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Brouwers L, de Gier S, Vogelvang TE, Veerbeek JHW, Franx A, van Rijn BB, Nikkels PGJ. Prevalence of placental bed spiral artery pathology in preeclampsia and fetal growth restriction: A prospective cohort study. Placenta 2024; 156:1-9. [PMID: 39214009 DOI: 10.1016/j.placenta.2024.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 08/15/2024] [Accepted: 08/17/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Preeclampsia and fetal growth restriction (PE/FGR) are pregnancy complications known to be associated with poor utero-placental function due to abnormal "physiological" remodeling of spiral arteries and unfavorable maternal cardiovascular health. However, the prevalence and degree of impaired spiral artery remodeling has not been clearly established. METHOD Prospective, multi-center observational cohort study to assess the prevalence of lesions associated with abnormal development of spiral arteries in placental bed biopsies systematically obtained from 121 women undergoing Caesarian section for PE/FGR compared with a reference group of 149 healthy controls. RESULTS PE/FGR was associated with a high prevalence of impaired spiral artery remodeling compared with controls (63.6 vs 10.1 %, p < 0.001), and a higher prevalence of non-remodeled spiral arteries without the presence of intramural trophoblast (45.5 vs 6.7 %, p < 0.001), despite abundant interstitial trophoblast invasion in surrounding decidua and myometrium. Normal remodeling was associated with circumferential presence of intramural trophoblast and hardly any trophoblast in surrounding tissue. Acute atherosis (28.9 vs 3.4 %, p < 0.001) and thrombosis (16.5 vs 5.4 %, p = 0.003) lesions were significantly more prevalent in PE/FGR. Impaired remodeling, acute atherosis and thrombosis lesions were equally present in both decidual and myometrial segments of the spiral arteries in both groups. Impaired remodeling was most prominent in the groups with FGR (with or without PE) and thrombosis was most often seen in the group with PE and FGR. CONCLUSION PE/FGR is associated with a high prevalence of impaired physiological remodeling and vascular lesions of the uterine spiral arteries in the placental bed.
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Affiliation(s)
- Laura Brouwers
- Wilhelmina Children's Hospital Birth Center, Department of Obstetrics, Division Woman and Baby, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, the Netherlands
| | - Steffie de Gier
- Department of Pathology, University Medical Center Utrecht, Utrecht University, PO Box 85090, 3508 AB, Utrecht, the Netherlands
| | - Tatjana E Vogelvang
- Department of Gynecology & Obstetrics, Diakonessenhuis Hospital, PO Box 80250, 3508 TG, Utrecht, the Netherlands
| | - Jan H W Veerbeek
- Department of Gynecology & Obstetrics, Diakonessenhuis Hospital, PO Box 80250, 3508 TG, Utrecht, the Netherlands
| | - Arie Franx
- Wilhelmina Children's Hospital Birth Center, Department of Obstetrics, Division Woman and Baby, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, the Netherlands; Division of Obstetrics & Gynecology, Department of Obstetrics and Fetal Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Bas B van Rijn
- Wilhelmina Children's Hospital Birth Center, Department of Obstetrics, Division Woman and Baby, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, the Netherlands; Department of Obstetrics and Gynecology, Maxima Medical Center, PO Box 7777, 5500 MB, Veldhoven, the Netherlands; Department of Biomedical Engineering, Eindhoven Technical University, PO Box 513, 5600 MB, Eindhoven, the Netherlands
| | - Peter G J Nikkels
- Department of Pathology, University Medical Center Utrecht, Utrecht University, PO Box 85090, 3508 AB, Utrecht, the Netherlands.
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2
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Bodnar LM, Kirkpatrick SI, Roberts JM, Kennedy EH, Naimi AI. Is the Association Between Fruits and Vegetables and Preeclampsia Due to Higher Dietary Vitamin C and Carotenoid Intakes? Am J Clin Nutr 2023; 118:459-467. [PMID: 37321543 PMCID: PMC10447882 DOI: 10.1016/j.ajcnut.2023.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/03/2023] [Accepted: 06/08/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Diets dense in fruits and vegetables are associated with a reduced risk of preeclampsia, but pathways underlying this relationship are unclear. Dietary antioxidants may contribute to the protective effect. OBJECTIVE We determined the extent to which the effect of dietary fruit and vegetable density on preeclampsia is because of high intakes of dietary vitamin C and carotenoids. METHODS We used data from 7572 participants in the Nulliparous Pregnancy Outcomes Study: monitoring mothers-to-be (8 United States medical centers, 2010‒2013). Usual daily periconceptional intake of total fruits and total vegetables was estimated from a food frequency questionnaire. We estimated the indirect effect of ≥2.5 cups/1000 kcal of fruits and vegetables through vitamin C and carotenoid on the risk of preeclampsia. We estimated these effects using targeted maximum likelihood estimation and an ensemble of machine learning algorithms, adjusting for confounders, including other dietary components, health behaviors, and psychological, neighborhood, and sociodemographic factors. RESULTS Participants who consumed ≥2.5 cups of fruits and vegetables per 1000 kcal were less likely than those who consumed <2.5 cups/1000 kcal to develop preeclampsia (6.4% compared with 8.6%). After confounder adjustment, we observed that higher fruit and vegetable density was associated with 2 fewer cases of preeclampsia (risk difference: -2.0; 95% CI: -3.9, -0.1)/100 pregnancies compared with lower density diets. High dietary vitamin C and carotenoid intake was not associated with preeclampsia. The protective effect of high fruit and vegetable density on the risk of preeclampsia and late-onset preeclampsia was not mediated through dietary vitamin C and carotenoids. CONCLUSIONS Evaluating other nutrients and bioactives in fruits and vegetables and their synergy is worthwhile, along with characterizing the effect of individual fruits or vegetables on preeclampsia risk.
