1
|
Zheng Y, McElrath T, Cantonwine D, Hu H. Longitudinal Associations between Ambient Air Pollution and Angiogenic Biomarkers among Pregnant Women in the LIFECODES Study, 2006-2008. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:87005. [PMID: 37556304 PMCID: PMC10411633 DOI: 10.1289/ehp11909] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 06/21/2023] [Accepted: 07/12/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Exposures to ambient air pollution during pregnancy have been linked to adverse pregnancy outcomes such as preeclampsia and fetal growth restriction. Although evidence has shown that women with preeclampsia have higher ratio of soluble fms-like tyrosine kinase 1 to placental growth factor (sFlt-1/PlGF ratio), the potential impact of air pollution on markers of placental growth and function has not been well studied. OBJECTIVES We aimed to examine longitudinal associations between ambient air pollution exposure and angiogenic factors among pregnant women in LIFECODES, a prospective birth cohort and biorepository in Massachusetts in the United States. METHODS PlGF and sFlt-1 were measured among pregnant women using plasma samples collected around 10, 18, 26, and 35 wk' gestation. Women's exposures to ozone (O 3 ), fine particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ), and nitrogen dioxide (NO 2 ) within 1, 2, 4, and 8 wk prior to each plasma sample collection were estimated based on geocoded residential addresses, and mixed effect linear regression models were fitted to assess their associations with sFlt-1/PlGF ratio, sFlt-1 (ng/mL), and PlGF (pg/mL). Percent changes in outcomes associated with each interquartile range increase in exposures were reported, along with their 95% confidence intervals. RESULTS A total of 1,066 pregnant women were included. In the multipollutant models, significant associations were observed for increased sFlt-1/PlGF ratio (PM 2.5 3-8 wk' gestation, NO 2 : 35-39 wk' gestation), elevated sFlt-1 (O 3 : 26-34 wk' gestation, PM 2.5 : 3-8 wk' gestation), decreased sFlt-1 (NO 2 : 4-8 wk' gestation), and decreased PlGF (NO 2 : 34-39 wk' gestation) after adjusting for sociodemographic status, smoking, drinking, body mass index, parity, history of chronic hypertension, and conception time. DISCUSSION Exposures to PM 2.5 during early pregnancy and exposures to O 3 and NO 2 during late pregnancy were associated with increased sFlt-1/PlGF ratio, elevated sFlt-1 and with decreased PlGF, which may be a potential mechanism underlying ambient air pollution's impacts on adverse pregnancy and birth outcomes. https://doi.org/10.1289/EHP11909.
Collapse
Affiliation(s)
- Yi Zheng
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas McElrath
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - David Cantonwine
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Hui Hu
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
2
|
Sakowicz A, Bralewska M, Rybak-Krzyszkowska M, Grzesiak M, Pietrucha T. New Ideas for the Prevention and Treatment of Preeclampsia and Their Molecular Inspirations. Int J Mol Sci 2023; 24:12100. [PMID: 37569476 PMCID: PMC10418829 DOI: 10.3390/ijms241512100] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Preeclampsia (PE) is a pregnancy-specific disorder affecting 4-10% of all expectant women. It greatly increases the risk of maternal and foetal death. Although the main symptoms generally appear after week 20 of gestation, scientific studies indicate that the mechanism underpinning PE is initiated at the beginning of gestation. It is known that the pathomechanism of preeclampsia is strongly related to inflammation and oxidative stress, which influence placentation and provoke endothelial dysfunction in the mother. However, as of yet, no "key players" regulating all these processes have been discovered. This might be why current therapeutic strategies intended for prevention or treatment are not fully effective, and the only effective method to stop the disease is the premature induction of delivery, mostly by caesarean section. Therefore, there is a need for further research into new pharmacological strategies for the treatment and prevention of preeclampsia. This review presents new preventive methods and therapies for PE not yet recommended by obstetrical and gynaecological societies. As many of these therapies are in preclinical studies or under evaluation in clinical trials, this paper reports the molecular targets of the tested agents or methods.
Collapse
Affiliation(s)
- Agata Sakowicz
- Department of Medical Biotechnology, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland; (M.B.); (T.P.)
| | - Michalina Bralewska
- Department of Medical Biotechnology, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland; (M.B.); (T.P.)
| | - Magda Rybak-Krzyszkowska
- Department of Obstetrics and Perinatology, University Hospital in Krakow, 31-501 Krakow, Poland;
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother’s Memorial Hospital-Research Institute in Lodz, 93-338 Lodz, Poland;
- Department of Gynecology and Obstetrics, Medical University of Lodz, 93-338 Lodz, Poland
| | - Tadeusz Pietrucha
- Department of Medical Biotechnology, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland; (M.B.); (T.P.)
| |
Collapse
|
3
|
Słota D, Piętak K, Jampilek J, Sobczak-Kupiec A. Polymeric and Composite Carriers of Protein and Non-Protein Biomolecules for Application in Bone Tissue Engineering. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2235. [PMID: 36984115 PMCID: PMC10059071 DOI: 10.3390/ma16062235] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
Conventional intake of drugs and active substances is most often based on oral intake of an appropriate dose to achieve the desired effect in the affected area or source of pain. In this case, controlling their distribution in the body is difficult, as the substance also reaches other tissues. This phenomenon results in the occurrence of side effects and the need to increase the concentration of the therapeutic substance to ensure it has the desired effect. The scientific field of tissue engineering proposes a solution to this problem, which creates the possibility of designing intelligent systems for delivering active substances precisely to the site of disease conversion. The following review discusses significant current research strategies as well as examples of polymeric and composite carriers for protein and non-protein biomolecules designed for bone tissue regeneration.
Collapse
Affiliation(s)
- Dagmara Słota
- Department of Materials Science, Faculty of Materials Engineering and Physics, Cracow University of Technology, 37 Jana Pawła II Av., 31-864 Krakow, Poland
| | - Karina Piętak
- Department of Materials Science, Faculty of Materials Engineering and Physics, Cracow University of Technology, 37 Jana Pawła II Av., 31-864 Krakow, Poland
| | - Josef Jampilek
- Department of Analytical Chemistry, Faculty of Natural Sciences, Comenius University, Ilkovicova 6, 842 15 Bratislava, Slovakia
- Department of Chemical Biology, Faculty of Science, Palacky University Olomouc, Slechtitelu 27, 783 71 Olomouc, Czech Republic
| | - Agnieszka Sobczak-Kupiec
- Department of Materials Science, Faculty of Materials Engineering and Physics, Cracow University of Technology, 37 Jana Pawła II Av., 31-864 Krakow, Poland
| |
Collapse
|
4
|
Modzelewski J, Siarkowska I, Pajurek-Dudek J, Feduniw S, Muzyka-Placzyńska K, Baran A, Kajdy A, Bednarek-Jędrzejek M, Cymbaluk-Płoska A, Kwiatkowska E, Kwiatkowski S. Atypical Preeclampsia before 20 Weeks of Gestation-A Systematic Review. Int J Mol Sci 2023; 24:ijms24043752. [PMID: 36835158 PMCID: PMC9964444 DOI: 10.3390/ijms24043752] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
This systematic review was conducted to gather evidence of preeclampsia occurring before the 20th week of gestation, additionally considering the role of PLGF and sFlt-1 in the development of the disease. In the three cases of preeclampsia before the 20th week of gestation presented in the authors' material, all pregnancies ended up with IUFD, and the SFlt-1/PLGF ratios were significantly elevated in all women. Eligible publications were identified with searches in the PubMed, Embase, Scopus, and Web of Science databases. No date or language restrictions were made. All original peer-reviewed scientific reports were included. A total of 30 publications were included in the final report, including case reports and case series. No other publication types regarding this issue were identified. In the literature, 34 cases of preeclampsia with onset occurring before the 20th week of gestation were identified, for a final total of 37 cases. Live births were reported in 5 cases (10.52%), and there were 9 intrauterine fetal demises (24.32%), and 23 terminations of pregnancy (62.16%). Preeclampsia before the 20th week of gestation is rare but can occur. We collected all available evidence regarding this phenomenon, with 37 cases reported worldwide. We call for large-scale cohort or register-based studies to establish revised definitions or develop new ones regarding the currently unrecognized very early onset preeclampsia.
Collapse
Affiliation(s)
- Jan Modzelewski
- 1st Clinic of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 St., 01-004 Warsaw, Poland
| | - Iga Siarkowska
- 1st Clinic of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 St., 01-004 Warsaw, Poland
| | - Justyna Pajurek-Dudek
- 1st Clinic of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 St., 01-004 Warsaw, Poland
| | - Stepan Feduniw
- 1st Clinic of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 St., 01-004 Warsaw, Poland
| | - Katarzyna Muzyka-Placzyńska
- 1st Clinic of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 St., 01-004 Warsaw, Poland
| | - Arkadiusz Baran
- 1st Clinic of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 St., 01-004 Warsaw, Poland
| | - Anna Kajdy
- 1st Clinic of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 St., 01-004 Warsaw, Poland
| | | | - Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Ewa Kwiatkowska
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Pomeranian Medical University, 70-111 Szczecin, Poland
| |
Collapse
|
5
|
Ovayolu A, Bostancieri N. A prospective and comparative investigation of blood sFlt-1, P1GF, and niacin concentrations in women with premature ovarian insufficiency. J Obstet Gynaecol Res 2023; 49:1198-1205. [PMID: 36682889 DOI: 10.1111/jog.15554] [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: 09/01/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Endothelial dysfunction is an important component of preeclampsia like premature ovarian insufficiency (POI), and it is reported that placental growth factor (P1GF) and soluble fms-like tyrosine kinase receptor-1 (sFlt-1) levels are important in preeclampsia. Extra-placental sources for P1GF and sFlt-1 have also been identified, including various cell types. In animal models of POI, niacin treatment inhibited follicular apoptosis under hazardous conditions while significantly reducing cumulus cell apoptosis. The number of developing follicles also increased after niacin was given. This study was designed to determine blood sFlt-1, P1GF, and niacin concentrations in women with idiopathic POI (iPOI) compared with those of healthy women. METHODS The study comprised 45 women with iPOI and 45 healthy women. Blood was obtained and analyzed at the early follicular phase of the menstrual cycle and sFlt-1, P1GF, and niacin levels were measured using a commercially available enzyme-linked immunosorbent assay kit. RESULTS No significant differences were observed in the two groups according to the gravidity numbers, parity, abortion, live births, and menarche ages (p ≥ 0.05). In the iPOI group, the mean anti-mullerian hormone value was 0.03 ± 0.04 (min-max, 0.00-0.21) ng/ml. sFlt-1, P1GF, niacin levels, and also the sFlt-1/P1GF ratio were lower in the iPOI group (p < 0.01). A significant discriminative role of sFlt-1, P1GF, niacin levels, and the sFlt-1/P1GF ratio for the presence of iPOI, with cut-off values of 5.13, 10.28, 37.17, and 0.61 ng/ml, respectively, were reported in the receiver operating characteristics curve analysis. CONCLUSIONS Lower levels of P1GF, sFlt-1, niacin, and sFlt-1/P1GF ratios may be associated with the development of POI/iPOI. Further studies are required to better understand the etiopathogenesis of POI/iPOI. CLINICAL TRIAL NUMBER NCT04641624 (clinicaltrials.gov).
Collapse
Affiliation(s)
- Ali Ovayolu
- Department of Obstetrics and Gynecology, Medical School of Istinye University, Istanbul, Turkey.,Department of Obstetrics and Gynecology, Liv Hospital, Gaziantep, Turkey.,Formerly, Department of Obstetrics and Gynecology, Cengiz Gokcek Women's and Children's Hospital, Gaziantep, Turkey
| | - Nuray Bostancieri
- Department of Histology and Embryology, Gaziantep University School of Medicine, Gaziantep, Turkey
| |
Collapse
|
6
|
Non-invasive diagnosis of endometriosis: Immunologic and genetic markers. Clin Chim Acta 2023; 538:70-86. [PMID: 36375526 DOI: 10.1016/j.cca.2022.11.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
Endometriosis, a benign gynecologic and chronic inflammatory disease, is defined by the presence of endometrial tissue outside the uterus characterized mainly by pelvic pain and infertility. Because endometriosis affects approximately 10% of females, it represents a significant socioeconomic burden worldwide having tremendous impact on daily quality of life. Accurate and prompt diagnosis is crucial for the management of this debilitating disorder. Unfortunately, diagnosis is typically delayed to lack of specific symptoms and readily accessible biomarkers. Although histopathologic examination remains the current gold standard, this approach is highly invasive and not applicable for early screening. Recent work has focused on the identification of reliable biomarkers including immunologic, ie, immune cells, antibodies and cytokines, as well as genetic and biochemical markers, ie, microRNAs, lncRNAs, circulating and mitochondrial nucleic acids, along with some hormones, glycoproteins and signaling molecules. Confirmatory research studies are, however, needed to more fully establish these markers in the diagnosis, progression and staging of these endometrial lesions.
