identified, apoptosis-related pathways were significantly regulated in both the L group vs. CTRL group and the LA group vs. L group comparisons. We demonstrated that apoptosis was increased in the placenta of PE-like mice and was inhibited in the LA group by quantify the apoptosis-positive cells and the protein levels of cleaved caspase 3, 8, and 9. Moreover, the phosphorylation of HSP90β (S254) and GSK3β (Y216) may be a crucial factor in the aspirin-mediated regulation of apoptosis according to protein-protein interaction analysis. This study revealed that apoptosis regulation is a mechanism of aspirin action in PE, particularly in women with over-activated inflammation. The phosphorylation of HSP90β (S254) and GSK3β (Y216) could be the key intervention targets.
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Affiliation(s)
- Jing Huai
- Department of Obstetrics and Gynecology, Peking University First HospitalBeijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes MellitusBeijing, China
| | - Guan-Lin Li
- Department of Obstetrics and Gynecology, Peking University First HospitalBeijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes MellitusBeijing, China
| | - Li Lin
- Department of Obstetrics and Gynecology, Peking University First HospitalBeijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes MellitusBeijing, China
| | - Jing-Mei Ma
- Department of Obstetrics and Gynecology, Peking University First HospitalBeijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes MellitusBeijing, China
| | - Hui-Xia Yang
- Department of Obstetrics and Gynecology, Peking University First HospitalBeijing, China
- Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes MellitusBeijing, China
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107
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Cornelius DC, Wallace K. Autophagy in preeclampsia: A new target? EBioMedicine 2020; 57:102864. [PMID: 32650269 PMCID: PMC7341341 DOI: 10.1016/j.ebiom.2020.102864] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/12/2020] [Indexed: 01/12/2023] Open
Affiliation(s)
- Denise C Cornelius
- Departments of Emergency Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, United States; Departments of Pharmacology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, United States
| | - Kedra Wallace
- Departments of Obstetrics & Gynecology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, United States; Departments of Neurobiology & Anatomical Sciences, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, United States.
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108
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The bioflavonoid quercetin improves pathophysiology in a rat model of preeclampsia. Biomed Pharmacother 2020; 127:110122. [DOI: 10.1016/j.biopha.2020.110122] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 03/19/2020] [Accepted: 03/27/2020] [Indexed: 01/12/2023] Open
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109
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Zaccara G, Lattanzi S, Cincotta M, Russo E. Drug treatments in patients with cardiac diseases and epilepsy. Acta Neurol Scand 2020; 142:37-49. [PMID: 32259277 DOI: 10.1111/ane.13249] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 03/06/2020] [Accepted: 03/29/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Comorbidity between epilepsy and heart diseases is frequent. METHODS All drugs classified within the group of drugs for cardiovascular system according to the Anatomical Therapeutic Chemical (ATC) classification system were reviewed for their effects on seizures or epilepsy. RESULTS Several agents showed antiseizure properties in animal models of seizures and/or in patients with epilepsy and only few were proconvulsant. Drugs with anticonvulsant effects include mecamylamine and guanfacine (antihypertensive drugs), indapamide, amiloride, furosemide and bumetanide (diuretics), fasudil (peripheral vasodilator), bioflavonoids (vasoprotective drug), propranolol (beta blocking agent), isradipine, nimodipine, verapamil and diltiazem (calcium channel blockers: CCBs), fosinopril and zofenopril (agents acting on the renin-angiotensin system), several statins, and fenofibrate (lipid-modifying agents). Drugs with proconvulsant properties in experimental models or in patients include reserpine, buflomedil, naftidrofuryl, and clonidine and propranolol at high doses. Drug-drug interactions (DDI) between antiseizure medications (ASMs) and drugs for cardiovascular system were also searched in two leading publicly accessible drug compendia. The most important DDIs occur between enzyme-inducing (EI) ASMs and ivabradine, ranolazine, macitenan and between EI-ASMs and the CCBs felodipine, nicardipine, nisoldipine, and verapamil. Simvastatin and atorvastatin are the lipid-modifying agents with more DDIs with EI-ASMs. Several pharmacodynamic interactions have been also documented. DISCUSSION AND CONCLUSIONS Available data show that the treatment of patients with epilepsy and vascular comorbidities is challenging and requires the appropriate knowledge of pharmacological properties of drugs and drug interactions.
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Affiliation(s)
| | - Simona Lattanzi
- Neurological Clinic Department of Experimental and Clinical Medicine Marche Polytechnic University Ancona Italy
| | - Massimo Cincotta
- Unit of Neurology of Florence Central Tuscany Local Health Authority Firenze Italy
| | - Emilio Russo
- Science of Health Department School of Medicine University “Magna Graecia” of Catanzaro Catanzaro Italy
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110
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Impact of Physical Activity During Pregnancy on Gestational Hypertension. PHYSICAL ACTIVITY AND HEALTH 2020. [DOI: 10.5334/paah.49] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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111
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Manurung HA, Sunarno I, Usman AN. Hematology profile in severe preeclampsia at the mother and child hospital of Makassar city. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2019.07.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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112
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Mo L, Hong S, Li Y, Hu Z, Han B, Wei Z, Jia J. Sevoflurane inhibited inflammatory response induced by TNF-α in human trophoblastic cells through p38MAPK signaling pathway. J Recept Signal Transduct Res 2020; 40:218-223. [PMID: 32069432 DOI: 10.1080/10799893.2020.1726951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Purpose: Excessive inflammatory response is one of the possible pathogenic mechanisms of preeclampsia (PE). It remains unclear whether sevoflurane has an anti-inflammatory effect in human trophoblastic cells, which are corresponding to the dysfunction of placentas in PE. This study probed into the regulatory function of sevoflurane toward HTR8/SVneo cells so as to find PE pathology and PE treatment.Materials and methods: HTR8/SVneo cells were treated with sevoflurane, TNF-α with different concentrations, sevoflurane plus 10 ng/mL TNF-α and SB203580 plus 10 ng/mL TNF-α. Cell counting kit-8 (CCK-8) assays were performed to detect cell viability, while enzyme linked immunoSorbent assay (ELISA) was used to measure IL-6, IL-8, GM-CSF and MCP-1 levels in HTR8/SVneo cells. Besides, relative mRNA expression levels of IL-6 and IL-8 were tested via quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR), and p38 phosphorylation-related protein expressions were assessed through western blot.Results: Cell viability remained stable when HTR8/SVneo cells were treated with or without sevoflurane and SB203580 in inflammatory microenvironment created by TNF-α. MCP-1 and GM-CSF levels, as well as gene expressions of IL-6 and IL-8 in HTR8/SVneo cells were greatly increased by TNF-α (5, 10 and 20 ng/mL), but reversed by sevoflurane and SB203580. Simultaneously, TNF-α-induced phosphorylation of p38MAPK signaling pathway was inhibited by sevoflurane and SB203580.Conclusions: Sevoflurane inhibited inflammatory response induced by TNF-α in human trophoblastic cells HTR8/SVneo through suppressing the phosphorylation of p38MAPK signaling pathway.
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Affiliation(s)
- Li Mo
- Department of Anesthesiology, Guangdong Women and Children Hospital, Guangzhou, China
| | - Shuzhen Hong
- Department of Obestetrics, Guangdong Women and Children Hospital, Guangzhou, China
| | - Yi Li
- Department of Gynecology, Guangdong Women and Children Hospital, Guangzhou, China
| | - Zurong Hu
- Department of Anesthesiology, Guangdong Women and Children Hospital, Guangzhou, China
| | - Baoyi Han
- Department of Anesthesiology, Guangdong Women and Children Hospital, Guangzhou, China
| | - Zaomei Wei
- Department of Anesthesiology, Guangdong Women and Children Hospital, Guangzhou, China
| | - Jie Jia
- Department of Anesthesiology, Guangdong Women and Children Hospital, Guangzhou, China
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113
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Szczepanski J, Griffin A, Novotny S, Wallace K. Acute Kidney Injury in Pregnancies Complicated With Preeclampsia or HELLP Syndrome. Front Med (Lausanne) 2020; 7:22. [PMID: 32118007 PMCID: PMC7020199 DOI: 10.3389/fmed.2020.00022] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/15/2020] [Indexed: 01/12/2023] Open
Abstract
Acute kidney injury that occurs during pregnancy or in the post-partum period (PR-AKI) is a serious obstetric complication with risk of significant associated maternal and fetal morbidity and mortality. Recent data indicates that the incidence of PR-AKI is increasing, although accurate calculation is limited by the lack of a uniform diagnostic criteria that is validated in pregnancy. Hypertensive and thrombotic microangiopathic disorders of pregnancy have been identified as major contributors to the burden of PR-AKI. As is now accepted regarding preeclampsia, HELLP syndrome and atypical hemolytic uremic syndrome, it is believed that PR-AKI may have long-term renal, cardiovascular and neurocognitive consequences that persist beyond the post-partum period. Further research regarding PR-AKI could be advanced by the development of a pregnancy-specific validated definition and classification system; and the establishment of refined animal models that would allow researchers to further elucidate the mechanisms and sequelae of the disorder.
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Affiliation(s)
- Jamie Szczepanski
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Ashley Griffin
- Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS, United States
| | - Sarah Novotny
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Kedra Wallace
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, United States.,Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, MS, United States
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114
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Karatza AA, Dimitriou G. Preeclampsia Emerging as a Novel Risk Factor for Cardiovascular Disease in the Offspring. Curr Pediatr Rev 2020; 16:194-199. [PMID: 31884930 PMCID: PMC8193805 DOI: 10.2174/1573396316666191224092405] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/20/2019] [Accepted: 12/10/2019] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Preeclampsia is a pregnancy specific disorder which affects 2%-8% of all gestations and is associated with high maternal, fetal and neonatal morbidity and mortality worldwide. There is no "cure" for the disease except for early delivery of the fetus and placenta, however leaving preeclampsia a long term health risk both for mothers and infants. AIM The aim of the study is to review currently available information linking preclampsia to longterm cardiovascular complications in infants and children. RESULTS Currently, there is evidence of predisposition to cardiovascular disease, and a higher incidence of cardiovascular risk factors among children born to preeclamptic mothers. Both in experimental models and human epidemiological studies it is now clear that the infants of pregnancies complicated by preeclampsia have an increased risk of developing high blood pressure and double the risk of stroke in later life. Preeclampsia is consistently associated with higher blood pressure and body mass index as early as 4-10 years of age. Also there is some evidence of higher cardiovascular risk in adults exposed to maternal hypertensive disorders of pregnancy. It seems that preeclampsia has an impact on the cardiovascular system independent of preterm birth and is associated with endothelial dysfunction, increased carotid intima media thickness and reductions in cardiac function that cannot be accounted for by prematurity alone. CONCLUSION Taking into consideration the currently available evidence, it can now be suggested that preeclampsia is linked to adverse effects on the cardiometabolic health of the infant. Understanding the relationship between preeclampsia and cardiovascular disease will allow for implementation of early interventions to prevent or delay the onset of adverse events in this high risk population.