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Affiliation(s)
- Lisa M Bodnar
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States; Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
| | - Sharon I Kirkpatrick
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - James M Roberts
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States; Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Edward H Kennedy
- Department of Statistics, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Ashley I Naimi
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States
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3
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Korzeniewski SJ, Sutton E, Escudero C, Roberts JM. The Global Pregnancy Collaboration (CoLab) symposium on short- and long-term outcomes in offspring whose mothers had preeclampsia: A scoping review of clinical evidence. Front Med (Lausanne) 2022; 9:984291. [PMID: 36111112 PMCID: PMC9470009 DOI: 10.3389/fmed.2022.984291] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Preeclampsia is a maternal syndrome characterized by the new onset of hypertension after 20 weeks of gestation associated with multisystemic complications leading to high maternal and fetal/neonatal morbidity and mortality. However, sequelae of preeclampsia may extend years after pregnancy in both mothers and their children. In addition to the long-term adverse cardiovascular effects of preeclampsia in the mother, observational studies have reported elevated risk of cardiovascular, metabolic, cerebral and cognitive complications in children born from women with preeclampsia. Less clear is whether the association between maternal preeclampsia and offspring sequelae are causal, or to what degree the associations might be driven by fetal factors including impaired growth and the health of its placenta. Our discussion of these complexities in the 2018 Global Pregnancy Collaboration annual meeting prompted us to write this review. We aimed to summarize the evidence of an association between maternal preeclampsia and neurobehavioral developmental disorders in offspring in hopes of generating greater research interest in this important topic.
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Affiliation(s)
- Steven J. Korzeniewski
- Department of Family Medicine and Population Health Sciences, Wayne State University School of Medicine, Detroit, MI, United States
- *Correspondence: Steven J. Korzeniewski
| | - Elizabeth Sutton
- Magee-Womens Research Institute, Pittsburgh, PA, United States
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Carlos Escudero
- Group of Research and Innovation in Vascular Health, Chillán, Chile
- Vascular Physiology Laboratory, Department of Basic Sciences, Faculty of Sciences, University of Bío-Bío, Chillán, Chile
| | - James M. Roberts
- Department of Obstetrics Gynecology and Reproductive Sciences, Epidemiology and Clinical and Translational Research, Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA, United States
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4
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Kulandavelu S, Dulce RA, Murray CI, Bellio MA, Fritsch J, Kanashiro-Takeuchi R, Arora H, Paulino E, Soetkamp D, Balkan W, Van Eyk JE, Hare JM. S-Nitrosoglutathione Reductase Deficiency Causes Aberrant Placental S-Nitrosylation and Preeclampsia. J Am Heart Assoc 2022; 11:e024008. [PMID: 35191317 PMCID: PMC9075059 DOI: 10.1161/jaha.121.024008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background Preeclampsia, a leading cause of maternal and fetal mortality and morbidity, is characterized by an increase in S‐nitrosylated proteins and reactive oxygen species, suggesting a pathophysiologic role for dysregulation in nitrosylation and nitrosative stress. Methods and Results Here, we show that mice lacking S‐nitrosoglutathione reductase (GSNOR−⁄−), a denitrosylase regulating protein S‐nitrosylation, exhibit a preeclampsia phenotype, including hypertension, proteinuria, renal pathology, cardiac concentric hypertrophy, decreased placental vascularization, and fetal growth retardation. Reactive oxygen species, NO, and peroxynitrite levels are elevated. Importantly, mass spectrometry reveals elevated placental S‐nitrosylated amino acid residues in GSNOR−⁄− mice. Ascorbate reverses the phenotype except for fetal weight, reduces the difference in the S‐nitrosoproteome, and identifies a unique set of S‐nitrosylated proteins in GSNOR−⁄− mice. Importantly, human preeclamptic placentas exhibit decreased GSNOR activity and increased nitrosative stress. Conclusions Therefore, deficiency of GSNOR creates dysregulation of placental S‐nitrosylation and preeclampsia in mice, which can be rescued by ascorbate. Coupled with similar findings in human placentas, these findings offer valuable insights and therapeutic implications for preeclampsia.
