1
|
Stevenson DK, Vreman HJ, Wong RJ. Heme, Heme Oxygenase-1, Statins, and SARS-CoV-2. Antioxidants (Basel) 2023; 12:antiox12030614. [PMID: 36978862 PMCID: PMC10044896 DOI: 10.3390/antiox12030614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Heme, a metalloporphyrin, or more specifically, a tetrapyrrole containing ferrous iron, is an ancient molecule [...]
Collapse
|
2
|
Intergenerational protein deficiency and adolescent reproductive function of subsequent female generations (F 1 and F 2) in rat model. Curr Res Physiol 2022; 5:16-24. [PMID: 35024624 PMCID: PMC8724923 DOI: 10.1016/j.crphys.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 12/02/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background Efficient reproductive function is an important characteristic that has evolved through natural selection. Nutrition can modulate reproductive activities at different levels, and its effect on reproduction is deemed complex and less predictable. Objective This study aims at investigating the underlying effect of persistent dietary protein deficiency during early life on reproductive parameters of subsequent (F1 and F2) generations. Method Rats in group of four (4) were fed daily, different ration of protein diet (PD) formulated as: 21% protein diet, 10%protein diet, 5%protein diet and control diet (rat chow, containing 16–18% protein). They were fed ad libitum before mating, throughout gestation and lactation, and next generations were weaned to the maternal diet. Reproductive function analysis (which include; gestation and pubertal hormonal profiling, onset of puberty, oestrus cyclicity, sexual response) and morphometric analysis of the ovarian structure were carried out to assess associated consequences. Results There was significant reduction in the fertility index (Control; 85.8%., 21%PD; 88.43%., as compared to 10%PD; 65.9%., 5%PD; 35.78%.,) at F1, also recurring in F2 respectively as a consequence of altered reproductive function in the protein deficient models at P ≤ 0.05. Low protein diet posed suboptimal intrauterine condition, which was linked to increased prenatal morbidity and mortality (control; 11.3%., 21%PD; 3.3%., 10%PD; 27.4%., 5%PD; 32.9%), low birthweight (control; 5.29, 4.9 g., 21%PD; 5.5, 5.06 g., 10%PD; 4.05, 3.86 g., 5%PD; 2.7, 2.5 g) at F1 and F2 respectively, delayed onset of puberty (with average pubertal age set at: control; PND 36, 21%PD; PND 38 while 10%PD; PND 62., and 5%PD; PND 67), followed by induced cycle irregularity, altered follicular maturation and endocrine dysfunction, more severe in 5%PD. Conclusion Reproductive status of a female organism depends on the maintenance of ovarian structure and function that has been associated with the hypothalamic pituitary-gonadal axis, hormonal events and sexual maturity. There is therefore an association between persistent early life protein deficiency and reproductive response which mechanistically involves life-long changes in key ovarian cytoarchitecture and function. Intergenerational protein malnutrition exerts female hormonal dysregulation and irregular cyclicity at adolescence. It delayed pubertal attainment and reproductive performance that persists to the next–generation of rats. Perinatal protein deficiency also altered the ovarian morphology with an implication on fertility index across generations.
Collapse
Key Words
- (↑), Concentration Increase
- (↓), Concentration decrease
- Cycle irregularity
- E2, Estradiol/Estrogen
- F0, Parent
- F1, First filial generation
- F2, Second filial generation
- FSH, Follicle Stimulating Hormone
- Fertility index
- Follicle
- GD, Gestation Day
- IUGR, Intrauterine Growth Restriction
- LH, Leutenizing Hormone
- Ovarian-degeneration. ovarian function
- PD, Protein Diet
- PDD, Protein Deficient Diet
- PND, Postnatal Day
- PROG, Progesterone
- Protein deficiency
- Reproductive hormone
Collapse
|
3
|
Hadar E, Dollinger S, Wiznitzer A. Coronavirus disease and vaccination during pregnancy and childbirth: a review of the Israeli perspective and experience. J Matern Fetal Neonatal Med 2021; 35:7794-7805. [PMID: 34130586 DOI: 10.1080/14767058.2021.1937110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Purpose of the study: To discuss selected aspects of our local and national experience in treating and vaccinating pregnant women with SARS-CoV-2 infection and COVID-19 disease.Materials and methods: A comprehensive, retrospective review of COVID-19 parturients in our center as well as a detailed literature review of several aspects from the groundbreaking research done in Israel to investigate the direct obstetrical impact of COVID-19, indirect effect of the lockdown measures and the vaccination effort among pregnant women.Results: The study shows our local and national experience in treating COVID-19 in pregnancy and the maternal and neonatal impact of vaccination in nationwide scale. We treated our first COVID-19 pregnant patient on April 4th, 2020 reaching a total of 193 pregnant women, with PCR-positive SARS-CoV-2 by 8th March 2021. Several studies from Israel have evaluated pregnancy-related outcomes of COVID-19, be it maternal, obstetrical or neonatal complications. We suggest that only in a small subset of severely ill mothers, intubated and otherwise respiratory or hemodynamically unstable, an emergency cesarean delivery should be considered, factoring gestational age, in order to assist maternal ventilation and circulation, as well as to avoid possible secondary fetal compromise due the maternal deterioration.In addition, there is conflicting evidence as to the price of lockdown on obstetrical outcomes, i.e., not the direct medical impact of the virus, but rather the impact of the measures to contain its spread - mainly lockdowns, which has been a major tool in Israel to combat COVID-19.Finally, we demonstrate to overall safety and efficacy of vaccination pregnant women and the beneficial impact on pregnancy outcome and neonatal gain of protecting antibodies.Conclusion: The data emerging from Israel is overall reassuring, as for the association of COVID-19 with adverse pregnancy outcome and the possible protective effect of the vaccinations. Further, long term studies, should be conducted to answer the long-term maternal outcomes, as well and neonatal prognosis.
