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Bharati J, Kumar S, Mohan NH, Pegu SR, Borah S, Gupta VK, Sarkar M. CRISPR/Cas genome editing revealed non-angiogenic role of VEGFA gene in porcine luteal cells: a preliminary report. Mol Biol Rep 2024; 51:195. [PMID: 38270707 DOI: 10.1007/s11033-023-09115-8] [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: 05/19/2023] [Accepted: 12/06/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND The angiogenic cytokine vascular endothelial growth factor A (VEGFA) also exerts non-angiogenic effects on endocrine functionality of porcine luteal cells critical for progesterone (P4) production. METHOD AND RESULTS The expression dynamics of VEGFA-FLT/KDR system were investigated using RT-qPCR during luteal stages and VEGFA gene knock out (KO) porcine luteal cells were generated using CRISPR/Cas9 technology. The downstream effects of VEGFA ablation were studied using RT-qPCR, Annexin V, MTT, ELISA for P4 estimation and scratch wound assay. Bioinformatics analysis of RNA-Seq data of porcine mid-luteal stage was conducted for exploring protein-protein interaction network, KEGG pathways, transcription factors and kinase mapping for VEGFA-FLT/KDR interactomes. The VEGFA-FLT/KDR system expressed throughout the luteal stages with highest expression during mid- luteal stage. Cellular morphology, structure and oil-red-o staining for lipid droplets did not differ significantly between VEGFA KO and wild type cells, however, VEGFA KO significantly decreased (p < 0.05) viability and proliferation efficiency of edited cells on subsequent passages. Expression of apoptotic gene, CASP3 and hypoxia related gene, HIF1A were significantly (p < 0.05) upregulated in KO cells. The relative mRNA expression of VEGFA and steroidogenic genes STAR, CYP11A1 and HSD3B1 decreased significantly (p < 0.05) upon KO, which was further validated by the significant (p < 0.05) decrease in P4 output from KO cells. Bioinformatics analysis mapped VEGFA-FLT/KDR system to signalling pathways associated with steroidogenic cell functionality and survival, which complemented the findings of the study. CONCLUSION The ablation of VEGFA gene resulted in decreased steroidogenic capability of luteal cells, which suggests that VEGFA exerts additional non-angiogenic regulatory effects in luteal cell functionality.
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Affiliation(s)
- Jaya Bharati
- ICAR-National Research Centre on Pig, Rani, Guwahati, Assam, 781131, India.
- Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243122, India.
| | - Satish Kumar
- ICAR-National Research Centre on Pig, Rani, Guwahati, Assam, 781131, India
| | - N H Mohan
- ICAR-National Research Centre on Pig, Rani, Guwahati, Assam, 781131, India
| | - Seema Rani Pegu
- ICAR-National Research Centre on Pig, Rani, Guwahati, Assam, 781131, India
| | - Sanjib Borah
- Lakhimpur College of Veterinary Science, Assam Agricultural University, North Lakhimpur, Assam, India
| | - Vivek Kumar Gupta
- Lakhimpur College of Veterinary Science, Assam Agricultural University, North Lakhimpur, Assam, India
| | - Mihir Sarkar
- ICAR-National Research Centre On Yak, Dirang, Arunachal Pradesh, 790101, India.
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2
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Guzmán A, Hernández-Coronado CG, Gutiérrez CG, Rosales-Torres AM. The vascular endothelial growth factor (VEGF) system as a key regulator of ovarian follicle angiogenesis and growth. Mol Reprod Dev 2023; 90:201-217. [PMID: 36966489 DOI: 10.1002/mrd.23683] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/27/2023]
Abstract
The vascular endothelial growth factor-A (VEGFA) system is a complex set of proteins, with multiple isoforms and receptors, including both angiogenic (VEGFxxx, VEGFR2) and antiangiogenic members (VEGFxxxb, VEGFR1 and soluble forms of VEGFR). The members of the VEGF system affect the proliferation, survival, and migration of endothelial and nonendothelial cells and are involved in the regulation of follicular angiogenesis and development. The production of VEGF by secondary follicles stimulates preantral follicular development by directly affecting follicular cells and promoting the acquisition of the follicular vasculature and downstream antrum formation. Additionally, the pattern of expression of the components of the VEGF system may provide a proangiogenic milieu capable of triggering angiogenesis and stimulating follicular cells to promote antral follicle growth, whereas, during atresia, this milieu becomes antiangiogenic and blocks follicular development.
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Affiliation(s)
- Adrian Guzmán
- Departamento de Producción Agrícola y Animal, Universidad Autónoma Metropolitana-Xochimilco, Distrito Federal, México
| | - Cyndi G Hernández-Coronado
- Departamento de Producción Agrícola y Animal, Universidad Autónoma Metropolitana-Xochimilco, Distrito Federal, México
| | - Carlos G Gutiérrez
- Departamento de Reproducción, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Ana M Rosales-Torres
- Departamento de Producción Agrícola y Animal, Universidad Autónoma Metropolitana-Xochimilco, Distrito Federal, México
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3
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Sadek S, Ramadan H, Matitashvili T, Stadtmauer L. To curette or not to curette; efficiency of oocyte retrieval technique. Arch Gynecol Obstet 2022; 306:1771-1776. [PMID: 36066617 DOI: 10.1007/s00404-022-06695-x] [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: 04/04/2022] [Accepted: 06/26/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Follicular curetting is the gentle and rapidly rotating movement of the aspiration needle in a clockwise and counterclockwise fashion. The aim of our study is to assess this retrieval technique comparing cycle and pregnancy outcomes between curetting and non-curetting. METHODS This was a retrospective review of 817 patients that underwent oocyte retrieval at our fertility center from January 1st, 2016 until August 31st, 2019. All patients enrolled in the study underwent standard ovarian stimulation protocols. Three physicians routinely utilized follicle curetting during oocyte retrieval, while a fourth physician did not curette. Retrievals and embryo transfers were performed based on a rotating physician schedule. RESULTS Retrievals that were performed using a curetting technique had a significantly higher number of total oocytes retrieved 12.4 ± 8.1 vs 10.7 ± 7.5 (p = 0.01), and number of M2 oocytes retrieved 8.1 ± 6.4 vs 6.9 ± 6.0 (p = 0.03), resulting in an increased M2 oocyte yield 63.7% ± 41.3 vs 50.9% ± 30.6 (p = 0.0001). These patients also had a significant increase in clinical pregnancy rate per retrieval 55 vs 41% (p = 0.0016), live birth rate per retrieval 42 vs 34% (p = 0.04) and with no significant difference in multiple gestations or OHSS. CONCLUSIONS A significant improvement in clinical pregnancy rates and live birth per retrieval was detected in patients undergoing curetting. These patients had more embryos frozen, leading to more transfers and more successful pregnancies.
