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Silvano A, Sisti G, Seravalli V, Strambi N, Parenti A, Amedei A, Witkin SS, Di Tommaso M. Changes in cytokine and sequestosome-1 levels during twin pregnancy progression: Association with outcome. Cytokine 2024; 180:156668. [PMID: 38851146 DOI: 10.1016/j.cyto.2024.156668] [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: 02/02/2024] [Revised: 05/07/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Twin pregnancies are associated with complications and adverse outcomes. The number of twin pregnancies has increased in the last decades, due to the use of assisted reproductive techniques and delayed childbearing. Analysis of changes that occur during twin pregnancy progression and their association with outcome will lead to improved clinical interventions. OBJECTIVE We evaluated if the plasma concentration of select cytokines and the level of sequestosome-1 (p62) in peripheral blood mononuclear cells (PBMCs) during each trimester of twin gestations was predictive of pregnancy outcome. STUDY DESIGN This prospective, observational study was conducted at Careggi University Hospital, Florence, Italy. Plasma from 82 women with twin pregnancies was collected in each trimester for measurement of interleukin (IL)-1β, IL-6, IL-10, IL-12 and tumor necrosis factor (TNF)-α. The intracellular PBMC concentration of p62, a protein involved in autophagy, kinase activity and cell differentiation, was also determined. RESULTS IL-1β (p < 0.001), IL-6 (p < 0.001), TNF-α (p < 0.001) and p62 (p < 0.05) increased from the 1st to the 2nd to the 3rd trimester. The TNF-α level was correlated with the IL-1β concentration in the 1st and 3rd trimesters p < 0.01) and with the IL-6 concentration in each of the three trimesters (p < 0.01). The intracellular p62 level in PBMCs was negatively correlated with the concentration of IL-1β in the 2nd trimester (p < 0.05) and negatively correlated with the IL-6 level in the 3rd trimester (p < 0.05). The TNF-α level was significantly higher in the 2nd (p < 0.05) and 3rd (p < 0.001) trimester in women with a spontaneous preterm delivery. The TNF-α concentrations in the 2nd (p < 0.05) and 3rd (p < 0.01) trimester, respectively, and 3rd trimester IL-6 (p < 0.01), were negatively associated with gestational age at delivery. The concentration of IL-6 was highest in the 2nd (p < 0.05) and 3rd (p < 0.05) trimesters in women who utilized assisted reproductive technologies. An elevated IL-1β level in the 3rd trimester was associated with gestational diabetes mellitus (p < 0.05). CONCLUSION Variations in cytokine levels between individual women during the three trimesters of twin gestations are predictive of spontaneous preterm delivery and the onset of gestational diabetes.
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Affiliation(s)
- Angela Silvano
- Department of Health Sciences, Division of Obstetrics and Gynecology, Careggi Hospital, University of Florence, Florence, Italy
| | - Giovanni Sisti
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, College of Medicine, University of Arizona, USA
| | - Viola Seravalli
- Department of Health Sciences, Division of Obstetrics and Gynecology, Careggi Hospital, University of Florence, Florence, Italy
| | - Noemi Strambi
- Department of Health Sciences, Division of Obstetrics and Gynecology, Careggi Hospital, University of Florence, Florence, Italy
| | - Astrid Parenti
- Department of Health Sciences, Clinical Pharmacology and Oncology Section, University of Florence, Italy
| | - Amedeo Amedei
- Department of Clinical and Experimental Medicine, University of Florence, Italy
| | - Steven S Witkin
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, NY, USA; Department of Infectious Diseases and Parasitology, Laboratory of Virology, University of Sao Paulo Faculty of Medicine, Sao Paulo, Brazil
| | - Mariarosaria Di Tommaso
- Department of Health Sciences, Division of Obstetrics and Gynecology, Careggi Hospital, University of Florence, Florence, Italy.