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Affiliation(s)
- Ageliki A. Karatza
- Neonatal Intensive Care Unit, Department of Paediatrics, University of Patras Medical School, 26504, Patras, Greece
- Address correspondence to this author at the Department of Paediatrics, General University Hospital of Patras, 26504, Rio, Patras, Greece; Tel: +30 2610 999821; Fax: +30 2610 994533; E-mail:
| | - Gabriel Dimitriou
- Neonatal Intensive Care Unit, Department of Paediatrics, University of Patras Medical School, 26504, Patras, Greece
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115
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Bossung V, Fortmann MI, Fusch C, Rausch T, Herting E, Swoboda I, Rody A, Härtel C, Göpel W, Humberg A. Neonatal Outcome After Preeclampsia and HELLP Syndrome: A Population-Based Cohort Study in Germany. Front Pediatr 2020; 8:579293. [PMID: 33154958 PMCID: PMC7586782 DOI: 10.3389/fped.2020.579293] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/08/2020] [Indexed: 01/12/2023] Open
Abstract
Aim: To analyze short term outcomes of very low birth weight infants (VLBWI) born preterm after maternal preeclampsia and HELLP syndrome within the German Neonatal Network. Methods: The German Neonatal Network is a large population-based cohort study enrolling VLBWI since 2009. Two thousand six hundred and fifty two infants below 32 weeks of gestation born after maternal preeclampsia or HELLP syndrome and 13,383 infants born prematurely for other causes between 2009 and 2018 were included in our analysis. Descriptive statistics and multinomial regression models including preeclampsia and HELLP syndrome were performed for short-term outcome measures such as intracerebral hemorrhage, necrotizing enterocolitis requiring surgery, bronchopulmonary dysplasia, retinopathy of prematurity, periventricular leukomalacia, persistent ductus arteriosus requiring surgery, blood culture positive sepsis and death. Results: After adjustment for confounding variables, preterm birth due to preeclampsia or HELLP syndrome was associated with a reduced risk for intracerebral hemorrhage (OR 0.73, 95% CI 0.60-0.89), necrotizing enterocolitis requiring surgery (OR 0.35 95% CI 0.15-0.82), periventricular leukomalacia (OR 0.61 95% CI 0.40-0.92), and death (OR 0.72 95% CI 0.55-0.96) as compared to other causes of preterm birth. Conclusions: The indication for preterm birth has an impact on neonatal outcome in preterm infants born below 32 weeks. This notion should be included when counseling the families.
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Affiliation(s)
- Verena Bossung
- Department of Obstetrics and Gynaecology, University Hospital of Schleswig-Holstein, Lübeck, Germany
- *Correspondence: Verena Bossung
| | - Mats Ingmar Fortmann
- Department of Paediatrics, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Christoph Fusch
- Department of Paediatrics, Paracelsus Medical School, General Hospital of Nuremberg, Nuremberg, Germany
| | - Tanja Rausch
- Department of Paediatrics, University Hospital of Schleswig-Holstein, Lübeck, Germany
- Institute of Medical Biometry and Statistics, University Medical Centre of Schleswig-Holstein, University of Luebeck, Luebeck, Germany
| | - Egbert Herting
- Department of Paediatrics, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Isabelle Swoboda
- Department of Paediatrics, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Achim Rody
- Department of Obstetrics and Gynaecology, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Christoph Härtel
- Department of Paediatrics, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Wolfgang Göpel
- Department of Paediatrics, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Alexander Humberg
- Department of Paediatrics, University Hospital of Schleswig-Holstein, Lübeck, Germany
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116
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Graham N, Heazell AEP. When the Fetus Goes Still and the Birth Is Tragic: The Role of the Placenta in Stillbirths. Obstet Gynecol Clin North Am 2019; 47:183-196. [PMID: 32008668 DOI: 10.1016/j.ogc.2019.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Because of the critical role that placental structure and function plays during pregnancy, abnormal placental structure and function is closely related to stillbirth: when an infant dies before birth. However, understanding the role of the placental and specific lesions is incomplete, in part because of the variation in definitions of lesions and in classifying causes of stillbirths. Nevertheless, placental abnormalities are seen more frequently in stillbirths than live births, with placental abruption, chorioamnionitis, and maternal vascular malperfusion most commonly reported. Critically, some placental lesions affect the management of subsequent pregnancies. Histopathological examination of the placenta is recommended following stillbirth.
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Affiliation(s)
- Nicole Graham
- Faculty of Biological, Medical and Human Sciences, Maternal and Fetal Health Research Centre, School of Medical Sciences, University of Manchester, Manchester Academic Health Science Centre, St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, 5th Floor (Research), Oxford Road, Manchester M13 9WL, UK
| | - Alexander E P Heazell
- Faculty of Biological, Medical and Human Sciences, Maternal and Fetal Health Research Centre, School of Medical Sciences, University of Manchester, Manchester Academic Health Science Centre, St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, 5th Floor (Research), Oxford Road, Manchester M13 9WL, UK.
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117
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Schumacher SA, Toribio RE, Lakritz J, Bertone AL. Radio-Telemetric Assessment of Cardiac Variables and Locomotion With Experimentally Induced Hypermagnesemia in Horses Using Chronically Implanted Catheters. Front Vet Sci 2019; 6:414. [PMID: 31850378 PMCID: PMC6881382 DOI: 10.3389/fvets.2019.00414] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 11/05/2019] [Indexed: 01/12/2023] Open
Abstract
The objective of this study was to characterize the pharmacokinetics and pharmacodynamics of intravenous administration of magnesium sulfate to horses using a novel radio-telemetry system for physiologic signal capture. Five Horses were surgically implanted with a radio-telemetric carotid catheter. Implants were paired with a non-invasive telemetric unit which acquired a six lead ECG and 3-axis acceleration to assess activity acquired wirelessly in real-time for future analysis. Horses were exposed to a new stall environment before (baseline) and after 60 mg/kg (30 mL) of magnesium sulfate (MgSO4), or the same volume of 0.9% saline, administered intravenously in a blinded, random crossover design. Blood for pharmacokinetics, telemetric data, and body temperature were recorded serially for 24 h. Data were analyzed across time and between treatments. Significance was set at P < 0.05. Ionized magnesium concentration (Mg2+) increased and the Ca2+ to Mg2+ ratio decreased and persisted for 5 h after MgSO4 administration. Heart rate (HR) increased and mean arterial blood pressure (MAP) decreased for at least 6 h. Electrocardiogram (ECG) intervals (RR) decreased and (PR and QTc) increased in duration compared to controls indicating an increase in heart rate, and slower myocardial conduction in the MgSO4 group. Acceleration in all planes was less in the MgSO4 group compared to controls indicating decreased locomotion. This novel method permitted collection of physiologic signals without interference by handlers or animal restraint. An intravenous bolus of MgSO4 produced cardiac variable changes associated with the reduction of locomotion in these horses, and in a direction that may be causal. Locomotion was decreased when horses were first introduced into a new environment which reflects the calming effect desired in sport horses. Telemetric monitoring can be used as a model to elucidate the behavior and physiologic effects of other drugs. The administration of MgSO4 may be detected for regulatory purposes with the monitoring of Mg2+ and Ca2+ concentrations and their ratio.
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Affiliation(s)
- Stephen A Schumacher
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States.,The United States Equestrian Federation, Equine Drugs and Medications Program, Columbus, OH, United States
| | - Ramiro E Toribio
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
| | - Jeffrey Lakritz
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
| | - Alicia L Bertone
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
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118
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Vaka VR, Cunningham MW, Deer E, Franks M, Ibrahim T, Amaral LM, Usry N, Cornelius DC, Dechend R, Wallukat G, LaMarca BD. Blockade of endogenous angiotensin II type I receptor agonistic autoantibody activity improves mitochondrial reactive oxygen species and hypertension in a rat model of preeclampsia. Am J Physiol Regul Integr Comp Physiol 2019; 318:R256-R262. [PMID: 31721604 DOI: 10.1152/ajpregu.00179.2019] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Preeclampsia (PE) is characterized by new-onset hypertension that usually occurs in the third trimester of pregnancy and is associated with oxidative stress and angiotensin II type 1 receptor agonistic autoantibodies (AT1-AAs). Inhibition of the AT1-AAs in the reduced uterine perfusion pressure (RUPP) rat, a model of PE, attenuates hypertension and many other characteristics of PE. We have previously shown that mitochondrial oxidative stress (mtROS) is a newly described PE characteristic exhibited by the RUPP rat that contributes to hypertension. However, the factors that cause mtROS in PE or RUPP are unknown. Thus, the objective of the current study is to use pharmacologic inhibition of AT1-AAs to examine their role in mtROS in the RUPP rat model of PE. AT1-AA inhibition in RUPP rats was achieved by administration of an epitope-binding peptide ('n7AAc'). Female Sprague-Dawley rats were divided into the following two groups: RUPP and RUPP + AT1-AA inhibition (RUPP + 'n7AAc'). On day 14 of gestation (GD), RUPP surgery was performed; 'n7AAc' peptide (2 µg/μL) was administered by miniosmotic pumps in a subset of RUPP rats; and on GD19, sera, placentas, and kidneys were collected. mitochondrial respiration and mtROS were measured in isolated mitochondria using the Oxygraph 2K and fluorescent microplate reader, respectively. Placental and renal mitochondrial respiration and mtROS were improved in RUPP + 'n7AAc' rats compared with RUPP controls. Moreover, endothelial cells (human umbilical vein endothelial cells) treated with RUPP + 'n7AAc' sera exhibited less mtROS compared with those treated with RUPP sera. Overall, our findings suggest that AT1-AA signaling is one stimulus of mtROS during PE.
