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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.
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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
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Zeigler MB, Fay EE, Moreni SL, Mao J, Totah RA, Hebert MF. Plasma hydrogen sulfide, nitric oxide, and thiocyanate levels are lower during pregnancy compared to postpartum in a cohort of women from the Pacific northwest of the United States. Life Sci 2023; 322:121625. [PMID: 37001802 PMCID: PMC10133030 DOI: 10.1016/j.lfs.2023.121625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/03/2023]
Abstract
AIMS Pregnancy alters multiple physiological processes including angiogenesis, vasodilation, inflammation, and cellular redox, which are partially modulated by the gasotransmitters hydrogen sulfide (H2S) and nitric oxide (NO). In this study, we sought to determine how plasma levels of H2S, NO, and the H2S-related metabolites thiocyanate (SCN-), and methanethiol (CH3SH) change during pregnancy progression. MATERIALS AND METHODS Plasma was collected from 45 women at three points: 25-28 weeks gestation, 28-32 week gestation, and at ≥3 months postpartum. Plasma levels of H2S, SCN-, and CH3SH were measured following derivatization using monobromobimane followed by LC-MS/MS. Plasma NO was measured indirectly using the Griess reagent. KEY FINDINGS NO and SCN- were significantly lower in women at 25-28 weeks gestation and 28-32 weeks gestation than postpartum while plasma H2S levels were significantly lower at 28-32 weeks gestation than postpartum. No significant differences were observed in CH3SH. SIGNIFICANCE Previous reports demonstrated that the production of H2S and NO are stimulated during pregnancy, but we observed lower levels during pregnancy compared to postpartum. Previous reports on NO have been mixed, but given the related effects of H2S and NO, it is expected that their levels would be higher during pregnancy vs. postpartum. Future studies determining the mechanism for decreased H2S and NO during pregnancy will elucidate the role of these gasotransmitters during normal and pathological progression of pregnancy.
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Affiliation(s)
- Maxwell B Zeigler
- University of Washington, Department of Medicinal Chemistry, Seattle, WA, USA.
| | - Emily E Fay
- University of Washington, Department of Obstetrics and Gynecology, Seattle, WA, USA
| | - Sue L Moreni
- University of Washington, Department of Obstetrics and Gynecology, Seattle, WA, USA
| | - Jennie Mao
- University of Washington, Department of Obstetrics and Gynecology, Seattle, WA, USA
| | - Rheem A Totah
- University of Washington, Department of Medicinal Chemistry, Seattle, WA, USA
| | - Mary F Hebert
- University of Washington, Department of Obstetrics and Gynecology, Seattle, WA, USA; University of Washington, Department of Pharmacy, Seattle, WA, USA
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Evaluation of oxidative stress markers in subtypes of preeclampsia: A systematic review and meta-analysis. Placenta 2023; 132:55-67. [PMID: 36669343 DOI: 10.1016/j.placenta.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023]
Abstract
Studies about oxidative stress biomarkers revealed different phenotypes between early and late preeclampsia (PE). Despite that, there is extensive evidence of oxidative stress in investigations that combinate forms different of preeclampsia. This study reviews the oxidative stress profile in the PE subtypes and evaluates which markers are altered in the blood and placental tissue. A search was conducted in databases such as MEDLINE, EMBASE, LILACS, and Web of Science without restricting the year and language of publication. The quality of the studies was evaluated by the Newcastle-Ottawa scale and Joanna Briggs Institute for analytical Cross-Sectional Studies. After 13,319 screened records, 65 were included in the systematic review. The markers of stress oxidative of damage and reactive species were those selected, such as malondialdehyde (MDA), lipid peroxide, advanced protein oxidation products, carbonyl protein, 8-hydroxy-2'-deoxyguanosine, total oxidant status, hydrogen peroxide, nitric oxide (NO). We described the antioxidant activity, including the superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione-S-transferase, free glutathione, and total antioxidant capacity (TAC). We results demonstrated that oxidative stress is related to pathophysiology of PE, there were increased lipid peroxidation in the blood and placenta, and in blood a reduction of NO levels and of TAC, like lower enzymatic activity of GPx, CAT in PE, and SOD in mild PE. In addition, altered levels of MDA in the placenta and blood show that placental changes have repercussions on the clinical syndrome and are related to the severity of the disease.
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Decrease in Nitric Oxide Production as a Key Mediator in the Pathogenesis of Preeclampsia and a Potential Therapeutic Target: A Case-Control Study. Biomedicines 2022; 10:biomedicines10102653. [PMID: 36289915 PMCID: PMC9599382 DOI: 10.3390/biomedicines10102653] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/13/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Pregnancy-induced hypertension (GH) complicates 6−10% of all pregnancies and, in 2019, was responsible for approximately 28,000 deaths. The most common cause of gestational hypertension is pre-eclampsia (PE), which afflicts 2−8% of all pregnancies and is one of the three leading causes of maternal morbidity and mortality worldwide. The aim of this study was to clarify how NO metabolism changes during the course of PE. Due to the short half-life of NO, we measured the concentrations of its stable metabolites, nitrite and nitrate (NOx). Out of 100 enrolled patients: 58 pregnant women with a diagnosed early form of PE formed a study group, and 42 healthy pregnant women formed a control group. NOx concentrations were significantly lower in the PE group than in the control group, with mean values of 5.33 and 27.64 μmol/L, respectively (p < 0.0001). The decrease in NO is most likely the result and mediator of systemic endothelial dysfunction. The impairment of NO metabolism in PE appears to play an important role in its pathogenesis. Therefore, it is a potential therapeutic target.
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Ahirwar AK, Singh A, Bhattacharjee J. Biological reference interval of nitric oxide in health and disease. Horm Mol Biol Clin Investig 2022; 43:315-321. [PMID: 35420263 DOI: 10.1515/hmbci-2021-0066] [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: 07/28/2021] [Accepted: 03/12/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES There is a need to develop reference interval of NO in health and disease. METHODS Subjects aged between 25 and 55 years were drawn from a random sample of the north Indian population, based on defined inclusion and exclusion criteria. Measurement of NO was done based on principle of greiss reaction. RESULTS Reference interval of NO in healthy individual of age group 25-55 years was 21 ± 13.3 μM/L (n=350), Premenopausal women of age group 25-35 years was 12.7 ± 4.9 μM/L (n=180), Postmenopausal women of age group 40-55 years was 10.3 ± 3.84 μM/L (n=100) and healthy pregnant females of age group 25-35 years was 70.9 ± 15.95 μM/L (n=330). In pathological state group, reference interval of NO in metabolic syndrome cases of age group 25-55 years was 19.4 ± 15.3 μM/L (n=100), coronary artery disease patient of age group more than 35 years was 17.6 ± 10.8 μM/L (n=160), pregnancy induced hypertension (PIH) of age group 25-30 years was 45.7 ± 7.2 μM/L (n=330), pre-eclampsia patient of age group 25-35 years was 39.8 ± 14.7 μM/L (n=200) and diabetic individuals of age group of more than 30 years was 15.5 ± 1.4 μM/L (n=50). CONCLUSIONS The reference intervals presented may be used for various research purposes. Based upon our study, reference interval for NO levels of various disease states like MetS, CAD, diabetes, PIH showed lower levels of NO compared to their respective healthy group due to shared etiopathologies with decreased NO levels.
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Affiliation(s)
- Ashok Kumar Ahirwar
- Department of Biochemistry, University College of Medical Sciences, New Delhi, India
| | - Archana Singh
- Department of Biochemistry, All India Institute of Medical Sciences, Delhi, India
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Wagle M, Basnet P, Vårtun Å, Acharya G. Nitric Oxide, Oxidative Stress and Streptococcus mutans and Lactobacillus Bacterial Loads in Saliva during the Different Stages of Pregnancy: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179330. [PMID: 34501918 PMCID: PMC8430619 DOI: 10.3390/ijerph18179330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 12/30/2022]
Abstract
Hormonal changes associated with pregnancy promote oral bacterial growth, which may affect salivary nitric oxide (NO) levels, oxidative stress (OS), and antioxidant capacity (AC). We hypothesized that caries-related bacterial load, NO level, and OS in the saliva change with advancing gestation. The aim of this study was to investigate longitudinal changes in salivary NO, OS, and AC during pregnancy and correlate them with Streptococcus mutans (SM) and Lactobacillus (LB) colonization at different stages of pregnancy. We assessed NO level by Griess method, OS by measuring malondialdehyde (MDA), AC by ABTS radicals and bacterial load by culturing SM and LB in the saliva of pregnant women (n = 96) and compared with non-pregnant women (n = 50) as well as between different stages of pregnancy. Compared with non-pregnant women, NO was 77% higher (4.73 ± 2.87 vs. 2.67 ± 1.55 µM; p < 0.001), MDA was 13% higher (0.96 ± 0.27 vs. 0.85 ± 0.22 nM; p = 0.0055), and AC was 34% lower (60.35 ± 14.33 vs. 80.82 ± 11.60%; p < 0.001) in the late third trimester. NO increased with advancing gestation, but AC and OS did not change significantly during pregnancy. SM were more abundant in pregnant women compared with non-pregnant (p = 0.0012). Pregnancy appears to have an adverse impact on oral health emphasizing the importance optimal oral healthcare during pregnancy.
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Affiliation(s)
- Madhu Wagle
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT—The Arctic University of Norway, 9037 Tromsø, Norway; (Å.V.); (G.A.)
- Correspondence: (M.W.); (P.B.)
| | - Purusotam Basnet
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT—The Arctic University of Norway, 9037 Tromsø, Norway; (Å.V.); (G.A.)
- Department of Obstetrics and Gynecology, University Hospital of North Norway, 9038 Tromsø, Norway
- Correspondence: (M.W.); (P.B.)
| | - Åse Vårtun
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT—The Arctic University of Norway, 9037 Tromsø, Norway; (Å.V.); (G.A.)
| | - Ganesh Acharya
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT—The Arctic University of Norway, 9037 Tromsø, Norway; (Å.V.); (G.A.)
- Department of Obstetrics and Gynecology, University Hospital of North Norway, 9038 Tromsø, Norway
- Department of Clinical Science, Intervention and Technology, Division of Obstetrics and Gynaecology, Karolinska Institutet, 141 86 Stockholm, Sweden
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Gomes VJ, Rezeck Nunes P, Haworth SM, Sandrim VC, Peraçoli JC, Peraçoli MTS, Carlström M. Monocytes from preeclamptic women previously treated with silibinin attenuate oxidative stress in human endothelial cells. Hypertens Pregnancy 2021; 40:124-132. [PMID: 33586558 DOI: 10.1080/10641955.2021.1884258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: To investigate whether the supernatant from monocytes of preeclamptic and normotensive pregnant women, cultured in vitro with silibinin, can modulate oxidative stress in HUVEC.Methods: Concentrations of IL-1β, IL-10, and TNF-α in monocyte culture supernatants were determined by ELISA. HUVEC and their supernatant cultures were employed for determination of NO, nitrite and nitrate, lipid peroxidation, and hemeoxygenase-1 (HO-1).Results: HUVEC treatment with supernatant of preeclamptic monocytes cultured with silibinin produced increased levels of nitrite, reduced lipid peroxidation, and increased HO-1.Conclusion: Supernatant of monocytes from preeclamptic women induce oxidative stress in HUVEC which can be reduced by silibinin treatment.Abbreviations: DAF-FMTM, Diaminofluorescein-FM; EDTA, Ethylenediaminetetraacetic acid; HO-1, heme oxygenase-1; HPLC, high-performance liquid chromatography; HUVEC, human umbilical vein endothelial cell; MDA, malondialdehyde; NO, nitric oxide; NT, normotensive; PE, preeclampsia; ROS, reactive oxygen species; Sb, silibinin.