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Huang Z, Cheng S, Jash S, Fierce J, Agudelo A, Higashiyama T, Hanna N, Nakashima A, Saito S, Padbury J, Schuster J, Sharma S. Exploiting sweet relief for preeclampsia by targeting autophagy-lysosomal machinery and proteinopathy. Exp Mol Med 2024; 56:1206-1220. [PMID: 38760513 PMCID: PMC11148015 DOI: 10.1038/s12276-024-01234-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: 08/25/2023] [Revised: 02/02/2024] [Accepted: 02/27/2024] [Indexed: 05/19/2024] Open
Abstract
The etiology of preeclampsia (PE), a severe complication of pregnancy with several clinical manifestations and a high incidence of maternal and fetal morbidity and mortality, remains unclear. This issue is a major hurdle for effective treatment strategies. We recently demonstrated that PE exhibits an Alzheimer-like etiology of impaired autophagy and proteinopathy in the placenta. Targeting of these pathological pathways may be a novel therapeutic strategy for PE. Stimulation of autophagy with the natural disaccharide trehalose and its lacto analog lactotrehalose in hypoxia-exposed primary human trophoblasts restored autophagy, inhibited the accumulation of toxic protein aggregates, and restored the ultrastructural features of autophagosomes and autolysosomes. Importantly, trehalose and lactotrehalose inhibited the onset of PE-like features in a humanized mouse model by normalizing autophagy and inhibiting protein aggregation in the placenta. These disaccharides restored the autophagy-lysosomal biogenesis machinery by increasing nuclear translocation of the master transcriptional regulator TFEB. RNA-seq analysis of the placentas of mice with PE indicated the normalization of the PE-associated transcriptome profile in response to trehalose and lactotrehalose. In summary, our results provide a novel molecular rationale for impaired autophagy and proteinopathy in patients with PE and identify treatment with trehalose and its lacto analog as promising therapeutic options for this severe pregnancy complication.
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Affiliation(s)
- Zheping Huang
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI, 02905, USA
| | - Shibin Cheng
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI, 02905, USA
| | - Sukanta Jash
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI, 02905, USA
| | - Jamie Fierce
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI, 02905, USA
| | - Anthony Agudelo
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI, 02905, USA
| | | | - Nazeeh Hanna
- Division of Neonatology, Department of Pediatrics, New York University Long Island School of Medicine, Mineola, New York, NY, USA
| | - Akitoshi Nakashima
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Shigeru Saito
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - James Padbury
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Jessica Schuster
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI, 02905, USA
| | - Surendra Sharma
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI, 02905, USA.
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, 77555, USA.
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Li Y, Guo Y, Wu D, Ai L, Wu R, Ping Z, Zhu K. Phenylbutyric acid inhibits hypoxia-induced trophoblast apoptosis and autophagy in preeclampsia via the PERK/ATF-4/CHOP pathway. Mol Reprod Dev 2024; 91:e23742. [PMID: 38644727 DOI: 10.1002/mrd.23742] [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: 12/28/2023] [Revised: 03/13/2024] [Accepted: 03/24/2024] [Indexed: 04/23/2024]
Abstract
Preeclampsia (PE) is a common pregnancy complication with a high mortality rate. Abnormally activated endoplasmic reticulum stress (ERS) is believed to be responsible for the destruction of key placental cells-trophoblasts. Phenylbutyric acid (4-PBA), an ERS inhibitor, is involved in regulating the development of ERS-related diseases. At present, how 4-PBA affects trophoblasts and its mechanisms is still unclear. In this study, PE cell models were established by stimulating HTR-8/SVneo cells with hypoxia. To verify the underlying mechanisms of 4-PBA on PE, CCT020312, an activator of PERK, was also used. The results showed that 4-PBA restored hypoxia-induced trophoblast viability, inhibited HIF-1α protein expression, inflammation, and PERK/ATF-4/CHOP pathway. Hoechst 33342 staining and flow cytometry results confirmed that 4-PBA decreased hypoxia-induced apoptosis in trophoblasts. The results of the JC-1 analysis and apoptosis initiation enzyme activity assay also demonstrated that 4-PBA inhibited apoptosis related to the mitochondrial pathway. Furthermore, by detecting autophagy in trophoblasts, an increased number of autophagic vesicles, damaged mitochondria, enhanced dansylcadaverine fluorescence, enhanced levels of autophagy proteins Beclin-1, LC3II, and decreased p62 were seen in hypoxia-stimulated cells. These changes were reversed by 4-PBA. Furthermore, it was observed that CCT020312 reversed the effects of 4-PBA on the viability, apoptosis, and autophagosome number of hypoxia-induced trophoblasts. In summary, 4-PBA reduces autophagy and apoptosis via the PERK/ATF-4/CHOP pathway and mitochondrial pathway, thereby restoring the viability of hypoxic trophoblasts. These findings provide a solid evidence base for the use of 4-PBA in PE treatment and guide a new direction for improving the outcomes of patients with PE.