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Affiliation(s)
- Shathiyah Kulandavelu
- Interdisciplinary Stem Cell InstituteUniversity of Miami Miller School of Medicine Miami FL.,Department of Pediatrics University of Miami Miller School of Medicine Miami FL
| | - Raul A Dulce
- Interdisciplinary Stem Cell InstituteUniversity of Miami Miller School of Medicine Miami FL
| | | | - Michael A Bellio
- Interdisciplinary Stem Cell InstituteUniversity of Miami Miller School of Medicine Miami FL
| | - Julia Fritsch
- Interdisciplinary Stem Cell InstituteUniversity of Miami Miller School of Medicine Miami FL
| | - Rosemeire Kanashiro-Takeuchi
- Interdisciplinary Stem Cell InstituteUniversity of Miami Miller School of Medicine Miami FL.,Department of Molecular and Cellular Pharmacology University of Miami Miller School of Medicine Miami FL
| | - Himanshu Arora
- Interdisciplinary Stem Cell InstituteUniversity of Miami Miller School of Medicine Miami FL.,Department of Urology University of Miami Miller School of Medicine Miami FL
| | - Ellena Paulino
- Interdisciplinary Stem Cell InstituteUniversity of Miami Miller School of Medicine Miami FL
| | - Daniel Soetkamp
- Medicine and Heart InstituteCedars Sinai Medical Center Los Angeles CA
| | - Wayne Balkan
- Interdisciplinary Stem Cell InstituteUniversity of Miami Miller School of Medicine Miami FL.,Division of Cardiology Department of Medicine University of Miami Miller School of Medicine Miami FL
| | - Jenny E Van Eyk
- Medicine and Heart InstituteCedars Sinai Medical Center Los Angeles CA
| | - Joshua M Hare
- Interdisciplinary Stem Cell InstituteUniversity of Miami Miller School of Medicine Miami FL.,Division of Cardiology Department of Medicine University of Miami Miller School of Medicine Miami FL
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Association of maternal angiotensin II type 1 and type 2 receptor combination genotypes with susceptibility to early-onset preeclampsia. J Hum Hypertens 2021; 36:271-279. [PMID: 33758348 DOI: 10.1038/s41371-021-00524-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/25/2021] [Accepted: 03/03/2021] [Indexed: 11/08/2022]
Abstract
Allelic variations affecting the activity of the maternal renin-angiotensin system may play a role in the development of hypertensive disorders of pregnancy like preeclampsia, its more severe early-onset form, and intrauterine growth restriction. We examined the association of common allelic variants of angiotensin II type 1 and type 2 receptor genes (AT1R and AT2R) sorted in five AT1R/AT2R receptor combination genotype groups with susceptibility to early-onset preeclampsia (EOP). The occurrence of AT1R (A1166C) and A2TR (C3123A) alleles in wild type (AA, CC), heterozygous (A/C, C/A), and homozygous (C/C, A/A) states was recorded in 84 women with a history of EOP and 84 age-matched controls sorted in five AT1R/AT2R receptor combination genotype (wild type: AA/CC, one mutant: AA/CA, AC/CC, two mutant: AC/CA, AA/AA, CC/CC, three mutants: AC/AA, CC/CA and four mutant: CC/AA) groups, by polymerase chain reaction-RFLP analysis. Three mutant receptor combination genotype carriers were more common in women with a history of EOP than in controls (26.18% vs. 4.76%, p = 0.003, OR = 8.25). Receptor combination genotyping may be of clinical value in: (a) maternal prediction of susceptibility to EOP, (b) disease subtyping for directed studies with receptor signaling antagonists, (c) the broader study of hypertension.
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Cadmium exposure reduces invasion of the human trophoblast-derived HTR-8/SVneo cells by inhibiting cell adhesion and matrix metalloproteinase-9 secretion. Reprod Toxicol 2021; 100:68-73. [PMID: 33422613 DOI: 10.1016/j.reprotox.2021.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/20/2020] [Accepted: 01/01/2021] [Indexed: 01/19/2023]
Abstract
Preeclampsia and intrauterine growth restriction, multisystemic disorders characterized by a shallow trophoblast invasion, have been associated with maternal cadmium (Cd) exposure. The molecular mechanisms of this association remain unknown. Cell adhesion and matrix metalloproteinase production are essential for an adequate trophoblast invasion. Thus, the aim of this study was to determine the effect of Cd exposure on invasion, adhesion, and matrix metalloproteinase-9 (MMP-9) production in the trophoblast-derived HTR-8/SVneo cell line. Cultured HTR-8/SVneo trophoblast cells were incubated with different concentrations of CdCl2 for 6 h. Cell invasion was determined by the transwell assay, while cell adhesion was examined on collagen type I. MMP-9 release and activity were measured by ELISA and zymography, respectively. MMP-9 mRNA expression was detected by reverse-transcription polymerase chain reaction, while intracellular MMP-9 protein was assessed by Western blotting. Cd exposure significantly decreased the invasion and adhesion of HTR-8/SVneo cells. Also, MMP-9 levels and activity in the culture medium were significantly reduced after Cd incubation. In contrast, MMP-9 mRNA expression and intracellular protein levels were significantly increased. These data indicate that Cd reduces trophoblast cells invasiveness by inhibiting cell adhesion and MMP-9 secretion.