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Affiliation(s)
- Venkata Ramana Vaka
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Mark W Cunningham
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Evangeline Deer
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Michael Franks
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Tarek Ibrahim
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Lorena M Amaral
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Nathan Usry
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Denise C Cornelius
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, Mississippi.,Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Ralf Dechend
- Experimental and Clinical Research Center, HELIOS Clinic, Berlin, Germany
| | - Gerd Wallukat
- Experimental and Clinical Research Center, Charité Campus Buch, Max-Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Babbette D LaMarca
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, Mississippi.,Department of Obstetrics & Gynecology, University of Mississippi Medical Center, Jackson, Mississippi
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Erfanian S, Yazdanpour L, Javeshghani D, Roustazadeh A. Association of arginine vasopressin (AVP) promoter polymorphisms with preeclampsia. Pregnancy Hypertens 2019; 18:122-125. [PMID: 31593833 DOI: 10.1016/j.preghy.2019.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 09/05/2019] [Accepted: 09/24/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Preeclampsia (PE) is a disease of pregnancy characterized by early onset of maternal hypertension and proteinuria. New findings indicate that arginine vasopressin (AVP) may be a contributing factor to ignite PE. The aim of this study was to identify if there is any correlation between arginine vasopressin promoter polymorphisms and PE. STUDY DESIGN Venous blood samples of 100 PE and 100 normal pregnant women were obtained for DNA extraction to identify the polymorphisms of AVP promoter by RFLP and nested-PCR techniques. MAIN OUTCOME rs3729965 polymorphism of PE women was detected to have significant correlation with body mass index (BMI) (P = 0.028). RESULTS Statistical analysis of three polymorphisms namely rs3729965, rs61138008 and rs3761249 of preeclamptic women (PEW) and none preeclamptic pregnant women (NPEW) revealed that rs3729965 genotypic distribution was significantly different between both groups (P = 0.04). Further analysis revealed that rs3729965 CT genotype of PEW had significant correlation to their BMI (P = 0.028). CONCLUSION Polymorphic variants located on the promoter region of AVP are associated with PE. Thus we hypothesize that allelic variation may have a role in increasing the risk of developing PE.
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Affiliation(s)
- Saiedeh Erfanian
- Research Center for Non-Communicable Diseases, Department of Advanced Medical Sciences and Technologies, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Danesh Javeshghani
- Department of Physiology, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Abazar Roustazadeh
- Department of Biochemistry, Department of Advanced Medical Sciences and Technologies, Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran.
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Tang JM, Shi N, Dong K, Brown SA, Coleman AE, Boegehold MA, Chen SY. Response Gene to Complement 32 Maintains Blood Pressure Homeostasis by Regulating α-Adrenergic Receptor Expression. Circ Res 2019; 123:1080-1090. [PMID: 30355157 DOI: 10.1161/circresaha.118.313266] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
RATIONALE Hypertension prevalence is much higher among children and adolescents with low birth weight and greater postnatal weight gain than in individuals with normal birth weight. However, the cause and molecular mechanisms underlying this complication remain largely unknown. Our previous studies have shown that RGC-32 (response gene to complement 32)-deficient (RGC-32-/-) mice are born significantly smaller but grow faster than their WT (wild type) controls, which allows adult RGC-32-/- mice to attain body weights similar to those of control mice. OBJECTIVE The objective of this study is to determine whether RGC-32-/- mice develop hypertension, and if so, to elucidate the underlying mechanisms. METHODS AND RESULTS By using a radiotelemetry system, we found that RGC-32-/- mice exhibit higher mean arterial pressure than WT mice (101±4 versus 119±5 mm Hg), which enabled us to use RGC-32-/- mice to study the mechanisms underlying low birth weight-related hypertension. The increased blood pressure in RGC-32-/- mice was associated with increased vascular tone and decreased distensibility of small resistance arteries. The increased vascular tone was because of an increase in the relative contribution of sympathetic versus parasympathetic activity and was linked to increased expression of AT1R (angiotensin II type I receptor) and α1-AdR (α1-adrenergic receptor) in arterial smooth muscles. Mechanistically, RGC-32 regulated AT1R gene transcription by interacting with Sp1 (specificity protein 1) transcription factor and further blocking its binding to the AT1R promoter, leading to suppression of AT1R expression. The attenuation of AT1R leads to reduction in α1-AdR expression, which was critical for the balance of sympathetic versus parasympathetic control of vascular tone. Of importance, downregulation of RGC-32 in arterial smooth muscles was also associated with low birth weight and hypertension in humans. CONCLUSIONS Our results indicate that RGC-32 is a novel protein factor vital for maintaining blood pressure homeostasis, especially in individuals with low birth weight.
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Affiliation(s)
- Jun-Ming Tang
- From the Department of Physiology and Pharmacology (J.-M.T., N.S., K.D., S.A.B., M.A.B., S.-Y.C.), University of Georgia, Athens.,Institute of Clinical Medicine (J.-M.T.), Renmin Hospital, Hubei University of Medicine, Shiyan, China.,Department of Cardiology (J.-M.T.), Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Ning Shi
- From the Department of Physiology and Pharmacology (J.-M.T., N.S., K.D., S.A.B., M.A.B., S.-Y.C.), University of Georgia, Athens
| | - Kun Dong
- From the Department of Physiology and Pharmacology (J.-M.T., N.S., K.D., S.A.B., M.A.B., S.-Y.C.), University of Georgia, Athens
| | - Scott A Brown
- From the Department of Physiology and Pharmacology (J.-M.T., N.S., K.D., S.A.B., M.A.B., S.-Y.C.), University of Georgia, Athens
| | - Amanda E Coleman
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine (A.E.C.), University of Georgia, Athens
| | - Matthew A Boegehold
- From the Department of Physiology and Pharmacology (J.-M.T., N.S., K.D., S.A.B., M.A.B., S.-Y.C.), University of Georgia, Athens
| | - Shi-You Chen
- From the Department of Physiology and Pharmacology (J.-M.T., N.S., K.D., S.A.B., M.A.B., S.-Y.C.), University of Georgia, Athens
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121
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Han C, Han L, Huang P, Chen Y, Wang Y, Xue F. Syncytiotrophoblast-Derived Extracellular Vesicles in Pathophysiology of Preeclampsia. Front Physiol 2019; 10:1236. [PMID: 31632289 PMCID: PMC6779799 DOI: 10.3389/fphys.2019.01236] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 09/09/2019] [Indexed: 01/12/2023] Open
Abstract
Preeclampsia is a common obstetric complication associated with pregnancy and it endangers lives of the mother and the infant. The histopathological changes associated with preeclampsia include systemic endothelial dysfunction, persistent inflammatory state, and coagulation and fibrinolysis dysregulations. Preeclampsia is considered to be caused by the systemic vasoconstriction of small arteries and disruption of the endothelial integrity, resulting in hypertension, proteinuria, and multiple organ dysfunction. However, mediators that trigger or propagate the pathology of preeclampsia remain poorly defined. Syncytiotrophoblast-derived extracellular vesicles (SDEVs) are increasingly recognized as a key mediator for the development of preeclampsia, but the underlying mechanisms through which these SDEVs are released and induce systemic responses are not fully understood. This review focuses on multiple roles of SDEVs in the pathogenesis of preeclampsia.
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Affiliation(s)
- Cha Han
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Lulu Han
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Pengzhu Huang
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuanyuan Chen
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yingmei Wang
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Fengxia Xue
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
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122
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Le Y, Ye J, Lin J. Expectant management of early-onset severe preeclampsia: a principal component analysis. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:519. [PMID: 31807501 DOI: 10.21037/atm.2019.10.11] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Preeclampsia is a multisystem disorder that is characterized by hypertension with either proteinuria or end-organ dysfunction in both previously normotensive women and chronically hypertensive women. To identify the important influencing factors for early-onset severe preeclampsia, this study undertook to explore the associations between preeclampsia characteristics, along with the decreased latency and poor neonatal outcomes during expectant management of severe preeclampsia before 34 weeks of gestation. Methods A total of 213 patients were retrospectively studied. Pregnancy outcomes in terms of maternal complications and neonatal outcomes were determined. Statistical analysis was performed by principal component analysis, Student's t-test, and Pearson correlation analysis. Results Neonatal mortality was influenced by gestational age at delivery and birth weight. The main factors that influenced pregnancy outcome were gestational age at diagnosis, the 24-h urine protein level, the plasma albumin level, and hydrothorax plus ascites. When the gestational age at diagnosis was 25 weeks, and 4/7 days, the probability that the pregnancy would be classified into group 2 with 79.3% neonatal survival was almost 50%. Only the plasma albumin level and hydrothorax plus ascites affected prolongation. Conclusions Plasma albumin level and hydrothorax plus ascites should be considered seriously, as they may be a reason to terminate the expectant management of early-onset severe preeclampsia. Given its unsatisfactory pregnancy outcomes, expectant management should be reconsidered before 25 weeks and 4/7 days.
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Affiliation(s)
- Yiping Le
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Jing Ye
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Jianhua Lin
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
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Han C, Wang C, Chen Y, Wang J, Xu X, Hilton T, Cai W, Zhao Z, Wu Y, Li K, Houck K, Liu L, Sood AK, Wu X, Xue F, Li M, Dong JF, Zhang J. Placenta-derived extracellular vesicles induce preeclampsia in mouse models. Haematologica 2019; 105:1686-1694. [PMID: 31439676 PMCID: PMC7271597 DOI: 10.3324/haematol.2019.226209] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/22/2019] [Indexed: 01/23/2023] Open
Abstract
Preeclampsia is a pregnancy-induced condition that impairs the mother’s health and results in pregnancy termination or premature delivery. Elevated levels of placenta-derived extracellular vesicles (pcEV) in the circulation have been consistently associated with preeclampsia, but whether these vesicles induce preeclampsia or are the product of preeclampsia is not known. Guided by a small cohort study of preeclamptic patients, we examined the impact of pcEV on the pathogenesis of preeclampsia in mouse models. We detected pcEV in pregnant C56BL/6J mice with a peak level of 3.8±0.9×107/mL at 17-18 days post-coitum. However, these pregnant mice developed hypertension and proteinuria only after being infused with vesicles purified from injured placenta. These extracellular vesicles released from injured placenta disrupted endothelial integrity and induced vasoconstriction. Enhancing the clearance of extracellular vesicles prevented the development of the extracellular vesicle-induced preeclampsia in mice. Our results demonstrate a causal role of pcEV in preeclampsia and identify microvesicle clearance as a new therapeutic strategy for the treatment of this pregnancy-associated complication.