Collapse
|
7
|
Combined Effects of Methyldopa and Baicalein or Scutellaria baicalensis Roots Extract on Blood Pressure, Heart Rate, and Expression of Inflammatory and Vascular Disease-Related Factors in Spontaneously Hypertensive Pregnant Rats. Pharmaceuticals (Basel) 2022; 15:ph15111342. [PMID: 36355514 PMCID: PMC9694684 DOI: 10.3390/ph15111342] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/21/2022] [Accepted: 10/27/2022] [Indexed: 12/04/2022] Open
Abstract
The aim of the study was to investigate the effect of baicalein or Scutellaria baicalensis root extract interaction with methyldopa in pregnant spontaneously hypertensive rats (SHR) at the pharmacodynamic, molecular, and biochemical levels. The rats, after confirming pregnancy, received baicalein (200 mg/kg/day, p.o.) and extract (1000 mg/kg/day, p.o.), in combination with methyldopa (400 mg/kg/day; p.o.), for 14 consecutive days, 1 h before blood pressure and heart rate measurements. In the heart and placenta from mothers after giving birth to their offspring, mRNA expression of factors related to inflammatory processes (TNF-α, Il-1β, IL-6) and vascular diseases (TGF-β, HIF-1α, VEGF, PlGF) was measured. Levels of markers of oxidative stress (superoxide dismutase and malondialdehyde) in the placenta and indicators of myocardial damage (troponin cTnC and cTnI, creatine kinase, myoglobin, and lactate dehydrogenase) in the heart were also assessed. Baicalein co-administered with methyldopa was associated with reduced blood pressure, especially during the first three days. The interactions were more pronounced for such factors as TGF-β, HIF-1α, VEGF, and PlGF than TNF-α, Il-1β, and IL-6. Combined application of baicalein and extract with methyldopa may be of value in the development of a new antihypertensive medication intended for patients suffering from preeclampsia or pregnancy-induced hypertension.
Collapse
|
8
|
LI MINGQUN, GUO HONGYAN, XI HONGLI, ZHOU SUFEN. A STUDY ON THE CORRELATION BETWEEN THE ENDOTHELIN-1, NITRIC OXIDE FUNCTION AND THE RENAL HEMODYNAMICS IN PATIENTS WITH HYPERTENSIVE DISORDERS IN PREGNANCY IN HUBEI. J MECH MED BIOL 2021. [DOI: 10.1142/s0219519421400467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective: To analyze the correlation between the vascular endothelial function (characterized by endothelin-1 and nitric oxide) and the renal hemodynamics in patients with hypertensive disorders in pregnancy (HDP) by color Doppler ultrasound. Method: Depending on the severity of the disease, 76 HDP patients were divided into three groups, namely, pregnancy-induced hypertension (PIH) group ([Formula: see text]), mild preeclampsia (PE) group ([Formula: see text]), and severe PE group ([Formula: see text]). In the meantime, 28 healthy pregnant women were selected as controls. Color Doppler ultrasound was performed to determine the following parameters in the interlobar arteries of the kidney: Resistance index (RI), peak end-diastolic velocity (EDV), pulsatility index (PI), peak systolic velocity (PSV), and S/D ratio. The correlations of these parameters with the serum levels of ET-1 and NO were then analyzed. Result: (1) In the interlobar arteries of the kidney, RI, S/D, PI were positively significantly correlated to the serum level of ET-1 in HDP patients (All [Formula: see text]) and negatively to the serum level of NO (All [Formula: see text]). (2) RI, S/D, PI of the mild and severe PE groups were significantly higher than those of the control group (All [Formula: see text]). However, EDV of the mild and severe PE groups was significantly lower than that of the control group (All [Formula: see text]). (3) The serum level of ET-1 was significantly higher in the HDP patients than in the control group ([Formula: see text]). However, the serum level of NO was significantly lower in the former than in the latter ([Formula: see text]). As HDP became more severe, there was an elevation in the serum level of ET-1 and a decrease in NO. Conclusion: Indicators of renal hemodynamics measured by color Doppler ultrasound were correlated to the serum levels of ET-1 and NO characterizing the vascular endothelial function. They were sensitive indicators reflecting hemodynamic changes and renal impairment in HDP patients.
Collapse
Affiliation(s)
- MINGQUN LI
- Department of Obstetrics and Gynecology, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang 441000, P. R. China
| | - HONG YAN GUO
- Department of Obstetrics and Gynecology, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang 441000, P. R. China
| | - HONG LI XI
- Department of Obstetrics and Gynecology, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang 441000, P. R. China
| | - SU FEN ZHOU
- Department of Ultrasound, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine Xiangyang 441000, P. R. China
| |
Collapse
|
9
|
Shinar S, Tigert M, Agrawal S, Parks WA, Kingdom JC. Placental growth factor as a diagnostic tool for placental mediated fetal growth restriction. Pregnancy Hypertens 2021; 25:123-128. [PMID: 34119877 DOI: 10.1016/j.preghy.2021.05.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/03/2021] [Accepted: 05/30/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Placental growth factor (PlGF) has shown promise in identification of placental fetal growth restriction (FGR). We aimed to investigate the association between PlGF and sonographic markers of placental dysfunction and assess its ability to diagnose FGR secondary to maternal vascular malperfusion (MVM). STUDY DESIGN A retrospective study of singleton pregnancies with small for gestational age (SGA) fetuses, who had PlGF testing at 16-36 weeks. Fetuses with major chromosomal and/or structural anomalies and pregnancies with missing outcomes were excluded. Sonographic characteristics, perinatal outcomes and placental histopathology were compared between pregnancies with normal and low PlGF (<10th percentile for gestational age). The diagnostic accuracy of PlGF for prediction of MVM was calculated. RESULTS 130 fetuses met inclusion criteria. Compared to normal PlGF (n = 65), pregnancies with low PlGF (n = 65) were associated with an estimated fetal weight < 5th centile (73.8% (48) vs 53% (35), respectively, p = 0.01), abnormal uterine, umbilical and MCA Dopplers (p = 0.001 for all), fetal demise (18.8% (12) vs 0% respectively, p = 0.01) and preterm delivery (100% (65) vs 39% (59), respectively, p < 0.001) . Low PlGF had a 70.1% (58.6-80.0) sensitivity and a 79.6% (64.7-90.2) specificity for identifying MVM, with an AUC of 0.73 (0.63-0.84). Positive and negative predictive values were 85.7% (76.8-91.2) and 60.3% (51.2-68.9), respectively. PlGF outperformed other parameters of placental FGR (uterine, umbilical artery, middle cerebral artery and abdominal circumference < 5th centile), in isolation and when combined. CONCLUSION PlGF is a useful tool to aid in the diagnosis of placental FGR secondary to MVM.
Collapse
Affiliation(s)
- Shiri Shinar
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
| | - Melissa Tigert
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Swati Agrawal
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - William A Parks
- Department of Laboratory Medicine & Pathobiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - John C Kingdom
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada; Department of Laboratory Medicine & Pathobiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
10
|
Syncytiotrophoblast stress in early onset preeclampsia: The issues perpetuating the syndrome. Placenta 2021; 113:57-66. [PMID: 34053733 DOI: 10.1016/j.placenta.2021.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 04/26/2021] [Accepted: 05/14/2021] [Indexed: 01/08/2023]
Abstract
Preeclampsia is a pregnancy-specific syndrome characterized by a sudden increase in blood pressure accompanied by proteinuria and/or maternal multi-system damage associated to poor fetal outcome. In early-onset preeclampsia, utero-placental perfusion is altered, causing constant and progressive damage to the syncytiotrophoblast, generating syncytiotrophoblast stress. The latter leads to the detachment and release of syncytiotrophoblast fragments, anti-angiogenic factors and pro-inflammatory molecules into maternal circulation, resulting in the emergence and persistence of the characteristic symptoms of this syndrome during pregnancy. Therefore, understanding the origin and consequences of syncytiotrophoblast stress in preeclampsia is vital to develop new therapeutic alternatives, focused on reducing the burden of this syndrome. In this review, we describe five central characteristics of syncytial stress that should be targeted or prevented in order to reduce preeclampsia symptoms: histological alterations, syncytiotrophoblast damage, antiangiogenic protein export, placental deportation, and altered syncytiotrophoblast turnover. Therapeutic management of these characteristics may improve maternal and fetal outcomes.
Collapse
|
11
|
Bogacz A, Mikołajczak PŁ, Wolek M, Górska A, Szulc M, Ożarowski M, Kujawski R, Czerny B, Wolski H, Karpiński TM, Seremak-Mrozikiewicz A. Combined Effects of Methyldopa and Flavonoids on the Expression of Selected Factors Related to Inflammatory Processes and Vascular Diseases in Human Placenta Cells-An In Vitro Study. Molecules 2021; 26:molecules26051259. [PMID: 33652665 PMCID: PMC7956652 DOI: 10.3390/molecules26051259] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/16/2021] [Accepted: 02/22/2021] [Indexed: 12/26/2022] Open
Abstract
The aim of the study was to investigate combined effects of flavonoids (apigenin, baicalein, chrysin, quercetin, and scutellarin) and methyldopa on the expression of selected proinflammatory and vascular factors in vitro for prediction of their action in pregnancy-induced hypertension. The research was conducted on a trophoblast-derived human choriocarcinoma cell line and a primary human umbilical vein endothelial cell line. Cytotoxicity of compounds in selected concentrations (20, 40, and 100 µmol) was measured using the MTT test and the concentration of 40 µmol was selected for further analysis. Subsequently, their effects with methyldopa on the expression of selected markers responsible for inflammation (TNF-α; IL-1β; IL-6) and vascular effects (hypoxia-inducible factor 1α—HIF-1α; placental growth factor—PIGF; transforming growth factor β—TGF-β; vascular endothelial growth factor—VEGF) at the mRNA and protein levels were assessed. It was found that every combined administration of a flavonoid and methyldopa in these cells induced a down-regulating effect on all tested factors, except PIGF, especially at the mRNA expression level. As hypertension generally raises TNF-α, IL-1β, IL-6, HIF-1α, TGF-β, and VEGF mRNA expression and/or protein levels, the results obtained in the studied model may provide a positive prognostic factor for such activity in vivo.
Collapse
Affiliation(s)
- Anna Bogacz
- Department of Pharmacology and Phytochemistry, Institute of Natural Fibres and Medicinal Plants, Kolejowa 2, 62-064 Plewiska, Poland; (A.B.); (P.Ł.M.); (A.S.-M.)
| | - Przemysław Ł. Mikołajczak
- Department of Pharmacology and Phytochemistry, Institute of Natural Fibres and Medicinal Plants, Kolejowa 2, 62-064 Plewiska, Poland; (A.B.); (P.Ł.M.); (A.S.-M.)
- Department of Pharmacology, Poznan University of Medical Sciences, Rokietnicka 5a, 60-806 Poznań, Poland; (M.S.); (R.K.)
| | - Marlena Wolek
- Department of Stem Cells and Regenerative Medicine, Institute of Natural Fibres and Medicinal Plants, Kolejowa 2, 62-064 Plewiska, Poland; (M.W.); (A.G.); (B.C.)
| | - Aleksandra Górska
- Department of Stem Cells and Regenerative Medicine, Institute of Natural Fibres and Medicinal Plants, Kolejowa 2, 62-064 Plewiska, Poland; (M.W.); (A.G.); (B.C.)
| | - Michał Szulc
- Department of Pharmacology, Poznan University of Medical Sciences, Rokietnicka 5a, 60-806 Poznań, Poland; (M.S.); (R.K.)
| | - Marcin Ożarowski
- Department of Biotechnology, Institute of Natural Fibres and Medicinal Plants, WojskaPolskiego 71b, 60-630 Poznań, Poland
- Correspondence:
| | - Radosław Kujawski
- Department of Pharmacology, Poznan University of Medical Sciences, Rokietnicka 5a, 60-806 Poznań, Poland; (M.S.); (R.K.)
| | - Bogusław Czerny
- Department of Stem Cells and Regenerative Medicine, Institute of Natural Fibres and Medicinal Plants, Kolejowa 2, 62-064 Plewiska, Poland; (M.W.); (A.G.); (B.C.)
- Department of General Pharmacology and Pharmacoeconomics, Pomeranian Medical University in Szczecin, Żołnierska 48, 70-204 Szczecin, Poland
| | - Hubert Wolski
- Division of Gynecology and Obstetrics, Podhale Multidisciplinary Hospital, 34-400 NowyTarg, Poland;
- Division of Perinatology and Women’s Diseases, Poznan University of Medical Sciences, Polna 33, 60-535 Poznań, Poland
| | - Tomasz M. Karpiński
- Chair and Department of Medical Microbiology, Poznań University of Medical Sciences, Wieniawskiego 3, 61-712 Poznań, Poland;
| | - Agnieszka Seremak-Mrozikiewicz
- Department of Pharmacology and Phytochemistry, Institute of Natural Fibres and Medicinal Plants, Kolejowa 2, 62-064 Plewiska, Poland; (A.B.); (P.Ł.M.); (A.S.-M.)
