1
|
Yoshida K, Kusama K, Azumi M, Yoshie M, Kato K, Tamura K. Endoplasmic reticulum stress-regulated high temperature requirement A1 (HTRA1) modulates invasion and angiogenesis-related genes in human trophoblasts. J Pharmacol Sci 2022; 150:267-274. [DOI: 10.1016/j.jphs.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 09/29/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
|
2
|
Placental Syndromes-A New Paradigm in Perinatology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127392. [PMID: 35742640 PMCID: PMC9224387 DOI: 10.3390/ijerph19127392] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/08/2022] [Accepted: 06/13/2022] [Indexed: 12/10/2022]
Abstract
Placental syndromes include pregnancy loss, fetal growth restriction, preeclampsia, preterm delivery, premature rupture of membranes, placental abruption and intrauterine fetal demise. This paper discusses the common etiopathogenesis of those syndromes and the role of angiogenic biomarkers in their development. Pregnancy implantation, placental development and maternal adaptation are complex processes in which fetal and maternal cells interact. The syncytiotrophoblast, trophoblast, uterine natural killer cells and regulatory T cells interfere and interact in all the above-mentioned processes. The proper angioneogenesis and vasculogenesis of the placenta, as well as maternal circulatory adaptation, are dependent on angiogenic factor expression. Insufficient maternal immunotolerance, dysregulation in uterine natural killer or regulatory T cell function, syncytiotrophoblast and trophoblast ischemia and hypoxia or impaired balance in angiogenic factors are all related to the occurrence of placental syndromes. Differences in the time of impairment onset and its intensity and correlation with other dysfunctions result in the development of a specific syndrome. The clinical manifestations in the form of a combination of specific symptoms determine the diagnosis. However, they are just symptoms of an underlying complex trophoblast disorder.
Collapse
|
3
|
Lorenz-Meyer LA, Frank L, Sroka D, Busjahn A, Henrich W, Verlohren S. Correlation between placental weight and angiogenic markers sFlt-1 and PlGF in women with preeclampsia and fetal growth restriction. Pregnancy Hypertens 2022; 28:149-155. [DOI: 10.1016/j.preghy.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/25/2022] [Accepted: 04/04/2022] [Indexed: 11/26/2022]
|
4
|
Sammar M, Siwetz M, Meiri H, Sharabi-Nov A, Altevogt P, Huppertz B. Reduced Placental CD24 in Preterm Preeclampsia Is an Indicator for a Failure of Immune Tolerance. Int J Mol Sci 2021; 22:ijms22158045. [PMID: 34360811 PMCID: PMC8348750 DOI: 10.3390/ijms22158045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/18/2021] [Accepted: 07/21/2021] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION CD24 is a mucin-like glycoprotein expressed at the surface of hematopoietic and tumor cells and was recently shown to be expressed in the first trimester placenta. As it was postulated as an immune suppressor, CD24 may contribute to maternal immune tolerance to the growing fetus. Preeclampsia (PE), a major pregnancy complication, is linked to reduced immune tolerance. Here, we explored the expression of CD24 in PE placenta in preterm and term cases. METHODS Placentas were derived from first and early second trimester social terminations (N = 43), and third trimester normal term delivery (N = 67), preterm PE (N = 18), and preterm delivery (PTD) (N = 6). CD24 expression was determined by quantitative polymerase chain reaction (qPCR) and Western blotting. A smaller cohort included 3-5 subjects each of term and early PE, and term and preterm delivery controls analyzed by immunohistochemistry. RESULTS A higher expression (2.27-fold) of CD24 mRNA was determined in the normal term delivery compared to first and early second trimester cases. The mRNA of preterm PE cases was only higher by 1.31-fold compared to first and early second trimester, while in the age-matched PTD group had a fold increase of 5.72, four times higher compared to preterm PE. The delta cycle threshold (ΔCt) of CD24 mRNA expression in the preterm PE group was inversely correlated with gestational age (r = 0.737) and fetal size (r = 0.623), while correlation of any other group with these parameters was negligible. Western blot analysis revealed that the presence of CD24 protein in placental lysate of preterm PE was significantly reduced compared to term delivery controls (p = 0.026). In immunohistochemistry, there was a reduction of CD24 staining in villous trophoblast in preterm PE cases compared to gestational age-matched PTD cases (p = 0.042). Staining of PE cases at term was approximately twice higher compared to preterm PE cases (p = 0.025) but not different from normal term delivery controls. CONCLUSION While higher CD24 mRNA expression levels were determined for normal term delivery compared to earlier pregnancy stages, this expression level was found to be lower in preterm PE cases, and could be said to be linked to reduced immune tolerance in preeclampsia.