Collapse
Affiliation(s)
- Eran Hadar
- Rabin Medical Center, Helen Schneider Hospital for Women, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sarah Dollinger
- Rabin Medical Center, Helen Schneider Hospital for Women, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arnon Wiznitzer
- Rabin Medical Center, Helen Schneider Hospital for Women, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
4
|
Ozen M, Zhao H, Kalish F, Yang Y, Jantzie LL, Wong RJ, Stevenson DK. Inflammation-induced alterations in maternal-fetal Heme Oxygenase (HO) are associated with sustained innate immune cell dysregulation in mouse offspring. PLoS One 2021; 16:e0252642. [PMID: 34086785 PMCID: PMC8177474 DOI: 10.1371/journal.pone.0252642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/19/2021] [Indexed: 12/28/2022] Open
Abstract
Heme oxygenase-1 (HO-1) is an evolutionarily conserved stress response enzyme and important in pregnancy maintenance, fetal and neonatal outcomes, and a variety of pathologic conditions. Here, we investigated the effects of an exposure to systemic inflammation late in gestation [embryonic day (E)15.5] on wild-type (Wt) and HO-1 heterozygous (Het, HO-1+/-) mothers, fetuses, and offspring. We show that alterations in fetal liver and spleen HO homeostasis during inflammation late in gestation can lead to a sustained dysregulation of innate immune cell populations and intracellular myeloid HO-1 expression in the spleen through young adolescence [postnatal day 25] in mice.
Collapse
Affiliation(s)
- Maide Ozen
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, California, United States of America
- * E-mail:
| | - Hui Zhao
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Flora Kalish
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Yang Yang
- Department of Genetics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Lauren L. Jantzie
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Ronald J. Wong
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - David K. Stevenson
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| |
Collapse
|
5
|
Friedrich L, Levin G, Maixner N, Bart Y, Tsur A, Yinon Y, Meyer R. Hematologic adaptation to mask-wearing among pregnant women and obstetrical outcome during the coronavirus disease 2019 pandemic. Int J Gynaecol Obstet 2021; 154:297-303. [PMID: 33872397 PMCID: PMC9087669 DOI: 10.1002/ijgo.13715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/16/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the effect of the coronavirus disease 2019 (COVID-19) mask-wearing on hematological laboratory components and obstetrical outcomes among women delivering during the COVID-19 pandemic. METHODS Laboratory results and obstetrical outcomes of women with singleton gestations, admitted for delivery during the COVID-19 mask-wearing period (April-June 2020) were compared with those of women delivering during the parallel period in 2019 and with a larger cohort derived from nine pre-pandemic years (March 2011-April 2020). RESULTS Overall, 1838 women delivered during the COVID-19 pandemic. Compared with the pre-pandemic period, mean hemoglobin and fibrinogen levels were significantly higher during the mask-wearing period (12.15 ± 1.1 vs 11.96 ± 1.2, P < 0.001 and 472 ± 103.6 vs 448 ± 85.1 mg/dl, P < 0.001, respectively). Platelet levels were lower (200 ± 56.0 vs 206 ± 57.5 K/µl, P < 0.001). The rate of delivery at <34 weeks of gestation was lower during the mask-wearing period (1.1% vs 2%, odds ratio [OR] 0.57, 95% confidence intervals [CI] 0.37-0.88, P = 0.01), whereas cesarean delivery and postpartum hemorrhage rates were higher (26.7% vs 24.4%, OR 1.13, 95% CI 1.02-1.25, P = 0.022 and 4.1% vs 2.8%, OR 1.5, 95% CI 1.2-1.8, P = 0.001, respectively). CONCLUSION A hard-to-ventilate space created by wearing a mask during the COVID-19 era may be the underlying cause of the observed higher hemoglobin level among pregnant women, possibly affecting obstetrical outcomes.
