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Lockman S, Tandon P. Low-Dose Aspirin Use in Pregnancy in Patients with IBD with Risk Factors for Preeclampsia: A Retrospective Cohort Study. Dig Dis Sci 2024:10.1007/s10620-024-08544-0. [PMID: 38965156 DOI: 10.1007/s10620-024-08544-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 06/21/2024] [Indexed: 07/06/2024]
Affiliation(s)
- Sandhini Lockman
- Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Parul Tandon
- Division of Gastroenterology and Hepatology, University Health Network, University of Toronto, Toronto, ON, Canada.
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2
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Englund Ögge L, Dotevall A, Elfvin A, Sandgren U, Linden K, Bohlin L, Wallstersson B, Sjödell M, Augustinsson J, Hagman A. Glycemic control assessed by continuous glucose monitoring during pregnancy in women with type 1 diabetes and its association with preeclampsia, an observational Swedish cohort study. Acta Obstet Gynecol Scand 2024; 103:1426-1436. [PMID: 38725185 PMCID: PMC11168267 DOI: 10.1111/aogs.14856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION Women with type 1 diabetes have an increased risk of preeclampsia (PE), but it is not fully understood if degree of glycemic control is associated with this risk. The aim of this study was to assess glycemic control during pregnancy analyzed by continuous glucose monitoring (CGM) in women with and without PE and to investigate if glycemic control is associated with increased risk of PE. MATERIAL AND METHODS A total of 120 pregnant Swedish women with type 1 diabetes using CGM were included. Background factors and pregnancy outcomes were collected from medical records. CGM data were collected via the internet-based platform Diasend. Mean glucose, standard deviation of mean glucose, percentage of time in target, time below target, and time above target were presented for each trimester in women who did or did not develop PE. Associations between CGM-derived metrics and PE were analyzed with logistic regression and adjusted for confounders. RESULTS Twenty-two women (18.3%) developed PE. There were no significant differences in maternal characteristics between women with and without PE. Glycemic control improved in each trimester but was suboptimal in both groups. Time in target increased from 59% in the non-PE group and 54% in the PE group in the first trimester to 65% in both groups in the third trimester. There were no significant associations between glycemic control and PE after adjustment for confounders. CONCLUSIONS Degree of glycemic control during pregnancy assessed by CGM was not associated with development of PE in women with type 1 diabetes. However, more research is needed to understand the role of glycemic control in relation to development of PE.
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Affiliation(s)
- Linda Englund Ögge
- Department of Obstetrics and GynecologySahlgrenska University Hospital/ÖstraGothenburgSweden
- Department of Obstetrics and GynecologyInstitute of Clinical Sciences, University of GothenburgGothenburgSweden
| | - Annika Dotevall
- Department of MedicineSahlgrenska University Hospital/ÖstraGothenburgSweden
| | - Anders Elfvin
- Department of PediatricsInstitute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Ulrika Sandgren
- Department of Obstetrics and GynecologySahlgrenska University Hospital/ÖstraGothenburgSweden
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Linnea Bohlin
- Regionhälsan Health Care, Gynecology and Obstetrics ClinicGothenburgSweden
| | - Bernadette Wallstersson
- Department of Obstetrics and GynecologySahlgrenska University Hospital/ÖstraGothenburgSweden
| | - Mårten Sjödell
- Department of Obstetrics and GynecologySkaraborg HospitalSkövdeSweden
| | - Jaine Augustinsson
- Regionhälsan Health Care, Gynecology and Obstetrics ClinicGothenburgSweden
| | - Anna Hagman
- Regionhälsan Health Care, Gynecology and Obstetrics ClinicGothenburgSweden
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3
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Huang Y, Sun Q, Zhou B, Peng Y, Li J, Li C, Xia Q, Meng L, Shan C, Long W. Lipidomic signatures in patients with early-onset and late-onset Preeclampsia. Metabolomics 2024; 20:65. [PMID: 38879866 PMCID: PMC11180640 DOI: 10.1007/s11306-024-02134-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/22/2024] [Indexed: 06/19/2024]
Abstract
BACKGROUND Preeclampsia is a pregnancy-specific clinical syndrome and can be subdivided into early-onset preeclampsia (EOPE) and late-onset preeclampsia (LOPE) according to the gestational age of delivery. Patients with preeclampsia have aberrant lipid metabolism. This study aims to compare serum lipid profiles of normal pregnant women with EOPE or LOPE and screening potential biomarkers to diagnose EOPE or LOPE. METHODS Twenty normal pregnant controls (NC), 19 EOPE, and 19 LOPE were recruited in this study. Untargeted lipidomics based on ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was used to compare their serum lipid profiles. RESULTS The lipid metabolism profiles significantly differ among the NC, EOPE, and LOPE. Compared to the NC, there were 256 and 275 distinct lipids in the EOPE and LOPE, respectively. Furthermore, there were 42 different lipids between the LOPE and EOPE, of which eight were significantly associated with fetal birth weight and maternal urine protein. The five lipids that both differed in the EOPE and LOPE were DGTS (16:3/16:3), LPC (20:3), LPC (22:6), LPE (22:6), PC (18:5e/4:0), and a combination of them were a potential biomarker for predicting EOPE or LOPE. The receiver operating characteristic analysis revealed that the diagnostic power of the combination for distinguishing the EOPE from the NC and for distinguishing the LOPE from the NC can reach 1.000 and 0.992, respectively. The association between the lipid modules and clinical characteristics of EOPE and LOPE was investigated by the weighted gene co-expression network analysis (WGCNA). The results demonstrated that the main different metabolism pathway between the EOPE and LOPE was enriched in glycerophospholipid metabolism. CONCLUSIONS Lipid metabolism disorders may be a potential mechanism of the pathogenesis of preeclampsia. Lipid metabolites have the potential to serve as biomarkers in patients with EOPE or LOPE. Furthermore, lipid metabolites correlate with clinical severity indicators for patients with EOPE and LOPE, including fetal birth weight and maternal urine protein levels.
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Affiliation(s)
- Yu Huang
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123rd Tianfei Street, Mochou Road, Nanjing, 210004, China
| | - Qiaoqiao Sun
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123rd Tianfei Street, Mochou Road, Nanjing, 210004, China
| | - Beibei Zhou
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123rd Tianfei Street, Mochou Road, Nanjing, 210004, China
| | - Yiqun Peng
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123rd Tianfei Street, Mochou Road, Nanjing, 210004, China
| | - Jingyun Li
- Nanjing Maternal and Child Health Institute, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, China
| | - Chunyan Li
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123rd Tianfei Street, Mochou Road, Nanjing, 210004, China
| | - Qing Xia
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123rd Tianfei Street, Mochou Road, Nanjing, 210004, China
| | - Li Meng
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123rd Tianfei Street, Mochou Road, Nanjing, 210004, China
| | - Chunjian Shan
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123rd Tianfei Street, Mochou Road, Nanjing, 210004, China
| | - Wei Long
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123rd Tianfei Street, Mochou Road, Nanjing, 210004, China.
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, China.
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4
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Deng J, Peng L, Wang Y, Li J, Tang L, Yu Y. Population pharmacokinetics and dose optimization of magnesium sulfate in Chinese preeclampsia population. BMC Pregnancy Childbirth 2024; 24:424. [PMID: 38872116 PMCID: PMC11170845 DOI: 10.1186/s12884-024-06620-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024] Open
Abstract
OBJECTIVE To establish the population pharmacokinetics (PPK) of magnesium sulfate (MgSO4)in women with preeclampsia (PE), and to determine the key covariates having an effect in magnesium pharmacokinetics in Chinese PE. METHODS Pregnant women with PE prescribed MgSO4 were enrolled in this prospective study from April 2021 to April 2023. On the initial day of administration, the patients were administered a loading dose of 5 g in conjunction with 10 g of magnesium sulfate as a maintenance dose. On the second day, only the maintenance dose was administration, and maternal blood samples were taken at 0, 4, 5, and 12 h after the second day's 10 g maintenance dose. The software Phoenix was used to estimate PPK parameters of MgSO4, such as clearance (CL) and volume of distribution (V), and to model PPK models with patient demographic, clinical, and laboratory covariates. RESULTS A total of 199 blood samples were collected from 51 women with PE and PPK profiles were analyzed. The PPK of MgSO4 is consistent with to a one-compartment model. The base model adequately described the maternal serum magnesium concentrations after magnesium administration. The population parameter estimates were as follows: CL was 2.98 L/h, V was 25.07 L. The model predictions changed significantly with covariates (BMI, creatinine clearance, and furosemide). Furosemide statistically influences V. The creatinine clearance, BMI and furosemide jointly affects CL. Monte Carlo simulation results showed that a loading dose combined with a maintenance dose would need to be administered daily to achieve the therapeutic blood magnesium concentrations. For the non-furosemide group, the optimal dosing regimen was a 5 g loading dose combined with a 10 g maintenance dose of MgSO4. For the furosemide group, the optimal dosing regimen was a 2.5 g loading dose combined with a 10 g maintenance dose of MgSO4. CONCLUSIONS The magnesium PPK model was successfully developed and evaluated in Chinese preeclampsia population, and the dose optimization of MgSO4 was completed through Monte Carlo simulation.
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Affiliation(s)
- Jing Deng
- The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Suzhou, Jiangsu, 215002, China
| | - Lan Peng
- Department of Obstetrics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, 215002, China
| | - Yuwei Wang
- The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Suzhou, Jiangsu, 215002, China
| | - Jingjing Li
- Department of Pharmacy, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, 215002, China.
| | - Lian Tang
- Department of Pharmacy, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, 215002, China.
| | - Yanxia Yu
- Department of Pharmacy, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, 215002, China.
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Lee YH, Kim DY, Bae JG, Kim YC. Relationship between proteinuria and changes in antepartum and postpartum choroidal thickness in patients with pre-eclampsia. Sci Rep 2024; 14:12672. [PMID: 38830948 PMCID: PMC11148149 DOI: 10.1038/s41598-024-63359-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 05/28/2024] [Indexed: 06/05/2024] Open
Abstract
Pre-eclampsia (PE) is a hypertensive disorder characterised by systemic vascular resistance and endothelial dysfunction. It is known to influence choroidal thickness (CT). No previous studies have explored the antepartum and postpartum changes in CT with respect to the protein-creatinine ratio (PCR), a measure of proteinuria that is a clinical hallmark of PE. This study evaluated the correlations between antepartum and postpartum CT and the PCR in patients with PE. In this retrospective study, sixty-six eyes (66 patients) were analysed. The patients were divided into two groups according to the median PCR value (2.36 mg/mg): low PCR group (< 2.36 mg/mg) and high PCR group (≥ 2.36 mg/mg). Ophthalmologic clinical data were collected and assessed. We observed higher antepartum CT and higher mean arterial pressure in high PCR group than in low PCR group. Moreover, postpartum CT decreased significantly in high PCR group. In the multivariate analysis, CT changes were correlated with antepartum CT and antepartum PCR after logarithm transformation. In conclusion, a greater decrease in CT was observed in high PCR group than in low PCR group. Further, the antepartum PCR showed a correlation with the extent of CT reduction.
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Affiliation(s)
- You Hyun Lee
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Do Yeon Kim
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Jin Gon Bae
- Department of Obstetrics, Keimyung University School of Medicine, Daegu, Korea
| | - Yu Cheol Kim
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Republic of Korea.
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6
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Schofield LG, Delforce SJ, Pryor JC, Endacott SK, Lumbers ER, Marshall SA, Pringle KG. The soluble (pro)renin receptor promotes a preeclampsia-like phenotype both in vitro and in vivo. Hypertens Res 2024; 47:1627-1641. [PMID: 38605139 PMCID: PMC11150152 DOI: 10.1038/s41440-024-01678-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/14/2024] [Accepted: 03/22/2024] [Indexed: 04/13/2024]
Abstract
Preeclampsia is classified as new-onset hypertension coupled with gross endothelial dysfunction. Placental (pro)renin receptor ((P)RR) and plasma soluble (P)RR (s(P)RR) are elevated in patients with preeclampsia. Thus, we aimed to interrogate the role (P)RR may play in the pathogenesis of preeclampsia. Human uterine microvascular endothelial cells (HUtMECs, n = 4) were cultured with either; vehicle (PBS), 25-100 nM recombinant s(P)RR, or 10 ng/ml TNF-a (positive control) for 24 h. Conditioned media and cells were assessed for endothelial dysfunction markers via qPCR, ELISA, and immunoblot. Angiogenic capacity was assessed through tube formation and adhesion assays. Additionally, pregnant rats were injected with an adenovirus overexpressing s(P)RR from mid-pregnancy (day 8.5), until term (n = 6-7 dams/treatment). Maternal and fetal tissues were assessed. HUtMECs treated with recombinant s(P)RR displayed increased expression of endothelial dysfunction makers including vascular cell adhesion molecule-1, intracellular adhesion molecule-1, and endothelin-1 mRNA expression (P = 0.003, P = 0.001, P = 0.009, respectively), along with elevated endothelin-1 protein secretion (P < 0.001) compared with controls. Recombinant s(P)RR impaired angiogenic capacity decreasing the number of branches, total branch length, and mesh area (P < 0.001, P = 0.004, and P = 0.009, respectively), while also increasing vascular adhesion (P = 0.032). +ADV rats exhibited increased systolic (P = 0.001), diastolic (P = 0.010), and mean arterial pressures (P = 0.012), compared with -ADV pregnancies. Renal arteries from +ADV-treated rats had decreased sensitivity to acetylcholine-induced relaxation (P = 0.030), compared with -ADV pregnancies. Our data show that treatment with s(P)RR caused hypertension and growth restriction in vivo and caused marked endothelial dysfunction in vitro. These findings demonstrate the significant adverse actions of s(P)RR on vascular dysfunction that is characteristic of the preeclamptic phenotype.
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Affiliation(s)
- Lachlan G Schofield
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Mothers and Babies Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Sarah J Delforce
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Mothers and Babies Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Jennifer C Pryor
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Immune Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Health & Medical Research Council (NHMRC) Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, NSW, Australia
| | - Saije K Endacott
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Mothers and Babies Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Eugenie R Lumbers
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Mothers and Babies Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Sarah A Marshall
- Department of Obstetrics and Gynaecology, The Ritchie Centre, School of Clinical Sciences, Monash University and The Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Kirsty G Pringle
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Mothers and Babies Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.