- Division of Perinatology and Women’s Diseases, Poznan University of Medical Sciences, Polna 33, 60-535 Poznań, Poland
| |
Collapse
|
12
|
El-Malkey NF, Aref M, Emam H, Khalil SS. Impact of Melatonin on Full-Term Fetal Brain Development and Transforming Growth Factor-β Level in a Rat Model of Preeclampsia. Reprod Sci 2021; 28:2278-2291. [PMID: 33591564 DOI: 10.1007/s43032-021-00497-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 02/08/2021] [Indexed: 01/27/2023]
Abstract
Preeclampsia (PE) is a leading cause of stroke and cognitive impairment in the offspring. Melatonin is involved in the outcome of normal pregnancy. Its receptors are widespread in the embryo. This study aimed to investigate the fetal neuroprotective effect of melatonin in experimentally induced PE. After induction of pregnancy in 18 female rats, they were divided into three equal groups. PE was induced in groups II and III by injection of deoxycorticosterone acetate and drinking isotonic saline. Melatonin was supplied to group III orally (10 mg/kg body weight) throughout pregnancy. Pregnancy was terminated on day 20, and macroanatomical investigation of three fetuses from each pregnant rat and their placentae was performed. Placental and brain homogenates were analyzed for malondialdehyde (MDA), placental growth factor (PLGF), tumor necrosis factor-α (TNF-α), and brain transforming growth factor-β (TGF-β). Histopathological analysis of fetal brain sections was performed. Melatonin improved placental, fetal, and brain weight; significantly reduced fetal death rate; significantly increased PLGF, placental and brain superoxide dismutase, and brain TGF-β; and significantly decreased placental TNF-α and brain MDA. Brain micromorphological study found normal glial cells and neuropil in the melatonin-treated group and a loss of neuronal cell outlines with an accumulation of cellular debris in the untreated group. In conclusion, melatonin approximately showed a neuroprotective activity by managing PE-induced oxidative stress in the placenta and fetal cerebral cortex of rats.
Collapse
Affiliation(s)
| | - Mohammed Aref
- Anatomy and Embryology Department, Faculty of Veterinary Medicine, Zagazig University, Al Sharqiya, Egypt
| | - Hassan Emam
- Anatomy and Embryology Department, Faculty of Veterinary Medicine, Zagazig University, Al Sharqiya, Egypt
| | - Sama Salah Khalil
- Physiology Department, Faculty of Medicine, Zagazig University, Al Sharqiya, Egypt
| |
Collapse
|
13
|
Badeghiesh A, Volodarsky-Perel A, Lasry A, Hemmings R, Gil Y, Balayla J. Use of Placental Growth Factor for Trisomy 21 Screening in Pregnancy: A Systematic Review. AJP Rep 2020; 10:e234-e240. [PMID: 33094011 PMCID: PMC7571571 DOI: 10.1055/s-0040-1713785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/05/2020] [Indexed: 11/03/2022] Open
Abstract
Background Prenatal serum screening is an important modality to screen for aneuploidy in pregnancy. The addition of placental growth factor (PLGF) to screen for trisomy 21 remains controversial. Objective To determine whether the addition of PLGF to combined serum aneuploidy screening improves detection rates (DRs) for trisomy 21. Study Design We performed a systematic review of the literature until October 2019 to determine the benefits of adding PLGF to prenatal screening. We performed a goodness-of-fit test and retrieved the coefficient of determinations ( R 2 ) as a function of false positive rates (FPRs), providing mean-weighted improvements in the DRs after accounting for PLGF levels. Results We identified 51 studies, of which 8 met inclusion criteria (834 aneuploidy cases and 105,904 euploid controls). DRs were proportional to FPR across all studies, ranging from 59.0 to 95.3% without PLGF and 61.0 to 96.3% with PLGF (FPR 1-5%). Goodness-of-fit regression analysis revealed a logarithmic distribution of DRs as a function of the FPR, with R 2 = 0.109 (no PLGF) and R 2 = 0.06 (PLGF). Two-sample Kolmogorov-Smirnov's test reveals a p -value of 0.44. Overall, addition of PLGF improves DRs of 3.3% for 1% FPR, 1.7% for 3% FPR, and 1.4% for 5% FPR, respectively. Conclusion Addition of PLGF to prenatal screening using serum analytes mildly improves trisomy 21 DRs as a function of FPRs.
Collapse
Affiliation(s)
- Ahmad Badeghiesh
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
| | - Alexander Volodarsky-Perel
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.,Lady Davis Research Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Ariane Lasry
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
| | - Robert Hemmings
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.,Department of Obstetrics and Gynecology, CIUSS Ouest de l'Ile, Montreal, Quebec, Canada
| | - Yaron Gil
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
| | - Jacques Balayla
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
14
|
Voto LS, Zeitune MG. Re: Pravastatin for early-onset pre-eclampsia: a randomised, blinded, placebo-controlled trial. BJOG 2020; 127:1036. [PMID: 32372433 DOI: 10.1111/1471-0528.16240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Liliana S Voto
- Departamento Materno infantil, Hospital General de Agudos Dr. Juan A. Fernández, Ciudad de Buenos Aires, Argentina
| | - Moises G Zeitune
- Departamento Materno infantil, Hospital General de Agudos Dr. Juan A. Fernández, Ciudad de Buenos Aires, Argentina
| |
Collapse
|
15
|
Umapathy A, Chamley LW, James JL. Reconciling the distinct roles of angiogenic/anti-angiogenic factors in the placenta and maternal circulation of normal and pathological pregnancies. Angiogenesis 2019; 23:105-117. [DOI: 10.1007/s10456-019-09694-w] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/26/2019] [Indexed: 01/03/2023]
|
16
|
Hendrix MLE, Palm KCM, Van Kuijk SMJ, Bekers O, Spaanderman MEA, Bons JAP, Al-Nasiry S. Longitudinal changes in placental biomarkers in women with early versus late placental dysfunction. Hypertens Pregnancy 2019; 38:268-277. [PMID: 31559879 DOI: 10.1080/10641955.2019.1668948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective: To evaluate longitudinal changes of angiogenic biomarkers in early- (EO-PD) versus late-onset (LO-PD) placental dysfunction. Methods: Serum PlGF and sFlt-1 measured at different intervals in EO-PD (n= 43), LO-PD (n= 31) and controls (n = 133). Results: sFlt-1/PlGF ratio was higher at 16 weeks (30.6 vs 17.5), 20 weeks (29.3 vs 8.9) and 30 weeks (16.6 vs 6.7) in EO-PD vs controls (all p< 0.05), but not in LO-PD. Longitudinal changes for all intervals had higher AUC than single measurements. Conclusion: Longitudinal biomarker change between 12 and 30 weeks could improve prediction of EO-PD compared to single measurements.
Collapse
Affiliation(s)
- Manouk L E Hendrix
- Department of Obstetrics & Gynecology, Maastricht University Medical Centre (MUMC+) , Maastricht , The Netherlands
| | - Kirsten C M Palm
- Department of Obstetrics & Gynecology, Maastricht University Medical Centre (MUMC+) , Maastricht , The Netherlands
| | - Sander M J Van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre(MUMC+) , Maastricht , The Netherlands
| | - Otto Bekers
- Central Diagnostic Laboratory, Maastricht University Medical Centre (MUMC+) , Maastricht , The Netherlands
| | - Marc E A Spaanderman
- Department of Obstetrics & Gynecology, Maastricht University Medical Centre (MUMC+) , Maastricht , The Netherlands
| | - Judith A P Bons
- Central Diagnostic Laboratory, Maastricht University Medical Centre (MUMC+) , Maastricht , The Netherlands
| | - Salwan Al-Nasiry
- Department of Obstetrics & Gynecology, Maastricht University Medical Centre (MUMC+) , Maastricht , The Netherlands
| |
Collapse
|
17
|
Kim TG, Do Ki K, Lee MK, So JW, Chung SK, Kang J. Comparison of cytokine expression and ultrastructural alterations in fresh-frozen and dried electron beam-irradiated human amniotic membrane and chorion. Cell Tissue Bank 2019; 20:163-172. [PMID: 31062125 DOI: 10.1007/s10561-019-09748-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 01/03/2019] [Indexed: 10/26/2022]
Abstract
The purpose of the current study was to compare the effects of drying and fresh-freezing on human amniotic membrane (HAM) and amnion/chorion membrane (HACM) in terms of histological and structural characteristics and cytokine levels. HAM and HACM samples, obtained from six placentae, were investigated. HAM and HACM were dried, electron beam-irradiated (dehydration group; d-HAM/d-HACM), or fresh-frozen (freezing group; f-HAM/f-HACM). Luminex assay was used to assay the levels of 15 cytokines. The ultrastructural characteristics of HAM and HACM were evaluated using light and transmission electron microscopies. Total cytokine contents did not show the statistical difference between dehydration and fresh-freezing process. Significantly higher levels of total cytokines were observed in HACM than in HAM. Epidermal growth factor (EGF) level was significantly higher in d-HAM than in the other samples. The levels of most of the other growth factors were higher in HACM than in HAM, but there was no statistical difference between the dehydration process and the fresh-freezing process. The levels of the cytokines, other than the growth factors, were higher in HACM than in HAM, and higher concentrations of cytokines were observed in the freezing group than in the dehydration group. Histological examination revealed that the dehydration group had thinner tissues than the freezing group, but the structural stability, including the basement membrane, did not differ between the two groups. Microscopic structures such as microvilli and nuclei were well-preserved in the freezing group, based on the results of the transmission electron microscopy. Our dehydration process maintained the histological structure of HAM/HACM and a variety of growth factors and cytokines were identified. Especially, the HAM, processed with the dehydration method, had a higher EGF level than that processed with the fresh-freezing method. Therefore, dehydration method can be used to effectively promote wound repair.
Collapse
Affiliation(s)
- Tae Gi Kim
- Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, # 892, Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Kyung Do Ki
- Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul, Republic of Korea
| | - Myeong-Kyu Lee
- Department of Research and Development, Korea Public Tissue Bank, Seoul, Republic of Korea
| | - Jung-Won So
- Department of Research and Development, Korea Public Tissue Bank, Seoul, Republic of Korea
| | | | - Jaheon Kang
- Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, # 892, Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea.
| |
Collapse
|
18
|
Narvaez-Sanchez R, Calderón JC, Vega G, Trillos MC, Ospina S. Skeletal muscle as a protagonist in the pregnancy metabolic syndrome. Med Hypotheses 2019; 126:26-37. [PMID: 31010495 DOI: 10.1016/j.mehy.2019.02.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 02/12/2019] [Accepted: 02/27/2019] [Indexed: 12/13/2022]
Abstract
The pregnant woman normally shows clinical manifestations similar to a metabolic syndrome (MS), due to her metabolic and hemodynamic adaptations in order to share nutrients with the child. If those adjustments are surpassed, a kind of pregnancy MS (PregMS) could appear, characterized by excessive insulin resistance and vascular maladaptation. Skeletal muscle (SKM) must be a protagonist in the PregMS: SKM strength and mass have been associated inversely with MS incidence in non-pregnant patients, and in pregnant women muscular activity modulates metabolic and vascular adaptations that favor better outcomes. Of note, a sedentary lifestyle affects exactly in the other way. Those effects may be explained not only by the old paradigm of SKM being a great energy consumer and store, but because it is an endocrine organ whose chronic activity or deconditioning correspondingly releases myokines modulating insulin sensitivity and cardiovascular adaptation, by direct or indirect mechanisms not well understood. In this document, we present evidence to support the concept of a PregMS and hypothesize on the role of the SKM mass, fiber types composition and myokines in its pathophysiology. Also, we discuss some exercise interventions in pregnancy as a way to test our hypotheses.
