1
|
Salem AA, Taha DA, Nasr AA, El-Sagheer M, Daghash W, Taghian RA. Effect of vitamin E, D-limonene, and their combination on nulliparous rabbit reproductive performance. Anim Reprod Sci 2023; 259:107378. [PMID: 37989002 DOI: 10.1016/j.anireprosci.2023.107378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023]
Abstract
Oxidative status is important in reproductive performance and using two natural antioxidants is more beneficial than one in nulliparous rabbits. The goal, effect of vitamin E (VitE), D-limonene (DL), and VitE+DL on maternal LBW (MLBW), conception (CR), pregnancy (PR), and kindling rates (KR), gestation length (GL), total litter size at birth (TLSB) and weaning (TLSW), live kits at birth (LKB) and weaning (LKW), dead kits at birth (DKB) and weaning (DKW), kits mortality rate at weaning (KMRW), Kit weight at birth (KWB) and weaning (KWW), total kit weight at birth (TKWB) and weaning (TKWW), and concentrations of progesterone (P4) and Malondialdehyde (MDA), during first two pregnancies. A total of 24 healthy female WNZ rabbits were randomly selected and assigned into four groups (6/each). Control (animals injected with 1.0 mL propylene glycol), VitE (60 mg IM injection/animal, 2X/week pre-mating and 3X post-mating until mid-pregnancy, DL (20 mg IM injection/animal, 2X/week pre-mating and 1X at mating, and VitE+DL (IM injection/animal with the same doses and times applied in VitE and DL groups. All animals were treated during 1st pregnancy only. The results confirmed that animals treated with VitE+DL gained significant maternal LBW in 1st pregnancy, reduced dead kit number at birth and kit mortality rate at weaning, increased live kits and total kit weight at birth and weaning in the two pregnancies, and also increased significantly kit weight at birth and weaning in the treatments than controls in the two pregnancies, and DL was greater in 1st pregnancy. Progesterone concentrations in mid-pregnancy rose significantly in VitE+DL during 1st pregnancy and DL in 2nd pregnancy. Malondialdehyde concentrations dropped significantly in VitE and VitE+DL in mid-pregnancy in the two pregnancies. Eventually, the integration of VitE and DL displayed their unique properties for improving productive and reproductive performance in nulliparous rabbits.
Collapse
Affiliation(s)
- Anas A Salem
- Animal Production Department, Fac. of Agriculture, Assiut University, Assiut, Egypt.
| | - Doaa A Taha
- Animal Production Department, Fac. of Agriculture, Assiut University, Assiut, Egypt.
| | - Asmaa Ae Nasr
- Pathology Department, Institute of Veterinary Health, Assiut, Egypt.
| | - Mohamed El-Sagheer
- Poultry Production Department, Fac. of Agriculture, Assiut University, Egypt
| | - Wael Daghash
- Animal Production Department, Fac. of Agriculture, Assiut University, Assiut, Egypt
| | - Raghda A Taghian
- Animal Production Department, Fac. of Agriculture, Assiut University, Assiut, Egypt
| |
Collapse
|
2
|
Kaltsas A, Zikopoulos A, Moustakli E, Zachariou A, Tsirka G, Tsiampali C, Palapela N, Sofikitis N, Dimitriadis F. The Silent Threat to Women's Fertility: Uncovering the Devastating Effects of Oxidative Stress. Antioxidants (Basel) 2023; 12:1490. [PMID: 37627485 PMCID: PMC10451552 DOI: 10.3390/antiox12081490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
Oxidative stress (OS), which arises through an imbalance between the formation of reactive oxygen species (ROS) and antioxidant defenses, plays a key role in the pathophysiology of female infertility, with the latter constituting just one of a number of diseases linked to OS as a potential cause. The aim of the present article is to review the literature regarding the association between OS and female infertility. Among the reproductive diseases considered are endometriosis and polycystic ovary syndrome (PCOS), while environmental pollutants, lifestyle variables, and underlying medical conditions possibly resulting in OS are additionally examined. Current evidence points to OS likely contributing to the pathophysiology of the above reproductive disorders, with the amount of damage done by OS being influenced by such variables as duration and severity of exposure and the individual's age and genetic predisposition. Also discussed are the processes via which OS may affect female fertility, these including DNA damage and mitochondrial dysfunction. Finally, the last section of the manuscript contains an evaluation of treatment options, including antioxidants and lifestyle modification, capable of minimizing OS in infertile women. The prime message underlined by this review is the importance of considering OS in the diagnosis and treatment of female infertility. Further studies are, nevertheless required to identify the best treatment regimen and its ideal duration.
Collapse
Affiliation(s)
- Aris Kaltsas
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (A.Z.); (N.S.)
| | - Athanasios Zikopoulos
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (A.Z.); (N.S.)
| | - Efthalia Moustakli
- Laboratory of Medical Genetics in Clinical Practice, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (E.M.); (G.T.)
| | - Athanasios Zachariou
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (A.Z.); (N.S.)
| | - Georgia Tsirka
- Laboratory of Medical Genetics in Clinical Practice, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (E.M.); (G.T.)
| | | | - Natalia Palapela
- Medical Faculty, Medical University of Sofia, 1431 Sofia, Bulgaria;
| | - Nikolaos Sofikitis
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (A.Z.); (N.S.)
| | - Fotios Dimitriadis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| |
Collapse
|
3
|
Stephenson DJ, MacKnight HP, Hoeferlin LA, Washington SL, Sawyers C, Archer KJ, Strauss JF, Walsh SW, Chalfant CE. Bioactive lipid mediators in plasma are predictors of preeclampsia irrespective of aspirin therapy. J Lipid Res 2023; 64:100377. [PMID: 37119922 PMCID: PMC10230265 DOI: 10.1016/j.jlr.2023.100377] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 05/01/2023] Open
Abstract
There are few early biomarkers to identify pregnancies at risk of preeclampsia (PE) and abnormal placental function. In this cross-sectional study, we utilized targeted ultra-performance liquid chromatography-ESI MS/MS and a linear regression model to identify specific bioactive lipids that serve as early predictors of PE. Plasma samples were collected from 57 pregnant women prior to 24-weeks of gestation with outcomes of either PE (n = 26) or uncomplicated term pregnancies (n = 31), and the profiles of eicosanoids and sphingolipids were evaluated. Significant differences were revealed in the eicosanoid, (±)11,12 DHET, as well as multiple classes of sphingolipids; ceramides, ceramide-1-phosphate, sphingomyelin, and monohexosylceramides; all of which were associated with the subsequent development of PE regardless of aspirin therapy. Profiles of these bioactive lipids were found to vary based on self-designated race. Additional analyses demonstrated that PE patients can be stratified based on the lipid profile as to PE with a preterm birth linked to significant differences in the levels of 12-HETE, 15-HETE, and resolvin D1. Furthermore, subjects referred to a high-risk OB/GYN clinic had higher levels of 20-HETE, arachidonic acid, and Resolvin D1 versus subjects recruited from a routine, general OB/GYN clinic. Overall, this study shows that quantitative changes in plasma bioactive lipids detected by ultra-performance liquid chromatography-ESI-MS/MS can serve as an early predictor of PE and stratify pregnant people for PE type and risk.
Collapse
Affiliation(s)
- Daniel J Stephenson
- Division of Hematology & Oncology, Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - H Patrick MacKnight
- Division of Hematology & Oncology, Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - L Alexis Hoeferlin
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Sonya L Washington
- Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, USA
| | - Chelsea Sawyers
- Virginia Institute for Psychiatric & Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Kellie J Archer
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH, USA
| | - Jerome F Strauss
- Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, USA
| | - Scott W Walsh
- Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, USA.
| | - Charles E Chalfant
- Division of Hematology & Oncology, Department of Medicine, University of Virginia, Charlottesville, VA, USA; Department of Biochemistry and Molecular Biology, Virginia Commonwealth University (VCU), Richmond, VA, USA; Department of Cell Biology, University of Virginia, Charlottesville, VA, USA; Program in Cancer Biology, University of Virginia Cancer Center, Charlottesville, VA, USA; Research Service, Richmond Veterans Administration Medical Center, Richmond, VA, USA.
| |
Collapse
|
4
|
Williams IM, Albertolle ME, Layden AJ, Tao SY, Fisher SJ, Gandley RE, Roberts JM. Lipidomics Reveals Elevated Plasmalogens in Women with Obesity Who Develop Preeclampsia. J Clin Med 2023; 12:jcm12082970. [PMID: 37109308 PMCID: PMC10147017 DOI: 10.3390/jcm12082970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/03/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Objective: Preeclampsia (PE) is a prevalent pregnancy disorder worldwide with limited preventative treatments available. Obesity triples the risk for PE, yet only 10% of women with obesity develop PE. The factors that distinguish PE from uncomplicated pregnancies in the context of obesity have not been fully established. Methods: We studied a cohort of women with obesity throughout pregnancy to identify lipid mediators and/or biomarkers of PE. Blood samples were collected at each trimester and analyzed by both targeted lipidomics and standard lipid panels. Individual lipid species were compared by PE status at each trimester, as well as by self-identified race (Black vs. White) and fetal sex. Results: Standard lipid panels and clinical measurements revealed few differences between PE and uncomplicated pregnancies. Targeted lipidomics, however, identified plasmalogen, phosphatidylethanolamine, and free fatty acid species that were elevated in the third trimester of women with PE. Furthermore, race and trimester of pregnancy were considerable sources of plasma lipidomic variation in women with obesity. Conclusions: First and second trimester individual plasma lipid species do not predict the development of PE in obese women. In the third trimester, PE patients have elevated levels of plasmalogens-a class of lipoprotein-associated phospholipids that have been implicated in the response to oxidative stress.
Collapse
Affiliation(s)
- Ian M Williams
- Lipid Nanoparticle Platform Department, Takeda Development Center Americas, San Diego, CA 92121, USA
| | - Matthew E Albertolle
- Drug Metabolism and Pharmacokinetics Department, Takeda Development Center Americas, San Diego, CA 92121, USA
| | - Alexander J Layden
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261, USA
| | - Sunny Y Tao
- University of Pittsburgh Medical Center and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Susan J Fisher
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | | | - James M Roberts
- Magee-Womens Research Institute, Pittsburgh, PA 15213, USA
- Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| |
Collapse
|
5
|
Eid J, Rood KM, Costantine MM. Aspirin and Pravastatin for Preeclampsia Prevention in High-Risk Pregnancy. Obstet Gynecol Clin North Am 2023; 50:79-88. [PMID: 36822711 DOI: 10.1016/j.ogc.2022.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Preeclampsia is a hypertensive disorder of pregnancy affecting up to 8% of pregnancies. It is associated with significant neonatal and maternal morbidities and mortality. Although its pathogenesis is not completely understood, abnormal placentation resulting in imbalance in angiogenic factors, increased inflammation, and endothelial dysfunction are thought to be key pathways in the development of the disease. Administration of low-dose aspirin is recommended by professional societies for the prevention of preeclampsia in high-risk individuals. In this review, we summarize the evidence behind the use of low-dose aspirin and pravastatin in pregnant individuals at high risk of preeclampsia.
Collapse
Affiliation(s)
- Joe Eid
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
| | - Kara M Rood
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Maged M Costantine
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| |
Collapse
|
6
|
Xiao Y, Ling Q, Yao M, Gu Y, Lan Y, Liu S, Yin J, Ma Q. Aspirin 75 mg to prevent preeclampsia in high-risk pregnancies: a retrospective real-world study in China. Eur J Med Res 2023; 28:56. [PMID: 36732824 PMCID: PMC9893656 DOI: 10.1186/s40001-023-01024-7] [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: 10/04/2022] [Accepted: 01/20/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Several randomized clinical trials showed that aspirin could decrease the incidence of preeclampsia (PE) in women at high risk, but data from sources other than traditional clinical trials that investigating the preventive effect of aspirin 75 mg on PE is still lacking, especially in mainland China. We aimed to use Chinese real-world data to estimate the preventive effect of low-dose aspirin (LDA) on PE. METHODS Clinical data of pregnant women who were at high risk of PE and had their first prenatal visit at the affiliated Taicang People's Hospital of Soochow University during November 31, 2018 and May 10, 2021 was retrospectively analyzed. Among the 266 included pregnant women, 115 individuals treated with aspirin 75 mg per day and the other 151 without such treatment were considered as the LDA group and the control group, respectively. RESULTS In the LDA group, 64 (55.65%) of 115 pregnant women took aspirin before 16 weeks of gestation. Besides, 12 (10.43%) and 34 (22.52%) women developed PE in the LDA group and control group, respectively; the aspirin prophylaxis was associated with a lower risk of PE (odds ratio = 0.40, 95% confidence interval = 0.20-0.82, P = 0.0098). In addition, LDA is slightly more effective when initiated before 16 weeks of gestation or in those without chronic hypertension, when compared with their counterparts. CONCLUSION Prophylaxis with 75 mg per day of aspirin in high-risk women resulted in a significantly lower incidence of PE than that in the control group.