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Affiliation(s)
- Cha Han
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China.,Bloodworks Research Institute, Seattle, WA, USA
| | - Chenyu Wang
- Institute of Pathology, School of Medical Sciences and Gansu Provincial Key Laboratory of Preclinical Study for New Drug Development, Lanzhou University, Lanzhou, China
| | - Yuanyuan Chen
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiwei Wang
- Department of Neurosurgery, Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin, China
| | - Xin Xu
- Bloodworks Research Institute, Seattle, WA, USA
| | | | - Wei Cai
- Institute of Pathology, School of Medical Sciences and Gansu Provincial Key Laboratory of Preclinical Study for New Drug Development, Lanzhou University, Lanzhou, China
| | - Zilong Zhao
- Department of Neurosurgery, Tianjin Medical University General Hospital and Tianjin Neurological Institute, Tianjin, China
| | - Yingang Wu
- Department of Neurosurgery, the First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Ke Li
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Katie Houck
- Bloodworks Research Institute, Seattle, WA, USA
| | - Li Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital and Tianjin Neurological Institute, Tianjin, China
| | - Anil K Sood
- Department of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Xiaoping Wu
- Bloodworks Research Institute, Seattle, WA, USA
| | - Fengxia Xue
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Min Li
- Institute of Pathology, School of Medical Sciences and Gansu Provincial Key Laboratory of Preclinical Study for New Drug Development, Lanzhou University, Lanzhou, China
| | - Jing-Fei Dong
- Bloodworks Research Institute, Seattle, WA, USA .,Division of Hematology, Department of Medicine, University of Washington, School of Medicine, Seattle, WA, USA
| | - Jianning Zhang
- Department of Neurosurgery, Tianjin Medical University General Hospital and Tianjin Neurological Institute, Tianjin, China
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Xie N, Jia Z, Li L. miR‑320a upregulation contributes to the development of preeclampsia by inhibiting the growth and invasion of trophoblast cells by targeting interleukin 4. Mol Med Rep 2019; 20:3256-3264. [PMID: 31432141 PMCID: PMC6755235 DOI: 10.3892/mmr.2019.10574] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 07/10/2019] [Indexed: 01/12/2023] Open
Abstract
Preeclampsia (PE) is a serious pregnancy‑specific pathologic complication, and represents a primary cause of mother and fetus mortality. Abnormally expressed microRNAs (miRNAs) serve important regulatory roles in the development of PE. At present, the pathogenesis and molecular mechanism of PE remain unclear. The aim of the present study was to investigate the potential functions of miRNA (miR)‑320a in the human extravillous trophoblast cell line HTR‑8/SVneo and to identify the molecular mechanisms underlying miR‑320a function. Reverse transcription‑quantitative PCR was used in the present study to detect the levels of miR‑320a in the placentas of 57 pregnant patients with PE and 57 healthy pregnant patients. The effects of miR‑320a overexpression on the proliferation and invasion of HTR‑8/SVneo cells were determined using MTT and Transwell invasion assays. Western blot analysis and dual luciferase reporter assay were used to identify the genes targeted by miR‑320a. The present results suggested that miR‑320a expression level was decreased in placentas of patients with PE and the expression level of miR‑320a was found to be associated with the pathogenesis of PE (P<0.05). Overexpression of miR‑320a using miR‑320a mimics significantly inhibited cell proliferation and invasion in HTR‑8/SVneo cells in vitro (P<0.05). Furthermore, interleukin (IL)‑4 was identified to be a direct target gene of miR‑320a. miR‑320a could repress IL‑4 expression by binding to its 3' untranslated region (P<0.05). Mechanistic studies suggested that IL‑4 was a functional target gene of miR‑320a, and miR‑320a upregulation inhibited the proliferation and invasion of HTR‑8/SVneo cells by directly targeting IL‑4 (P<0.05). Collectively, to the best of our knowledge, the present study is the first to suggest that miR‑320a may be a downregulated miRNA during PE, and IL‑4 may act as a functional target gene of miR‑320a. The present study suggested that miR‑320a upregulation was involved in the development of PE by inhibiting the proliferation and invasion of trophoblast cells by targeting IL‑4, indicating that the miR‑320a/IL‑4 pathway may represent a novel therapeutic target for PE treatment.
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Affiliation(s)
- Ning Xie
- Department of Obstetrics, The Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Zhi Jia
- Department of Anesthesiology, The Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Li Li
- Department of Obstetrics, The Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
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125
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Pergialiotis V, Karampetsou N, Bellos I, Papantoniou N, Daskalakis G. Nocturnal blood pressure alterations in patients with preeclampsia – Do they really matter? A systematic review of the literature. Eur J Obstet Gynecol Reprod Biol 2019; 239:39-44. [DOI: 10.1016/j.ejogrb.2019.05.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 01/12/2023]
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126
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Cheng D, Jiang S, Chen J, Li J, Ao L, Zhang Y. Upregulated long noncoding RNA Linc00261 in pre-eclampsia and its effect on trophoblast invasion and migration via regulating miR-558/TIMP4 signaling pathway. J Cell Biochem 2019; 120:13243-13253. [PMID: 30891826 DOI: 10.1002/jcb.28598] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 12/03/2018] [Accepted: 12/06/2018] [Indexed: 01/12/2023]
Abstract
Pre-eclampsia (PE) is a leading cause of maternal and perinatal morbidity and mortality but the exact underlying mechanisms of PE pathogenesis remain elusive. Accumulated data suggested that the long noncoding RNAs (lncRNAs) play important roles in the pathogenesis of PE. The present study identified the changes of lncRNA Linc00261 in PE and its effects on trophoblasts invasion and migration. Our results showed that the expression of Linc00261 was upregulated in placental tissues of PE women compared with those of healthy pregnant women. Overexpression of Linc00261 suppressed cell invasion and migration, induced cell apoptosis, and caused cell-cycle arrest at G0 /G1 phase of HTR-8/SVneo cells; while knockdown of Linc00261 had the opposite effects on the HTR-8/SVneo cells. Mechanistic studies showed Linc00261 functioned as a competing endogenous RNA for miR-558 in HTR-8/SVneo cells, and miR-558 was negatively regulated by Linc00261. The expression level of miR-558 in the PE group was significantly lower than the control group, and the expression level of Linc00261 was negatively correlated with the expression level of miR-558 in the placental tissues of women with PE. Furthermore, miR-558 was found to negatively regulate the expression of TIMP metallopeptidase inhibitor 4 (TIMP4) via targeting the 3' untranslated region in the HTR-8/SVneo cells. Overexpression of miR-558 increased HTR-8/SVneo cell invasion and migration, which was attenuated by TIMP4 overexpression. More importantly, both overexpression of miR-558 and knockdown of TIMP4 partially reversed the suppressive effects of Linc00261 overexpression on cell invasion and migration of HTR-8/SVneo cells. Collectively, our results for the first time showed the upregulation of Linc00261 in the placental tissues of severe PE patients. The mechanistic results indicated that Linc00261 exerted the suppressive effects on the trophoblast invasion and migration via targeting miR-558/TIMP4 axis, which may involve in the pathogenesis of PE.
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Affiliation(s)
- Dan Cheng
- Center for Reproductive Medicine, Wuhan University Renmin Hospital, Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, Hubei, China
| | - Shan Jiang
- Department of Dermatology, Wuhan University Renmin Hospital, Wuhan, Hubei, China
| | - Jiao Chen
- Center for Reproductive Medicine, Wuhan University Renmin Hospital, Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, Hubei, China
| | - Jie Li
- Center for Reproductive Medicine, Wuhan University Renmin Hospital, Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, Hubei, China
| | - Liangfei Ao
- Center for Reproductive Medicine, Wuhan University Renmin Hospital, Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, Hubei, China
| | - Ying Zhang
- Center for Reproductive Medicine, Wuhan University Renmin Hospital, Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, Hubei, China
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Gao Q, Li H, Ding H, Fan X, Xu T, Tang J, Liu Y, Chen X, Zhou X, Tao J, Xu Z. Hyper-methylation of AVPR1A and PKCΒ gene associated with insensitivity to arginine vasopressin in human pre-eclamptic placental vasculature. EBioMedicine 2019; 44:574-581. [PMID: 31175056 PMCID: PMC6606951 DOI: 10.1016/j.ebiom.2019.05.056] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/28/2019] [Accepted: 05/28/2019] [Indexed: 01/12/2023] Open
Abstract
Background Pre-eclampsia is a leading cause of maternal mortality and morbidity. Although the exact mechanisms that cause pre-eclampsia remain unclear, it is undeniable that abnormal placental function and circulation are a center for initiation pre-eclampsia. As a potent vasoconstrictor, arginine vasopressin (AVP) has long been implicated in controlling placental vascular tone and circulation; its secretion is grossly elevated in pre-eclamptic circulation. However, little is known about the reactivity of AVP in pre-eclamptic placental vasculature. Methods To reveal the special features of placental vascular regulations with placental pathophysiological changes, as well as the corresponding molecular mechanisms under pre-eclamptic conditions, vascular function and molecular assays were conducted with placental vessel samples from normal and pre-eclamptic pregnancies. Findings The present study found that vasoconstriction responses of placental vessels to AVP were attenuated in pre-eclampsia as compared to in normal pregnancy. The insensitivity of AVP was correlated with the down-regulated AVP receptor 1a (AVPR1A, AVPR1A gene) and protein kinase C isoform β (PKCβ, PKCΒ gene), particularly the hyper-methylation-mediated AVPR1A and PKCΒ gene down-regulation, respectively. Interpretation The findings collectively revealed that aberrant DNA methylation-mediated gene expressions are correlated with vascular dysfunction in pre-eclamptic placental circulation. Fund This work was supported by National Nature & Science Foundation of China. “333 Project”, “Six one project”, “Shuang Chuang Tuan Dui” and Key Discipline “Fetal medicine” of Jiangsu Province, and the Suzhou city “Wei Sheng Ren Cai” program.