Collapse
Affiliation(s)
- Lior Friedrich
- Faculty of Health Sciences, The Joyce & Irving Goldman Medical School, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Gabriel Levin
- The Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.,The Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Nitzan Maixner
- Faculty of Health Sciences, The Joyce & Irving Goldman Medical School, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Yossi Bart
- The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel.,The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Abraham Tsur
- The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel.,The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yoav Yinon
- The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel.,The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Raanan Meyer
- The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel.,The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| |
Collapse
|
6
|
Kim SY, Kim SY, Kil K, Lee Y. Impact of COVID-19 Mitigation Policy in South Korea on the Reduction of Preterm or Low Birth Weight Birth Rate: A Single Center Experience. CHILDREN (BASEL, SWITZERLAND) 2021; 8:332. [PMID: 33922899 PMCID: PMC8144961 DOI: 10.3390/children8050332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 11/16/2022]
Abstract
The government of South Korea implemented social distancing measures to control the coronavirus disease 2019 (COVID-19) outbreak. This study aimed to compare the composite preterm (PT) or low birth weight (LBW) birth rates during the COVID-19 pandemic period in South Korea to those during the prior decade, and to find out the associations of childbirth during the pandemic period with PT or LBW births. Over a ten-year period, this retrospective cohort study was performed in a single hospital in the Seoul metropolitan city. The COVID-19 period was defined as running from 22 March 2020, to 31 October 2020, and the pre-COVID-19 period as the sum of parallel periods from 2011 to 2019. Trends in composite birth rates were investigated, and logistic regression analysis was conducted to investigate independent factors associated with composite births. There were 246 and 2765 singleton deliveries during the COVID-19 period and the pre-COVID-19 period, respectively. The composite birth rate decreased from 16.5% to 9.8%. Childbirth during the pandemic was independently associated with a decreased composite birth rate (adjusted odds ratio, 0.563; 95% confidence interval, 0.355-0.844, p = 0.015). These findings suggested that the COVID-19 pandemic might provide an opportunity to find out preventive factors for PT or LBW births.
Collapse
Affiliation(s)
- Sae-Yun Kim
- Department of Pediatrics, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - So-Young Kim
- Department of Pediatrics, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Kicheol Kil
- Department of Obstetrics and Gynecology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (K.K.); (Y.L.)
| | - Young Lee
- Department of Obstetrics and Gynecology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (K.K.); (Y.L.)
| |
Collapse
|
7
|
Marić I, Oskotsky T, Kosti I, Le B, Wong RJ, Shaw GM, Sirota M, Stevenson DK. Decreased Mortality Rate Among COVID-19 Patients Prescribed Statins: Data From Electronic Health Records in the US. Front Med (Lausanne) 2021; 8:639804. [PMID: 33614688 PMCID: PMC7887302 DOI: 10.3389/fmed.2021.639804] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/06/2021] [Indexed: 12/12/2022] Open
Abstract
The severe respiratory illness due to SARS-CoV-2, the virus responsible for coronavirus disease 2019 (COVID-19), is triggered by an intense pro-inflammatory host response. Statins, prescribed primarily for lipid reduction, are known to have anti-inflammatory and immunomodulatory properties and have been associated with a reduced mortality rate among COVID-19 patients taking statins as reported in two recent retrospective studies. However, a meta-analysis that included nine studies showed that statin use did not improve in-hospital outcomes of those with COVID-19. In addition, concerns regarding the use of statins and an increase in COVID-19 infections have been raised, as statins may increase the expression of angiotensin-converting enzyme 2 (ACE2), the primary receptor for the SARS-CoV-2 virus. Our goal was to investigate the effect of statins in COVID-19 patients in a large, diverse patient population across the United States containing nearly 120,000 patients diagnosed with COVID-19. We used propensity score matching of demographics, comorbidities, and medication indication to compare statin-treated patients (N = 2,297) with matched controls (N = 4,594). We observed a small, but statistically significant, decrease in mortality among patients prescribed statins (16.1%) when compared with matched COVID-19-positive controls (18.0 to 20.6%). These results support previous evidence that statins do not increase COVID-19-related mortality and may, in fact, have a mitigating effect on severity of the disease reflected in a slight reduction in mortality. Mixed findings on effects of statins in COVID-19 patients reported in the literature should prompt prospective randomized controlled trials in order to define better who might be advantaged with respect to clinical outcomes.