Collapse
Affiliation(s)
- Yue Xiao
- grid.263761.70000 0001 0198 0694Taicang Affiliated Hospital of Soochow University, The First People’s Hospital of Taicang, 58 Changsheng Road, Suzhou, 215413 China ,grid.263761.70000 0001 0198 0694Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123 Jiangsu China
| | - Qi Ling
- grid.263761.70000 0001 0198 0694Taicang Affiliated Hospital of Soochow University, The First People’s Hospital of Taicang, 58 Changsheng Road, Suzhou, 215413 China
| | - Mengxin Yao
- grid.263761.70000 0001 0198 0694Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123 Jiangsu China
| | - Yingjie Gu
- grid.16821.3c0000 0004 0368 8293Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yanshi Lan
- grid.263761.70000 0001 0198 0694Taicang Affiliated Hospital of Soochow University, The First People’s Hospital of Taicang, 58 Changsheng Road, Suzhou, 215413 China
| | - Songliang Liu
- grid.263761.70000 0001 0198 0694Taicang Affiliated Hospital of Soochow University, The First People’s Hospital of Taicang, 58 Changsheng Road, Suzhou, 215413 China
| | - Jieyun Yin
- grid.263761.70000 0001 0198 0694Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123 Jiangsu China
| | - Qiuping Ma
- grid.263761.70000 0001 0198 0694Taicang Affiliated Hospital of Soochow University, The First People’s Hospital of Taicang, 58 Changsheng Road, Suzhou, 215413 China
| |
Collapse
|
7
|
Marić I, Contrepois K, Moufarrej MN, Stelzer IA, Feyaerts D, Han X, Tang A, Stanley N, Wong RJ, Traber GM, Ellenberger M, Chang AL, Fallahzadeh R, Nassar H, Becker M, Xenochristou M, Espinosa C, De Francesco D, Ghaemi MS, Costello EK, Culos A, Ling XB, Sylvester KG, Darmstadt GL, Winn VD, Shaw GM, Relman DA, Quake SR, Angst MS, Snyder MP, Stevenson DK, Gaudilliere B, Aghaeepour N. Early prediction and longitudinal modeling of preeclampsia from multiomics. PATTERNS (NEW YORK, N.Y.) 2022; 3:100655. [PMID: 36569558 PMCID: PMC9768681 DOI: 10.1016/j.patter.2022.100655] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 09/28/2022] [Accepted: 11/11/2022] [Indexed: 12/13/2022]
Abstract
Preeclampsia is a complex disease of pregnancy whose physiopathology remains unclear. We developed machine-learning models for early prediction of preeclampsia (first 16 weeks of pregnancy) and over gestation by analyzing six omics datasets from a longitudinal cohort of pregnant women. For early pregnancy, a prediction model using nine urine metabolites had the highest accuracy and was validated on an independent cohort (area under the receiver-operating characteristic curve [AUC] = 0.88, 95% confidence interval [CI] [0.76, 0.99] cross-validated; AUC = 0.83, 95% CI [0.62,1] validated). Univariate analysis demonstrated statistical significance of identified metabolites. An integrated multiomics model further improved accuracy (AUC = 0.94). Several biological pathways were identified including tryptophan, caffeine, and arachidonic acid metabolisms. Integration with immune cytometry data suggested novel associations between immune and proteomic dynamics. While further validation in a larger population is necessary, these encouraging results can serve as a basis for a simple, early diagnostic test for preeclampsia.
Collapse
Affiliation(s)
- Ivana Marić
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Kévin Contrepois
- Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Mira N. Moufarrej
- Departments of Bioengineering and Applied Physics, Stanford University and Chan Zuckerberg Biohub, Stanford, CA 94305, USA
| | - Ina A. Stelzer
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Dorien Feyaerts
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Xiaoyuan Han
- University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA 94103, USA
| | - Andy Tang
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Natalie Stanley
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Ronald J. Wong
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Gavin M. Traber
- Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Mathew Ellenberger
- Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Alan L. Chang
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Ramin Fallahzadeh
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Huda Nassar
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Martin Becker
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Maria Xenochristou
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Camilo Espinosa
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Davide De Francesco
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Mohammad S. Ghaemi
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
- Digital Technologies Research Centre, National Research Council Canada, Toronto, Canada
| | - Elizabeth K. Costello
- Departments of Medicine, and of Microbiology & Immunology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Anthony Culos
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Xuefeng B. Ling
- Department of Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Karl G. Sylvester
- Department of Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Gary L. Darmstadt
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Virginia D. Winn
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Gary M. Shaw
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - David A. Relman
- Departments of Medicine, and of Microbiology & Immunology, Stanford University School of Medicine, Stanford, CA 94305, USA
- Infectious Diseases Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Stephen R. Quake
- Departments of Bioengineering and Applied Physics, Stanford University and Chan Zuckerberg Biohub, Stanford, CA 94305, USA
| | - Martin S. Angst
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Michael P. Snyder
- Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - David K. Stevenson
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Brice Gaudilliere
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Nima Aghaeepour
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
- Department of Biomedical Data Science, Stanford University, Stanford, CA 94305, USA
| |
Collapse
|
8
|
Gestational NSAIDs distinctly reprogram cardiac injury in preeclamptic rats: Roles of cyclooxygenase, apoptotic and autophagic trails. Life Sci 2022; 310:121130. [DOI: 10.1016/j.lfs.2022.121130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/15/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
|
9
|
Barden AE, Shinde S, Phillips M, Beilin LJ, Mori TA. Mediators of inflammation resolution and vasoactive eicosanoids in gestational diabetes and preeclampsia. J Hypertens 2022; 40:2236-2244. [PMID: 35950986 DOI: 10.1097/hjh.0000000000003253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Women with gestational diabetes (GDM) have an increased risk of preeclampsia and postpartum diabetes. Inflammation associates with both GDM and preeclampsia. This study examined specialized proresolving mediators (SPM) that direct inflammation resolution and eicosanoids that are involved in inflammation, in relation to the development of preeclampsia and ongoing postpartum glucose intolerance in GDM. METHODS Participants were selected from a prospective study examining the development of preeclampsia in women with GDM. Four groups of age-matched women were studied: GDM ( n = 20), GDM who developed preeclampsia (GDM+PE, n = 21), GDM who remained glucose-intolerant postpartum (GDM+PPIGT, n = 20), or pregnancies with glucose tolerance within the normal range (NGT, n = 21). Measurement of SPM (E-series resolvins and D-series resolvins), SPM pathway intermediates (14-HDHA, 18-HEPE and 17-HDHA), 20-hydroxyeicosatetraenoic acid (20-HETE), and the urinary metabolite of the vasodilator prostacyclin 2,3-dinor-6-Keto-PGF 1α , were made at 28, 32 and 36 weeks gestation and at 6 months postpartum. RESULTS Compared with GDM, GDM+PE had elevated levels of 20-HETE and the SPM pathway intermediates 14-HDHA, 18-HEPE, 17-HDHA, at 32 weeks, and the SPM RvE1 at 32 and 36 weeks gestation. Compared with NGT and regardless of whether they developed preeclampsia or PPIGT, GDM had lower levels of 2,3-dinor-6-Keto-PGF 1α during pregnancy. CONCLUSION Reduced levels of the prostacyclin metabolite 2,3-dinor-6-Keto-PGF 1α may contribute to the increased risk of preeclampsia in women with GDM. The increase in 20-HETE, a vasoconstrictor and mediator of inflammation, and SPM that contribute to inflammation resolution, prior to the onset of preeclampsia require further investigation to clarify their clinical significance.
Collapse
Affiliation(s)
- Anne E Barden
- Medical School, University of Western Australia, Royal Perth Hospital Unit
| | - Sujata Shinde
- Medical School, University of Western Australia, Royal Perth Hospital Unit
| | - Michael Phillips
- Harry Perkins Institute for Medical Research, University of Western Australia, Perth, Australia
| | - Lawrence J Beilin
- Medical School, University of Western Australia, Royal Perth Hospital Unit
| | - Trevor A Mori
- Medical School, University of Western Australia, Royal Perth Hospital Unit
| |
Collapse
|
10
|
Walsh SW, Al Dulaimi M, Strauss JF. Aspirin Inhibits the Inflammatory Response of Protease-Activated Receptor 1 in Pregnancy Neutrophils: Implications for Treating Women with Preeclampsia. Int J Mol Sci 2022; 23:13218. [PMID: 36362006 PMCID: PMC9654155 DOI: 10.3390/ijms232113218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/20/2022] [Accepted: 10/28/2022] [Indexed: 07/30/2023] Open
Abstract
Neutrophils expressing cyclooxygenase-2 (COX-2) extensively infiltrate maternal blood vessels in preeclampsia, associated with vascular inflammation. Because pregnancy neutrophils also express protease-activated receptor 1 (PAR-1, F2R thrombin receptor), which they do not in non-pregnant subjects, they can be activated by proteases. We tested the hypothesis that aspirin at a dose sufficient to inhibit COX-2 would reduce inflammatory responses in preeclampsia neutrophils. Neutrophils were isolated from normal pregnant and preeclamptic women at approximately 30 weeks' gestation. Normal pregnancy neutrophils were treated with elastase, a protease elevated in preeclampsia, or elastase plus aspirin to inhibit COX-2, or elastase plus pinane thromboxane, a biologically active structural analog of thromboxane and a thromboxane synthase inhibitor. Preeclamptic pregnancy neutrophils were treated with the same doses of aspirin or pinane thromboxane. Confocal microscopy with immunofluorescence staining was used to determine the cellular localization of the p65 subunit of nuclear factor-kappa B (NF-κB) and media concentrations of thromboxane were measured to evaluate the inflammatory response. In untreated neutrophils of normal pregnant women, p65 was localized to the cytosol. Upon stimulation with elastase, p65 translocated from the cytosol to the nucleus coincident with increased thromboxane production. When neutrophils were co-treated with aspirin or pinane thromboxane, elastase was not able to cause nuclear translocation of p65 or increase thromboxane. In untreated neutrophils of preeclamptic women, the p65 subunit was present in the nucleus and thromboxane production was elevated, but when preeclamptic neutrophils were treated with aspirin or pinane thromboxane, p65 was cleared from the nucleus and returned to the cytosol along with decreased thromboxane production. These findings suggest that COX-2 is a downstream mediator of PAR-1 and demonstrate that PAR-1- mediated inflammation can be inhibited by aspirin. Given the extensive and ubiquitous expression of PAR-1 and COX-2 in preeclamptic women, consideration should be given to treating women with preeclampsia using a dose of aspirin sufficient to inhibit COX-2.
Collapse
Affiliation(s)
- Scott W. Walsh
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0034, USA
- Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0034, USA
| | - Marwah Al Dulaimi
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0034, USA
| | - Jerome F. Strauss
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0034, USA
| |
Collapse
|
11
|
Griffith JA, Garner KL, Bowdridge EC, DeVallance E, Schafner KJ, Engles KJ, Batchelor TP, Goldsmith WT, Wix K, Hussain S, Nurkiewicz TR. Nanomaterial Inhalation During Pregnancy Alters Systemic Vascular Function in a Cyclooxygenase-Dependent Manner. Toxicol Sci 2022; 188:219-233. [PMID: 35642938 PMCID: PMC9333412 DOI: 10.1093/toxsci/kfac055] [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] [Indexed: 11/14/2022] Open
Abstract
Pregnancy requires rapid adaptations in the uterine microcirculation to support fetal development. Nanomaterial inhalation is associated with cardiovascular dysfunction, which may impair gestation. We have shown that maternal nano-titanium dioxide (nano-TiO2) inhalation impairs microvascular endothelial function in response to arachidonic acid and thromboxane (TXA2) mimetics. However, the mechanisms underpinning this process are unknown. Therefore, we hypothesize that maternal nano-TiO2 inhalation during gestation results in uterine microvascular prostacyclin (PGI2) and TXA2 dysfunction. Pregnant Sprague-Dawley rats were exposed from gestational day 10-19 to nano-TiO2 aerosols (12.17 ± 1.67 mg/m3) or filtered air (sham-control). Dams were euthanized on gestational day 20, and serum, uterine radial arterioles, implantation sites, and lungs were collected. Serum was assessed for PGI2 and TXA2 metabolites. TXB2, the stable TXA2 metabolite, was significantly decreased in nano-TiO2 exposed dams (597.3 ± 84.4 vs 667.6 ± 45.6 pg/ml), whereas no difference was observed for 6-keto-PGF1α, the stable PGI2 metabolite. Radial arteriole pressure myography revealed that nano-TiO2 exposure caused increased vasoconstriction to the TXA2 mimetic, U46619, compared with sham-controls (-41.3% ± 4.3% vs -16.8% ± 3.4%). Nano-TiO2 exposure diminished endothelium-dependent vasodilation to carbaprostacyclin, a PGI2 receptor agonist, compared with sham-controls (30.0% ± 9.0% vs 53.7% ± 6.0%). Maternal nano-TiO2 inhalation during gestation decreased nano-TiO2 female pup weight when compared with sham-control males (3.633 ± 0.064 vs 3.995 ± 0.124 g). Augmented TXA2 vasoconstriction and decreased PGI2 vasodilation may lead to decreased placental blood flow and compromise maternofetal exchange of waste and nutrients, which could ultimately impact fetal health outcomes.