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7
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Deady C, McCarthy FP, Barron A, McCarthy CM, O’Keeffe GW, O’Mahony SM. An altered gut microbiome in pre-eclampsia: cause or consequence. Front Cell Infect Microbiol 2024; 14:1352267. [PMID: 38774629 PMCID: PMC11106424 DOI: 10.3389/fcimb.2024.1352267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/22/2024] [Indexed: 05/24/2024] Open
Abstract
Hypertensive disorders of pregnancy, including pre-eclampsia, are a leading cause of serious and debilitating complications that affect both the mother and the fetus. Despite the occurrence and the health implications of these disorders there is still relatively limited evidence on the molecular underpinnings of the pathophysiology. An area that has come to the fore with regard to its influence on health and disease is the microbiome. While there are several microbiome niches on and within the body, the distal end of the gut harbors the largest of these impacting on many different systems of the body including the central nervous system, the immune system, and the reproductive system. While the role of the microbiome in hypertensive disorders, including pre-eclampsia, has not been fully elucidated some studies have indicated that several of the symptoms of these disorders are linked to an altered gut microbiome. In this review, we examine both pre-eclampsia and microbiome literature to summarize the current knowledge on whether the microbiome drives the symptoms of pre-eclampsia or if the aberrant microbiome is a consequence of this condition. Despite the paucity of studies, obvious gut microbiome changes have been noted in women with pre-eclampsia and the individual symptoms associated with the condition. Yet further research is required to fully elucidate the role of the microbiome and the significance it plays in the development of the symptoms. Regardless of this, the literature highlights the potential for a microbiome targeted intervention such as dietary changes or prebiotic and probiotics to reduce the impact of some aspects of these disorders.
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Affiliation(s)
- Clara Deady
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Fergus P. McCarthy
- Department of Obstetrics and Gynecology, University College Cork, Cork, Ireland
- The Infant Research Centre, University College Cork, Cork, Ireland
| | - Aaron Barron
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
- Department of Pharmacology and Therapeutics, University College Cork, Cork, Ireland
| | - Cathal M. McCarthy
- Department of Pharmacology and Therapeutics, University College Cork, Cork, Ireland
| | - Gerard W. O’Keeffe
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
- Cork Neuroscience Centre, University College Cork, Cork, Ireland
| | - Siobhain M. O’Mahony
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
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8
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Soliman Y, Eke C, Guo X, Wang M, Silva T, Désir GV, Konnikova L. Renalase Levels are Decreased in Maternal Blood and Placental Tissues in Pregnancies Associated with Preterm Preeclampsia. RESEARCH SQUARE 2024:rs.3.rs-4319658. [PMID: 38765989 PMCID: PMC11100877 DOI: 10.21203/rs.3.rs-4319658/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Preeclampsia (PEC) is a complication of pregnancy associated with hypertension and the risk of eclampsia. The pathophysiology of PEC is unknown and identifying factors associated with PEC during pregnancy is crucial for placental, fetal, and maternal health. Renalase (RNLS) is an anti-inflammatory secretory flavoprotein associated with hypertension. Recent data demonstrated a correlation between maternal serum RNLS and PEC, and work from our group identified RNLS expression in the placenta. However, it remains unknown whether RNLS levels in placenta are altered by preeclampsia. Additionally, it is unclear if there is a differential effect of preterm and term PEC on RNLS. We demonstrate that serum RNLS was reduced in preterm cases of PEC. Similarly, placental RNLS was diminished in the chorion of preterm cases of PEC. However, a reduction of RNLS in the decidua was observed with all cases of PEC, while the levels of RNLS within the placental villi were similar in all cases. Overall, we demonstrate that RNLS correlates with PEC both systemically in maternal serum and locally within the placenta, with variable effects on the different layers of the placenta and more pronounced in preterm cases.
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Affiliation(s)
- Youstina Soliman
- Department of Pediatrics, New Haven, CT, USA
- Department of Medical Sciences Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA
| | - Chino Eke
- Department of Pediatrics, New Haven, CT, USA
| | - Xiaojia Guo
- Department of Pediatrics, New Haven, CT, USA
- Internal Medicine, New Haven, CT, USA
| | - Melinda Wang
- Department of Internal Medicine, University of California San Francisco, San Francisco, CA
| | | | - Gary V. Désir
- Department of Pediatrics, New Haven, CT, USA
- Internal Medicine, New Haven, CT, USA
- VA CT Medical Center, Yale University, New Haven, CT, USA
| | - Liza Konnikova
- Department of Pediatrics, New Haven, CT, USA
- Obstetrics, Gynecology and Reproductive Sciences, New Haven, CT, USA
- Immunobiology Yale University School of Medicine, New Haven, CT, USA
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9
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Lai W, Yu L, Deng Y. PPARγ alleviates preeclampsia development by regulating lipid metabolism and ferroptosis. Commun Biol 2024; 7:429. [PMID: 38594496 PMCID: PMC11004023 DOI: 10.1038/s42003-024-06063-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 03/18/2024] [Indexed: 04/11/2024] Open
Abstract
The study aims to explore the effect of PPARγ signaling on ferroptosis and preeclampsia (PE) development. Serum and placental tissue are collected from healthy subjects and PE patients. The PPARγ and Nrf2 decreases in the PE. Rosiglitazone intervention reverses hypoxia-induced trophoblast ferroptosis and decreases lipid synthesis by regulating Nfr2 and SREBP1. Compared to the Hypoxia group, the migratory and invasive abilities enhance after rosiglitazone and ferr1 treatment. Rosiglitazone reduces the effect of hypoxia and erastin. The si-Nrf2 treatment attenuats the effects of rosiglitazone on proliferation, migration, and invasion. The si-Nrf2 does not affect SREBP1 expression. PPARγ agonists alleviates ferroptosis in the placenta of the PE rats. The study confirms that PPARγ signaling and ferroptosis-related indicators were dysregulated in PE. PPARγ/Nrf2 signaling affects ferroptosis by regulating lipid oxidation rather than SREBP1-mediated lipid synthesis. In conclusion, our study find that PPARγ can alleviate PE development by regulating lipid oxidation and ferroptosis.
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Affiliation(s)
- Weisi Lai
- Department of Obstetrics and Gynecology, Second XiangYa Hospital of Central South University, Changsha, China
| | - Ling Yu
- Department of Obstetrics and Gynecology, Second XiangYa Hospital of Central South University, Changsha, China
| | - Yali Deng
- Department of Obstetrics and Gynecology, Second XiangYa Hospital of Central South University, Changsha, China.
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10
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Liao CC, Ku JC, Lin CL, Li JW, Tsai FJ, Li JM. Investigating causal relationships between extensive peripheral immune cell phenotypes and preeclampsia: A bi-directional Mendelian randomization analysis. Am J Reprod Immunol 2024; 91:e13840. [PMID: 38606695 DOI: 10.1111/aji.13840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/06/2024] [Accepted: 03/31/2024] [Indexed: 04/13/2024] Open
Abstract
PROBLEM Preeclampsia, a multifaceted condition during pregnancy characterized by hypertension and organ dysfunction, poses significant risks to both maternal and fetal health. This study aims to investigate the bidirectional causal relationship between peripheral immune cell phenotypes and preeclampsia using a two-sample Mendelian randomization (MR) approach. METHOD OF STUDY Genetic data from two sizable cohorts were utilized: 3757 individuals from Sardinia, providing information on 731 immune traits, and 200 929 Finnish adult females, encompassing 6663 preeclampsia cases. Single-nucleotide polymorphisms served as instrumental variables. The MR analyses employed the inverse variance-weighted (IVW) method as the primary tool, supplemented by MR-Egger, weighted median, and weighted mode methods to enhance reliability and address potential heterogeneity and horizontal pleiotropy. RESULTS Among the 731 immune cell phenotypes studied, 18 displayed a suggestive positive association (IVW p < .05) with heightened preeclampsia risk, while 20 exhibited a suggestive negative association linked to reduced risk. Following false discovery rate (FDR) adjustment, four immune phenotypes showed significant associations with decreased preeclampsia risk: CD27 on CD24+ CD27+ B cells (B-cell panel) (odds ratio [OR] = 0.927, PFDR = 0.061), CD33+ HLA DR+ CD14- absolute count (OR = 0.963, PFDR = 0.061), CD80 on plasmacytoid dendritic cells (OR = 0.923, PFDR = 0.061); and CD80 on CD62L+ plasmacytoid dendritic cells (OR = 0.923, PFDR = 0.061). In the reverse-direction MR analysis, no significant causal effects of preeclampsia on immune cell phenotypes were observed. CONCLUSIONS This study provides quantifiable evidence linking specific immune cell phenotypes to the risk of developing preeclampsia. This novel understanding of the immunological aspects underlying preeclampsia's pathogenesis could lead to innovative therapeutic strategies centered on immune modulation.
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Affiliation(s)
- Chung-Chih Liao
- Department of Post-Baccalaureate Veterinary Medicine, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Chuyuan Chinese Medicine Clinic, Taichung, Taiwan
| | - Ju-Chun Ku
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Ju-Wan Li
- Anxin Postpartum Nursing Home, Lee Women's Hospital, Taichung, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Division of Medical Genetics, China Medical University Children's Hospital, Taichung, Taiwan
- Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan
| | - Jung-Miao Li
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
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11
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Björkman S, Lilliecreutz C, Bladh M, Strömberg T, Östgren CJ, Mahmoud A, Kafashian A, Bergstrand S, Sederholm Lawesson S. Microvascular dysfunction in women with a history of hypertensive disorders of pregnancy: A population-based retrospective cohort study. BJOG 2024; 131:433-443. [PMID: 37732494 DOI: 10.1111/1471-0528.17665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/04/2023] [Accepted: 08/31/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE To evaluate microvascular function in women with previous hypertensive disorders of pregnancy (HDP). DESIGN Retrospective population-based cohort study. SETTING Linköping, Sweden. POPULATION Women aged 50-65 years, participating in the Swedish CArdioPulmonary bioImage Study (SCAPIS) at one site (Linköping) 2016-18, who underwent microcirculatory assessment (N = 1222). METHODS Forearm skin comprehensive microcirculatory assessment was performed with a PeriFlux PF6000 EPOS (Enhanced Perfusion and Oxygen Saturation) system measuring oxygen saturation and total speed resolved perfusion. Obstetric records were reviewed to identify women with previous HDP. Data on cardiovascular risk factors, comorbidities, medication, lifestyle, anthropometric data, and biochemical analyses were obtained from SCAPIS. The microcirculatory data were compared between women with and without previous HDP. MAIN OUTCOME MEASURES Skin microcirculatory oxygen saturation and total speed resolved perfusion at baseline and post-ischaemic peak. RESULTS Women with previous pre-eclampsia displayed impaired post-ischaemic peak oxygen saturation compared with women with normotensive pregnancies (88%, interquartile range [IQR] 84-89% vs 91%, IQR 87-94%, p = 0.001) 6-30 years after pregnancy. The difference remained after multivariable adjustment (β -2.69, 95% CI -4.93 to -0.45). CONCLUSIONS The findings reveal microvascular dysfunction at long-term follow up in women with previous pre-eclampsia and strengthen the possible role of endothelial dysfunction as a link to the increased risk of cardiovascular disease in women with HDP.
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Affiliation(s)
- Stina Björkman
- Department of Obstetrics and Gynaecology in Norrköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Caroline Lilliecreutz
- Department of Obstetrics and Gynaecology in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Marie Bladh
- Department of Obstetrics and Gynaecology in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Tomas Strömberg
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Carl Johan Östgren
- Department of Health, Medicine and Caring Sciences, and CMIV Centre of Medical Image Science and Visualization, Linköping University, Linköping, Sweden
| | | | | | - Sara Bergstrand
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Sofia Sederholm Lawesson
- Department of Cardiology, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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12
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Singh Thakur A, Tayade S, Patel D, Gupta A, Batra N. Unraveling the Predictive Power: Placenta Growth Factor and Pregnancy-Associated Plasma Protein A in Pre-eclampsia. Cureus 2024; 16:e52752. [PMID: 38389635 PMCID: PMC10881904 DOI: 10.7759/cureus.52752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
This review provides a comprehensive exploration of the roles of placenta growth factor (PlGF) and pregnancy-associated plasma protein A (PAPP-A) in the context of pre-eclampsia, a pregnancy-related hypertensive disorder with significant implications for maternal and fetal health. The background elucidates the clinical significance of pre-eclampsia, highlighting its prevalence and impact. The review delves into the biological importance of PlGF and PAPP-A, emphasizing their critical roles in normal placental development and their dysregulation in pre-eclampsia. Notably, altered levels of these biomarkers emerge as potential diagnostic indicators, offering insights into the pathophysiology of the disorder. The exploration of pathophysiological mechanisms, including angiogenic imbalance and placental dysfunction, provides a nuanced understanding of pre-eclampsia's molecular landscape. The therapeutic implications of targeting PlGF and PAPP-A open avenues for future research, aiming at effective intervention strategies. The conclusion summarizes key findings, outlines implications for future research, and underscores the crucial role of PlGF and PAPP-A in understanding and managing pre-eclampsia, with the ultimate goal of improving outcomes for both mothers and infants.
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Affiliation(s)
- Aditi Singh Thakur
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Wardha, IND
| | - Surekha Tayade
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Wardha, IND
| | - Drashti Patel
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Wardha, IND
| | - Aishwarya Gupta
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Wardha, IND
| | - Nitish Batra
- Medicine, Jawaharlal Nehru Medical College, Wardha, IND
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13
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Luo QQ, Tian Y, Qu GJ, Huang K, Hu PP, Xue Y, Hu BF, Luo SS. The targeting of DAPK1 with miR-190a-3p promotes autophagy in trophoblast cells. Mol Reprod Dev 2024; 91:e23724. [PMID: 38282318 DOI: 10.1002/mrd.23724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/26/2023] [Accepted: 12/04/2023] [Indexed: 01/30/2024]
Abstract
Pre-eclampsia (PE) is a dangerous pathological status that occurs during pregnancy and is a leading reason for both maternal and fetal death. Autophagy is necessary for cellular survival in the face of environmental stress as well as cellular homeostasis and energy management. Aberrant microRNA (miRNA) expression is crucial in the pathophysiology of PE. Although studies have shown that miRNA (miR)-190a-3p function is tissue-specific, the precise involvement of miR-190a-3p in PE has yet to be determined. We discovered that miR-190a-3p was significantly lower and death-associated protein kinase 1 (DAPK1) was significantly higher in PE placental tissues compared to normal tissues, which is consistent with the results in cells. The luciferase analyses demonstrated the target-regulatory relationship between miR-190a-3p and DAPK1. The inhibitory effect of miR-190a-3p on autophagy was reversed by co-transfection of si-DAPK1 and miR-190a-3p inhibitors. Thus, our data indicate that the hypoxia-dependent miR-190a-3p/DAPK1 regulatory pathway is implicated in the development and progression of PE by promoting autophagy in trophoblast cells.