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Affiliation(s)
- Qinqin Gao
- Institute for Fetology and Department of Obstetrics and Gynecology, First Hospital of Soochow University, Suzhou, China.
| | - Huan Li
- Institute for Fetology and Department of Obstetrics and Gynecology, First Hospital of Soochow University, Suzhou, China
| | - Hongmei Ding
- Institute for Fetology and Department of Obstetrics and Gynecology, First Hospital of Soochow University, Suzhou, China
| | - Xiaorong Fan
- Institute for Fetology and Department of Obstetrics and Gynecology, First Hospital of Soochow University, Suzhou, China
| | - Ting Xu
- Institute for Fetology and Department of Obstetrics and Gynecology, First Hospital of Soochow University, Suzhou, China
| | - Jiaqi Tang
- Institute for Fetology and Department of Obstetrics and Gynecology, First Hospital of Soochow University, Suzhou, China
| | - Yanping Liu
- Institute for Fetology and Department of Obstetrics and Gynecology, First Hospital of Soochow University, Suzhou, China
| | - Xueyi Chen
- Institute for Fetology and Department of Obstetrics and Gynecology, First Hospital of Soochow University, Suzhou, China
| | - Xiuwen Zhou
- Institute for Fetology and Department of Obstetrics and Gynecology, First Hospital of Soochow University, Suzhou, China
| | - Jianying Tao
- Department of Obstetrics and Gynecology, Suzhou Municipal Hospital, Suzhou, China.
| | - Zhice Xu
- Institute for Fetology and Department of Obstetrics and Gynecology, First Hospital of Soochow University, Suzhou, China.
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Zhang L, Wang K, Wu Q, Jin L, Lu H, Shi Y, Liu L, Yang L, Lv L. Let-7 inhibits the migration and invasion of extravillous trophoblast cell via targeting MDM4. Mol Cell Probes 2019; 45:48-56. [DOI: 10.1016/j.mcp.2019.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/23/2019] [Accepted: 05/09/2019] [Indexed: 01/12/2023]
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Yu L, Zhou Q, Peng Q, Zeng S, Yang Z. Velocity vector imaging echocardiography and NT-proBNP study of fetal cardiac function in pregnancy-induced maternal hypertension. JOURNAL OF CLINICAL ULTRASOUND : JCU 2019; 47:285-291. [PMID: 30883813 DOI: 10.1002/jcu.22720] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 01/03/2019] [Accepted: 02/17/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE To investigate whether acute and transient pressure overload in patients with pregnancy-induced hypertension affects cardiac function in fetuses. METHODS We enrolled 104 singleton pregnant women with gestational ages ranging 30 to 33 weeks, visiting for prenatal care. Among them, 34 had gestational hypertension (GH), 32 had preeclampsia (PE), and 38 were healthy and formed the control group. Conventional echocardiographic and velocity vector imaging (VVI) variables were prospectively collected. Blood levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured from cord blood drawn at birth. RESULTS The fetuses of mothers with preeclampsia had significantly lower left (LV) and right ventricle (RV) diastolic strain rate (SRd) and RV strain (S) and systolic strain rate (SRs) than controls. LV and RV S, SRd, and SRS were not different in fetuses of mothers with GH and controls. The NT-proBNP levels were higher in fetuses of patients with PE than in GH and controls. CONCLUSIONS In the third trimester of pregnancy, fetal biventricular function and NT-proBNP levels are not significantly influenced by GH. Fetuses of mothers with PE present signs of LV and RV diastolic dysfunction, right ventricular systolic dysfunction, and elevated NT-pro-BNP levels. VVI echocardiography appears more sensitive than conventional echocardiography to evaluate fetal cardiac function.
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MESH Headings
- Adult
- Biomarkers/blood
- Case-Control Studies
- Cross-Sectional Studies
- Echocardiography/methods
- Female
- Fetal Blood/metabolism
- Fetal Heart/diagnostic imaging
- Fetal Heart/physiopathology
- Gestational Age
- Heart Ventricles/diagnostic imaging
- Humans
- Hypertension, Pregnancy-Induced/physiopathology
- Infant, Newborn
- Male
- Natriuretic Peptide, Brain/blood
- Observer Variation
- Peptide Fragments/blood
- Pregnancy
- Pregnancy Trimester, Third
- Prospective Studies
- Single-Blind Method
- Ultrasonography, Prenatal/methods
- Ventricular Dysfunction, Left/blood
- Ventricular Dysfunction, Left/diagnosis
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Dysfunction, Right/blood
- Ventricular Dysfunction, Right/diagnosis
- Ventricular Dysfunction, Right/physiopathology
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Affiliation(s)
- Li Yu
- Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, China
| | - Qichang Zhou
- Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, China
| | - Qinghai Peng
- Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, China
| | - Shi Zeng
- Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, China
| | - Zurong Yang
- Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, China
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130
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El-Achi V, Park F, O'Brien C, Tooher J, Hyett J. Does low dose aspirin prescribed for risk of early onset preeclampsia reduce the prevalence of preterm prelabor rupture of membranes? J Matern Fetal Neonatal Med 2019; 34:618-623. [PMID: 31018725 DOI: 10.1080/14767058.2019.1611768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background: Placental dysfunction, inflammation and degradation of fetal membranes has been hypothesized as a cause of preterm prelabor of rupture of membranes.Objective: To examine the effect of aspirin, an anti-inflammatory agent, on the prevalence of preterm prelabor rupture of membranes (PPRoMs).Methods: A retrospective analysis was conducted to examine the effect of aspirin on the prevalence of PPRoM. Aspirin (150 mg, nocte) was prescribed to women who were identified through a screening program at 11-13+6 weeks' gestation as being at high risk for developing early-onset preeclampsia. Women who were at low risk for developing preeclampsia did not receive aspirin. The prevalence of PPRoM was compared with an observational cohort.Results: In the observational cohort, there were 3027 women, including 32 (1.1%) cases of PPRoM. The prevalence of PPRoM in the high risk group was 3.1% (4/128) and was statistically significantly higher compared to the low risk group (1.0%) (28/2899). The relative risk was 3.02 (95% CI 1.2-7.7; p= .04). In the interventional cohort, there were 7280 women, with 114 (1.6%) cases of PPRoM. The prevalence of PPRoM in the high risk group who were treated with aspirin was 1.8% (14/766) compared to 1.5% (100/6516) in the low risk group (p= .54). The prevalence of PPRoM in high risk patients in the observational group (who did not receive aspirin) compared with the high risk patients in the interventional group (who were treated with aspirin) was not statistically significant (p= .31).Conclusions: PPRoM is significantly associated with a description of high risk for ePET; although, this algorithm is not a good screening tool for predicting PPRoM. Aspirin treatment of women deemed high risk for ePET is safe in the context of PPRoM and there may be some reduction in prevalence of PPRoM in treated high risk women; although, this study was not powered to demonstrate a small reduction in the prevalence of PPRoM. The findings merit further investigation through a larger prospective study with adequate sample size.
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Affiliation(s)
- Vanessa El-Achi
- RPA Women and Babies, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Felicity Park
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Cecelia O'Brien
- Fetal Medicine Unit, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Jane Tooher
- Royal Prince Alfred Hospital, Camperdown, Australia
| | - Jon Hyett
- Royal Prince Alfred Hospital, Camperdown, Australia
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Wallace K, Bean C, Bowles T, Spencer SK, Randle W, Kyle PB, Shaffery J. Hypertension, Anxiety, and Blood-Brain Barrier Permeability Are Increased in Postpartum Severe Preeclampsia/Hemolysis, Elevated Liver Enzymes, and Low Platelet Count Syndrome Rats. Hypertension 2019; 72:946-954. [PMID: 30354708 DOI: 10.1161/hypertensionaha.118.11770] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hypertension and inflammation during pregnancy are suggested to contribute to the development of postpartum depression and anxiety. Using a rat model of severe preeclampsia and hemolysis, elevated liver enzymes, and low platelet count syndrome, which displays both hypertension and inflammation during pregnancy, we evaluated whether rats were prone to develop depression or anxiety in the postpartum period. On gestational day 12, miniosmotic pumps infusing sFlt-1 (soluble fms-like tyrosine kinase-1) and sEng (soluble endoglin) were placed into rats, a subset of these rats was infused with 2 mg/kg of Orencia (abatacept) the following day to determine whether immune suppression via T-cell depletion prevented any changes in maternal depression or anxiety-like behavior. All rats, including normal pregnant (NP) controls, delivered between gestational days 21 and 22. Postpartum severe preeclamptic rats buried significantly more marbles compared with NP rats ( P=0.002) and Orencia-treated rats ( P=0.05). Severe preeclamptic rats spent significantly more time in closed arms of the elevated plus maze compared with NP rats ( P=0.009) and Orencia-treated rats ( P=0.05). Severe preeclamptic rats were hypertensive compared with NP ( P=0.03) and Orencia-treated rats ( P=0.01). Finally, severe preeclamptic rats had increased blood-brain barrier permeability compared with NP rats ( P=0.03), which was reversed in Orencia-treated rats ( P=0.008). These results suggest that severe preeclampsia/hemolysis, elevated liver enzymes, and low platelet count syndrome during pregnancy contributes to an increase in anxiety-like behavior, blood-brain barrier permeability, and hypertension in the postpartum. The current results suggest that T-cell suppression during pregnancy can also help prevent chronic hypertension and increased anxiety in the postpartum period.