Collapse
Affiliation(s)
- Julie A Griffith
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
| | - Krista L Garner
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
| | - Elizabeth C Bowdridge
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
| | - Evan DeVallance
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
| | - Kallie J Schafner
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
| | - Kevin J Engles
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
| | - Thomas P Batchelor
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
| | - William T Goldsmith
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
| | - Kimberley Wix
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
| | - Salik Hussain
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
| | - Timothy R Nurkiewicz
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, West Virginia 26505-9229, USA
| |
Collapse
|
12
|
Maternal Blood Fatty Acid Levels in Small and Adequate for Gestational Age Pregnancies. J Obstet Gynaecol India 2022; 72:217-223. [PMID: 35928082 PMCID: PMC9343542 DOI: 10.1007/s13224-022-01632-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 02/01/2022] [Indexed: 10/18/2022] Open
Abstract
Background The aim is to assess the levels of fatty acids (FAs) in pregnancies with small for gestational age (SGA) and adequate for gestational age (AGA) fetuses, constituting an association between FAs and fetal growth; according to the role of FA, lower levels were expected in SGA. Materials and Methods This was an analytical cross-sectional study including pregnant women with gestational ages of 26-36 weeks with AGA and constitutionally SGA fetuses diagnosed by ultrasonography. The levels of saturated, trans, monounsaturated, and polyunsaturated fatty acids were measured using centrifugation and liquid chromatography. Student's t test and general linear model using gestational age as covariant were used to compare the levels of FAs and the groups (AGA and SGA). Chi-square was used to evaluate the association between groups and studied variables. Pearson correlation coefficient and linear regression were used to evaluate the correlation between the levels of FAs and gestational age. Results Peripheral blood was collected from 67 pregnant women, 3 of whom were excluded from the study. No significant statistical differences were observed between SGA (n = 40) and AGA (n = 24) in relation to saturated, trans, monounsaturated, and polyunsaturated fatty acids (p > 0.05). There was not significant correlation between saturated, trans, monounsaturated, and polyunsaturated FAs and gestational age (p > 0.05). Conclusion The levels of saturated, trans, monounsaturated, and polyunsaturated FAs were similar in constitutionally SGA and AGA fetuses.
Collapse
|
13
|
Walsh SW, Strauss JF. Pregnancy-specific expression of protease-activated receptor 1: a therapeutic target for prevention and treatment of preeclampsia? Am J Obstet Gynecol 2022; 226:S945-S953. [PMID: 35177224 PMCID: PMC8868505 DOI: 10.1016/j.ajog.2021.11.1367] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 02/03/2023]
Abstract
Neutrophils extensively infiltrate maternal blood vessels in preeclampsia. This could explain why multiple organs are affected in this enigmatic disorder. Lipid peroxides produced by the placenta are probably the first factors that activate neutrophils as they circulate through the intervillous space, but then a second factor specific to pregnancy comes into play, protease-activated receptor 1. The only time neutrophils express protease-activated receptor 1 is during pregnancy. This means that neutrophils can be activated by a mechanism specific to pregnancy, that is, by proteases. Two proteases that are elevated in preeclampsia and activate protease-activated receptor 1 are matrix metalloproteinase-1 and neutrophil elastase. There is an 8-fold increase in vascular protease-activated receptor 1 expression in women with preeclampsia, and protease-activated receptor 1 is also expressed on the placenta, a pregnancy-specific tissue. The question arises if the pregnancy-specific expression of protease-activated receptor 1 is essential to the pathophysiology of preeclampsia. Protease activation of protease-activated receptor 1 in neutrophils of women with normal pregnancies causes activation of RhoA kinase. RhoA kinase phosphorylates nuclear factor-kappa B causing its translocation from the cytosol into the nucleus, increasing the expression of inflammatory genes. This signaling pathway is blocked by inhibition of either protease-activated receptor 1 or RhoA kinase activity. In contrast, neutrophils obtained from preeclamptic women are already activated, with nuclear factor-kappa B localized in the nucleus. Surprisingly, inhibition of either protease-activated receptor 1 or RhoA kinase results in an efflux of nuclear factor-kappa B from the nucleus back into the cytoplasm. Cyclooxygenase-2 seems to be a downstream mediator between protease-activated receptor 1 and RhoA kinase because aspirin inhibits the nuclear translocation of nuclear factor-kappa B and inhibits neutrophil production of superoxide, thromboxane, and tumor necrosis factor alpha. Currently, low-dose aspirin is the standard of care to prevent preeclampsia in high-risk women. Generally, the actions of low-dose aspirin are attributed to selective inhibition of maternal platelet thromboxane production. However, a recent study showed that beneficial effects extend to the placenta, where aspirin corrected the imbalance of increased thromboxane and reduced prostacyclin and oxidative stress. Selective inhibition of placental thromboxane is possible because thromboxane and prostacyclin are compartmentalized. Thromboxane is produced by trophoblast cells and prostacyclin by endothelial cells, so as aspirin crosses the placenta, its levels decline, sparing prostacyclin. Placental oxidative stress is attenuated because cyclooxygenase-2 inhibition decreases the generation of reactive oxygen species to decrease the formation of isoprostanes. The clinical manifestations of preeclampsia can be explained by protease activation of protease-activated receptor 1 in different tissues. In neutrophils, it can account for their activation and inflammatory response. In vascular tissue, protease-activated receptor 1 activation leads to enhanced vascular reactivity to angiotensin II to cause hypertension. In the placenta, it leads to oxidative stress, increased soluble fms-like tyrosine kinase, and thromboxane production. Activation of protease-activated receptor 1 on endothelial cells causes contraction, leading to edema and proteinuria, and activation on platelets leads to coagulation abnormalities. As proteases that activate protease-activated receptor 1 are elevated in the circulation of women with preeclampsia, consideration should be given to the inhibition of protease-activated receptor 1 as a treatment. Recently, The Food and Drug Administration (FDA) approved a protease-activated receptor 1 inhibitor, creating an opportunity to test whether protease-activated receptor 1 inhibition can prevent and/or treat preeclampsia, but a standard dose of aspirin might be just as effective by blocking its downstream actions.
Collapse
|
14
|
Mauro AK, Rengarajan A, Albright C, Boeldt DS. Fatty acids in normal and pathological pregnancies. Mol Cell Endocrinol 2022; 539:111466. [PMID: 34610360 DOI: 10.1016/j.mce.2021.111466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/26/2021] [Accepted: 09/28/2021] [Indexed: 12/26/2022]
Abstract
Long chain fatty acids, namely omega-3 and omega-6, are essential fatty acids and are necessary for proper pregnancy progression and fetal growth and development. Maternal fatty acid consumption and release of fatty acids from lipid stores provide increased availability of fatty acids for the placenta to transport to the growing fetus. Both omega-3 and omega-6 fatty acids are then utilized for generation of signaling molecules, such as eicosanoids, and for promoting of growth and developmental, most notably in the nervous system. Perturbations in fatty acid concentration and fatty acid signaling have been implicated in three major pregnancy complications - gestational diabetes, preeclampsia, and preterm birth. In this review we discuss the growing literature surrounding the role of fatty acids in normal and pathological pregnancies. Differences in maternal, placental, and fetal fatty acids and molecular regulation of fatty acid signaling and transport are presented. A look into novel fatty acid-based therapies for each of the highlighted disorders are discussed, and may present exciting bench to bedside alternatives to traditional pharmacological intervention.
Collapse
Affiliation(s)
- Amanda K Mauro
- Perinatal Research Laboratories, Department of Obstetrics & Gynecology, University of Wisconsin - Madison, School Medicine and Public Health, Madison, WI, 53715, USA
| | - Aishwarya Rengarajan
- Perinatal Research Laboratories, Department of Obstetrics & Gynecology, University of Wisconsin - Madison, School Medicine and Public Health, Madison, WI, 53715, USA
| | - Carly Albright
- Perinatal Research Laboratories, Department of Obstetrics & Gynecology, University of Wisconsin - Madison, School Medicine and Public Health, Madison, WI, 53715, USA
| | - Derek S Boeldt
- Perinatal Research Laboratories, Department of Obstetrics & Gynecology, University of Wisconsin - Madison, School Medicine and Public Health, Madison, WI, 53715, USA.
| |
Collapse
|
15
|
Poniedziałek-Czajkowska E, Mierzyński R. Could Vitamin D Be Effective in Prevention of Preeclampsia? Nutrients 2021; 13:nu13113854. [PMID: 34836111 PMCID: PMC8621759 DOI: 10.3390/nu13113854] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 12/23/2022] Open
Abstract
Prevention of preeclampsia (PE) remains one of the most significant problems in perinatal medicine. Due to the possible unpredictable course of hypertension in pregnancy, primarily PE and the high complication rate for the mother and fetus/newborn, it is urgent to offer pregnant women in high-risk groups effective methods of preventing the PE development or delaying its appearance. In addition, due to the association of PE with an increased risk of developing cardiovascular diseases (CVD) in later life, effective preeclampsia prevention could also be important in reducing their incidence. Ideal PE prophylaxis should target the pathogenetic changes leading to the development of PE and be safe for the mother and fetus, inexpensive and freely available. Currently, the only recognized method of PE prevention recommended by many institutions around the world is the use of a small dose of acetylsalicylic acid in pregnant women with risk factors. Unfortunately, some cases of PE are diagnosed in women without recognized risk factors and in those in whom prophylaxis with acetylsalicylic acid is not adequate. Hence, new drugs which would target pathogenetic elements in the development of preeclampsia are studied. Vitamin D (Vit D) seems to be a promising agent due to its beneficial effect on placental implantation, the immune system, and angiogenic factors. Studies published so far emphasize the relationship of its deficiency with the development of PE, but the data on the benefits of its supplementation to reduce the risk of PE are inconclusive. In the light of current research, the key issue is determining the protective concentration of Vit D in a pregnant woman. The study aims to present the possibility of using Vit D to prevent PE, emphasizing its impact on the pathogenetic elements of preeclampsia development.
Collapse
|
16
|
Sakr HI, Khowailed AA, Al-Fakharany RS, Abdel-Fattah DS, Taha AA. Serum Uric Acid Level as a Predictive Biomarker of Gestational Hypertension Severity; A Prospective Observational Case-Control Study. Rev Recent Clin Trials 2021; 15:227-239. [PMID: 32646363 DOI: 10.2174/1574887115666200709142119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/08/2020] [Accepted: 06/19/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pre-eclampsia poses a significant potential risk of hypertensive disorders during pregnancy, a leading cause of maternal deaths. Hyperuricemia is associated with adverse effects on endothelial function, normal cellular metabolism, and platelet aggregation and adhesion. This study was designed to compare serum urate levels in normotensive pregnant women to those with pregnancy-induced hypertension, and to evaluate its value as a potential predictive marker of hypertension severity during pregnancy. METHODS A prospective, observational, case-control study conducted on 100 pregnant women in their third trimester. Pregnant women were classified into two groups (n=50) according to arterial blood pressure measurements: group I had normal blood pressure, and group II had a blood pressure of ≥ 140/90, which was further subdivided according to hypertension severity into IIa (pregnancy- induced hypertension, IIb (mild pre-eclampsia), and IIc (severe pre-eclampsia). Blood samples were obtained on admission. Serum urate, high sensitive C-reactive protein, and interleukin-1β levels, and lipid profile were compared among the groups. RESULTS A significant increase in the mean values of serum urate, C-reactive protein, and interleukin- 1β levels was detected in gestational hypertensives. In addition, there was a positive correlation between serum urate levels and C-reactive protein and interleukin-1β, as well as between serum urate levels and hypertension severity. CONCLUSION Hyperuricemia and increased C-reactive protein and interleukin-1β serum levels correlate with the severity of pregnancy-induced hypertension, and these biomarkers may play a role in the pathogenesis of pre-eclampsia. Serum urate measurement is sensitive, reliable markers that correlate well with the severity of hypertension in pregnant females with pre-eclampsia.
Collapse
Affiliation(s)
- Hader I Sakr
- Department of Medical Physiology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Akef A Khowailed
- Department of Medical Physiology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Reham S Al-Fakharany
- Department of Medical Physiology, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Dina S Abdel-Fattah
- Department of Biochemistry, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed A Taha
- Department of Obstetrics and Gynecology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| |
Collapse
|
17
|
Ribeiro JC, Braga PC, Martins AD, Silva BM, Alves MG, Oliveira PF. Antioxidants Present in Reproductive Tract Fluids and Their Relevance for Fertility. Antioxidants (Basel) 2021; 10:antiox10091441. [PMID: 34573073 PMCID: PMC8466935 DOI: 10.3390/antiox10091441] [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: 07/29/2021] [Revised: 08/27/2021] [Accepted: 09/05/2021] [Indexed: 12/14/2022] Open
Abstract
Nowadays, infertility is classified as a disease of the reproductive system. Although it does not compromise the life of the individual, it can have detrimental effects on the physiological and psychological health of the couple. Male fertility evaluation is mainly focused on the analysis of sperm parameters. However, the ejaculated fluid is also composed of seminal plasma, and the study of this fluid can provide crucial information to help in the assessment of male fertility status. Total antioxidant capacity of the seminal plasma has been positively correlated with the fertility of men. Moreover, evidence highlights to a similar importance as that of female reproductive tract fluid antioxidant capabilities and female fertility. Herein, we describe the functions of seminal plasma and female reproductive tract fluids, as well as their main antioxidant components and their relationships with fertility outcomes. Additionally, this review contains the most up to date information regarding the mechanisms of the interaction between the male and the female reproductive fluids and the importance of proper antioxidant capacity for fertilization.
Collapse
Affiliation(s)
- João C. Ribeiro
- Department of Anatomy, Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, 4050-313 Porto, Portugal; (J.C.R.); (P.C.B.); (M.G.A.)