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Affiliation(s)
- Seifeldin Sadek
- Department of ObGyn, Eastern Virginia Medical School, The Jones Institute for Reproductive Medicine, 601 Colley Avenue, Norfolk, VA, 23507, USA.
| | - Hadi Ramadan
- Department of ObGyn, Eastern Virginia Medical School, The Jones Institute for Reproductive Medicine, 601 Colley Avenue, Norfolk, VA, 23507, USA
| | - Tamar Matitashvili
- Department of ObGyn, Eastern Virginia Medical School, The Jones Institute for Reproductive Medicine, 601 Colley Avenue, Norfolk, VA, 23507, USA
| | - Laurel Stadtmauer
- Department of ObGyn, Eastern Virginia Medical School, The Jones Institute for Reproductive Medicine, 601 Colley Avenue, Norfolk, VA, 23507, USA
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Huang J, Mao Y, Li Q, Hong H, Tang N, Kang X, Huang Y, Liu J, Gong Q, Yao Y, Li L. Kallistatin prevents ovarian hyperstimulation syndrome by regulating vascular leakage. J Cell Mol Med 2022; 26:4613-4623. [PMID: 35866203 PMCID: PMC9357611 DOI: 10.1111/jcmm.17491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/12/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022] Open
Abstract
Angiogenesis and increased permeability are essential pathological basis for the development of ovarian hyperstimulation syndrome (OHSS). Kallistatin (KS) is an endogenous anti-inflammatory and anti-angiogenic factor that participates in a variety of diseases, but its role in OHSS remains unknown. In this study, treating a human ovarian granulosa-like tumour cell line KGN and human primary granulosa cells (PGCs) with human chorionic gonadotropin (hCG) reduced the expression of KS, but increased the expression of VEGF. Furthermore, we found that KS could attenuate the protein level of VEGF in both KGN cells and human PGCs. More interestingly, we observed that exogenous supplementation of KS significantly inhibited a series of signs of OHSS in mice, including weight gain, ovarian enlargement, increased vascular permeability and up-regulation of VEGF expression. In addition, KS was proved to be safe on mice ovulation, progression of normal pregnancy and fetus development. Collectively, these findings demonstrated that KS treatment prevented OHSS, at least partially, through down-regulating VEGF expression. For the first time, these results highlight the potential preventive value of KS in OHSS.
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Affiliation(s)
- Jianfang Huang
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Department of Obstetrics and Gynecology, Center for Reproductive Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Department of Reproductive Medicine, Ganzhou People's Hospital, Ganzhou, Jiangxi, China
| | - Yuling Mao
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Department of Obstetrics and Gynecology, Center for Reproductive Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Quanxin Li
- Department of Biochemistry and Molecular Biology, GMU-GIBH Joint School of Life Sciences, Guangzhou Medical University, Guangzhou, China
| | - Honghai Hong
- Department of Clinical Laboratory, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ni Tang
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Department of Obstetrics and Gynecology, Center for Reproductive Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiangjin Kang
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Department of Obstetrics and Gynecology, Center for Reproductive Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuling Huang
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Department of Obstetrics and Gynecology, Center for Reproductive Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jianqiao Liu
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Department of Obstetrics and Gynecology, Center for Reproductive Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qing Gong
- Department of Biochemistry and Molecular Biology, GMU-GIBH Joint School of Life Sciences, Guangzhou Medical University, Guangzhou, China
| | - Yachao Yao
- Department of Laboratory Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Lei Li
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Department of Obstetrics and Gynecology, Center for Reproductive Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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5
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Segal TR, Amini P, Wang J, Peters G, Skomorovska-Prokvolit Y, Mainigi MA, Goldfarb JM, Mesiano S, Weinerman R. Superovulation with human chorionic gonadotropin (hCG) trigger and gonadotropin releasing hormone agonist (GnRHa) trigger differentially alter essential angiogenic factors in the endometrium in a mouse ART model†. Biol Reprod 2021; 102:1122-1133. [PMID: 31995151 DOI: 10.1093/biolre/ioaa014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/18/2019] [Accepted: 01/28/2020] [Indexed: 12/11/2022] Open
Abstract
Gonadotropin-releasing hormone agonists (GnRHa) are used as an alternative to human chorionic gonadotropin (hCG) to trigger ovulation and decrease the risk of ovarian hyperstimulation syndrome. GnRHa is less potent at inducing ovarian vascular endothelial growth factor (VEGF), but may also affect endometrial angiogenesis and early placental development. In this study, we explore the effect of superovulation on endometrial angiogenesis during critical periods of gestation in a mouse model. We assigned female mice to three groups: natural mating or mating following injection with equine chorionic gonadotropin and trigger with GnRHa or hCG trigger. Females were killed prior to implantation (E3.5), post-implantation (E7.5), and at midgestation (E10.5), and maternal serum, uterus, and ovaries were collected. During peri-implantation, endometrial Vegfr1 and Vegfr2 mRNA were significantly increased in the GnRHa trigger group (P < 0.02) relative to the hCG group. Vegfr1 is highly expressed in the endometrial lining and secretory glands immediately prior to implantation. At E7.5, the ectoplacental cone expression of Vegfa and its receptor, Vegfr2, was significantly higher in the hCG trigger group compared to the GnRHa group (P < 0.05). Soluble VEGFR1 and free VEGFA were much higher in the serum of mice exposed to the hCG trigger compared to GnRHa group. At midgestation, there was significantly more local Vegfa expression in the placenta of mice triggered with hCG. GnRHa and hCG triggers differentially disrupt the endometrial expression of key angiogenic factors during critical periods of mouse gestation. These results may have significant implications for placental development and neonatal outcomes following human in vitro fertilization.
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Affiliation(s)
- Thalia R Segal
- Division of Reproductive Endocrinology and Infertility, University of California, San Francisco, CA, USA.,Department of Reproductive Biology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Peyvand Amini
- Department of Reproductive Biology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Junye Wang
- Department of Reproductive Biology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Gregory Peters
- Department of Reproductive Biology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Monica A Mainigi
- Department of Reproductive Endocrinology and Infertility, University of Pennsylvania, Philadelphia, PA, USA
| | - James M Goldfarb
- Division of Reproductive Endocrinology and Infertility, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Sam Mesiano
- Department of Reproductive Biology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Rachel Weinerman
- Department of Reproductive Biology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Division of Reproductive Endocrinology and Infertility, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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6
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Libby VR, Wilson R, Kresak A, Cameron C, Redline R, Mesiano S, Weinerman R. Superovulation with gonadotropin-releasing hormone agonist or chorionic gonadotropin for ovulation trigger differentially affects leukocyte populations in the peri-implantation mouse uterus. F&S SCIENCE 2021; 2:198-206. [PMID: 35559753 DOI: 10.1016/j.xfss.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To investigate the effect of superovulation with human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone agonist (GnRHa) trigger on leukocyte density and expression of leukocyte-specific genes in the peri-implantation period in the mouse uterus. DESIGN Laboratory research. SETTING University laboratory facility. INTERVENTIONS Female mice were mated to fertile male mice in one of three protocols: (1) natural mating or mating following injection with pregnant mare serum gonadotropin followed by trigger with (2) GnRHa or (3) hCG. Female mice were killed prior to implantation, 3 days after ovulation (E3.5), and the ovaries and uterine tissue were collected. Total RNA was isolated and assayed using quantitative reverse transcription polymerase chain reaction, and the uterine tissue was stained for histologic analysis of immune cell markers. MAIN OUTCOME MEASURES Endometrial leukocyte (CD45) and vessel density (CD31) by immunohistochemical staining; expression of leukocyte markers CD11b, CD335, and CD22, by quantitative reverse transcription polymerase chain reaction in the whole uterine tissue. RESULTS Superovulation decreased (compared with controls) the endometrial leukocyte density, based on the number of cells staining for CD45, and endometrial vessel density, based on the number of cells staining for CD31. Leukocyte density was additionally decreased in the GnRHa trigger group compared with that in the hCG trigger group. Superovulation with hCG and GnRHa triggers decreased the uterine expression of the B-cell marker CD22 compared with controls. The expression of the natural killer cell marker CD11b was decreased by the hCG trigger but not by the GnRHa. Abundance of mRNA encoding the CD335 natural killer cell marker was not affected by superovulation or trigger agent. CONCLUSIONS In mice, superovulation with the GnRHa trigger compared with that with the hCG trigger differentially alters key immunologic factors in the uterine peri-implantation. These altered immunologic factors have roles in angiogenesis that may assist in elucidating the effects of assisted reproductive technologies on implantation efficiency and fetal growth and development.