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Affiliation(s)
- Qi-Qi Luo
- Department of Gerontology, First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
- Department of Cardiovascular Medicine, Army Characteristic Medical Center of PLA, Da ping Hospital, Chongqing, People's Republic of China
| | - Yu Tian
- Department of Gerontology, First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
| | - Guang-Jin Qu
- Department of Gerontology, First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
| | - Kun Huang
- Department of Gerontology, First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
- Department of Gerontology, The First Hospital of Jiaxing, Jiaxing, People's Republic of China
| | - Pan-Pan Hu
- Department of Gerontology, First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
| | - Ying Xue
- Department of Gerontology, First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
| | - Bi-Feng Hu
- Department of Neurology, Army Characteristic Medical Center of PLA, Da ping Hospital, Chongqing, People's Republic of China
| | - Shan-Shun Luo
- Department of Gerontology, First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
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14
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Chaudhary N, Newby AN, Whitehead KA. Non-Viral RNA Delivery During Pregnancy: Opportunities and Challenges. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023:e2306134. [PMID: 38145340 PMCID: PMC11196389 DOI: 10.1002/smll.202306134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/25/2023] [Indexed: 12/26/2023]
Abstract
During pregnancy, the risk of maternal and fetal adversities increases due to physiological changes, genetic predispositions, environmental factors, and infections. Unfortunately, treatment options are severely limited because many essential interventions are unsafe, inaccessible, or lacking in sufficient scientific data to support their use. One potential solution to this challenge may lie in emerging RNA therapeutics for gene therapy, protein replacement, maternal vaccination, fetal gene editing, and other prenatal treatment applications. In this review, the current landscape of RNA platforms and non-viral RNA delivery technologies that are under active development for administration during pregnancy is explored. Advancements of pregnancy-specific RNA drugs against SARS-CoV-2, Zika, influenza, preeclampsia, and for in-utero gene editing are discussed. Finally, this study highlights bottlenecks that are impeding translation efforts of RNA therapies, including the lack of accurate cell-based and animal models of human pregnancy and concerns related to toxicity and immunogenicity during pregnancy. Overcoming these challenges will facilitate the rapid development of this new class of pregnancy-safe drugs.
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Affiliation(s)
- Namit Chaudhary
- Department of Chemical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Alexandra N. Newby
- Department of Chemical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Kathryn A. Whitehead
- Department of Chemical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213
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15
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Vanhaesebrouck S, Zecic A, Goossens L, Keymeulen A, Garabedian L, De Meulemeester J, Naessens P, De Coen K, Smets K. Trends in neonatal morbidity and mortality for very low birthweight infants: a 20-year single-center experience. J Matern Fetal Neonatal Med 2023; 36:2227311. [PMID: 38092422 DOI: 10.1080/14767058.2023.2227311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 06/14/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVE To describe trends in mortality and morbidity rates of very low birth weight infants as well as their pre-, peri- and postnatal characteristics over a period of 20 years' time. METHODS Retrospective study in all very low birth weight infants admitted to the neonatal intensive care unit of the University Hospitals Ghent from 1 January 2000, to 31 December 2020. Mortality was the primary outcome variable with major morbidities being co-primary outcome variables. Pre-, peri- and postnatal characteristics are secondary outcome variables. We compared pre-, peri- and postnatal characteristics, as well as major morbidities between different groups with comparable rates of mortality. RESULTS We included a total of 2037 very low birth weight infants and divided them in 3 epochs based on stepwise reductions in mortality in 2008 and 2013: 2000-2007 (n = 718), 2008-2012 (n = 506) and 2013-2020 (n = 813). Mortality decreased significantly over the years in all gestational ages, but predominantly in those with the youngest gestational age. Changes in obstetric and neonatal care were observed over time. Most significant changes were the increased use of antenatal corticosteroids, magnesium sulfate and surfactant. Intraventricular hemorrhage grade III/IV decreased significantly in all gestational ages. Significant increase in retinopathy of prematurity was observed. Bronchopulmonary dysplasia at 36 weeks and discharge home with oxygen is increasing in the total group. In those born below 26 weeks a slight increase in all major morbidities was observed especially of patent ductus arteriosus and retinopathy of prematurity. Increase of all other major morbidities seems to stabilize in epoch 3. The number of infants surviving without any major morbidity increases to almost 1/2 in all very low birth weight infants and to 1/10 in those born 24-25 weeks gestation. CONCLUSION Analysis of the real-life experience showed that survival in very low birth weight infants significantly increased over time. Evolution of major morbidities will have to be carefully watched in the future.
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Affiliation(s)
- Sophie Vanhaesebrouck
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Belgium
| | - Alexandra Zecic
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Belgium
| | - Linde Goossens
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Belgium
| | - Annelies Keymeulen
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Belgium
| | - Lara Garabedian
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Belgium
| | - Julie De Meulemeester
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Belgium
| | - Pauline Naessens
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Belgium
| | - Kris De Coen
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Belgium
| | - Koenraad Smets
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Belgium
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16
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Ayoub SE, Shaker OG, Aboshama RA, Etman MK, Khalefa AA, khamiss Abd elguaad MM, Zaki OM, Ali DY, Hemeda NF, Amin A, Ali MA. Expression profile of LncRNA ANRIL, miR-186, miR-181a, and MTMR-3 in patients with preeclampsia. Noncoding RNA Res 2023; 8:481-486. [PMID: 37456780 PMCID: PMC10344750 DOI: 10.1016/j.ncrna.2023.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/18/2023] [Accepted: 06/06/2023] [Indexed: 07/18/2023] Open
Abstract
Preeclampsia (PE) is a leading cause of maternal and neonatal morbidity and mortality worldwide. Several studies demonstrated the role of lncRNAs and miRNAs in the pathogenesis of preeclampsia; the aim was to detect the expression profiles of serum LncRNA ANRIL, miR-186, miR-181a, and MTMR-3 in patients with preeclampsia. The study included 160 subjects divided into 80 subjects considered as a control group, 80 patients with preeclampsia. We found that there was a significant difference between the preeclampsia and control groups with up-regulation of miR-186 median (IQR) = 4, 29 (1.35-7.73) (P < 0.0001), miR-181a median (IQR) = 2.45 (0.83-6.52) (P = 0.028), and downregulation of lncRNA ANRIL median (IQR) = 0.35(0.28-0.528) (P < 0.0001), MTMR median (IQR) = 0.32(0.155-1.11), (P < 0.0001). ROC curve of lncRNA ANRIL, miR-186, miR-181a, and MTMR-3 in preeclampsia patients showing the roles of these markers in the diagnosis of preeclampsia. In conclusion, serum LncRNA ANRIL, miR-186, miR-181a, and MTMR-3 could be promising biomarkers in the diagnosis of preeclampsia.
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Affiliation(s)
- Shymaa E. Ayoub
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Fayoum University, Al Fayoum, Egypt
| | - Olfat G. Shaker
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Mohamed K. Etman
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Al Fayoum, Egypt
| | - Abeer A. Khalefa
- Department of Physiology, Faculty of Medicine, Zagazig University, El Zagazig, Egypt
| | | | - Othman M. Zaki
- Department of Clinical Pathology, Faculty of Medicine, Damietta University, Damietta, Egypt
| | - Doaa Y. Ali
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Fayoum University, Al Fayoum, Egypt
| | - Nada F. Hemeda
- Department of Genetics, Faculty of Agriculture, Fayoum University, Fayoum, Egypt
| | - Amal Amin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Fayoum University, Al Fayoum, Egypt
| | - Marwa A. Ali
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Fayoum University, Al Fayoum, Egypt
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17
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Ping Z, Feng Y, Lu Y, Ai L, Jiang H. Integrated analysis of microRNA and mRNA expression profiles in Preeclampsia. BMC Med Genomics 2023; 16:309. [PMID: 38041082 PMCID: PMC10691005 DOI: 10.1186/s12920-023-01740-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 11/15/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Preeclampsia (PE), a pregnancy specific syndrome, is one kind of common gestational hypertension disease, which can cause maternal and perinatal mortality and morbidity. This study was conducted to identify key microRNAs (miRNAs), mRNAs and related signaling pathways in the pathogenesis of PE. METHODS Whole transcriptome sequencing and small RNA sequencing of the peripheral blood from 3 PE patients and 3 normal pregnant women were performed. Differential expressed (DE) miRNAs were identified using the DEseq2 package. Target genes of the selected upregulated and downregulated DE miRNAs were predicted. Based on the hypergeometric distribution of DE miRNA target genes, we analyzed GO enrichment and KEGG pathway enrichment using R. RESULTS Total 1291 and 1281 novel RNAs were obtained from the preeclampsia patients and healthy individuals. 70 miRNAs were screened out with significant levels with 51 significantly upregulated and 19 significantly downregulated. 44,306 genes were predicted as the targets of these miRNAs. Besides, KEGG pathway analysis revealed that the upregulated miRNAs were enriched in Glycosaminoglycan biosynthesis-chondroitin sulfate / dermatan sulfate, Base excision repair and the downregulated miRNAs were enriched in Tuberculosis, Phagosome. CONCLUSION We constructed regulatory networks of miRNAs and target genes, there were 2208 negative miRNA-mRNA interactions in total. The network and pathway information illustrate the potential functions of mRNAs and miRNAs in PE pathogenesis.
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Affiliation(s)
- Zepeng Ping
- Department of Obstetrics, Maternity and Child Health Care Affiliated Hospital, Jiaxing University, 2468 Central South Road, Jiaxing, 314000, China
| | - Ying Feng
- Department of Obstetrics, Maternity and Child Health Care Affiliated Hospital, Jiaxing University, 2468 Central South Road, Jiaxing, 314000, China
| | - Ying Lu
- Department of Obstetrics, Maternity and Child Health Care Affiliated Hospital, Jiaxing University, 2468 Central South Road, Jiaxing, 314000, China
| | - Ling Ai
- Department of Obstetrics, Maternity and Child Health Care Affiliated Hospital, Jiaxing University, 2468 Central South Road, Jiaxing, 314000, China.
| | - Huling Jiang
- Department of Obstetrics, Maternity and Child Health Care Affiliated Hospital, Jiaxing University, 2468 Central South Road, Jiaxing, 314000, China.
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18
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Hijazi H, Alameddine M, Al Abdi RM, Baniissa W, Sindiani A, Al-Yateem N, Al-Sharman A, Al Marzouqi A, Hossain A. Association between inter-pregnancy interval and risk of adverse birth outcomes in subsequent pregnancy: A retrospective study from Jordan. Birth 2023; 50:946-958. [PMID: 37455440 DOI: 10.1111/birt.12746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Adverse birth outcomes, such as preterm birth and low birth weight (LBW), are leading causes of neonatal morbidity and mortality. In this study, we aimed to estimate the association between inter-pregnancy interval (IPI) and the risks of adverse birth outcomes in a subsequent pregnancy. METHODS We conducted a retrospective analysis involving 630 mothers who delivered a singleton live infant at a leading tertiary hospital in northern Jordan from March to August 2021. Outcome variables were preterm birth (<37 weeks of gestation) and LBW (<2.5 kg). Using multivariable logistic regression, the association between IPI and these two adverse birth outcomes was investigated. RESULTS The rates of preterm birth and LBW were 12.4% and 16.8%, respectively. Compared with an optimal IPI (24-36 months), a short IPI (<24 months) was positively associated with preterm birth (aOR: 4.09; 95% CI: 1.48-6.55) and LBW (aOR: 3.58; 95% CI: 1.57-5.15). Infants conceived after a long IPI (≥ 60 months) had increased odds of preterm birth (aOR: 3.78; 95% CI: 1.12-5.78) and LBW (aOR: 2.65; 95% CI: 1.67-4.03). Preterm delivery was also significantly associated with the mother's age (aOR: 1.10; 95% CI: 1.04-1.17), history of multiple cesarean births (aOR: 2.67; 95% CI: 1.14-4.29), prolonged rupture of membranes (aOR: 2.46; 95% CI: 1.10-5.52), and perinatal death (aOR: 3.42; 95% CI: 1.10-5.49). A mother's history of prior LBW (aOR: 4.39; 95% CI: 1.08-6.80), hypertensive disorders (aOR: 1.95; 95% CI: 1.03-3.89), and multiple cesarean births (aOR: 4.35; 95% CI: 2.10-6.99) was associated with LBW. CONCLUSIONS Both short and long IPIs were related to preterm delivery and LBW. Optimal birth spacing is recommended to improve birth outcomes and must be considered when designing effective family planning programs.