Collapse
Affiliation(s)
- Marei Sammar
- Prof. Ephraim Katzir’s Department of Biotechnology Engineering, ORT Braude College, 51 Snunit St, Karmiel 2161002, Israel
- Correspondence: ; Tel.: +972-(04)-9901769; Fax: +972-(04)990171
| | - Monika Siwetz
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Neue Stiftingtalstr. 6/II, 8010 Graz, Austria; (M.S.); (B.H.)
| | - Hamutal Meiri
- Hylabs, Rehovot and TeleMarpe, 21 Beit El St., Tel Aviv 6908742, Israel;
| | - Adi Sharabi-Nov
- Ziv Medical Center, Safed, and Tel Hai College, Tel Hai 1220800, Israel;
| | - Peter Altevogt
- Skin Cancer Unit, DKFZ and Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany;
| | - Berthold Huppertz
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Neue Stiftingtalstr. 6/II, 8010 Graz, Austria; (M.S.); (B.H.)
| |
Collapse
|
5
|
|
6
|
M Dave K, Kaur L, Randhir KN, Mehendale SS, Sundrani DP, Chandak GR, Joshi SR. Placental growth factor and Fms related tyrosine kinase-1 are hypomethylated in preeclampsia placentae. Epigenomics 2021; 13:257-269. [PMID: 33471580 DOI: 10.2217/epi-2020-0318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Aim: This study aims to examine the DNA methylation (DNAm) and expression patterns of genes associated with placental angiogenesis in preeclampsia. Materials & methods: DNAm and expression were examined in normotensive (n = 100) and preeclampsia (n = 100) women using pyrosequencing and quantitative real-time PCR respectively. Results: Hypomethylation at several CpGs was observed in PlGF and FLT-1 in women with preeclampsia compared to normotensive controls. PlGF expression was lower in women with preeclampsia while FLT-1 expression was comparable. DNAm at various CpGs was negatively correlated with expression in both the genes and were associated with maternal blood pressure and birth outcomes. Conclusion: DNAm and expression of angiogenic factors in placentae are differentially regulated in preeclampsia and influence birth outcomes.