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Affiliation(s)
- Valerie R Libby
- Division of Reproductive Endocrinology and Infertility, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Rachel Wilson
- Department of Reproductive Biology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Adam Kresak
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Cheryl Cameron
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Raymond Redline
- Department of Reproductive Biology, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Sam Mesiano
- Department of Reproductive Biology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Rachel Weinerman
- Division of Reproductive Endocrinology and Infertility, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Department of Reproductive Biology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
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7
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Surcel M, Surcel M, Zlatescu-Marton C, Micu R, Nemeti GI, Axente DD, Mirza C, Neamtiu I. THE ROLE OF HIGH FOLLICULAR LEVELS OF ANGIOTENSIN II AND VASCULAR ENDOTHELIAL GROWTH FACTOR IN ANTICIPATING THE DEVELOPMENT OF SEVERE OVARIAN HYPERSTIMULATION SYNDROME IN PATIENTS WITH PROPHYLACTIC CABERGOLINE THERAPY UNDERGOING AN IN VITRO FERTILIZATION PROCEDURE. ACTA ENDOCRINOLOGICA-BUCHAREST 2020; 16:30-36. [PMID: 32685035 DOI: 10.4183/aeb.2020.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background and aims Severe Ovarian Hyperstimulation Syndrome (OHSS) forms with very aggressive clinical evolution are still common, despite prophylactic measures. Besides the Vascular Endothelial Growth Factor (VEGF), there are other angiogenic factors, like Renin-Angiotensin-Aldosterone System (RAS), that might be associated with this disorder. Our study aims to evaluate the role of VEGF and Angiotensin II (ANG II) in the development of early severe OHSS, in high risk patients under prophylactic Cabergoline therapy. Material and Methods We recruited 192 patients undergoing in vitro fertilization (IVF) procedures with high risk for OHSS development. Out of these, 106 patients with OHSS were enrolled in the study, of which 28 subjects had a severe form of disease (group I), and 78 patients had a mild/moderate form (group II). We collected blood and follicular fluid from our study participants and determined serum and follicular VEGF and ANG II levels using Enzyme-Linked Immunosorbent Assay (ELISA) technique. Results Follicular VEGF, ANG II, and serum VEGF levels were significantly higher in group I versus group II. Serum VEGF titers were 645.97 versus 548.62 (p = 0.0008), follicular VEGF titers were 2919.52 versus 1093.68 (p < 0.0001), and follicular ANG II levels were 281.64 versus 65.76 (p < 0.0001). No significant differences have been shown between the two groups for serum ANG II levels. Conclusion Our study results provide evidence of a OHSS phenotype that is more prone to undergo severe clinical forms of disease, despite treatments with VEGF receptor blockers, and show that ANG II appears to play a major role alongside VEGF, in the development of these severe forms of disease.
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Affiliation(s)
- M Surcel
- "Iuliu Hatieganu" University of Medicine and Pharmacy - Mother and Child, Gynaecology Clinic 1, Cluj-Napoca, Romania.,"Iuliu Hatieganu" University of Medicine and Pharmacy - Mother and Child, Surgery 5, Cluj-Napoca, Romania.,"Iuliu Hatieganu" University of Medicine and Pharmacy - Mother and Child, Physio-pathology, Cluj-Napoca, Romania.,"Iuliu Hatieganu" University of Medicine and Pharmacy - Mother and Child, Environmental Health Center - Health Department, Cluj-Napoca, Romania
| | - M Surcel
- "Iuliu Hatieganu" University of Medicine and Pharmacy - Mother and Child, Gynaecology Clinic 1, Cluj-Napoca, Romania
| | - C Zlatescu-Marton
- "Iuliu Hatieganu" University of Medicine and Pharmacy - Mother and Child, Gynaecology Clinic 1, Cluj-Napoca, Romania
| | - R Micu
- "Iuliu Hatieganu" University of Medicine and Pharmacy - Mother and Child, Gynaecology Clinic 1, Cluj-Napoca, Romania
| | - G I Nemeti
- "Iuliu Hatieganu" University of Medicine and Pharmacy - Mother and Child, Gynaecology Clinic 1, Cluj-Napoca, Romania
| | - D D Axente
- "Iuliu Hatieganu" University of Medicine and Pharmacy - Mother and Child, Surgery 5, Cluj-Napoca, Romania
| | - C Mirza
- "Iuliu Hatieganu" University of Medicine and Pharmacy - Mother and Child, Physio-pathology, Cluj-Napoca, Romania
| | - I Neamtiu
- "Iuliu Hatieganu" University of Medicine and Pharmacy - Mother and Child, Environmental Health Center - Health Department, Cluj-Napoca, Romania
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Convissar S, Winston NJ, Fierro MA, Scoccia H, Zamah AM, Stocco C. Sp1 regulates steroidogenic genes and LHCGR expression in primary human luteinized granulosa cells. J Steroid Biochem Mol Biol 2019; 190:183-192. [PMID: 30954507 PMCID: PMC6511456 DOI: 10.1016/j.jsbmb.2019.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/02/2019] [Accepted: 04/04/2019] [Indexed: 01/29/2023]
Abstract
Luteinizing hormone and human chorionic gonadotropin (hCG) bind to the luteinizing hormone/chorionic gonadotropin receptor (LHCGR). LHCGR is required to maintain corpus luteum function but the mechanisms involved in the regulation of LHCGR in human luteal cells remain incompletely understood. This study aimed to characterize the expression of LHCGR mRNA in primary human luteinized granulosa cells (hLGCs) obtained from patients undergoing in vitro fertilization and to correlate LHCGR expression with the response of hLGCs to hCG by assessing the expression of genes known to be markers of hCG actions. The results show that LHCGR expression is low in freshly isolated cells but recovers rapidly in culture and that hCG maintains LHCGR expression, suggesting a positive feedback loop. The activity of a LHCGR-LUC reporter increased in cells treated with hCG but not with follicle-stimulating hormone. Treatment with hCG also stimulated the expression of genes involved in steroidogenesis in a time-dependent manner. LHCGR promoter expression was found to be regulated by SP1, which we show is highly expressed in hLGCs. Moreover, SP1 inhibition prevented the stimulation of steroidogenic genes and the increase in LHCGR-LUC reporter activity by hCG. Finally, we provide evidence that a complex formed by SP1 and GATA4 may play a role in the maintenance of LHCGR expression. This report reveals the mechanisms involved in the regulation of the LHCGR and provides experimental data demonstrating that the proximal region of the LHCGR promoter is sufficient to drive the expression of this gene in primary hLGCs.