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Affiliation(s)
- Virgínia Juliani Gomes
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, Sao Paulo, Brazil
| | - Priscila Rezeck Nunes
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, Sao Paulo, Brazil
| | - Sarah McCann Haworth
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Valéria Cristina Sandrim
- Department of Biological and Chemical Sciences, Institute of Biosciences of Botucatu, Sao Paulo State University (Unesp), Botucatu, Sao Paulo, Brazil
| | - José Carlos Peraçoli
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University (Unesp), Botucatu, Sao Paulo, Brazil
| | - Maria Terezinha S Peraçoli
- Department of Biological and Chemical Sciences, Institute of Biosciences of Botucatu, Sao Paulo State University (Unesp), Botucatu, Sao Paulo, Brazil
| | - Mattias Carlström
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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Rimmer L, Mellor S, Harky A, Gouda M, Bashir M. Pernicious pregnancy: Type B aortic dissection in pregnant women. J Card Surg 2021; 36:1232-1240. [PMID: 33533078 DOI: 10.1111/jocs.15354] [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: 08/15/2020] [Revised: 09/22/2020] [Accepted: 10/14/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Type B aortic dissection (TBAD) occurs seldomly, particularly in pregnancy, but has disastrous consequences for both mother and fetus. The focus of immediate surgical repair of type A aortic dissection due to higher mortality of patients is less clear in its counterpart, TBAD, in which management is controversial and debated. This article collates knowledge so far on this rare event during pregnancy. METHODS A comprehensive literature search was performed in PubMed, Scopus, Google Scholar, Embase, and Medline. Key search terms included "type B aortic dissection," "pregnancy," and corresponding synonyms. Non-English papers were excluded. RESULTS Risk factors for TBAD include aortic wall stress due to hypertension, previous cardiac surgery, structural abnormalities (bicuspid aortic valve, aortic coarctation), and connective tissue disorders. In pregnancy, pre-eclampsia is a cause of increased aortic wall stress. Management of this condition is often conservative, but this is dependent on a number of factors, including gestation, cardiovascular stability of the patient, and symptomology. In most cases, a cesarean section before intervention is carried out unless certain indications are present. CONCLUSIONS Due to a scarce number of cases across the decades, it is difficult to determine which management is optimal. The gold-standard management of TBAD has traditionally been the medical treatment for uncomplicated cases and open surgery for those needing urgent intervention, but with the advent of techniques, such as thoracic endovascular aortic repair, the management of these group of patients continues to develop.
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Affiliation(s)
- Lara Rimmer
- Vascular Surgery Department, Royal Blackburn Teaching Hospital, Blackburn, UK
| | - Sophie Mellor
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Amer Harky
- Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Mohamed Gouda
- Vascular & Endovascular Surgery, Mataria Teaching Hospital, Cairo, Egypt
| | - Mohamad Bashir
- Vascular Surgery Department, Royal Blackburn Teaching Hospital, Blackburn, UK
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Qu H, Khalil RA. Vascular mechanisms and molecular targets in hypertensive pregnancy and preeclampsia. Am J Physiol Heart Circ Physiol 2020; 319:H661-H681. [PMID: 32762557 DOI: 10.1152/ajpheart.00202.2020] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Preeclampsia is a major complication of pregnancy manifested as hypertension and often intrauterine growth restriction, but the underlying pathophysiological mechanisms are unclear. Predisposing genetic and environmental factors cause placental maladaptations leading to defective placentation, apoptosis of invasive cytotrophoblasts, inadequate expansive remodeling of the spiral arteries, reduced uteroplacental perfusion pressure, and placental ischemia. Placental ischemia promotes the release of bioactive factors into the maternal circulation, causing an imbalance between antiangiogenic soluble fms-like tyrosine kinase-1 and soluble endoglin and proangiogenic vascular endothelial growth factor, placental growth factor, and transforming growth factor-β. Placental ischemia also stimulates the release of proinflammatory cytokines, hypoxia-inducible factor, reactive oxygen species, and angiotensin type 1 receptor agonistic autoantibodies. These circulating factors target the vascular endothelium, causing generalized endotheliosis in systemic, renal, cerebral, and hepatic vessels, leading to decreases in endothelium-derived vasodilators such as nitric oxide, prostacyclin, and hyperpolarization factor and increases in vasoconstrictors such as endothelin-1 and thromboxane A2. The bioactive factors also target vascular smooth muscle and enhance the mechanisms of vascular contraction, including cytosolic Ca2+, protein kinase C, and Rho-kinase. The bioactive factors could also target matrix metalloproteinases and the extracellular matrix, causing inadequate vascular remodeling, increased arterial stiffening, and further increases in vascular resistance and hypertension. As therapeutic options are limited, understanding the underlying vascular mechanisms and molecular targets should help design new tools for the detection and management of hypertension in pregnancy and preeclampsia.
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Affiliation(s)
- Hongmei Qu
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Raouf A Khalil
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
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Biomarkers of neutrophil extracellular traps (NETs) and nitric oxide-(NO)-dependent oxidative stress in women who miscarried. Sci Rep 2020; 10:13088. [PMID: 32753622 PMCID: PMC7403427 DOI: 10.1038/s41598-020-70106-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/23/2020] [Indexed: 11/08/2022] Open
Abstract
Pregnancy loss is a multidisciplinary problem which concerns researchers from the fields of medicine, epidemiology, psychology, and public health. The primary objective of the present study was to explain the potential role of neutrophil extracellular traps (NETs) in the process of spontaneous miscarriage. Enzyme-linked immunosorbent assay to assess the levels of biomarkers of NETs in the serum of examined women was conducted. Furthermore, levels of nitric oxide (NO) and late markers of its action were measured in serum samples. Analyses results demonstrated the existence of NETs in the placental tissue of women who miscarried as well as a simultaneous increase in the levels of myeloperoxidase and pentraxin 3. This clearly confirms the participation of NETs in the course of pregnancy loss. Women who have had a miscarriage but did not show the presence of NETs in their placenta exhibited the highest contents of NO, nitrotyrosine, and malondialdehyde suggesting a different pathway leading to pregnancy loss associated with disturbed oxidative-antioxidative processes. Although study results demonstrate new aspects associated with the formation of NETs they are not, however, sufficient to unambiguously determine the role of NETs in the course of miscarriage.
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Sutton EF, Gemmel M, Powers RW. Nitric oxide signaling in pregnancy and preeclampsia. Nitric Oxide 2020; 95:55-62. [DOI: 10.1016/j.niox.2019.11.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/10/2019] [Accepted: 11/22/2019] [Indexed: 01/08/2023]
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Dymara-Konopka W, Laskowska M. The Role of Nitric Oxide, ADMA, and Homocysteine in The Etiopathogenesis of Preeclampsia-Review. Int J Mol Sci 2019; 20:ijms20112757. [PMID: 31195628 PMCID: PMC6600256 DOI: 10.3390/ijms20112757] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 05/27/2019] [Accepted: 05/28/2019] [Indexed: 12/18/2022] Open
Abstract
Preeclampsia is a serious, pregnancy-specific, multi-organ disease process of compound aetiology. It affects 3–6% of expecting mothers worldwide and it persists as a leading cause of maternal and foetal morbidity and mortality. In fact, hallmark features of preeclampsia (PE) result from vessel involvement and demonstrate maternal endothelium as a target tissue. Growing evidence suggests that chronic placental hypoperfusion triggers the production and release of certain agents that are responsible for endothelial activation and injury. In this review, we will present the latest findings on the role of nitric oxide, asymmetric dimethylarginine (ADMA), and homocysteine in the etiopathogenesis of preeclampsia and their possible clinical implications.
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Affiliation(s)
- Weronika Dymara-Konopka
- Department of Obstetrics and Perinatology, Medical University of Lublin, Poland, 20-950 Lublin, Jaczewskiego 8, Poland.
| | - Marzena Laskowska
- Department of Obstetrics and Perinatology, Medical University of Lublin, Poland, 20-950 Lublin, Jaczewskiego 8, Poland.
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Bahadoran Z, Mirmiran P, Jeddi S, Carlström M, Azizi F, Ghasemi A. Circulating markers of nitric oxide homeostasis and cardiometabolic diseases: insights from population-based studies. Free Radic Res 2019; 53:359-376. [PMID: 30821533 DOI: 10.1080/10715762.2019.1587168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Emerging data suggest that impaired nitric oxide (NO) homeostasis has a key role in development of cardiometabolic disorders. The association between circulating levels of NO metabolites, i.e. nitrate and nitrite (NOx), and risk of chronic diseases has not yet been fully clarified. This work aims to address epidemiologic aspects of NO metabolism and discusses different physiologic and pathophysiologic conditions influencing circulating NOx. Further, cross-sectional associations of serum NOx with metabolic disorders are described and along the way, potential short-term and long-term power of serum NOx for predicting cardiometabolic outcomes are reviewed. Results from population-based studies show that circulating NOx is affected by aging, smoking habits, pregnancy, menopause status, thyroid hormones, and various pathologic conditions including type 2 diabetes, insulin resistance, hypertension, and renal dysfunction. Lifestyle factors, especially dietary habits, but also smoking habits and the degree of physical activity influence NO homeostasis and the circulating levels of NOx. Elevated serum NOx, due to increased iNOS activity, is associated with increased incidence of metabolic syndrome, different obesity phenotypes, and cardiovascular events.