Collapse
Affiliation(s)
- Kinjal M Dave
- Mother & Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune 411043, India
| | - Lovejeet Kaur
- Genomic Research on Complex diseases (GRC Group), Council of Scientific and Industrial Research Centre for Cellular & Molecular Biology (CSIR-CCMB), Hyderabad 500007, India
| | - Karuna N Randhir
- Mother & Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune 411043, India
| | - Savita S Mehendale
- Department of Gynecology & Obstetrics, Bharati Vidyapeeth Medical College & Hospital, Pune 411043, India
| | - Deepali P Sundrani
- Mother & Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune 411043, India
| | - Giriraj R Chandak
- Genomic Research on Complex diseases (GRC Group), Council of Scientific and Industrial Research Centre for Cellular & Molecular Biology (CSIR-CCMB), Hyderabad 500007, India
| | - Sadhana R Joshi
- Mother & Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune 411043, India
| |
Collapse
|
7
|
Aplin JD, Myers JE, Timms K, Westwood M. Tracking placental development in health and disease. Nat Rev Endocrinol 2020; 16:479-494. [PMID: 32601352 DOI: 10.1038/s41574-020-0372-6] [Citation(s) in RCA: 162] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2020] [Indexed: 12/14/2022]
Abstract
Pre-eclampsia and fetal growth restriction arise from disorders of placental development and have some shared mechanistic features. Initiation is often rooted in the maldevelopment of a maternal-placental blood supply capable of providing for the growth requirements of the fetus in later pregnancy, without exerting undue stress on maternal body systems. Here, we review normal development of a placental bed with a safe and adequate blood supply and a villous placenta-blood interface from which nutrients and oxygen can be extracted for the growing fetus. We consider disease mechanisms that are intrinsic to the maternal environment, the placenta or the interaction between the two. Systemic signalling from the endocrine placenta targets the maternal endothelium and multiple organs to adjust metabolism for an optimal pregnancy and later lactation. This signalling capacity is skewed when placental damage occurs and can deliver a dangerous pathogenic stimulus. We discuss the placental secretome including glycoproteins, microRNAs and extracellular vesicles as potential biomarkers of disease. Angiomodulatory mediators, currently the only effective biomarkers, are discussed alongside non-invasive imaging approaches to the prediction of disease risk. Identifying the signs of impending pathology early enough to intervene and ameliorate disease in later pregnancy remains a complex and challenging objective.
Collapse
Affiliation(s)
- John D Aplin
- Maternal and Fetal Health Group, Manchester Academic Health Sciences Centre, St Mary's Hospital, Manchester, UK.
| | - Jenny E Myers
- Maternal and Fetal Health Group, Manchester Academic Health Sciences Centre, St Mary's Hospital, Manchester, UK
| | - Kate Timms
- Lydia Becker Institute of Inflammation and Immunology, The University of Manchester, Manchester, UK
| | - Melissa Westwood
- Maternal and Fetal Health Group, Manchester Academic Health Sciences Centre, St Mary's Hospital, Manchester, UK
| |
Collapse
|
8
|
Lecarpentier E, Zsengellér ZK, Salahuddin S, Covarrubias AE, Lo A, Haddad B, Thadhani RI, Karumanchi SA. Total Versus Free Placental Growth Factor Levels in the Pathogenesis of Preeclampsia. Hypertension 2020; 76:875-883. [PMID: 32654553 DOI: 10.1161/hypertensionaha.120.15338] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Elevated circulating sFLT-1 (soluble fms-like tyrosine kinase) and low levels of its ligand, PlGF (placental growth factor), are key characteristics of preeclampsia. However, it is unclear if the low levels of plasma PlGF noted during preeclampsia are due to decreased placental production of PlGF or due to binding of PlGF by increased circulating sFLT-1. Here, we describe a biochemical procedure to dissociate PlGF-sFLT-1 complex ex vivo and when used in conjunction with an immunoassay platform, demonstrate a method to measure total and free PlGF in human blood samples. Using this method, we noted that plasma free PlGF levels were significantly lower in preeclampsia (N=22) than in nonhypertensive controls (N=24; mean, 314 versus 686 pg/mL, P<0.05), but total PlGF levels were not different (mean, 822 versus 800 pg/mL, P=0.49). In contrast, total sFLT-1 levels were significantly higher in preeclampsia than in nonhypertensive controls (mean, 16 957 versus 3029 pg/mL, P<0.01) and sFLT-1 levels correlated with bound PlGF levels (bound PlGF=total PlGF-free PlGF) in these samples (r2=0.68). We confirmed these findings in an independent cohort of subjects (N=49). Furthermore, we did not detect any difference in PlGF mRNA by quantitative polymerase chain reaction or in PlGF protein expression by immunohistochemistry in preeclamptic placentas when compared with nonhypertensive controls. In contrast, sFLT-1 mRNA and protein levels were upregulated in placentas from women with preeclampsia. Taken together with prior studies, our results provide evidence that decrease in circulating PlGF noted during preeclampsia is largely mediated by excess circulating sFLT-1.