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Affiliation(s)
- Heba Hijazi
- Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohamad Alameddine
- Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Rabah M Al Abdi
- Electrical, Computer, and Biomedical Engineering Department, College of Engineering, Abu Dhabi University, Abu Dhabi, United Arab Emirates
- Biomedical Engineering Department, Faculty of Engineering, Jordan University of Science and Technology, Irbid, Jordan
| | - Wegdan Baniissa
- Nursing Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Amer Sindiani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nabeel Al-Yateem
- Nursing Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Alham Al-Sharman
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Rehabilitation Sciences Department, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Alounoud Al Marzouqi
- Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Ahmed Hossain
- Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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19
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Peng Z, Zhang J, Xiao Y, Dong W. Comparison of outcomes following intravenous magnesium compared with intravenous labetalol and oral nifedipine in 355 pregnant Han Chinese women with preeclampsia. Medicine (Baltimore) 2023; 102:e35334. [PMID: 37986315 PMCID: PMC10659676 DOI: 10.1097/md.0000000000035334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 11/22/2023] Open
Abstract
As per the American College of Obstetricians and Gynecologists in 2013, magnesium sulfate is the gold standard for the management of preeclampsia, but it has a short action time that does not provide stable maintenance of blood pressure. Labetalol is currently recommended as first-line treatment by the national UK guidance. This study included 355 pregnant Han Chinese women with preeclampsia and aimed to compare outcomes following intravenous magnesium compared with intravenous labetalol and oral nifedipine. Women received 4 g intravenous magnesium sulfate followed by the maintenance dose of 1 g/h intravenous magnesium sulfate (MS cohort, n = 104) or intravenous labetalol (LB cohort, n = 115), or oral nifedipine (NF cohort, n = 136). Therapy success: systolic blood pressure ~140 mm Hg and diastolic blood pressure ~90 mm Hg, therapy failure: persistent systolic blood pressure ≥ 160 or diastolic blood pressure ≥ 110 mm Hg after maximum dosage of therapy (EL). Women of all cohorts successfully decreased systolic and diastolic blood pressures at EL as compared to them before therapy conditions (P < .001, for all). At EL, systolic and diastolic blood pressures of women of the LB cohort decreased more than those of women of the MS and NF cohorts (P < .05, for all). Therapy was more successful in women of the LB cohort than those of the NF cohort (107 [93%] vs 112 [82%], P = .0132). More numbers of women were reduced blood pressure after 1 day of therapy from the LB cohort than those of the NF (75 [65%] vs 21 [15%]) and MS (75 [65%] vs 35 [34%]) cohorts (P < .0001 for both). Labetalol-induced tachycardia, bradycardia, and intracranial hemorrhage in pregnant women and respiratory distress syndrome and hypoglycemia in neonates. Intravenous labetalol provides proper reduction of blood pressure in Han Chinese women with preeclampsia but has the risk of undesirable maternal and neonatal adverse effects (Level of Evidence: IV; Technical Efficacy: Stage 4).
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Affiliation(s)
- Zhouli Peng
- Department of Obstetrics, Beijing Shunyi Hospital, Beijing, China
| | - Jidong Zhang
- Department of Obstetrics, Beijing Shunyi Hospital, Beijing, China
| | - Yuhui Xiao
- Department of Obstetrics, Beijing Shunyi Hospital, Beijing, China
| | - Weiyan Dong
- Department of Obstetrics, Beijing Shunyi Hospital, Beijing, China
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20
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Carter D, Better M, Abbasi S, Zulfiqar F, Shapiro R, Ensign LM. Nanomedicine for Maternal and Fetal Health. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023:e2303682. [PMID: 37817368 PMCID: PMC11004090 DOI: 10.1002/smll.202303682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/25/2023] [Indexed: 10/12/2023]
Abstract
Conception, pregnancy, and childbirth are complex processes that affect both mother and fetus. Thus, it is perhaps not surprising that in the United States alone, roughly 11% of women struggle with infertility and 16% of pregnancies involve some sort of complication. This presents a clear need to develop safe and effective treatment options, though the development of therapeutics for use in women's health and particularly in pregnancy is relatively limited. Physiological and biological changes during the menstrual cycle and pregnancy impact biodistribution, pharmacokinetics, and efficacy, further complicating the process of administration and delivery of therapeutics. In addition to the complex pharmacodynamics, there is also the challenge of overcoming physiological barriers that impact various routes of local and systemic administration, including the blood-follicle barrier and the placenta. Nanomedicine presents a unique opportunity to target and sustain drug delivery to the reproductive tract and other relevant organs in the mother and fetus, as well as improve the safety profile and minimize side effects. Nanomedicine-based approaches have the potential to improve the management and treatment of infertility, obstetric complications, and fetal conditions.
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Affiliation(s)
- Davell Carter
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Marina Better
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Saed Abbasi
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Fareeha Zulfiqar
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rachel Shapiro
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Chemical & Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Laura M. Ensign
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University, Baltimore, MD, USA
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Chemical & Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
- Departments of Gynecology and Obstetrics, Biomedical Engineering, Oncology, and Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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21
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Villalobos-Labra R, Liu R, Spaans F, Sáez T, Semeria Maitret T, Quon A, Sawamura T, Cooke CLM, Davidge ST. Placenta-Derived Extracellular Vesicles From Preeclamptic Pregnancies Impair Vascular Endothelial Function via Lectin-Like Oxidized LDL Receptor-1. Hypertension 2023; 80:2226-2238. [PMID: 37615097 DOI: 10.1161/hypertensionaha.123.21205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/08/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Preeclampsia is a complex syndrome that includes maternal vascular dysfunction. Syncytiotrophoblast-derived extracellular vesicles from preeclampsia placentas (preeclampsia-STBEVs) were shown to induce endothelial dysfunction, but an endothelial transmembrane mediator is still unexplored. The LOX-1 (lectin-like oxidized low-density lipoprotein receptor-1) is a transmembrane scavenger receptor that can cause endothelial dysfunction, and its expression is increased in the endothelium of preeclampsia women. In this study, we hypothesized that LOX-1 mediates the effects of preeclampsia-STBEVs on endothelial function. METHODS Preeclampsia-STBEVs were collected by perfusion of placentas from women with preeclampsia and in vitro and ex vivo endothelial cell function were assessed. RESULTS In human umbilical vein endothelial cells, inhibition of LOX-1 with LOX-1 blocking antibody (TS20) reduced the uptake of preeclampsia-STBEVs (61.3±8.8%). TS20 prevented the activation of ERK (extracellular signal-regulated kinase, a kinase downstream of LOX-1) and reduced the activation of NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells; 21.1±8.0%) and nitrative stress (23.2±10.3%) that was induced by preeclampsia-STBEVs. Vascular function was assessed by wire myography in isolated mesenteric arteries from pregnant rats that were incubated overnight with preeclampsia-STBEVs±TS20. TS20 prevented endothelium-dependent vasodilation impairment induced by preeclampsia-STBEVs. Nitric oxide contribution to the relaxation was reduced by preeclampsia-STBEVs, which was prevented by TS20. Superoxide dismutase or apocynin, an inhibitor of NOX (nicotinamide adenine dinucleotide phosphate oxidase), restored the impaired endothelium-dependent vasodilation in arteries exposed to preeclampsia-STBEVs. CONCLUSIONS Taken together, our findings demonstrate that LOX-1 mediates the endothelial dysfunction induced by preeclampsia-STBEVs. Our study further expands on the mechanisms that may lead to adverse outcomes in preeclampsia and proposes LOX-1 as a potential target for future interventions.
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Affiliation(s)
- Roberto Villalobos-Labra
- Department of Obstetrics and Gynecology (R.V.-L., R.L., F.S., T. Sáez, A.Q., C.-L.M.C., S.T.D.), University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute (R.V.-L., R.L., F.S., T. Sáez, A.Q., C.-L.M.C., S.T.D.), University of Alberta, Edmonton, Canada
- Escuela de Medicina sede San Felipe (R.V.-L.), Universidad de Valparaíso, Chile
| | - Ricky Liu
- Department of Obstetrics and Gynecology (R.V.-L., R.L., F.S., T. Sáez, A.Q., C.-L.M.C., S.T.D.), University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute (R.V.-L., R.L., F.S., T. Sáez, A.Q., C.-L.M.C., S.T.D.), University of Alberta, Edmonton, Canada
- Department of Physiology (R.L., S.T.D.), University of Alberta, Edmonton, Canada
| | - Floor Spaans
- Department of Obstetrics and Gynecology (R.V.-L., R.L., F.S., T. Sáez, A.Q., C.-L.M.C., S.T.D.), University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute (R.V.-L., R.L., F.S., T. Sáez, A.Q., C.-L.M.C., S.T.D.), University of Alberta, Edmonton, Canada
| | - Tamara Sáez
- Department of Obstetrics and Gynecology (R.V.-L., R.L., F.S., T. Sáez, A.Q., C.-L.M.C., S.T.D.), University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute (R.V.-L., R.L., F.S., T. Sáez, A.Q., C.-L.M.C., S.T.D.), University of Alberta, Edmonton, Canada
- Departamento de Medicina Interna (T. Sáez), Universidad de Valparaíso, Chile
- Centro de Investigaciones Biomédicas, Escuela de Medicina, Facultad de Medicina (T. Sáez), Universidad de Valparaíso, Chile
| | - Tamara Semeria Maitret
- Department of Laboratory Medicine and Pathology (T.S.M.), University of Alberta, Edmonton, Canada
| | - Anita Quon
- Department of Obstetrics and Gynecology (R.V.-L., R.L., F.S., T. Sáez, A.Q., C.-L.M.C., S.T.D.), University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute (R.V.-L., R.L., F.S., T. Sáez, A.Q., C.-L.M.C., S.T.D.), University of Alberta, Edmonton, Canada
| | - Tatsuya Sawamura
- Departments of Molecular Pathophysiology and Life Innovation, Shinshu University, Matsumoto, Japan (T. Sawamura)
| | - Christy-Lynn M Cooke
- Department of Obstetrics and Gynecology (R.V.-L., R.L., F.S., T. Sáez, A.Q., C.-L.M.C., S.T.D.), University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute (R.V.-L., R.L., F.S., T. Sáez, A.Q., C.-L.M.C., S.T.D.), University of Alberta, Edmonton, Canada
| | - Sandra T Davidge
- Department of Obstetrics and Gynecology (R.V.-L., R.L., F.S., T. Sáez, A.Q., C.-L.M.C., S.T.D.), University of Alberta, Edmonton, Canada
- Women and Children's Health Research Institute (R.V.-L., R.L., F.S., T. Sáez, A.Q., C.-L.M.C., S.T.D.), University of Alberta, Edmonton, Canada
- Department of Physiology (R.L., S.T.D.), University of Alberta, Edmonton, Canada
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22
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Shah A, Kapcin K, Deicke M, Pappan N, Holden K, Routray SK, Schmetzer A, DuMont T, Nashar K, Bajwa O, Ivanova V. Hypertension in Women and Pregnancy. Crit Care Nurs Q 2023; 46:377-390. [PMID: 37684733 DOI: 10.1097/cnq.0000000000000480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Hypertension has been shown to have long-term cardiovascular effects if left untreated. Hypertension also has been shown to affect women during pregnancy, which can be detrimental not only to the patient but also to the fetus. Early identification and treatment are paramount to prevent adverse outcomes. This article details the epidemiology, clinical presentation, diagnosis, and treatment of essential hypertension in women, gestational hypertension, preeclampsia, and eclampsia.
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Affiliation(s)
- Aaisha Shah
- Divisions of Internal Medicine (Drs Shah, Kapcin, and Deicke), Pulmonary and Critical Care (Drs Holden, Schmetzer, and DuMont), Nephrology and Critical Care Medicine (Dr Routray), Nephrology (Dr Nashar), and Pulmonary and Critical Care Medicine (Dr Bajwa), Allegheny Health Network Medicine Institute, Pittsburgh, Pennsylvania; and Division of Cardiovascular Disease, Allegheny Health Network Cardiovascular Institute (Drs Pappan and Ivanova)
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23
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Bretón I, Ballesteros-Pomar MD, Calle-Pascual A, Alvarez-Sala LA, Rubio-Herrera MA. Micronutrients in Pregnancy after Bariatric Surgery: A Narrative Review. J Clin Med 2023; 12:5429. [PMID: 37629473 PMCID: PMC10455502 DOI: 10.3390/jcm12165429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Bariatric surgery is increasingly used in women of childbearing age due to the rising prevalence of obesity and the effectiveness and availability of this treatment. Pregnancy in women with previous bariatric surgery deserves special attention. Weight loss induced by surgery reduces the risks that obesity poses to pregnancy. But on the other hand, decreased intake and malabsorption may increase the risk of malnutrition and micronutrient deficiency and negatively affect maternal and foetal health. The aim of this narrative review is to provide an updated analysis of the impact of different bariatric surgery techniques on mineral and micronutrient nutritional status during pregnancy and the possible effect on maternal-foetal health.
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Affiliation(s)
- Irene Bretón
- Department of Endocrinology and Nutrition, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
- Department of Medicine, Facultad de Medicina, Universidad Complutense, 28040 Madrid, Spain
| | - María D. Ballesteros-Pomar
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, 24008 León, Spain
| | - Alfonso Calle-Pascual
- Department of Medicine, Facultad de Medicina, Universidad Complutense, 28040 Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Luis Antonio Alvarez-Sala
- Department of Medicine, Facultad de Medicina, Universidad Complutense, 28040 Madrid, Spain
- Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Miguel Angel Rubio-Herrera
- Department of Medicine, Facultad de Medicina, Universidad Complutense, 28040 Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
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24
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Liu X, Liu H, Gu N, Pei J, Lin X, Zhao W. Preeclampsia promotes autism in offspring via maternal inflammation and fetal NFκB signaling. Life Sci Alliance 2023; 6:e202301957. [PMID: 37290815 PMCID: PMC10250690 DOI: 10.26508/lsa.202301957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/28/2023] [Accepted: 05/30/2023] [Indexed: 06/10/2023] Open
Abstract
Preeclampsia (PE) is a risk factor for autism spectrum disorder (ASD) in offspring. However, the exact mechanisms underlying the impact of PE on progeny ASD are not fully understood, which hinders the development of effective therapeutic approaches. This study shows the offspring born to a PE mouse model treated by Nω-nitro-L-arginine methyl ester (L-NAME) exhibit ASD-like phenotypes, including neurodevelopment deficiency and behavioral abnormalities. Transcriptomic analysis of the embryonic cortex and adult offspring hippocampus suggested the expression of ASD-related genes was dramatically changed. Furthermore, the level of inflammatory cytokines TNFα in maternal serum and nuclear factor kappa B (NFκB) signaling in the fetal cortex were elevated. Importantly, TNFα neutralization during pregnancy enabled to ameliorate ASD-like phenotypes and restore the NFκB activation level in the offspring exposed to PE. Furthermore, TNFα/NFκB signaling axis, but not L-NAME, caused deficits in neuroprogenitor cell proliferation and synaptic development. These experiments demonstrate that offspring exposed to PE phenocopies ASD signatures reported in humans and indicate therapeutic targeting of TNFα decreases the likelihood of bearing children with ASD phenotypes from PE mothers.