Collapse
Affiliation(s)
- Raul Narvaez-Sanchez
- Physiology and Biochemistry Research Group PHYSIS, Faculty of Medicine, University of Antioquia, Medellin, Colombia; Red iberoamericana de trastornos vasculares y del embarazo, RIVATREM, Colombia.
| | - Juan C Calderón
- Physiology and Biochemistry Research Group PHYSIS, Faculty of Medicine, University of Antioquia, Medellin, Colombia. http://www.udea.edu.co/physis
| | - Gloria Vega
- Physiology and Biochemistry Research Group PHYSIS, Faculty of Medicine, University of Antioquia, Medellin, Colombia. http://www.udea.edu.co/physis
| | - Maria Camila Trillos
- Physiology and Biochemistry Research Group PHYSIS, Faculty of Medicine, University of Antioquia, Medellin, Colombia. http://www.udea.edu.co/physis
| | - Sara Ospina
- Physiology and Biochemistry Research Group PHYSIS, Faculty of Medicine, University of Antioquia, Medellin, Colombia. http://www.udea.edu.co/physis
| |
Collapse
|
19
|
Wang Y, Liu C, He X, Li Y, Zou Y. Effects of metoprolol, methyldopa, and nifedipine on endothelial progenitor cells in patients with gestational hypertension and preeclampsia. Clin Exp Pharmacol Physiol 2019; 46:302-312. [PMID: 30614608 DOI: 10.1111/1440-1681.13063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/25/2018] [Accepted: 01/04/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Yangui Wang
- Department of General Practice Hunan Provincial People’s Hospital/The First Affiliated Hospital of Hunan Normal University Changsha China
| | - Cuizhong Liu
- Department of General Practice Hunan Provincial People’s Hospital/The First Affiliated Hospital of Hunan Normal University Changsha China
| | - Xin He
- Department of Obstetrics and GynaecologyHunan Provincial People’s Hospital/The First Affiliated Hospital of Hunan Normal University Changsha China
| | - Yingzhao Li
- Department of General Practice Hunan Provincial People’s Hospital/The First Affiliated Hospital of Hunan Normal University Changsha China
| | - Yan Zou
- Department of General Practice Hunan Provincial People’s Hospital/The First Affiliated Hospital of Hunan Normal University Changsha China
| |
Collapse
|
20
|
Meng Q, Duan P, Li L, Miao Y. Expression of Placenta Growth Factor Is Associated with Unfavorable Prognosis of Advanced-Stage Serous Ovarian Cancer. TOHOKU J EXP MED 2018; 244:291-296. [PMID: 29643276 DOI: 10.1620/tjem.244.291] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Ovarian cancer is the fourth leading cause of cancer death in women and the most fatal gynecologic malignancy. Placenta growth factor (PGF), a member of the vascular endothelial growth factor, plays an important role in angiogenesis. The overexpression of PGF was observed in several types of cancers, but the clinical significance of PGF in epithelial ovarian cancer (EOC) is still unknown. To explore the prognostic value of PGF among patients with serous EOC, we analyzed the expression of PGF in 89 EOC specimens by immunohistochemistry. The scoring system of immunohistochemistry was based on the staining intensity and the percentage of PGF-positive cells in each EOC tissue. According to the immunohistochemical score, 34 patients with score ≥ 6 were defined as high PGF expression, and other 55 patients were the group with low PGF expression. The prognostic significance of PGF expression was analyzed. EOC patients with higher IHC scores of PGF expression are significantly associated with positive lymphatic invasion and poorer response to chemotherapy. Patients with higher IHC scores of PGF expression had poorer response to chemotherapy and lower overall survival rate. Additionally, the positive lymph node metastasis, advanced TNM stage, and poorer response to chemotherapy were all remarkably correlated to poorer prognosis. In conclusion, patients with higher PGF in EOC tissues were more predisposed to positive lymphatic invasion, poorer response to chemotherapy and unfavorable prognosis of patients with serous EOC. We propose that PGF expression may be predictive of chemoresistance and poor prognosis of serous EOC.
Collapse
Affiliation(s)
- Qin Meng
- Department of Gynecology and Obstetrics, Shandong Medical College Linyi
| | - Pengjing Duan
- Department of Gynecology and Obstetrics, Affiliated Hospital of Shandong Medical College Linyi
| | - Lin Li
- Department of Gynecology and Obstetrics, Linyi People's Hospital
| | - Yongmei Miao
- Department of Gynecology and Obstetrics, Linyi People's Hospital
| |
Collapse
|
21
|
Zhang S, Liu J, Jiang D, Wuren T, Ma S, Du Y, Yi X, Wu S. The plasma level changes of VEGF and soluble VEGF receptor-1 are associated with high-altitude pulmonary edema. THE JOURNAL OF MEDICAL INVESTIGATION 2018; 65:64-68. [PMID: 29593196 DOI: 10.2152/jmi.65.64] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Hypoxia-induced plasma levels of VEGF and sFlt-1 are responsible for increased vascular permeability occurred in both brain and pulmonary edema. Currently, it remains unclear the exact roles of VEGF and sFlt-1 in High Altitude Pulmonary Edema (HAPE) pathogenesis. In this study, plasma levels of VEGF and sFlt-1 from 10 HAPE and 10 non-HAPE subjects were measured and compared. The results showed that plasma levels of both VEGF and sFlt-1 in HAPE patients were significantly increased as compared to the non-HAPE group. Interestingly, increased plasma levels of these two protein factors were markedly reduced after treatments. As compared to VEGF, sFlt-1 was much more affected by hypoxia and treatments, suggesting this factor was a key factor contributed to HAPE pathogenesis. Importantly, the ratio of sFlt-1 and VEGF in group of either non-HAPE or HAPE after recovery was significantly lower than the ratio in HAPE patients prior to treatments. Our findings suggested that sFlt-1 was a key factor that involved in HAPE pathogenesis and the sFlt-1/VEGF ratio could be used as a sensitive diagnostic marker for HAPE. J. Med. Invest. 65:64-68, February, 2018.
Collapse
Affiliation(s)
- Shukun Zhang
- Department of Pathology, Weihai Municipal Hospital.,Department of Pathology, Qinghai Provincial People's Hospital
| | - Juanli Liu
- Department of Internal Medicine, Qinghai Provincial People's Hospital
| | - Dongmei Jiang
- Institute for Neurological diseases, Qinghai Provincial People's Hospital
| | - Tana Wuren
- Research Centre for High Altitude Medicine, Qinghai University Medical College
| | - Siqing Ma
- Department of Intensive Care Unit, Qinghai Provincial People's Hospital
| | - Yansheng Du
- Department of Neurology, Indiana University School of Medicine
| | - Xin Yi
- Department of Neurology, Indiana University School of Medicine
| | - Shizheng Wu
- Department of Neurology, Qinghai Provincial People's Hospital
| |
Collapse
|
22
|
Herwati TW, Yulistiani Y, M EZ. Analysis of Methyldopa Therapy on sFlt-1 Antiangiogenic Levels in Patients with Severe Preeclampsia. FOLIA MEDICA INDONESIANA 2018. [DOI: 10.20473/fmi.v54i1.8052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Methyldopa is the first-line drugs to treat hypertension in pregnancy. It can decrease blood pressure in preeclampsia by affecting a2-adrenoreceptors in central nervous system. However, it could also act by decreasing production of sFlt-1 antiangiogenic protein levels involved in the pathophysiology of hypertention in preeclampsia. The purpose of this study was to analyze methyldopa therapy on sFlt-1 antiangiogenic levels in the plasma of pregnant women with severe preeclampsia at the Obstetric Departement, Haji Hospital, Surabaya. This was a prospective study with observational cross-section study design. The sFlt-1 angiogenic levels were observed before and after (48 hours) methyldopa administration in severe preeclampsia patient with or without complications in the period of August to October 2016. Patient received methyldopa 250 mg or 500 mg, three times a day for clinical indications according a standard protocol. The study was approved by the ethical committee of Haji Hospital, Surabaya. There were 19 patients with preeclampsia who met the inclusion criteria, showed a decrease in the levels of sFlt-1 before and 48 hours after methyldopa therapy. Levels of sFlt-1 before methyldopa therapy in a dose of 250 mg was 10.15±10.00 (2.55-34.70) ng/ml and after therapy 8,37±9,20 (0.72-9.20) ng/ml, with a percentage decrease 17.54%. sFlt-1 levels before methyldopa therapy in a dose of 500 mg was 8.05±7.07 (2.55-20.76) ng/ml, after therapy 4.50±2.90 (2.19-9.95) ng/ml, with a percentage decrease 44.16%. Methyldopa therapy could decrease sFlt-1 levels of antiangiogenic factor in patients with severe preeclampsia.
Collapse
|
23
|
Baqui AH, Khanam R, Rahman MS, Ahmed A, Rahman HH, Moin MI, Ahmed S, Jehan F, Nisar I, Hussain A, Ilyas M, Hotwani A, Sajid M, Qureshi S, Zaidi A, Sazawal S, Ali SM, Deb S, Juma MH, Dhingra U, Dutta A, Ame SM, Hayward C, Rudan I, Zangenberg M, Russell D, Yoshida S, Polašek O, Manu A, Bahl R. Understanding biological mechanisms underlying adverse birth outcomes in developing countries: protocol for a prospective cohort (AMANHI bio-banking) study. J Glob Health 2018; 7:021202. [PMID: 29163938 PMCID: PMC5665675 DOI: 10.7189/jogh.07.021202] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives The AMANHI study aims to seek for biomarkers as predictors of important pregnancy–related outcomes, and establish a biobank in developing countries for future research as new methods and technologies become available. Methods AMANHI is using harmonised protocols to enrol 3000 women in early pregnancies (8–19 weeks of gestation) for population–based follow–up in pregnancy up to 42 days postpartum in Bangladesh, Pakistan and Tanzania, with collection taking place between August 2014 and June 2016. Urine pregnancy tests will be used to confirm reported or suspected pregnancies for screening ultrasound by trained sonographers to accurately date the pregnancy. Trained study field workers will collect very detailed phenotypic and epidemiological data from the pregnant woman and her family at scheduled home visits during pregnancy (enrolment, 24–28 weeks, 32–36 weeks & 38+ weeks) and postpartum (days 0–6 or 42–60). Trained phlebotomists will collect maternal and umbilical blood samples, centrifuge and obtain aliquots of serum, plasma and the buffy coat for storage. They will also measure HbA1C and collect a dried spot sample of whole blood. Maternal urine samples will also be collected and stored, alongside placenta, umbilical cord tissue and membrane samples, which will both be frozen and prepared for histology examination. Maternal and newborn stool (for microbiota) as well as paternal and newborn saliva samples (for DNA extraction) will also be collected. All samples will be stored at –80°C in the biobank in each of the three sites. These samples will be linked to numerous epidemiological and phenotypic data with unique study identification numbers. Importance of the study AMANHI biobank proves that biobanking is feasible to implement in LMICs, but recognises that biobank creation is only the first step in addressing current global challenges.
Collapse
Affiliation(s)
| | - Abdullah H Baqui
- Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rasheda Khanam
- Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mohammad Sayedur Rahman
- Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Aziz Ahmed
- Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Hasna Hena Rahman
- Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mamun Ibne Moin
- Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Salahuddin Ahmed
- Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Fyezah Jehan
- Department of Pediatrics and Child Health, Aga Khan University, Pakistan
| | - Imran Nisar
- Department of Pediatrics and Child Health, Aga Khan University, Pakistan
| | - Atiya Hussain
- Department of Pediatrics and Child Health, Aga Khan University, Pakistan
| | - Muhammad Ilyas
- Department of Pediatrics and Child Health, Aga Khan University, Pakistan
| | - Aneeta Hotwani
- Department of Pediatrics and Child Health, Aga Khan University, Pakistan
| | - Muhammad Sajid
- Department of Pediatrics and Child Health, Aga Khan University, Pakistan
| | - Shahida Qureshi
- Department of Pediatrics and Child Health, Aga Khan University, Pakistan
| | - Anita Zaidi
- Department of Pediatrics and Child Health, Aga Khan University, Pakistan
| | - Sunil Sazawal
- Centre for Public Health Kinetics, India and Public Health Laboratory-IdC, Pemba, Tanzania
| | - Said M Ali
- Centre for Public Health Kinetics, India and Public Health Laboratory-IdC, Pemba, Tanzania
| | - Saikat Deb
- Centre for Public Health Kinetics, India and Public Health Laboratory-IdC, Pemba, Tanzania
| | - Mohammed Hamad Juma
- Centre for Public Health Kinetics, India and Public Health Laboratory-IdC, Pemba, Tanzania
| | - Usha Dhingra
- Centre for Public Health Kinetics, India and Public Health Laboratory-IdC, Pemba, Tanzania
| | - Arup Dutta
- Centre for Public Health Kinetics, India and Public Health Laboratory-IdC, Pemba, Tanzania
| | - Shaali Makame Ame
- Centre for Public Health Kinetics, India and Public Health Laboratory-IdC, Pemba, Tanzania
| | - Caroline Hayward
- University of Edinburgh: Centre for Global Health Research, Old Medical School, Edinburgh, Scotland, UK
| | - Igor Rudan
- University of Edinburgh: Centre for Global Health Research, Old Medical School, Edinburgh, Scotland, UK
| | | | - Donna Russell
- World Health Organization (MCA/MRD), Geneva, Switzerland
| | | | - Ozren Polašek
- University of Split School of Medicine, Split, Croatia.,Gen-info Ltd, Zagreb, Croatia
| | - Alexander Manu
- World Health Organization (MCA/MRD), Geneva, Switzerland
| | - Rajiv Bahl
- World Health Organization (MCA/MRD), Geneva, Switzerland
| |
Collapse
|
24
|
Alibakhshi A, Abarghooi Kahaki F, Ahangarzadeh S, Yaghoobi H, Yarian F, Arezumand R, Ranjbari J, Mokhtarzadeh A, de la Guardia M. Targeted cancer therapy through antibody fragments-decorated nanomedicines. J Control Release 2017; 268:323-334. [DOI: 10.1016/j.jconrel.2017.10.036] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 10/22/2017] [Accepted: 10/24/2017] [Indexed: 01/10/2023]
|
25
|
Xu B, Bobek G, Makris A, Hennessy A. Antihypertensive methyldopa, labetalol, hydralazine, and clonidine reversed tumour necrosis factor-α inhibited endothelial nitric oxide synthase expression in endothelial-trophoblast cellular networks. Clin Exp Pharmacol Physiol 2017; 44:421-427. [PMID: 27998008 DOI: 10.1111/1440-1681.12712] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 12/08/2016] [Accepted: 12/11/2016] [Indexed: 11/29/2022]
Abstract
Medications used to control hypertension in pregnancy also improve trophoblast and endothelial cellular interaction in vitro. Tumour necrosis factor-α (TNF-α) inhibits trophoblast and endothelial cellular interactions and simultaneously decreases endothelial nitric oxide synthase (eNOS) expression. This study investigated whether antihypertensive medications improved these cellular interactions by modulating eNOS and inducible nitric oxide synthase (iNOS) expression. Human uterine myometrial microvascular endothelial cells (UtMVECs) were pre-incubated with (or without) low dose TNF-α (0.5 ng/mL) or TNF-α plus soluble fms-like tyrosine kinase-1 (sFlt-1) (100 ng/mL). The endothelial cells were cultured on Matrigel. After endothelial cellular networks appeared, trophoblast derived HTR-8/SVneo cells were co-cultured in the presence of clinically relevant doses of methyldopa, labetalol, hydralazine or clonidine for 24 hours. Cells were retrieved from the Matrigel to extract mRNA and eNOS and iNOS expression were examined by quantitative PCR. Methyldopa, labetalol, hydralazine and clonidine reversed the inhibitory effect of TNF-α on eNOS mRNA expression. After pre-incubating endothelial cells with TNF-α and sFlt-1, all the medications except methyldopa lost their effect on eNOS mRNA expression. In the absence of TNF-α, antihypertensive medications did not change eNOS expression. The mRNA expression of iNOS was not affected by TNF-α or any medications. This study shows that selected antihypertensive medications used in the treatment of hypertension in pregnancy increase eNOS expression in vitro when induced by the inflammatory TNF-α. The anti-angiogenic molecule sFlt-1 may antagonise the potential benefit of these medications by interfering with the NOS pathway.
