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Ju Y, Feng Y, Yang Y, Hou X, Zhang X, Zhu X, Wang Y, Yang M. Combining curcumin and aspirin ameliorates preeclampsia-like symptoms by inhibiting the placental TLR4/NF-κB signaling pathway in rats. J Obstet Gynaecol Res 2023; 49:128-140. [PMID: 36288911 DOI: 10.1111/jog.15473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/06/2022] [Accepted: 10/08/2022] [Indexed: 01/19/2023]
Abstract
AIM Preeclampsia (PE) is a common medical complication of pregnancy characterized by high blood pressure and proteinuria after the 20th gestational week. This study aimed to investigate the potency of the combination of curcumin and aspirin in the treatment of PE and explore the underlying mechanisms. MATERIAL AND METHODS The PE model was constructed in female rats by administering 0.5 mg/mL N-nitro-L-arginine methyl ester from gestational days (GDs) 6 to 16. The pregnant female rats were divided into five groups according to the drug treatment. The curcumin or aspirin was given to the rats by tail vein injection (0.36 mg/kg) or gavage treatment (1.5 mg/kg BW/day) from GD4 to GD18. RESULTS Treatment with curcumin and aspirin combination significantly reduced the systolic blood pressure and proteinuria in the PE rats. Meanwhile, in comparison to the PE rats treated with single-dose curcumin or aspirin, the rats treated with combined curcumin and aspirin showed significantly decreased sFlt-1, increased placental growth factor, and alleviated oxidative stress in both blood and placental tissues, which are abnormal in no-treated PE rats. Furthermore, dramatically decreased inflammatory cytokines secretion and TLR4 and NF-κB p65 expression in placental tissues were also observed in the PE rats with combined treatment compared to those of no-treated, signal-dose curcumin or aspirin-treated PE rats. CONCLUSIONS Our results suggested that the combined treatment of curcumin and aspirin significantly ameliorates the symptoms of PE in rats, which is most likely due to the inhibition of the placental TLR4/NF-κB p65 signaling pathway.
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Affiliation(s)
- Yaru Ju
- Perinatal Center, The Fourth Hospital of Shijiazhuang, Shijiazhuang, China
| | - Yan Feng
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yanjing Yang
- Perinatal Center, The Fourth Hospital of Shijiazhuang, Shijiazhuang, China
| | - Xiaolin Hou
- Prenatal Diagnostic, The Fourth Hospital of Shijiazhuang, Shijiazhuang, China
| | - Xiaofeng Zhang
- Department of Obstetrics, The Fourth Hospital of Shijiazhuang, Shijiazhuang, China
| | - Xihui Zhu
- Perinatal Center, The Fourth Hospital of Shijiazhuang, Shijiazhuang, China
| | - Yage Wang
- Department of Obstetrics, Gaocheng District Hospital of Traditional Chinese and Western Medicine, Shijiazhuang, China
| | - Meiliu Yang
- Department of Biology, Hengshui University, Hengshui, China
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Ju Y, Feng Y, Hou X, Wu L, Yang H, Zhang H, Ma Y. Combined apocyanin and aspirin treatment activates the PI3K/Nrf2/HO-1 signaling pathway and ameliorates preeclampsia symptoms in rats. Hypertens Pregnancy 2021; 41:39-50. [PMID: 34875953 DOI: 10.1080/10641955.2021.2014518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Pre-eclampsia (PE) is a pregnancy-associated disease characterized by placental dysfunction and increased oxidative stress. Apocyanin is a potent antioxidant and anti-inflammatory which has shown beneficial effects on PE pathogenesis. Aspirin is recognized as the recommendable drug in PE prevention and therapy. Therefore, we aimed to investigate the effects of combining apocyanin and aspirin to treat PE on rat models induced by N-nitro-L-arginine methyl ester (L-NAME) from gestational day (GD) 6 to 16 and elucidate the potential mechanisms. METHODS First, female pregnant rats were divided into five different groups: pregnant control, PE, PE + apocyanin, PE + aspirin, and PE + apocyanin + aspirin. Animals received apocyanin (16 mg/kg/day) orally or aspirin by gavage (1.5 mg/kg BM/day) from GD 4 to 16. Blood pressure and urine protein content were monitored every 4 days. RESULTS In the PE rat model, elevated systolic blood pressure and proteinuria were ameliorated by the combination of apocyanin and aspirin. Meanwhile, compared with single-dose apocyanin or aspirin, the combined treatment significantly corrected abnormal pregnancy outcomes, decreased sFlt-1 and PlGF, and alleviated oxidative stress both in blood and placental tissues. Moreover, the combined treatment upregulated PI3K, Akt, Nrf2, and HO-1 protein levels in the placental tissues from PE rats.Conclusion: Overall, our results suggested that combined treatment of apocyanin and aspirin ameliorates the PE symptoms compared with single-dose apocyanin or aspirin in a PE rat model. Also, we demonstrated that activating the PI3K/Nrf2/HO-1 pathway can be a valuable therapeutic target to improve the pregnancy outcomes of PE.