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Affiliation(s)
- Zahra Bahadoran
- a Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Parvin Mirmiran
- b Department of Clinical Nutrition and Diet Therapy, Faculty of Nutrition Sciences and Food Technology , National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Sajad Jeddi
- c Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Mattias Carlström
- d Department of Physiology and Pharmacology , Karolinska Institutet , Stockholm , Sweden
| | - Fereidoun Azizi
- e Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Asghar Ghasemi
- c Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
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Influence of Active Exposure to Tobacco Smoke on Nitric Oxide Status of Pregnant Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122719. [PMID: 30513890 PMCID: PMC6313314 DOI: 10.3390/ijerph15122719] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 12/12/2022]
Abstract
Smoking tobacco can impair proper vascular endothelial functioning. This is exhibited through reduced nitric oxide synthesis as well as activity due to accompanying oxidative stress. We examined the relationship between nitric oxide and markers of oxidative stress/antioxidant defense in serum of smoking and non-smoking pregnant women. Subjects included 99 healthy pregnant women, who were tested for nitric oxide (NO), endothelial (eNOS) and inducible (iNOS) nitric oxide synthase, total oxidant capacity (TOC), and total antioxidant capacity (TAC). NO, eNOS, and TAC serum concentrations were significantly lower (p < 0.005), but iNOS (p < 0.05) and TOC (p < 0.001) were higher in smokers than in non-smokers. Multivariate regression analysis showed associations between NO concentration and eNOS, TAC, and smoking status in the whole group of patients. In the model estimated separately for smokers, the highest impact of eNOS (β = 0.375; p = 0.021) and cotinine (β = −0.323; p = 0.037) was indicated for NO concentration. In the model of non-smokers, eNOS (β = 0.291, p = 0.030) and TAC (β = 0.350; p = 0.015) were important for NO level. Smoking during pregnancy could exacerbate oxidative stress, impair the action of nitric oxide synthases, and adversely affect the balance of oxygen and nitrogen metabolism. Relationships between NO concentrations and TAC in the studied women’s blood can confirm the antioxidant nature of nitric oxide.
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Taravati A, Tohidi F. Comprehensive analysis of oxidative stress markers and antioxidants status in preeclampsia. Taiwan J Obstet Gynecol 2018; 57:779-790. [DOI: 10.1016/j.tjog.2018.10.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2018] [Indexed: 12/13/2022] Open
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Yu W, Gao W, Rong D, Wu Z, Khalil RA. Molecular determinants of microvascular dysfunction in hypertensive pregnancy and preeclampsia. Microcirculation 2018; 26:e12508. [PMID: 30338879 PMCID: PMC6474836 DOI: 10.1111/micc.12508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/05/2018] [Accepted: 10/15/2018] [Indexed: 12/16/2022]
Abstract
Preeclampsia is a pregnancy-related disorder characterized by hypertension and often fetal intrauterine growth restriction, but the underlying mechanisms are unclear. Defective placentation and apoptosis of invasive cytotrophoblasts cause inadequate remodeling of spiral arteries, placental ischemia, and reduced uterine perfusion pressure (RUPP). RUPP causes imbalance between the anti-angiogenic factors soluble fms-like tyrosine kinase-1 and soluble endoglin and the pro-angiogenic vascular endothelial growth factor and placental growth factor, and stimulates the release of proinflammatory cytokines, hypoxia-inducible factor, reactive oxygen species, and angiotensin AT1 receptor agonistic autoantibodies. These circulating factors target the vascular endothelium, smooth muscle and various components of the extracellular matrix. Generalized endotheliosis in systemic, renal, cerebral, and hepatic vessels causes decreases in endothelium-derived vasodilators such as nitric oxide, prostacyclin and hyperpolarization factor, and increases in vasoconstrictors such as endothelin-1 and thromboxane A2. Enhanced mechanisms of vascular smooth muscle contraction, such as intracellular Ca2+ , protein kinase C, and Rho-kinase cause further increases in vasoconstriction. Changes in matrix metalloproteinases and extracellular matrix cause inadequate vascular remodeling and increased arterial stiffening, leading to further increases in vascular resistance and hypertension. Therapeutic options are currently limited, but understanding the molecular determinants of microvascular dysfunction could help in the design of new approaches for the prediction and management of preeclampsia.
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Affiliation(s)
- Wentao Yu
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Wei Gao
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Dan Rong
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Zhixian Wu
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Raouf A Khalil
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Kim S, Lee KS, Choi S, Kim J, Lee DK, Park M, Park W, Kim TH, Hwang JY, Won MH, Lee H, Ryoo S, Ha KS, Kwon YG, Kim YM. NF-κB-responsive miRNA-31-5p elicits endothelial dysfunction associated with preeclampsia via down-regulation of endothelial nitric-oxide synthase. J Biol Chem 2018; 293:18989-19000. [PMID: 30279269 DOI: 10.1074/jbc.ra118.005197] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/06/2018] [Indexed: 11/06/2022] Open
Abstract
Inflammatory cytokines, including tumor necrosis factor-α (TNFα), were elevated in patients with cardiovascular diseases and are also considered as crucial factors in the pathogenesis of preeclampsia; however, the underlying pathogenic mechanism has not been clearly elucidated. This study provides novel evidence that TNFα leads to endothelial dysfunction associated with hypertension and vascular remodeling in preeclampsia through down-regulation of endothelial nitric-oxide synthase (eNOS) by NF-κB-dependent biogenesis of microRNA (miR)-31-5p, which targets eNOS mRNA. In this study, we found that miR-31-5p was up-regulated in sera from patients with preeclampsia and in human endothelial cells treated with TNFα. TNFα-mediated induction of miR-31-5p was blocked by an NF-κB inhibitor and NF-κB p65 knockdown but not by mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3-kinase inhibitors, indicating that NF-κB is essential for biogenesis of miR-31-5p. The treatment of human endothelial cells with TNFα or miR-31-5p mimics decreased endothelial nitric-oxide synthase (eNOS) mRNA stability without affecting eNOS promoter activity, resulting in inhibition of eNOS expression and NO/cGMP production through blocking of the functional activity of the eNOS mRNA 3'-UTR. Moreover, TNFα and miR-31-5p mimic evoked endothelial dysfunction associated with defects in angiogenesis, trophoblastic invasion, and vasorelaxation in an ex vivo cultured model of human placental arterial vessels, which are typical features of preeclampsia. These results suggest that NF-κB-responsive miR-31-5p elicits endothelial dysfunction, hypertension, and vascular remodeling via post-transcriptional down-regulation of eNOS and is a molecular risk factor in the pathogenesis and development of preeclampsia.
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Affiliation(s)
- Suji Kim
- From the Departments of Molecular and Cellular Biochemistry
| | - Kyu-Sun Lee
- From the Departments of Molecular and Cellular Biochemistry
| | - Seunghwan Choi
- From the Departments of Molecular and Cellular Biochemistry
| | - Joohwan Kim
- From the Departments of Molecular and Cellular Biochemistry
| | - Dong-Keon Lee
- From the Departments of Molecular and Cellular Biochemistry
| | - Minsik Park
- From the Departments of Molecular and Cellular Biochemistry
| | - Wonjin Park
- From the Departments of Molecular and Cellular Biochemistry
| | - Tae-Hoon Kim
- From the Departments of Molecular and Cellular Biochemistry
| | | | - Moo-Ho Won
- Neurobiology, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341
| | - Hansoo Lee
- the Department of Biology, College of Natural Sciences, Kangwon National University, Chuncheon, Gangwon-do 24341, and
| | - Sungwoo Ryoo
- the Department of Biology, College of Natural Sciences, Kangwon National University, Chuncheon, Gangwon-do 24341, and
| | - Kwon-Soo Ha
- From the Departments of Molecular and Cellular Biochemistry
| | - Young-Guen Kwon
- the Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul 03722, South Korea
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Larré AB, Sontag F, Pasin DM, Paludo N, do Amaral RR, da Costa BEP, Poli-de-Figueiredo CE. Phosphodiesterase Inhibition in the Treatment of Preeclampsia: What Is New? Curr Hypertens Rep 2018; 20:83. [PMID: 30051151 DOI: 10.1007/s11906-018-0883-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW The present study intends to review the possibility of using phosphodiesterase inhibitors as a treatment option for preeclampsia, addressing potential risks and benefits. RECENT FINDINGS Preeclampsia is the most common hypertensive disorder of pregnancy, often responsible for severe maternal and fetal complications, which can lead to early pregnancy termination and death. Despite the numerous studies, its pathophysiology is still unclear, although it seems to involve a multiplicity of complex factors related to angiogenesis, ineffective vasodilation, oxidative stress, inflammatory cytokines, and endothelial dysfunction. It has been hypothetically suggested that the use of phosphodiesterase inhibitors is capable of improving placental and fetal perfusion, contributing to gestational scenario, by decreasing the symptomatology and severity of this syndrome. In this literature review, it has been found that most of the studies were conducted in animal models, and there is still lack of evidence supporting its use in clinical practice. Research in human indicates conflicting findings; randomized controlled trials were scarce and did not demonstrate any benefit in morbidity or mortality. Data regarding to pathophysiological and interventional research are described and commented in this review. The use of phosphodiesterase inhibitors in the treatment of preeclampsia is controversial and should not be encouraged taking into account recent data.
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Affiliation(s)
- Anne Brandolt Larré
- Postgraduate Program in Medicine and Health Sciences (Nephrology), Laboratory of Nephrology-School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernando Sontag
- Postgraduate Program in Medicine and Health Sciences (Nephrology), Laboratory of Nephrology-School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Débora Montenegro Pasin
- Postgraduate Program in Medicine and Health Sciences (Nephrology), Laboratory of Nephrology-School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Nathália Paludo
- Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Bartira Ercília Pinheiro da Costa
- Department of Internal Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil. .,São Lucas Hospital, Av Ipiranga 6690, Porto Alegre, 90 610 000, Brazil.
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Owusu Darkwa E, Djagbletey R, Sottie D, Owoo C, Vanderpuye NM, Essuman R, Aryee G. Serum nitric oxide levels in healthy pregnant women: a case- control study in a tertiary facility in Ghana. Matern Health Neonatol Perinatol 2018; 4:3. [PMID: 29479454 PMCID: PMC5819155 DOI: 10.1186/s40748-017-0072-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 12/28/2017] [Indexed: 12/31/2022] Open
Abstract
Background Pregnancy is associated with significant changes in maternal cardiovascular system which regulates oxygen and nutrient supply to the growing foetus. Nitric oxide, a physiologic vascular smooth muscle relaxant regulates blood flow and therefore may play a role in the cardiovascular changes in pregnancy. The study aimed to determine the levels and changes in maternal serum nitric oxide levels during healthy pregnancy. Methods A case-control study was conducted among 32 healthy non-pregnant women as controls and 100 healthy pregnant women (consisting of 33 first trimester, 37 s trimester, and 30 third trimester) as cases. Subjects were consecutively recruited into the study after obtaining an informed consent and meeting the inclusion criteria. Griess Reagent method was used to determine serum nitric oxide levels. Results There were no statistically significant difference in the ages and parity of recruited cases and controls. Mean arterial blood pressures were significantly lower (p = 0.009) and serum nitric oxide levels were significantly higher (p < 0.001) in healthy pregnant women compared to healthy non-pregnant women. There was a non-significant progressive increase in serum nitric oxide levels during healthy normal pregnancy. Conclusions The finding of a significantly reduced blood pressures and a significant increase in serum nitric oxide levels in healthy pregnancy may suggest a role of nitric oxide in vascular adaptation in pregnancy.