Collapse
Affiliation(s)
- Edouard Lecarpentier
- From the Center for Vascular Biology Research, Beth Israel Deaconess Medical Center (E.L., Z.K.Z., S.S., A.C., A.L., S.A.K.), Harvard Medical School, Boston, MA.,Department of Obstetrics and Gynecology, University Paris Est Créteil and CHI Créteil, Créteil, France (E.L., B.H.).,INSERM U955 Institut Biomédical Henri Mondor, France (E.L.)
| | - Zsuzsanna K Zsengellér
- From the Center for Vascular Biology Research, Beth Israel Deaconess Medical Center (E.L., Z.K.Z., S.S., A.C., A.L., S.A.K.), Harvard Medical School, Boston, MA
| | - Saira Salahuddin
- From the Center for Vascular Biology Research, Beth Israel Deaconess Medical Center (E.L., Z.K.Z., S.S., A.C., A.L., S.A.K.), Harvard Medical School, Boston, MA
| | - Ambart E Covarrubias
- From the Center for Vascular Biology Research, Beth Israel Deaconess Medical Center (E.L., Z.K.Z., S.S., A.C., A.L., S.A.K.), Harvard Medical School, Boston, MA.,Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA (A.C., S.A.K.)
| | - Agnes Lo
- From the Center for Vascular Biology Research, Beth Israel Deaconess Medical Center (E.L., Z.K.Z., S.S., A.C., A.L., S.A.K.), Harvard Medical School, Boston, MA
| | - Bassam Haddad
- Department of Obstetrics and Gynecology, University Paris Est Créteil and CHI Créteil, Créteil, France (E.L., B.H.)
| | - Ravi I Thadhani
- Mass General Brigham (R.I.T.), Harvard Medical School, Boston, MA
| | - S Ananth Karumanchi
- From the Center for Vascular Biology Research, Beth Israel Deaconess Medical Center (E.L., Z.K.Z., S.S., A.C., A.L., S.A.K.), Harvard Medical School, Boston, MA.,Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA (A.C., S.A.K.)
| |
Collapse
|
9
|
Aspirin enhances trophoblast invasion and represses soluble fms-like tyrosine kinase 1 production: a putative mechanism for preventing preeclampsia. J Hypertens 2020; 37:2461-2469. [PMID: 31335509 DOI: 10.1097/hjh.0000000000002185] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Recent studies suggested that prophylactic aspirin prior to 16 weeks of gestation in high-risk patients may reduce the risk of developing preeclampsia; however, the exact mechanism of aspirin's effect on the pathophysiology of preeclampsia is not clear. This study was designed to investigate the effect of aspirin on trophoblast cell function and its effect on soluble fms-like tyrosine kinase 1 (sFlt-1) production to elucidate the preventive mechanisms for preeclampsia. METHODS AND RESULTS We used two human trophoblastic cell lines (HTR-8/SVneo and JAR) and freshly isolated cytotrophoblasts from normal and preeclamptic placenta at term to determine the effect of aspirin on trophoblast cell function. Trophoblasts were pretreated with aspirin, and then cell functions and sFlt-1 expression were assessed. Our results showed that aspirin promoted trophoblast invasion not only in HTR-8/SVneo and JAR cells, but also in isolated cytotrophoblasts. sFlt-1 production was repressed by aspirin in a dose-dependent manner. By adding Flt-1 recombinant protein, the trophoblast invasion ability was inhibited in HTR-8/SVneo cells, which was reversed by Flt-1 small interfering ribonucleic acid knockdown. In addition, metalloproteinase 2/9 expression and activity were activated by aspirin but inhibited by sFlt-1. Aspirin also downregulated Akt phosphorylation, and trophoblast invasiveness was facilitated under Akt inhibitor treatment. CONCLUSION Aspirin enhances cell invasiveness and inhibits sFlt-1 production in trophoblasts. Moreover, sFlt-1 itself also inhibits trophoblast invasion. Our novel findings suggest that the preeclampsia prevention effect of aspirin may be exerted through these two mechanisms.