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Affiliation(s)
- Xueyuan Liu
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Environmental and Occupational Health Science Institute, Rutgers University, Piscataway, NJ, USA
| | - Haiyan Liu
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Nihao Gu
- International Peace Maternity & Child Health Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Shanghai Key Laboratory for Embryo-Feta Original Adult Disease, Shanghai Jiao Tong University, Shanghai, China
| | - Jiangnan Pei
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xianhua Lin
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Wenlong Zhao
- Environmental and Occupational Health Science Institute, Rutgers University, Piscataway, NJ, USA
- International Peace Maternity & Child Health Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Shanghai Key Laboratory for Embryo-Feta Original Adult Disease, Shanghai Jiao Tong University, Shanghai, China
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25
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Xie Y, Zhao F, Freitag N, Borowski S, Wang Y, Harms C, Pang PC, Desforges J, Wen T, Schwedhelm E, Singh M, Dechend R, Dell A, Haslam SM, Dveksler G, Garcia MG, Blois SM. Maternal-derived galectin-1 shapes the placenta niche through Sda terminal glycosylation: Implication for preeclampsia. PNAS NEXUS 2023; 2:pgad247. [PMID: 37575671 PMCID: PMC10416815 DOI: 10.1093/pnasnexus/pgad247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/20/2023] [Indexed: 08/15/2023]
Abstract
Placental abnormalities cause impaired fetal growth and poor pregnancy outcome (e.g. preeclampsia [PE]) with long-lasting consequences for the mother and offspring. The molecular dialogue between the maternal niche and the developing placenta is critical for the function of this organ. Galectin-1 (gal-1), a highly expressed glycan-binding protein at the maternal-fetal interface, orchestrates the maternal adaptation to pregnancy and placenta development. Down-regulation or deficiency of gal-1 during pregnancy is associated with the development of PE; however, the maternal- and placental-derived gal-1 contributions to the disease onset are largely unknown. We demonstrate that lack of gal-1 imposes a risk for PE development in a niche-specific manner, and this is accompanied by a placental dysfunction highly influenced by the absence of maternal-derived gal-1. Notably, differential placental glycosylation through the Sda-capped N-glycans dominates the invasive trophoblast capacity triggered by maternal-derived gal-1. Our findings show that gal-1 derived from the maternal niche is essential for healthy placenta development and indicate that impairment of the gal-1 signaling pathway within the maternal niche could be a molecular cause for maternal cardiovascular maladaptation during pregnancy.
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Affiliation(s)
- Yiran Xie
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Fangqi Zhao
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Nancy Freitag
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
- Experimental and Clinical Research Center (ECRC), a cooperation of the Max-Delbrück Center for Molecular Medicine (MDC) and Charité-Universitätsmedizin, 13125 Berlin, Germany
| | - Sophia Borowski
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
- Experimental and Clinical Research Center (ECRC), a cooperation of the Max-Delbrück Center for Molecular Medicine (MDC) and Charité-Universitätsmedizin, 13125 Berlin, Germany
| | - Yiru Wang
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Charlotte Harms
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Poh-Choo Pang
- Department of Life Sciences, Imperial College London, London SW7 2AZ, UK
| | - Juliette Desforges
- Department of Life Sciences, Imperial College London, London SW7 2AZ, UK
| | - Tianyu Wen
- Department of Life Sciences, Imperial College London, London SW7 2AZ, UK
| | - Edzard Schwedhelm
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf and German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, 20249 Hamburg, Germany
| | - Manvendra Singh
- Clinical Neuroscience, Max Planck Institute for Multidisciplinary Sciences, 37075 Göttingen, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center (ECRC), a cooperation of the Max-Delbrück Center for Molecular Medicine (MDC) and Charité-Universitätsmedizin, 13125 Berlin, Germany
- Department of Cardiology and Nephrology, HELIOS-Klinikum, 13125 Berlin, Germany
| | - Anne Dell
- Department of Life Sciences, Imperial College London, London SW7 2AZ, UK
| | - Stuart M Haslam
- Department of Life Sciences, Imperial College London, London SW7 2AZ, UK
| | - Gabriela Dveksler
- Department of Pathology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Mariana G Garcia
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Sandra M Blois
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
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26
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Jin PP, Ding N, Dai J, Liu XY, Mao PM. Investigation of the relationship between changes in maternal coagulation profile in the first trimester and the risk of developing preeclampsia. Heliyon 2023; 9:e17983. [PMID: 37496928 PMCID: PMC10366388 DOI: 10.1016/j.heliyon.2023.e17983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/20/2023] [Accepted: 07/04/2023] [Indexed: 07/28/2023] Open
Abstract
Normal pregnancy is a hypercoagulable state with an increase in coagulation factor levels and a decrease in natural anticoagulation. However, a higher hypercoagulable state with prolonged activated partial thromboplastin time (APTT), prothrombin time (PT), increased D-dimer, and mean platelet volume is seen in women with preeclampsia at the time of onset. In addition, endothelial dysfunction occurs before the clinical symptoms of preeclampsia. Therefore, we undertook this study to investigate the coagulation profile in the first trimester in women who developed preeclampsia later. A total of 853 pregnant women with singleton births at the Obstetrics and Gynecology Hospital of Fudan University between January 2021 and December 2021 were included in this case-control study. In the comparison with the controls (n = 531), the mean value of D-dimer, APTT, thrombin time (TT), antithrombin (AT)), and fibrin degradation products (FDP) was significantly lower in preeclamptic women at the time of diagnosis (n = 322). The changes in the coagulation profile were not associated with the severity or the time of onset. The reduced values of D-dimer, AT, and FDP, and increased values of TT were also observed in the first trimester in women who developed preeclampsia later and were not associated with the severity, or the time of onset of preeclampsia. After adjusting for maternal age and BMI, the values of D-dimer and AT in the first trimester were correlated to the risk of developing preeclampsia. Our findings suggest that there is an abnormal maternal response to the hemostatic system in early gestational age in women who developed preeclampsia later and measuring the coagulation profile could be an additional predictive marker of preeclampsia.
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Affiliation(s)
- Pei-Pei Jin
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ning Ding
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Dai
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Yan Liu
- Department of Blood Transfusion, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Pei-Min Mao
- Department of Blood Transfusion, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
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27
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Abu-Awwad SA, Craina M, Gluhovschi A, Boscu L, Bernad E, Iurciuc M, Abu-Awwad A, Iurciuc S, Tudoran C, Bernad R, Maghiari AL. Comparative Analysis of Neonatal Effects in Pregnant Women with Cardiovascular Risk versus Low-Risk Pregnant Women. J Clin Med 2023; 12:4082. [PMID: 37373775 DOI: 10.3390/jcm12124082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/10/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Cardiovascular diseases are a leading cause of mortality and morbidity worldwide. Pregnancy imposes unique physiological changes on a woman's cardiovascular system. MATERIALS AND METHODS A cohort of 68 participants, comprising 30 pregnant women with cardiovascular risk and 38 without cardiovascular risk, was recruited for this study. These participants were prospectively followed during their pregnancies from 2020 to 2022 at the Obstetrics and Gynecology Department of the "Pius Brînzeu" Emergency County Clinical Hospital in Timişoara, Romania. All women included in this study underwent cesarean section deliveries at the same medical facility. Data regarding the gestational weeks at delivery, birth weight, and Apgar scores assessed by neonatologists were collected for each participant. Statistical analyses were performed to compare the neonatal effects between the two groups. RESULTS The results of this study revealed significant differences between the groups in terms of Apgar scores (p = 0.0055), gestational weeks (p = 0.0471), and baby birth weight (p = 0.0392). CONCLUSION The findings underscore the importance of considering maternal cardiovascular health as a potential determinant of neonatal outcomes. Further research is needed to elucidate the underlying mechanisms and develop strategies for optimizing neonatal outcomes in high-risk pregnancies.
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Affiliation(s)
- Simona-Alina Abu-Awwad
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- "Clinic of Obstetrics and Gynecology", "Pius Brinzeu" County Clinical Emergency Hospital, 300723 Timisoara, Romania
| | - Marius Craina
- "Clinic of Obstetrics and Gynecology", "Pius Brinzeu" County Clinical Emergency Hospital, 300723 Timisoara, Romania
- Department of Obstetrics and Gynecology, Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center for Laparoscopy, Laparoscopic Surgery and In Vitro Fertilization, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Adrian Gluhovschi
- "Clinic of Obstetrics and Gynecology", "Pius Brinzeu" County Clinical Emergency Hospital, 300723 Timisoara, Romania
- Department of Obstetrics and Gynecology, Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Lioara Boscu
- Senate Office, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Elena Bernad
- "Clinic of Obstetrics and Gynecology", "Pius Brinzeu" County Clinical Emergency Hospital, 300723 Timisoara, Romania
- Department of Obstetrics and Gynecology, Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center for Laparoscopy, Laparoscopic Surgery and In Vitro Fertilization, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Mircea Iurciuc
- Senate Office, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Departament VI-Discipline of Outpatient Internal Medicine, Cardiovascular Prevention and Recovery, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Ahmed Abu-Awwad
- "Clinic of Obstetrics and Gynecology", "Pius Brinzeu" County Clinical Emergency Hospital, 300723 Timisoara, Romania
- Department XV-Discipline of Orthopedics-Traumatology, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Research Center University Professor Doctor Teodor Șora, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Stela Iurciuc
- Senate Office, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Departament VI-Discipline of Outpatient Internal Medicine, Cardiovascular Prevention and Recovery, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Cristina Tudoran
- Discipline of Cardiology, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- "Pius Brinzeu" Emergency County Clinical Hospital, Blvd Liviu Rebreanu, No. 156, 300723 Timisoara, Romania
| | - Robert Bernad
- Department of Automatic Control and Applied Informatics, Politehnica University of Timisoara, 300223 Timisoara, Romania
| | - Anca Laura Maghiari
- "Clinic of Obstetrics and Gynecology", "Pius Brinzeu" County Clinical Emergency Hospital, 300723 Timisoara, Romania
- Department I-Discipline of Anatomy and Embryology, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
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28
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Rashid H, Saleem MS, Podile S, Javaid MS, Holder SS, Shafique MU. Eclampsia-Associated Posterior Reversible Encephalopathy Syndrome (PRES) Complicated by Intracerebral Hemorrhage: A Case Report and Review of Management Strategies. Cureus 2023; 15:e41147. [PMID: 37519549 PMCID: PMC10386880 DOI: 10.7759/cureus.41147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome that is being increasingly recognized due to the advancements in brain imaging, specifically MRI. This syndrome is characterized by symptoms including, but not limited to, headache, seizures, altered mental status, and vision loss. There are various underlying etiologies which lead to PRES occurrence; the etiology of focus in this report is preeclampsia and eclampsia. PRES is associated with the development of various types of intracerebral hemorrhage which can lead to detrimental and even fatal consequences in a patient. In our case, a 22-year-old female developed PRES within one week postpartum, which was complicated by parenchymal hemorrhage development in the fronto-parietal lobe. MRI findings were characteristic for PRES with multiple subcortical hyperintensities within the bilateral occipital lobe. The patient improved symptomatically after management with intravenous fluids, antihypertensives, antiepileptics, and antibiotics. This report aims to explore the association between preeclampsia/eclampsia (PE/E) and PRES and underscore the importance of prompt diagnosis and treatment, which can lead to recovery within a week and significantly reduce morbidity and mortality.
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Affiliation(s)
- Hina Rashid
- Faculty of Medicine, Dow International Medical College, Dow University of Health Sciences, Karachi, PAK
| | | | - Somasekhar Podile
- Internal Medicine, Nimra Institute of Medical Sciences, Vijayawada, IND
- Internal Medicine, Jackson Park Hospital and Medical Center, Chicago, USA
| | - Mohammad Saad Javaid
- General Physician, Lahore General Hospital/Ameer ud din Medical College, Lahore, PAK
| | - Shaniah S Holder
- Medicine, American University of Barbados School of Medicine, Bridgetown, BRB
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Geisler HC, Safford HC, Mitchell MJ. Rational Design of Nanomedicine for Placental Disorders: Birthing a New Era in Women's Reproductive Health. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023:e2300852. [PMID: 37191231 PMCID: PMC10651803 DOI: 10.1002/smll.202300852] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/16/2023] [Indexed: 05/17/2023]
Abstract
The placenta is a transient organ that forms during pregnancy and acts as a biological barrier, mediating exchange between maternal and fetal circulation. Placental disorders, such as preeclampsia, fetal growth restriction, placenta accreta spectrum, and gestational trophoblastic disease, originate in dysfunctional placental development during pregnancy and can lead to severe complications for both the mother and fetus. Unfortunately, treatment options for these disorders are severely lacking. Challenges in designing therapeutics for use during pregnancy involve selectively delivering payloads to the placenta while protecting the fetus from potential toxic side effects. Nanomedicine holds great promise in overcoming these barriers; the versatile and modular nature of nanocarriers, including prolonged circulation times, intracellular delivery, and organ-specific targeting, can control how therapeutics interact with the placenta. In this review, nanomedicine strategies are discussed to treat and diagnose placental disorders with an emphasis on understanding the unique pathophysiology behind each of these diseases. Finally, prior study of the pathophysiologic mechanisms underlying these placental disorders has revealed novel disease targets. These targets are highlighted here to motivate the rational design of precision nanocarriers to improve therapeutic options for placental disorders.