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7
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Rietze AH, Conley YP, Ren D, Anderson CM, Roberts JM, Jeyabalan A, Hubel CA, Schmella MJ. DNA Methylation of Endoglin Pathway Genes in Pregnant Women With and Without Preeclampsia. Epigenet Insights 2020; 13:2516865720959682. [PMID: 33103056 PMCID: PMC7550939 DOI: 10.1177/2516865720959682] [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: 05/09/2020] [Accepted: 08/25/2020] [Indexed: 11/15/2022] Open
Abstract
Objective We compared blood-based DNA methylation levels of endoglin (ENG) and transforming growth factor beta receptor 2 (TGFβR2) gene promoter regions between women with clinically-overt preeclampsia and women with uncomplicated, normotensive pregnancies. Methods We used EpiTect Methyl II PCR Assays to evaluate DNA methylation of CpG islands located in promoter regions of ENG (CpG Island 114642) and TGFβR2 (CpG Island 110111). Preeclampsia was diagnosed based on blood pressure, protein, and uric acid criteria. N = 21 nulliparous preeclampsia case participants were 1:1 frequency matched to N = 21 nulliparous normotensive control participants on gestational age at sample collection (±2 weeks), smoking status, and labor status at sample collection. Methylation values were compared between case and control participant groups [(ENG subset: n = 20 (9 cases, 11 controls); TGFβR2 subset: n = 28 (15 cases, 13 controls)]. Results The majority of the preeclampsia cases delivered at ⩾34 weeks' gestation (83%). Average methylation levels for ENG ([M ± (SD)]; Case Participant Group = 6.54% ± 4.57 versus Control Participant group = 4.81% ± 5.08; P = .102) and TGFβR2 (Case Participant Group = 1.50% ± 1.37 vs Control Participant Group = 1.70% ± 1.40; P = .695) promoter CpG islands did not differ significantly between the participant groups. Removal of 2 extreme outliers in the ENG analytic subset revealed a trend between levels of ENG methylation and pregnancy outcome (Case Participant Group = 5.17% ± 2.16 vs Control Participant Group = 3.36% ± 1.73; P = .062). Conclusion Additional epigenetic studies that include larger sample sizes, investigate preeclampsia subtypes, and capture methylation status of CpG island shores and shelves are needed to further inform us of the potential role that ENG and TGFβR2 DNA methylation plays in preeclampsia pathophysiology.
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Affiliation(s)
- Allison H Rietze
- Department of Health Promotion and Development (School of Nursing), University of Pittsburgh, Pittsburgh, PA, USA
| | - Yvette P Conley
- Department of Health Promotion and Development (School of Nursing), University of Pittsburgh, Pittsburgh, PA, USA.,Department of Human Genetics (Graduate School of Public Health), University of Pittsburgh, Pittsburgh, PA, USA
| | - Dianxu Ren
- Department of Health and Community Systems (School of Nursing), University of Pittsburgh, Pittsburgh, PA, USA
| | - Cindy M Anderson
- Martha S Pitzer Center for Women, Children, and Youth (College of Nursing), The Ohio State University, Columbus, OH, USA
| | - James M Roberts
- Department of Obstetrics, Gynecology, & Reproductive Sciences (School of Medicine), University of Pittsburgh, PA, USA.,Magee-Womens Research Institute, Pittsburgh, PA, USA.,Department of Epidemiology (Graduate School of Public Health), University of Pittsburgh, Pittsburgh, PA, USA.,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Arun Jeyabalan
- Department of Obstetrics, Gynecology, & Reproductive Sciences (School of Medicine), University of Pittsburgh, PA, USA.,Magee-Womens Research Institute, Pittsburgh, PA, USA.,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carl A Hubel
- Department of Obstetrics, Gynecology, & Reproductive Sciences (School of Medicine), University of Pittsburgh, PA, USA.,Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - Mandy J Schmella
- Department of Health Promotion and Development (School of Nursing), University of Pittsburgh, Pittsburgh, PA, USA
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8
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Patch EA, McGrath ER. Mother knows best … except when it comes to a diagnosis of preeclampsia: an exploratory study of the convergence between maternal recall of pregnancy-related outcomes and objective medical data. J Matern Fetal Neonatal Med 2020; 35:366-371. [PMID: 31986938 DOI: 10.1080/14767058.2020.1718645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: This study details the importance of medical professionals accurately explaining a diagnosis of preeclampsia to their patients. Self-report data were compared to medical record data. We examined reporting and recall of infant data and maternal health during pregnancy.Methods: Reliability between maternal self-report and medical record data was explored in 53 women whose infants had recently been discharged from the nearest Level Three Neonatal Intensive Care Unit. Data were collected in a neurodevelopmental follow-up clinic.Results: Maternal reporting of gestational age and infant birth weight was highly accurate (r = 0.99, p < .0001 and r = 0.95, p < .0001, respectively), even when controlling for indicators of low socioeconomic status; however, maternal reporting of their own medical diagnoses was weak. There was a discrepancy between the medical records and maternal self-report of preeclampsia (k = 0.50).Conclusions for practice: Medical professionals should reiterate to women at postpartum appointments whether or not they had preeclampsia.