Collapse
|
10
|
Huppertz B. Biology of preeclampsia: Combined actions of angiogenic factors, their receptors and placental proteins. Biochim Biophys Acta Mol Basis Dis 2018; 1866:165349. [PMID: 30553017 DOI: 10.1016/j.bbadis.2018.11.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/07/2018] [Accepted: 11/22/2018] [Indexed: 12/13/2022]
Abstract
Although massive efforts have been undertaken to elucidate the etiology of the pregnancy syndrome preeclampsia, its developmental origin remains a mystery. Most efforts of the last decade have focused on biomarkers to predict and/or diagnose preeclampsia, including the anti-angiogenic factor sFlt-1 (soluble fms-like tyrosin kinase-1), the angiogenic factor PGF (placental growth factor) and PP13 (placental protein 13). The origins of these marker proteins are still under debate, and so far their actions have only been describe separate from each other. This study will focus on the origins and actions of all three markers during pregnancy and outside pregnancy and will describe a scenario where all three markers act synergistically to rescue the mother from the deleterious effects of the debris that is released from the placenta during preeclampsia. This more holistic approach may open new avenues to think about maternal-fetal interactions and putative therapies.
Collapse
Affiliation(s)
- Berthold Huppertz
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria.
| |
Collapse
|
11
|
Olaya-C M, Garrido M, Hernandez-Losa J, Sesé M, Ayala-Ramirez P, Somoza R, Vargas MJ, Ramón Y Cajal S. The umbilical cord, preeclampsia and the VEGF family. Int J Womens Health 2018; 10:783-795. [PMID: 30568515 PMCID: PMC6276640 DOI: 10.2147/ijwh.s174734] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The VEGF family has been identified as abnormal in preeclampsia (PE). Hypertensive disorders of pregnancy (HDP) are major contributors to maternal and neonatal morbidity and mortality worldwide; likewise, umbilical cord anatomical abnormalities (UCAA) are linked to poor neonatal outcomes. Based on the relationship described between PE and UCAA and the role of the VEGF family in PE, this study explored VEGF expression in placental and UC tissued from patients with PE and with UCAA. Methods We performed an observational, analytical study on placentas, comparing protein and mRNA expression in four groups: patients with PE, patients with UC abnormalities, patients with both, and patients with none of them. Using immunohistochemistry, we studied VEGF A, VEGF R1 (FLT1), MMP1, and PLGF. With quantitative reverse transcription polymerase chain reaction we described mRNA expression of PLGF, VEGF and sFLT1, and sFLT1/PLGF ratio. Results Forty newborns were included. Sixty-seven percent of mothers and 45% of newborns developed no complications. Immunohistochemistry was performed on UC and placental disc paraffin-embedded tissue; in the latter, the mRNA of the VEGF family was also measured. Statistically significant differences were observed among different expressions in both HDP and UCAA groups. Interestingly, the UCAA group exhibited lower levels of sFLT1 and VEGF-A in comparison with other groups, with significant P-value for sFLT1 (P=0000.1). Conclusion The origin of UCAA abnormalities and their relation with HDP are still unknown. VEGF family alterations could be involved in both. This study provides the first approach related to molecules linked to UCAA.