- QOPNA & LAQV, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Patrícia C. Braga
- Department of Anatomy, Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, 4050-313 Porto, Portugal; (J.C.R.); (P.C.B.); (M.G.A.)
| | - Ana D. Martins
- QOPNA & LAQV, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Branca M. Silva
- CICS, Faculty of Health Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal;
| | - Marco G. Alves
- Department of Anatomy, Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, 4050-313 Porto, Portugal; (J.C.R.); (P.C.B.); (M.G.A.)
| | - Pedro F. Oliveira
- QOPNA & LAQV, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal;
- Correspondence: ; Tel.: +351-234370718
| |
Collapse
|
18
|
Abstract
Cardiovascular diseases (CVD) constitute the major cause of death worldwide and show a higher prevalence in the adult population. The human umbilical cord consistsof two arteries and one vein, both composed of three tunics. The tunica intima, lined with endothelial cells, regulates vascular tone through the production/release of vasoregulatory substances. These substances can be vasoactive factors released by endothelial cells (ECs) that cause vasodilation (NO, PGI2, EDHF, and Bradykinin) or vasoconstriction (ET1, TXA2, and Ang II) depending on the cell type (ECs or SMC) that reacts to the stimulus. Vascular studies using ECs are important for the analysis of cardiovascular diseases since endothelial dysfunction is an important CVD risk factor. In this paper, we will address the morphological characteristics of the human umbilical cord and its component vessels. the constitution of the vascular endothelium, and the evolution of human umbilical cord-derived endothelial cells when isolated. Moreover, the role played by the endothelium in the vasomotor tone regulation, and how it may be associated with the existence of CVD, were discussed.
Collapse
|
19
|
Habib YH, Gowayed MA, Abdelhady SA, El-Deeb NM, Darwish IE, El-Mas MM. Modulation by antenatal therapies of cardiovascular and renal programming in male and female offspring of preeclamptic rats. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2021; 394:2273-2287. [PMID: 34468816 DOI: 10.1007/s00210-021-02146-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/26/2021] [Indexed: 11/28/2022]
Abstract
Morbidity and mortality risks are enhanced in preeclamptic (PE) mothers and their offspring. Here, we asked if sexual dimorphism exists in (i) cardiovascular and renal damage evolved in offspring of PE mothers, and (ii) offspring responsiveness to antenatal therapies. PE was induced by administering NG-nitro-L-arginine methyl ester (L-NAME, 50 mg/kg/day, oral gavage) to pregnant rats for 7 days starting from gestational day 14. Three therapies were co-administered orally with L-NAME, atrasentan (endothelin ETA receptor antagonist), terutroban (thromboxane A2 receptor antagonist, TXA2), or α-methyldopa (α-MD, central sympatholytic drug). Cardiovascular and renal profiles were assessed in 3-month-old offspring. Compared with offspring of non-PE rats, PE offspring exhibited elevated systolic blood pressure and proteinuria and reduced heart rate and creatinine clearance (CrCl). Apart from a greater bradycardia in male offspring, similar PE effects were noted in male and female offspring. While terutroban, atrasentan, or α-MD partially and similarly blunted the PE-evoked changes in CrCl and proteinuria, terutroban was the only drug that virtually abolished PE hypertension. Rises in cardiorenal inflammatory (tumor necrosis factor alpha, TNFα) and oxidative (isoprostane) markers were mostly and equally eliminated by all therapies in the two sexes, except for a greater dampening action of atrasentan, compared with α-MD, on tissue TNFα in female offspring only. Histopathologically, antenatal terutroban or atrasentan was more effective than α-MD in rectifying cardiac structural damage, myofiber separation, and cytoplasmic alterations, in PE offspring. The repair by antenatal terutroban or atrasentan of cardiovascular and renal anomalies in PE offspring is mostly sex-independent and surpasses the protection offered by α-MD, the conventional PE therapy.
Collapse
Affiliation(s)
- Yasser H Habib
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Pharos University in Alexandria, Alexandria, Egypt
| | - Mennatallah A Gowayed
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Pharos University in Alexandria, Alexandria, Egypt
| | - Sherien A Abdelhady
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Pharos University in Alexandria, Alexandria, Egypt
| | - Nevine M El-Deeb
- Department of Clinical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Inas E Darwish
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Pharos University in Alexandria, Alexandria, Egypt
- Department of Clinical Pharmacology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mahmoud M El-Mas
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt.
- Department of Pharmacology and Toxicology, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
| |
Collapse
|
20
|
Hu X, Zhang L. Uteroplacental Circulation in Normal Pregnancy and Preeclampsia: Functional Adaptation and Maladaptation. Int J Mol Sci 2021; 22:8622. [PMID: 34445328 PMCID: PMC8395300 DOI: 10.3390/ijms22168622] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 02/07/2023] Open
Abstract
Uteroplacental blood flow increases as pregnancy advances. Adequate supply of nutrients and oxygen carried by uteroplacental blood flow is essential for the well-being of the mother and growth/development of the fetus. The uteroplacental hemodynamic change is accomplished primarily through uterine vascular adaptation, involving hormonal regulation of myogenic tone, vasoreactivity, release of vasoactive factors and others, in addition to the remodeling of spiral arteries. In preeclampsia, hormonal and angiogenic imbalance, proinflammatory cytokines and autoantibodies cause dysfunction of both endothelium and vascular smooth muscle cells of the uteroplacental vasculature. Consequently, the vascular dysfunction leads to increased vascular resistance and reduced blood flow in the uteroplacental circulation. In this article, the (mal)adaptation of uteroplacental vascular function in normal pregnancy and preeclampsia and underlying mechanisms are reviewed.
Collapse
Affiliation(s)
- Xiangqun Hu
- Lawrence D. Longo, MD Center for Perinatal Biology, Department of Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
| | - Lubo Zhang
- Lawrence D. Longo, MD Center for Perinatal Biology, Department of Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
| |
Collapse
|
21
|
Walsh SW, Strauss JF. The Road to Low-Dose Aspirin Therapy for the Prevention of Preeclampsia Began with the Placenta. Int J Mol Sci 2021; 22:6985. [PMID: 34209594 PMCID: PMC8268135 DOI: 10.3390/ijms22136985] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/23/2021] [Accepted: 06/23/2021] [Indexed: 01/21/2023] Open
Abstract
The road to low-dose aspirin therapy for the prevention of preeclampsia began in the 1980s with the discovery that there was increased thromboxane and decreased prostacyclin production in placentas of preeclamptic women. At the time, low-dose aspirin therapy was being used to prevent recurrent myocardial infarction and other thrombotic events based on its ability to selectively inhibit thromboxane synthesis without affecting prostacyclin synthesis. With the discovery that thromboxane was increased in preeclamptic women, it was reasonable to evaluate whether low-dose aspirin would be effective for preeclampsia prevention. The first clinical trials were very promising, but then two large multi-center trials dampened enthusiasm until meta-analysis studies showed aspirin was effective, but with caveats. Low-dose aspirin was most effective when started <16 weeks of gestation and at doses >100 mg/day. It was effective in reducing preterm preeclampsia, but not term preeclampsia, and patient compliance and patient weight were important variables. Despite the effectiveness of low-dose aspirin therapy in correcting the placental imbalance between thromboxane and prostacyclin and reducing oxidative stress, some aspirin-treated women still develop preeclampsia. Alterations in placental sphingolipids and hydroxyeicosatetraenoic acids not affected by aspirin, but with biologic actions that could cause preeclampsia, may explain treatment failures. Consideration should be given to aspirin's effect on neutrophils and pregnancy-specific expression of protease-activated receptor 1, as well as additional mechanisms of action to prevent preeclampsia.
Collapse
Affiliation(s)
- Scott W. Walsh
- Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA 23298, USA;
| | | |
Collapse
|
22
|
Habib YH, Abdelhady SA, Gowayed MA, El-Deeb NM, Darwish IE, El-Mas MM. Prenatal endothelin or thromboxane receptor antagonism surpasses sympathoinhibition in improving cardiorenal malfunctions in preeclamptic rats. Toxicol Appl Pharmacol 2021; 426:115615. [PMID: 34102242 DOI: 10.1016/j.taap.2021.115615] [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: 02/08/2021] [Revised: 05/20/2021] [Accepted: 06/04/2021] [Indexed: 01/06/2023]
Abstract
Current therapies for preeclampsia (PE) and its complications are limited and defective. Considering the importance of endothelin (ET) and thromboxane A2 (TXA2) signaling in PE pathophysiology, we tested the hypothesis that prenatal blockade of endothelin ETA or thromboxane TXA2 receptors favorably reprograms preeclamptic cardiovascular and renal insults. PE was induced by daily oral administration of L-NAME (50 mg/kg) to pregnant rats for 7 consecutive days starting from gestational day 14. The effects of co-exposure to atrasentan (ETA receptor blocker, 10 mg/kg/day) or terutroban (TXA2 receptor blocker, 10 mg/kg/day) on cardiovascular and renal anomalies induced by PE were assessed on gestational day 20 (GD20) and at weaning time and compared with those evoked by the sympatholytic drug α-methyldopa (α-MD, 100 mg/kg/day), a prototypic therapy for PE management. Among all drugs, terutroban was basically the most potent in ameliorating PE-evoked increments in blood pressure and decrements in creatinine clearance. Cardiorenal tissues of PE rats exhibited significant increases in ETA and TXA2 receptor expressions and these effects disappeared after treatment with atrasentan and to a lesser extent by terutroban or α-MD. Atrasentan was also the most effective in reversing the reduced ETB receptor expression in renal tissues of PE rats. Signs of histopathological damage in cardiac and renal tissues of PE rats were mostly improved by all therapies. Together, pharmacologic elimination of ETA or TXA2 receptors offers a relatively better prospect than α-MD in controlling perinatal cardiorenal irregularities sparked by PE.
Collapse
Affiliation(s)
- Yasser H Habib
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Pharos University in Alexandria, Alexandria, Egypt
| | - Sherien A Abdelhady
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Pharos University in Alexandria, Alexandria, Egypt
| | - Mennatallah A Gowayed
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Pharos University in Alexandria, Alexandria, Egypt
| | - Nevine M El-Deeb
- Department of Clinical Pathology, Faculty of Medicine, Alexandria University, Egypt
| | - Inas E Darwish
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Pharos University in Alexandria, Alexandria, Egypt; Department of Clinical Pharmacology, Faculty of Medicine, Alexandria University, Egypt
| | - Mahmoud M El-Mas
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Alexandria University, Egypt; Department of Pharmacology and Toxicology, Faculty of Medicine, Kuwait University, Kuwait.
| |
Collapse
|
23
|
Feng X, Liu Y, Zhang Y, Zhang Y, Li H, Zheng Q, Li N, Tang J, Xu Z. New views on endothelial dysfunction in gestational hypertension and potential therapy targets. Drug Discov Today 2021; 26:1420-1436. [PMID: 33677145 DOI: 10.1016/j.drudis.2021.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/10/2020] [Accepted: 03/01/2021] [Indexed: 12/14/2022]
Abstract
The placenta has vital roles in metabolite exchange, fetal growth, and pre-eclampsia (PE). In this review, we discuss the pathogenesis of hypertension in pregnancy, focusing on four major theories to explain PE, discussing endothelial roles in those theories. We focus in particular on the roles of nitric oxide (NO) and prostacyclin (PGI2) in placental endothelium, and propose new hypotheses for the influence and mechanisms of endothelial NO and PGI2 signaling pathways in PE.
Collapse
Affiliation(s)
- Xueqin Feng
- First Hospital of Soochow University & Maternal and Child Health Care Hospital of Wuxi, Jiangsu, China; Department of Obstetrics, Affiliated Hospital of Jining Medical University, Shandong, China
| | - Yanping Liu
- First Hospital of Soochow University & Maternal and Child Health Care Hospital of Wuxi, Jiangsu, China
| | - Yingying Zhang
- First Hospital of Soochow University & Maternal and Child Health Care Hospital of Wuxi, Jiangsu, China
| | - Yumeng Zhang
- First Hospital of Soochow University & Maternal and Child Health Care Hospital of Wuxi, Jiangsu, China
| | - Huan Li
- First Hospital of Soochow University & Maternal and Child Health Care Hospital of Wuxi, Jiangsu, China
| | - Qiutong Zheng
- First Hospital of Soochow University & Maternal and Child Health Care Hospital of Wuxi, Jiangsu, China
| | - Na Li
- First Hospital of Soochow University & Maternal and Child Health Care Hospital of Wuxi, Jiangsu, China
| | - Jiaqi Tang
- First Hospital of Soochow University & Maternal and Child Health Care Hospital of Wuxi, Jiangsu, China.
| | - Zhice Xu
- First Hospital of Soochow University & Maternal and Child Health Care Hospital of Wuxi, Jiangsu, China.
| |
Collapse
|
24
|
Abstract
Preeclampsia (PE) is associated with long-term morbidity in mothers and lifelong morbidities for their children, ranging from cerebral palsy and cognitive delay in preterm infants, to hypertension, diabetes and obesity in adolescents and young adults. There are several processes that are critical for development of materno-fetal exchange, including establishing adequate perfusion of the placenta by maternal blood, and the formation of the placental villous vascular tree. Recent studies provide persuasive evidence that placenta-derived extracellular vesicles (EVs) represent a significant intercellular communication pathway, and that they may play an important role in placental and endothelial cell (both fetal and maternal) function. These functions are known to be altered in PE. EVs can carry and transport a wide range of bioactive molescules that have potential to be used as biomarkers and therapeutic delivery tools for PE. EV content is often parent cell specific, thus providing an insight or "thumbprint" of the intracellular environment of the originating cell (e.g., human placenta). EV have been identified in plasma under both normal and pathological conditions, including PE. The concentration of EVs and their content in plasma has been reported to increase in association with disease severity and/or progression. Placenta-derived EVs have been identified in maternal plasma during normal pregnancy and PE pregnancies. They contain placenta-specific proteins and miRNAs and, as such, may be differentiated from maternally-derived EVs. The aim of this review, thus, is to describe the potential roles of EVs in preecmpatic pregnancies, focussing on EVs secreted from placental cells. The biogenesis, specificity of placental EVs, and methods used to characterise EVs in the context of PE pregnancies will be also discussed.