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Affiliation(s)
- Yinfeng Li
- Department of ICU, Jiaxing Maternity and Children Health Care Hospital, Jiaxing, Zhejiang, China
| | - Yongjie Guo
- Department of ICU, Jiaxing Maternity and Children Health Care Hospital, Jiaxing, Zhejiang, China
| | - Dan Wu
- Department of ICU, Jiaxing Maternity and Children Health Care Hospital, Jiaxing, Zhejiang, China
| | - Ling Ai
- Department of Obstetrics, Jiaxing Maternity and Children Health Care Hospital, Jiaxing, Zhejiang, China
| | - Rongrong Wu
- Department of Laboratory, Jiaxing Maternity and Children Health Care Hospital, Jiaxing, Zhejiang, China
| | - Zepeng Ping
- Department of Obstetrics, Jiaxing Maternity and Children Health Care Hospital, Jiaxing, Zhejiang, China
| | - Kangyuan Zhu
- Department of ICU, Jiaxing Maternity and Children Health Care Hospital, Jiaxing, Zhejiang, China
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Zhou P, Wang J, Wang J, Liu X. When autophagy meets placenta development and pregnancy complications. Front Cell Dev Biol 2024; 12:1327167. [PMID: 38371923 PMCID: PMC10869551 DOI: 10.3389/fcell.2024.1327167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/22/2024] [Indexed: 02/20/2024] Open
Abstract
Autophagy is a common biological phenomenon in eukaryotes that has evolved and reshaped to maintain cellular homeostasis. Under the pressure of starvation, hypoxia, and immune damage, autophagy provides energy and nutrients to cells, which benefits cell survival. In mammals, autophagy is an early embryonic nutrient supply system involved in early embryonic development, implantation, and pregnancy maintenance. Recent studies have found that autophagy imbalance in placental tissue plays a key role in the occurrence and development of pregnancy complications, such as gestational hypertension, gestational obesity, premature birth, miscarriage, and intrauterine growth restriction. This mini-review summarizes the molecular mechanism of autophagy regulation, the autophagy pathways, and related factors involved in placental tissue and comprehensively describes the role of autophagy in pregnancy complications.
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Affiliation(s)
- Pei Zhou
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Junqi Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jun Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
- Department of Obstetrics and Gynecology, Benxi Central Hospital of China Medical University, Benxi, Liaoning, China
| | - Xiaomei Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
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5
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Jash S, Banerjee S, Cheng S, Wang B, Qiu C, Kondo A, Ernerudh J, Zhou XZ, Lu KP, Sharma S. Cis P-tau is a central circulating and placental etiologic driver and therapeutic target of preeclampsia. Nat Commun 2023; 14:5414. [PMID: 37669931 PMCID: PMC10480164 DOI: 10.1038/s41467-023-41144-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/24/2023] [Indexed: 09/07/2023] Open
Abstract
Preeclampsia (PE) is the leading cause of maternal and fetal mortality globally and may trigger dementia later in life in mothers and their offspring. However, the etiological drivers remain elusive. Cis P-tau is an early etiological driver and blood biomarker in pre-clinical Alzheimer's and after vascular or traumatic brain injury, which can be targeted by stereo-specific antibody, with clinical trials ongoing. Here we find significant cis P-tau in the placenta and serum of PE patients, and in primary human trophoblasts exposed to hypoxia or sera from PE patients due to Pin1 inactivation. Depletion of cis P-tau from PE patient sera by the antibody prevents their ability to disrupt trophoblast invasion and endovascular activity and to cause the PE-like pathological and clinical features in pregnant humanized tau mice. Our studies uncover that cis P-tau is a central circulating etiological driver and its stereo-specific antibody is valuable for early PE diagnosis and treatment.
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Affiliation(s)
- Sukanta Jash
- Departments of Pediatrics, Women and Infants Hospital, Warren Alpert Medical School, Brown University, Providence, RI, 02905, USA
| | - Sayani Banerjee
- Departments of Pediatrics, Women and Infants Hospital, Warren Alpert Medical School, Brown University, Providence, RI, 02905, USA
| | - Shibin Cheng
- Departments of Pediatrics, Women and Infants Hospital, Warren Alpert Medical School, Brown University, Providence, RI, 02905, USA
| | - Bin Wang
- Division of Translational Therapeutics, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Chenxi Qiu
- Division of Translational Therapeutics, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Asami Kondo
- Division of Translational Therapeutics, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Jan Ernerudh
- Department of Biomedical and Clinical Sciences, Linköping University, SE 58183, Linköping, Sweden
- Department of Clinical Immunology and Transfusion Medicine, Linköping University, SE 58183, Linköping, Sweden
| | - Xiao Zhen Zhou
- Departments of Biochemistry, Schulich School of Medicine & Dentistry, Western University, London, ON, N6G 2V4, Canada.
- Departments of Oncology, Schulich School of Medicine & Dentistry, Western University, London, ON, N6G 2V4, Canada.
- Departments of Pathology & Laboratory Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, N6G 2V4, Canada.
- Lawson Health Research Institute, Schulich School of Medicine & Dentistry, Western University, London, ON, N6G 2V4, Canada.
| | - Kun Ping Lu
- Departments of Biochemistry, Schulich School of Medicine & Dentistry, Western University, London, ON, N6G 2V4, Canada.