Collapse
Affiliation(s)
- Mercedes Olaya-C
- Department of Pathology, Institute of Human Genetics, The Medical School, Pontificia Universidad Javeriana - Hospital Universitario San Ignacio, Bogota, Colombia,
| | - Marta Garrido
- Pathology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | - Javier Hernandez-Losa
- Institute of Human Genetics, The Medical School, Pontificia Universidad Javeriana, Bogota, Colombia.,Institute of Human Genetics, The Medical School, Pontificia Universidad Javeriana, Bogota, Colombia.,Institute of Human Genetics, The Medical School, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Marta Sesé
- Institute of Human Genetics, The Medical School, Pontificia Universidad Javeriana, Bogota, Colombia.,Institute of Human Genetics, The Medical School, Pontificia Universidad Javeriana, Bogota, Colombia.,Institute of Human Genetics, The Medical School, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Paola Ayala-Ramirez
- Institute of Human Genetics, The Medical School, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Rosa Somoza
- Institute of Human Genetics, The Medical School, Pontificia Universidad Javeriana, Bogota, Colombia.,Institute of Human Genetics, The Medical School, Pontificia Universidad Javeriana, Bogota, Colombia.,Institute of Human Genetics, The Medical School, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Magda Jimena Vargas
- Department of Pathology, The Medical School, Pontificia Universidad Javeriana - Hospital Universitario San Ignacio, Bogota, Colombia
| | - Santiago Ramón Y Cajal
- Institute of Human Genetics, The Medical School, Pontificia Universidad Javeriana, Bogota, Colombia.,Institute of Human Genetics, The Medical School, Pontificia Universidad Javeriana, Bogota, Colombia.,Institute of Human Genetics, The Medical School, Pontificia Universidad Javeriana, Bogota, Colombia
| |
Collapse
|
12
|
Huppertz B. An updated view on the origin and use of angiogenic biomarkers for preeclampsia. Expert Rev Mol Diagn 2018; 18:1053-1061. [PMID: 30413130 DOI: 10.1080/14737159.2018.1546579] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: The last decade has seen massive efforts towards the identification and the potential use of predictive biomarkers for the pregnancy pathology preeclampsia. The angiogenic factors sFlt-1 and placental growth factor (PGF) have been in focus and have been massively supported. Areas covered: This review describes preeclampsia and intra-uterine growth restriction (IUGR), focusing on sFlt-1 and PGF, their sources during and outside pregnancy and the application of these markers in diseases outside pregnancy. Finally, the specificity of the angiogenic markers for preeclampsia is discussed. Expert commentary: The admixture of the two independent syndromes preeclampsia and IUGR has not helped in identifying the etiologies of either. Rather, it has made the search for new markers and pathways much more complicated as has the constriction on the angiogenic markers. The current markers sFlt-1 and PGF have a clear value once an adverse outcome is diagnosed but are not specific for preeclampsia. Also, they are mostly derived from the maternal vascular system rather than the placenta and are already in use as markers outside pregnancy. A new holistic approach using disease maps and interoperable workflows based on topic-related big data will help in broadening our understanding of the etiology of preeclampsia and hence, develop new markers and therapies.
Collapse
Affiliation(s)
- Berthold Huppertz
- a Division of Cell Biology, Histology and Embryology , Gottfried Schatz Research Center, Medical University of Graz , Graz , Austria
| |
Collapse
|
13
|
Mach P, Nolte-Boenigk L, Droste L, Fox L, Frank M, Schmidt B, Herse F, Verlohren S, Wicherek L, Iannaccone A, Birdir C, Andrikos D, Kimmig R, Gellhaus A, Köninger A. Soluble B7-H4 blood serum levels are elevated in women at high risk for preeclampsia in the first trimester, as well as in patients with confirmed preeclampsia. Am J Reprod Immunol 2018; 80:e12988. [PMID: 29797540 DOI: 10.1111/aji.12988] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/06/2018] [Indexed: 12/23/2022] Open
Abstract
PROBLEM B7-H4 negatively regulates T-cell-mediated immunity and might play an important role in preeclampsia (PE). Here, we have investigated the association between PE and maternal soluble B7-H4 (sB7-H4) serum levels and B7-H4 mRNA expression in the placenta. METHOD OF STUDY Maternal serum levels of sB7-H4 were determined by enzyme-linked immunosorbent assay in women between 11 and 13 weeks' gestation with elevated risk for PE (n = 48) and women without elevated risk for PE (n = 47). In the third trimester, sB7-H4 serum levels (n = 166) and B7-H4 mRNA expression in the placenta (n = 54) were determined in women with early-onset PE, late-onset PE, fetal growth restriction (FGR), and in healthy controls. RESULTS In the first trimester, significant higher levels of sB7-H4 were detected in women at elevated risk for PE compared to women without risk for PE (P < .0001). sB7-H4 has some predictive ability to identify cases with an elevated risk of developing PE with area under the curve (AUC) value of 0.88 (95% CI 0.8-0.94). Using a specificity of 90.0% led to a sensitivity of 47.9% and a threshold of 3.63 ng/mL. In the third trimester, the highest serum levels of sB7-H4 and B7-H4 mRNA expression in the placenta were observed in early-onset PE. Significant higher serum levels of sB7-H4 and B7-H4 mRNA expression in the placenta were observed in women with early-onset PE (P = .01 and P = .006, respectively) and late-onset PE (P = .03 and P = .004, respectively) compared to healthy controls, but not compared to FGR. CONCLUSION sB7-H4 is involved in the regulation of immune tolerance in women with PE in the third trimester. In the first trimester of pregnancy, sB7-H4 might serve as a predictive immunological biomarker for women who are at elevated risk of developing PE.