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Affiliation(s)
- Ebenezer Owusu Darkwa
- 1Department of Anaesthesia, Korle-bu Teaching Hospital, University of Ghana School of Medicine and Dentistry, College of Health Sciences, P. O. Box 4236, Accra, Ghana
| | - Robert Djagbletey
- 1Department of Anaesthesia, Korle-bu Teaching Hospital, University of Ghana School of Medicine and Dentistry, College of Health Sciences, P. O. Box 4236, Accra, Ghana
| | - Daniel Sottie
- 2Department of Anaesthesia, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Christian Owoo
- 1Department of Anaesthesia, Korle-bu Teaching Hospital, University of Ghana School of Medicine and Dentistry, College of Health Sciences, P. O. Box 4236, Accra, Ghana
| | | | - Raymond Essuman
- 1Department of Anaesthesia, Korle-bu Teaching Hospital, University of Ghana School of Medicine and Dentistry, College of Health Sciences, P. O. Box 4236, Accra, Ghana
| | - George Aryee
- 1Department of Anaesthesia, Korle-bu Teaching Hospital, University of Ghana School of Medicine and Dentistry, College of Health Sciences, P. O. Box 4236, Accra, Ghana
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Hemodynamic and Electrocardiographic Aspects of Uncomplicated Singleton Pregnancy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1065:413-431. [PMID: 30051399 DOI: 10.1007/978-3-319-77932-4_26] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Pregnancy is associated with significant changes in maternal hemodynamics, which are triggered by profound systemic vasodilation and mediated through the autonomic nervous system as well as the renin-angiotensin-aldosterone system. Vascular function changes to help accommodate an increase in intravascular volume due to blood volume expansion associated with pregnancy while maintaining the efficiency of ventricular-arterial coupling and diastolic perfusion pressure. The heart undergoes physiological (eccentric) hypertrophy due to increased volume load and cardiac stroke work, whereas the functional change of the left ventricle remains controversial. There are changes in cardiac electrical activity during pregnancy which can be detected in the electrocardiogram that are not related to disease. Sympathetic activation is a common phenomenon during uncomplicated pregnancy and may be a compensatory mechanism induced by profound systemic vasodilation and a decrease in mean arterial pressure. Despite marked sympathetic activation, vasoconstrictor responsiveness is blunted during uncomplicated pregnancy. There are race and ethnic differences in maternal hemodynamic adaptations to uncomplicated pregnancy, which may be attributed to differences in socioeconomic status or in prevalence rates of cardiovascular risk factors.
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Gao Q, Tang J, Li N, Liu B, Zhang M, Sun M, Xu Z. What is precise pathophysiology in development of hypertension in pregnancy? Precision medicine requires precise physiology and pathophysiology. Drug Discov Today 2017; 23:286-299. [PMID: 29101000 DOI: 10.1016/j.drudis.2017.10.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 09/25/2017] [Accepted: 10/23/2017] [Indexed: 01/12/2023]
Abstract
It is widely accepted that placental ischemia is central in the evolution of hypertension in pregnancy. Many studies and reviews have targeted placental ischemia to explain mechanisms for initiating pregnancy hypertension. The placenta is rich in blood vessels, which are the basis for developing placental ischemia. However, is the physiology of placental vessels the same as that of nonplacental vessels? What is the pathophysiology of placental vessels in development of pregnancy hypertension? This review aims to provide a comprehensive summary of special features of placental vascular regulations and the pathophysiological changes linked to preeclamptic conditions. Interestingly, some popular theories or accepted concepts could be based on our limited knowledge and evidence regarding placental vascular physiology, pharmacology and pathophysiology. New views raised could offer interesting ideas for future investigation of mechanisms as well as targets for pregnancy hypertension.
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Affiliation(s)
- Qinqin Gao
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Jiaqi Tang
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Na Li
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Bailin Liu
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Mengshu Zhang
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Miao Sun
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China.
| | - Zhice Xu
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China; Center for Perinatal Biology, Loma Linda University, CA, USA.
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Amaral LM, Faulkner JL, Elfarra J, Cornelius DC, Cunningham MW, Ibrahim T, Vaka VR, McKenzie J, LaMarca B. Continued Investigation Into 17-OHPC: Results From the Preclinical RUPP Rat Model of Preeclampsia. Hypertension 2017; 70:1250-1255. [PMID: 29084881 DOI: 10.1161/hypertensionaha.117.09969] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 07/31/2017] [Accepted: 09/25/2017] [Indexed: 12/24/2022]
Abstract
Preeclampsia is characterized by elevated TNF-α (tumor necrosis factor-α), antiangiogenic factors, such as sFlt-1 (soluble vascular endothelial growth factor receptor 1), increased uterine artery resistance index, and decreased of NO during pregnancy. Previously we showed that 17-hydroxyprogesterone caproate (17-OHPC) administered into reduced uterine perfusion pressure (RUPP) rats on day 18 of gestation improved hypertension without improving pup weight. We hypothesized that earlier administration of 17-OHPC on day 15 of gestation could improve pathophysiology of preeclampsia and fetal outcomes in response to placental ischemia. Carotid catheters were inserted on day 18, and mean arterial blood pressure and samples were collected on day 19. Mean arterial blood pressure in normal pregnant rats was 102±2, 105±2 in normal pregnant+day 15 of gestation (GD15) 17-OHPC, 127±2 in RUPP and 112±1 mm Hg in RUPP+GD15 17-OHPC, P<0.05. Pup weight and litter size were improved from 1.9±0.05, 10.1±1.4 in RUPP to 2.1±0.07 g and 13.2±0.6 in RUPP+GD15 17-OHPC, P<0.05. Uterine artery resistance index was 0.8±0.03 in RUPP, which was decreased to 0.6±0.04 in RUPP+GD15 17-OHPC, P<0.05. Plasma TNF-α levels were 164±34 in RUPP and blunted to 29±9 pg/mL in RUPP+GD15 17-OHPC, P<0.05. Plasma nitrate-nitrite levels were 10.8±2.3 in RUPP rats and significantly increased to 25.5±5.2 µmol/L in RUPP+GD15 17-OHPC, P<0.05. sFlt-1 levels were 386±141 in RUPP rats, which were reduced to 110.2±11 in RUPP+17-OHPC, P<0.05. These data indicate that GD15 17-OHPC improves pathophysiology in RUPP rats, possibly via improving sFlt-1 reduced NO during pregnancy.
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Affiliation(s)
- Lorena M Amaral
- From the Department of Pharmacology (L.M.A., M.W.C., T.I., V.R.V., B.L.), Department of Obstetrics and Gynecology (J.E.), and Departments of Emergency Medicine and Pharmacology (D.C.C.), University of Mississippi Medical Center, Jackson; Department of Vascular Biology Center, Augusta University, GA (J.L.F.); and Department of Biological Sciences, Mississippi College, Clinton (J.M.)
| | - Jessica L Faulkner
- From the Department of Pharmacology (L.M.A., M.W.C., T.I., V.R.V., B.L.), Department of Obstetrics and Gynecology (J.E.), and Departments of Emergency Medicine and Pharmacology (D.C.C.), University of Mississippi Medical Center, Jackson; Department of Vascular Biology Center, Augusta University, GA (J.L.F.); and Department of Biological Sciences, Mississippi College, Clinton (J.M.)
| | - Jamil Elfarra
- From the Department of Pharmacology (L.M.A., M.W.C., T.I., V.R.V., B.L.), Department of Obstetrics and Gynecology (J.E.), and Departments of Emergency Medicine and Pharmacology (D.C.C.), University of Mississippi Medical Center, Jackson; Department of Vascular Biology Center, Augusta University, GA (J.L.F.); and Department of Biological Sciences, Mississippi College, Clinton (J.M.)
| | - Denise C Cornelius
- From the Department of Pharmacology (L.M.A., M.W.C., T.I., V.R.V., B.L.), Department of Obstetrics and Gynecology (J.E.), and Departments of Emergency Medicine and Pharmacology (D.C.C.), University of Mississippi Medical Center, Jackson; Department of Vascular Biology Center, Augusta University, GA (J.L.F.); and Department of Biological Sciences, Mississippi College, Clinton (J.M.)
| | - Mark W Cunningham
- From the Department of Pharmacology (L.M.A., M.W.C., T.I., V.R.V., B.L.), Department of Obstetrics and Gynecology (J.E.), and Departments of Emergency Medicine and Pharmacology (D.C.C.), University of Mississippi Medical Center, Jackson; Department of Vascular Biology Center, Augusta University, GA (J.L.F.); and Department of Biological Sciences, Mississippi College, Clinton (J.M.)
| | - Tarek Ibrahim
- From the Department of Pharmacology (L.M.A., M.W.C., T.I., V.R.V., B.L.), Department of Obstetrics and Gynecology (J.E.), and Departments of Emergency Medicine and Pharmacology (D.C.C.), University of Mississippi Medical Center, Jackson; Department of Vascular Biology Center, Augusta University, GA (J.L.F.); and Department of Biological Sciences, Mississippi College, Clinton (J.M.)
| | - Venkata Ramana Vaka
- From the Department of Pharmacology (L.M.A., M.W.C., T.I., V.R.V., B.L.), Department of Obstetrics and Gynecology (J.E.), and Departments of Emergency Medicine and Pharmacology (D.C.C.), University of Mississippi Medical Center, Jackson; Department of Vascular Biology Center, Augusta University, GA (J.L.F.); and Department of Biological Sciences, Mississippi College, Clinton (J.M.)
| | - Jessica McKenzie
- From the Department of Pharmacology (L.M.A., M.W.C., T.I., V.R.V., B.L.), Department of Obstetrics and Gynecology (J.E.), and Departments of Emergency Medicine and Pharmacology (D.C.C.), University of Mississippi Medical Center, Jackson; Department of Vascular Biology Center, Augusta University, GA (J.L.F.); and Department of Biological Sciences, Mississippi College, Clinton (J.M.)
| | - Babbette LaMarca
- From the Department of Pharmacology (L.M.A., M.W.C., T.I., V.R.V., B.L.), Department of Obstetrics and Gynecology (J.E.), and Departments of Emergency Medicine and Pharmacology (D.C.C.), University of Mississippi Medical Center, Jackson; Department of Vascular Biology Center, Augusta University, GA (J.L.F.); and Department of Biological Sciences, Mississippi College, Clinton (J.M.).