Collapse
Affiliation(s)
- Bei Xu
- School of Medicine, Western Sydney University, Sydney, NSW, Australia.,Vascular Immunology Research Laboratory, The Heart Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Gabriele Bobek
- School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Angela Makris
- School of Medicine, Western Sydney University, Sydney, NSW, Australia.,Vascular Immunology Research Laboratory, The Heart Research Institute, University of Sydney, Sydney, NSW, Australia.,Renal Unit, Liverpool Hospital, Sydney, NSW, Australia
| | - Annemarie Hennessy
- School of Medicine, Western Sydney University, Sydney, NSW, Australia.,Vascular Immunology Research Laboratory, The Heart Research Institute, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
26
|
Navaratnam K, Abreu P, Clarke H, Jorgensen A, Alfirevic A, Alfirevic Z. Evaluation of agreement of placental growth factor (PlGF) tests and the soluble FMS-like tyrosine kinase 1 (sFlt-1)/PlGF ratio, comparison of predictive accuracy for pre-eclampsia, and relation to uterine artery Doppler and response to aspirin. J Matern Fetal Neonatal Med 2017; 32:179-187. [PMID: 28851242 DOI: 10.1080/14767058.2017.1373760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The objective of this study is to evaluate agreement between PlGF and sFlt-1/PlGF ratio tests and compare their predictive accuracy for pre-eclampsia in high-risk women. Also, to examine for associations of abnormal PlGF or sFlt-1/PlGF ratio with abnormal uterine artery Doppler and platelet response to aspirin. METHODS Prospective cohort study, 150 pregnant women at high risk of pre-eclampsia prescribed 75 mg aspirin daily. Uterine artery Dopplers were assessed at 20+0-23+6 weeks. At 33+0-35+6 weeks platelet function aspirin metabolites, PlGF and the sFlt-1/PlGF ratio were measured. OUTCOME Measures were all pre-eclampsia and pre-eclampsia requiring delivery prior to 37 weeks. RESULTS Overall percent agreement was 89.3% for PlGF tests but 74.7-78% for PlGF tests and the sFlt-1/PlGF ratio. AUCs were 0.70-0.75 for prediction of any pre-eclampsia and 0.92-0.99 for preterm pre-eclampsia. We found a significant association between abnormal PlGF or sFlt-1/PlGF ratio and abnormal uterine artery Doppler (χ2 5.47, p = .019), but no association with platelet response to aspirin (χ2 0.12, p = .913). There were no associations between suboptimal aspirin adherence and either abnormal angiogenic markers or uterine artery Dopplers (χ2 0.144, 0.038, p = .704, .846, respectively). CONCLUSIONS There was good agreement between PlGF tests and limited agreement between PlGF tests and the sFlt-1/PlGF ratio. All tests have heightened predictive accuracy for preterm pre-eclampsia. Abnormal PlGF or sFlt-1/PlGF ratio relates to abnormal uterine artery Doppler but not platelet response to aspirin.
Collapse
Affiliation(s)
- Kate Navaratnam
- a Centre for Women's Health Research, Institute of Translational Medicine , University of Liverpool , Liverpool , UK.,b Liverpool Women's Hospital , Liverpool , UK
| | | | | | - Andrea Jorgensen
- c Department of Biostatistics, Institute of Translational Medicine , University of Liverpool , Liverpool , UK
| | - Ana Alfirevic
- d The Wolfson Centre for Personalised Medicine, Institute of Translational Medicine , University of Liverpool , Liverpool , UK
| | - Zarko Alfirevic
- a Centre for Women's Health Research, Institute of Translational Medicine , University of Liverpool , Liverpool , UK.,b Liverpool Women's Hospital , Liverpool , UK
| |
Collapse
|
27
|
Saleh L, Samantar R, Garrelds IM, van den Meiracker AH, Visser W, Danser AHJ. Low Soluble Fms-Like Tyrosine Kinase-1, Endoglin, and Endothelin-1 Levels in Women With Confirmed or Suspected Preeclampsia Using Proton Pump Inhibitors. Hypertension 2017; 70:594-600. [PMID: 28716993 DOI: 10.1161/hypertensionaha.117.09741] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 05/31/2017] [Accepted: 06/14/2017] [Indexed: 01/01/2023]
Abstract
Patients with preeclampsia display elevated placenta-derived sFlt-1 (soluble Fms-like tyrosine kinase-1) and endoglin levels and decreased placental growth factor levels. Proton pump inhibitors (PPIs) decrease trophoblast sFlt-1 and endoglin secretion in vitro. PPIs are used during pregnancy to combat reflux disease. Here, we investigated whether PPIs affect sFlt-1 in women with confirmed/suspected preeclampsia, making use of a prospective cohort study involving 430 women. Of these women, 40 took PPIs (6 esomeprazole, 32 omeprazole, and 2 pantoprazole) for 8 to 45 (median 29) days before sFlt-1 measurement. Measurements were only made once, at study entry between weeks 20 and 41 (median 33 weeks). PPI use was associated with lower sFlt-1 levels, with no change in placental growth factor levels, both when compared with all non-PPI users and with 80 gestational age-matched controls selected from the non-PPI users. No sFlt-1/placental growth factor alterations were observed in women using ferrous fumarate or macrogol while, as expected, women using antihypertensive medication displayed higher sFlt-1 levels and lower placental growth factor levels. The PPI use-associated decrease in sFlt-1 was independent of the application of antihypertensive drugs and also occurred when restricting our analysis to patients with hypertensive disease of pregnancy at study entry. PPI users displayed more cases with preexisting proteinuria, less gestational hypertension, and a lower number of neonatal sepsis cases. Finally, their plasma endoglin and endothelin-1 levels were lower while sFlt-1 levels correlated positively with both. In conclusion, PPI use associates with low sFlt-1, endoglin, and endothelin-1 levels, warranting prospective trials to investigate the therapeutic potential of PPIs in preeclampsia.
Collapse
Affiliation(s)
- Langeza Saleh
- From the Division of Vascular Medicine and Pharmacology, Department of Internal Medicine (L.S., I.M.G., A.H.v.d.M., W.V., A.H.J.D.) and Division Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology (L.S., R.S., W.V.), Erasmus MC, Rotterdam, The Netherlands
| | - Raaho Samantar
- From the Division of Vascular Medicine and Pharmacology, Department of Internal Medicine (L.S., I.M.G., A.H.v.d.M., W.V., A.H.J.D.) and Division Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology (L.S., R.S., W.V.), Erasmus MC, Rotterdam, The Netherlands
| | - Ingrid M Garrelds
- From the Division of Vascular Medicine and Pharmacology, Department of Internal Medicine (L.S., I.M.G., A.H.v.d.M., W.V., A.H.J.D.) and Division Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology (L.S., R.S., W.V.), Erasmus MC, Rotterdam, The Netherlands
| | - Anton H van den Meiracker
- From the Division of Vascular Medicine and Pharmacology, Department of Internal Medicine (L.S., I.M.G., A.H.v.d.M., W.V., A.H.J.D.) and Division Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology (L.S., R.S., W.V.), Erasmus MC, Rotterdam, The Netherlands
| | - Willy Visser
- From the Division of Vascular Medicine and Pharmacology, Department of Internal Medicine (L.S., I.M.G., A.H.v.d.M., W.V., A.H.J.D.) and Division Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology (L.S., R.S., W.V.), Erasmus MC, Rotterdam, The Netherlands
| | - A H Jan Danser
- From the Division of Vascular Medicine and Pharmacology, Department of Internal Medicine (L.S., I.M.G., A.H.v.d.M., W.V., A.H.J.D.) and Division Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology (L.S., R.S., W.V.), Erasmus MC, Rotterdam, The Netherlands.
| |
Collapse
|
28
|
Yu M, Chen L, Peng Z, Wang D, Song Y, Wang H, Yao P, Yan H, Nüssler AK, Liu L, Yang W. Embryotoxicity Caused by DON-Induced Oxidative Stress Mediated by Nrf2/HO-1 Pathway. Toxins (Basel) 2017; 9:toxins9060188. [PMID: 28598396 PMCID: PMC5488038 DOI: 10.3390/toxins9060188] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 06/02/2017] [Accepted: 06/06/2017] [Indexed: 11/21/2022] Open
Abstract
Deoxynivalenol (DON) belongs to the type B group of trichothecenes family, which is composed of sesquiterpenoid metabolites produced by Fusarium and other fungi in grain. DON may cause various toxicities, such as cytotoxicity, immunotoxicity, genotoxicity as well as teratogenicity and carcinogenicity. In the present study, we focus on a hypothesis that DON alters the expressions of Nrf2/HO-1 pathway by inducing embryotoxicity in C57BL/6 mouse (5.0, 2.5, 1.0, and 0 mg/kg/day) and BeWo cell lines (0 and 50 nM; 3 h, 12 h and 24 h). Our results indicate that DON treatment in mice during pregnancy leads to ROS accumulation in the placenta, which results in embryotoxicity. At the same time Nrf2/HO-1 pathway is up-regulated by ROS to protect placenta cells from oxidative damage. In DON-treated BeWo cells, the level of ROS has time–effect and dose–effect relationships with HO-1 expression. Moderate increase in HO-1 protects the cell from oxidative damage, while excessive increase in HO-1 aggravates the oxidative damage, which is called in some studies the “threshold effect”. Therefore, oxidative stress may be the critical molecular mechanism for DON-induced embryotoxicity. Besides, Nrf2/HO-1 pathway accompanied by the “threshold effect” also plays an important role against DON-induced oxidative damage in this process.
Collapse
Affiliation(s)
- Miao Yu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
- Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
- Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China.
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
- Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
| | - Zhao Peng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
- Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
| | - Di Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
- Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
| | - Yadong Song
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
- Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
| | - Hanying Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
- Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
| | - Ping Yao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
- Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
| | - Hong Yan
- Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
| | - Andreas K Nüssler
- Department of Traumatology, BG Trauma center, Eberhard Karls University of Tübingen, Schnarrenbergstr. 95, 72076 Tübingen, Germany.