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Affiliation(s)
- Kedra Wallace
- From the Department of Obstetrics and Gynecology (K.W., C.B., T.B., S.-K.S., W.R.), University of Mississippi Medical Center, Jackson
| | - Cynthia Bean
- From the Department of Obstetrics and Gynecology (K.W., C.B., T.B., S.-K.S., W.R.), University of Mississippi Medical Center, Jackson
| | - Teylor Bowles
- From the Department of Obstetrics and Gynecology (K.W., C.B., T.B., S.-K.S., W.R.), University of Mississippi Medical Center, Jackson
| | - Shauna-Kay Spencer
- From the Department of Obstetrics and Gynecology (K.W., C.B., T.B., S.-K.S., W.R.), University of Mississippi Medical Center, Jackson
| | - Wisdom Randle
- From the Department of Obstetrics and Gynecology (K.W., C.B., T.B., S.-K.S., W.R.), University of Mississippi Medical Center, Jackson
| | - Patrick B Kyle
- Department of Pathology (P.B.K.), University of Mississippi Medical Center, Jackson
| | - James Shaffery
- Department of Psychiatry, Center of Psychiatric Neuroscience (J.S.), University of Mississippi Medical Center, Jackson
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132
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Kelley AS, Banker M, Goodrich JM, Dolinoy DC, Burant C, Domino SE, Smith YR, Song PXK, Padmanabhan V. Early pregnancy exposure to endocrine disrupting chemical mixtures are associated with inflammatory changes in maternal and neonatal circulation. Sci Rep 2019; 9:5422. [PMID: 30931951 PMCID: PMC6443771 DOI: 10.1038/s41598-019-41134-z] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 02/26/2019] [Indexed: 01/12/2023] Open
Abstract
Endocrine disrupting chemicals (EDCs) are ubiquitous, and pregnancy is a sensitive window for toxicant exposure. EDCs may disrupt the maternal immune system, which may lead to poor pregnancy outcomes. Most studies investigate single EDCs, even though "real life" exposures do not occur in isolation. We tested the hypothesis that uniquely weighted mixtures of early pregnancy exposures are associated with distinct changes in the maternal and neonatal inflammasome. First trimester urine samples were tested for 12 phthalates, 12 phenols, and 17 metals in 56 women. Twelve cytokines were measured in first trimester and term maternal plasma, and in cord blood after delivery. Spearman correlations and linear regression were used to relate individual exposures with inflammatory cytokines. Linear regression was used to relate cytokine levels with gestational age and birth weight. Principal component analysis was used to assess the effect of weighted EDC mixtures on maternal and neonatal inflammation. Our results demonstrated that maternal and cord blood cytokines were differentially associated with (1) individual EDCs and (2) EDC mixtures. Several individual cytokines were positively associated with gestational age and birth weight. These observed associations between EDC mixtures and the pregnancy inflammasome may have clinical and public health implications for women of childbearing age.
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Affiliation(s)
- Angela S Kelley
- Department of Obstetrics and Gynecology, University of Michigan, L4001 Women's Hospital, 1500 East Medical Center Drive, Ann Arbor, Michigan, 48109, USA
| | - Margaret Banker
- Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, Michigan, 48109, USA
| | - Jaclyn M Goodrich
- Department of Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, Michigan, 48109, USA
| | - Dana C Dolinoy
- Department of Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, Michigan, 48109, USA.,Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, Michigan, 48109, USA
| | - Charles Burant
- Department of Internal Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, Michigan, 48105, USA
| | - Steven E Domino
- Department of Obstetrics and Gynecology, University of Michigan, L4001 Women's Hospital, 1500 East Medical Center Drive, Ann Arbor, Michigan, 48109, USA
| | - Yolanda R Smith
- Department of Obstetrics and Gynecology, University of Michigan, L4001 Women's Hospital, 1500 East Medical Center Drive, Ann Arbor, Michigan, 48109, USA
| | - Peter X K Song
- Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, Michigan, 48109, USA
| | - Vasantha Padmanabhan
- Department of Obstetrics and Gynecology, University of Michigan, L4001 Women's Hospital, 1500 East Medical Center Drive, Ann Arbor, Michigan, 48109, USA. .,Department of Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, Michigan, 48109, USA. .,Department of Pediatrics, University of Michigan, 7510 MSRB 1, 1500 W. Medical Center Dr., Ann Arbor, MI, 48109, USA.
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133
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Jamil Z, Shahid S, Baig E, Ahmad R, Subhani F, Fatima SS. Serum anti mullerian hormone and renalase levels in predicting the risk of preeclampsia. Taiwan J Obstet Gynecol 2019; 58:188-191. [PMID: 30910136 DOI: 10.1016/j.tjog.2019.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2018] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE The aim of the study was to explore the association of serum AMH and Renalase with the risk of preeclampsia thereby assessing them as screening tools, reducing the risk of gravid consequences of preeclampsia. MATERIALS AND METHODS This cross-sectional study recruited n = 95 pregnant women between 14 and 32 gestational weeks. They were categorized as a) women with gestational hypertension (n = 45); b) women with pre-eclampsia (n = 20) and c) normotensive pregnant women (n = 30) according to the ACOG criteria. Anthropometrics data and blood and urine samples were collected. AMH and Renalase levels were measured by ELISA assay. RESULTS The mean age of study cohort was 27.3 ± 6.2 year and weight was 65.1 ± 14.1 kg. Blood pressures were significantly higher in pre-eclamptic patients versus both the gestational hypertensive females and controls (p < 0.05). AMH was found to be significantly higher in controls but no difference was observed between gestational hypertensive and pre-eclamptic patients. No difference was seen for serum Renalase among the three groups (p > 0.05). AMH showed a negative weak correlation with diastolic blood pressure (r = -0.272; p = 0.008) that remained significant even after adjustment (r = -0.236; p = 0.023) whereas Renalase did not show any difference (r = -0.051; p > 0.05). Females with low levels of AMH were 1.07 times at risk of developing hypertension even after adjustment for age and BMI (p < 0.05). CONCLUSION Low AMH levels may lead to hypertension in pregnancy suggesting a role in detecting vascular diseases as well as its effect on ovarian aging. However, further research is required to establish a causal relationship.
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Affiliation(s)
- Zehra Jamil
- Department of Biological & Biomedical Sciences, Aga Khan University, Pakistan
| | - Sana Shahid
- Department of Physiology, Sir Syed College of Medical Sciences for Girls, Pakistan
| | - Erum Baig
- Medical Students, Aga Khan University, Pakistan
| | - Rida Ahmad
- Medical Students, Aga Khan University, Pakistan
| | | | - Syeda Sadia Fatima
- Department of Biological & Biomedical Sciences, Aga Khan University, Pakistan.
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134
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Preeclampsia and future stroke risk in women: What NPs need to know. Nurse Pract 2019; 44:50-54. [PMID: 30889110 DOI: 10.1097/01.npr.0000554088.97825.ad] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Preeclampsia is a complication of pregnancy that affects approximately 4% of pregnancies. Preeclampsia is defined as new-onset hypertension after 20 weeks gestation often accompanied by new-onset proteinuria. Women who experience preeclampsia during pregnancy are at an increased risk for hypertension and stroke later in life. Healthcare providers should screen women appropriately to minimize risk.
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135
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Spradley FT. Sympathetic nervous system control of vascular function and blood pressure during pregnancy and preeclampsia. J Hypertens 2019; 37:476-487. [PMID: 30160658 PMCID: PMC6355368 DOI: 10.1097/hjh.0000000000001901] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
: Proper vascular tone and blood pressure regulation during pregnancy are important for immediate and long-term cardiovascular health of the mother and her offspring. Preeclampsia is clinically defined as new-onset maternal hypertension accompanied by cardiovascular, renal, and/or neural abnormalities presenting in the second half of pregnancy. There is strong evidence to support that preeclampsia is mediated by attenuations in uteroplacental vascular remodeling and increases in vasoconstriction with subsequent placental ischemia/reperfusion-induced release of hypertensive substances into the maternal circulation. These include antiangiogenic and pro-inflammatory factors. There is also evidence implicating increased sympathetic nervous system activity (SNA) in this maternal disorder, but this mostly includes data correlating severity of disease with catecholamine levels and elevated muscle SNA. These measurements have not confirmed a causative role for SNA in the pathogenesis of preeclampsia. Therefore, studies are needed to provide a comprehensive understanding of SNA and its control of vascular function and blood pressure regulation during normal pregnancy in order to set the stage for exploring the mechanisms mediating the exaggerated SNA and signaling during preeclampsia. This review examines the role of SNA in control of uteroplacental vascular tone and blood pressure regulation during normal pregnancy. Furthermore, it is proposed that over-activation of the SNA contributes to altered uteroplacental vascular tone and perfusion leading to placental ischemic events and modulates the systemic vasoconstriction and hypertensive responses to soluble placenta ischemic factors. Recognizing the integrative role and importance of SNA in the pathophysiology of preeclampsia will advance our understanding of this maternal disorder.
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Affiliation(s)
- Frank T Spradley
- Department of Surgery, The University of Mississippi Medical Center, Jackson, Mississippi, USA
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Liu Y, Wang L, Shi H. The biological function of ELABELA and APJ signaling in the cardiovascular system and pre-eclampsia. Hypertens Res 2019; 42:928-934. [PMID: 30626933 DOI: 10.1038/s41440-018-0193-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 11/21/2018] [Accepted: 12/02/2018] [Indexed: 01/12/2023]
Abstract
Pre-eclampsia (PE) is a pregnancy-specific syndrome that is characterized by hypertension and proteinuria. The etiology of PE is not completely understood but is believed to involve placental insufficiency and maternal vascular damage. Growing evidence supports an important role for the apelin receptor (APJ) system in regulating cardiovascular physiology. There are two vertebrate APJ ligands, APELIN and ELABELA, both of which mediate vasodilatory functions. A recent study linked deficient ELABELA signaling and the development of PE, though the molecular mechanism remains largely unknown. In this review, we summarize the biological function of the ELABELA and APJ system in cardiovascular homeostasis and discuss the potential mechanisms by which ELABELA and APJ regulate placenta trophoblast invasion and vascular functions and participate in the development of PE.
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Affiliation(s)
- Yuanyuan Liu
- Department of Obstetrics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Liquan Wang
- Department of Obstetrics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
| | - Hongjun Shi
- School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China.
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Agra IK, Liao AW, Hoshida MS, Schultz R, Toscano MP, Francisco RP, Zugaib M, Brizot ML. Expression of dNK cells and their cytokines in twin pregnancies with preeclampsia. Clinics (Sao Paulo) 2019; 74:e1200. [PMID: 31721933 PMCID: PMC6820511 DOI: 10.6061/clinics/2019/e1200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/23/2019] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES To assess the expression of decidual natural killer (dNK) cells and their cytokines in twin pregnancies with preeclampsia. METHODS This was a prospective case-control study. The inclusion criteria were diamniotic (monochorionic or dichorionic) twin pregnancies in the third trimester with negative serological results for infectious diseases; absence of major fetal abnormalities or twin-twin transfusion syndrome; and no history of administration of corticosteroids in this pregnancy. The control group (CG) included uncomplicated twin pregnancies, and the preeclampsia group (PEG) included twin gestations with clinical and laboratory confirmation of the disease according to well-established criteria. Samples of the decidua were obtained and analyzed by immunohistochemistry for the expression of dNK cells and interleukins (ILs) 10, 12 and 15. In addition, maternal serum samples were collected to determine the levels of these interleukins. RESULTS Thirty twin pregnancies were selected: 20 in the control group (CG) and 10 in the preeclampsia group (PEG). The PEG showed strong placental immunostaining for IL-15 (p=0.001) and high maternal serum levels of IL-10 (22.7 vs. 11.9 pg/mL, p=0.024) and IL-15 (15.9 vs. 7.4 pg/mL, p=0.024). CONCLUSION A higher maternal serum concentration of both pro- and anti-inflammatory factors was observed in the twin pregnancies in the PEG. However, no difference in placental expression of IL-10 was found between the groups. These findings may suggest that maternal attempts to balance these interleukins were not sufficient to cause a placental response, and this failure may contribute to the development of preeclampsia.