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Affiliation(s)
- Scott Convissar
- Department of Physiology and Biophysics, University of Illinois at Chicago, United States
| | - Nicola J Winston
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Illinois at Chicago College of Medicine, United States
| | - Michelle A Fierro
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Illinois at Chicago College of Medicine, United States
| | - Humberto Scoccia
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Illinois at Chicago College of Medicine, United States
| | - Alberuni M Zamah
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Illinois at Chicago College of Medicine, United States
| | - Carlos Stocco
- Department of Physiology and Biophysics, University of Illinois at Chicago, United States.
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9
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Genome-wide screening differential long non-coding RNAs expression profiles discloses its roles involved in OHSS development. J Assist Reprod Genet 2018; 35:1473-1482. [PMID: 29869218 DOI: 10.1007/s10815-018-1199-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 04/25/2018] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVE To screen differentially expressed lncRNAs involved in OHSS. OHSS is defined as ovarian hyperstimulation syndrome. It is characterized as enlarged ovary and increased vascular permeability. DESIGN Case-control study. SETTING University-affiliated hospital. PATIENT(S) Patients with OHSS high risk (n = 30) and low risk (n = 30) were included in this study. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) LncRNAs from women with OHSS high risk and low risk were used for high-throughput sequencing profiling. The eight most differentially expressed lncRNAs in granulosa cells were validated by semi-quantitative reverse transcription-polymerase chain reaction analysis. RESULT(S) A total of 23,815 lncRNAs were detected and 482 were differentially expressed (fold-change ≥2; p < 0.05, FDR value < 0.001), of which 205 were upregulated and 277 were downregulated. Lnc-SEC16B.1-6, lnc-SNURF-13, lnc-LGR6-6, and lnc-H2AFY2-2 were up-regulated, while lnc-BRD2-2, lnc-HSPA6-2, and lnc-CLIC6-5 were downregulated significantly in granulosa cells. These results were confirmed by qRT-PCR. KEGG pathways and Gene Ontology enrichment analysis revealed that several biological processes were significantly associated. Meanwhile, the lncRNA/miRNA interaction network was established according to ceRNA network model. CONCLUSION(S) Comprehensive expression screening identified eight novel lncRNAs associated with risk factors of OHSS process. Although it is unclear how these altered lncRNAs regulate the process of OHSS, our findings suggest these lncRNAs may be novel players in OHSS development.
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Ozgur S, Oktem M, Altinkaya SO, Oktem EO, Cenksoy C, Erdem O, Elbeg S, Helvaci A, Erdem A, Erdem M. The effects of resveratrol on ovarian hyperstimulation syndrome in a rat model. Taiwan J Obstet Gynecol 2018; 57:383-388. [DOI: 10.1016/j.tjog.2018.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2017] [Indexed: 11/25/2022] Open
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11
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Kitsou C, Kosmas I, Lazaros L, Tzallas C, Tinelli A, Mynbaev O, Prapas N, Prapas I, Dalkalitsis A, Georgiou I. The combination of Everolimus with Verapamil reduces ovarian weight and vascular permeability on ovarian hyperstimulation syndrome: a preclinical experimental randomized controlled study. Gynecol Endocrinol 2016; 32:886-890. [PMID: 27223459 DOI: 10.1080/09513590.2016.1188376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The efficacy of pathways inhibition and the combined effect of Everolimus (mTOR inhibitor) and Verapamil (CYP3A inhibitor) in ovarian hyperstimulation syndrome (OHSS) need to be tested. Therefore, the impact of a leucotriene receptor antagonist, an anticoagulant, a GnRH antagonist as well as Everolimus plus Verapamil (at various doses and days of administration) on an OHSS rat model was tested. Sixty three female Wistar rats were randomly divided into seven groups. The control group received saline, while the OHSS group received rec-FSH for four consecutive days. The other five groups received rec-FSH for four days and Montelukast daily, Heparin daily, GnRH antagonist daily, Everolimus plus Verapamil in the last two days (half days group) and Everolimus plus Verapamil (half dose group) daily, respectively. All groups received also hCG at the fifth day. Significantly reduced ovarian weight was observed in the Everolimus plus Verapamil groups (half days and half-dose groups) and the Montelukast group compared to the OHSS group (p = 0.001 and p = 0.001, respectively). The vascular permeability was significantly reduced in the Everolimus plus Verapamil group (half dose group) and the GnRH antagonist group compared to the OHSS group (p < 0.001 and p = 0.011, respectively). However, estradiol and progesterone levels did not differ significantly between the groups. Studying the inhibition of different pathways, we concluded that the co-administration of Everolimus and Verapamil (at half dose) is beneficial for reducing ovarian weight and vascular permeability in an OHSS animal model.
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Affiliation(s)
- Chrysoula Kitsou
- a Department of Obstetrics and Gynecology , Genetics and IVF Unit, Medical School, Ioannina University , Ioannina , Greece
| | - Ioannis Kosmas
- b Department of Obstetrics and Gynecology , Ioannina State General Hospital G. Chatzikosta , Ioannina , Greece
- c The International Translational Medicine and Biomodeling Research Team, Laboratory of Molecular and Cellular Technologies, MIPT Center for Human Physiology Studies, Moscow Institute of Physics and Technology , Dolgoprudny , Russia
| | - Leandros Lazaros
- a Department of Obstetrics and Gynecology , Genetics and IVF Unit, Medical School, Ioannina University , Ioannina , Greece
| | - Christos Tzallas
- d Laboratory of Biochemistry , Ioannina University Hospital , Ioannina , Greece
| | - Andrea Tinelli
- c The International Translational Medicine and Biomodeling Research Team, Laboratory of Molecular and Cellular Technologies, MIPT Center for Human Physiology Studies, Moscow Institute of Physics and Technology , Dolgoprudny , Russia
- e Department of Obstetrics and Gynecology , Division of Experimental Endoscopic Surgery, Imaging, Minimally Invasive Therapy and Technology, Vito Fazzi Hospital , Lecce , Italy , and
| | - Ospan Mynbaev
- c The International Translational Medicine and Biomodeling Research Team, Laboratory of Molecular and Cellular Technologies, MIPT Center for Human Physiology Studies, Moscow Institute of Physics and Technology , Dolgoprudny , Russia
| | | | | | - Alexandros Dalkalitsis
- a Department of Obstetrics and Gynecology , Genetics and IVF Unit, Medical School, Ioannina University , Ioannina , Greece
| | - Ioannis Georgiou
- a Department of Obstetrics and Gynecology , Genetics and IVF Unit, Medical School, Ioannina University , Ioannina , Greece
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Şahin N, Apaydın N, Töz E, Sivrikoz ON, Genç M, Turan GA, Cengiz H, Eskicioğlu F. Comparison of the effects of letrozole and cabergoline on vascular permeability, ovarian diameter, ovarian tissue VEGF levels, and blood PEDF levels, in a rat model of ovarian hyperstimulation syndrome. Arch Gynecol Obstet 2015; 293:1101-6. [PMID: 26690356 DOI: 10.1007/s00404-015-3987-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 12/08/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the effects of letrozole and cabergoline in a rat model of ovarian hyperstimulation syndrome (OHSS). STUDY DESIGN In this prospective, controlled experimental study, the 28 female Wistar rats were divided into four subgroups (one non-stimulated control and three OHSS-positive groups: placebo, letrozole, and cabergoline). To induce OHSS, rats were injected with 10 IU of pregnant mare serum gonadotropin from day 29 to day 32 of life, followed by subcutaneous injection of 30 IU hCG on day 33. Letrozole rats received with a single dose of 0.1 mg/kg letrozole via oral gavage, on the hCG day. Cabergoline rats received with a single dose of 100 µg/kg cabergoline via oral gavage, on the hCG day. All animals were compared in terms of body weight, vascular permeability (VP), ovarian diameter, ovarian tissue VEGF expression (assessed via immunohistochemical staining), and blood pigment epithelium-derived growth factor (PEDF) levels. RESULTS The OHSS-positive placebo group (group 2) exhibited the highest VP, ovarian diameter, extent of VEGF staining, and lowest PEDF level, as expected. No significant difference was evident between the letrozole and cabergoline groups in terms of any of body weight; VP; PEDF level; ovarian diameter; or the staining intensity of, or percentage staining for, VEGF in ovarian tissues. CONCLUSIONS Letrozole and cabergoline were equally effective to prevent OHSS, reducing the ovarian diameter, VP, and PEDF and VEGF levels to similar extents.