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
- Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
| | - Wei Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
- Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
| |
Collapse
|
29
|
In utero perfluorooctane sulfonate exposure causes low body weights of fetal rats: A mechanism study. Placenta 2016; 39:125-33. [DOI: 10.1016/j.placenta.2016.01.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 01/01/2016] [Accepted: 01/10/2016] [Indexed: 11/17/2022]
|
30
|
Rasmussen LG, Lykke JA, Staff AC. Angiogenic biomarkers in pregnancy: defining maternal and fetal health. Acta Obstet Gynecol Scand 2015; 94:820-32. [DOI: 10.1111/aogs.12629] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 03/04/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Lene G. Rasmussen
- Department of Obstetrics and Gynecology; Oslo University Hospital; Oslo Norway
- Faculty of Medicine; University of Copenhagen; Copenhagen Denmark
| | - Jacob A. Lykke
- Faculty of Medicine; University of Copenhagen; Copenhagen Denmark
- Department of Obstetrics and Gynecology; Hvidovre University Hospital; Copenhagen Denmark
- Departement of Obstetrics; Rigshospitalet Copenhagen University Hospital; Copenhagen Denmark
| | - Anne C. Staff
- Department of Obstetrics and Gynecology; Oslo University Hospital; Oslo Norway
- Faculty of Medicine; University of Oslo; Oslo Norway
| |
Collapse
|
31
|
Angiogenesis in the placenta: the role of reactive oxygen species signaling. BIOMED RESEARCH INTERNATIONAL 2015; 2015:814543. [PMID: 25705690 PMCID: PMC4325211 DOI: 10.1155/2015/814543] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 08/28/2014] [Indexed: 02/07/2023]
Abstract
Proper placental development and function are central to the health of both the mother and the fetus during pregnancy. A critical component of healthy placental function is the proper development of its vascular network. Poor vascularization of the placenta can lead to fetal growth restriction, preeclampsia, and in some cases fetal death. Therefore, understanding the mechanisms by which uterine stressors influence the development of the placental vasculature and contribute to placental dysfunction is of central importance to ensuring a healthy pregnancy. In this review we discuss how oxidative stress observed in maternal smoking, maternal obesity, and preeclampsia has been associated with aberrant angiogenesis and placental dysfunction resulting in adverse pregnancy outcomes. We also highlight that oxidative stress can influence the expression of a number of transcription factors important in mediating angiogenesis. Therefore, understanding how oxidative stress affects redox-sensitive transcription factors within the placenta may elucidate potential therapeutic targets for correcting abnormal placental angiogenesis and function.
Collapse
|
32
|
Gangooly S, Muttukrishna S, Jauniaux E. In-vitro study of the effect of anti-hypertensive drugs on placental hormones and angiogenic proteins synthesis in pre-eclampsia. PLoS One 2014; 9:e107644. [PMID: 25251016 PMCID: PMC4175458 DOI: 10.1371/journal.pone.0107644] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 08/21/2014] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Antihypertensive drugs lower the maternal blood pressure in pre-eclampsia (PE) by direct or central vasodilatory mechanisms but little is known about the direct effects of these drugs on placental functions. OBJECTIVE The aim of our study is to evaluate the effect of labetolol, hydralazine, α-methyldopa and pravastatin on the synthesis of placental hormonal and angiogenic proteins know to be altered in PE. DESIGN Placental villous explants from late onset PE (n = 3) and normotensive controls (n = 6) were cultured for 3 days at 10 and 20% oxygen (O2) with variable doses anti-hypertensive drugs. The levels of activin A, inhibin A, human Chorionic Gonadotrophin (hCG), soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng) were measured in explant culture media on day 1, 2 and 3 using standard immunoassays. Data at day 1 and day 3 were compared. RESULTS Spontaneous secretion of sEndoglin and sFlt-1 were higher (p < 0.05) in villous explants from PE pregnancies compared to controls. There was a significant time dependent decrease in the secretion of sFlt-1 and sEndoglin in PE cases, which was seen only for sFlt-1 in controls. In both PE cases and controls the placental protein secretions were not affected by varying doses of anti-hypertensive drugs or the different O2 concentration cultures, except for Activin, A which was significantly (p < 0.05) higher in controls at 10% O2. INTERPRETATION Our findings suggest that the changes previously observed in maternal serum hormones and angiogenic proteins level after anti-hypertensive treatment in PE could be due to a systemic effect of the drugs on maternal blood pressure and circulation rather than a direct effect of these drugs on placental biosynthesis and/or secretion.
Collapse
Affiliation(s)
- Subrata Gangooly
- Institute for Women’s Health, University College London, London, United Kingdom
| | - Shanthi Muttukrishna
- Institute for Women’s Health, University College London, London, United Kingdom
- Anu Research Centre, Department of Obstetrics and Gynaecology, University College Cork, Cork University Maternity Hospital, Cork, Republic of Ireland
| | - Eric Jauniaux
- Institute for Women’s Health, University College London, London, United Kingdom
- * E-mail:
| |
Collapse
|
33
|
Kang MC, Park SJ, Kim HJ, Lee J, Yu DH, Bae KB, Ji YR, Park SJ, Jeong J, Jang WY, Kim JH, Choi MS, Lee DS, Lee HS, Lee S, Kim SH, Kim MO, Park G, Choo YS, Cho JY, Ryoo ZY. Gestational loss and growth restriction by angiogenic defects in placental growth factor transgenic mice. Arterioscler Thromb Vasc Biol 2014; 34:2276-82. [PMID: 25147341 DOI: 10.1161/atvbaha.114.303693] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Angiogenesis is an important biological process during development, reproduction, and in immune responses. Placental growth factor (PlGF) is a member of vascular endothelial growth factor that is critical for angiogenesis and vasculogenesis. We generated transgenic mice overexpressing PlGF in specifically T cells using the human CD2-promoter to investigate the effects of PlGF overexpression. APPROACH AND RESULTS Transgenic mice were difficult to obtain owing to high lethality; for this reason, we investigated why gestational loss occurred in these transgenic mice. Here, we report that placenta detachment and inhibition of angiogenesis occurred in PlGF transgenic mice during the gestational period. Moreover, even when transgenic mice were born, their growth was restricted. CONCLUSIONS Conclusively, PlGF overexpression prevents angiogenesis by inhibiting Braf, extracellular signal-regulated kinase activation, and downregulation of HIF-1α in the mouse placenta. Furthermore, it affected regulatory T cells, which are important for maintenance of pregnancy.
Collapse
Affiliation(s)
- Min-Cheol Kang
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Seo Jin Park
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Hei Jung Kim
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Jinhee Lee
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Dong Hoon Yu
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Ki Beom Bae
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Young Rae Ji
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Si Jun Park
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Jain Jeong
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Woo Young Jang
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Jung-Hak Kim
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Myung-Sook Choi
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Dong-Seok Lee
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Hyun-Shik Lee
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Sanggyu Lee
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Sung Hyun Kim
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Myoung Ok Kim
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Gyeongsin Park
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Yeon Sik Choo
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Je-Yoel Cho
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.)
| | - Zae Young Ryoo
- From the School of Life Sciences and Biotechnology (M.K., S.J.P., H.J.K., J.L., D.H.Y., K.B.B., Y.R.J., S.J.P., J.J., W.Y.J., J.-H.K., D.-S.L., H.-S.L., S.L., S.H.K., M.O.K., Z.Y.R.), Department of Food Science and Nutrition (M.S.C.), and School of Biology (Y.S.C.), Kyungpook National University, Daegu, Korea; Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea (G.P.); and Department of Biochemistry, College of Veterinary Medicine, Seoul National University, Seoul, Korea (J.-Y.C.).
| |
Collapse
|
34
|
Melamed N, Ray JG, Hladunewich M, Cox B, Kingdom JC. Gestational Hypertension and Preeclampsia: Are They the Same Disease? JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2014; 36:642-647. [DOI: 10.1016/s1701-2163(15)30545-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
35
|
Zamudio S, Borges M, Echalar L, Kovalenko O, Vargas E, Torricos T, Khan AA, Alvarez M, Illsley NP. Maternal and fetoplacental hypoxia do not alter circulating angiogenic growth effectors during human pregnancy. Biol Reprod 2014; 90:42. [PMID: 24352559 DOI: 10.1095/biolreprod.113.115592] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
One causal model of preeclampsia (PE) postulates that placental hypoxia alters the production of angiogenic growth effectors (AGEs), causing an imbalance leading to maternal endothelial cell dysfunction. We tested this model using the natural experiment of high-altitude (HA) residence. We hypothesized that in HA pregnancies 1) circulating soluble fms-like tyrosine kinase 1 (sFlt-1) is increased and placental growth factor (PlGF) decreased, and 2) AGE concentrations correlate with measures of hypoxia. A cross-sectional study of healthy pregnancies at low altitude (LA) (400 m) versus HA (3600 m) compared normal (n = 80 at HA, n = 90 at LA) and PE pregnancies (n = 20 PE at HA, n = 19 PE at LA). Blood was collected using standard serum separation and, in parallel, by a method designed to inhibit platelet activation. AGEs were measured by enzyme-linked immunosorbent assays. AGEs did not differ between altitudes in normal or PE pregnancies. AGE concentrations were unrelated to measures of maternal or fetal hypoxia. PlGF was lower and sFlt-1 higher in PE, but overlapped considerably with the range observed in normal samples. PlGF correlated with placental mass in both normal and PE pregnancies. The contribution of peripheral cells to the values measured for AGEs was similar at LA and HA, but was greater in PE than in normotensive women. Hypoxia, across a wide physiological range in pregnancy, does not alter levels of circulating AGEs in otherwise normal pregnancies. Peripheral cell release of AGEs with the hemostasis characteristic of standard blood collection is highly variable and contributes to a doubling of the amount of sFlt-1 measured in PE as compared to normal pregnancies.
Collapse
Affiliation(s)
- Stacy Zamudio
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Surgery, Hackensack University Medical Center, Hackensack, New Jersey
| | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Molvarec A, Gullai N, Stenczer B, Fügedi G, Nagy B, Rigó J. Comparison of placental growth factor and fetal flow Doppler ultrasonography to identify fetal adverse outcomes in women with hypertensive disorders of pregnancy: an observational study. BMC Pregnancy Childbirth 2013; 13:161. [PMID: 23937721 PMCID: PMC3751622 DOI: 10.1186/1471-2393-13-161] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 08/10/2013] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Hypertensive disorders of pregnancy and intrauterine growth restriction (IUGR) are leading causes of maternal and perinatal morbidity and mortality. Failure to detect intrauterine growth restriction in women at high risk has been highlighted as a significant avoidable cause of serious fetal outcome. In this observational study we compare fetal flow using Doppler ultrasonography with a new test for placental growth factor (PlGF) to predict fetal adverse events. METHODS Eighty-nine women with hypertensive disorders of pregnancy (24 with chronic hypertension, 17 with gestational hypertension, 12 with HELLP syndrome, 19 with preeclampsia and 17 with superimposed preeclampsia) were enrolled. A single maternal blood sample to measure free PlGF (Alere Triage) taken before 35 weeks of pregnancy was compared to the last Doppler ultrasound measurement of fetal flow before delivery. PlGF was classified as normal (PlGF≥100 pg/ml), low (12<PlGF<100) or very low (PlGF≤12 pg/ml). A positive test for abnormal fetal flow was defined as either signs of centralisation of the fetal circulation or diastolic block or reverse flow in the umbilical artery or descending aorta; this was a criterion for delivery. Fetal outcomes were intrauterine growth restriction and birth before 37 weeks of pregnancy. RESULTS In total 61/89 women had a preterm birth and 22 infants had IUGR. Of those who delivered preterm, 20/20 women with abnormal fetal flow and 36/41 (87.8%) women with normal fetal flow had low or very low PlGF. Of those infants with IUGR, 22/22 had low or very low maternal PlGF and 10/22 had abnormal fetal flow. CONCLUSIONS PlGF may provide useful information before 35th gestational week to identify fetuses requiring urgent delivery, and those at risk of later adverse outcomes not identified by fetal flow Doppler ultrasonography.
Collapse
Affiliation(s)
- Attila Molvarec
- First Department of Obstetrics and Gynecology, Semmelweis University, Baross utca 27, Budapest H-1088, Hungary.
| | | | | | | | | | | |
Collapse
|
37
|
Conti E, Zezza L, Ralli E, Caserta D, Musumeci MB, Moscarini M, Autore C, Volpe M. Growth factors in preeclampsia: a vascular disease model. A failed vasodilation and angiogenic challenge from pregnancy onwards? Cytokine Growth Factor Rev 2013; 24:411-25. [PMID: 23800655 DOI: 10.1016/j.cytogfr.2013.05.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Revised: 04/30/2013] [Accepted: 05/21/2013] [Indexed: 12/25/2022]
Abstract
Preeclampsia is the major cause of maternofetal and neonatal morbi-mortality including intrauterine growth retardation, miscarriages and stillbirths. Inadequate vascular dilation and angiogenesis represent the crucial underlying defect of gravidic hypertension, denoting a failed response to the vasodilatory and pro-angiogenic challenge imposed by pregnancy, especially if multifetal. A similar pathogenesis appears involved in gestational diabetes. In this review we aimed to provide a hint on understanding the deeply involved angiogenic disorders which eventually culminate in utero-placental failure. The key players in these complex processes may be found in an intricate network of growth factors (GFs) and GF inhibitors, controlled by several vascular risk factors modulated by environment and genes, which eventually impact on early and late cardiovascular outcomes of mother and fetus.