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Affiliation(s)
- Emily A Patch
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, USA
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9
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Perschbacher KJ, Deng G, Sandgren JA, Walsh JW, Witcher PC, Sapouckey SA, Owens CE, Zhang SY, Scroggins SM, Pearson NA, Devor EJ, Sebag JA, Pierce GL, Fisher RA, Kwitek AE, Santillan DA, Gibson-Corley KN, Sigmund CD, Santillan MK, Grobe JL. Reduced mRNA Expression of RGS2 (Regulator of G Protein Signaling-2) in the Placenta Is Associated With Human Preeclampsia and Sufficient to Cause Features of the Disorder in Mice. Hypertension 2019; 75:569-579. [PMID: 31865781 DOI: 10.1161/hypertensionaha.119.14056] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cascade-specific termination of G protein signaling is catalyzed by the RGS (regulator of G protein signaling) family members, including RGS2. Angiotensin, vasopressin, and endothelin are implicated in preeclampsia, and RGS2 is known to inhibit G protein cascades activated by these hormones. Mutations in RGS2 are associated with human hypertension and increased risk of developing preeclampsia and its sequelae. RGS family members are known to influence maternal vascular function, but the role of RGS2 within the placenta has not been explored. Here, we hypothesized that reduced expression of RGS2 within the placenta represents a risk factor for the development of preeclampsia. Although cAMP/CREB signaling was enriched in placentas from human pregnancies affected by preeclampsia compared with clinically matched controls and RGS2 is known to be a CREB-responsive gene, RGS2 mRNA was reduced in placentas from pregnancies affected by preeclampsia. Experimentally reducing Rgs2 expression within the feto-placental unit was sufficient to induce preeclampsia-like phenotypes in pregnant wild-type C57BL/6J mice. Stimulation of RGS2 transcription within immortalized human HTR8/SVneo trophoblasts by cAMP/CREB signaling was discovered to be dependent on the activity of histone deacetylase activity, and more specifically, HDAC9 (histone deacetylase-9), and HDAC9 expression was reduced in placentas from human pregnancies affected by preeclampsia. We conclude that reduced expression of RGS2 within the placenta may mechanistically contribute to preeclampsia. More generally, this work identifies RGS2 as an HDAC9-dependent CREB-responsive gene, which may contribute to reduced RGS2 expression in placenta during preeclampsia.
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Affiliation(s)
- Katherine J Perschbacher
- From the Department of Pharmacology (K.J.P., G.D., J.A.S., J.W.W., P.C.W., S.A.S., C.E.O., S.Y.Z., N.A.P., R.A.F.), University of Iowa, Iowa City
| | - Guorui Deng
- From the Department of Pharmacology (K.J.P., G.D., J.A.S., J.W.W., P.C.W., S.A.S., C.E.O., S.Y.Z., N.A.P., R.A.F.), University of Iowa, Iowa City
| | - Jeremy A Sandgren
- From the Department of Pharmacology (K.J.P., G.D., J.A.S., J.W.W., P.C.W., S.A.S., C.E.O., S.Y.Z., N.A.P., R.A.F.), University of Iowa, Iowa City
| | - John W Walsh
- From the Department of Pharmacology (K.J.P., G.D., J.A.S., J.W.W., P.C.W., S.A.S., C.E.O., S.Y.Z., N.A.P., R.A.F.), University of Iowa, Iowa City
| | - Phillip C Witcher
- From the Department of Pharmacology (K.J.P., G.D., J.A.S., J.W.W., P.C.W., S.A.S., C.E.O., S.Y.Z., N.A.P., R.A.F.), University of Iowa, Iowa City
| | - Sarah A Sapouckey
- From the Department of Pharmacology (K.J.P., G.D., J.A.S., J.W.W., P.C.W., S.A.S., C.E.O., S.Y.Z., N.A.P., R.A.F.), University of Iowa, Iowa City
| | - Caitlyn E Owens
- From the Department of Pharmacology (K.J.P., G.D., J.A.S., J.W.W., P.C.W., S.A.S., C.E.O., S.Y.Z., N.A.P., R.A.F.), University of Iowa, Iowa City
| | - Shao Yang Zhang
- From the Department of Pharmacology (K.J.P., G.D., J.A.S., J.W.W., P.C.W., S.A.S., C.E.O., S.Y.Z., N.A.P., R.A.F.), University of Iowa, Iowa City
| | - Sabrina M Scroggins