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Affiliation(s)
- Nur Şahin
- Department of Obstetrics and Gynecology, Sifa University Medicine School, Sanayi cad. No: 7 Bornova, Izmir, Turkey.
| | - Nesin Apaydın
- Department of Obstetrics and Gynecology, M.H. Tepecik Research and Education Hospital, Izmir, Turkey
| | - Emrah Töz
- Department of Obstetrics and Gynecology, M.H. Tepecik Research and Education Hospital, Izmir, Turkey
| | | | - Mine Genç
- Department of Obstetrics and Gynecology, Sifa University Medicine School, Sanayi cad. No: 7 Bornova, Izmir, Turkey
| | - Gülüzar Arzu Turan
- Department of Obstetrics and Gynecology, Sifa University Medicine School, Sanayi cad. No: 7 Bornova, Izmir, Turkey
| | - Hakan Cengiz
- Department of Biostatistics and Medical Informatics, Sifa University Medicine School, Izmir, Turkey
| | - Fatma Eskicioğlu
- Department of Obstetrics and Gynecology, M.H. Manisa Public Hospital, Manisa, Turkey
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Ortega HH, Veiga-Lopez A, Sreedharan S, del Luján Velázquez MM, Salvetti NR, Padmanabhan V. Developmental Programming: Does Prenatal Steroid Excess Disrupt the Ovarian VEGF System in Sheep? Biol Reprod 2015; 93:58. [PMID: 26178718 DOI: 10.1095/biolreprod.115.131607] [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: 05/13/2015] [Accepted: 07/10/2015] [Indexed: 01/10/2023] Open
Abstract
Prenatal testosterone (T), but not dihydrotestosterone (DHT), excess disrupts ovarian cyclicity and increases follicular recruitment and persistence. We hypothesized that the disruption in the vascular endothelial growth factor (VEGF) system contributes to the enhancement of follicular recruitment and persistence in prenatal T-treated sheep. The impact of T/DHT treatments from Days 30 to 90 of gestation on VEGFA, VEGFB, and their receptor (VEGFR-1 [FLT1], VEGFR-2 [KDR], and VEGFR-3 [FLT4]) protein expression was examined by immunohistochemistry on Fetal Days 90 and 140, 22 wk, 10 mo (postpubertal), and 21 mo (adult) of age. Arterial morphometry was performed in Fetal Day 140 and postpubertal ovaries. VEGFA and VEGFB expression were found in granulosa cells at all stages of follicular development with increased expression in antral follicles. VEGFA was present in theca interna, while VEGFB was present in theca interna/externa and stromal cells. All three receptors were expressed in the granulosa, theca, and stromal cells during all stages of follicular development. VEGFR-3 increased with follicular differentiation with the highest level seen in the granulosa cells of antral follicles. None of the members of the VEGF family or their receptor expression were altered by age or prenatal T/DHT treatments. At Fetal Day 140, area, wall thickness, and wall area of arteries from the ovarian hilum were larger in prenatal T- and DHT-treated females, suggestive of early androgenic programming of arterial differentiation. This may facilitate increased delivery of endocrine factors and thus indirectly contribute to the development of the multifollicular phenotype.
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Affiliation(s)
- Hugo Héctor Ortega
- Department of Morphological Sciences, Faculty of Veterinary Sciences, National University of Litoral, Esperanza, Santa Fe, Argentina Argentine National Research Council (CONICET), Esperanza, Santa Fe, Argentina
| | - Almudena Veiga-Lopez
- Department of Pediatrics and the Reproductive Sciences Program, University of Michigan, Ann Arbor, Michigan
| | - Shilpa Sreedharan
- Department of Pediatrics and the Reproductive Sciences Program, University of Michigan, Ann Arbor, Michigan
| | - Melisa María del Luján Velázquez
- Department of Morphological Sciences, Faculty of Veterinary Sciences, National University of Litoral, Esperanza, Santa Fe, Argentina Argentine National Research Council (CONICET), Esperanza, Santa Fe, Argentina
| | - Natalia Raquel Salvetti
- Department of Morphological Sciences, Faculty of Veterinary Sciences, National University of Litoral, Esperanza, Santa Fe, Argentina Argentine National Research Council (CONICET), Esperanza, Santa Fe, Argentina
| | - Vasantha Padmanabhan
- Department of Pediatrics and the Reproductive Sciences Program, University of Michigan, Ann Arbor, Michigan
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Kosmas IP, Kitsou C, Lazaros L, Markoula S, Peschos D, Mynbaev O, Tournaye H, Prapas N, Prapas I, Zikopoulos A, Galani V, Georgiou I. Everolimus, an mTOR pathway inhibitor, is highly successful on ovarian hyperstimulation syndrome by reducing ovarian weight and progesterone levels: a preclinical experimental randomized controlled study. Gynecol Endocrinol 2015; 31:702-7. [PMID: 26172931 DOI: 10.3109/09513590.2015.1065479] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The usefulness of various pathways inhibitors, Everolimus, an inhibitor of mammalian target of rapamycin (mTOR), Infliximab, a monoclonal antibody which blocks the tumor necrosis factor-a (TNF-a), Erlotinib, a tyrosine protein kinase inhibitor of the epidermal growth factor receptor (EGFR), Metformin, an activator of AMP-activated protein kinase enzyme (AMPK) and vascular permeability reducers were explored in an ovarian hyperstimulation syndrome (OHSS) rat model. Sixty-three female Wistar rats were randomly divided in seven groups. The control group received saline, while the OHSS group received recombinant -- follicle-stimulating hormone (rec-FSH) for four consecutive days. The other five groups received rec-FSH for 4 d and Everolimus daily, Infliximab once, Erlotinib daily, Metformin daily and Vitamin C daily, respectively. All groups received human chorionic gonadotropin (hCG) at the fifth day. The efficacy of Everolimus administration for various intervals was also explored. Significantly reduced ovarian weight was observed in the Everolimus group (rec-FSH + hCG + mTOR inhibitor) compared to the OHSS group (p < 0.001). The Everolimus group also showed the lowest progesterone (PRG) concentration (p = 0.007). The Erlotinib group (rec-FSH + hCG + EGFR inhibitor) presented with the lowest graafian follicle number, while the Everolimus group was characterized by the lowest corpus luteum number. The vascular permeability and the estradiol levels did not differ between groups. Finally, the Everolimus intra-comparison showed no difference in all measured outcomes. Studying the different pathways linked to vascular endothelial growth factor (VEGF) pathway, we conclude that targeting mTOR pathways is beneficial for reducing ovarian weight and PRG levels in an OHSS animal model.