- Departments of Oncology, Schulich School of Medicine & Dentistry, Western University, London, ON, N6G 2V4, Canada.
- Robarts Research Institute, Schulich School of Medicine & Dentistry Western University, London, ON, N6G 2V4, Canada.
| | - Surendra Sharma
- Departments of Pediatrics, Women and Infants Hospital, Warren Alpert Medical School, Brown University, Providence, RI, 02905, USA.
- Departments of Pathology, Women and Infants Hospital, Warren Alpert Medical School, Brown University, Providence, RI, 02905, USA.
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6
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Cheng S, Huang Z, Banerjee S, Jash S, Buxbaum JN, Sharma S. Evidence From Human Placenta, Endoplasmic Reticulum-Stressed Trophoblasts, and Transgenic Mice Links Transthyretin Proteinopathy to Preeclampsia. Hypertension 2022; 79:1738-1754. [PMID: 35607996 PMCID: PMC9308752 DOI: 10.1161/hypertensionaha.121.18916] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND We have demonstrated that protein aggregation plays a pivotal role in the pathophysiology of preeclampsia and identified several aggregated proteins in the circulation of preeclampsia patients, the most prominent of which is the serum protein TTR (transthyretin). However, the mechanisms that underlie protein aggregation remain poorly addressed. METHODS We examined TTR aggregates in hypoxia/reoxygenation-exposed primary human trophoblasts (PHTs) and the preeclampsia placenta using complementary approaches, including a novel protein aggregate detection assay. Mechanistic analysis was performed in hypoxia/reoxygenation-exposed PHTs and Ttr transgenic mice overexpressing transgene-encoded wild-type human TTR or Ttr-/- mice. High-resolution ultrasound analysis was used to measure placental blood flow in pregnant mice. RESULTS TTR aggregation was inducible in PHTs and the TCL-1 trophoblast cell line by endoplasmic reticulum stress inducers or autophagy-lysosomal disruptors. PHTs exposed to hypoxia/reoxygenation showed increased intracellular BiP (binding immunoglobulin protein), phosphorylated IRE1α (inositol-requiring enzyme-1α), PDI (protein disulfide isomerase), and Ero-1, all markers of the unfolded protein response, and the apoptosis mediator caspase-3. Blockade of IRE1α inhibited hypoxia/reoxygenation-induced upregulation of Ero-1 in PHTs. Excessive unfolded protein response activation was observed in the early-onset preeclampsia placenta. Importantly, pregnant human TTR mice displayed aggregated TTR in the junctional zone of the placenta and severe preeclampsia-like features. High-resolution ultrasound analysis revealed low blood flow in uterine and umbilical arteries in human TTR mice compared with control mice. However, Ttr-/- mice did not show any pregnancy-associated abnormalities. CONCLUSIONS These observations in the preeclampsia placenta, cultured trophoblasts, and Ttr transgenic mice indicate that TTR aggregation is an important causal contributor to preeclampsia pathophysiology.
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Affiliation(s)
- Shibin Cheng
- Department of Pediatrics, Women & Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI (S.C., Z.H., S.B., S.J., S.S.)
| | - Zheping Huang
- Department of Pediatrics, Women & Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI (S.C., Z.H., S.B., S.J., S.S.)
| | - Sayani Banerjee
- Department of Pediatrics, Women & Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI (S.C., Z.H., S.B., S.J., S.S.)
| | - Sukanta Jash
- Department of Pediatrics, Women & Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI (S.C., Z.H., S.B., S.J., S.S.)
| | - Joel N Buxbaum
- Department of Molecular Medicine, Scripps Research Institute, La Jolla, CA (J.N.B.).,Protego Biopharma, Inc, San Diego, CA (J.N.B.)
| | - Surendra Sharma
- Department of Pediatrics, Women & Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI (S.C., Z.H., S.B., S.J., S.S.)
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7
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Cheng S, Huang Z, Jash S, Wu K, Saito S, Nakashima A, Sharma S. Hypoxia-Reoxygenation Impairs Autophagy-Lysosomal Machinery in Primary Human Trophoblasts Mimicking Placental Pathology of Early-Onset Preeclampsia. Int J Mol Sci 2022; 23:5644. [PMID: 35628454 PMCID: PMC9147570 DOI: 10.3390/ijms23105644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 12/10/2022] Open
Abstract
We have previously described that placental activation of autophagy is a central feature of normal pregnancy, whereas autophagy is impaired in preeclampsia (PE). Here, we show that hypoxia-reoxygenation (H/R) treatment dysregulates key molecules that maintain autophagy-lysosomal flux in primary human trophoblasts (PHTs). Ultrastructural analysis using transmission electron microscopy reveals a significant reduction in autophagosomes and autolysosomes in H/R-exposed PHTs. H/R-induced accumulation of protein aggregates follows a similar pattern that occurs in PHTs treated with a lysosomal disruptor, chloroquine. Importantly, the placenta from early-onset PE deliveries exhibits the same features as seen in H/R-treated PHTs. Taken together, our results indicate that H/R disrupts autophagic machinery in PHTs and that impaired autophagy in the placenta from early-onset PE deliveries mimics the events in H/R-treated PHTs. Notably, assessment of key regulators at each stage of autophagic processes, especially lysosomal integrity, and verification of autophagic ultrastructure are essential for an accurate evaluation of autophagy activity in human trophoblasts and placental tissue from PE deliveries.