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Affiliation(s)
- Hannah C. Geisler
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Hannah C. Safford
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Michael J. Mitchell
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
- Penn Institute for RNA Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
- Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19014, USA
- Institute for Regenerative Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
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Ongun MC, Tonyali NV, Kaplan O, Deger I, Celebier M, Basci Akduman NE, Sahin D, Yucel A, Babaoglu MO. Effects of genetic polymorphisms of CYP2J2, CYP2C9, CYP2C19, CYP4F2, CYP4F3 and CYP4A11 enzymes in preeclampsia and gestational hypertension. Placenta 2023; 137:88-95. [PMID: 37141740 DOI: 10.1016/j.placenta.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 04/04/2023] [Accepted: 04/26/2023] [Indexed: 05/06/2023]
Abstract
INTRODUCTION The aim of this study was to investigate the effects of cytochrome P450 (CYP) 2J2, CYP2C9, CYP2C19 and CYP4F2, CYP4F3 and CYP4A11 genetic polymorphisms in preeclampsia and gestational hypertension (GHT) patients in a sample of Turkish population. MATERIALS-METHODS Patients (n = 168; 110 GHT and 58 preeclampsia) and healthy pregnant women (n = 155, controls) participated in the study. For genotyping, polymerase chain reaction (PCR) and restriction analysis (RFLP) were used. Substance levels were measured using LC-MS. RESULTS Plasma DHET levels in GHT and preeclampsia patients were significantly lower than those in the control group (62.7%, 66.3% vs.100.0%, respectively, p < 0.0001). An increase in CYP2J2*7 allele frequency was observed in the preeclampsia group, as compared to GHT group (12.1% vs. 4.5%; odds ratio, O.R. = 2.88, p < 0.01). The frequencies of CYP2C19*2 and*17 alleles were higher in GHT group as compared to the control group (17.7% vs. 11.6%, O.R. = 1.99, p < 0.01; and 28.6% vs.18.4%, O.R. = 2.03, p < 0.01, respectively). An increased frequency of CYP4F3 rs3794987 G allele was found in GHT group as compared to the control group (48.0% vs. 38.0%; O.R. = 1.53, p < 0.01). DISCUSSION DHET plasma levels were significantly reduced in hypertensive pregnant groups as compared to the control group. The allele frequency distributions for CYP2J2*7, CYP2C19 *2, *17 and CYP4F3 rs3794987 were significantly different in hypertensive pregnant patients as compared to the healthy control subjects. Our results may suggest that investigated genetic polymorphisms may be useful in diagnosis and clinical management of GHT and preeclampsia patients.
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Affiliation(s)
- Mert C Ongun
- Hacettepe University, Faculty of Medicine, Department of Medical Pharmacology, Ankara, Turkey.
| | | | - Ozan Kaplan
- Hacettepe University, Faculty of Pharmacy, Department of Analytical Chemistry, Ankara, Turkey
| | - Ilter Deger
- Hacettepe University, Faculty of Medicine, Department of Medical Pharmacology, Ankara, Turkey
| | - Mustafa Celebier
- Hacettepe University, Faculty of Pharmacy, Department of Analytical Chemistry, Ankara, Turkey
| | | | - Dilek Sahin
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Aykan Yucel
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Melih O Babaoglu
- Hacettepe University, Faculty of Medicine, Department of Medical Pharmacology, Ankara, Turkey
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Kim HR, Lee BK. Outcomes of singleton preterm very low birth weight infants born to mothers with pregnancy-induced hypertension. Sci Rep 2023; 13:6100. [PMID: 37055502 PMCID: PMC10102139 DOI: 10.1038/s41598-023-33206-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 04/09/2023] [Indexed: 04/15/2023] Open
Abstract
The association between maternal pregnancy-induced hypertension (PIH) and neonatal mortality and morbidities in preterm infants has not been consistent. This study aimed to evaluate the influence of maternal PIH on mortality and morbidities in singleton infants with very low birth weight born before 30 weeks of gestational age using the Korean Neonatal Network (KNN) database. A total of 5340 singleton infants with very low birth weight were registered in the KNN registry, who were born at 23+0 to 29+6 weeks of gestational age between January 2015 and December 2020. Baseline characteristics and neonatal mortality and morbidities were compared between infants with PIH and non-PIH mothers. After adjustment for potential confounders, infants with PIH mothers had significantly higher odds of respiratory distress syndrome (OR 1.983; 95% CI 1.285-3.061, p = 0.002) and bronchopulmonary dysplasia (OR 1.458; 95% CI 1.190-1.785, p < 0.001), and severe bronchopulmonary dysplasia (OR 1.411; 95% CI 1.163-1.713, p < 0.001) than infants with non-PIH mothers, while there were no significant differences in severe intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity, or death during neonatal intensive care unit admission between infants with PIH and non-PIH mothers. This study showed that preterm infants with PIH mothers had an increased risk of neonatal respiratory morbidities, including respiratory distress syndrome and bronchopulmonary dysplasia.
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Affiliation(s)
- Hye-Rim Kim
- Department of Pediatrics, Bundang CHA Medical Center, CHA University, Seongnam, Korea
| | - Byoung Kook Lee
- Department of Pediatrics, Chungnam National University Sejong Hospital, 20, Bodeum 7-ro, Sejong-si, Sejong, Republic of Korea.
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Alzubaidi KRK, Mahdavi M, Dolati S, Yousefi M. Observation of increased levels of autophagy-related genes and proteins in women with preeclampsia: a clinical study. Mol Biol Rep 2023; 50:4831-4840. [PMID: 37039997 DOI: 10.1007/s11033-023-08385-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/13/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Preeclampsia is a type of pregnancy-related disease that is not fully understood underlying mechanisms of it till now. Reported results from autophagy-related studies in PE show some controversial roles of this mechanism in PE development and progression. In this study, we aimed to evaluate the autophagy process in preeclampsia women. MATERIALS AND METHODS Peripheral blood was taken from 50 preeclampsia women and 50 healthy pregnant women. After PBMC isolation, Total RNA and total protein were extracted from PBMCs to cDNA synthesis and real-time PCR and western blotting, respectively. Atg5, Atg7, beclin1, LC3B, FOXO1, FOXO3a, FOXO4, and FOXO6 genes were evaluated using real-time PCR. Atg5, beclin1, LC3B, and FOXO1 expression at the protein level was evaluated by the western blot technique. RESULTS Real-time PCR results showed an increased expression of Atg5, Atg7, beclin1, LC3B, FOXO1, FOXO3a, FOXO4, and FOXO6 genes in PE patients compared to the healthy pregnant women and also in LOPE patients in comparison with EOPE cases. Western blotting results revealed higher expression of Atg5, beclin1, LC3B, and FOXO1 proteins in PE women compared to healthy pregnant group and in LOPE patients in comparison with EOPE cases. Our findings revealed a positive correlation between proteinuria and protein levels of Atg5, beclin1, LC3B, and FOXO1 in LOPE patients. CONCLUSION Our investigation showed an elevated activation of autophagy in PE women in comparison with healthy pregnant women which is in controversy with some other studies. More targeted and comprehensive studies regarding the relationship of autophagy in pre-eclamptic women are needed.
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Affiliation(s)
| | - Majid Mahdavi
- Department of Biology, Faculty of Natural Science, University of Tabriz, Tabriz, Iran.
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran.
| | - Sanam Dolati
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Yousefi
- Department of Immunology, Faculty of Medicine, Medical School, Tabriz University of Medical Sciences, Tabriz, 5166614766, IR, Iran.
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Jeba Malar Abraham A, Bobby Z, Chaturvedula L, Vinayagam V. Association of Umbilical Cord Serum Oxidative Stress Markers, ADMA and Adiponectin with Adverse Fetal Outcomes in Hypertensive Disorders of Pregnancy. Fetal Pediatr Pathol 2023; 42:227-240. [PMID: 35983848 DOI: 10.1080/15513815.2022.2112791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Limited studies are available on fetal oxidative stress and endothelial dysfunction and their association with adverse fetal outcomes in hypertensive disorders of pregnancy (HDP). Method: Umbilical cord blood samples were collected at delivery from 134 pregnant women with HDP and 59 controls. Markers of oxidative stress, endothelial dysfunction and inflammation and adipokines were analyzed. Results were correlated with adverse fetal outcomes. Results: Malondialdehyde, total antioxidant status(TAS), ADMA and hsCRP levels were increased in late and early onset preeclampsia. Adiponectin levels were decreased in early onset preeclampsia. High ADMA levels were positively associated with preterm births and fetal mortality and high TAS, protein carbonyl content(PC), ADMA and low adiponectin levels were positively associated with low birth weight babies. Conclusion: Fetal systemic oxidative stress, endothelial dysfunction and inflammation were altered in early and late onset preeclampsia. High TAS, PC and ADMA levels and low adiponectin levels were positively associated with adverse fetal outcomes in HDP.
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Affiliation(s)
- Angelin Jeba Malar Abraham
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Zachariah Bobby
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Latha Chaturvedula
- Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Vickneshwaran Vinayagam
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Bisson C, Dautel S, Patel E, Suresh S, Dauer P, Rana S. Preeclampsia pathophysiology and adverse outcomes during pregnancy and postpartum. Front Med (Lausanne) 2023; 10:1144170. [PMID: 37007771 PMCID: PMC10060641 DOI: 10.3389/fmed.2023.1144170] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
BackgroundPreeclampsia is a disease with far-reaching consequences that extend beyond the immediate postpartum period and have a significant impact later in life. Preeclampsia exerts an effect on most organ systems in the body. These sequelae are mediated in part by the incompletely elucidated pathophysiology of preeclampsia and the associated vascular changes.ContentCurrent research focuses on unraveling the pathophysiology of preeclampsia with the goal of implementing accurate screening and treatment modalities based on disease development and progression. Preeclampsia causes significant short- and long-term maternal morbidity and mortality, not only in the cardiovascular system but also in other organ systems throughout the body. This impact persists beyond pregnancy and the immediate postpartum period.SummaryThe goal of this review is to discuss the current understanding of the pathophysiology of preeclampsia as it relates to the adverse health consequences in patients impacted by this disease, along with a brief discussion of ways to improve overall outcomes.
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HAN ZY, HUANG SJ, WANG R, GUAN HQ. Screening of differential circRNAs in the placenta of patients with preeclampsia and their regulatory mechanism. MINERVA BIOTECHNOLOGY AND BIOMOLECULAR RESEARCH 2023. [DOI: 10.23736/s2724-542x.22.02913-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
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Vanhaesebrouck S, Zecic A, Goossens L, Keymeulen A, Garabedian L, De Meulemeester J, Naessens P, De Coen K, Smets K. Association of antenatal magnesium sulfate with reduced late-onset sepsis in extreme preterm infants. Acta Clin Belg 2023; 78:11-15. [PMID: 35254224 DOI: 10.1080/17843286.2022.2048531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Neonatal intensive care has changed extensively over the last decades resulting in improved survival of extreme preterm infants. However, improved survival is associated with prolonged hospitalization, mechanical ventilation and use of invasive devices, which are all predisposing factors for LOS. LOS is known to increase short- and long-term morbidities resulting in impaired neurodevelopmental outcome. Besides treatment with antibiotics and supportive care, there is an unmet need for adjunctive therapies to prevent neonatal sepsis and hereby improve outcome. METHODS In a retrospective single-center design, we explored underlying pre-, peri- and postnatal factors in extreme preterm infants with and without LOS to potentially identify future strategies in the prevention of LOS in these infants. RESULTS Associations formerly published could be confirmed, such as lower birth weight, longer duration of respiratory support, parenteral nutrition and NICU stay and a higher incidence of almost all neonatal morbidities. A new interesting finding was the fact that infants with LOS received more antenatal magnesium sulfate (p = 0.002). After nearest neighbor matching based on birth weight, gestational age, gender and multiplicity increased duration of parenteral nutrition and NICU stay, the incidence of PVL remained significantly different between the two groups (LOS/no LOS), but also the association between antenatal magnesium sulfate administration and less LOS held true (p = 0.004). CONCLUSION In this study, extreme preterm infants receiving antenatal magnesium sulfate developed less LOS. Whether this is merely an associative factor reflecting illness severity or an interesting link for new preventive strategies for LOS, should be further explored.
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Affiliation(s)
- Sophie Vanhaesebrouck
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Ghent, Belgium
| | - Alexandra Zecic
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Ghent, Belgium
| | - Linde Goossens
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Ghent, Belgium
| | - Annelies Keymeulen
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Ghent, Belgium
| | - Lara Garabedian
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Ghent, Belgium
| | - Julie De Meulemeester
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Ghent, Belgium
| | - Pauline Naessens
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Ghent, Belgium
| | - Kris De Coen
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Ghent, Belgium
| | - Koenraad Smets
- Neonatal Intensive Care Unit, Department of Internal Medicine and Pediatrics, University Hospitals Ghent, Ghent, Belgium
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Stepan H, Galindo A, Hund M, Schlembach D, Sillman J, Surbek D, Vatish M. Clinical utility of sFlt-1 and PlGF in screening, prediction, diagnosis and monitoring of pre-eclampsia and fetal growth restriction. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 61:168-180. [PMID: 35816445 DOI: 10.1002/uog.26032] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 05/27/2023]
Abstract
Pre-eclampsia (PE) is characterized by placental and maternal endothelial dysfunction, and associated with fetal growth restriction (FGR), placental abruption, preterm delivery and stillbirth. The angiogenic factors soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are altered in pregnancies complicated by placenta-related disorders. In this Review, we summarize the existing knowledge, examining the performance of maternal PlGF, sFlt-1 and the sFlt-1/PlGF ratio for screening PE, predicting development of PE in the short term, diagnosing PE, monitoring established PE and predicting other placenta-related disorders in singleton pregnancy. We also discuss the performance of PlGF and the sFlt-1/PlGF ratio for predicting PE in twin pregnancy. For first-trimester screening in singleton pregnancy, a more accurate way of identifying high-risk women than current practice is to combine maternal PlGF levels with clinical risk factors and ultrasound markers. Later in pregnancy, the sFlt-1/PlGF ratio has advantages over PlGF because it has a higher pooled sensitivity and specificity for diagnosing and monitoring PE. It has clinical value because it can rule out the development of PE in the 1-4-week period after the test. Once a diagnosis of PE is established, repeat measurement of sFlt-1 and PlGF can help monitor progression of the condition and may inform clinical decision-making regarding the optimal time for delivery. The sFlt-1/PlGF ratio is useful for predicting FGR and preterm delivery, but the association between stillbirth and the angiogenic factors is unclear. The sFlt-1/PlGF ratio can be used to predict PE in twin pregnancy, although different sFlt-1/PlGF ratio cut-offs from those for singleton pregnancy should be applied for optimal performance. In summary, PlGF, sFlt-1 and the sFlt-1/PlGF ratio are useful for screening, diagnosing, predicting and monitoring placenta-related disorders in singleton and twin pregnancy. We propose that tests for these angiogenic factors are integrated more fully into clinical practice.© 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- H Stepan
- University Hospital Leipzig, Leipzig, Germany
| | - A Galindo
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M Hund
- Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | | | - J Sillman
- Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | - D Surbek
- University Hospital, University of Bern, Bern, Switzerland
| | - M Vatish
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
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Goodarzi-Khoigani M, Imanpour V, Khoshhali M, Kelishadi R. Systematic review and meta-analysis of nutritional interventions to prevent of gestational hypertension or/and preeclampsia among healthy pregnant women. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2023; 28:25. [DOI: 10.4103/jrms.jrms_89_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 10/12/2022] [Accepted: 10/27/2022] [Indexed: 04/07/2023]
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Darmochwal-Kolarz D, Chara A. The Association of IL-17 and PlGF/sENG Ratio in Pre-Eclampsia and Adverse Pregnancy Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:768. [PMID: 36613090 PMCID: PMC9819392 DOI: 10.3390/ijerph20010768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
The aim of the study was to assess the role of concentrations of interleukin-17 (IL-17), placental growth factor (PlGF) and soluble endoglin (sENG), as well as the PlGF/sENG ratio in pregnancy complicated by pre-eclampsia (PE) and normal pregnancy. The concentrations of IL-17, PlGF and sENG were measured with the use of immunoenzymatic methods. The concentrations of IL-17 were significantly higher in PE patients when compared to control patients. In the group of patients with PE, the levels of IL-17 positively correlated with systolic blood pressure. On the other hand, IL-17 negatively correlated with neonatal birth weight. The concentrations of PLGF were significantly lower and sENG significantly higher in studied patients when compared to controls. The PlGF/sENG ratio in the PE group was significantly lower when compared to healthy third trimester pregnant patients. In the study group, negative correlations were observed between the sENG concentrations and thrombocyte levels. The higher concentrations of IL-17 in PE could suggest its role as an inflammatory agent in the pathogenesis of the syndrome. Moreover, the negative correlation between IL-17 and a neonatal birth weight could suggest the role of the cytokine in the development of fetal growth restriction (FGR) associated with PE. It seems possible that IL-17 can be a useful marker of the risk of FGR in pregnancy complicated by PE. Furthermore, the results suggested the potential role of sENG and the PlGF/sENG ratio in the prediction of adverse outcomes such as HELLP syndrome and DIC.