Collapse
|
25
|
Zhang Y, Shen F, Yang W, Wang J, Zhou J, Chen Y. Effects of low-molecular-weight heparin and aspirin in recurrent pre-eclampsia: A stratified cohort study. Int J Gynaecol Obstet 2020; 154:337-342. [PMID: 33314052 DOI: 10.1002/ijgo.13535] [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: 05/28/2020] [Revised: 10/09/2020] [Accepted: 12/11/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate the effects of low-molecular-weight heparin (LMWH) combined with low-dose aspirin (LDA) in pregnant women with a history of pregnancy-related hypertensive disorders. METHODS In the current retrospective stratified cohort study, 33 women with previous hypertensive disorders of pregnancy treated with LMWH and LDA were compared with 37 control women who did not undergo LMWH or LDA treatment. Rates of pre-eclampsia recurrence, placental abruption, and other adverse outcomes for the fetuses and pregnant women were compared in the two groups. RESULTS The pre-eclampsia recurrence rates were 12/33 (36.4%) in the LMWH + LDA group and 28/37 (75.7%) in the control group (P < 0.01). In stratified cohort analysis, pregnant women with a history of early-onset pre-eclampsia, a body mass index of at least 24 (calculated as weight in kilograms divided by the square of height in meters), and aged less than 35 years benefited from LMWH + LDA treatment. In women with chronic hypertension or a history of placental abruption there was no protective effect. There were no significant differences in other adverse outcomes such as placental abruption and small size for gestational age in fetuses or pregnant women in the two groups. CONCLUSION Administration of LMWH + LDA only lowered the risk of pre-eclampsia recurrence in subgroups of pregnant women with a history of pregnancy-associated hypertensive disorders.
Collapse
Affiliation(s)
- Yi Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Fangrong Shen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Weiwen Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Juan Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jinhua Zhou
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Youguo Chen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
26
|
The Role of Arachidonic and Linoleic Acid Derivatives in Pathological Pregnancies and the Human Reproduction Process. Int J Mol Sci 2020; 21:ijms21249628. [PMID: 33348841 PMCID: PMC7766587 DOI: 10.3390/ijms21249628] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/13/2020] [Accepted: 12/15/2020] [Indexed: 02/07/2023] Open
Abstract
The aim of the available literature review was to focus on the role of the proinflammatory mediators of AA and LA derivatives in pathological conditions related to reproduction and pregnancy. Arachidonic (AA) and linoleic acid (LA) derivatives play important roles in human fertility and the course of pathological pregnancies. Recent studies have demonstrated that uncontrolled inflammation has a significant impact on reproduction, spermatogenesis, endometriosis, polycystic ovary syndrome (PCOS) genesis, implantation, pregnancy and labor. In addition, cyclooxygenase-mediated prostaglandins and AA metabolite levels are higher in women’s ovarian tissue when suffering from PCOS. It has been demonstrated that abnormal cyclooxygenase-2 (COX-2) levels are associated with ovulation failure, infertility, and implantation disorders and the increase in 9-HODE/13-HODE was a feature recognized in PCOS patients. Maintaining inflammation without neutrophil participation allows pregnant women to tolerate the fetus, while excessive inflammatory activation may lead to miscarriages and other pathological complications in pregnancies. Additionally AA and LA derivatives play an important role in pregnancy pathologies, e.g., gestational diabetes mellitus, preeclampsia (PE), and fetal growth, among others. The pathogenesis of PE and other pathological states in pregnancy involving eicosanoids have not been fully identified. A significant expression of 15-LOX-1,2 was found in women with PE, leading to an increase in the synthesis of AA and LA derivatives, such as hydroxyeicozatetraenoic acids (HETE) and hydroxyoctadecadiene acids (HODE). Synthesis of the metabolites 5-, 8-, 12-, and 15-HETE increased in the placenta, while 20-HETE increased only in umbilical cord blood in women with preeclampsia compared to normal pregnancies. In obese women with gestational diabetes mellitus (GDM) an increase in epoxygenase products in the cytochrome P450 (CYP) and the level of 20-HETE associated with the occurrence of insulin resistance (IR) were found. In addition, 12- and 20-HETE levels were associated with arterial vasoconstriction and epoxyeicosatrienoic acids (EETs) with arterial vasodilatation and uterine relaxation. Furthermore, higher levels of 5- and 15-HETE were associated with premature labor. By analyzing the influence of free fatty acids (FFA) and their derivatives on male reproduction, it was found that an increase in the AA in semen reduces its amount and the ratio of omega-6 to omega-3 fatty acids showed higher values in infertile men compared to the fertile control group. There are several studies on the role of HETE/HODE in relation to male fertility. 15-Hydroperoxyeicosatetraenoic acid may affect the integrity of the membrane and sperm function. Moreover, the incubation of sperm with physiologically low levels of prostaglandins (PGE2/PGF2α) improves the functionality of human sperm. Undoubtedly, these problems are still insufficiently understood and require further research. However, HETE and HODE could serve as predictive and diagnostic biomarkers for pregnancy pathologies (especially in women with risk factors for overweight and obesity). Such knowledge may be helpful in finding new treatment strategies for infertility and the course of high-risk pregnancies.
Collapse
|
27
|
Abstract
Preeclampsia is an obstetric disorder that affects 3-8% of pregnant women and remains a leading cause of short- and long-term neonatal and maternal morbidity and mortality. Professional societies recommend the use of low dose aspirin to prevent preeclampsia in high-risk women. However, interest in prevention of this disease and better understanding of its pathophysiology have led to growing research on other agents. This review focuses on the main therapeutic agents evaluated or in use for preeclampsia prevention.
Collapse
|
28
|
Walsh SW, Nugent WH, Al Dulaimi M, Washington SL, Dacha P, Strauss JF. Proteases Activate Pregnancy Neutrophils by a Protease-Activated Receptor 1 Pathway: Epigenetic Implications for Preeclampsia. Reprod Sci 2020; 27:2115-2127. [PMID: 32542542 DOI: 10.1007/s43032-020-00232-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/04/2020] [Accepted: 06/03/2020] [Indexed: 12/14/2022]
Abstract
We tested a novel hypothesis that elevated levels of proteases in the maternal circulation of preeclamptic women activate neutrophils due to their pregnancy-specific expression of protease-activated receptor 1 (PAR-1). Plasma was collected longitudinally from normal pregnant and preeclamptic women and analyzed for MMP-1 and neutrophil elastase. Neutrophils were isolated for culture and confocal microscopy. Omental fat was collected for immunohistochemistry. Circulating proteases were significantly elevated in preeclampsia. Confocal microscopy revealed that tet methylcytosine dioxygenase 2 (TET2), a DNA de-methylase, and p65 subunit of NF-κB were strongly localized to the nucleus of untreated neutrophils of preeclamptic women, but in untreated neutrophils of normal pregnant women they were restricted to the cytosol. Treatment of normal pregnancy neutrophils with proteases activated PAR-1, leading to activation of RhoA kinase (ROCK), which triggered translocation of TET2 and p65 from the cytosol into the nucleus, mimicking the nuclear localization in neutrophils of preeclamptic women. IL-8, an NF-κB-regulated gene, increased in association with TET2 and p65 nuclear localization. Co-treatment with inhibitors of PAR-1 or ROCK prevented nuclear translocation and IL-8 did not increase. Treatment of preeclamptic pregnancy neutrophils with inhibitors emptied the nucleus of TET2 and p65, mimicking the cytosolic localization of normal pregnancy neutrophils. Expression of PAR-1 and TET2 were markedly increased in omental fat vessels and neutrophils of preeclamptic women. We conclude that elevated levels of circulating proteases in preeclamptic women activate neutrophils due to their pregnancy-specific expression of PAR-1 and speculate that TET2 DNA de-methylation plays a role in the inflammatory response.
Collapse
Affiliation(s)
- Scott W Walsh
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0034, USA.
- Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0034, USA.
| | - William H Nugent
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0034, USA
| | - Marwah Al Dulaimi
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0034, USA
| | - Sonya L Washington
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0034, USA
| | - Phoebe Dacha
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0034, USA
| | - Jerome F Strauss
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0034, USA
| |
Collapse
|
29
|
Nandi A, Wadhwani N, Randhir K, Wagh G, Joshi SR. Association of vitamin D with fatty acids in pregnancy. Prostaglandins Leukot Essent Fatty Acids 2020; 157:102030. [PMID: 31753523 DOI: 10.1016/j.plefa.2019.102030] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 11/05/2019] [Indexed: 12/24/2022]
Abstract
Preeclampsia is a pregnancy complication, associated with an increased risk of maternal and neonatal morbidity and mortality. The etiology of preeclampsia is not yet fully understood, although the current literature indicates an up regulation of inflammatory mediators. Vitamin D is known to have anti-inflammatory properties and influence vascular function. Fatty acids are also known to regulate inflammation in pregnancy. This study was carried out to explore the association of maternal vitamin D and fatty acids in pregnancy. The present study includes 69 normotensive control (NC) and 50 women with preeclampsia (PE). Maternal and cord serum 25-hydroxyvitamin D [25(OH)D] levels were lower (p<0.01for both) in women with PE compared to NC women. Maternal plasma total polyunsaturated fatty acids (PUFA) levels were lower (p<0.05) while levels of total saturated fatty acids (SFA) and total monounsaturated fatty acids (MUFA) were higher (p<0.05 for both) in women with PE. Cord erythrocyte PUFA levels were higher (p<0.01) in PE women. Maternal 25(OH)D levels were negatively associated with maternal systolic and diastolic BP (p<0.01 for both). Maternal 25(OH)D levels were positively associated with maternal total PUFA (p<0.01) and negatively associated with maternal total SFA (p<0.05), total MUFA (p<0.01). This study for the first time demonstrates an association of maternal vitamin D with fatty acid levels in pregnancy. Our results suggest that vitamin D and fatty acids may work in concert to regulate fetal growth.
Collapse
Affiliation(s)
- A Nandi
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune Satara Road, Pune, Maharashtra 411043, India
| | - N Wadhwani
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune Satara Road, Pune, Maharashtra 411043, India
| | - K Randhir
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune Satara Road, Pune, Maharashtra 411043, India
| | - G Wagh
- Department of Obstetrics and Gynaecology, Bharati Medical College and Hospital, Bharati Vidyapeeth (Deemed to be University), Pune Satara Road, Pune, Maharashtra 411043, India
| | - S R Joshi
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune Satara Road, Pune, Maharashtra 411043, India.
| |
Collapse
|
30
|
Abstract
PURPOSE OF REVIEW To review the rationale and biological plausibility and discuss the current research on novel interventions for the prevention of preeclampsia. RECENT FINDINGS Preeclampsia affects up to 8% of pregnancies worldwide and remains a major cause of maternal and neonatal morbidity and mortality. Multiple medications have been investigated or repurposed as potential effective interventions for preeclampsia prevention. Aspirin is currently the only drug for which there is some evidence of benefit for preeclampsia prevention, and its use is recommended by professional societies for pregnancies at risk. Statins have shown promise for prevention of preeclampsia in animal models and human pilot studies, without any trend or concerns for safety signals or teratogenicity. The use of metformin has also gained popularity in experimental studies, but observations from randomized clinical trials were not consistent on its utility as a possible intervention for preeclampsia prevention. While initial studies evaluating esomeprazole were promising, randomized trials failed to show benefit. Contemporary research shows exciting new opportunities for prophylactic treatment for preeclampsia, to prevent this debilitating and life-threatening disease.
Collapse
Affiliation(s)
- Marwan Ma'ayeh
- Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, 395 W 12th Avenue, Columbus, OH, 43210, USA. Marwan.Ma'
| | - Kara M Rood
- Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, 395 W 12th Avenue, Columbus, OH, 43210, USA
| | - Douglas Kniss
- Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, 395 W 12th Avenue, Columbus, OH, 43210, USA
| | - Maged M Costantine
- Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, 395 W 12th Avenue, Columbus, OH, 43210, USA
| |
Collapse
|
31
|
Molecular Targets of Aspirin and Prevention of Preeclampsia and Their Potential Association with Circulating Extracellular Vesicles during Pregnancy. Int J Mol Sci 2019; 20:ijms20184370. [PMID: 31492014 PMCID: PMC6769718 DOI: 10.3390/ijms20184370] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 07/30/2019] [Accepted: 08/26/2019] [Indexed: 12/26/2022] Open
Abstract
Uncomplicated healthy pregnancy is the outcome of successful fertilization, implantation of embryos, trophoblast development and adequate placentation. Any deviation in these cascades of events may lead to complicated pregnancies such as preeclampsia (PE). The current incidence of PE is 2–8% in all pregnancies worldwide, leading to high maternal as well as perinatal mortality and morbidity rates. A number of randomized controlled clinical trials observed the association between low dose aspirin (LDA) treatment in early gestational age and significant reduction of early onset of PE in high-risk pregnant women. However, a substantial knowledge gap exists in identifying the particular mechanism of action of aspirin on placental function. It is already established that the placental-derived exosomes (PdE) are present in the maternal circulation from 6 weeks of gestation, and exosomes contain bioactive molecules such as proteins, lipids and RNA that are a “fingerprint” of their originating cells. Interestingly, levels of exosomes are higher in PE compared to normal pregnancies, and changes in the level of PdE during the first trimester may be used to classify women at risk for developing PE. The aim of this review is to discuss the mechanisms of action of LDA on placental and maternal physiological systems including the role of PdE in these phenomena. This review article will contribute to the in-depth understanding of LDA-induced PE prevention.