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Affiliation(s)
- Shibin Cheng
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI 02905, USA; (Z.H.); (S.J.); (K.W.); (S.S.)
| | - Zheping Huang
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI 02905, USA; (Z.H.); (S.J.); (K.W.); (S.S.)
| | - Sukanta Jash
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI 02905, USA; (Z.H.); (S.J.); (K.W.); (S.S.)
| | - Kathleen Wu
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI 02905, USA; (Z.H.); (S.J.); (K.W.); (S.S.)
| | - Shigeru Saito
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toyama, Toyama 30-0194, Japan; (S.S.); (A.N.)
| | - Akitoshi Nakashima
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toyama, Toyama 30-0194, Japan; (S.S.); (A.N.)
| | - Surendra Sharma
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI 02905, USA; (Z.H.); (S.J.); (K.W.); (S.S.)
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8
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Gottschalk G, Peterson D, Knox K, Maynard M, Whelan RJ, Roy A. Elevated ATG13 in serum of patients with ME/CFS stimulates oxidative stress response in microglial cells via activation of receptor for advanced glycation end products (RAGE). Mol Cell Neurosci 2022; 120:103731. [PMID: 35487443 DOI: 10.1016/j.mcn.2022.103731] [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: 12/28/2021] [Revised: 04/13/2022] [Accepted: 04/17/2022] [Indexed: 10/18/2022] Open
Abstract
Myalgic Encephalomyelitis, also known as Chronic Fatigue Syndrome (ME/CFS), is a multisystem illness characterized by extreme muscle fatigue associated with pain, neurocognitive impairment, and chronic inflammation. Despite intense investigation, the molecular mechanism of this disease is still unknown. Here we demonstrate that autophagy-related protein ATG13 is strongly upregulated in the serum of ME/CFS patients, indicative of impairment in the metabolic events of autophagy. A Thioflavin T-based protein aggregation assay, array screening for autophagy-related factors, densitometric analyses, and confirmation with ELISA revealed that the level of ATG13 was strongly elevated in serum samples of ME/CFS patients compared to age-matched controls. Moreover, our microglia-based oxidative stress response experiments indicated that serum samples of ME/CFS patients evoke the production of reactive oxygen species (ROS) and nitric oxide in human HMC3 microglial cells, whereas neutralization of ATG13 strongly diminishes the production of ROS and NO, suggesting that ATG13 plays a role in the observed stress response in microglial cells. Finally, an in vitro ligand binding assay provided evidence that ATG13 employs the Receptor for Advanced Glycation End-products (RAGE) to stimulate ROS in microglial cells. Collectively, our results suggest that an impairment of autophagy following the release of ATG13 into serum could be a pathological signal in ME/CFS.
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Affiliation(s)
- Gunnar Gottschalk
- Simmaron Research Institute, 948 Incline Way, Incline Village, NV 89451, United States of America; Simmaron R&D lab, Technology Innovation Center, 10437 W Innovation Drive, Wauwatosa, WI 53226, United States of America
| | - Daniel Peterson
- Simmaron Research Institute, 948 Incline Way, Incline Village, NV 89451, United States of America
| | - Konstance Knox
- Coppe Laboratories, W229N1870 Westwood Dr, Waukesha, WI 53186., United States of America
| | - Marco Maynard
- Simmaron R&D lab, Technology Innovation Center, 10437 W Innovation Drive, Wauwatosa, WI 53226, United States of America
| | - Ryan J Whelan
- Simmaron R&D lab, Technology Innovation Center, 10437 W Innovation Drive, Wauwatosa, WI 53226, United States of America
| | - Avik Roy
- Simmaron Research Institute, 948 Incline Way, Incline Village, NV 89451, United States of America; Simmaron R&D lab, Technology Innovation Center, 10437 W Innovation Drive, Wauwatosa, WI 53226, United States of America.