- Department of Obstetrics and Gynecology (S.M.S., E.J.D., D.A.S., M.K.S.), University of Iowa, Iowa City
| | - Nicole A Pearson
- From the Department of Pharmacology (K.J.P., G.D., J.A.S., J.W.W., P.C.W., S.A.S., C.E.O., S.Y.Z., N.A.P., R.A.F.), University of Iowa, Iowa City
| | - Eric J Devor
- Department of Obstetrics and Gynecology (S.M.S., E.J.D., D.A.S., M.K.S.), University of Iowa, Iowa City
| | - Julien A Sebag
- Department of Physiology (J.A.S.), University of Iowa, Iowa City
| | - Gary L Pierce
- Department of Health and Human Physiology (G.L.P.), University of Iowa, Iowa City.,Abboud Cardiovascular Research Center (G.L.P., D.A.S., M.K.S.), University of Iowa, Iowa City
| | - Rory A Fisher
- From the Department of Pharmacology (K.J.P., G.D., J.A.S., J.W.W., P.C.W., S.A.S., C.E.O., S.Y.Z., N.A.P., R.A.F.), University of Iowa, Iowa City
| | - Anne E Kwitek
- Department of Physiology (A.E.K., C.D.S., J.L.G.), Medical College of Wisconsin, Milwaukee.,Cardiovascular Center (A.E.K., C.D.S., J.L.G.), Medical College of Wisconsin, Milwaukee.,Department of Medicine (A.E.K.), Medical College of Wisconsin, Milwaukee
| | - Donna A Santillan
- Department of Obstetrics and Gynecology (S.M.S., E.J.D., D.A.S., M.K.S.), University of Iowa, Iowa City.,Abboud Cardiovascular Research Center (G.L.P., D.A.S., M.K.S.), University of Iowa, Iowa City
| | | | - Curt D Sigmund
- Department of Physiology (A.E.K., C.D.S., J.L.G.), Medical College of Wisconsin, Milwaukee.,Cardiovascular Center (A.E.K., C.D.S., J.L.G.), Medical College of Wisconsin, Milwaukee
| | - Mark K Santillan
- Department of Obstetrics and Gynecology (S.M.S., E.J.D., D.A.S., M.K.S.), University of Iowa, Iowa City.,Abboud Cardiovascular Research Center (G.L.P., D.A.S., M.K.S.), University of Iowa, Iowa City
| | - Justin L Grobe
- Department of Physiology (A.E.K., C.D.S., J.L.G.), Medical College of Wisconsin, Milwaukee.,Cardiovascular Center (A.E.K., C.D.S., J.L.G.), Medical College of Wisconsin, Milwaukee.,Department of Biomedical Engineering (J.L.G.), Medical College of Wisconsin, Milwaukee
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Maric-Bilkan C, Abrahams VM, Arteaga SS, Bourjeily G, Conrad KP, Catov JM, Costantine MM, Cox B, Garovic V, George EM, Gernand AD, Jeyabalan A, Karumanchi SA, Laposky AD, Miodovnik M, Mitchell M, Pemberton VL, Reddy UM, Santillan MK, Tsigas E, Thornburg KLR, Ward K, Myatt L, Roberts JM. Research Recommendations From the National Institutes of Health Workshop on Predicting, Preventing, and Treating Preeclampsia. Hypertension 2019; 73:757-766. [PMID: 30686084 DOI: 10.1161/hypertensionaha.118.11644] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Christine Maric-Bilkan
- From the Division of Cardiovascular Sciences (C.M.-B., S.S.A., V.L.P.), National Institutes of Health, Bethesda, MD
| | - Vikki M Abrahams
- Department of Ob/Gyn and Reproductive Sciences, Yale University School of Medicine, New Haven, CT (V.M.A.)
| | - S Sonia Arteaga
- From the Division of Cardiovascular Sciences (C.M.-B., S.S.A., V.L.P.), National Institutes of Health, Bethesda, MD
| | - Ghada Bourjeily
- Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI (G.B.)
| | - Kirk P Conrad
- Department of Physiology and Functional Genomics and Ob/Gyn, University of Florida College of Medicine, Gainesville (K.P.C.)
| | - Janet M Catov
- Department of Ob/Gyn and Reproductive Sciences, Magee-Women's Research Institute and Clinical and Translational Sciences Research Institute, University of Pittsburgh, PA (J.M.C., A.J., J.M.R.)
| | - Maged M Costantine
- Department of Ob/Gyn, University of Texas Medical Branch, Galveston (M.M.C.)
| | - Brian Cox
- Department of Physiology and Ob/Gyn, University of Toronto, ON, Canada (B.C.)
| | - Vesna Garovic
- Department of Internal Medicine and Division of Nephrology and Hypertension, Department of Ob/Gyn, Mayo Clinic, Rochester, MN (V.G.)
| | - Eric M George
- Department of Physiology and Biophysics and Cell and Molecular Biology, University of Mississippi Medical Center, Jackson (E.M.G.)