Collapse
Affiliation(s)
- E Conti
- Cardiology, Clinical and Molecular Medicine Department, "Sapienza" University of Rome, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
38
|
Vrachnis N, Kalampokas E, Sifakis S, Vitoratos N, Kalampokas T, Botsis D, Iliodromiti Z. Placental growth factor (PlGF): a key to optimizing fetal growth. J Matern Fetal Neonatal Med 2013; 26:995-1002. [PMID: 23330778 DOI: 10.3109/14767058.2013.766694] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The needs of the uterus and the fetus for the provision of nutrients and oxygen, supplied by the blood flow, are understandably extremely high, with the circulatory system playing the most important role in this action. Abnormal vascular growth and transformation that create a high vessel resistance network have been associated with various pregnancy pathologies, including miscarriage, small for gestational age (SGA) fetuses with or without preeclampsia and intrauterine growth restriction (IUGR). Placental growth factor (PlGF) has a major role in vasculogenesis and angiogenesis in human placenta. Low concentrations of PlGF and high concentrations of its inhibitor-soluble Fms-like tyrosine kinase-1 (sFlt-1) are linked with impaired angiogenesis and placental development, leading to the above pregnancy complications. The activity of vascular endothelial growth factor (VEGF), which is the most potent of all angiogenic mediators, is partly modulated by PlGF. Although the mechanisms via which PlGF exerts its various effects are still under investigation, we herein discuss the known actions exerted by this major mediator together with its results on fetal growth.
Collapse
Affiliation(s)
- Nikolaos Vrachnis
- 2nd Department of Obstetrics and Gynecology, University of Athens Medical School, Athens, Greece.
| | | | | | | | | | | | | |
Collapse
|
39
|
Evaluation of a rapid and simple placental growth factor test in hypertensive disorders of pregnancy. Hypertens Res 2013; 36:457-62. [PMID: 23324863 DOI: 10.1038/hr.2012.206] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of this study was to investigate the diagnostic accuracy of the Triage placental growth factor (PlGF) assay, together with its prognostic efficiency in determining the need for preterm delivery in all forms of hypertensive disorders of pregnancy. A total of 130 pregnant women with a diagnosis of preeclampsia (PE: 23), HELLP syndrome (20), superimposed preeclampsia (SIPE: 17), chronic hypertension (CHT: 25), gestational hypertension (GHT: 18) and 27 normotensive pregnant controls were enrolled in this case-control study. A single blood sample was taken between 22 and 34 weeks of gestation, and the plasma was analyzed for PlGF using the Alere Triage PlGF assay. The PlGF levels found in all hypertensive disorder groups differed significantly from those observed in controls. There was a highly significant difference in PlGF concentrations between women with a pregnancy duration <35 weeks and controls. Using a gestational age-dependent threshold of 5% of normal, a positive PlGF test predicted delivery before 35 weeks in 93.7% of hypertensive women and delivery before 37 weeks in 90.5% of hypertensive women. A positive PlGF test identified the following proportions of hypertensive patients: 95.7% (PE), 95.0% (HELLP syndrome), 82.4% (SIPE), 60.0% (CHT) and 44.4% (GHT). A positive PlGF test was associated with a significantly shorter duration of pregnancy (hazard ratio of 3.43 adjusted for the gestational age at the time of sample collection and hypertension with proteinuria). In conclusion, PlGF concentrations are significantly lower in all hypertensive disorders. A positive test using the Triage PlGF assay at 22-34 weeks of gestation predicts delivery before 37 weeks in women with both proteinuric and non-proteinuric hypertensive disorders of pregnancy.
Collapse
|
40
|
Sezer SD, Küçük M, Yenisey C, Yüksel H, Odabaşı AR, Türkmen MK, Çetinkaya Çakmak B, Ömürlü IK. Comparison of angiogenic and anti-angiogenic factors in maternal and umbilical cord blood in early- and late-onset pre-eclampsia. Gynecol Endocrinol 2012; 28:628-32. [PMID: 22429154 DOI: 10.3109/09513590.2011.650759] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The aim of this study was to compare maternal and umbilical cord serum levels of the angiogenic and anti-angiogenic factors in early- and late-onset pre-eclamptic pregnancies as well as in normal pregnancies, which might have significant importance in the etiology of pre-eclampsia. MATERIALS AND METHODS This prospective case-control study was carried out with pre-eclamptic (early-onset, ≤ 34 weeks and late-onset, >34 weeks) and normal pregnant women. VEGF, PIGF, sFlt-1 and sEng levels in maternal and umbilical cord serum were measured before delivery and the findings were compared. RESULTS The study was conducted with 15 early- and 15 late-onset pre-eclampsia patients, and 17 patients with normal pregnancies. It was found that sEng levels were higher in the umbilical cord serum in the early-onset and in the maternal serum in the late-onset pre-eclampsia group than the control group (p < 0.05). No significant difference in any factor was observed between the early- and late-onset pre-eclampsia groups. CONCLUSION In this study, the results showed that angiogenic and anti-angiogenic factor levels in maternal serum and umbilical cord serum may not be related to the time of onset of pre-eclampsia.
Collapse
Affiliation(s)
- Selda Demircan Sezer
- Department of Obstetrics and Gynecology, Adnan Menderes University, Faculty of Medicine, Aydın, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Ali KZM, Burton GJ, Al-BinAli AM, Eskandar MA, El-Mekki AA, Moosa RA, Abd-Alla SA, Salih AGA, Sideeg AMB, Mahfouz AA. Concentration of free vascular endothelial growth factor and its soluble receptor, sFlt-1 in the maternal and fetal circulations of normal term pregnancies at high and low altitudes. J Matern Fetal Neonatal Med 2012; 25:2066-70. [DOI: 10.3109/14767058.2012.667462] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
42
|
Mateus J, Bytautiene E, Lu F, Tamayo EH, Betancourt A, Hankins GDV, Longo M, Saade GR. Endothelial growth factor therapy improves preeclampsia-like manifestations in a murine model induced by overexpression of sVEGFR-1. Am J Physiol Heart Circ Physiol 2011; 301:H1781-7. [DOI: 10.1152/ajpheart.00373.2011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study examines the effects of VEGF-121 therapy in an animal model of preeclampsia induced by overexpression of soluble VEGF receptor 1 (sVEGFR-1). At day 8 of gestation, CD-1 mice were implanted with subcutaneous osmotic pumps containing either VEGF-121 or vehicle and fitted with telemetric blood pressure (BP) catheters for continuous BP monitoring ( days 8–18 of gestation). On day 9, the animals in the VEGF-121 group were randomly allocated for injection with adenovirus carrying sVEGFR-1 or the murine immunoglobulin G2α Fc fragment (mFc) as virus control (Adv-sVEGFR-1; Adv-mFc). Animals in the vehicle group were injected with Adv-sVEGFR-1. On day 18, mice were euthanized, placentas and pups weighted, carotid arteries isolated, and their responses studied in vitro using a wire myograph for isometric tension recording. In mice overexpressing sVEGFR-1, treatment with VEGF-121 significantly reduced BP from days 10 to 18 of gestation compared with that of vehicle. VEGF-sVEGFR-1 animals had significantly higher vasorelaxant response to sodium nitroprusside and significantly lower contractile response to the thromboxane agonist (U-46619) compared with that of the vehicle-sVEGFR-1 mice. Phenylephrine and acetylcholine responses did not significantly vary between the VEGF-sVEGFR-1 and the vehicle-sVEGFR-1 mice. Average pup weight was significantly lower in the vehicle-sVEGFR-1 group compared with the VEGF-sVEGFR-1 and VEGF-mFc groups. In conclusion, VEGF-121 therapy attenuates vascular dysfunction and diminishes intrauterine growth abnormality in an animal model of preeclampsia induced by overexpression of sVEGFR-1. Modulation of VEGF pathway turns into a promising therapeutic approach of preeclampsia.
Collapse
Affiliation(s)
- Julio Mateus
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas
| | - Egle Bytautiene
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas
| | - Fangxian Lu
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas
| | - Esther H. Tamayo
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas
| | - Ancizar Betancourt
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas
| | - Gary D. V. Hankins
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas
| | - Monica Longo
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas
| | - George R. Saade
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas
| |
Collapse
|
43
|
Groesch KA, Torry RJ, Wilber AC, Abrams R, Bieniarz A, Guilbert LJ, Torry DS. Nitric oxide generation affects pro- and anti-angiogenic growth factor expression in primary human trophoblast. Placenta 2011; 32:926-31. [PMID: 21963217 DOI: 10.1016/j.placenta.2011.08.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 08/17/2011] [Accepted: 08/18/2011] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Preeclampsia is associated with reduced trophoblast placenta growth factor (PGF) expression, elevated soluble fms-like tyrosine kinase-1 (sFlt-1) and decreased bioactivity of nitric oxide (NO). Elevated sFlt-1 reduces bio-availability of PGF and vascular endothelial growth factor (VEGF) leading to maternal endothelial dysfunction. Although NO can regulate gene expression, its ability to regulate trophoblast expression of angiogenic growth factors is not known. STUDY DESIGN Human primary term trophoblast and JEG-3 choriocarcinoma cells were cultured under 21%O(2) or 1%O(2) conditions in the presence or absence of NO donor (SNP) or inhibitor (L-NAME). Effects on PGF, VEGF and Flt-1 isoform mRNA expression were determined by quantitative real-time PCR. Changes in expression of soluble protein isoforms of FLT-1 was monitored by ELISA. RESULTS Hypoxia decreased PGF mRNA but increased VEGF, sFlt-1 and Flt-1 mRNA expression in trophoblast. Generation of NO in trophoblast under 1%O(2) culture conditions significantly reversed sFlt-1 mRNA and protein expression, independent of mFlt-1. Conversely NO generation in hypoxic trophoblast increased VEGF and PGF mRNA expression. CONCLUSIONS NO production in primary human trophoblast cultures had divergent effects on pro-angiogenic (PGF, VEGF) versus anti-angiogenic (sFlt-1) mRNA expression, resulting in an enhanced pro-angiogenic gene expression environment in vitro.
Collapse
Affiliation(s)
- K A Groesch
- Department of Medical Microbiology, Immunology and Cell Biology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | | | | | | | | | | | | |
Collapse
|
44
|
Benedetti G, Morais KLP, Guerreiro JR, de Oliveira EF, Hoshida MS, Oliveira L, Sass N, Lebrun I, Ulrich H, Lameu C, de Camargo ACM. Bothrops jararaca peptide with anti-hypertensive action normalizes endothelium dysfunction involved in physiopathology of preeclampsia. PLoS One 2011; 6:e23680. [PMID: 21858206 PMCID: PMC3157462 DOI: 10.1371/journal.pone.0023680] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Accepted: 07/25/2011] [Indexed: 11/19/2022] Open
Abstract
Preeclampsia, a pregnancy-specific syndrome characterized by hypertension, proteinuria and edema, is a major cause of fetal and maternal morbidity and mortality especially in developing countries. Bj-PRO-10c, a proline-rich peptide isolated from Bothrops jararaca venom, has been attributed with potent anti-hypertensive effects. Recently, we have shown that Bj-PRO-10c-induced anti-hypertensive actions involved NO production in spontaneous hypertensive rats. Using in vitro studies we now show that Bj-PRO-10c was able to increase NO production in human umbilical vein endothelial cells from hypertensive pregnant women (HUVEC-PE) to levels observed in HUVEC of normotensive women. Moreover, in the presence of the peptide, eNOS expression as well as argininosuccinate synthase activity, the key rate-limiting enzyme of the citrulline-NO cycle, were enhanced. In addition, excessive superoxide production due to NO deficiency, one of the major deleterious effects of the disease, was inhibited by Bj-PRO-10c. Bj-PRO-10c induced intracellular calcium fluxes in both, HUVEC-PE and HUVEC, which, however, led to activation of eNOS expression only in HUVEC-PE. Since Bj-PRO-10c promoted biological effects in HUVEC from patients suffering from the disorder and not in normotensive pregnant women, we hypothesize that Bj-PRO-10c induces its anti-hypertensive effect in mothers with preeclampsia. Such properties may initiate the development of novel therapeutics for treating preeclampsia.