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Affiliation(s)
- Isabela K.R. Agra
- Departamento de Ginecologia e Obstetricia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Adolfo W. Liao
- Departamento de Ginecologia e Obstetricia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Mara S. Hoshida
- Departamento de Ginecologia e Obstetricia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Regina Schultz
- Departamento de Patologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Marcello P. Toscano
- Departamento de Patologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Rossana P.V. Francisco
- Departamento de Ginecologia e Obstetricia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Marcelo Zugaib
- Departamento de Ginecologia e Obstetricia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Maria L. Brizot
- Departamento de Ginecologia e Obstetricia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
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Benfica CZ, Zanella T, Farias LB, Oppermann MLR, Canani LHS, Lavinsky D. Choroidal thickness in preeclampsia measured by spectral-domain optical coherence tomography. Int Ophthalmol 2018; 39:2069-2076. [DOI: 10.1007/s10792-018-1043-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 11/10/2018] [Indexed: 01/12/2023]
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139
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Pergialiotis V, Karampetsou N, Zoumpourlis P, Papantoniou N, Thomakos N, Daskalakis G. Serum neopterin levels in women with preeclampsia: a systematic review. Hypertens Pregnancy 2018; 37:220-226. [DOI: 10.1080/10641955.2018.1526300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Vasilios Pergialiotis
- Laboratory of Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens, Athens, Greece
- 2nd department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikoleta Karampetsou
- Laboratory of Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Zoumpourlis
- Laboratory of Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- 2nd department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Thomakos
- 1st dpt of Obstetrics and Gynecology, Alexandra University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Daskalakis
- 1st dpt of Obstetrics and Gynecology, Alexandra University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Wang H, Liu J, Zhang R, Liu Y, Ren X, Gao K, Zhao C, Liu S. The relationship between DNA repair genes (XPA, XPF, XPG) polymorphism and the risk of preeclampsia in Chinese Han Women. Pregnancy Hypertens 2018; 14:145-149. [DOI: 10.1016/j.preghy.2018.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/30/2018] [Indexed: 01/12/2023]
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Wojcik-Baszko D, Charkiewicz K, Laudanski P. Role of dyslipidemia in preeclampsia-A review of lipidomic analysis of blood, placenta, syncytiotrophoblast microvesicles and umbilical cord artery from women with preeclampsia. Prostaglandins Other Lipid Mediat 2018; 139:19-23. [PMID: 30248406 DOI: 10.1016/j.prostaglandins.2018.09.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 09/09/2018] [Accepted: 09/20/2018] [Indexed: 01/12/2023]
Abstract
Preeclampsia is a complex disorder and the pathogenesis of it is still not fully understood. The most commonly accepted theory of pathogenesis assumes that there occurs impaired trophoblastic invasion and failure in spiral artery remodeling. Nowadays, obesity becomes one of the most important, modifiable risk factors for the development of preeclampsia. Despite research into the condition, predicting which women with risk factors will develop preeclampsia remains problematic. Emerging evidence suggests that dysregulation of maternal and placental lipid metabolism are involved in the pathogenesis of the condition. Hence, researchers are focused on finding a lipid fingerprint, which contains information about the lipid composition and abundance of individual lipids by using new methods in the field of lipidomics. In this review we aimed to discuss the role of dyslipidemia in the pathogenesis of preeclampsia. In addition, on the basis of current research, we attempted to find a specific lipid profile of different tissues in women with preeclampsia.
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Affiliation(s)
- Daniela Wojcik-Baszko
- Department of Perinatology and Obstetrics, Medical University of Bialystok, Marii Sklodowskiej-Curie 24a, 15-276, Bialystok, Poland.
| | - Karol Charkiewicz
- Department of Perinatology and Obstetrics, Medical University of Bialystok, Marii Sklodowskiej-Curie 24a, 15-276, Bialystok, Poland
| | - Piotr Laudanski
- Department of Perinatology and Obstetrics, Medical University of Bialystok, Marii Sklodowskiej-Curie 24a, 15-276, Bialystok, Poland; 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicza 1/3, 02-015, Warsaw, Poland.
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142
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Platelets in preeclamptic pregnancies fail to exhibit the decrease in mitochondrial oxygen consumption rate seen in normal pregnancies. Biosci Rep 2018; 38:BSR20180286. [PMID: 29654168 PMCID: PMC5938420 DOI: 10.1042/bsr20180286] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/17/2018] [Accepted: 03/29/2018] [Indexed: 01/12/2023] Open
Abstract
Cellular oxygen consumption and lactate production rates have been measured in both placental and myometrial cells to study obstetrics-related disease states such as preeclampsia. Platelet metabolic alterations indicate systemic bioenergetic changes that can be useful as disease biomarkers. We tested the hypothesis that platelet mitochondria display functional alterations in preeclampsia. Platelets were harvested from women in the third trimester of either a healthy, non-preeclamptic or preeclamptic pregnancy, and from healthy, non-pregnant women. Using Seahorse respirometry, we analyzed platelets for oxygen consumption (OCR) and extracellular acidification (ECAR) rates, indicators of mitochondrial electron transport and glucose metabolism, respectively. There was a 37% decrease in the maximal respiratory capacity measured in platelets from healthy, non-preeclamptic compared with preeclamptic pregnancy (P<0.01); this relationship held true for other measurements of OCR, including basal respiration; ATP-linked respiration; respiratory control ratio (RCR); and spare respiratory capacity. RCR, a measure of mitochondrial efficiency, was significantly lower in healthy pregnant compared with non-pregnant women. In contrast with increased OCR, basal ECAR was significantly reduced in platelets from preeclamptic pregnancies compared with either normal pregnancies (−25%; P<0.05) or non-pregnant women (−22%; P<0.01). Secondary analysis of OCR revealed reduced basal and maximal platelet respiration in normal pregnancy prior to 34 weeks’ estimated gestational age (EGA) compared with the non-pregnant state; these differences disappeared after 34 weeks. Taken together, findings suggest that in preeclampsia, there exists either a loss or early (before the third trimester) reversal of a normal biologic mechanism of platelet mitochondrial respiratory reduction associated with normal pregnancy.
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143
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Millen KR, Buhimschi CS, Zhao G, Rood KM, Tabbah S, Buhimschi IA. Serum and Urine Thioflavin-T-Enhanced Fluorescence in Severe Preeclampsia. Hypertension 2018; 71:1185-1192. [PMID: 29686018 DOI: 10.1161/hypertensionaha.118.11034] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 03/07/2018] [Accepted: 03/23/2018] [Indexed: 01/23/2023]
Abstract
Common features of amyloid-like proteotoxic aggregates are the ability to bind Congo red (congophilia) and to induce fluorescence of thioflavin-T (ThT). Based on the prior discovery that women with preeclampsia exhibit urine congophilia, we proposed that amyloid-like protein aggregates present in urine also circulate in the bloodstream and this feature is linked to disease severity and clinical phenotype. ThT fluorescence was investigated in 217 paired serum and urine samples from women with severe features of preeclampsia (n=101; median [interquartile range] gestational age [GA], 32 [29-35] weeks), mild features of preeclampsia (n=22; GA, 36 [36-37] weeks), chronic hypertension (n=15; GA, 38 [37-39] weeks), healthy pregnant controls (n=57; GA, 39 [38-39] weeks), and nonpregnant controls (n=22). Serum and urine fluorescence attributable to advanced glycation end products was measured in the same samples with correction for autofluorescence. There were no GA-related changes in ThT fluorescence, although near-term serum ThT fluorescence increased compared with nonpregnant state. Compared with healthy pregnant controls, serum and urine ThT fluorescence was increased in severe features of preeclampsia (P<0.001 for both) but not in mild features of preeclampsia or chronic hypertension. Except for chronic hypertension, advanced glycation end products-related fluorescence of serum or urine did not differ from controls. Urine congophilia had a stronger relationship with preeclampsia severity compared with either urine or serum ThT fluorescence. However, serum ThT fluorescence was independently associated with clinical features of hemolysis, elevated liver enzyme levels, and low platelet levels syndrome (P=0.003). We demonstrate that ThT fluorescence, a marker of amyloid-like aggregates, is increased in serum of women with preeclampsia and likely because of their cytotoxicity associated with hemolysis, elevated liver enzyme levels, and low platelet levels syndrome.
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Affiliation(s)
- Katherine R Millen
- From the Department of Obstetrics and Gynecology (K.R.M., C.S.B., K.M.R., S.T., I.A.B.)
| | - Catalin S Buhimschi
- From the Department of Obstetrics and Gynecology (K.R.M., C.S.B., K.M.R., S.T., I.A.B.).,and Department of Pediatrics (C.S.B., I.A.B.)
| | - Guomao Zhao
- The Ohio State University College of Medicine, Columbus; and Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH (G.Z., I.A.B.)
| | - Kara M Rood
- From the Department of Obstetrics and Gynecology (K.R.M., C.S.B., K.M.R., S.T., I.A.B.)
| | - Sammy Tabbah
- From the Department of Obstetrics and Gynecology (K.R.M., C.S.B., K.M.R., S.T., I.A.B.)
| | - Irina A Buhimschi
- From the Department of Obstetrics and Gynecology (K.R.M., C.S.B., K.M.R., S.T., I.A.B.) .,and Department of Pediatrics (C.S.B., I.A.B.).,The Ohio State University College of Medicine, Columbus; and Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH (G.Z., I.A.B.)