Collapse
Affiliation(s)
- Ivana Marić
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Tomiko Oskotsky
- Department of Pediatrics, UCSF, San Francisco, CA, United States.,Bakar Computational Health Sciences Institute, UCSF, San Francisco, CA, United States
| | - Idit Kosti
- Department of Pediatrics, UCSF, San Francisco, CA, United States.,Bakar Computational Health Sciences Institute, UCSF, San Francisco, CA, United States
| | - Brian Le
- Department of Pediatrics, UCSF, San Francisco, CA, United States.,Bakar Computational Health Sciences Institute, UCSF, San Francisco, CA, United States
| | - Ronald J Wong
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Gary M Shaw
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Marina Sirota
- Department of Pediatrics, UCSF, San Francisco, CA, United States.,Bakar Computational Health Sciences Institute, UCSF, San Francisco, CA, United States
| | - David K Stevenson
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| |
Collapse
|
8
|
Meyer R, Bart Y, Tsur A, Yinon Y, Friedrich L, Maixner N, Levin G. A marked decrease in preterm deliveries during the coronavirus disease 2019 pandemic. Am J Obstet Gynecol 2021; 224:234-237. [PMID: 33069683 PMCID: PMC7560113 DOI: 10.1016/j.ajog.2020.10.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 11/25/2022]
|
9
|
Singh D, Wasan H, Reeta KH. Heme oxygenase-1 modulation: A potential therapeutic target for COVID-19 and associated complications. Free Radic Biol Med 2020; 161:263-271. [PMID: 33091573 PMCID: PMC7571447 DOI: 10.1016/j.freeradbiomed.2020.10.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 12/12/2022]
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to infect hundred thousands of people every day worldwide. Since it is a novel virus, research continues to update the possible therapeutic targets when new evidence regarding COVID-19 are gathered. This article presents an evidence-based hypothesis that activating the heme oxygenase-1 (HO-1) pathway is a potential target for COVID-19. Interferons (IFNs) have broad-spectrum antiviral activity including against SARS-CoV-2. Induction of HO-1 and increase in the heme catabolism end-product confer antiviral activity. IFN activation results in inhibition of viral replication in various viral infections. COVID-19 induced inflammation as well as acute respiratory distress syndrome (ARDS), and coagulopathies are now known major causes of mortality. A protective role of HO-1 induction in inflammation, inflammation-induced coagulation, and ARDS has been reported. Based on an association of HO-1 promoter polymorphisms and disease severity, we propose an evaluation of the status of these polymorphisms in COVID-19 patients who become severely ill. If an association is established, it might be helpful in identifying patients at high risk. Hence, we hypothesize that HO-1 pathway activation could be a therapeutic strategy against COVID-19 and associated complications.
Collapse
Affiliation(s)
- Devendra Singh
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - Himika Wasan
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - K H Reeta
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India.
| |
Collapse
|
10
|
Chau AS, Cole BL, Debley JS, Nanda K, Rosen ABI, Bamshad MJ, Nickerson DA, Torgerson TR, Allenspach EJ. Heme oxygenase-1 deficiency presenting with interstitial lung disease and hemophagocytic flares. Pediatr Rheumatol Online J 2020; 18:80. [PMID: 33066778 PMCID: PMC7565350 DOI: 10.1186/s12969-020-00474-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 10/06/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Heme oxygenase-1 (HMOX1) catalyzes the metabolism of heme into carbon monoxide, ferrous iron, and biliverdin. Through biliverdin reductase, biliverdin becomes bilirubin. HMOX1-deficiency is a rare autosomal recessive disorder with hallmark features of direct antibody negative hemolytic anemia with normal bilirubin, hyperinflammation and features similar to macrophage activation syndrome. Clinical findings have included asplenia, nephritis, hepatitis, and vasculitis. Pulmonary features and evaluation of the immune response have been limited. CASE PRESENTATION We present a young boy who presented with chronic respiratory failure due to nonspecific interstitial pneumonia following a chronic history of infection-triggered recurrent hyperinflammatory flares. Episodes included hemolysis without hyperbilirubinemia, immunodeficiency, hepatomegaly with mild transaminitis, asplenia, leukocytosis, thrombocytosis, joint pain and features of macrophage activation with negative autoimmune serologies. Lung biopsy revealed cholesterol granulomas. He was found post-mortem by whole exome sequencing to have a compound heterozygous paternal frame shift a paternal frame shift HMOX1 c.264_269delCTGG (p.L89Sfs*24) and maternal splice donor HMOX1 (c.636 + 2 T > A) consistent with HMOX1 deficiency. Western blot analysis confirmed lack of HMOX1 protein upon oxidant stimulation of the patient cells. CONCLUSIONS Here, we describe a phenotype expansion for HMOX1-deficiency to include not only asplenia and hepatomegaly, but also interstitial lung disease with cholesterol granulomas and inflammatory flares with hemophagocytosis present in the bone marrow.