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Affiliation(s)
- Yaru Ju
- Perinatal Center, the Fourth Hospital of Shijiazhuang, Shijiazhuang, Hebei, China
| | - Yan Feng
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Hebei, China
| | - Xiaolin Hou
- Prenatal Diagnostic, The Fourth Hospital of Shijiazhuang, Shijiazhuang, Hebei, China
| | - Lixia Wu
- Department of Obstetrics, The Fourth Hospital of Shijiazhuang; Hebei, China
| | - Huixia Yang
- Department of Obstetrics, Gaoyi County People's Hospital, Shijiazhuang, Hebei, China
| | - Hongjuan Zhang
- Department of Obstetrics, Xiongxian Maternal and Child Health Care Hospital, Baoding, Hebei China
| | - Yan'Na Ma
- Department of Obstetrics, Xiongxian Maternal and Child Health Care Hospital, Baoding, Hebei China
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Zhang Y, Liu CY, Chen WC, Shi YC, Wang CM, Lin S, He HF. Regulation of neuropeptide Y in body microenvironments and its potential application in therapies: a review. Cell Biosci 2021; 11:151. [PMID: 34344469 PMCID: PMC8330085 DOI: 10.1186/s13578-021-00657-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/12/2021] [Indexed: 12/26/2022] Open
Abstract
Neuropeptide Y (NPY), one of the most abundant neuropeptides in the body, is widely expressed in the central and peripheral nervous systems and acts on the cardiovascular, digestive, endocrine, and nervous systems. NPY affects the nutritional and inflammatory microenvironments through its interaction with immune cells, brain-derived trophic factor (BDNF), and angiogenesis promotion to maintain body homeostasis. Additionally, NPY has great potential for therapeutic applications against various diseases, especially as an adjuvant therapy for stem cells. In this review, we discuss the research progress regarding NPY, as well as the current evidence for the regulation of NPY in each microenvironment, and provide prospects for further research on related diseases.
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Affiliation(s)
- Yan Zhang
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, No. 34 North Zhongshan Road, Quanzhou, 362000, Fujian, China
| | - Chu-Yun Liu
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, No. 34 North Zhongshan Road, Quanzhou, 362000, Fujian, China
| | - Wei-Can Chen
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, No. 34 North Zhongshan Road, Quanzhou, 362000, Fujian, China
| | - Yan-Chuan Shi
- Diabetes and Metabolism Division, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia
| | - Cong-Mei Wang
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, No. 34 North Zhongshan Road, Quanzhou, 362000, Fujian, China
| | - Shu Lin
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, No. 34 North Zhongshan Road, Quanzhou, 362000, Fujian, China. .,Diabetes and Metabolism Division, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia. .,Centre of Neurological and Metabolic Research, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China.
| | - He-Fan He
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, No. 34 North Zhongshan Road, Quanzhou, 362000, Fujian, China.