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Affiliation(s)
- Ioannis P Kosmas
- a Department of Obstetrics and Gynecology , Ioannina State General Hospital G. Chatzikosta , Ioannina , Greece
- b The International Translational Medicine and Biomodeling Research Team, MIPT Center for Human Physiology Studies, Laboratory of Cellular and Molecular Technologies, Moscow Institute of Physics and Technology , Moscow , Russia
| | - Chrysoula Kitsou
- c Genetics and IVF Unit, Department of Obstetrics and Gynecology , Medical School, Ioannina University , Ioannina , Greece
| | - Leandros Lazaros
- c Genetics and IVF Unit, Department of Obstetrics and Gynecology , Medical School, Ioannina University , Ioannina , Greece
| | - Sofia Markoula
- d Department of Neurology , Medical School, Ioannina University , Ioannina , Greece
| | - Dimitrios Peschos
- e Laboratory of Physiology , Medical School, Ioannina University , Ioannina , Greece
| | - Ospan Mynbaev
- b The International Translational Medicine and Biomodeling Research Team, MIPT Center for Human Physiology Studies, Laboratory of Cellular and Molecular Technologies, Moscow Institute of Physics and Technology , Moscow , Russia
| | - Herman Tournaye
- f Vrije Universiteit Brussel and Centre for Reproductive Medicine , Brussels , Belgium
| | | | | | - Athanasios Zikopoulos
- c Genetics and IVF Unit, Department of Obstetrics and Gynecology , Medical School, Ioannina University , Ioannina , Greece
| | - Vasiliki Galani
- h Department of Anatomy-Histology-Embryology , Medical School, Ioannina University , Ioannina , Greece
| | - Ioannis Georgiou
- c Genetics and IVF Unit, Department of Obstetrics and Gynecology , Medical School, Ioannina University , Ioannina , Greece
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Herr D, Bekes I, Wulff C. Regulation of endothelial permeability in the primate corpora lutea: implications for ovarian hyperstimulation syndrome. Reproduction 2014; 149:R71-9. [PMID: 25301969 DOI: 10.1530/rep-13-0296] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In a developing human corpus luteum, a closely regulated cellular communication system exists between the luteal steroidogenic cells and endothelial cells. This system guaranties the vascularization process during luteal formation. The process is combined with rapid release of large amounts of progesterone into the bloodstream. The regulation of endothelial proliferation and permeability by LH and human chorionic gonadotropin (hCG) is integral to this process. On the cellular level, endothelial permeability is regulated by intercellular junctions, such as adherens junctions (AJ) and tight junctions (TJ), which act as zipper-like structures between interacting endothelial cells. Several cell junctional proteins are localized to the corpus luteum, including Occludin, Nectin 2, Claudin 1, and Claudin 5, as well as, vascular endothelial (VE)-Cadherin. It has been assumed that regulation of AJ- and TJ-proteins is of particular importance for permeability, and accordingly, for the functionality of the corpus luteum in early pregnancy, because treatment with hCG induces downregulation of juntional proteins in the luteal vessels. The effect of hCG on the adhesive molecules is mediated by VE growth factor (VEGF). On a functional level, the hCG-dependent and VEGF-mediated decrease in junctional proteins causes a decrease in the density of cell-cell closure and, accordingly, an increase in endothelial permeability. In doing so, the different junctional proteins are not only directly influenced by VEGF but also interact among themselves and influence each other reciprocally. Disturbances in this strictly, regulated interactions may explain the development of pathologies with increased vascular permeability, such as the ovarian hyperstimulation syndrome.
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Affiliation(s)
- Daniel Herr
- Department of Obstetrics and GynecologyUniversity of Würzburg, Josef-Schneider-Str. 4, 97080 Würzburg, GermanyDepartment of Obstetrics and GynecologyUlm University Medical Centre, Ulm, Germany
| | - Inga Bekes
- Department of Obstetrics and GynecologyUniversity of Würzburg, Josef-Schneider-Str. 4, 97080 Würzburg, GermanyDepartment of Obstetrics and GynecologyUlm University Medical Centre, Ulm, Germany
| | - Christine Wulff
- Department of Obstetrics and GynecologyUniversity of Würzburg, Josef-Schneider-Str. 4, 97080 Würzburg, GermanyDepartment of Obstetrics and GynecologyUlm University Medical Centre, Ulm, Germany
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16
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Weinerman R, Mainigi M. Why we should transfer frozen instead of fresh embryos: the translational rationale. Fertil Steril 2014; 102:10-8. [PMID: 24890274 DOI: 10.1016/j.fertnstert.2014.05.019] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 04/24/2014] [Accepted: 05/13/2014] [Indexed: 12/17/2022]
Abstract
Epidemiologic studies have shown an increased rate of adverse perinatal outcomes, including small for gestational age (SGA) births, in fresh in vitro fertilization (IVF) cycles compared with frozen embryo transfer cycles. This increase is not seen in the donor oocyte population, suggesting that it is the peri-implantation environment created after superovulation that is responsible for these changes. During a fresh IVF cycle, multiple corpora lutea secrete high levels of hormones and other factors that can affect the endometrium and the implanting embryo. In this review, we discuss both animal and human data demonstrating that superovulation has significant effects on the endometrium and embryo. Additionally, potential mechanisms for the adverse effects of gonadotropin stimulation on implantation and placental development are proposed. We think that these data, along with the growing body of epidemiologic evidence, support the proposal that frozen embryo transfer should be considered preferentially, particularly in high responders, as a means to potentially decrease at least some of the adverse perinatal outcomes associated with IVF.
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Affiliation(s)
- Rachel Weinerman
- Division of Reproductive Endocrinology and Infertility, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Monica Mainigi
- Division of Reproductive Endocrinology and Infertility, University of Pennsylvania, Philadelphia, Pennsylvania.