Collapse
Affiliation(s)
- Alice S. Chau
- grid.34477.330000000122986657Division of Allergy & Infectious Disease, Department of Medicine, University of Washington, Seattle, Washington USA ,grid.240741.40000 0000 9026 4165Center for Immunity and Immunotherapies, Seattle Children’s Research Institute, Jack MacDonald Building – 6th floor, 1900 9th Avenue, Seattle, Washington 98101 USA
| | - Bonnie L. Cole
- grid.34477.330000000122986657Department of Pathology and Laboratory Medicine, University of Washington, Seattle, Washington USA ,grid.507913.9Brotman Baty Institute for Precision Medicine, Seattle, Washington USA
| | - Jason S. Debley
- grid.240741.40000 0000 9026 4165Center for Immunity and Immunotherapies, Seattle Children’s Research Institute, Jack MacDonald Building – 6th floor, 1900 9th Avenue, Seattle, Washington 98101 USA ,grid.34477.330000000122986657Department of Pediatrics, University of Washington, Seattle, Washington USA
| | - Kabita Nanda
- grid.34477.330000000122986657Department of Pediatrics, University of Washington, Seattle, Washington USA
| | - Aaron B. I. Rosen
- grid.240741.40000 0000 9026 4165Center for Immunity and Immunotherapies, Seattle Children’s Research Institute, Jack MacDonald Building – 6th floor, 1900 9th Avenue, Seattle, Washington 98101 USA
| | - Michael J. Bamshad
- grid.507913.9Brotman Baty Institute for Precision Medicine, Seattle, Washington USA ,grid.34477.330000000122986657Department of Pediatrics, University of Washington, Seattle, Washington USA ,grid.34477.330000000122986657Genome Sciences, University of Washington, Seattle, Washington USA
| | - Deborah A. Nickerson
- grid.507913.9Brotman Baty Institute for Precision Medicine, Seattle, Washington USA ,grid.34477.330000000122986657Genome Sciences, University of Washington, Seattle, Washington USA
| | - Troy R. Torgerson
- grid.507729.eExperimental Immunology, Allen Institute, Seattle, Washington USA
| | - Eric J. Allenspach
- grid.240741.40000 0000 9026 4165Center for Immunity and Immunotherapies, Seattle Children’s Research Institute, Jack MacDonald Building – 6th floor, 1900 9th Avenue, Seattle, Washington 98101 USA ,grid.507913.9Brotman Baty Institute for Precision Medicine, Seattle, Washington USA ,grid.34477.330000000122986657Department of Pediatrics, University of Washington, Seattle, Washington USA
| |
Collapse
|
11
|
Suttorp CM, van Rheden REM, van Dijk NWM, Helmich MPAC, Kuijpers-Jagtman AM, Wagener FADTG. Heme Oxygenase Protects against Placental Vascular Inflammation and Abortion by the Alarmin Heme in Mice. Int J Mol Sci 2020; 21:ijms21155385. [PMID: 32751152 PMCID: PMC7432719 DOI: 10.3390/ijms21155385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/25/2020] [Accepted: 07/27/2020] [Indexed: 12/16/2022] Open
Abstract
Both infectious as non-infectious inflammation can cause placental dysfunction and pregnancy complications. During the first trimester of human gestation, when palatogenesis takes place, intrauterine hematoma and hemorrhage are common phenomena, causing the release of large amounts of heme, a well-known alarmin. We postulated that exposure of pregnant mice to heme during palatogenesis would initiate oxidative and inflammatory stress, leading to pathological pregnancy, increasing the incidence of palatal clefting and abortion. Both heme oxygenase isoforms (HO-1 and HO-2) break down heme, thereby generating anti-oxidative and -inflammatory products. HO may thus counteract these heme-induced injurious stresses. To test this hypothesis, we administered heme to pregnant CD1 outbred mice at Day E12 by intraperitoneal injection in increasing doses: 30, 75 or 150 μmol/kg body weight (30H, 75H or 150H) in the presence or absence of HO-activity inhibitor SnMP from Day E11. Exposure to heme resulted in a dose-dependent increase in abortion. At 75H half of the fetuses where resorbed, while at 150H all fetuses were aborted. HO-activity protected against heme-induced abortion since inhibition of HO-activity aggravated heme-induced detrimental effects. The fetuses surviving heme administration demonstrated normal palatal fusion. Immunostainings at Day E16 demonstrated higher numbers of ICAM-1 positive blood vessels, macrophages and HO-1 positive cells in placenta after administration of 75H or SnMP + 30H. Summarizing, heme acts as an endogenous “alarmin” during pregnancy in a dose-dependent fashion, while HO-activity protects against heme-induced placental vascular inflammation and abortion.