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Larré AB, Parisotto A, Rockenbach BF, Pasin DM, Capellari C, Escouto DC, Pinheiro da Costa BE, Poli-de-Figueiredo CE. Phosphodiesterases and preeclampsia. Med Hypotheses 2017; 108:94-100. [DOI: 10.1016/j.mehy.2017.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 07/20/2017] [Accepted: 08/03/2017] [Indexed: 01/12/2023]
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Nasifah I, Soeharto S, Nooryanto M. Effects of anti-lipid peroxidation of Punica granatum fruit extract in endothelial cells induced by plasma of severe pre-eclamptic patients. J Ayurveda Integr Med 2017; 8:215-217. [PMID: 28928008 PMCID: PMC5747508 DOI: 10.1016/j.jaim.2017.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 02/06/2017] [Accepted: 02/06/2017] [Indexed: 01/16/2023] Open
Abstract
Preeclampsia is a pregnancy disorder characterized by hypertension and proteinuria. This disorder involves oxidative stress and changes in endothelial homeostasis. This study was aimed to seek whether an ethanolic extract of Punica granatum fruit inhibits 8-iso-PGFα formation and modulates nitric oxide (NO) in endothelial cells induced by plasma from pre-eclamptic patients. Endothelial cells were cultured from human umbilical vein endothelial cells. At confluence, endothelial cells were divided into five groups, which included endothelial cells exposed to 2% plasma from normal pregnancy (NP), endothelial cells exposed to 2% plasma from pre-eclamptic patients (PP), endothelial cells exposed to PP in the presence of ethanolic extract of P. granatum (PP + PG) at the following three doses: 14; 28; and 56 ppm. Analysis of 8-iso-PGFα was done by immunoassay technique. Analysis of NO level was done by colorimetric technique. Plasma from PP significantly increased 8-iso-PGFα level compared to cells treated by normal pregnancy plasma. This increase in 8-iso-PGFα was significantly (p < 0.05) attenuated by all doses treatments of P. granatum extract. The level of NO was insignificant (p > 0.05) between groups. P. granatum fruit extract protects endothelial cells from oxidative stress induced by plasma from pre-eclamptic patients. Endothelial cells induce by preeclamptic plasma. 8-iso-PGFα level significantly increased. NO level insignificantly changed. All doses of Theobroma cacao attenuated this 8-iso-PGFα increase.
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Affiliation(s)
- Isri Nasifah
- Midwifery Programme, Ngudi Waluyo University, Ungaran, Semarang, Central of Java, Indonesia.
| | - Setyawati Soeharto
- Pharmacology Laboratory, Faculty of Medicine, Brawijaya University, Malang, East Java, Indonesia
| | - Mukhamad Nooryanto
- Obstetric and Gynecology Laboratory, Saiful Anwar General Hospital, Faculty of Medicine Brawijaya University, Malang, East Java, Indonesia
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Chen J, Khalil RA. Matrix Metalloproteinases in Normal Pregnancy and Preeclampsia. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2017; 148:87-165. [PMID: 28662830 PMCID: PMC5548443 DOI: 10.1016/bs.pmbts.2017.04.001] [Citation(s) in RCA: 183] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Normal pregnancy is associated with marked hemodynamic and uterine changes that allow adequate uteroplacental blood flow and uterine expansion for the growing fetus. These pregnancy-associated changes involve significant uteroplacental and vascular remodeling. Matrix metalloproteinases (MMPs) are important regulators of vascular and uterine remodeling. Increases in MMP-2 and MMP-9 have been implicated in vasodilation, placentation, and uterine expansion during normal pregnancy. The increases in MMPs could be induced by the increased production of estrogen and progesterone during pregnancy. MMP expression/activity may be altered during complications of pregnancy. Decreased vascular MMP-2 and MMP-9 may lead to decreased vasodilation, increased vasoconstriction, hypertensive pregnancy, and preeclampsia. Abnormal expression of uteroplacental integrins, cytokines, and MMPs may lead to decreased maternal tolerance, apoptosis of invasive trophoblast cells, inadequate remodeling of spiral arteries, and reduced uterine perfusion pressure (RUPP). RUPP may cause imbalance between the antiangiogenic factors soluble fms-like tyrosine kinase-1 and soluble endoglin and the proangiogenic vascular endothelial growth factor and placental growth factor, or stimulate the release of inflammatory cytokines, hypoxia-inducible factor, reactive oxygen species, and angiotensin AT1 receptor agonistic autoantibodies. These circulating factors could target MMPs in the extracellular matrix as well as endothelial and vascular smooth muscle cells, causing generalized vascular dysfunction, increased vasoconstriction and hypertension in pregnancy. MMP activity can also be altered by endogenous tissue inhibitors of metalloproteinases (TIMPs) and changes in the MMP/TIMP ratio. In addition to their vascular effects, decreases in expression/activity of MMP-2 and MMP-9 in the uterus could impede uterine growth and expansion and lead to premature labor. Understanding the role of MMPs in uteroplacental and vascular remodeling and function could help design new approaches for prediction and management of preeclampsia and premature labor.
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Affiliation(s)
- Juanjuan Chen
- Vascular Surgery Research Laboratories, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, United States
| | - Raouf A Khalil
- Vascular Surgery Research Laboratories, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, United States.
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Kim J, Lee KS, Kim JH, Lee DK, Park M, Choi S, Park W, Kim S, Choi YK, Hwang JY, Choe J, Won MH, Jeoung D, Lee H, Ryoo S, Ha KS, Kwon YG, Kim YM. Aspirin prevents TNF-α-induced endothelial cell dysfunction by regulating the NF-κB-dependent miR-155/eNOS pathway: Role of a miR-155/eNOS axis in preeclampsia. Free Radic Biol Med 2017; 104:185-198. [PMID: 28087411 DOI: 10.1016/j.freeradbiomed.2017.01.010] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 12/28/2016] [Accepted: 01/06/2017] [Indexed: 12/13/2022]
Abstract
Preeclampsia is an inflammatory disease with endothelial cell dysfunction that occurs via decreased endothelial nitric oxide synthase/nitric oxide (eNOS/NO) activity. Aspirin reduces the incidence of hypertensive pregnancy complications. However, the underlying mechanism has not been clearly explained. Here, we found that tumor necrosis factor (TNF)-α, microRNA (miR)-155, and eNOS levels as well as endothelial redox phenotype were differentially regulated in preeclamptic patients, implying the involvement of TNF-α- and redox signal-mediated miR-155 biogenesis and eNOS downregulation in the pathogenesis of preeclampsia. Aspirin prevented the TNF-α-mediated increase in miR-155 biogenesis and decreases in eNOS expression and NO/cGMP production in cultured human umbilical vein endothelial cells (HUVECs). Similar effects of aspirin were also observed in HUVECs treated with H2O2. The preventive effects of aspirin was associated with the inhibition of nuclear factor-κB (NF-κB)-dependent MIR155HG (miR-155 host gene) expression. Aspirin recovered the TNF-α-mediated decrease in wild-type, but not mutant, eNOS 3'-untranslated region reporter activity, whose effect was blocked by miR-155 mimic. Moreover, aspirin prevented TNF-α-mediated endothelial cell dysfunction associated with impaired vasorelaxation, angiogenesis, and trophoblast invasion, and the preventive effects were blocked by miR-155 mimic or an eNOS inhibitor. Aspirin rescued TNF-α-mediated eNOS downregulation coupled with endothelial dysfunction by inhibiting NF-κB-dependent transcriptional miR-155 biogenesis. Thus, the redox-sensitive NF-κB/miR-155/eNOS axis may be crucial in the pathogenesis of vascular disorders including preeclampsia.
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Affiliation(s)
- Joohwan Kim
- Departments of Molecular and Cellular Biochemistry, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341, South Korea
| | - Kyu-Sun Lee
- Departments of Molecular and Cellular Biochemistry, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341, South Korea
| | - Ji-Hee Kim
- Departments of Molecular and Cellular Biochemistry, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341, South Korea
| | - Dong-Keon Lee
- Departments of Molecular and Cellular Biochemistry, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341, South Korea
| | - Minsik Park
- Departments of Molecular and Cellular Biochemistry, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341, South Korea
| | - Seunghwan Choi
- Departments of Molecular and Cellular Biochemistry, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341, South Korea
| | - Wonjin Park
- Departments of Molecular and Cellular Biochemistry, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341, South Korea
| | - Suji Kim
- Departments of Molecular and Cellular Biochemistry, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341, South Korea
| | - Yoon Kyung Choi
- Departments of Molecular and Cellular Biochemistry, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341, South Korea
| | - Jong Yun Hwang
- Departments of Obstetrics and Gynecology, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341, South Korea
| | - Jongseon Choe
- Departments of Immunology, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341, South Korea
| | - Moo-Ho Won
- Departments of Neurobiology, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341, South Korea
| | - Dooil Jeoung
- Departments of Biochemistry, College of Natural Sciences, Kangwon National University, Chuncheon, Gangwon-do 24341, South Korea
| | - Hansoo Lee
- Departments of Biology, College of Natural Sciences, Kangwon National University, Chuncheon, Gangwon-do 24341, South Korea
| | - Sungwoo Ryoo
- Departments of Biology, College of Natural Sciences, Kangwon National University, Chuncheon, Gangwon-do 24341, South Korea
| | - Kwon-Soo Ha
- Departments of Molecular and Cellular Biochemistry, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341, South Korea
| | - Young-Guen Kwon
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul 03722, South Korea
| | - Young-Myeong Kim
- Departments of Molecular and Cellular Biochemistry, Kangwon National University School of Medicine, Chuncheon, Gangwon-do 24341, South Korea.
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Villalobos-Labra R, Silva L, Subiabre M, Araos J, Salsoso R, Fuenzalida B, Sáez T, Toledo F, González M, Quezada C, Pardo F, Chiarello DI, Leiva A, Sobrevia L. Akt/mTOR Role in Human Foetoplacental Vascular Insulin Resistance in Diseases of Pregnancy. J Diabetes Res 2017; 2017:5947859. [PMID: 29104874 PMCID: PMC5618766 DOI: 10.1155/2017/5947859] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 08/15/2017] [Indexed: 12/25/2022] Open
Abstract
Insulin resistance is characteristic of pregnancies where the mother shows metabolic alterations, such as preeclampsia (PE) and gestational diabetes mellitus (GDM), or abnormal maternal conditions such as pregestational maternal obesity (PGMO). Insulin signalling includes activation of insulin receptor substrates 1 and 2 (IRS1/2) as well as Src homology 2 domain-containing transforming protein 1, leading to activation of 44 and 42 kDa mitogen-activated protein kinases and protein kinase B/Akt (Akt) signalling cascades in the human foetoplacental vasculature. PE, GDM, and PGMO are abnormal conditions coursing with reduced insulin signalling, but the possibility of the involvement of similar cell signalling mechanisms is not addressed. This review aimed to determine whether reduced insulin signalling in PE, GDM, and PGMO shares a common mechanism in the human foetoplacental vasculature. Insulin resistance in these pathological conditions results from reduced Akt activation mainly due to inhibition of IRS1/2, likely due to the increased activity of the mammalian target of rapamycin (mTOR) resulting from lower activity of adenosine monophosphate kinase. Thus, a defective signalling via Akt/mTOR in response to insulin is a central and common mechanism of insulin resistance in these diseases of pregnancy. In this review, we summarise the cell signalling mechanisms behind the insulin resistance state in PE, GDM, and PGMO focused in the Akt/mTOR signalling pathway in the human foetoplacental endothelium.