Collapse
Affiliation(s)
- Pawel Mach
- Department of Obstetrics and Gynecology, University Hospital of Essen, Essen, Germany
| | - Luisa Nolte-Boenigk
- Department of Obstetrics and Gynecology, University Hospital of Essen, Essen, Germany
| | - Leonie Droste
- Department of Obstetrics and Gynecology, University Hospital of Essen, Essen, Germany
| | - Laura Fox
- Department of Obstetrics and Gynecology, University Hospital of Essen, Essen, Germany
| | - Mirjam Frank
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Boerge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Florian Herse
- Charité Medical Faculty, Experimental and Clinical Research Center, a joint cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Stefan Verlohren
- Department of Obstetrics, Charité University Medicine, Berlin, Germany
| | - Lukasz Wicherek
- Department of Gynecology and Oncology and Gynecological Nursing, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Antonella Iannaccone
- Department of Obstetrics and Gynecology, University Hospital of Essen, Essen, Germany
| | - Cahit Birdir
- Department of Obstetrics and Gynecology, University Hospital of Essen, Essen, Germany.,Medical Faculty, Department of Obstetrics and Gynecology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Dimitrios Andrikos
- Department of Obstetrics and Gynecology, University Hospital of Essen, Essen, Germany
| | - Rainer Kimmig
- Department of Obstetrics and Gynecology, University Hospital of Essen, Essen, Germany
| | - Alexandra Gellhaus
- Department of Obstetrics and Gynecology, University Hospital of Essen, Essen, Germany
| | - Angela Köninger
- Department of Obstetrics and Gynecology, University Hospital of Essen, Essen, Germany
| |
Collapse
|
14
|
Martinez-Fierro ML, Castruita-De La Rosa C, Garza-Veloz I, Cardiel-Hernandez RM, Espinoza-Juarez MA, Delgado-Enciso I, Castañeda-Lopez ME, Cardenas-Vargas E, Trejo-Vázquez F, Sotelo-Ham EI, Castañeda-Miranda R, Cid-Baez MA, Ortiz-Rodriguez JM, Solis-Sanchez LO, Aviles AG, Ortiz-Castro Y. Early pregnancy protein multiplex screening reflects circulating and urinary divergences associated with the development of preeclampsia. Hypertens Pregnancy 2018; 37:37-50. [PMID: 29308696 DOI: 10.1080/10641955.2017.1411946] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Preeclampsia, a pregnancy disorder characterized by hypertension and proteinuria, represents the leading cause of fetal and maternal morbidity and mortality in developing countries. The identification of novel and accurate biomarkers that are predictive of preeclampsia is necessary to improve the prognosis of patients with preeclampsia. OBJECTIVE To evaluate the preeclampsia predictive value of 34 angiogenic-related proteins. METHODS We performed a nested cohort case-control study of pregnant women. The profile of the 34 proteins was evaluated at 12, 16, and 20 gestational weeks (GWs), using urine/plasma from 16 women who developed preeclampsia and 20 normotensive pregnant controls by Bio-Plex ProTM Human Cancer Biomarker Panels 1 and 2. RESULTS The urine concentration of soluble epidermal growth factor receptor (sEGFR), hepatocyte growth factor (HGF), angiopoietin-2 (ANG-2), endoglin (ENG), soluble fas ligand (sFASL), interleukin 6 (IL-6), placental growth factor (PLGF), and vascular endothelial growth factor A (VEGF-A) at 12 GW, prolactin (PRL), ANG-2, transforming growth factor alpha (TGF-α), and VEGF-A at 16 GW, and soluble IL-6 receptor alpha (sIL-6Rα), ANG-2 and sFASL at 20 GW, were different between groups (p < 0.05). The concentration cut-off values calculated in this study for the mentioned proteins, predicted an increased risk to developing preeclampsia in a range of 3.8-29.8 times in the study population. CONCLUSION The proteins sEGFR, HGF, ANG-2, sFASL, IL-6, PLGF, VEGF-A, PRL, TGF-α FGF-b, sHER2/Neu sIL-6Rα, ENG, uPA, and insulin-like growth factor binding protein 1 (IGFBP-1), were predictive of the development of preeclampsia and their use as markers for this disease should be considered.