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Affiliation(s)
| | - Anita Chara
- Department of Obstetrics and Gynaecology, 27-600 Sandomierz, Poland
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Issotina Zibrila A, Wang Z, Sangaré-Oumar MM, Zeng M, Liu X, Wang X, Zeng Z, Kang YM, Liu J. Role of blood-borne factors in sympathoexcitation-mediated hypertension: Potential neurally mediated hypertension in preeclampsia. Life Sci 2022; 320:121351. [PMID: 36592790 DOI: 10.1016/j.lfs.2022.121351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 01/01/2023]
Abstract
Hypertension remains a threat for society due to its unknown causes, preventing proper management, for the growing number of patients, for its state as a high-risk factor for stroke, cardiac and renal complication and as cause of disability. Data from clinical and animal researches have suggested the important role of many soluble factors in the pathophysiology of hypertension through their neuro-stimulating effects. Central targets of these factors are of molecular, cellular and structural nature. Preeclampsia (PE) is characterized by high level of soluble factors with strong pro-hypertensive activity and includes immune factors such as proinflammatory cytokines (PICs). The potential neural effect of those factors in PE is still poorly understood. Shedding light into the potential central effect of the soluble factors in PE may advance our current comprehension of the pathophysiology of hypertension in PE, which will contribute to better management of the disease. In this paper, we summarized existing data in respect of hypothesis of this review, that is, the existence of the neural component in the pathophysiology of the hypertension in PE. Future studies would address this hypothesis to broaden our understanding of the pathophysiology of hypertension in PE.
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Affiliation(s)
- Abdoulaye Issotina Zibrila
- Department of Physiology and Pathophysiology, Xi'an Jiaotong University School of Basic Medical Sciences, Key Laboratory of Environment and Genes Related to Diseases, Xi'an 710061, Shaanxi, PR China; Department of Animal Physiology, Faculty of science and Technology, University of Abomey-Calavi, 06 BP 2584 Cotonou, Benin
| | - Zheng Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, PR China
| | - Machioud Maxime Sangaré-Oumar
- Department of Animal Physiology, Faculty of science and Technology, University of Abomey-Calavi, 06 BP 2584 Cotonou, Benin
| | - Ming Zeng
- Department of Physiology and Pathophysiology, Xi'an Jiaotong University School of Basic Medical Sciences, Key Laboratory of Environment and Genes Related to Diseases, Xi'an 710061, Shaanxi, PR China
| | - Xiaoxu Liu
- Department of Physiology and Pathophysiology, Xi'an Jiaotong University School of Basic Medical Sciences, Key Laboratory of Environment and Genes Related to Diseases, Xi'an 710061, Shaanxi, PR China
| | - Xiaomin Wang
- Department of Physiology and Pathophysiology, Xi'an Jiaotong University School of Basic Medical Sciences, Key Laboratory of Environment and Genes Related to Diseases, Xi'an 710061, Shaanxi, PR China
| | - Zhaoshu Zeng
- Department of Physiology and Pathophysiology, Xi'an Jiaotong University School of Basic Medical Sciences, Key Laboratory of Environment and Genes Related to Diseases, Xi'an 710061, Shaanxi, PR China
| | - Yu-Ming Kang
- Department of Physiology and Pathophysiology, Xi'an Jiaotong University School of Basic Medical Sciences, Key Laboratory of Environment and Genes Related to Diseases, Xi'an 710061, Shaanxi, PR China.
| | - Jinjun Liu
- Department of Physiology and Pathophysiology, Xi'an Jiaotong University School of Basic Medical Sciences, Key Laboratory of Environment and Genes Related to Diseases, Xi'an 710061, Shaanxi, PR China.
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Placenta-derived extracellular vesicles from preeclamptic and healthy pregnancies impair ex vivo vascular endothelial function. Biosci Rep 2022; 42:232126. [PMID: 36408626 PMCID: PMC9760606 DOI: 10.1042/bsr20222185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/08/2022] [Accepted: 11/18/2022] [Indexed: 11/22/2022] Open
Abstract
Preeclampsia (PE) is a pregnancy syndrome characterized by new-onset hypertension and end-organ dysfunction. The pathophysiology of PE remains undetermined, but it is thought that maternal vascular dysfunction plays a central role, potentially due, in part, to the release of syncytiotrophoblast-derived extracellular vesicles (STBEVs) into the maternal circulation by a dysfunctional placenta. STBEVs from normal pregnancies (NP) impair vascular function, but the effect of PE STBEVs (known to differ in composition with elevated circulating levels) on vascular function are not known. We hypothesized that PE STBEVs have more detrimental effects on vascular function compared with NP STBEVs. STBEVs were collected by perfusion of placentas from women with NP or PE. Mesenteric arteries from pregnant rats were incubated overnight with NP or PE STBEVs, and vascular function was assessed by wire myography. NP and PE STBEVs impaired endothelial function, partially by reducing nitric oxide (NO) bioavailability. Incubation of human umbilical vein endothelial cells with NP and PE STBEVs increased nuclear factor κ-light-chain-enhancer of activated B cell (NF-κB) activation, reactive oxygen species, nitrotyrosine levels, and reduced NO levels. However, PE STBEVs increased NF-κB activation and nitrotyrosine levels to a lesser extent than NP STBEVs. Taken together, no greater impact of PE STBEVs compared with NP STBEVs on endothelial function was found. However, the impaired vascular function by PE STBEVs and increased levels of STBEVs in PE suggest PE STBEVs may contribute to maternal vascular dysfunction in PE. Our study further expands on the potential mechanisms that lead to adverse outcomes in PE and provides potential targets for future interventions.
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Hu J, Guo Q, Liu C, Yu Q, Ren Y, Wu Y, Li Q, Li Y, Liu J. Immune cell profiling of preeclamptic pregnant and postpartum women by single-cell RNA sequencing. Int Rev Immunol 2022; 43:1-12. [PMID: 36369864 DOI: 10.1080/08830185.2022.2144291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/30/2022] [Indexed: 11/15/2022]
Abstract
Preeclampsia (PE), a leading cause of maternal and fetal morbidity and mortality, is closely related to the immune system alterations. However, little is known about the landscape and heterogeneity of maternal immune system at single-cell level among PE patients. In this study, peripheral blood mononuclear cells (PBMCs) were isolated from three early-onset preeclamptic pregnant women and two healthy control, respectively. Single-cell RNA sequencing was performed on 10× genomics platform and single-cell transcriptomes were obtained to characterize immune cell subgroups at the pregnant and postpartum stages. In total, 80,429 single-cell transcriptomes were obtained. 19 cellular compositions were identified, which were categorized into six cell types including T cells, natural killer (NK) cells, B cells, monocytes, plasmacytoid dendritic cells and conventional dendritic cells. There were excessive activation of B cells, monocytes and NK cells in PE patients at the pregnant stage based on comparative analysis. Lower immune response activation was noticed in CD4+ and CD8+ T cells in PE patients, especially the low-activation of memory T cells at the pregnant and postpartum stages. PE patients showed high activation of B cells in pregnancy persisted postpartum and lower activation of memory T cells, indicating their persistent effects on the pathogenesis and recurrence risk of PE. This study provide a broad characterization of the single-cell transcriptome of PBMCs in PE, which contributes to identification of immune imbalance for its monitoring and treatment.
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Affiliation(s)
- Jing Hu
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qi Guo
- Berry Genomics Corporation, Beijing, China
| | - Congcong Liu
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qian Yu
- Berry Genomics Corporation, Beijing, China
| | - Yuan Ren
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yueni Wu
- Berry Genomics Corporation, Beijing, China
| | - Qin Li
- Berry Genomics Corporation, Beijing, China
| | - Yuezhen Li
- Berry Genomics Corporation, Beijing, China
| | - Juntao Liu
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Ashraf UM, Hall DL, Campbell N, Waller JP, Rawls AZ, Solise D, Cockrell K, Bidwell GL, Romero DG, Ojeda NB, LaMarca B, Alexander BT. Inhibition of the AT 1R agonistic autoantibody in a rat model of preeclampsia improves fetal growth in late gestation. Am J Physiol Regul Integr Comp Physiol 2022; 323:R670-R681. [PMID: 36121142 PMCID: PMC9602704 DOI: 10.1152/ajpregu.00122.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/17/2022] [Accepted: 09/09/2022] [Indexed: 02/07/2023]
Abstract
Placenta ischemia, the initiating event in preeclampsia (PE), is associated with fetal growth restriction. Inhibition of the agonistic autoantibody against the angiotensin type 1 receptor AT1-AA, using an epitope-binding inhibitory peptide ('n7AAc') attenuates increased blood pressure at gestational day (G)19 in the clinically relevant reduced uterine perfusion pressure (RUPP) model of PE. Thus we tested the hypothesis that maternal administration of 'n7AAc' does not transfer to the fetus, improves uterine blood flow and fetal growth, and attenuates elevated placental expression of miRNAs implicated in PE and FGR. Sham or RUPP surgery was performed at G14 with vehicle or 'n7AAc' (144 µg/day) administered via an osmotic pump from G14 to G20. Maternal plasma levels of the peptide on G20 were 16.28 ± 4.4 nM, and fetal plasma levels were significantly lower at 1.15 ± 1.7 nM (P = 0.0007). The uterine artery resistance index was significantly elevated in RUPP (P < 0.0001) but was not increased in 'n7AAc'-RUPP or 'n7AAc'-Sham versus Sham. A significant reduction in fetal weight at G20 in RUPP (P = 0.003) was not observed in 'n7AAc'-RUPP. Yet, percent survival was reduced in RUPP (P = 0.0007) and 'n7AAc'-RUPP (P < 0.0002). Correlation analysis indicated the reduction in percent survival during gestation was specific to the RUPP (r = 0.5342, P = 0.043) and independent of 'n7AAc'. Placental miR-155 (P = 0.0091) and miR-181a (P = 0.0384) expression was upregulated in RUPP at G20 but was not elevated in 'n7AAc'-RUPP. Collectively, our results suggest that maternal administration of 'n7AAc' does not alter fetal growth in the RUPP implicating its potential as a therapeutic for the treatment of PE.NEW & NOTEWORTHY The seven amino acid inhibitory peptide to the AT1-AA ('n7AAc') has limited transfer to the fetus at gestational day 20, improves uterine blood flow and fetal growth in the reduced uterine perfusion pressure model of preeclampsia (PE), and does not impair fetal survival during gestation in sham-operated or placental ischemic rats. Collectively, these findings suggest that maternal administration of 'n7AAc' as an effective strategy for the treatment of PE is associated with improved outcomes in the fetus.
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Affiliation(s)
- Usman M Ashraf
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi
| | | | - Nathan Campbell
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Jamarius P Waller
- Department of Neurology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Adam Z Rawls
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Dylan Solise
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Kathy Cockrell
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Gene L Bidwell
- Department of Neurology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Damian G Romero
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Norma B Ojeda
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Babbette LaMarca
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Barbara T Alexander
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi
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Mukosha M, Vwalika B, Lubeya MK, Kumwenda A, Kaonga P, Jacobs C, Kapembwa KM, Mwangu LM, Musonda P. Determinants and neonatal outcomes of preeclampsia among women living with and without HIV at a tertiary hospital in Zambia: a review of medical records. Pan Afr Med J 2022; 43:110. [PMID: 36699973 PMCID: PMC9834805 DOI: 10.11604/pamj.2022.43.110.34390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 10/17/2022] [Indexed: 01/27/2023] Open
Abstract
Introduction pre-eclampsia, a pregnancy-specific condition that occurs after 20 weeks of gestation, is a significant public health problem. In the extant literature, there are still conflicting reports on whether Human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) affect preeclampsia rates. We, therefore, explored the determinants and neonatal outcomes of preeclampsia among pregnant women living with and without HIV. Methods we reviewed delivery registers and neonatal files from the 1st January 2018, to 30th of September 2019 for women who delivered at Women and Newborn Hospital. The logistic regression model estimated the odds of preeclampsia and described the neonatal outcomes. Results the prevalence of preeclampsia was 7.7% (95% confidence intervals: 6.8 to 8.7). On ART, pregnant women with HIV infection were less likely to develop preeclampsia than those without HIV infection (aOR=0.50; 95% CI: 0.32 to 0.80). However, neonates born to women with preeclampsia were more likely to be admitted to kangaroo mother care than neonates born to normotensive women, regardless of the HIV-exposure status. Conclusion overall, the prevalence of preeclampsia was 7.7%, but it was less common among HIV-infected pregnant women receiving ART. Neonates born from women with preeclampsia are at increased risk of adverse outcomes, including admission to kangaroo mother care. These findings underscore the need for healthcare workers to direct their efforts on early diagnosis and detection of preeclampsia in pregnant women to prevent poor outcomes.