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The maternal blood lipidome is indicative of the pathogenesis of severe preeclampsia. J Lipid Res 2021; 62:100118. [PMID: 34547287 PMCID: PMC8503628 DOI: 10.1016/j.jlr.2021.100118] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 08/27/2021] [Accepted: 09/13/2021] [Indexed: 11/23/2022] Open
Abstract
Preeclampsia is a pregnancy-specific syndrome characterized by hypertension and proteinuria after 20 weeks of gestation. However, it is not well understood what lipids are involved in the development of this condition, and even less is known how these lipids mediate its formation. To reveal the relationship between lipids and preeclampsia, we conducted lipidomic profiling of maternal sera of 44 severe preeclamptic and 20 healthy pregnant women from a multiethnic cohort in Hawaii. Correlation network analysis showed that oxidized phospholipids have increased intercorrelations and connections in preeclampsia, whereas other lipids, including triacylglycerols, have reduced network correlations and connections. A total of 10 lipid species demonstrate significant changes uniquely associated with preeclampsia but not any other clinical confounders. These species are from the lipid classes of lysophosphatidylcholines, phosphatidylcholines (PCs), cholesteryl esters, phosphatidylethanolamines, lysophosphatidylethanolamines, and ceramides. A random forest classifier built on these lipids shows highly accurate and specific prediction (F1 statistic = 0.94; balanced accuracy = 0.88) of severe preeclampsia, demonstrating their potential as biomarkers for this condition. These lipid species are enriched in dysregulated biological pathways, including insulin signaling, immune response, and phospholipid metabolism. Moreover, causality inference shows that various PCs and lysophosphatidylcholines mediate severe preeclampsia through PC 35:1e. Our results suggest that the lipidome may play a role in the pathogenesis and serve as biomarkers of severe preeclampsia.
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10
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Banerjee S, Huang Z, Wang Z, Nakashima A, Saito S, Sharma S, Cheng S. Etiological Value of Sterile Inflammation in Preeclampsia: Is It a Non-Infectious Pregnancy Complication? Front Cell Infect Microbiol 2021; 11:694298. [PMID: 34485175 PMCID: PMC8415471 DOI: 10.3389/fcimb.2021.694298] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/30/2021] [Indexed: 12/25/2022] Open
Abstract
Understanding of sterile inflammation and its associated biological triggers and diseases is still at the elementary stage. This becomes more warranted in cases where infections are not associated with the pathology. Detrimental effects of bacterial and viral infections on the immune responses at the maternal-fetal interface as well as pregnancy outcomes have been well documented. However, an infection-induced etiology is not thought to be a major contributing component to severe pregnancy complications such as preeclampsia (PE) and gestational diabetes. How is then an inflammatory signal thought to be associated with these pregnancy complications? It is not clear what type of inflammation is involved in the onset of PE-like features. We opine that sterile inflammation regulated by the inflammasome-gasdermins-caspase-1 axis is a contributory factor to the onset of PE. We hypothesize that increased production and release of damage-associated molecular patterns (DAMPs) or Alarmins such as high-mobility group box1 (HMGB1), cell-free fetal DNA, uric acid, the NOD-like receptor pyrin-containing receptor 3 (NLRP3) inflammasome, IL-1β and IL-18 occur in the PE placenta. Some of these molecules have already been observed in the placenta from women with PE. Mechanistically, emerging evidence has demonstrated that excessive placental endoplasmic reticulum (ER) stress, impaired autophagy and gasdermine D (GSDMD)-mediated intrinsic pyroptosis are key events that contribute to systemic sterile inflammation in patients with PE, especially early-onset PE (e-PE). In this review, we highlight the advances on the roles of sterile inflammation and inflammatory signaling cascades involving ER stress, autophagy deficiency and pyroptosis in PE pathophysiology. Deciphering the mechanisms underlying these inflammatory pathways may provide potential diagnostic biomarkers and facilitate the development of therapeutic strategies to treat this devastating disease.