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17
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Nouri K, Haslinger P, Szabo L, Sator M, Schreiber M, Schneeberger C, Pietrowski D. Polymorphisms of VEGF and VEGF receptors are associated with the occurrence of ovarian hyperstimulation syndrome (OHSS)-a retrospective case-control study. J Ovarian Res 2014; 7:54. [PMID: 24851136 PMCID: PMC4029886 DOI: 10.1186/1757-2215-7-54] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 05/05/2014] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Ovarian hyperstimulation syndrome (OHSS) is the most serious complication of IVF/ICSI therapy. The pathophysiology and etiology of the disease is still not fully clarified. METHODS To assess whether polymorphisms of the VEGF/VEGF-receptor system contribute to the occurrence of ovarian hyperstimulation syndrome (OHSS), we performed a retrospective analysis of 116 OHSS patients, and 124 female controls. The following SNPs were genotyped: Rs2071559 (VEGFR2-604); rs2305948 (VEGFR2-1192); rs1870377 (VEGFR2-1719); rs2010963 (VEGF-405); and rs111458691 (VEGFR1-519). Odds ratios (ORs) were estimated with a 95% confidence interval (CI). Linkage disequilibrium (LD) analysis was performed in the three loci of the VEGFR2 gene. RESULT We found an overrepresentation of the T allele of the VEGFR1-519 polymorphism in OHSS patients (P = 0.02, OR: 3.62, CI: 1.16 - 11.27). By genotype modeling, we found that polymorphism of VEGFR1-519 and VEGF-405 showed significant differences in patients and controls (p = 0.02, OR: 3.79 CI: 1.98 - 11.97 and p = 0.000005, OR: 0.29, CI: 0.17 - 0.50). LD analysis revealed significant linkage disequilibrium in VEGFR2. CONCLUSION Polymorphisms in the VEGFR2 gene and in the VEGF gene are associated with the occurrence of OHSS. This strengthens the evidence for an important role of the VEGF/VEGF- receptor system in the occurrence of OHSS.
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Affiliation(s)
- Kazem Nouri
- Department of Endocrinology and Reproductive Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Peter Haslinger
- Department of Endocrinology and Reproductive Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Ladislaus Szabo
- Department of Endocrinology and Reproductive Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Michael Sator
- Department of Endocrinology and Reproductive Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria ; Privatklinik Doebling, Fertility Center Doebling, Vienna, Austria
| | - Martin Schreiber
- Department of Endocrinology and Reproductive Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Christian Schneeberger
- Department of Endocrinology and Reproductive Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Detlef Pietrowski
- Department of Endocrinology and Reproductive Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
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18
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O’Brien TJ, Harralson AF, Tran T, Gindoff I, Orkunoglu-Suer FE, Frankfurter D, Gindoff P. Kinase insert domain receptor/vascular endothelial growth factor receptor 2 (KDR) genetic variation is associated with ovarian hyperstimulation syndrome. Reprod Biol Endocrinol 2014; 12:36. [PMID: 24886133 PMCID: PMC4024119 DOI: 10.1186/1477-7827-12-36] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 05/01/2014] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The objective of this investigation was to determine if kinase insert domain/vascular endothelial growth factor receptor 2 (KDR/VEGFR2) genetic variation was associated with the development of ovarian hyperstimulation syndrome (OHSS) in patients undergoing controlled ovarian hyperstimulation (COH). METHODS This was a case-control study of 174 patients who underwent controlled ovarian stimulation. Patient blood samples were genotyped for single nucleotide polymorphisms (SNPs) spanning the KDR locus. OHSS development, clinical outcome variables, SNP and haplotype frequencies were compared between control (n = 155) and OHSS (n = 19) groups. RESULTS Patients who developed OHSS had significantly higher response markers (estradiol levels of the day of hCG administration, number of follicles developed, number of eggs retrieved) than control patients. When adjusted for age and self-identified race, the rs2305945 G/T genotype was associated (P = 0.027) with a decreased risk (OR = 0.30; 95% CI = 0.10, 0.93) of developing OHSS using an overdominant model. The rs2305945 G/T variant was also associated with decreased COH response (number of follicles, number of eggs retrieved) in an overdominant model. The rs2305948, rs1870378, rs2305945 (C-T-G) haplotype was associated with both decreased COH response and OHSS risk (unadjusted OR = 0.10; 95% CI = 0.01, 0.80, P = 0.031). CONCLUSIONS The KDR receptor is believed to play a central role OHSS development and is a target for pharmacological prevention of OHSS. These results indicate that genetic variation in the KDR gene may impact individual risk of developing OHSS from COH. In addition, the rs2305948 SNP and C-T-G haplotype might serve as potential biomarkers for poor ovarian response to COH.
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Affiliation(s)
- Travis J O’Brien
- Department of Pharmacology and Physiology, The George Washington University, Washington, DC, USA
| | - Arthur F Harralson
- Department of Pharmacology and Physiology, The George Washington University, Washington, DC, USA
- Department of Pharmacogenomics, Bernard J. Dunn School of Pharmacy, Shenandoah University, Ashburn, VA, USA
| | - Tuyen Tran
- Center for Neuroscience, Children’s National Medical Center, Washington, DC 20010, USA
| | - Ian Gindoff
- Department of Pharmacology and Physiology, The George Washington University, Washington, DC, USA
| | | | - David Frankfurter
- Department of Obstetrics and Gynecology, The George Washington University, Washington, DC, USA
| | - Paul Gindoff
- Department of Obstetrics and Gynecology, The George Washington University, Washington, DC, USA
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Lainas GT, Kolibianakis EM, Sfontouris IA, Zorzovilis IZ, Petsas GK, Lainas TG, Tarlatzis BC. Serum vascular endothelial growth factor levels following luteal gonadotrophin-releasing hormone antagonist administration in women with severe early ovarian hyperstimulation syndrome. BJOG 2014; 121:848-55. [DOI: 10.1111/1471-0528.12572] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2013] [Indexed: 11/29/2022]
Affiliation(s)
- GT Lainas
- Eugonia Unit of Assisted Reproduction; Athens Greece
| | - EM Kolibianakis
- Unit for Human Reproduction; 1st Department of Obstetrics and Gynaecology; Papageorgiou General Hospital; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - IA Sfontouris
- Eugonia Unit of Assisted Reproduction; Athens Greece
| | - IZ Zorzovilis
- Eugonia Unit of Assisted Reproduction; Athens Greece
| | - GK Petsas
- Eugonia Unit of Assisted Reproduction; Athens Greece
| | - TG Lainas
- Eugonia Unit of Assisted Reproduction; Athens Greece
| | - BC Tarlatzis
- Unit for Human Reproduction; 1st Department of Obstetrics and Gynaecology; Papageorgiou General Hospital; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
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20
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Rutkowski JM, Ihm JE, Lee ST, Kilarski WW, Greenwood VI, Pasquier MC, Quazzola A, Trono D, Hubbell JA, Swartz MA. VEGFR-3 neutralization inhibits ovarian lymphangiogenesis, follicle maturation, and murine pregnancy. THE AMERICAN JOURNAL OF PATHOLOGY 2013; 183:1596-1607. [PMID: 24036251 DOI: 10.1016/j.ajpath.2013.07.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 07/15/2013] [Accepted: 07/31/2013] [Indexed: 11/18/2022]
Abstract
Lymphatic vessels surround follicles within the ovary, but their roles in folliculogenesis and pregnancy, as well as the necessity of lymphangiogenesis in follicle maturation and health, are undefined. We used systemic delivery of mF4-31C1, a specific antagonist vascular endothelial growth factor receptor 3 (VEGFR-3) antibody to block lymphangiogenesis in mice. VEGFR-3 neutralization for 2 weeks before mating blocked ovarian lymphangiogenesis at all stages of follicle maturation, most notably around corpora lutea, without significantly affecting follicular blood angiogenesis. The numbers of oocytes ovulated, fertilized, and implanted in the uterus were normal in these mice; however, pregnancies were unsuccessful because of retarded fetal growth and miscarriage. Fewer patent secondary follicles were isolated from treated ovaries, and isolated blastocysts exhibited reduced cell densities. Embryos from VEGFR-3-neutralized dams developed normally when transferred to untreated surrogates. Conversely, normal embryos transferred into mF4-31C1-treated dams led to the same fetal deficiencies observed with in situ gestation. Although no significant changes were measured in uterine blood or lymphatic vascular densities, VEGFR-3 neutralization reduced serum and ovarian estradiol concentrations during gestation. VEGFR-3-mediated lymphangiogenesis thus appears to modulate the folliculogenic microenvironment and may be necessary for maintenance of hormone levels during pregnancy; both of these are novel roles for the lymphatic vasculature.