Collapse
Affiliation(s)
- Margarita L Martinez-Fierro
- a Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas , Zacatecas , Mexico.,b Centro de Innovacion Tecnologica e Industrial, Unidad Academica de Ingenieria Electrica. Universidad Autonoma de Zacatecas , Zacatecas , Mexico
| | - Claudia Castruita-De La Rosa
- a Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas , Zacatecas , Mexico
| | - Idalia Garza-Veloz
- a Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas , Zacatecas , Mexico.,b Centro de Innovacion Tecnologica e Industrial, Unidad Academica de Ingenieria Electrica. Universidad Autonoma de Zacatecas , Zacatecas , Mexico
| | - Rosa M Cardiel-Hernandez
- a Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas , Zacatecas , Mexico
| | - Marcela A Espinoza-Juarez
- a Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas , Zacatecas , Mexico
| | - Ivan Delgado-Enciso
- c School of Medicine , University of Colima , Colima , Mexico.,d Instituto Estatal de Cancerologia, Servicios de Salud del Estado de Colima , Colima , Mexico
| | - Maria E Castañeda-Lopez
- a Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas , Zacatecas , Mexico
| | - Edith Cardenas-Vargas
- a Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas , Zacatecas , Mexico.,e Hospital General Zacatecas "Luz González Cosío", Servicios de Salud de Zacatecas , Zacatecas , México
| | - Fabiola Trejo-Vázquez
- a Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas , Zacatecas , Mexico
| | - Elma I Sotelo-Ham
- f Coordinacion de Investigacion Estatal de la Secretaría de Salud de Zacatecas, Servicios de Salud de Zacatecas , Zacatecas , Mexico
| | - Rodrigo Castañeda-Miranda
- b Centro de Innovacion Tecnologica e Industrial, Unidad Academica de Ingenieria Electrica. Universidad Autonoma de Zacatecas , Zacatecas , Mexico
| | - Miguel A Cid-Baez
- a Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas , Zacatecas , Mexico.,b Centro de Innovacion Tecnologica e Industrial, Unidad Academica de Ingenieria Electrica. Universidad Autonoma de Zacatecas , Zacatecas , Mexico
| | - Jose M Ortiz-Rodriguez
- b Centro de Innovacion Tecnologica e Industrial, Unidad Academica de Ingenieria Electrica. Universidad Autonoma de Zacatecas , Zacatecas , Mexico
| | - Luis O Solis-Sanchez
- b Centro de Innovacion Tecnologica e Industrial, Unidad Academica de Ingenieria Electrica. Universidad Autonoma de Zacatecas , Zacatecas , Mexico
| | - Angelica Garcia Aviles
- e Hospital General Zacatecas "Luz González Cosío", Servicios de Salud de Zacatecas , Zacatecas , México
| | - Yolanda Ortiz-Castro
- a Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas , Zacatecas , Mexico
| |
Collapse
|