| | - Alison D Gernand
- Department of Nutritional Sciences, The Pennsylvania State University (A.D.G.)
| | - Arun Jeyabalan
- Department of Ob/Gyn and Reproductive Sciences, Magee-Women's Research Institute and Clinical and Translational Sciences Research Institute, University of Pittsburgh, PA (J.M.C., A.J., J.M.R.)
| | - S Ananth Karumanchi
- Department of Medicine, Cedars Sinai Medical Center, Los Angeles, CA (S.A.K.)
| | - Aaron D Laposky
- Division of Lung Diseases, National Center on Sleep Disorders Research (A.D.L.), National Institutes of Health, Bethesda, MD
| | - Menachem Miodovnik
- National Heart, Lung, and Blood Institute and Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development (M. Miodovnik, U.M.R.), National Institutes of Health, Bethesda, MD
| | - Megan Mitchell
- Division of Extramural Research Activities (M. Mitchell), National Institutes of Health, Bethesda, MD
| | - Victoria L Pemberton
- From the Division of Cardiovascular Sciences (C.M.-B., S.S.A., V.L.P.), National Institutes of Health, Bethesda, MD
| | - Uma M Reddy
- National Heart, Lung, and Blood Institute and Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development (M. Miodovnik, U.M.R.), National Institutes of Health, Bethesda, MD
| | - Mark K Santillan
- Department of Ob/Gyn, University of Iowa Carver College of Medicine (M.K.S.)
| | | | - Kent L R Thornburg
- Bob & Charlee Moore Institute for Nutrition & Wellness, Oregon Health and Science University, Portland (K.L.R.T.)
| | | | - Leslie Myatt
- Bob & Charlee Moore Institute for Nutrition & Wellness and Department of Ob/Gyn, Oregon Health and Science University, Portland (L.M.)
| | - James M Roberts
- Department of Ob/Gyn and Reproductive Sciences, Magee-Women's Research Institute and Clinical and Translational Sciences Research Institute, University of Pittsburgh, PA (J.M.C., A.J., J.M.R.)
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11
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Goldman-Wohl D, Gamliel M, Mandelboim O, Yagel S. Learning from experience: cellular and molecular bases for improved outcome in subsequent pregnancies. Am J Obstet Gynecol 2019; 221:183-193. [PMID: 30802436 DOI: 10.1016/j.ajog.2019.02.037] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 02/07/2019] [Accepted: 02/18/2019] [Indexed: 12/23/2022]
Abstract
The frequencies of preeclampsia, fetal growth restriction, fetal demise, and low birthweight are lower in subsequent pregnancies. Enhanced maternal cardiovascular adaptation, shorter first and second stages of labor, and more robust lactation also have been observed in subsequent as compared with first pregnancies. We sought to investigate the cellular and molecular bases for better outcomes in subsequent pregnancies. Based on the knowledge that specialized immune cells at the maternal-fetal interface, decidual natural killer cells, promote development of the placental bed and conversion of the spiral arteries by secreting a myriad of angiogenic and growth factors, we asked whether decidual natural killer cells differ in subsequent as compared with first pregnancies. This idea stemmed from recent studies suggesting that natural killer cells, although part of the innate immune system, possess some features of adaptive immunity, including a certain type of immune cell memory, termed trained immunity. We found that decidual natural killer cells from parous women "remember pregnancy" and differ from decidual natural killer cells of primigravidae. Compared with the decidual natural killer cells of first pregnancy, these cells, that we termed pregnancy-trained decidual natural killer cells, express greater levels of the natural killer receptors NKG2C and leukocyte immunoglobulin-like receptor B1, which interact with ligands expressed on invasive trophoblasts. Furthermore, they secrete greater levels of several growth factors, including vascular endothelial growth factor α as well as interferon-γ, augmenting remodeling of the placental bed. We propose that this pregnancy-trained memory dwells in the epigenome, where memory of stimuli is known to persist even when the stimulus is no longer present. This epigenetic memory apparently resides in endometrial natural killer cells between pregnancies. We suggest that this trained memory, which we coined pregnancy-trained decidual natural killer cells, may be the missing link in the immune basis for enhanced subsequent pregnancy. Epigenetic memory (chromatin modification) also may afford a global explanation for additional findings of enhanced maternal cardiovascular adaptation, shorter first and second stages of labor, and more robust lactation. Understanding the molecular and cellular bases of improved outcomes of subsequent pregnancy may lead to the development of treatment modalities designed for women at high risk for pregnancy disorders originating at the maternal-fetal interface.