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Affiliation(s)
- Joseph M Rutkowski
- Institute of Bioengineering, Swiss Federal Institute of Technology in Lausanne (EPFL), Lausanne, Switzerland
| | - Jong Eun Ihm
- Institute of Bioengineering, Swiss Federal Institute of Technology in Lausanne (EPFL), Lausanne, Switzerland
| | - Seung Tae Lee
- Institute of Bioengineering, Swiss Federal Institute of Technology in Lausanne (EPFL), Lausanne, Switzerland
| | - Witold W Kilarski
- Institute of Bioengineering, Swiss Federal Institute of Technology in Lausanne (EPFL), Lausanne, Switzerland
| | - Veronique I Greenwood
- Institute of Bioengineering, Swiss Federal Institute of Technology in Lausanne (EPFL), Lausanne, Switzerland
| | - Miriella C Pasquier
- Institute of Bioengineering, Swiss Federal Institute of Technology in Lausanne (EPFL), Lausanne, Switzerland
| | - Alexandra Quazzola
- Global Health Institute, Swiss Federal Institute of Technology in Lausanne (EPFL), Lausanne, Switzerland
| | - Didier Trono
- Global Health Institute, Swiss Federal Institute of Technology in Lausanne (EPFL), Lausanne, Switzerland
| | - Jeffrey A Hubbell
- Institute of Bioengineering, Swiss Federal Institute of Technology in Lausanne (EPFL), Lausanne, Switzerland
| | - Melody A Swartz
- Institute of Bioengineering, Swiss Federal Institute of Technology in Lausanne (EPFL), Lausanne, Switzerland.
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Engin-Ustun Y, Yılmaz S, Timur H, Ustun Y, Moraloglu O, Deveer R, Yılmaz N. Comparison of bevacizumab and cabergoline in the treatment of ovarian hyperstimulation syndrome in a rat model. Gynecol Endocrinol 2013; 29:851-4. [PMID: 23862585 DOI: 10.3109/09513590.2013.813470] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this study is to investigate the effects of bevacizumab in a rat model of ovarian hyperstimulation syndrome (OHSS) and compare with cabergoline. The study was performed with 24 rats in four main groups (one non-stimulated control and three OHSS treatment groups; bevacizumab, cabergoline and placebo). The rats were randomly assigned to four experimental groups (six rats per group). Efficacy of treatment was assessed on 29th day by measuring weight gain, number of eggs, presence of ascites and ovarian weight. Peritoneal fluid levels of vascular endothelial growth factor (VEGF) were measured using an enzyme-linked immunosorbent assay. Ovarian weights were significantly higher in the OHSS groups than the control group. Ovarian weights in OHSS placebo group were found to be higher than those in OHSS-treatment groups (p = 0.002). VEGF levels were found increased in the OHSS-placebo group compared with the control group (p < 0.05). This increase was not seen in the OHSS groups treated with either bevacizumab or cabergoline. We demonstrate in this study that bevacizumab can lower VEGF production and ovarian weight in rats treated with gonadotropins.
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Affiliation(s)
- Yaprak Engin-Ustun
- Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Gynecology and Obstetrics Department, Reproductive Endocrinology Unit.
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Duncan WC, Nio-Kobayashi J. Targeting angiogenesis in the pathological ovary. Reprod Fertil Dev 2013; 25:362-71. [PMID: 22951108 DOI: 10.1071/rd12112] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Accepted: 07/13/2012] [Indexed: 12/17/2022] Open
Abstract
The ovary is a key tissue in the study of physiological neo-vascularisation in the adult and its study has highlighted important molecules involved in the regulation of angiogenesis in vivo. These include vascular endothelial growth factor, delta-like ligand 4, thrombospondin-1, prokineticin-1 and prostaglandin E2. Targeting these molecular pathways has therapeutic potential and their manipulation has an increasing preclinical and clinical role in the management of the pathological ovary. Targeting angiogenic pathways has utility in the promotion of ovarian angiogenesis to improve tissue and follicle survival and function as well as the prevention and management of ovarian hyperstimulation syndrome. There is a theoretical possibility that targeting angiogenesis may improve the function of the polycystic ovary and a real role for targeting angiogenesis in ovarian cancer.
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Affiliation(s)
- W Colin Duncan
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute, The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
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Tan BK, Mathur R. Management of ovarian hyperstimulation syndrome. Produced on behalf of the BFS Policy and Practice Committee. HUM FERTIL 2013; 16:151-9. [DOI: 10.3109/14647273.2013.788313] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Alama P, Bellver J, Vidal C, Giles J. GnRH analogues in the prevention of ovarian hyperstimulation syndrome. Int J Endocrinol Metab 2013; 11:107-16. [PMID: 23825982 PMCID: PMC3693668 DOI: 10.5812/ijem.5034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 08/11/2012] [Accepted: 08/18/2012] [Indexed: 01/12/2023] Open
Abstract
The GnRH analogue (agonist and antagonist GnRH) changed ovarian stimulation. On the one hand, it improved chances of pregnancy to obtain more oocytes and better embryos. This leads to an ovarian hyper-response, which can be complicated by the ovarian hyperstimulation syndrome (OHSS). On the other hand, the GnRH analogue can prevent the incidence of OHSS: GnRH antagonist protocols, GnRH agonist for triggering final oocyte maturation, either together or separately, coasting, and the GnRH analogue may prove useful for avoiding OHSS in high-risk patients. We review these topics in this article.
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Affiliation(s)
- Pilar Alama
- Department of Reproduction, IVI-Valencia, Plaza de la Policia Local, Valencia, Spain
| | - Jose Bellver
- Department of Reproduction, IVI-Valencia, Plaza de la Policia Local, Valencia, Spain
- Department of Paediatrics, Obstetrics and Gynaecology, Faculty of Medicine. University of Valencia, Valencia, Spain
| | - Carmen Vidal
- Department of Reproduction, IVI-Valencia, Plaza de la Policia Local, Valencia, Spain
| | - Juan Giles
- Department of Reproduction, IVI-Valencia, Plaza de la Policia Local, Valencia, Spain
- Corresponding author: Juan Giles, Department of Reproduction, Valencia Infertility Institute, Plaza de la Policia Local 3, Valencia 46015, Spain. Tel: +34-963050900, E-mail:
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