Collapse
Affiliation(s)
- Christiaan M. Suttorp
- Department of Dentistry—Orthodontics and Craniofacial Biology, Radboud University Medical Center, 6525 EX Nijmegen, The Netherlands; (C.M.S.); (R.E.M.v.R.); (N.W.M.v.D.); (M.P.A.C.H.)
- Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - René E. M. van Rheden
- Department of Dentistry—Orthodontics and Craniofacial Biology, Radboud University Medical Center, 6525 EX Nijmegen, The Netherlands; (C.M.S.); (R.E.M.v.R.); (N.W.M.v.D.); (M.P.A.C.H.)
| | - Natasja W. M. van Dijk
- Department of Dentistry—Orthodontics and Craniofacial Biology, Radboud University Medical Center, 6525 EX Nijmegen, The Netherlands; (C.M.S.); (R.E.M.v.R.); (N.W.M.v.D.); (M.P.A.C.H.)
| | - Maria P. A. C. Helmich
- Department of Dentistry—Orthodontics and Craniofacial Biology, Radboud University Medical Center, 6525 EX Nijmegen, The Netherlands; (C.M.S.); (R.E.M.v.R.); (N.W.M.v.D.); (M.P.A.C.H.)
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics, University of Groningen and University Medical Center Groningen, 9713 GZ Groningen, The Netherlands;
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, CH-3010 Bern, Switzerland
- Faculty of Dentistry, Universitas Indonesia, Jakarta ID-10430, Indonesia
| | - Frank A. D. T. G. Wagener
- Department of Dentistry—Orthodontics and Craniofacial Biology, Radboud University Medical Center, 6525 EX Nijmegen, The Netherlands; (C.M.S.); (R.E.M.v.R.); (N.W.M.v.D.); (M.P.A.C.H.)
- Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Correspondence: ; Tel.: +31-24-36-18824
| |
Collapse
|
12
|
Hao S, You J, Chen L, Zhao H, Huang Y, Zheng L, Tian L, Maric I, Liu X, Li T, Bianco YK, Winn VD, Aghaeepour N, Gaudilliere B, Angst MS, Zhou X, Li YM, Mo L, Wong RJ, Shaw GM, Stevenson DK, Cohen HJ, Mcelhinney DB, Sylvester KG, Ling XB. Changes in pregnancy-related serum biomarkers early in gestation are associated with later development of preeclampsia. PLoS One 2020; 15:e0230000. [PMID: 32126118 PMCID: PMC7053753 DOI: 10.1371/journal.pone.0230000] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/19/2020] [Indexed: 12/19/2022] Open
Abstract
Background Placental protein expression plays a crucial role during pregnancy. We hypothesized that: (1) circulating levels of pregnancy-associated, placenta-related proteins throughout gestation reflect the temporal progression of the uncomplicated, full-term pregnancy, and can effectively estimate gestational ages (GAs); and (2) preeclampsia (PE) is associated with disruptions in these protein levels early in gestation; and can identify impending PE. We also compared gestational profiles of proteins in the human and mouse, using pregnant heme oxygenase-1 (HO-1) heterozygote (Het) mice, a mouse model reflecting PE-like symptoms. Methods Serum levels of placenta-related proteins–leptin (LEP), chorionic somatomammotropin hormone like 1 (CSHL1), elabela (ELA), activin A, soluble fms-like tyrosine kinase 1 (sFlt-1), and placental growth factor (PlGF)–were quantified by ELISA in blood serially collected throughout human pregnancies (20 normal subjects with 66 samples, and 20 subjects who developed PE with 61 samples). Multivariate analysis was performed to estimate the GA in normal pregnancy. Mean-squared errors of GA estimations were used to identify impending PE. The human protein profiles were then compared with those in the pregnant HO-1 Het mice. Results An elastic net-based gestational dating model was developed (R2 = 0.76) and validated (R2 = 0.61) using serum levels of the 6 proteins measured at various GAs from women with normal uncomplicated pregnancies. In women who developed PE, the model was not (R2 = -0.17) associated with GA. Deviations from the model estimations were observed in women who developed PE (P = 0.01). The model developed with 5 proteins (ELA excluded) performed similarly from sera from normal human (R2 = 0.68) and WT mouse (R2 = 0.85) pregnancies. Disruptions of this model were observed in both human PE-associated (R2 = 0.27) and mouse HO-1 Het (R2 = 0.30) pregnancies. LEP outperformed sFlt-1 and PlGF in differentiating impending PE at early human and late mouse GAs. Conclusions Serum placenta-related protein profiles are temporally regulated throughout normal pregnancies and significantly disrupted in women who develop PE. LEP changes earlier than the well-established biomarkers (sFlt-1 and PlGF). There may be evidence of a causative action of HO-1 deficiency in LEP upregulation in a PE-like murine model.