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Affiliation(s)
- Debra Goldman-Wohl
- Magda and Richard Hoffman Center for Human Placenta Research, Department of Obstetrics and Gynecology, Hebrew University Hadassah Medical Center, Jerusalem, Israel
| | - Moriya Gamliel
- The Concern Foundation Laboratories at the Lautenberg Centre for Immunology and Cancer Research, IMRIC, Faculty of Medicine, Hebrew University Hadassah Medical Center, Jerusalem, Israel
| | - Ofer Mandelboim
- The Concern Foundation Laboratories at the Lautenberg Centre for Immunology and Cancer Research, IMRIC, Faculty of Medicine, Hebrew University Hadassah Medical Center, Jerusalem, Israel
| | - Simcha Yagel
- Magda and Richard Hoffman Center for Human Placenta Research, Department of Obstetrics and Gynecology, Hebrew University Hadassah Medical Center, Jerusalem, Israel.
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12
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Paniagua L, Diaz-Cueto L, Huerta-Reyes M, Arechavaleta-Velasco F. Cadmium exposure induces interleukin-6 production via ROS-dependent activation of the ERK1/2 but independent of JNK signaling pathway in human placental JEG-3 trophoblast cells. Reprod Toxicol 2019; 89:28-34. [PMID: 31252067 DOI: 10.1016/j.reprotox.2019.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 12/12/2022]
Abstract
Maternal exposure to cadmium (Cd) has been associated with preeclampsia (PE), which is a multisystemic disorder characterized by endothelial dysfunction. Elevated interleukin (IL)-6 expression is linked to PE and has been suggested to contribute to maternal endothelial dysfunction. Cd induces IL-6 production in various cell types through different signaling pathways. Thus, this study was designed to investigate the effect of Cd on IL-6 production and the underlying mechanisms in a trophoblast-derived cell line. Cultured JEG-3 trophoblast cells were exposed to non-toxic concentrations of CdCl2 in the presence or absence of various MAPK inhibitors or N-Acetyl-L-cysteine (NAC). IL-6 was measured by ELISA. Phosphorylation of ERK1/2, JNK, and c-Jun was assessed by Western blotting. Cd exposure induced IL-6 production and increased ERK1/2, JNK, and c-Jun phosphorylation. NAC and the inhibition of ERK1/2 significantly reduced Cd-induced IL-6 production. These data indicate that Cd induces IL-6 production in trophoblast cells through a ROS-dependent activation of ERK1/2.
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Affiliation(s)
- Lucero Paniagua
- Unidad de Investigacion Medica en Medicina Reproductiva, UMAE Hospital de Gineco Obstetricia No. 4 "Dr. Luis Castelazo Ayala", IMSS, CDMX, Mexico; Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, CDMX, Mexico
| | - Laura Diaz-Cueto
- Unidad de Investigacion Medica en Medicina Reproductiva, UMAE Hospital de Gineco Obstetricia No. 4 "Dr. Luis Castelazo Ayala", IMSS, CDMX, Mexico
| | - Maira Huerta-Reyes
- Unidad de Investigacion Medica en Enfermedades Nefrologicas, Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Centro Medico Nacional Siglo XXI, IMSS, CDMX, Mexico
| | - Fabian Arechavaleta-Velasco
- Unidad de Investigacion Medica en Medicina Reproductiva, UMAE Hospital de Gineco Obstetricia No. 4 "Dr. Luis Castelazo Ayala", IMSS, CDMX, Mexico.
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Maric-Bilkan C. Portfolio analysis on preeclampsia and pregnancy-associated hypertension research funded by the National Heart, Lung, and Blood Institute. Physiol Genomics 2018; 50:982-987. [PMID: 30265594 DOI: 10.1152/physiolgenomics.00093.2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Chronic hypertension and preeclampsia are the most common complications of pregnancy. To clarify the contributions of the National Heart, Lung, and Blood Institute (NHLBI) to the field and identify potential research gaps, we performed portfolio analysis of awards related to preeclampsia and pregnancy-associated hypertension. A list of National Institutes of Health (NIH)-funded awards between fiscal years 2008-present was obtained through an NIH RePORTER search using the following terms: "preeclampsia" and "pregnancy-associated hypertension." More in-depth analyses were performed on currently active awards supported by the NHLBI. The NHLBI is the lead institute at the NIH in funding research related to pregnancy-associated hypertension and second leading in funding research related to preeclampsia. The NHLBI currently supports 38 awards related to preeclampsia and six awards related to pregnancy-associated hypertension, with a combined total dollar investment of $21 million. Of the currently active, NHLBI-supported awards on preeclampsia and pregnancy-associated hypertension combined, 47% are related to basic science research, 30% to clinical, 14% to clinical trials, and 9% to early translational research. The focus of NHLBI-funded awards is primarily on vascular mechanisms and short and long-term cardiovascular complications of preeclampsia and pregnancy-associated hypertension. Despite steady funding for research on preeclampsia and pregnancy-associated hypertension, several gaps in knowledge exist. NHLBI held a workshop entitled Predicting, Preventing and Treating Preeclampsia to address some of these gaps and inform future research directions for the institute.
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Affiliation(s)
- Christine Maric-Bilkan
- National Heart, Lung, and Blood Institute, National Institutes of Health, Division of Cardiovascular Sciences, Vascular biology and Hypertension branch, Bethesda, Maryland
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