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miR-126a-3p induces proliferation, migration and invasion of trophoblast cells in pre-eclampsia-like rats by inhibiting A Disintegrin and Metalloprotease 9. Biosci Rep 2020; 39:221380. [PMID: 31789346 PMCID: PMC6923329 DOI: 10.1042/bsr20191271] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 11/19/2019] [Accepted: 11/29/2019] [Indexed: 12/24/2022] Open
Abstract
The present study aimed to investigate the underlying mechanism of miR-126a-3p in the proliferation, migration and invasion of trophoblast cells in pre-eclampsia-like rats by targeting A Disintegrin and Metalloprotease 9 (ADAM9). First, the interaction between miR-126a-3p and ADAM9 was confirmed via biochemical assays. Placental tissues and trophoblast cells were then obtained. RNA in situ hybridization was performed in order to detect miR-126a-3p expression in the placenta. Subsequently, a series of biological assays, including reverse transcription-quantitative PCR (RT-qPCR), Western blotting, MTT assay, apoptosis assay, cell cycle assay, wound healing assay and transwell assay were adopted in order to determine the cell proliferation, cell cycle distribution, apoptotic rate, and migration and invasion of trophoblast cells in each group. The results revealed that miR-126a-3p was down-regulated in the placenta of pre-eclampsia-like rats. In vivo experiments’ results indicated that miR-126a-3p could inhibit ADAM9 expression, and induce cyclin D1, Matrix metalloproteinase (MMP) 2 (MMP-2), MMP-9 expression. MTT, apoptosis and cell cycle assay results revealed that trophoblast cells transfected with miR-126a-3p mimic or si-ADAM9 exhibited higher proliferative activity and a lower apoptotic rate compared with the blank group (all P<0.05). The wound healing assay and transwell assay results confirmed that, compared with the blank group, the migration and invasion ability of trophoblast cells in the miR-126a-3p mimic group and small interfering RNA (siRNA)-ADAM9 group were significantly increased (all P<0.05). Conversely, miR-126a-3p inhibitor treatment revealed the opposite effect (all P<0.05). In conclusion, the present study demonstrated that miR-126a-3p could enhance proliferation, migration and invasion, but decrease the apoptosis rate of trophoblast cells in pre-eclampsia-like rats through targeting ADAM9.
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Urata Y, Salehi R, Lima PDA, Osuga Y, Tsang BK. Neuropeptide Y regulates proliferation and apoptosis in granulosa cells in a follicular stage-dependent manner. J Ovarian Res 2020; 13:5. [PMID: 31915051 PMCID: PMC6950994 DOI: 10.1186/s13048-019-0608-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 12/29/2019] [Indexed: 12/17/2022] Open
Abstract
Background The complex regulatory mechanism involved in ovarian follicular development is not completely understood. Neuronal neuropeptide Y (NPY) is involved in the regulation of feeding behavior, energy homeostasis, and reproduction behavior, while its function in ovarian follicular development is not clear. The objective of this study was to investigate if and how NPY regulates follicle development in the ovary. Methods All experiments were performed using Sprague Dawley rats. To understand NPY expression pattern at different stages of follicular development, NPY content was assessed using immunohistochemistry in individual follicles. NPY and its receptors expression pattern were evaluated in granulosa cells isolated from preantral (PA), early antral (EA) and late antral follicles (LAF). The influence of NPY on granulosa cell proliferation and apoptosis were further assessed in vitro, using Ki67- and TUNEL-positivity assays. To investigate whether NPY induced-proliferation in EA granulosa cells is mediated through the activation of NPY receptor Y5 (NPY5R) and Mitogen-activated protein kinase (MEK) signal pathway, EA granulosa cells were treated with NPY5R antagonist (CGP71683) and MEK inhibitors (PD98059 and U0126), and Ki67-positive cells were assessed. Results NPY protein expression was follicular stage-dependent and cell type-specific. NPY signal intensity in EA was higher than those in PA and LAF. Antral granulosa cells showed the highest signal intensity compared to mural granulosa cells, cumulus cells and theca cells. Granulosa cells NPY protein content and mRNA abundance were higher in EA than in LAF. NPY receptor contents in granulosa cells were follicular stage-dependent. While NPY reduced apoptosis of EA granulosa cells, it increased the proliferation through NPY5R and MEK pathway. In contrast, in LAF granulosa cells, NPY reduced proliferation and increased the number of apoptotic cells, with no significant effects on PA granulosa cells. Conclusion This study is the first to evaluate the intraovarian role of NPY in granulosa cells at various stage of follicular development. These results indicate that NPY regulates granulosa cells proliferation and apoptosis in a follicular stage-dependent and autocrine manner. NPY may play a role in pathogenesis of ovarian follicular disorders.