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Affiliation(s)
- Sayani Banerjee
- Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Zheping Huang
- Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Zhengke Wang
- Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Akitoshi Nakashima
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Shigeru Saito
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Surendra Sharma
- Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Shibin Cheng
- Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, Providence, RI, United States
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Cheng S, Banerjee S, Daiello LA, Nakashima A, Jash S, Huang Z, Drake JD, Ernerudh J, Berg G, Padbury J, Saito S, Ott BR, Sharma S. Novel blood test for early biomarkers of preeclampsia and Alzheimer's disease. Sci Rep 2021; 11:15934. [PMID: 34354200 PMCID: PMC8342418 DOI: 10.1038/s41598-021-95611-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/19/2021] [Indexed: 12/24/2022] Open
Abstract
A non-invasive and sensitive blood test has long been a goal for early stage disease diagnosis and treatment for Alzheimer's disease (AD) and other proteinopathy diseases. We previously reported that preeclampsia (PE), a severe pregnancy complication, is another proteinopathy disorder with impaired autophagy. We hypothesized that induced autophagy deficiency would promote accumulation of pathologic protein aggregates. Here, we describe a novel, sensitive assay that detects serum protein aggregates from patients with PE (n = 33 early onset and 33 late onset) and gestational age-matched controls (n = 77) as well as AD in both dementia and prodromal mild cognitive impairment (MCI, n = 24) stages with age-matched controls (n = 19). The assay employs exposure of genetically engineered, autophagy-deficient human trophoblasts (ADTs) to serum from patients. The aggregated protein complexes and their individual components, including transthyretin, amyloid β-42, α-synuclein, and phosphorylated tau231, can be detected and quantified by co-staining with ProteoStat, a rotor dye with affinity to aggregated proteins, and respective antibodies. Detection of protein aggregates in ADTs was not dependent on transcriptional upregulation of these biomarkers. The ROC curve analysis validated the robustness of the assay for its specificity and sensitivity (PE; AUC: 1, CI: 0.949-1.00; AD; AUC: 0.986, CI: 0.832-1.00). In conclusion, we have developed a novel, noninvasive diagnostic and predictive assay for AD, MCI and PE.
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Affiliation(s)
- Shibin Cheng
- grid.40263.330000 0004 1936 9094Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, 101 Dudley Street, Providence, RI 02905 USA
| | - Sayani Banerjee
- grid.40263.330000 0004 1936 9094Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, 101 Dudley Street, Providence, RI 02905 USA
| | - Lori A. Daiello
- grid.40263.330000 0004 1936 9094Department of Neurology, Warren Alpert Medical School of Brown University and Alzheimer’s Disease and Memory Disorders Center At Rhode Island Hospital, Providence, RI 02903 USA
| | - Akitoshi Nakashima
- grid.267346.20000 0001 2171 836XDepartment of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Sukanta Jash
- grid.40263.330000 0004 1936 9094Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, 101 Dudley Street, Providence, RI 02905 USA
| | - Zheping Huang
- grid.40263.330000 0004 1936 9094Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, 101 Dudley Street, Providence, RI 02905 USA
| | - Jonathan D. Drake
- grid.40263.330000 0004 1936 9094Department of Neurology, Warren Alpert Medical School of Brown University and Alzheimer’s Disease and Memory Disorders Center At Rhode Island Hospital, Providence, RI 02903 USA
| | - Jan Ernerudh
- grid.5640.70000 0001 2162 9922Department of Biomedical and Clinical Services, Linkoping University, Linkoping, Sweden
| | - Goran Berg
- grid.5640.70000 0001 2162 9922Department of Biomedical and Clinical Services, Linkoping University, Linkoping, Sweden
| | - James Padbury
- grid.40263.330000 0004 1936 9094Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, 101 Dudley Street, Providence, RI 02905 USA
| | - Shigeru Saito
- grid.267346.20000 0001 2171 836XDepartment of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Brian R. Ott
- grid.40263.330000 0004 1936 9094Department of Neurology, Warren Alpert Medical School of Brown University and Alzheimer’s Disease and Memory Disorders Center At Rhode Island Hospital, Providence, RI 02903 USA
| | - Surendra Sharma
- grid.40263.330000 0004 1936 9094Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, 101 Dudley Street, Providence, RI 02905 USA
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12
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Assembly of Cytoplasmic Stress Granules in Placentas in Women with Preeclampsia. Reprod Sci 2021; 28:2869-2877. [PMID: 34101146 DOI: 10.1007/s43032-021-00592-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
Inflammation is a well-recognized factor associated with preeclampsia (PE). Stress granules (SGs) have been shown to play an important role in regulating inflammation and immune responses. However, whether SGs are involved in the pathogenesis of PE has not been studied. Here, we evaluated the expression of SG components in placenta of pregnancies with PE. Placental samples or serum were collected from PE patients (n = 31) or healthy age-matched pregnancy (n = 17). mRNA expressions of SG-associated genes in placenta from PE or normal pregnancies were detected by real-time quantitative PCR, and protein expressions of HuR and G3BP were detected using western blot. Immunofluorescence staining was performed to evaluate SG components expression in placentas or 10% serum treated HTR-8/Svneo cells using antibodies against HuR and G3BP. Our study showed higher levels of elavl1, lsm2, lsm4, and ago1 mRNA expression and SG marker proteins expression in placental homogenates of PE patients. HuR/G3BP-positive SG structure was further observed in placental villi of PE by immunofluorescence assay. Besides, serum from PE patients could induce SG aggregation in human trophoblast cell line HTR-8/Svneo cells, suggesting the involvement of SGs in the development of PE.