Collapse
Affiliation(s)
- Shiying Hao
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, United States of America
- Clinical and Translational Research Program, Betty Irene Moore Children's Heart Center, Lucile Packard Children’s Hospital, Palo Alto, CA, United States of America
| | - Jin You
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Lin Chen
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Hui Zhao
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Yujuan Huang
- Department of Emergency, Shanghai Children’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Le Zheng
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, United States of America
- Clinical and Translational Research Program, Betty Irene Moore Children's Heart Center, Lucile Packard Children’s Hospital, Palo Alto, CA, United States of America
| | - Lu Tian
- Department of Health Research and Policy, Stanford University, Stanford, CA, United States of America
| | - Ivana Maric
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Xin Liu
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Tian Li
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Ylayaly K. Bianco
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Virginia D. Winn
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Nima Aghaeepour
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Brice Gaudilliere
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Martin S. Angst
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Xin Zhou
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin, China
| | - Yu-Ming Li
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin, China
| | - Lihong Mo
- Department of Obstetrics and Gynecology, University of California San Francisco-Fresno, Fresno, CA, United States of America
| | - Ronald J. Wong
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Gary M. Shaw
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - David K. Stevenson
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Harvey J. Cohen
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Doff B. Mcelhinney
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, United States of America
- Clinical and Translational Research Program, Betty Irene Moore Children's Heart Center, Lucile Packard Children’s Hospital, Palo Alto, CA, United States of America
| | - Karl G. Sylvester
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Xuefeng B. Ling
- Clinical and Translational Research Program, Betty Irene Moore Children's Heart Center, Lucile Packard Children’s Hospital, Palo Alto, CA, United States of America
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States of America
- * E-mail:
| |
Collapse
|
13
|
Le BL, Iwatani S, Wong RJ, Stevenson DK, Sirota M. Computational discovery of therapeutic candidates for preventing preterm birth. JCI Insight 2020; 5:133761. [PMID: 32051340 DOI: 10.1172/jci.insight.133761] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/19/2019] [Indexed: 12/13/2022] Open
Abstract
Few therapeutic methods exist for preventing preterm birth (PTB), or delivery before completing 37 weeks of gestation. In the US, progesterone (P4) supplementation is the only FDA-approved drug for use in preventing recurrent spontaneous PTB. However, P4 has limited effectiveness, working in only approximately one-third of cases. Computational drug repositioning leverages data on existing drugs to discover novel therapeutic uses. We used a rank-based pattern-matching strategy to compare the differential gene expression signature for PTB to differential gene expression drug profiles in the Connectivity Map database and assigned a reversal score to each PTB-drug pair. Eighty-three drugs, including P4, had significantly reversed differential gene expression compared with that found for PTB. Many of these compounds have been evaluated in the context of pregnancy, with 13 belonging to pregnancy category A or B - indicating no known risk in human pregnancy. We focused our validation efforts on lansoprazole, a proton-pump inhibitor, which has a strong reversal score and a good safety profile. We tested lansoprazole in an animal inflammation model using LPS, which showed a significant increase in fetal viability compared with LPS treatment alone. These promising results demonstrate the effectiveness of the computational drug repositioning pipeline to identify compounds that could be effective in preventing PTB.
Collapse
Affiliation(s)
- Brian L Le
- Bakar Computational Health Sciences Institute and.,Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Sota Iwatani
- Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Ronald J Wong
- Department of Pediatrics, Stanford University, Stanford, California, USA
| | - David K Stevenson
- Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Marina Sirota
- Bakar Computational Health Sciences Institute and.,Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| |
Collapse
|
14
|
Kräker K, O'Driscoll JM, Schütte T, Herse F, Patey O, Golic M, Geisberger S, Verlohren S, Birukov A, Heuser A, Müller DN, Thilaganathan B, Dechend R, Haase N. Statins Reverse Postpartum Cardiovascular Dysfunction in a Rat Model of Preeclampsia. Hypertension 2019; 75:202-210. [PMID: 31786987 DOI: 10.1161/hypertensionaha.119.13219] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Preeclampsia is associated with increased cardiovascular long-term risk; however, the underlying functional and structural mechanisms are unknown. We investigated maternal cardiac alterations after preeclampsia. Female rats harboring the human angiotensinogen gene [TGR(hAogen)L1623] develop a preeclamptic phenotype with hypertension and albuminuria during pregnancy when mated with male rats bearing the human renin gene [TGR(hRen)L10J] but behave physiologically normal before and after pregnancy. Furthermore, rats were treated with pravastatin. We tested the hypothesis that statins are a potential therapeutic intervention to reduce cardiovascular alterations due to simulated preeclamptic pregnancy. Although hypertension persists for only 8 days in pregnancy, former preeclampsia rats exhibit significant cardiac hypertrophy 28 days after pregnancy observed in both speckle tracking echocardiography and histological staining. In addition, fibrosis and capillary rarefaction was evident. Pravastatin treatment ameliorated the remodeling and improved cardiac output postpartum. Preeclamptic pregnancy induces irreversible structural changes of cardiac hypertrophy and fibrosis, which can be moderated by pravastatin treatment. This pathological cardiac remodeling might be involved in increased cardiovascular risk in later life.