Collapse
|
32
|
Pogorelova TN, Krukier II, Gunko VO, Nikashina AA, Alliluev IA, Larichkin AV. [The imbalance of vasoactive components and arachidonic acid in the placenta and amniotic fluid in preeclampsia]. BIOMEDIT︠S︡INSKAI︠A︡ KHIMII︠A︡ 2019; 65:245-250. [PMID: 31258149 DOI: 10.18097/pbmc20196503245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The content of vasoactive compounds and arachidonic acid in the placenta and amniotic fluid was studied in full-term (39-40 weeks) physiological pregnancy and preeclampsia (PE). The content of metabolites of nitric oxide (NOx), endothelin-1, thromboxane B2 (TxB2), prostacycline (PGI2) and arachidonic acid was estimated using spectrophotometric, immunoenzyme methods and gas-liquid chromatography. It was found that in PE the content of vasoconstrictors, of endothelin and TxB2, increased in the placenta and amniotic fluid, while the content of vasodilators, PGI2 and NOx decreased. Despite the same directionality of changes in both studied objects, the degree of changes differed and was more pronounced in the placenta. A direct or inverse correlative relationship was found between various vasoactive components (depending on their effect on vascular tone). In the case of arachidonic acid changes in its content in PE correlated with the level of vasoactive compounds, the source of which it is. The revealed differences in the ratio of vasoactive components obviously play a pathogenetic role in the development of PE and its subsequent complications.
Collapse
Affiliation(s)
- T N Pogorelova
- Scientific-Research Institute of Obstetrics and Pediatrics of Rostov State Medical University, Rostov-on-Don, Russia
| | - I I Krukier
- Scientific-Research Institute of Obstetrics and Pediatrics of Rostov State Medical University, Rostov-on-Don, Russia
| | - V O Gunko
- Scientific-Research Institute of Obstetrics and Pediatrics of Rostov State Medical University, Rostov-on-Don, Russia
| | - A A Nikashina
- Scientific-Research Institute of Obstetrics and Pediatrics of Rostov State Medical University, Rostov-on-Don, Russia
| | - I A Alliluev
- Scientific-Research Institute of Obstetrics and Pediatrics of Rostov State Medical University, Rostov-on-Don, Russia; Academy of Biology and Biotechnology of the South Federal University, Rostov-on-Don, Russia
| | - A V Larichkin
- Scientific-Research Institute of Obstetrics and Pediatrics of Rostov State Medical University, Rostov-on-Don, Russia
| |
Collapse
|
33
|
Obesity and laboratory aspirin resistance in high-risk pregnant women treated with low-dose aspirin. Am J Obstet Gynecol 2019; 220:385.e1-385.e6. [PMID: 30786253 DOI: 10.1016/j.ajog.2019.01.222] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/14/2019] [Accepted: 01/21/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Low-dose aspirin is used for preeclampsia prevention in high-risk women, but the precise mechanism and optimal dose are unknown. Evidence suggests that an imbalance in prostacyclin and thromboxane A2 (TXA2) plays a key role in the pathogenesis of preeclampsia. Aspirin has a dose-dependent effect blocking production of TXA2, a potent stimulator of platelet aggregation and promoter of vasoconstriction. Incomplete inhibition of platelet aggregation, designated aspirin resistance, can be reduced by increasing the aspirin dose. Evidence in the nonobstetric literature suggests that aspirin resistance may be more common among patients with a high body mass index. OBJECTIVE To investigate the association of obesity on platelet-derived thromboxane inhibition in high-risk women treated with low-dose aspirin. MATERIALS AND METHODS This was a secondary analysis of a prospective multi-centered study investigating the effect of low-dose aspirin (60-mg) administration in women at high risk for preeclampsia. Maternal serum TXB2 (an indirect measure of TxA2) levels were drawn at 3 time points: randomization (13-26 weeks' gestation), second trimester (at least 2 weeks after randomization and 24-28 weeks' gestation), and third trimester (34-38 weeks' gestation). Patients were included in the analysis if a TXB2 level was recorded at randomization and at least 1 time point thereafter. Patients were stratified by body mass index category and treatment arm. Median TXB2 levels were calculated at each time point, as well as rates of complete TXB2 inhibition (<0.01 ng/mL). A multivariate logistic regression analysis was performed to generate odds ratios (OR) for complete TXB2 inhibition by body mass index category, adjusting for maternal age, race, high-risk group at randomization, nulliparity, and rate of randomization less than 16 weeks' gestation. RESULTS A total of 1002 patients were included in the analysis, 496 (49.5%) and 506 (50.5%) in the low-dose aspirin and placebo groups respectively. There were substantial decreases in TXB2 levels among low-dose aspirin-treated women in all body mass index categories. In contrast, women assigned to placebo did not show a marked decrease in TXB2 levels after randomization, and obese women had higher median TXB2 levels in both the second (16.5, interquartile range [IQR] 8.0-31.8 vs 14.0, IQR 6.9-26.7, ng/mL; P = .032) and third (15.7, IQR 7.6-28.5 vs 11.9, IQR 4.6-25.9, ng/mL; P = .043) trimesters. When comparing among stratified body mass index low-dose aspirin groups, women with class III obesity had the lowest odds of undetectable TXB2 levels in the second trimester (adjusted odds ratio [aOR], 0.33; 95% confidence interval [CI], 0.15-0.72) and third trimester (aOR, 0.30; 95% CI, 0.11-0.78) as well as at both time points (aOR, 0.09; 95% CI, 0.02-0.41). CONCLUSION High-risk obese women receiving low-dose aspirin for the prevention of preeclampsia have lower rates of complete inhibition of TXB2. These data suggest that an increase in aspirin dosing or frequency may be necessary in this population.
Collapse
|
34
|
Atallah A, Lecarpentier E, Goffinet F, Gaucherand P, Doret-Dion M, Tsatsaris V. [Aspirin and preeclampsia]. Presse Med 2019; 48:34-45. [PMID: 30665790 DOI: 10.1016/j.lpm.2018.11.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/02/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022] Open
Abstract
Indications for aspirin during pregnancy are a matter of debate and there is a recent trend to an extended prescription and an overuse of aspirin in pregnancy. Aspirin is efficient in secondary prevention of preeclampsia essentially in patients with a personal history of preeclampsia. The effect of aspirin on platelet aggregation and on the TXA2/PGI2 balance is dose-dependent. The optimum dosage, from 75mg/day to 150mg/day, needs to be determined. Fetal safety data at 150mg/day are still limited. The efficacy of aspirin seems to be subject to a chronobiological effect. It is recommended to prescribe an evening or bedtime intake. Aspirin, in primary prevention of preeclampsia, given to high-risk patients identified in the first trimester by screening tests, seems to reduce the occurrence of early-onset preeclampsia. Nevertheless, there are insufficient data for the implementation of such screening procedures in practice.
Collapse
Affiliation(s)
- Anthony Atallah
- Groupement hospitalier Est, centre hospitalier universitaire, département de gynécologie-obstétrique, maternité de l'hôpital Femme-Mère-Enfant, hospices civils de Lyon, 59, boulevard Pinel, 69100 Bron, France; Université Claude-Bernard Lyon1, Lyon, France.
| | - Edouard Lecarpentier
- Centre hospitalier intercommunal de Créteil, centre hospitalier universitaire, université Paris Est Créteil, département de gynécologie-obstétrique, maternité de l'hôpital intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France
| | - François Goffinet
- Assistance publique-Hôpital de Paris, centre hospitalier universitaire Cochin Broca Hôtel-Dieu, groupe hospitalier universitaire Ouest, département de gynécologie-obstétrique, maternité de Port-Royal, 53, avenue de l'Observatoire, 75014 Paris, France; PRES Sorbonne Paris Cité, université Paris Descartes, Paris, France; Fondation PremUP, Paris, France; DHU Risques et grossesse, Paris, France
| | - Pascal Gaucherand
- Groupement hospitalier Est, centre hospitalier universitaire, département de gynécologie-obstétrique, maternité de l'hôpital Femme-Mère-Enfant, hospices civils de Lyon, 59, boulevard Pinel, 69100 Bron, France; Université Claude-Bernard Lyon1, Lyon, France
| | - Muriel Doret-Dion
- Groupement hospitalier Est, centre hospitalier universitaire, département de gynécologie-obstétrique, maternité de l'hôpital Femme-Mère-Enfant, hospices civils de Lyon, 59, boulevard Pinel, 69100 Bron, France; Université Claude-Bernard Lyon1, Lyon, France
| | - Vassilis Tsatsaris
- Assistance publique-Hôpital de Paris, centre hospitalier universitaire Cochin Broca Hôtel-Dieu, groupe hospitalier universitaire Ouest, département de gynécologie-obstétrique, maternité de Port-Royal, 53, avenue de l'Observatoire, 75014 Paris, France; PRES Sorbonne Paris Cité, université Paris Descartes, Paris, France; Fondation PremUP, Paris, France; DHU Risques et grossesse, Paris, France
| |
Collapse
|
35
|
Antiplatelet Drugs in the Management of Venous Thromboembolism, Cardioembolism, Ventricular Assist Devices, and Pregnancy Complications. Platelets 2019. [DOI: 10.1016/b978-0-12-813456-6.00059-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
36
|
Maaliki D, Issa K, Al Shehabi T, El-Yazbi A, Eid AH. The role of α2-adrenergic receptors in hypertensive preeclampsia: A hypothesis. Microcirculation 2018; 26:e12511. [PMID: 30383326 DOI: 10.1111/micc.12511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 10/18/2018] [Accepted: 10/29/2018] [Indexed: 02/06/2023]
Abstract
Preeclampsia, a major disorder of human pregnancy, manifests as persistent hypertension and proteinuria presenting after 20 weeks of pregnancy. Multiple systemic symptoms might be associated with preeclampsia including thrombocytopenia, liver impairment, pulmonary edema, and cerebral disturbances. However, vascular dysfunction remains the core pathological driver of preeclampsia. Defective placental implantation followed by dysfunctional placental spiral artery development promotes a hypoxic environment. Massive endothelial dysfunction characterized by reduced vasodilation, augmented vasoconstriction, and increased vascular permeability and inflammation ensues. Interestingly, the same signaling and inflammatory pathways implicated in preeclampsia appear to be shared with other vascular disorders involving alteration of α2 -AR function. The role of α2 -ARs in the regulation of microcirculatory function has long been recognized, thus raising the question of whether they are involved in the pathogenesis of vascular dysfunction in preeclampsia. Here, we review possible interplay between signaling and inflammatory pathways common to preeclampsia and α2 -AR function/regulation. We speculate on the potential contribution of these receptors to the observed phenotype and the potential role for their pharmacological modulators as therapeutic interventions with preeclampsia.
Collapse
Affiliation(s)
- Dina Maaliki
- Department of Pharmacology and Toxicology, American University of Beirut, Beirut, Lebanon
| | - Khodr Issa
- Department of Pharmacology and Toxicology, American University of Beirut, Beirut, Lebanon
| | - Tuqa Al Shehabi
- Department of Biological and Environmental Sciences, Qatar University, Doha, Qatar
| | - Ahmed El-Yazbi
- Department of Pharmacology and Toxicology, American University of Beirut, Beirut, Lebanon.,Department of Pharmacology and Toxicology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
| | - Ali H Eid
- Department of Pharmacology and Toxicology, American University of Beirut, Beirut, Lebanon.,Department of Biological and Environmental Sciences, Qatar University, Doha, Qatar.,Department of Biomedical Sciences, Qatar University, Doha, Qatar
| |
Collapse
|
37
|
Zhu J, Huang R, Zhang J, Ye W, Zhang J. A prophylactic low-dose aspirin earlier than 12 weeks until delivery should be considered to prevent preeclampsia. Med Hypotheses 2018; 121:127-130. [PMID: 30396465 DOI: 10.1016/j.mehy.2018.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 08/01/2018] [Accepted: 08/07/2018] [Indexed: 02/07/2023]
Abstract
Clinical trials and meta-analyses have demonstrated that low-dose aspirin can reduce the risk of preeclampsia and fetal growth restriction in high-risk pregnant women. Current obstetric guidelines recommend that the administration of low-dose aspirin to prevent preeclampsia be initiated after 12 weeks' gestation. This starting time was chosen to minimize possible risks of maternal bleeding and fetal anomalies. However, evidence from reproductive medicine, where low-dose aspirin is commonly recommended to use before and in early pregnancy, as well as existing literature, does not support these concerns. On the other hand, defective placentation resulting in a subsequent ischemic placenta is considered as the starting point of preeclampsia. Low-dose aspirin initiated in early pregnancy can balance the levels of thromboxane A2 and prostacyclin and maintain adequate uteroplacental blood flow and, therefore, improve placentation. Thus, an initiation of low-dose aspirin earlier than 12 weeks can be considered. Meanwhile, evidence shows that low-dose aspirin can improve maternal vascular endothelial function without increasing the risks of adverse maternal and perinatal outcomes. Therefore, it appears safe to use low-dose aspirin as a prophylactic until delivery.