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144
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Fantasia HC. Low-Dose Aspirin for the Prevention of Preeclampsia. Nurs Womens Health 2018; 22:87-92. [PMID: 29433703 DOI: 10.1016/j.nwh.2017.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 10/13/2017] [Indexed: 01/12/2023]
Abstract
Preeclampsia is a hypertensive disorder specific to pregnancy that remains a significant cause of maternal and neonatal morbidity and mortality. Identification of women who are most at risk for preeclampsia is imprecise. Because of the potential negative health consequences of preeclampsia for women and newborns and the lack of effective screening mechanisms preventing preeclampsia is an important component of prenatal care. Researchers have documented that low-dose aspirin, taken daily after the first trimester, can decrease the development of preeclampsia and reduce the incidence of preterm birth and birth of small-for-gestational-age infants. This column includes an overview of low-dose aspirin in pregnancy and a review of current recommendations from leading national organizations.
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Perusquía M, Hanson AE, Meza CM, Kubli C, Herrera N, Stallone JN. Antihypertensive responses of vasoactive androgens in an in vivo experimental model of preeclampsia. J Steroid Biochem Mol Biol 2018; 178:65-72. [PMID: 29113921 DOI: 10.1016/j.jsbmb.2017.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 10/12/2017] [Accepted: 11/02/2017] [Indexed: 01/12/2023]
Abstract
Dehydroepiandrosterone (DHEA), testosterone (TES) and its 5-reduced metabolites induce a nongenomic vasorelaxation in several vascular beds of mammals; similarly these hormones produce systemic hypotensive and antihypertensive responses in normotensive and hypertensive male rats. Thus, it was hypothesized that the antihypertensive response of androgens, whose levels are elevated during gestation, protect against gestational hypertension. An animal model of preeclampsia was induced in female Wistar rats using DOCA-salt-treated pregnant (PT) and normal pregnant (NP) rats. In vivo experiments in conscious rats revealed that bolus intravenous injections of DHEA, TES, 5α- or 5β-dihydrotestosterone (-DHT) log -1.0 to 2.0μmolk-1min-1, produced substantial transient reductions in arterial blood pressure (BP), without significant changes in heart rate (HR). Mean arterial blood pressure (MAP) was reduced significantly in both groups. PT rats were more sensitive to the antihypertensive responses of androgens than NP. DHEA and 5β-DHT were the most potent to reduce MAP: 66±07 and 69±2.0mmHg in PT but only 33±0.5 and 35±1.2mmHg in NP rats, respectively. In isolated aortas of PT and NP, the concentration-response curves to each androgen (0.1-100μM) indicated that KCl-induced pre-contraction is more sensitive to all androgens than phenylephrine (Phe) pre-contractions. Notably, 5β-DHT is the greatest vasorelaxant with KCl-induced contraction than with Phe contraction of both groups, suggesting a preferential blockade on L-VOCCs. TES exhibited minor vasorelaxing effect of aortas pre-contracted with KCl, compared to its precursor DHEA and its 5-reduced metabolites. These data show that these androgens exert acute vasorelaxing effects in vitro and remarkably, reduce the BP in vivo in PT and NP at term pregnancy. Moreover, a deficit in feto-placental androgen production during pregnancy may trigger the development of preeclampsia or gestational hypertension.
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Affiliation(s)
- Mercedes Perusquía
- Universidad Nacional Autónoma de México, Instituto de Investigaciones Biomédicas, Departamento de Biología Celular y Fisiología, México City 04510, Mexico.
| | - Andrea E Hanson
- Department of Veterinary Physiology & Pharmacology, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4466, USA
| | - Claudia M Meza
- Universidad Nacional Autónoma de México, Instituto de Investigaciones Biomédicas, Departamento de Biología Celular y Fisiología, México City 04510, Mexico
| | - Cris Kubli
- Universidad Nacional Autónoma de México, Instituto de Investigaciones Biomédicas, Departamento de Biología Celular y Fisiología, México City 04510, Mexico
| | - Nieves Herrera
- Universidad Nacional Autónoma de México, Instituto de Investigaciones Biomédicas, Departamento de Biología Celular y Fisiología, México City 04510, Mexico
| | - John N Stallone
- Department of Veterinary Physiology & Pharmacology, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4466, USA; Women's Health Division, Michael E. DeBakey, Texas A&M University, College Station, TX 77843-4466, USA
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Overexpression of long non-coding RNA H19 promotes invasion and autophagy via the PI3K/AKT/mTOR pathways in trophoblast cells. Biomed Pharmacother 2018. [PMID: 29522949 DOI: 10.1016/j.biopha.2018.02.134] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Preeclampsia (PE), characterized by hypertension and proteinuria, is a leading cause of perinatal and maternal mortality. Considering that mutation of H19 gene is closely associated with PE, we aimed to explore the functional role of long non-coding RNA H19 (lncRNA-H19) in trophoblast cells. METHODS Expression of lncRNA-H19 in placenta tissues from patients with PE and healthy pregnant women after delivery was determined by quantitative reverse transcription PCR. Then, lncRNA-H19 was abnormally expressed in JEG-3 and HTR-8 cells by stable cell transfection. Cell viability and invasion were assessed by using CCK-8 and Matrigel-coated Millicell system, respectively. Expression of key proteins associated with invasion and autophagy as well as key kinases in the phosphatidylinositol-3-kinase (PI3K)/AKT/mechanistic target of rapamycin (mTOR) pathways were measured by Western blot analysis. Number of GFP-labeled autophagosomes was counted under a confocal microscope. RESULTS Level of lncRNA-H19 in the placenta tissues from PE patients was higher than that from healthy controls. LncRNA-H19 overexpression reduced cell viability but increased invasion of JEG-3 and HTR-8 cells. LncRNA-H19 silence showed the opposite effects. In addition, lncRNA-H19 overexpression promoted autophagy in trophoblast cells. Furthermore, phosphorylated levels of key kinases in the PI3K/AKT/mTOR pathways were enhanced by lncRNA-H19 overexpression while were reduced by lncRNA-H19 silence. CONCLUSION LncRNA-H19, which was up-regulated in PE, reduced cell viability but promoted invasion and autophagy in trophoblast cells, along with activation of the PI3K/AKT/mTOR pathways. Our study provides a theoretical basis for pathogenesis of PE, aiding to identification of novel therapeutic strategies for PE.
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147
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Maternal high-salt diet alters redox state and mitochondrial function in newborn rat offspring's brain. Br J Nutr 2018; 119:1003-1011. [PMID: 29502538 DOI: 10.1017/s0007114518000235] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Excessive salt intake is a common feature of Western dietary patterns, and has been associated with important metabolic changes including cerebral redox state imbalance. Considering that little is known about the effect on progeny of excessive salt intake during pregnancy, the present study investigated the effect of a high-salt diet during pregnancy and lactation on mitochondrial parameters and the redox state of the brains of resulting offspring. Adult female Wistar rats were divided into two dietary groups (n 20 rats/group): control standard chow (0·675 % NaCl) or high-salt chow (7·2 % NaCl), received throughout pregnancy and for 7 d after delivery. On postnatal day 7, the pups were euthanised and their cerebellum, hypothalamus, hippocampus, prefrontal and parietal cortices were dissected. Maternal high-salt diet reduced cerebellar mitochondrial mass and membrane potential, promoted an increase in reactive oxygen species allied to superoxide dismutase activation and decreased offspring cerebellar nitric oxide levels. A significant increase in hypothalamic nitric oxide levels and mitochondrial superoxide in the hippocampus and prefrontal cortex was observed in the maternal high-salt group. Antioxidant enzymes were differentially modulated by oxidant increases in each brain area studied. Taken together, our results suggest that a maternal high-salt diet during pregnancy and lactation programmes the brain metabolism of offspring, favouring impaired mitochondrial function and promoting an oxidative environment; this highlights the adverse effect of high-salt intake in the health state of the offspring.
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148
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Abstract
Preeclampsia is a complex genetic disorder with an incompletely understood pathogenesis. Its phenotype may be better elucidated by integrating symptoms. This study aimed to identify symptoms by gestational age and associations with novel preeclampsia candidate genes. Women with a history of preeclampsia recruited from The Preeclampsia Registry completed clinical/demographic, symptom surveys and provided medical records. DNA extracted from saliva was processed with multiplexed assays for eight single-nucleotide polymorphisms (SNPs) selected to tag candidate genes and/or located in symptom susceptibility regions. Groups with versus without symptoms were compared using χ2. Associations between SNPs and symptoms were analyzed as genotype categories and presence/absence of the variant allele. Logistic regression modeling was conducted with exploratory p = .05. In 114 participants, 113 reported at least 1 of the 18 symptoms. Symptoms varied by trimester. Nine symptoms were associated with seven SNPs. Visual disturbances were associated with three SNPs and nausea/vomiting with two SNPs. Modeling adjustment for maternal age and parity resulted in 15 associations between 9 symptoms and 8 SNPs. Medical records demonstrated 100% concordance with self-reported diagnosis and 48% concordance with reported severity. Findings indicated novel symptom-genotype associations in preeclampsia. The small sample was self-selected, but results support future studies including medical records review. When validated, these results may lead to holistic phenotyping of women to characterize subsets of preeclampsia. This approach may optimize health in pregnancy and later life for mothers and offspring through prediction, prevention, and precision nursing care.
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Affiliation(s)
- Sandra A Founds
- 1 Magee-Womens Research Institute, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | | | - Dianxu Ren
- 3 University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - M Michael Barmada
- 4 University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
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149
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Elgari MM, Khabour OF, Alhag SM. Correlations between changes in hematological indices of mothers with preeclampsia and umbilical cord blood of newborns. Clin Exp Hypertens 2018; 41:58-61. [DOI: 10.1080/10641963.2018.1441861] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Mahmoud M. Elgari
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia
- Faculty of Medical Laboratory Sciences, Sudan University for Sciences and Technology, Khartoum, Sudan
| | - Omar F. Khabour
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Samaher M. Alhag
- Faculty of Medical Laboratory Sciences, Sudan University for Sciences and Technology, Khartoum, Sudan
- Department of Medical Laboratory, Al- Ghad College of Applied Medical Sciences, Medina, Saudi Arabia
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Gao Y, She R, Wang Q, Li Y, Zhang H. Up-regulation of miR-299 suppressed the invasion and migration of HTR-8/SVneo trophoblast cells partly via targeting HDAC2 in pre-eclampsia. Biomed Pharmacother 2018; 97:1222-1228. [DOI: 10.1016/j.biopha.2017.11.053] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 11/07/2017] [Accepted: 11/07/2017] [Indexed: 02/06/2023] Open
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