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Preeclampsia-Associated lncRNA INHBA-AS1 Regulates the Proliferation, Invasion, and Migration of Placental Trophoblast Cells. MOLECULAR THERAPY-NUCLEIC ACIDS 2020; 22:684-695. [PMID: 33230466 PMCID: PMC7585871 DOI: 10.1016/j.omtn.2020.09.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 09/25/2020] [Indexed: 02/06/2023]
Abstract
Preeclampsia is believed to be caused by impaired placentation with insufficient trophoblast invasion, leading to impaired uterine spiral artery remodeling and angiogenesis. However, the underlying molecular mechanism remains unknown. We recently carried out transcriptome profiling of placental long noncoding RNAs (lncRNAs) and identified 383 differentially expressed lncRNAs in early-onset severe preeclampsia. Here, we are reporting our identification of lncRNA INHBA-AS1 as a potential causal factor of preeclampsia and its downstream pathways that may be involved in placentation. We found that INHBA-AS1 was upregulated in patients and positively correlated with clinical severity. We systematically searched for potential INHBA-AS1-binding transcription factors and their targets in databases and found that the targets were enriched with differentially expressed genes in the placentae of patients. We further demonstrated that the lncRNA INHBA-AS1 inhibited the invasion and migration of trophoblast cells through restraining the transcription factor CENPB from binding to the promoter of TNF receptor-associated factor 1 (TRAF1). Therefore, we have identified the dysregulated pathway "INHBA-AS1-CENPB-TRAF1" as a contributor to the pathogenesis of preeclampsia through prohibiting the proliferation, invasion, and migration of trophoblasts during placentation.
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Cheng SB, Nakashima A, Huber WJ, Davis S, Banerjee S, Huang Z, Saito S, Sadovsky Y, Sharma S. Pyroptosis is a critical inflammatory pathway in the placenta from early onset preeclampsia and in human trophoblasts exposed to hypoxia and endoplasmic reticulum stressors. Cell Death Dis 2019; 10:927. [PMID: 31804457 PMCID: PMC6895177 DOI: 10.1038/s41419-019-2162-4] [Citation(s) in RCA: 143] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 09/27/2019] [Accepted: 11/04/2019] [Indexed: 12/13/2022]
Abstract
Systemic manifestation of preeclampsia (PE) is associated with circulating factors, including inflammatory cytokines and damage-associated molecular patterns (DAMPs), or alarmins. However, it is unclear whether the placenta directly contributes to the increased levels of these inflammatory triggers. Here, we demonstrate that pyroptosis, a unique inflammatory cell death pathway, occurs in the placenta predominantly from early onset PE, as evidenced by elevated levels of active caspase-1 and its substrate or cleaved products, gasdermin D (GSDMD), IL-1β, and IL-18. Using cellular models mimicking pathophysiological conditions (e.g., autophagy deficiency, hypoxia, and endoplasmic reticulum (ER) stress), we observed that pyroptosis could be induced in autophagy-deficient human trophoblasts treated with sera from PE patients as well as in primary human trophoblasts exposed to hypoxia. Exposure to hypoxia elicits excessive unfolded protein response (UPR) and ER stress and activation of the NOD-like receptor pyrin-containing 3 (NLRP3) inflammasome in primary human trophoblasts. Thioredoxin-interacting protein (TXNIP), a marker for hyperactivated UPR and a crucial signaling molecule linked to NLRP3 inflammasome activation, is significantly increased in hypoxia-treated trophoblasts. No evidence was observed for necroptosis-associated events. Importantly, these molecular events in hypoxia-treated human trophoblasts are significantly observed in placental tissue from women with early onset PE. Taken together, we propose that placental pyroptosis is a key event that induces the release of factors into maternal circulation that possibly contribute to severe sterile inflammation and early onset PE pathology.
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Affiliation(s)
- Shi-Bin Cheng
- Departments of Pediatrics, Obstetrics and Gynecology and Pathology, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Akitoshi Nakashima
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Warren J Huber
- Departments of Pediatrics, Obstetrics and Gynecology and Pathology, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Sarah Davis
- Departments of Pediatrics, Obstetrics and Gynecology and Pathology, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Sayani Banerjee
- Departments of Pediatrics, Obstetrics and Gynecology and Pathology, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Zheping Huang
- Departments of Pediatrics, Obstetrics and Gynecology and Pathology, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Shigeru Saito
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yoel Sadovsky
- Magee-Womens Research Institute, Department of Obstetrics and Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Surendra Sharma
- Departments of Pediatrics, Obstetrics and Gynecology and Pathology, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI, USA.
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