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Affiliation(s)
- Roberto Villalobos-Labra
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024 Santiago, Chile
| | - Luis Silva
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024 Santiago, Chile
- Immunoendocrinology, Division of Medical Biology, Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen (UMCG), 9700 RB Groningen, Netherlands
| | - Mario Subiabre
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024 Santiago, Chile
| | - Joaquín Araos
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024 Santiago, Chile
| | - Rocío Salsoso
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024 Santiago, Chile
- Department of Physiology, Faculty of Pharmacy, Universidad de Sevilla, 41012 Seville, Spain
| | - Bárbara Fuenzalida
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024 Santiago, Chile
| | - Tamara Sáez
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024 Santiago, Chile
- Immunoendocrinology, Division of Medical Biology, Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen (UMCG), 9700 RB Groningen, Netherlands
| | - Fernando Toledo
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024 Santiago, Chile
- Department of Basic Sciences, Faculty of Sciences, Universidad del Bío-Bío, 3780000 Chillán, Chile
| | - Marcelo González
- Vascular Physiology Laboratory, Department of Physiology, Faculty of Biological Sciences, Universidad de Concepción, 4070386 Concepción, Chile
| | - Claudia Quezada
- Institute of Biochemistry and Microbiology, Science Faculty, Universidad Austral de Chile, 5110566 Valdivia, Chile
| | - Fabián Pardo
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024 Santiago, Chile
- Metabolic Diseases Research Laboratory, Center of Research, Development and Innovation in Health-Aconcagua Valley, School of Medicine, Faculty of Medicine, Universidad de Valparaíso, San Felipe Campus, 2172972 San Felipe, Chile
| | - Delia I. Chiarello
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024 Santiago, Chile
| | - Andrea Leiva
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024 Santiago, Chile
| | - Luis Sobrevia
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024 Santiago, Chile
- Department of Physiology, Faculty of Pharmacy, Universidad de Sevilla, 41012 Seville, Spain
- University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston, Brisbane, QLD 4029, Australia
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Possomato-Vieira JS, Gonçalves-Rizzi VH, Graça TUS, Nascimento RA, Dias-Junior CA. Sodium hydrosulfide prevents hypertension and increases in vascular endothelial growth factor and soluble fms-like tyrosine kinase-1 in hypertensive pregnant rats. Naunyn Schmiedebergs Arch Pharmacol 2016; 389:1325-1332. [DOI: 10.1007/s00210-016-1296-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 08/29/2016] [Indexed: 12/27/2022]
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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: 145] [Impact Index Per Article: 18.1] [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.
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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.
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Acauan Filho BJ, Pinheiro da Costa BE, Ogando PB, Vieira MC, Antonello IC, Poli-de-Figueiredo CE. Serum nitrate and NOx levels in preeclampsia are higher than in normal pregnancy. Hypertens Pregnancy 2016; 35:226-33. [PMID: 27003519 DOI: 10.3109/10641955.2016.1139718] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To compare nitric oxide (NO) serum levels in women with and without preeclampsia. METHODS 106 women were classified into preeclampsia group (n = 40) and normotensive group (n = 66). NO content was measured in the serum. Clinical and laboratorial data were recorded for comparison. RESULTS Preeclampsia presented a significant increase in nitrate and NOx levels compared to the control group. Uric acid, gestational age, systolic and diastolic blood pressure, and creatinine showed correlation with nitrates and NOx. CONCLUSION Increase of NO was observed in preeclampsia women. Failure in the mechanism of action, dependent on cyclic GMP, may justify this finding.
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Affiliation(s)
- Breno José Acauan Filho
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Bartira Ercilia Pinheiro da Costa
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Patrícia Barcelos Ogando
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Matias Costa Vieira
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Ivan Carlos Antonello
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Carlos Eduardo Poli-de-Figueiredo
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
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31
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Jorge Neto SD, Machado JSR, Palei ACT, Martins WP, Sandrim VC, Araujo Júnior E, Amaral LM, Tanus-Santos JE, Duarte G, Cavalli RC. Assessment of nitrite oxide and maternal-fetal Doppler parameters during pregnancy. J Matern Fetal Neonatal Med 2015; 29:3406-9. [PMID: 26653276 DOI: 10.3109/14767058.2015.1130817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The objective was to evaluate and compare the whole blood nitrite concentration in the three trimesters of pregnancy. Additionally, we investigate whether there is any relation between nitrite concentrations and Doppler ultrasound analysis of some maternal and fetal vessels. METHODS Thirty-three healthy pregnant women were examined at the first (11-14 weeks), second (20-24 weeks) and third trimester (34-36 weeks) of pregnancy. In the three exams, we determined the maternal whole blood nitrite concentration and uterine arteries Doppler analysis to determine pulsatility index (PI), and resistance index (RI). In the second and third trimester we also performed fetal umbilical and middle cerebral arteries PI and RI. We compared the concentrations of nitrite in three trimesters and correlated with Doppler parameters. RESULTS No difference was observed in the whole blood nitrite concentrations across trimesters: 151.70 ± 77.90 nmol/ml, 142.10 ± 73.50 nmol/ml and 147.10 ± 87.30 nmol/ml; first, second and third trimesters, respectively. We found no difference in correlation between whole blood nitrite concentration and Doppler parameters from the evaluated vessels. CONCLUSIONS In healthy pregnant women, the nitrite concentrations did not change across gestational trimesters and there was also no strong correlation with Doppler impedance indices from maternal uterine arteries and fetal umbilical and middle cerebral arteries.
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Affiliation(s)
- Salim Demétrio Jorge Neto
- a Department of Obstetrics and Gynecology , Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP) , Ribeirão Preto - SP , Brazil
| | - Jackeline Souza Rangel Machado
- a Department of Obstetrics and Gynecology , Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP) , Ribeirão Preto - SP , Brazil
| | - Ana Carolina Tavares Palei
- b Departament of Physiology and Biophysics , University of Mississipi Medical Center , Jackson , MS , USA
| | - Wellington Paula Martins
- a Department of Obstetrics and Gynecology , Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP) , Ribeirão Preto - SP , Brazil
| | - Valéria Cristina Sandrim
- c Departament of Pharmacology , Botucatu Medical School, São Paulo State University (UNESP) , Botucatu - SP , Brazil
| | - Edward Araujo Júnior
- d Department of Obstetrics , Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP) , São Paulo - SP , Brazil , and
| | - Lorena Machado Amaral
- b Departament of Physiology and Biophysics , University of Mississipi Medical Center , Jackson , MS , USA
| | - José Eduardo Tanus-Santos
- e Departament of Pharmacology , Ribeirão Preto Medical School, University of Sao Paulo (FMRP-USP) , Ribeirão Preto - SP , Brazil
| | - Geraldo Duarte
- a Department of Obstetrics and Gynecology , Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP) , Ribeirão Preto - SP , Brazil
| | - Ricardo Carvalho Cavalli
- a Department of Obstetrics and Gynecology , Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP) , Ribeirão Preto - SP , Brazil
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Amaral LM, Cunningham MW, Cornelius DC, LaMarca B. Preeclampsia: long-term consequences for vascular health. Vasc Health Risk Manag 2015. [PMID: 26203257 PMCID: PMC4508084 DOI: 10.2147/vhrm.s64798] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Preeclampsia (PE) is a pregnancy-specific syndrome and one of the leading causes of preterm birth, neonatal and maternal morbidity and mortality. This disease is characterized by new onset hypertension usually in the third trimester of pregnancy and is sometimes associated with proteinuria, although proteinuria is not a requirement for the diagnosis of PE. In developing countries, women have a higher risk of death due to PE than more affluent countries and one of the most frequent causes of death is high blood pressure and stroke. Although PE only affects approximately 2%-8% of pregnancies worldwide it is associated with severe complications such as eclampsia, hemorrhagic stroke, hemolysis, elevated liver enzymes and low platelets (HELLP syndrome), renal failure and pulmonary edema. Importantly, there is no "cure" for the disease except for early delivery of the baby and placenta, leaving PE a health care risk for babies born from PE moms. In addition, PE is linked to the development of cardiovascular disease and stroke in women after reproductive age, leaving PE a risk factor for long-term health in women. This review will highlight factors implicated in the pathophysiology of PE that may contribute to long-term effects in women with preeclamptic pregnancies.
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Affiliation(s)
- Lorena M Amaral
- Department of Pharmacology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Mark W Cunningham
- Department of Pharmacology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Denise C Cornelius
- Department of Pharmacology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Babbette LaMarca
- Department of Pharmacology, University of Mississippi Medical Center, Jackson, MS, USA
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Byrne TJ. A "cure" for preeclampsia: Improving neonatal outcomes by overcoming excess fetal placental vascular resistance. Med Hypotheses 2015; 85:311-9. [PMID: 26105573 DOI: 10.1016/j.mehy.2015.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 03/10/2015] [Accepted: 06/02/2015] [Indexed: 02/01/2023]
Abstract
From a broad perspective there are only three arterial systems that respond to relative hypoxia with vasoconstriction. They are the placental, the pulmonic and the renal vascular beds. The renal system's adaptation to hypoxia is markedly different from the other two circulatory beds and will not be further considered here. Regional vasoconstriction is adaptive in the placenta and lung because it redirects red blood cells from areas of relative hypoxia to more oxygenated areas thereby maximizing oxygen uptake for a given cardiac output. The fetal placental and pulmonary vascular systems are unique because their smooth muscle cells have a unique and possibly identical potassium channel that responds to hypoxia by closing, thereby depolarizing the cell membrane allowing calcium ion influx and muscle contraction. It may be that a variety of initial causes of temporary or local placental hypoxia initiate a cascade of first fetal placental then maternal vasoconstriction and endothelial activation leading to the clinical syndrome we call preeclampsia. The response cascades seen in preeclampsia, which for purposes of this article I will abbreviate as (PECL), after development of widespread vasoconstriction, will also be seen to be identical or at least parallel in pulmonary hypertension (PAH). This means that some or all of the pharmacotherapies presently used, tested or considered in early PAH may also have a therapeutic effect in PECL by reducing fetal placental arterial resistance thereby increasing fetal placental flow. This would allow increased oxygen and other nutrient uptake and possibly increased fetal cardiac output in the face of reduced fetal cardiac work. This may allow a delay in delivery in which fetuses grow and are better oxygenated in preterm PECL, improving neonatal outcomes.
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Affiliation(s)
- T J Byrne
- Maternal Fetal Medicine, Harlem Hospital, 506 Lenox Avenue, New York, NY 10037, USA.
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Association of common eNOS/NOS3 polymorphisms with preeclampsia in Tunisian Arabs. Gene 2015; 569:303-7. [PMID: 26049094 DOI: 10.1016/j.gene.2015.05.072] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 05/09/2015] [Accepted: 05/29/2015] [Indexed: 11/24/2022]
Abstract
We investigated the association of endothelial nitric oxide synthase (NOS3) polymorphisms -786T>C, 27-bp repeat 4b/4a, and Glu298Asp with preeclampsia (PE). This was a case-control study involving 345 unrelated Tunisian women with PE and 289 unrelated age- and ethnically matched control women. The -786C allele was significantly increased in PA patients when compared to healthy controls (P=0.015). In contrast, MAF of Glu298Asp (P=0.103) and 4b/4a (P=0.168) were not significantly different between the study groups. Higher frequencies of heterozygous Glu298/298Asp and homozygous -786T/-786T genotypes were seen in PE cases compared to healthy subjects. The combination of genotypes 221 (-786T>C, Glu298Asp, 4a/4a) was more in PE cases compared with control women (17.68% vs. 8.36%; P=0.029). Multivariate regression analysis confirmed this association. Genetic variation at the NOS3 locus represents a genetic risk factor for increased susceptibility to PE.