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Affiliation(s)
- Yoko Urata
- Departments of Obstetrics & Gynecology and Cellular & Molecular Medicine, Interdisciplinary School of Health Sciences, University of Ottawa; Chronic Disease Program, Ottawa Hospital Research Institute, Critical Care Wing, 3rd floor, Room W3107, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. .,Department of Obstetrics and Gynecology, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Reza Salehi
- Departments of Obstetrics & Gynecology and Cellular & Molecular Medicine, Interdisciplinary School of Health Sciences, University of Ottawa; Chronic Disease Program, Ottawa Hospital Research Institute, Critical Care Wing, 3rd floor, Room W3107, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Patricia D A Lima
- Departments of Obstetrics & Gynecology and Cellular & Molecular Medicine, Interdisciplinary School of Health Sciences, University of Ottawa; Chronic Disease Program, Ottawa Hospital Research Institute, Critical Care Wing, 3rd floor, Room W3107, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.,Queen's Cardiopulmonary Unit, Queen's University, BioSciences Complex, Room 1605, 116 Barrie Street, Kingston, ON, K7L 3N6, Canada
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Benjamin K Tsang
- Departments of Obstetrics & Gynecology and Cellular & Molecular Medicine, Interdisciplinary School of Health Sciences, University of Ottawa; Chronic Disease Program, Ottawa Hospital Research Institute, Critical Care Wing, 3rd floor, Room W3107, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
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Graham N, Ward J, Mackay D, Pell JP, Cavanagh J, Padmanabhan S, Smith DJ. Impact of major depression on cardiovascular outcomes for individuals with hypertension: prospective survival analysis in UK Biobank. BMJ Open 2019; 9:e024433. [PMID: 31575565 PMCID: PMC6797415 DOI: 10.1136/bmjopen-2018-024433] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To assess whether a history of major depressive disorder (MDD) in middle-aged individuals with hypertension influences first-onset cardiovascular disease outcomes. DESIGN Prospective cohort survival analysis using Cox proportional hazards regression with a median follow-up of 63 months (702 902 person-years). Four mutually exclusive groups were compared: hypertension only (n=56 035), MDD only (n=15 098), comorbid hypertension plus MDD (n=12 929) and an unaffected (no hypertension, no MDD) comparison group (n=50 798). SETTING UK Biobank. PARTICIPANTS UK Biobank participants without cardiovascular disease aged 39-70 who completed psychiatric questions relating International Classification of Diseases-10 Revision (ICD-10) diagnostic criteria on a touchscreen questionnaire at baseline interview in 2006-2010 (n=134 860). PRIMARY AND SECONDARY OUTCOME MEASURES First-onset adverse cardiovascular outcomes leading to hospital admission or death (ICD-10 codes I20-I259, I60-69 and G45-G46), adjusted in a stepwise manner for sociodemographic, health and lifestyle features. Secondary analyses were performed looking specifically at stroke outcomes (ICD-10 codes I60-69 and G45-G46) and in gender-separated models. RESULTS Relative to controls, adjusted HRs for adverse cardiovascular outcomes were increased for the hypertension only group (HR 1.36, 95% CI 1.22 to 1.52) and were higher still for the comorbid hypertension plus MDD group (HR 1.66, 95% CI 1.45 to 1.9). HRs for the comorbid hypertension plus MDD group were significantly raised compared with hypertension alone (HR 1.22, 95% CI 1.1 to 1.35). Interaction measured using relative excess risk due to interaction (RERI) and likelihood ratios (LRs) were identified at baseline (RERI 0.563, 95% CI 0.189 to 0.938; LR p=0.0116) but not maintained during the follow-up. LIMITATIONS Possible selection bias in UK Biobank and inability to assess for levels of medication adherence. CONCLUSIONS Comorbid hypertension and MDD conferred greater hazard than hypertension alone for adverse cardiovascular outcomes, although evidence of interaction between hypertension and MDD was inconsistent over time. Future cardiovascular risk prediction tools may benefit from the inclusion of questions about prior history of depressive disorders.