Collapse
Affiliation(s)
- Kristin Kräker
- From the Experimental and Clinical Research Center-a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Berlin Institute of Health, Germany (K.K., T.S., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,German Centre for Cardiovascular Research, partner site Berlin, Germany (K.K., T.S., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (K.K., F.H., M.G., S.G., A.B., A.H., D.N.M., N.H.)
| | - Jamie M O'Driscoll
- Molecular and Clinical Sciences Research Institute, St George's, University of London, United Kingdom (J.M.O., O.P., B.T.).,Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, United Kingdom (J.M.O., O.P., B.T.).,Canterbury Christ Church University, School of Human and Life Sciences, Kent, United Kingdom (J.M.O.)
| | - Till Schütte
- Berlin Institute of Health, Germany (K.K., T.S., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,German Centre for Cardiovascular Research, partner site Berlin, Germany (K.K., T.S., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Institute of Pharmacology (T.S.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Florian Herse
- From the Experimental and Clinical Research Center-a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (K.K., F.H., M.G., S.G., A.B., A.H., D.N.M., N.H.)
| | - Olga Patey
- Molecular and Clinical Sciences Research Institute, St George's, University of London, United Kingdom (J.M.O., O.P., B.T.).,Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, United Kingdom (J.M.O., O.P., B.T.)
| | - Michaela Golic
- From the Experimental and Clinical Research Center-a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Berlin Institute of Health, Germany (K.K., T.S., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,German Centre for Cardiovascular Research, partner site Berlin, Germany (K.K., T.S., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (K.K., F.H., M.G., S.G., A.B., A.H., D.N.M., N.H.)
| | - Sabrina Geisberger
- From the Experimental and Clinical Research Center-a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Berlin Institute of Health, Germany (K.K., T.S., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,German Centre for Cardiovascular Research, partner site Berlin, Germany (K.K., T.S., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (K.K., F.H., M.G., S.G., A.B., A.H., D.N.M., N.H.)
| | - Stefan Verlohren
- Institute of Obstetrics (S.V.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Anna Birukov
- From the Experimental and Clinical Research Center-a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Berlin Institute of Health, Germany (K.K., T.S., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,German Centre for Cardiovascular Research, partner site Berlin, Germany (K.K., T.S., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (K.K., F.H., M.G., S.G., A.B., A.H., D.N.M., N.H.)
| | - Arnd Heuser
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (K.K., F.H., M.G., S.G., A.B., A.H., D.N.M., N.H.)
| | - Dominik N Müller
- From the Experimental and Clinical Research Center-a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Berlin Institute of Health, Germany (K.K., T.S., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,German Centre for Cardiovascular Research, partner site Berlin, Germany (K.K., T.S., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (K.K., F.H., M.G., S.G., A.B., A.H., D.N.M., N.H.)
| | - Basky Thilaganathan
- Molecular and Clinical Sciences Research Institute, St George's, University of London, United Kingdom (J.M.O., O.P., B.T.).,Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, United Kingdom (J.M.O., O.P., B.T.)
| | - Ralf Dechend
- From the Experimental and Clinical Research Center-a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Berlin Institute of Health, Germany (K.K., T.S., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,German Centre for Cardiovascular Research, partner site Berlin, Germany (K.K., T.S., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,HELIOS-Klinikum, Berlin, Germany (R.D.)
| | - Nadine Haase
- From the Experimental and Clinical Research Center-a joint cooperation between the Max Delbrück Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Berlin Institute of Health, Germany (K.K., T.S., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,German Centre for Cardiovascular Research, partner site Berlin, Germany (K.K., T.S., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (K.K., F.H., M.G., S.G., A.B., D.N.M., R.D., N.H.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (K.K., F.H., M.G., S.G., A.B., A.H., D.N.M., N.H.)
| |
Collapse
|