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Peng S, Zhang J, Liu L, Zhang X, Huang Q, Alamdar A, Tian M, Shen H. Newborn Meconium and Urinary Metabolome Response to Maternal Gestational Diabetes Mellitus: A Preliminary Case–Control Study. J Proteome Res 2015; 14:1799-809. [DOI: 10.1021/pr5011857] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Siyuan Peng
- Key
Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, P.R. China
| | - Jie Zhang
- Key
Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, P.R. China
| | - Liangpo Liu
- Key
Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, P.R. China
| | - Xueqin Zhang
- Xiamen Maternity and Child Health Care Hospital, Xiamen 361003, P.R. China
| | - Qingyu Huang
- Key
Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, P.R. China
| | - Ambreen Alamdar
- Key
Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, P.R. China
| | - Meiping Tian
- Key
Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, P.R. China
| | - Heqing Shen
- Key
Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, P.R. China
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Adu-Bonsaffoh K, Antwi DA, Obed SA, Gyan B. Nitric oxide dysregulation in the pathogenesis of preeclampsia among Ghanaian women. Integr Blood Press Control 2015; 8:1-6. [PMID: 25733925 PMCID: PMC4340461 DOI: 10.2147/ibpc.s68454] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Preeclampsia (PE) is still a disease of theories as the exact cause remains uncertain. Widespread vascular endothelial cell dysfunction is thought to mediate the generalized vasospasm and hypertension characteristic of PE. Altered nitric oxide (NO) production has been associated with the endothelial dysfunction in the pathogenesis of PE but conflicting results have emerged from previous studies. OBJECTIVES To determine maternal serum levels of NO, a biomarker of endothelial function, in nonpregnant, normal pregnant, and preeclamptic women. MATERIALS AND METHODS This was a cross-sectional case-control study of 277 women comprising 75 nonpregnant, 102 normal pregnant, and 100 preeclamptic women conducted at the Korle Bu Teaching Hospital between April and June 2011. About 5 mL of venous blood was obtained from the participants for the various investigations after meeting the inclusion criteria and signing to a written consent. Serum levels of NO were determined by Griess reaction. The data obtained were analyzed with SPSS version 20. RESULTS The study showed significantly elevated serum levels of NO in preeclamptic women (82.45±50.31 μM) compared with normal pregnant (33.12±17.81 μM) and nonpregnant (16.92±11.41 μM) women with P<0.001. The alteration in maternal serum NO levels was significantly more profound in early-onset (severe) PE (119.63±45.860 μM) compared to that of late-onset (mild) disease (62.44±40.44 μM) with P<0.001, indicating a more severe vascular endothelial cell dysfunction in the early-onset disease. CONCLUSION This study has determined a profound NO upregulation in PE evidenced by significant elevation of NO metabolite levels compared to normal pregnancy. This might be due to deranged endothelial function with dysregulated production of NO to restore the persistent hypertension characteristic of PE.
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Affiliation(s)
- Kwame Adu-Bonsaffoh
- Department of Physiology, University of Ghana Medical School, Accra, Ghana ; Department of Obstetrics and Gynecology, Korle Bu Teaching Hospital, Accra, Ghana
| | | | - Samuel Amenyi Obed
- Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana
| | - Ben Gyan
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Sánchez-Aranguren LC, Prada CE, Riaño-Medina CE, Lopez M. Endothelial dysfunction and preeclampsia: role of oxidative stress. Front Physiol 2014; 5:372. [PMID: 25346691 PMCID: PMC4193194 DOI: 10.3389/fphys.2014.00372] [Citation(s) in RCA: 257] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 09/09/2014] [Indexed: 01/22/2023] Open
Abstract
Preeclampsia (PE) is an often fatal pathology characterized by hypertension and proteinuria at the 20th week of gestation that affects 5-10% of the pregnancies. The problem is particularly important in developing countries in where the incidence of hypertensive disorders of pregnancy is higher and maternal mortality rates are 20 times higher than those reported in developed countries. Risk factors for the development of PE include obesity, insulin resistance and hyperlipidemia that stimulate inflammatory cytokine release and oxidative stress leading to endothelial dysfunction (ED). However, how all these clinical manifestations concur to develop PE is still not very well understood. The related poor trophoblast invasion and uteroplacental artery remodeling described in PE, increases reactive oxygen species (ROS), hypoxia and ED. Here we aim to review current literature from research showing the interplay between oxidative stress, ED and PE to the outcomes of current clinical trials aiming to prevent PE with antioxidant supplementation.
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Affiliation(s)
- Lissette C. Sánchez-Aranguren
- Translational Biomedical Research Group, Biotechnology, Innovation and Technology Development, Cardiovascular Foundation of ColombiaFloridablanca, Colombia
- Graduate Program in Biomedical Sciences, Faculty of Health, Universidad del ValleCali, Colombia
| | - Carlos E. Prada
- Translational Biomedical Research Group, Biotechnology, Innovation and Technology Development, Cardiovascular Foundation of ColombiaFloridablanca, Colombia
- Center for Genomic Medicine and Metabolism, Instituto del Corazón de Floridablanca, Cardiovascular Foundation of ColombiaFloridablanca, Colombia
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of MedicineCincinnati, OH, USA
| | - Carlos E. Riaño-Medina
- Translational Biomedical Research Group, Biotechnology, Innovation and Technology Development, Cardiovascular Foundation of ColombiaFloridablanca, Colombia
- Maternal-Fetal Medicine Program, Cardiovascular Foundation of ColombiaFloridablanca, Colombia
| | - Marcos Lopez
- Translational Biomedical Research Group, Biotechnology, Innovation and Technology Development, Cardiovascular Foundation of ColombiaFloridablanca, Colombia
- Graduate Program in Biomedical Sciences, Faculty of Health, Universidad del ValleCali, Colombia
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Abstract
The microcirculation, like all physiological systems undergoes modifications during the course of pregnancy. These changes aid the adaption to the new anatomical and physiological environment of pregnancy and ensure adequate oxygen supply to the fetus. Even though the microcirculation is believed to be involved in major pregnancy related pathologies, it remains poorly understood. The availability of safe and non-interventional technologies enabling scientists to study the intact microcirculation of the pregnant patient will hopefully expand our understanding. In this article we review the physiological changes occurring in the microcirculation during pregnancy and the role of the microcirculation in gestational related pathologies. We will also describe the available techniques for the measurement and evaluation of the microcirculation. Lastly we will highlight the possible fields in which these techniques could be utilized to help provide a clearer view of the microcirculation in the pregnant woman.
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Affiliation(s)
| | | | | | - V. CERNY
- Department of Anesthesiology and Intensive Care Medicine, Charles University in Prague, Faculty of Medicine Hradec Kralove, Czech Republic
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Abstract
Pregnancy causes dramatic physiological changes in the expectant mother. The placenta, mostly foetal in origin, invades maternal uterine tissue early in pregnancy and unleashes a barrage of hormones and other factors. This foetal 'invasion' profoundly reprogrammes maternal physiology, affecting nearly every organ, including the heart and its metabolism. We briefly review here maternal systemic metabolic changes during pregnancy and cardiac metabolism in general. We then discuss changes in cardiac haemodynamic during pregnancy and review what is known about maternal cardiac metabolism during pregnancy. Lastly, we discuss cardiac diseases during pregnancy, including peripartum cardiomyopathy, and the potential contribution of aberrant cardiac metabolism to disease aetiology.
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Affiliation(s)
- Laura X Liu
- Cardiovascular Institute, and Center for Vascular Biology Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
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40
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Yusuf K, Wilson RD, Kamaluddeen M, Franta J, Hasan SU, Akierman A. Methemoglobin levels in umbilical cord blood of women with intrauterine growth restriction and preeclampsia. J Matern Fetal Neonatal Med 2013; 27:789-94. [DOI: 10.3109/14767058.2013.838949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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41
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Zhou Q, Shen J, Zhou G, Shen L, Zhou S, Li X. Effects of magnesium sulfate on heart rate, blood pressure variability and baroreflex sensitivity in preeclamptic rats treated with L-NAME. Hypertens Pregnancy 2013; 32:422-31. [DOI: 10.3109/10641955.2013.824978] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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McCarthy FP, Delany AC, Kenny LC, Walsh SK. PPAR-γ -- a possible drug target for complicated pregnancies. Br J Pharmacol 2013. [PMID: 23186152 DOI: 10.1111/bph.12069] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Peroxisome proliferator activated receptors (PPARs) are ligand-activated transcription factors expressed in trophoblasts, which regulate both cell differentiation and proliferation. In recent years, evidence has linked PPARs to playing an integral role in pregnancy; specifically, PPAR-β and PPAR-γ have been shown to play an integral role in placentation, with PPAR-γ additionally serving to regulate trophoblast differentiation. Recent evidence has shown that PPAR-γ expression is altered in many complications of pregnancy such as intrauterine growth restriction (IUGR), preterm birth, pre-clampsia and gestational diabetes. Thus, at present, accumulating evidence from the literature suggests both a pivotal role for PPAR-γ in the progression of a healthy pregnancy and the possibility that PPAR-γ may act as a therapeutic target in complicated pregnancies. This review aims to provide a succinct and comprehensive assessment of the role of PPAR-γ in normal pregnancy and pregnancy complications, and finally its potential as a therapeutic target in the treatment and/or prevention of adverse pregnancy outcomes.
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Affiliation(s)
- Fergus P McCarthy
- Department of Obstetrics & Gynaecology, Anu Research Centre, University College Cork, Cork, Ireland
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Demir B, Demir S, Pasa S, Guven S, Atamer Y, Atamer A, Kocyigit Y. The role of homocysteine, asymmetric dimethylarginine and nitric oxide in pre-eclampsia. J OBSTET GYNAECOL 2012; 32:525-8. [PMID: 22779953 DOI: 10.3109/01443615.2012.693985] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Nitric oxide (NO) contributes to vasodilatation that is observed during normal pregnancy. Hyperhomocysteinaemia (HHcy) is a vascular risk factor associated with placental microvascular diseases and pre-eclampsia. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of endothelial nitric oxide synthase (NOS) has been linked to endothelial dysfunction. Maternal ADMA has been reported to be higher in women with pre-eclampsia and HHcy leads to accumulation of ADMA. The aim of this presented study is to evaluate the alterations of plasma homocysteine, ADMA and NO levels in mild pre-eclampsia. A total of 40 pre-eclamptic women and 40 healthy controls were included into the study. Mean systolic and diastolic blood pressure, mean serum homocysteine and ADMA levels were significantly higher and NO level was lower in patients. Serum homocysteine, ADMA and NO levels found to be correlated among them and with blood pressure. In conclusion, we found that homocysteine and ADMA levels were increased and NO levels decreased in pre-eclampsia.