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Affiliation(s)
- Nicholas Graham
- Gartnavel Royal Hopsital, University of Glasgow Institute of Health and Wellbeing, Glasgow, UK
| | - Joey Ward
- Gartnavel Royal Hopsital, University of Glasgow Institute of Health and Wellbeing, Glasgow, UK
| | - Daniel Mackay
- 1 Lilybank Gardens, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - J P Pell
- 1 Lilybank Gardens, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jonathan Cavanagh
- 1 Lilybank Gardens, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Sandosh Padmanabhan
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - Daniel J Smith
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Zheng L, Huang J, Su Y, Wang F, Kong H, Xin H. Vitexin ameliorates preeclampsia phenotypes by inhibiting TFPI-2 and HIF-1α/VEGF in a l-NAME induced rat model. Drug Dev Res 2019; 80:1120-1127. [PMID: 31486114 DOI: 10.1002/ddr.21596] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/07/2019] [Accepted: 08/20/2019] [Indexed: 12/16/2022]
Abstract
Preeclampsia (PE) is a leading cause of maternal and perinatal morbidity and mortality with few safe, effective, and minimally invasive therapeutics. Inflammation, oxidative stress, and angiogenic imbalance have been reported to contribute to PE pathogenesis. Vitexin (VI) possesses various pharmacological activities including the potent regulation of the above biological processes in different conditions. This study aims to investigate whether VI has therapeutic potential to PE and the underlying mechanisms. Sprague-Dawley pregnant rats pretreated with or without VI were fed with l-NAME-containing water to induce experimental PE. Results showed that VI decreased high systolic blood pressure and urinary protein in PE rats time- and dose-dependently. Meanwhile, VI of higher dosage (45, 60 mg/kg) corrected abnormal pregnancy outcomes, including low pup weight and low pups/placenta ratio. In addition, VI of high dosage (60 mg/kg) decreased sFlt-1, increased PlGF and alleviated oxidative stress both in blood and placental samples compared with nontreated PE group. Furthermore, VI alleviated placental TFPI-2, HIF 1α, and VEGF in PE rats. In short, the present study suggests that the inhibition of placental TFPI-2 and HIF-1α/VEGF might be one of the potential mechanisms underlying the protective effects of VI to experimental PE induced by l-NAME.
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Affiliation(s)
- Lili Zheng
- Department of Obstetrics, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jing Huang
- Department of Obstetrics, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yuan Su
- Department of Obstetrics, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Fang Wang
- Department of Obstetrics, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Hongfang Kong
- Department of Obstetrics, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Hong Xin
- Department of Obstetrics, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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Klinjampa R, Sitticharoon C, Souvannavong-Vilivong X, Sripong C, Keadkraichaiwat I, Churintaraphan M, Chatree S, Lertbunnaphong T. Placental Neuropeptide Y ( NPY) and NPY receptors expressions and serum NPY levels in preeclampsia. Exp Biol Med (Maywood) 2019; 244:380-388. [PMID: 30760028 DOI: 10.1177/1535370219831437] [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] [Indexed: 11/17/2022] Open
Abstract
IMPACT STATEMENT Neuropeptide Y (NPY) has been reported as a vasoconstrictive substance which might be associated with preeclampsia. The novel findings of this study were that Y1R, Y2R, and Y5R expressions were significantly lower in the PE than the NP group. Moreover, the NPY receptor expression ratio between the PE/NP groups was lowest for Y2R (0.27) compared to Y1R (0.42) and Y5R (0.40) suggestive of a reduction of this receptor in the preeclampsia group. Our results suggested that decreased Y2R mRNA in the PE group might be associated with abnormalities of placental angiogenesis which probably contributes to the pathophysiology of preeclampsia.