Collapse
Affiliation(s)
- Jing Zhu
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Huang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinwen Zhang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Jiao Tong University School of Public Health, Shanghai, China
| | - Weiping Ye
- Department of Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Jiao Tong University School of Public Health, Shanghai, China.
| |
Collapse
|
38
|
Lu J, Wang Z, Cao J, Chen Y, Dong Y. A novel and compact review on the role of oxidative stress in female reproduction. Reprod Biol Endocrinol 2018; 16:80. [PMID: 30126412 PMCID: PMC6102891 DOI: 10.1186/s12958-018-0391-5] [Citation(s) in RCA: 252] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 07/23/2018] [Indexed: 12/30/2022] Open
Abstract
In recent years, the study of oxidative stress (OS) has become increasingly popular. In particular, the role of OS on female fertility is very important and has been focused on closely. The occurrence of OS is due to the excessive production of reactive oxygen species (ROS). ROS are a double-edged sword; they not only play an important role as secondary messengers in many intracellular signaling cascades, but they also exert indispensable effects on pathological processes involving the female genital tract. ROS and antioxidants join in the regulation of reproductive processes in both animals and humans. Imbalances between pro-oxidants and antioxidants could lead to a number of female reproductive diseases. This review focuses on the mechanism of OS and a series of female reproductive processes, explaining the role of OS in female reproduction and female reproductive diseases caused by OS, including polycystic ovary syndrome (PCOS), endometriosis, preeclampsia and so on. Many signaling pathways involved in female reproduction, including the Keap1-Nrf2, NF-κB, FOXO and MAPK pathways, which are affected by OS, are described, providing new ideas for the mechanism of reproductive diseases.
Collapse
Affiliation(s)
- Jiayin Lu
- Laboratory of Neurobiology, College of Animal Medicine, China Agricultural University, Haidian, Beijing, 100193 People’s Republic of China
| | - Zixu Wang
- Laboratory of Neurobiology, College of Animal Medicine, China Agricultural University, Haidian, Beijing, 100193 People’s Republic of China
| | - Jing Cao
- Laboratory of Neurobiology, College of Animal Medicine, China Agricultural University, Haidian, Beijing, 100193 People’s Republic of China
| | - Yaoxing Chen
- Laboratory of Neurobiology, College of Animal Medicine, China Agricultural University, Haidian, Beijing, 100193 People’s Republic of China
| | - Yulan Dong
- Laboratory of Neurobiology, College of Animal Medicine, China Agricultural University, Haidian, Beijing, 100193 People’s Republic of China
| |
Collapse
|
39
|
Khaliq OP, Konoshita T, Moodley J, Naicker T. The Role of Uric Acid in Preeclampsia: Is Uric Acid a Causative Factor or a Sign of Preeclampsia? Curr Hypertens Rep 2018; 20:80. [PMID: 29992361 DOI: 10.1007/s11906-018-0878-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW Because of the significant discrepancies on this topic, this review will focus on the role of uric acid in PE, uric acid as a predictor of preeclampsia and fetal growth retardation. We considered eligible review and original articles relevant to the research question. RECENT FINDINGS Hypertensive disorders of pregnancy such as preeclampsia (PE) are a major cause of both maternal and fetal morbidity and mortality worldwide. Uric acid has been reported as a key factor contributing to the pathogenesis of PE. Some studies have indicated that serum uric acid levels increase with the severity of PE, while several studies have shown contradictory results. Some studies suggested high uric acid levels lead to PE, while others state that PE causes an increase in uric acid levels. Despite the strong association of uric acid in the pathogenesis of preeclampsia, current data is still contradictory hence genetic and high-end laboratory investigations may clarify this enigma.
Collapse
Affiliation(s)
- Olive P Khaliq
- Optics and Imaging Centre, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
| | - Tadashi Konoshita
- Third Department of Internal Medicine, University of Fukui Faculty of Medicine Sciences, Fukui, Japan
| | - Jagidesa Moodley
- Department of Obstetrics and Gynaecology and Women's Health and HIV Research Group, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Thajasvarie Naicker
- Optics and Imaging Centre, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
| |
Collapse
|
40
|
Karemore MN, Avari JG. Zeta potential as a novel diagnostic tool for preeclampsia. Pregnancy Hypertens 2018; 13:187-197. [DOI: 10.1016/j.preghy.2018.06.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/10/2018] [Accepted: 06/22/2018] [Indexed: 11/28/2022]
|
41
|
Plenty NL, Faulkner JL, Cotton J, Spencer SK, Wallace K, LaMarca B, Murphy SR. Arachidonic acid metabolites of CYP4A and CYP4F are altered in women with preeclampsia. Prostaglandins Other Lipid Mediat 2018; 136:15-22. [DOI: 10.1016/j.prostaglandins.2018.03.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 02/24/2018] [Accepted: 03/01/2018] [Indexed: 01/25/2023]
|
42
|
Washington K, Ghosh S, Reeves IV. A Review: Molecular Concepts and Common Pathways Involving Vitamin D in the Pathophysiology of Preeclampsia. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/ojog.2018.83023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
43
|
Mous DS, Buscop-van Kempen MJ, Wijnen RMH, Tibboel D, Rottier RJ. Changes in vasoactive pathways in congenital diaphragmatic hernia associated pulmonary hypertension explain unresponsiveness to pharmacotherapy. Respir Res 2017; 18:187. [PMID: 29115963 PMCID: PMC5688796 DOI: 10.1186/s12931-017-0670-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/31/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with congenital diaphragmatic hernia (CDH) have structural and functional different pulmonary vessels, leading to pulmonary hypertension. They often fail to respond to standard vasodilator therapy targeting the major vasoactive pathways, causing a high morbidity and mortality. We analyzed whether the expression of crucial members of these vasoactive pathways could explain the lack of responsiveness to therapy in CDH patients. METHODS The expression of direct targets of current vasodilator therapy in the endothelin and prostacyclin pathway was analyzed in human lung specimens of control and CDH patients. RESULTS CDH lungs showed increased expression of both ETA and ETB endothelin receptors and the rate-limiting Endothelin Converting Enzyme (ECE-1), and a decreased expression of the prostaglandin-I2 receptor (PTGIR). These data were supported by increased expression of both endothelin receptors and ECE-1, endothelial nitric oxide synthase and PTGIR in the well-established nitrofen-CDH rodent model. CONCLUSIONS Together, these data demonstrate aberrant expression of targeted receptors in the endothelin and prostacyclin pathway in CDH already early during development. The analysis of this unique patient material may explain why a significant number of patients do not respond to vasodilator therapy. This knowledge could have important implications for the choice of drugs and the design of future clinical trials internationally.
Collapse
Affiliation(s)
- Daphne S Mous
- Department of Pediatric Surgery, Erasmus Medical Center, Sophia Children's Hospital, Wytemaweg 80, 3015 CN, PO Box 2040, Rotterdam, The Netherlands
| | - Marjon J Buscop-van Kempen
- Department of Pediatric Surgery, Erasmus Medical Center, Sophia Children's Hospital, Wytemaweg 80, 3015 CN, PO Box 2040, Rotterdam, The Netherlands
| | - Rene M H Wijnen
- Department of Pediatric Surgery, Erasmus Medical Center, Sophia Children's Hospital, Wytemaweg 80, 3015 CN, PO Box 2040, Rotterdam, The Netherlands
| | - Dick Tibboel
- Department of Pediatric Surgery, Erasmus Medical Center, Sophia Children's Hospital, Wytemaweg 80, 3015 CN, PO Box 2040, Rotterdam, The Netherlands
| | - Robbert J Rottier
- Department of Pediatric Surgery, Erasmus Medical Center, Sophia Children's Hospital, Wytemaweg 80, 3015 CN, PO Box 2040, Rotterdam, The Netherlands. .,Department of Cell Biology, Erasmus Medical Center, Rotterdam, The Netherlands.
| |
Collapse
|
44
|
Atallah A, Lecarpentier E, Goffinet F, Doret-Dion M, Gaucherand P, Tsatsaris V. Aspirin for Prevention of Preeclampsia. Drugs 2017; 77:1819-1831. [PMID: 29039130 PMCID: PMC5681618 DOI: 10.1007/s40265-017-0823-0] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Aspirin is currently the most widely prescribed treatment in the prevention of cardiovascular complications. The indications for the use of aspirin during pregnancy are, however, the subject of much controversy. Since the first evidence of the obstetric efficacy of aspirin in 1985, numerous studies have tried to determine the effect of low-dose aspirin on the incidence of preeclampsia, with very controversial results. Large meta-analyses including individual patient data have demonstrated that aspirin is effective in preventing preeclampsia in high-risk patients, mainly those with a history of preeclampsia. However, guidelines regarding the usage of aspirin to prevent preeclampsia differ considerably from one country to another. Screening modalities, target population, and aspirin dosage are still a matter of debate. In this review, we report the pharmacodynamics of aspirin, its main effects according to dosage and gestational age, and the evidence-based indications for primary and secondary prevention of preeclampsia.
Collapse
Affiliation(s)
- A Atallah
- Hospices Civils de Lyon, Department of Obstetrics and Gynecology, Femme Mère Enfant Hospital, University Hospital Center, 59 boulevard Pinel, 69500, Bron, France
- Claude-Bernard University Lyon1, Lyon, France
| | - E Lecarpentier
- Assistance Publique-Hôpital de Paris, Department of Obstetrics and Gynecology, Port-Royal Maternity, University Hospital Center Cochin Broca Hôtel Dieu, Groupe Hospitalier Universitaire Ouest, 53, Avenue de l'Observatoire, 75014, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
- PremUP Foundation, Paris, France
- DHU Risques et Grossesse, Paris, France
| | - F Goffinet
- Assistance Publique-Hôpital de Paris, Department of Obstetrics and Gynecology, Port-Royal Maternity, University Hospital Center Cochin Broca Hôtel Dieu, Groupe Hospitalier Universitaire Ouest, 53, Avenue de l'Observatoire, 75014, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
- PremUP Foundation, Paris, France
- DHU Risques et Grossesse, Paris, France
| | - M Doret-Dion
- Hospices Civils de Lyon, Department of Obstetrics and Gynecology, Femme Mère Enfant Hospital, University Hospital Center, 59 boulevard Pinel, 69500, Bron, France
- Claude-Bernard University Lyon1, Lyon, France
| | - P Gaucherand
- Hospices Civils de Lyon, Department of Obstetrics and Gynecology, Femme Mère Enfant Hospital, University Hospital Center, 59 boulevard Pinel, 69500, Bron, France
- Claude-Bernard University Lyon1, Lyon, France
| | - V Tsatsaris
- Assistance Publique-Hôpital de Paris, Department of Obstetrics and Gynecology, Port-Royal Maternity, University Hospital Center Cochin Broca Hôtel Dieu, Groupe Hospitalier Universitaire Ouest, 53, Avenue de l'Observatoire, 75014, Paris, France.
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France.
- PremUP Foundation, Paris, France.
- DHU Risques et Grossesse, Paris, France.
| |
Collapse
|
45
|
Nandi AA, Wadhwani NS, Joshi SR. Altered metabolic homeostasis between vitamin D and long chain polyunsaturated fatty acids in preeclampsia. Med Hypotheses 2017; 100:31-36. [PMID: 28236844 DOI: 10.1016/j.mehy.2017.01.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 12/15/2016] [Accepted: 01/15/2017] [Indexed: 12/13/2022]
Abstract
Sub-optimal maternal nutrition may result in pregnancy complications like preeclampsia. Preeclampsia is known to be of placental origin and a major cause of maternal morbidity and mortality worldwide. Our earlier studies suggest that altered metabolism of folic acid, vitamin B12 and long chain polyunsaturated fatty acid (LCPUFAs) in the one carbon cycle increases homocysteine levels in preeclampsia. Recent reports indicate that vitamin D deficiency may also have a role in preeclampsia, although the mechanisms are unclear. A disturbed one carbon cycle can influence methylation patterns of various genes involved in placental development. Altered expression of cystathionine beta synthase (CBS) gene can result in hyperhomocystenemia. Higher homocysteine levels are known to increase reactive oxygen species (ROS) production which in turn leads to increased expression of phospholipase A2 (PLA2) and cyclooxygenase-2 (COX-2). Higher expression of PLA2 and COX-2 can influence the release of arachidonic acid (AA) from membrane phospholipid and result in increased conversion to thromboxane. Vitamin D [1,25(OH)2D3] is known to induce the CBS gene expression while it can suppress the oxidative stress-induced COX-2 up-regulation and thromboxane production. Based on this, we propose a novel hypothesis that a disturbed vitamin D and LCPUFA metabolism influence the regulation of the one carbon cycle which will trigger inflammation through oxidative stress in preeclampsia. This may lead to altered feto-placental growth and development in preeclampsia.
Collapse
Affiliation(s)
- Anindita A Nandi
- Department of Nutritional Medicine, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth Deemed University, Pune 411043, India
| | - Nisha S Wadhwani
- Department of Nutritional Medicine, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth Deemed University, Pune 411043, India
| | - Sadhana R Joshi
- Department of Nutritional Medicine, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth Deemed University, Pune 411043, India.
| |
Collapse
|
46
|
Cantu TM, Bowden JA, Scott J, Pérez-Viscasillas JB, Huncik K, Guillette MP, Guillette LJ. Alterations in eicosanoid composition during embryonic development in the chorioallantoic membrane of the American alligator (Alligator mississippiensis) and domestic chicken (Gallus gallus). Gen Comp Endocrinol 2016; 238:78-87. [PMID: 27401262 PMCID: PMC5584055 DOI: 10.1016/j.ygcen.2016.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 06/23/2016] [Accepted: 07/07/2016] [Indexed: 12/21/2022]
Abstract
Eicosanoids are signaling lipids known to regulate several physiological processes in the mammalian placenta, including the initiation of parturition. Though all amniotes construct similar extraembryonic membranes during development, the composition and function of eicosanoids in extraembryonic membranes of oviparous reptiles is largely unknown. The majority of effort placed in eicosanoid investigations is typically targeted toward defining the role of specific compounds in disease etiology; however, comprehensive characterization of several pathways in eicosanoid synthesis during development is also needed to better understand the complex role of these lipids in comparative species. To this end, we have examined the chorioallantoic membrane (CAM) of the American alligator (Alligator mississippiensis) and domestic chicken (Gallus gallus) during development. Previously, our lab has demonstrated that the CAM of several oviparous species shared conserved steroidogenic activity, a feature originally attributed to mammalian amniotes. To further explore this, we have developed a liquid chromatography/tandem mass spectrometry method that is used here to quantify multiple eicosanoids in the CAM of two oviparous species at different stages of development. We identified 18 eicosanoids in the alligator CAM; the cyclooxygenase (COX) pathway showed the largest increase from early development to later development in the alligator CAM. Similarly, the chicken CAM had an increase in COX products and COX activity, which supports the LC-MS/MS analyses. Jointly, our findings indicate that the CAM tissue of an oviparous species is capable of eicosanoid synthesis, which expands our knowledge of placental evolution and introduces the possibility of future comparative models of placental function.