Collapse
Affiliation(s)
- Gabriel Benedetti
- Center for Applied Toxinology-Centros de Pesquisa, Inovacio e Difusao, Instituto Butantan, Sao Paulo, Brazil
- Departamento de Bioquímica, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Katia L. P. Morais
- Center for Applied Toxinology-Centros de Pesquisa, Inovacio e Difusao, Instituto Butantan, Sao Paulo, Brazil
- Departamento de Bioquímica, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Juliano R. Guerreiro
- Laboratório de Bioquímica de Proteínas, Centro de Biotecnologia Agrícola, Departamento de Ciências Biológicas, Escola Superior de Agricultura “Luiz de Queiroz”, University of Sao Paulo, Sao Paulo, Brazil
| | - Eduardo Fontana de Oliveira
- Center for Applied Toxinology-Centros de Pesquisa, Inovacio e Difusao, Instituto Butantan, Sao Paulo, Brazil
- Departamento de Bioquímica, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Mara Sandra Hoshida
- Laboratório de Fisiologia Obstétrica, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil
| | | | - Nelson Sass
- Hospital Maternidade Vila Nova Cachoeirinha, Sao Paulo, Brazil
| | - Ivo Lebrun
- Laboratório de Bioquímica e Biofísica, Instituto Butantan, Sao Paulo, Brazil
| | - Henning Ulrich
- Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, Sao Paulo, Brazil
| | - Claudiana Lameu
- Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, Sao Paulo, Brazil
- * E-mail:
| | - Antonio Carlos Martins de Camargo
- Center for Applied Toxinology-Centros de Pesquisa, Inovacio e Difusao, Instituto Butantan, Sao Paulo, Brazil
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, Sao Paulo, Brazil
| |
Collapse
|
45
|
Jeevaratnam K, Nadarajah VD, Judson JP, Nalliah S, Abdullah MF. Periodic assessment of plasma sFlt-1 and PlGF concentrations and its association with placental morphometry in gestational hypertension (GH) - a prospective follow-up study. BMC Pregnancy Childbirth 2010; 10:58. [PMID: 20920154 PMCID: PMC2958153 DOI: 10.1186/1471-2393-10-58] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Accepted: 09/28/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypertensive disorders in pregnancy contributes to about 12% of maternal deaths in Malaysia and similarly worldwide. Early detection and adequate management are preventable strategies. Biochemical markers of abnormal angiogenesis would be more specific in early detection than routine blood pressure and proteinuria measurements. The aim of this study was to estimate maternal plasma PlGF and sFlt-1 levels in pregnant women with gestational hypertension at three intervals of pregnancy and correlate these biomarker levels with placental morphometry. METHODS Venous blood samples (antepartum, intrapartum and post partum periods) were drawn to estimate for sFlt-1 and PlGF levels while placental tissue samples were examined for placental morphometry. RESULTS PlGF levels were lower in gestational hypertension (GH) compared to normotensive during antepartum and intrapartum period, whereas sFlt-1 levels were elevated in GH at antepartum, intrapartum and postpartum intervals during pregnancy. An inverse relationship between these two biomarkers was observed through correlation analysis. PlGF levels were inversely correlated with total villous surface area of the placental periphery (TCsa-C) and villous capillarization (VC-C) of the placental periphery. CONCLUSION We established periodic values of for sFlt-1 and PlGF levels for the first time in an ethnically diverse Malaysian setting. We suggest the development of GH in women is related to defective capillarization. In demonstrating periodic changes, this study suggest the possibility of developing GH and other long term health complications as a result of prolonged exposure to sFlt-1. The correlation between PlGF levels and morphometric findings also support possible capillarization defect.
Collapse
Affiliation(s)
- Kamalan Jeevaratnam
- Department of Human Biology, Faculty of Medicine, International Medical University, No,126, Jalan 19/155B Bukit Jalil, 57000 Kuala Lumpur, Malaysia
| | | | | | | | | |
Collapse
|
46
|
Khalil A, Harrington K, Muttukrishna S, Jauniaux E. Effect of antihypertensive therapy with alpha-methyldopa on uterine artery Doppler in pregnancies with hypertensive disorders. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2010; 35:688-694. [PMID: 20201113 DOI: 10.1002/uog.7611] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES Antihypertensive drugs lower blood pressure by direct vascular effects or central vasodilatory mechanisms. Their effect on uterine artery Doppler resistance indices in hypertensive disorders of pregnancy is uncertain. This study aimed to evaluate the impact of antihypertensive therapy with alpha-methyldopa on maternal uterine artery Doppler pulsatility index (PI) and resistance index (RI) in women presenting with hypertensive disorders of pregnancy. METHODS This was a cross-sectional study of 51 women with pre-eclampsia, 29 with gestational hypertension and 80 matched normotensive controls. Uterine artery PI and RI were measured at recruitment (between 24 and 40 weeks' gestation) and, in the hypertensive groups, 24-48 h after starting alpha-methyldopa. Differences between mild and severe, and between early- and late-onset pre-eclampsia were compared using the Mann-Whitney test. The Wilcoxon rank sum test was used to compare measurements before and after treatment. RESULTS Prior to treatment, uterine artery PI and RI were significantly higher in women with pre-eclampsia compared with those with gestational hypertension and controls (P < 0.0001). The median uterine artery PI multiple of the median (MoM) was significantly higher (P < 0.0001) in early-onset than in late-onset pre-eclampsia (1.83 (range, 0.88-3.65) vs. 1.19 (range, 0.91-1.72)) and in severe compared with mild disease (2.26 (range, 2.02-3.65) vs. 1.29 (range, 0.88-2.9)). Uterine artery PI- and RI-MoMs in both pre-eclampsia and gestational hypertension, before and after 34 weeks' gestation, were not affected by alpha-methyldopa treatment. CONCLUSIONS Antihypertensive therapy using alpha-methyldopa in women presenting with hypertensive disorders of pregnancy has no significant effect on uterine artery resistance to blood flow, suggesting that it does not impair uteroplacental circulation in these cases.
Collapse
Affiliation(s)
- A Khalil
- Academic Department of Obstetrics and Gynaecology, UCL Institute for Women's Health, University College London, London, UK.
| | | | | | | |
Collapse
|
47
|
Buhimschi CS, Baumbusch MA, Dulay AT, Lee S, Wehrum M, Zhao G, Bahtiyar MO, Pettker CM, Ali UA, Funai EF, Buhimschi IA. The role of urinary soluble endoglin in the diagnosis of pre-eclampsia: comparison with soluble fms-like tyrosine kinase 1 to placental growth factor ratio. BJOG 2009; 117:321-30. [PMID: 19943826 DOI: 10.1111/j.1471-0528.2009.02434.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Endoglin, an anti-angiogenic glycoprotein expressed on endothelial cells, has been proposed recently as a biomarker of pre-eclampsia (PE). Given that PE is characterised by an imbalance of angiogenic factors, we sought to determine the clinical utility of urinary soluble endoglin, relative to the soluble fms-like tyrosine kinase 1 to placental growth factor (PlGF) ratio, in the diagnosis of PE during gestation. DESIGN Prospective observational cohort. SETTING Tertiary referral university hospital. POPULATION Two hundred and thirty-four pregnant women were enrolled prospectively in the following groups: healthy controls, n = 63; gestational age (GA), median (interquartile range), 33 weeks (27-39 weeks); chronic hypertension, n = 27; GA, 33 weeks (30-36 weeks); mild PE, n = 38; GA, 37 weeks (34-40 weeks); severe PE, n = 106; GA, 32 weeks (29-37 weeks). METHODS Free urinary levels of soluble endoglin, soluble fms-like tyrosine kinase 1 and PlGF were measured by sensitive and specific immunoassay. Levels for all urinary analytes were normalised to creatinine. MAIN OUTCOME MEASURES Urinary soluble endoglin, and the soluble fms-like tyrosine kinase 1 to PlGF ratio. RESULTS In healthy controls, urinary soluble endoglin levels were increased significantly at term relative to those earlier in gestation. Severe PE was characterised by an increased urinary level of soluble endoglin, soluble fms-like tyrosine kinase 1, protein to creatinine ratio and soluble fms-like tyrosine kinase 1 to PlGF ratio compared with all other groups. There was a direct correlation between urinary soluble endoglin and proteinuria that remained after GA correction (R = 0.382, P < 0.001). Urinary soluble endoglin could not differentiate mild PE from severe preterm PE. Overall, soluble endoglin had the ability to discriminate PE from chronic hypertension and healthy controls only in women who were evaluated at <37 weeks of GA. The sensitivity, specificity and accuracy of urinary soluble endoglin alone in the diagnosis of PE or in the identification of women with PE requiring a mandated delivery before 37 weeks of gestation were 70%, 86% and 76%, respectively. These values were inferior to those of the soluble fms-like tyrosine kinase 1 to PlGF ratio (P < 0.001). The addition of urinary soluble endoglin did not improve the diagnostic accuracy of the soluble fms-like tyrosine kinase 1 to PlGF ratio alone. CONCLUSIONS We have provided evidence that soluble endoglin is present and elevated in the urine of women who develop preterm PE. Urinary soluble endoglin has only limited ability to determine the severity of PE and to distinguish between PE and chronic hypertension both preterm and at term. Compared with urinary soluble endoglin, the soluble fms-like tyrosine kinase 1 to PlGF ratio remains a better marker of disease presence, severity and outcome.
Collapse
Affiliation(s)
- C S Buhimschi
- Department of Obstetrics, Gynecology and Reproductive Science, Yale University, New Haven, CT 06520, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Antihypertensive therapy and central hemodynamics in women with hypertensive disorders in pregnancy. Obstet Gynecol 2009; 113:646-654. [PMID: 19300330 DOI: 10.1097/aog.0b013e318197c392] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To estimate the changes in central hemodynamics features of pregnant women presenting with hypertensive disorders and to analyze the effects of standard antihypertensive treatment on maternal central hemodynamics. METHODS Applanation tonometry was used to record the radial artery pulse waveform in 80 women presenting with preeclampsia or gestational hypertension and 80 normotensive controls matched for gestational age. In each case, an averaged aortic waveform was derived and analyzed to calculate augmentation pressure and augmentation index at heart rate 75 beats per minute (bpm). RESULTS In women with preeclampsia and gestational hypertension, both augmentation pressure (P<.001 and P<.05, respectively) and augmentation index at heart rate 75 bpm (P<.001 and P<.001, respectively) were significantly higher than in controls. Augmentation pressure and augmentation index at heart rate 75 bpm were significantly higher in early- compared with late-onset preeclampsia (P<.001) and in severe compared with mild preeclampsia (P<.001). Antihypertensive therapy with alpha methyldopa resulted in a significant fall in both augmentation pressure and augmentation index at heart rate 75 bpm in preeclampsia (P<.001) but not in gestational hypertension. CONCLUSION Arterial stiffness is increased in women with hypertensive disorders of pregnancy compared with normotensive controls. In preeclampsia, vascular stiffness was significantly improved by antihypertensive treatment with alpha methyldopa, but remained higher than in normotensive controls.
Collapse
|
49
|
Xu B, Thornton C, Tooher J, Ogle R, Lim S, Makris A, Hennessy A. Effects of anti-hypertensive drugs on production of soluble fms-like tyrosine kinase 1 and soluble endoglin from human normal and pre-eclamptic placentas in vitro. Clin Exp Pharmacol Physiol 2009; 36:839-42. [PMID: 19215236 DOI: 10.1111/j.1440-1681.2009.05155.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
1. Increases in soluble fms-like tyrosine kinase 1 (sFlt-1) and soluble endoglin (sEng) contribute to the pathogenesis of pre-eclampsia. Soluble Flt-1 binds to circulating free vascular endothelial growth factor and placenta growth factor and this is associated with endothelial dysfunction. Soluble endoglin, a transforming growth factor (TGF)-beta coreceptor, was reported to synergize with sFlt-1 to amplify endothelial dysfunction by inhibiting TGF-beta1-mediated vasorelaxation. 2. The aim of the present study was to examine whether the antihypertensive drugs clonidine (0.08-1.3 microg/mL), diazoxide (25-300 microg/mL), frusemide (60-1000 microg/mL) and hydralazine (6.3-100 microg/mL) have any effect on placental production of sFlt-1 and sEng in placentas from normal and pre-eclamptic pregnancies. 3. Explants were taken from non-laboured term placentas of normal pregnancy (n = 5) and women with pre-eclampsia (n = 5). Villous explants were cultured with increasing doses of antihypertensive drugs. Placental sFlt-1 and sEng production was examined using ELISA. 4. Baseline sFlt-1 production was higher in placentas from women with pre-eclampsia than from normal pregnancy (4.5 +/- 1.4 vs 3.2 +/- 0.6 ng/mg of total protein, respectively; P < 0.001), as was sEng production (9.0 +/- 2.3 vs 4.1 +/- 0.6 ng/mg of total protein, respectively; P < 0.001). With the exception of frusemide, none of the antihypertensive drugs tested had any effect on sFlt-1 and sEng production from placental explants of normal pregnancy and women with pre-eclampsia. Increasing frusemide concentrations were correlated with increased sEng production in normal pregnancy (P < 0.005). 5. In conclusion, placental sFlt-1 and sEng production was higher in pre-eclampsia and antihypertensive drugs had no effect on placental production of sFlt-1 and sEng in vitro.
Collapse
Affiliation(s)
- B Xu
- Vascular Immunology Research Laboratory, The Heart Research Institute, University of Sydney, 114 Pyrmont Bridge Road, Camperdown, NSW 2050, Australia.
| | | | | | | | | | | | | |
Collapse
|