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Affiliation(s)
- B Demir
- Ergani State Hospital, Department of Obstetrics and Gynecology, Diyarbakir, Turkey.
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Chedraui P, Solis EJ, Bocci G, Gopal S, Russo E, Escobar GS, Hidalgo L, Pérez-López FR, Genazzani AR, Mannella P, Simoncini T. Feto-placental nitric oxide, asymmetric dimethylarginine and vascular endothelial growth factor (VEGF) levels and VEGF gene polymorphisms in severe preeclampsia. J Matern Fetal Neonatal Med 2012; 26:226-32. [PMID: 23039092 DOI: 10.3109/14767058.2012.733760] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To measure plasma nitric oxide (NO), asymmetric dimethylarginine (ADMA) and vascular endothelial growth factor (VEGF) levels and VEGF gene polymorphisms in fetal circulation in severe preeclampsia. METHODS Cord vessels of singleton gestations complicated with severe preeclampsia 36 weeks or more (n = 31) and controls were sampled upon delivery for analyte measuring. Additionally, DNA was extracted from umbilical vein whole blood to determine the frequency of VEGF gene single nucleotide polymorphisms (SNPs): -2578 A/C, -1498 C/T, -1154 A/G, -634 C/G and +936 C/T. Coefficient correlations between analyte levels and placental and neonatal weight were calculated. RESULTS NO plasma levels in umbilical vessels (artery and vein) were significantly higher in preeclampsia cases as compared to controls (4.67 ± 3.0 vs. 0.82 ± 0.90; 4.46 ± 3.0 vs. 0.82 ± 0.99 mmol/L, respectively, p = 0.0001 both). ADMA levels displayed a similar increased trend in both fetal vessels, but this did not reach statistical significance (2.57 ± 1.03 vs. 2.34 ± 0.57; 2.74 ± 0.94 vs. 2.42 ± 0.59 mmol/L, respectively, p > 0.05). VEGF was significantly lower in artery but not in vein in preeclampsia cases (200.48 ± 225.62 vs. 338.61 ± 287.03 pg/mL, p = 0.04). A significant positive correlation was found between NO and ADMA levels (artery and vein) among preeclampsia cases. Overall, the frequency of the studied VEGF gene SNPs did not differ among pre-eclamptic cases and controls; nevertheless, a significant trend toward lower umbilical vein VEGF levels was observed in pre-eclampsia cases in the presence of -2578 CC and -1154 AG genotypes. CONCLUSION Near term gestations complicated with severe preeclampsia presented higher NO levels in fetal circulation, which correlated to ADMA and lower artery VEGF values. More research is warranted to confirm that selected VEGF SNPs may be associated with lower umbilical vein VEGF.
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Affiliation(s)
- Peter Chedraui
- High Risk Pregnancy Labor and Delivery Unit, Enrique C. Sotomayor Obstetrics and Gynecology Hospital Guayaquil, Ecuador.
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Agarwal A, Aponte-Mellado A, Premkumar BJ, Shaman A, Gupta S. The effects of oxidative stress on female reproduction: a review. Reprod Biol Endocrinol 2012; 10:49. [PMID: 22748101 PMCID: PMC3527168 DOI: 10.1186/1477-7827-10-49] [Citation(s) in RCA: 894] [Impact Index Per Article: 74.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 06/06/2012] [Indexed: 12/16/2022] Open
Abstract
Oxidative stress (OS), a state characterized by an imbalance between pro-oxidant molecules including reactive oxygen and nitrogen species, and antioxidant defenses, has been identified to play a key role in the pathogenesis of subfertility in both males and females. The adverse effects of OS on sperm quality and functions have been well documented. In females, on the other hand, the impact of OS on oocytes and reproductive functions remains unclear. This imbalance between pro-oxidants and antioxidants can lead to a number of reproductive diseases such as endometriosis, polycystic ovary syndrome (PCOS), and unexplained infertility. Pregnancy complications such as spontaneous abortion, recurrent pregnancy loss, and preeclampsia, can also develop in response to OS. Studies have shown that extremes of body weight and lifestyle factors such as cigarette smoking, alcohol use, and recreational drug use can promote excess free radical production, which could affect fertility. Exposures to environmental pollutants are of increasing concern, as they too have been found to trigger oxidative states, possibly contributing to female infertility. This article will review the currently available literature on the roles of reactive species and OS in both normal and abnormal reproductive physiological processes. Antioxidant supplementation may be effective in controlling the production of ROS and continues to be explored as a potential strategy to overcome reproductive disorders associated with infertility. However, investigations conducted to date have been through animal or in vitro studies, which have produced largely conflicting results. The impact of OS on assisted reproductive techniques (ART) will be addressed, in addition to the possible benefits of antioxidant supplementation of ART culture media to increase the likelihood for ART success. Future randomized controlled clinical trials on humans are necessary to elucidate the precise mechanisms through which OS affects female reproductive abilities, and will facilitate further explorations of the possible benefits of antioxidants to treat infertility.
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Affiliation(s)
- Ashok Agarwal
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | | | - Beena J Premkumar
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Amani Shaman
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Sajal Gupta
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
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Zorba E, Vavilis D, Venetis CA, Zournatzi V, Kellartzis D, Tarlatzis BC. Visfatin serum levels are increased in women with preeclampsia: A case-control study. J Matern Fetal Neonatal Med 2012; 25:1668-73. [DOI: 10.3109/14767058.2012.657275] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Mazzanti L, Cecati M, Vignini A, D'Eusanio S, Emanuelli M, Giannubilo SR, Saccucci F, Tranquilli AL. Placental expression of endothelial and inducible nitric oxide synthase and nitric oxide levels in patients with HELLP syndrome. Am J Obstet Gynecol 2011; 205:236.e1-7. [PMID: 21700268 DOI: 10.1016/j.ajog.2011.04.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Revised: 04/05/2011] [Accepted: 04/11/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine placental gene expression of endothelial and inducible nitric oxide synthases and measure nitric oxide levels in patients with hemolysis, elevated liver enzyme levels, and low platelet count syndrome. STUDY DESIGN Preterm placentas were obtained from 15 patients with hemolysis, elevated liver enzyme levels, and low platelet count syndrome and 30 controls matched for age, parity, and gestational age. mRNA levels were evaluated by real-time polymerase chain reaction, whereas nitric oxide and peroxynitrite production was measured by a commercially available kit. RESULTS Placental gene expression of inducible nitric oxide and endothelial nitric oxide synthases were significantly lower in the hemolysis, elevated liver enzyme levels, and low platelet count syndrome group than in controls, whereas nitric oxide and peroxynitrite production were significantly higher in hemolysis, elevated liver enzyme levels, and low platelet count syndrome compared with controls. CONCLUSION The reduced endothelial nitric oxide and inducible nitric oxide synthases gene expression in women with hemolysis, elevated liver enzyme levels, and low platelet count syndrome may indicate extreme placental dysfunction that is unable to compensate the endothelial derangement and the related hypertension. The higher nitric oxide formation found in hemolysis, elevated liver enzyme levels, and low platelet count syndrome placentas could be explained as a counteraction to the impaired fetoplacental perfusion, typical of the syndrome.
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Affiliation(s)
- Laura Mazzanti
- Department of Biochemistry, Biology and Genetics, Università Politecnica Marche, Ancona, Italy
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Mazzanti L, Raffaelli F, Vignini A, Nanetti L, Vitali P, Boscarato V, Giannubilo SR, Tranquilli AL. Nitric oxide and peroxynitrite platelet levels in gestational hypertension and preeclampsia. Platelets 2011; 23:26-35. [PMID: 21787174 DOI: 10.3109/09537104.2011.589543] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of the study was to investigate platelet nitric oxide (NO) pathways in women with Gestational Hypertension (GH), Preeclampsia (PE) and Controls. Platelet NO(x) and peroxynitrite (ONOO(-)) levels, inducible (iNOS) and endothelial nitric oxide synthase (eNOS) and Nitrotyrosine expression (N-Tyr) in 30 women with GH, 30 with PE and 30 healthy pregnant controls, age, parity and gestational age-matched, were assessed. Platelet NO(x) and ONOO(-) levels were significantly higher in GH and PE vs. Controls, with higher levels in GH vs. PE. At the same way, iNOS and N-Tyr were significantly higher in GH and PE vs. Controls, with higher levels in GH vs. PE. Since GH expressed higher amount of NO metabolites and higher activation of iNOS compared to PE, we can hypothesize that the severity of hypertensive pathology is almost not related to only NO metabolism, this research confirmed that GH and PE are associated with marked changes in NO pathways; it is not easy to understand if they could be interpreted as causes or consequence of these pathologic states.
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Affiliation(s)
- Laura Mazzanti
- Department of Biochemistry, Biology and Genetics, Marche Polytechnic University , via Tronto 10 - 60128 Ancona, Italy
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Zhang HH, Wang YP, Chen DB. Analysis of nitroso-proteomes in normotensive and severe preeclamptic human placentas. Biol Reprod 2011; 84:966-75. [PMID: 21228217 DOI: 10.1095/biolreprod.110.090688] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Nitric oxide (NO) plays a key role in placental biology, and placental dysfunction is the main pathogenesis pathway for preeclampsia, yet the direct placental targets of NO actions have not been determined. Covalent adduction of an NO moiety to cysteines, termed S-nitrosylation (SNO), is emerging as a key route by which NO can directly modulate protein functions. This study was conducted to analyze global S-nitroso (SNO)-proteins in human placentas and to determine if their levels differ in normotensive versus severe preeclamptic placentas. Although total nitrite/nitrate increased, total levels of SNO-proteins and nitrosylated forms of endothelial NO synthase and heat shock protein 90 were decreased by preeclampsia. We further compared normotensive and preeclamptic placental nitroso-proteomes (total SNO-protein profiles) by using a biotin and CyDye switch test combined with two-dimensional fluorescence difference gel electrophoresis (2D-DIGE) and identified SNO-proteins by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Numerous SNO-proteins were displayed as spots on 2D-DIGE gels. One hundred spots of interest were excised; 46 spots were identified, of which 8 spots were novel SNO-proteins; levels of 15 spots were increased, and 6 spots were decreased, and the rest were unchanged by preeclampsia. Pathway analysis suggested that placental SNO-proteins are involved in regulating various cellular functions including protein synthesis, cell movement and metabolism, cell signaling, and other functions. These data therefore show for the first time that SNO is a crucial mechanism by which NO directly regulates placental proteins linked to various biological pathways. The significantly altered placental nitroso-proteome in preeclampsia suggests that SNO plays a role in the placental pathophysiology in preeclampsia.
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Affiliation(s)
- Hong-hai Zhang
- Department of Obstetrics and Gynecology, University of California-Irvine, CA, USA
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Quinton AE, Peek MJ, Cook CM, Kirby A. Flow-Mediated Dilatation Assessment in Women with Preeclampsia Compared to Women with Gestational Hypertension. Hypertens Pregnancy 2010; 31:377-86. [DOI: 10.3109/10641955.2010.525282] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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