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Affiliation(s)
- Moses Mukosha
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia,,HIV and Women's Health Research Group, University Teaching Hospital, Lusaka, Zambia,,Young Emerging Scientists Zambia, Lusaka, Zambia,,Corresponding author: Moses Mukosha, Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia.
| | - Bellington Vwalika
- HIV and Women's Health Research Group, University Teaching Hospital, Lusaka, Zambia,,Department of Obstetrics and Gynecology, School of Medicine, University of Zambia, Lusaka, Zambia,,Women and Newborn Hospital, University Teaching Hospitals, Lusaka, Zambia
| | - Mwansa Ketty Lubeya
- HIV and Women's Health Research Group, University Teaching Hospital, Lusaka, Zambia,,Young Emerging Scientists Zambia, Lusaka, Zambia,,Department of Obstetrics and Gynecology, School of Medicine, University of Zambia, Lusaka, Zambia,,Women and Newborn Hospital, University Teaching Hospitals, Lusaka, Zambia
| | - Andrew Kumwenda
- HIV and Women's Health Research Group, University Teaching Hospital, Lusaka, Zambia,,Department of Obstetrics and Gynecology, School of Medicine, University of Zambia, Lusaka, Zambia,,Women and Newborn Hospital, University Teaching Hospitals, Lusaka, Zambia
| | - Patrick Kaonga
- Department of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Choolwe Jacobs
- Department of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Luwi Mercy Mwangu
- Department of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Patrick Musonda
- Department of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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Low Prognostic Nutritional Index Contributes to High Adverse Events in Preeclampsia. DISEASE MARKERS 2022; 2022:1187742. [PMID: 36267459 PMCID: PMC9578871 DOI: 10.1155/2022/1187742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/27/2022] [Indexed: 01/12/2023]
Abstract
Background Preeclampsia (PE) is a common obstetric complication that has caused significant harm to pregnant mothers. The clinical significance of poor nutritional status in PE patients is unclear. The aim of our study was to evaluate the nutritional status as measured by the prognostic nutritional index (PNI) score at admission, and its ability to predict in-hospitalization adverse events in patients with PE. Methods We enrolled patients diagnosed with PE in the Third Affiliated Hospital of Guangzhou Medical University from January 2019 to December 2021. Patients were divided into low and high nutritional status group according to the cut-off value of PNI score at admission using the receiver operating characteristic (ROC) curve. PNI score were used to explore the relationship between PNI score and in-hospitalization adverse events presented with hazard ratio (HR) and 95% confidence intervals (CI). Results A total of 733 patients were included in the study. The proportion of adverse events and admission to intensive care unit (ICU) was higher in the low nutritional status group than in the high nutritional status group (P < 0.05). ROC curve analysis revealed an area under curve (AUC) of 0.628 for PNI score and the cut-off value of PNI was 37. The free-event rates determined by KM analysis were significantly lower in the low nutritional status compared to the high nutritional status (P < 0.05). Adjusted multivariate analysis showed that PNI score was independently associated with favorable outcomes (HR: 2.66; 95% CI: 1.724-4.050, P < 0.001). Conclusion High PNI score at admission was associated with reduced in-hospitalization risk of adverse events in patients with PE. Additional enhancing nutritional status during hospitalization may help to prevent unfavorable prognosis in clinical practices.
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Association Between Serum Matrix Metalloproteinase-2 Levels and Mean Doppler Pulsatility Index of Uterine Arteries in Patients with Preeclampsia. ACTA MEDICA BULGARICA 2022. [DOI: 10.2478/amb-2022-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Abstract
Background: Мatrix metalloproteinase-2 (MMP-2) is an enzye from the gelatinases family involved mainly in collagen degradation. It is also known as a key regulator of normal vascular remodelling during a healthy pregnancy. Failure of regulation of MMP-2 has been associated with abnormal vasodilation, placentation, uterine expansion and development of preeclampsia (PE). Aims: (1) determine serum MMP-2 levels in women with PE and healthy pregnancy, (2) evaluate mean uterine arteries Doppler pulsatility index (UtA PI) and (3) investigate the a possible association between these parameters.
Materials and methods: This was a case-control study. Fifty-five women with PE (mean age 24.9 ± 6 years) and a control group of 35 women with normal pregnancies (mean age 24.7 ± 5.4 years) were examined. An enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of MMP-2. Mean UtA PI were evaluated by Doppler velocimetry.
Results: Serum ММР-2 levels in preeclampsia were significantly higher than in women with normal pregnancy 11.7 (9.1÷15.5) vs. 7.7 ng/ml (6.5÷13.4) (p = 0.016). Mean UtA PI was significantly higher in preeclampsia than in healthy pregnant women: 1.12 (0.82÷1.5) vs. 0.75 (0.69÷0.85); (p = 0.024). ММР-2 correlated with UtA PI (r = 0.214; p = 0.043). Cutoff value at 14 ng/ml for MMP-2 was found to discriminate between PE and healthy pregnancy.
Conclusion: Our data showed an association between serum MMP-2 and Mean UtA PI. We suggest that MMP-2 could have a potential imply on maternal uterine arteries’ structure, favoring their constriction, increased resistance and abnormal uterine vascular remodeling. Further studies are warranted to clarify whether determination of MMP-2 cutoff value might contribute in the diagnosic work-out strategy for PE.
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Shaohua Y, Bin Z, Mei L, Jingfei Z, Pingping Q, Yanping H, Liping Z, Jiexin Y, Guoshun M. Maternal risk factors and neonatal outcomes associated with low birth weight. Front Genet 2022; 13:1019321. [PMID: 36299581 PMCID: PMC9589494 DOI: 10.3389/fgene.2022.1019321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/09/2022] [Indexed: 01/12/2023] Open
Abstract
This study aims to evaluate the incidence of low birth weight (LBW) and related maternal risk factors (during pregnancy or childbirth) and neonatal outcomes. A retrospective cross-sectional study design was used to select 7,421 pregnant women who gave birth in our hospital from January 2018 to June 2021. The data were analyzed using STATA 14.1, and the dependent variable (LBW) and risk were analyzed by the chi-square test of independence. The association between factors is used to determine the factors related to LBW through bivariate and multivariate logistic regression. The incidence of LBW in this study was 4.77%. Compared with single pregnant women, the probability of newborn LBW in married pregnant women is 40% lower (AOR = 0.60 95%CI: 0.40–0.90, p = 0.013). Compared with gestational age less than 37 weeks, the LBW probability of gestational age 37–42 and 42 weeks or older is 85 and 81% lower respectively (AOR = 0.15 95% CI: 0.10–0.24, p = 0.001; AOR = 0.19 95 %CI: 0.09–38, p = 0.001), compared with normal pregnant women, the probability of neonatal LBW among pregnant women with hypertension is 94% higher [AOR = 1.94 (95% CI: 1.39–2.74, p = 0.001). Compared with neonates with normal birth weight, neonates with LBW are at Apgar 1 min And Apgar 5 min score is lower than 7 (AOR = 0.52 95%CI: 0.37–0.73, p = 0.001, AOR = 0.54 95%CI: 0.38–0.75, p = 0.001) higher risk. In conclusion, women’s marital status (single), gestational age (<37 weeks), and combined hypertension are independently associated with LBW, and the higher risk of Apgar 1 min and Apgar 5 min scores <7 is an independent result of LBW.
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Affiliation(s)
- Yang Shaohua
- Fuyang People’s Hospital Pediatrics, Fuyang, China
- *Correspondence: Yang Shaohua, ; Mao Guoshun,
| | - Zheng Bin
- Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Liu Mei
- Fuyang People’s Hospital Pediatrics, Fuyang, China
| | - Zhai Jingfei
- Fuyang People’s Hospital Pediatrics, Fuyang, China
| | | | - He Yanping
- Fuyang People’s Hospital Pediatrics, Fuyang, China
| | - Zhu Liping
- Fuyang People’s Hospital Pediatrics, Fuyang, China
| | - Yan Jiexin
- Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mao Guoshun
- Fuyang People’s Hospital Pediatrics, Fuyang, China
- *Correspondence: Yang Shaohua, ; Mao Guoshun,
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Yang W, Kang Q, Li C, Bo S, Wang Y. Matrine promotes trophoblast invasion and reduces inflammation via miR-19a-3p to prevent preeclampsia. Mol Cell Toxicol 2022. [DOI: 10.1007/s13273-022-00293-3] [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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Yang S, Zhang J, Chen D, Ding J, Zhang Y, Song L. Quercetin Supplement to Aspirin Attenuates Lipopolysaccharide-Induced Pre-eclampsia-Like Impairments in Rats Through the NLRP3 Inflammasome. Drugs R D 2022; 22:271-279. [PMID: 36136273 DOI: 10.1007/s40268-022-00402-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Aspirin is a common drug for the treatment of pre-eclampsia. We aimed to explore whether quercetin as a supplement to aspirin could enhance the therapeutic outcome in pre-eclampsia rat models. We further aimed to evaluate the nucleotide-binding oligomerization domain-like receptor family, pyrin domain containing 3 (NLRP3) inflammasome as a potential pre-eclampsia-related molecular mechanism, which can be affected by quercetin treatment. METHODS Rat pre-eclampsia models were established using an intravenous lipopolysaccharide injection after gestation. Rats were treated with aspirin and quercetin at 6-18 days after pregnancy. On day 20, blood, fetus, and placenta were harvested. Blood pressure and the level of proteinuria were measured every 4 days. Fetal outcomes were analyzed by pup body weight. Serum soluble Fms-like tyrosine kinase-1, PIGF, interleukin-6, and interleukin-10 levels were measured using the enzyme-linked immunosorbent assay. Caspase-1, NLRP3, apoptosis-associated speck-like protein containing a caspase recruitment domain, and p-caspase-1 levels in the placenta were assessed using western blot or quantitative real-time polymerase chain reaction analyses. RESULTS Pre-eclampsia rat models showed a pronounced increase in systolic blood pressure and proteinuria after 4 days of pregnancy, while aspirin, quercetin, and aspirin/quercetin combinatory treatment significantly attenuated the blood pressure and proteinuria abnormalities. Notably, the aspirin/quercetin combinatory treatment showed the highest efficacy in attenuating pre-eclampsia-like symptoms. Placental caspase-1 and NLRP3 levels also showed the greatest attenuation in pre-eclampsia rats after aspirin/quercetin treatment. CONCLUSIONS Our data suggested that quercetin supplementation to aspirin is more effective in attenuating symptoms of pre-eclampsia and improving pregnancy outcomes compared with quercetin or aspirin alone. Quercetin can ameliorate placental NLRP3 inflammasome activation, which might serve as an underlying mechanism for its therapeutic efficacies in pre-eclampsia.
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Affiliation(s)
- Shuangyan Yang
- Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, 061000, Hebei, China.
| | - Junfeng Zhang
- Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, 061000, Hebei, China.
| | - Dan Chen
- Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, 061000, Hebei, China
| | - Jie Ding
- Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, 061000, Hebei, China
| | - Yanhong Zhang
- Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, 061000, Hebei, China
| | - Lili Song
- Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, 061000, Hebei, China
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50
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Faulkner JL, Wright D, Antonova G, Jaffe IZ, Kennard S, Belin de Chantemèle EJ. Midgestation Leptin Infusion Induces Characteristics of Clinical Preeclampsia in Mice, Which Is Ablated by Endothelial Mineralocorticoid Receptor Deletion. Hypertension 2022; 79:1536-1547. [PMID: 35510543 DOI: 10.1161/hypertensionaha.121.18832] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Patients with preeclampsia demonstrate increases in placental leptin production in midgestation, and an associated increase in late gestation plasma leptin levels. The consequences of mid-late gestation increases in leptin production in pregnancy is unknown. Our previous work indicates that leptin infusion induces endothelial dysfunction in nonpregnant female mice via leptin-mediated aldosterone production and endothelial mineralocorticoid receptor (ECMR) activation, which is ablated by ECMR deletion. Therefore, we hypothesized that leptin infusion in mid-gestation of pregnancy induces endothelial dysfunction and hypertension, hallmarks of clinical preeclampsia, which are prevented by ECMR deletion. METHODS Leptin was infused via miniosmotic pump (0.9 mg/kg per day) into timed-pregnant ECMR-intact (WT) and littermate-mice with ECMR deletion (KO) on gestation day (GD)11-18. RESULTS Leptin infusion decreased fetal weight and placental efficiency in WT mice compared with WT+vehicle. Radiotelemetry recording demonstrated that blood pressure increased in leptin-infused WT mice during infusion. Leptin infusion reduced endothelial-dependent relaxation responses to acetylcholine (ACh) in both resistance (second-order mesenteric) and conduit (aorta) vessels in WT pregnant mice. Leptin infusion increased placental ET-1 (endothelin-1) production evidenced by increased PPET-1 (preproendothelin-1) and ECE-1 (endothelin-converting enzyme-1) expressions in WT mice. Adrenal aldosterone synthase (CYP11B2) and angiotensin II type 1 receptor b (AT1Rb) expression increased with leptin infusion in pregnant WT mice. KO pregnant mice demonstrated protection from leptin-induced reductions in pup weight, placental efficiency, increased BP, and endothelial dysfunction. CONCLUSIONS Collectively, these data indicate that leptin infusion in midgestation induces endothelial dysfunction, hypertension, and fetal growth restriction in pregnant mice, which is ablated by ECMR deletion.
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Affiliation(s)
- Jessica L Faulkner
- Department of Physiology (J.L.F.), Medical College of Georgia at Augusta University
| | - Derrian Wright
- Vascular Biology Center (D.W., G.A., S.K., E.J.B.d.C.), Medical College of Georgia at Augusta University
| | - Galina Antonova
- Vascular Biology Center (D.W., G.A., S.K., E.J.B.d.C.), Medical College of Georgia at Augusta University
| | - Iris Z Jaffe
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA (I.Z.J.)
| | - Simone Kennard
- Vascular Biology Center (D.W., G.A., S.K., E.J.B.d.C.), Medical College of Georgia at Augusta University
| | - Eric J Belin de Chantemèle
- Vascular Biology Center (D.W., G.A., S.K., E.J.B.d.C.), Medical College of Georgia at Augusta University.,Department of Cardiology (E.J.B.d.C.), Medical College of Georgia at Augusta University
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