Collapse
Affiliation(s)
- Theresa M Cantu
- Medical University of South Carolina, Department of Obstetrics and Gynecology, 331 Fort Johnson Road, Charleston, SC 29412, United States; Hollings Marine Laboratory, 331 Fort Johnson Road, Charleston, SC 29412, United States.
| | - John A Bowden
- National Institute of Standards and Technology, Chemical Sciences Division, Environmental Chemical Sciences Group, Hollings Marine Laboratory, 331 Fort Johnson Road, Charleston, SC 29412, United States
| | - Jacob Scott
- Hollings Marine Laboratory, 331 Fort Johnson Road, Charleston, SC 29412, United States
| | - Jimena B Pérez-Viscasillas
- Grice Marine Laboratory, College of Charleston, 205 Fort Johnson Rd, Charleston, SC 29412, United States
| | - Kevin Huncik
- National Institute of Standards and Technology, Chemical Sciences Division, Environmental Chemical Sciences Group, Hollings Marine Laboratory, 331 Fort Johnson Road, Charleston, SC 29412, United States
| | - Matthew P Guillette
- Medical University of South Carolina, Department of Obstetrics and Gynecology, 331 Fort Johnson Road, Charleston, SC 29412, United States; Hollings Marine Laboratory, 331 Fort Johnson Road, Charleston, SC 29412, United States
| | - Louis J Guillette
- Medical University of South Carolina, Department of Obstetrics and Gynecology, 331 Fort Johnson Road, Charleston, SC 29412, United States; Hollings Marine Laboratory, 331 Fort Johnson Road, Charleston, SC 29412, United States
| |
Collapse
|
47
|
Brosnihan KB, M. Pulgar V, Bharadwaj MS, Neves LAA, Yamaleyeva LM. Local intra-uterine Ang-(1-7) infusion attenuates PGE 2 and 6-keto PGF 1α in decidualized uterus of pseudopregnant rats. Reprod Biol Endocrinol 2016; 14:68. [PMID: 27756404 PMCID: PMC5070151 DOI: 10.1186/s12958-016-0202-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 10/11/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Cyclooxygenase (COX)-derived prostanoids (PGE2, PGI2) are important contributors to the process of decidualization. Previous studies showed the presence of Ang-(1-7) in the primary and secondary decidualized zones of the implantation site at early pregnancy. Decreased concentrations of Ang-(1-7) were found in the decidualized uterus compared to the non-decidualized uterus of pseudopregnant rats, suggesting that low levels of Ang-(1-7) are required for successful decidualization at early pregnancy. METHODS To understand the role of Ang-(1-7) in prostaglandin production in a decidualized uterus, induced by a bolus injection of sesame oil, Ang-(1-7) (24 μg/kg/h) or vehicle was then infused directly into the decidualized uterine horn using an osmotic minipump. The right horns were not injected or infused and served as non-decidualized uterine horns in both groups of animals. RESULTS Decidualization increased PGE2 concentration in the uterus (0.53 ± 0.05 vs. 12.0 ± 3.2 pmol/mg protein, p < 0.001, non-decidualized vs. decidualized horns); Ang-(1-7) infusion attenuated the increase of PGE2 (12.0 ± 3.2 vs. 5.1 ± 1.3 pmol/mg protein, p < 0.01 control vs. Ang-(1-7) treated decidualized horns). The stable metabolite of PGI2 (6-keto PGF1α) was increased with decidualization (0.79 ± 0.17 vs. 3.5 ± 0.82 pmol/mg protein, p < 0.001, non-decidualized vs. decidualized horns). Ang-(1-7) infusion attenuated the increase in 6-keto PGF1α in the decidualized horn (3.5 ± 0.82 vs 1.8 ± 0.37 pmol/mg protein, p < 0.05 control vs. Ang-(1-7) treated decidualized horns). The circulating levels of 6-keto-PGF1a and TXB2 were decreased by Ang-(1-7) infusion, while no difference was observed in circulating PGE2. Although the global assessment of cleaved caspase 3 immunostaining, a marker of apoptosis, was unchanged within the Ang-(1-7) decidualized horn, there were localized decreases in cleaved caspase 3 staining in the luminal region in the decidualized uterus of Ang-(1-7)-treated rats. CONCLUSIONS These studies show that increased local uterine Ang-(1-7) alters the uterine prostaglandin environment, possibly leading to disruptions of early events of decidualization.
Collapse
Affiliation(s)
- K. Bridget Brosnihan
- Hypertension and Vascular Research, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157-1032 USA
| | - Victor M. Pulgar
- Hypertension and Vascular Research, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157-1032 USA
- Department of Obstetrics & Gynecology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157-1032 USA
- Biomedical Research Infrastructure Center, Winston Salem State University, Winston-Salem, NC USA
| | - Manish S. Bharadwaj
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Liomar A. A. Neves
- Hypertension and Vascular Research, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157-1032 USA
| | - Liliya M. Yamaleyeva
- Hypertension and Vascular Research, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157-1032 USA
| |
Collapse
|
48
|
Possomato-Vieira JS, Khalil RA. Mechanisms of Endothelial Dysfunction in Hypertensive Pregnancy and Preeclampsia. ADVANCES IN PHARMACOLOGY 2016; 77:361-431. [PMID: 27451103 DOI: 10.1016/bs.apha.2016.04.008] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Preeclampsia is a pregnancy-related disorder characterized by hypertension and could lead to maternal and fetal morbidity and mortality. Although the causative factors and pathophysiological mechanisms are unclear, endothelial dysfunction is a major hallmark of preeclampsia. Clinical tests and experimental research have suggested that generalized endotheliosis in the systemic, renal, cerebral, and hepatic circulation could decrease endothelium-derived vasodilators such as nitric oxide, prostacyclin, and hyperpolarization factor and increase vasoconstrictors such as endothelin-1 and thromboxane A2, leading to increased vasoconstriction, hypertension, and other manifestation of preeclampsia. In search for the upstream mechanisms that could cause endothelial dysfunction, certain genetic, demographic, and environmental risk factors have been suggested to cause abnormal expression of uteroplacental integrins, cytokines, and matrix metalloproteinases, leading to decreased maternal tolerance, apoptosis of invasive trophoblast cells, inadequate spiral arteries remodeling, reduced uterine perfusion pressure (RUPP), and placental ischemia/hypoxia. RUPP may cause imbalance between the antiangiogenic factors soluble fms-like tyrosine kinase-1 and soluble endoglin and the proangiogenic factors vascular endothelial growth factor and placental growth factor, or stimulate the release of other circulating bioactive factors such as inflammatory cytokines, hypoxia-inducible factor-1, reactive oxygen species, and angiotensin AT1 receptor agonistic autoantibodies. These circulating factors could then target endothelial cells and cause generalized endothelial dysfunction. Therapeutic options are currently limited, but understanding the factors involved in endothelial dysfunction could help design new approaches for prediction and management of preeclampsia.
Collapse
Affiliation(s)
- J S Possomato-Vieira
- Vascular Surgery Research Laboratories, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - R A Khalil
- Vascular Surgery Research Laboratories, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
| |
Collapse
|
49
|
Pai CH, Yen CT, Chen CP, Yu IS, Lin SW, Lin SR. Lack of Thromboxane Synthase Prevents Hypertension and Fetal Growth Restriction after High Salt Treatment during Pregnancy. PLoS One 2016; 11:e0151617. [PMID: 26974824 PMCID: PMC4790927 DOI: 10.1371/journal.pone.0151617] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 02/29/2016] [Indexed: 11/29/2022] Open
Abstract
Preeclampsia (PE) is a potentially fatal pregnancy-related hypertensive disorder characterized by poor placenta development that can cause fetal growth restriction. PE-associated pathologies, including thrombosis, hypertension, and impaired placental development, may result from imbalances between thromboxane A2 (TXA2) and prostacyclin. Low-dose aspirin, which selectively inhibits TXA2 production, is used to prevent high-risk PE. However, the role of TXA2 in aspirin-mediated protective effects in women with PE is not understood fully. In this study, we examined the role of prostanoids in PE using human samples and an induced PE mouse model. We demonstrated that the administration of salted drinking water (2.7% NaCl) to wild-type mice resulted in elevated placental TXA2 synthase (TXAS) and plasma TXA2, but not prostacyclin, levels, which was also found in our clinical PE placenta samples. The high salt-treated wild-type pregnant mice had shown unchanged maternal body weight, hypertension (MAP increase 15 mmHg), and decreased pup weight (~50%) and size (~24%), but these adverse effects were ameliorated in TXAS knockout (KO) mice. Moreover, increased expression of interleukin-1β and downstream phosphorylated-p38-mitogen-activated protein kinase were concordant with apoptosis induction in the placentas of salt water-treated wild-type mice. These alterations were not observed in TXAS KO mice. Together, our data suggest that TXA2 depletion has anti-PE effects due to the prevention of hypertension and placental damage through downregulation of the interleukin-1β pathway.
Collapse
Affiliation(s)
- Chen-Hsueh Pai
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ching-Tzu Yen
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan
- Center of Genomic Medicine, National Taiwan University, Taipei, Taiwan
| | - Chie-Pein Chen
- Division of High Risk Pregnancy, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - I-Shing Yu
- Laboratory Animal Center, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shu-Wha Lin
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan
- * E-mail: (SRL); (SWL)
| | - Shu-Rung Lin
- Department of Bioscience Technology, College of Science, Chung-Yuan Christian University, Taoyuan, Taiwan
- Center for Nanotechnology and Center for Biomedical Technology, Chung-Yuan Christian University, Taoyuan, Taiwan
- * E-mail: (SRL); (SWL)
| |
Collapse
|
50
|
Pulgar VM, Yamaleyeva LM, Varagic J, McGee C, Bader M, Dechend R, Brosnihan KB. Functional changes in the uterine artery precede the hypertensive phenotype in a transgenic model of hypertensive pregnancy. Am J Physiol Endocrinol Metab 2015; 309:E811-7. [PMID: 26394667 PMCID: PMC4628942 DOI: 10.1152/ajpendo.00526.2014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 09/11/2015] [Indexed: 01/16/2023]
Abstract
The pregnant female human angiotensinogen (hAGN) transgenic rat mated with the male human renin (hREN) transgenic rat is a model of preeclampsia (TgA) with increased blood pressure, proteinuria, and placenta alterations of edema and necrosis at late gestation. We studied vascular responses and the role of COX-derived prostanoids in the uterine artery (UA) at early gestation in this model. TgA UA showed lower stretch response, similar smooth muscle α-actin content, and lower collagen content compared with Sprague-Dawley (SD) UA. Vasodilation to acetylcholine was similar in SD and TgA UA (64 ± 8 vs. 75 ± 6% of relaxation, P > 0.05), with an acetylcholine-induced contraction in TgA UA that was abolished by preincubation with indomethacin (78 ± 6 vs. 83 ± 11%, P > 0.05). No differences in the contraction to phenylephrine were observed (159 ± 11 vs. 134 ± 12 %KMAX, P > 0.05), although in TgA UA this response was greatly affected by preincubation with indomethacin (179 ± 16 vs. 134 ± 9 %KMAX, P < 0.05, pD2 5.92 ± 0.08 vs. 5.85 ± 0.03, P < 0.05). Endothelium-independent vasodilation was lower in TgA UA (92 ± 2 vs. 74 ± 5% preconstricted tone, P < 0.05), and preincubation with indomethacin restored the response to normal values (90 ± 3 vs. 84 ± 3%). Immunostaining showed similar signals for α-actin, COX-2, and eNOS between groups (P > 0.05). Plasma thromboxane levels were similar between groups. In summary, TgA UA displays functional alterations at early gestation before the preeclamptic phenotype is established. Inhibition of COX enzymes normalizes some of the functional defects in the TgA UA. An increased role for COX-derived prostanoids in this model of preeclampsia may contribute to the development of a hypertensive pregnancy.
Collapse
Affiliation(s)
- Victor M Pulgar
- Hypertension and Vascular Research Center and Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina; Biomedical Research and Infrastructure Center, Winston-Salem State University, Winston-Salem, North Carolina;
| | | | | | | | - Michael Bader
- Max Delbrück Center for Molecular Medicine, Berlin-Buch, Germany; Experimental and Clinical Research Center, Charité University Hospital Berlin, and HELIOS-Clinic, Berlin, Germany; and Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ralf Dechend
- Experimental and Clinical Research Center, Charité University Hospital Berlin, and HELIOS-Clinic, Berlin, Germany; and
| | | |
Collapse
|