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Affiliation(s)
- Roongrit Klinjampa
- 1 Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Chantacha Sitticharoon
- 1 Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | | | - Chanakarn Sripong
- 1 Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Issarawan Keadkraichaiwat
- 1 Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Malika Churintaraphan
- 1 Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Saimai Chatree
- 1 Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Tripop Lertbunnaphong
- 2 Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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Liu W, Wang F, Zhao M, Fan Y, Cai W, Luo M. The Neuropeptide Secretoneurin Exerts a Direct Effect on Arteriogenesis In Vivo and In Vitro. Anat Rec (Hoboken) 2018; 301:1917-1927. [PMID: 30288932 DOI: 10.1002/ar.23929] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/13/2018] [Accepted: 04/08/2018] [Indexed: 01/24/2023]
Abstract
It is well known that nerves modulate the development and remodeling of blood vessels by releasing different neuropeptides and neurotransmitters. Secretoneurin (SN), a neuropeptide located in nerve fibers along blood vessels, acts as a pro-angiogenic agent and induces postnatal vasculogenesis. However, little is known about its involvement in arteriogenesis. In the present study, we tested the hypothesis that SN promotes arteriogenesis in a rat model of hind limb ischemia, as such, we evaluated the effect of this neuropeptide on proliferation and the production of adhesion and chemotaxis molecules in vascular smooth muscle cells (VSMCs), the main component that carries the burden of the transformation of a small arteriole into a large collateral vessel. In vivo, SN-immunoreactive nerve fibers were abundantly distributed in the adventitia of the collateral vessel. Moreover, administration of SN induced cell proliferation in the vascular wall and the infiltration of inflammatory cells/macrophages to promote collateral vessel growth. This was shown by an increased density of arterioles/arteries, together with a well-developed network of collateral vessels, and well-preserved skeletal muscles. In vitro, SN exerted proliferative effects on VSMCs and stimulated these cells to express adhesion molecules. In conclusion, our data demonstrate for the first time that SN acts as a mediator of inflammation, contributing to collateral vessel growth, in addition to directly stimulating cell proliferation in the vascular wall to promote collateral vessel growth in a rat model of hind limb ischemia. Anat Rec, 301:1917-1927, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Weiqing Liu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Fei Wang
- Department of Neurosurgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Min Zhao
- Department of Anatomy, Histology & Embryology, Kunming Medical University, Kunming, Yunnan, China
| | - Yan Fan
- Department of Anatomy, Histology & Embryology, Kunming Medical University, Kunming, Yunnan, China
| | - Weijun Cai
- Department of Histology & Embryology, Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Mingying Luo
- Department of Anatomy, Histology & Embryology, Kunming Medical University, Kunming, Yunnan, China
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Businaro R, Scaccia E, Bordin A, Pagano F, Corsi M, Siciliano C, Capoano R, Procaccini E, Salvati B, Petrozza V, Totta P, Vietri MT, Frati G, De Falco E. Platelet Lysate-Derived Neuropeptide y Influences Migration and Angiogenesis of Human Adipose Tissue-Derived Stromal Cells. Sci Rep 2018; 8:14365. [PMID: 30254326 PMCID: PMC6156505 DOI: 10.1038/s41598-018-32623-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 07/24/2018] [Indexed: 02/07/2023] Open
Abstract
Neuropeptide Y (NPY), a powerful neurotransmitter of the central nervous system, is a key regulator of angiogenesis and biology of adipose depots. Intriguingly, its peripheral vascular and angiogenic powerful activity is strictly associated to platelets, which are source of clinical hemoderivates, such as platelet lysate (PL), routinely employed in several clinical applications as wound healing, and to preserve ex vivo the progenitor properties of the adipose stromal cells pool. So far, the presence of NPY in PL and its biological effects on the adipose stromal cell fraction (ASCs) have never been investigated. Here, we aimed to identify endogenous sources of NPY such as PL-based preparations and to investigate which biological properties PL-derived NPY is able to exert on ASCs. The results show that PL contains a high amount of NPY, which is in part also excreted by ASCs when stimulated with PL. The protein levels of the three main NPY subtype receptors (Y1, Y2, Y5) are unaltered by stimulation of ASCs with PL, but their inhibition through selective pharmacological antagonists, considerably enhances migration, and a parallel reduction of angiogenic features of ASCs including decrease in VEGF mRNA and intracellular calcium levels, both downstream targets of NPY. The expression of VEGF and NPY is enhanced within the sites of neovascularisation of difficult wounds in patients after treatment with leuco-platelet concentrates. Our data highlight the presence of NPY in PL preparations and its peripheral effects on adipose progenitors.
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Affiliation(s)
- Rita Businaro
- Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so della Repubblica 79, 04100, Latina, Italy
| | - Eleonora Scaccia
- Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so della Repubblica 79, 04100, Latina, Italy
| | - Antonella Bordin
- Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so della Repubblica 79, 04100, Latina, Italy
| | - Francesca Pagano
- Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so della Repubblica 79, 04100, Latina, Italy
| | - Mariangela Corsi
- Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so della Repubblica 79, 04100, Latina, Italy
| | - Camilla Siciliano
- Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so della Repubblica 79, 04100, Latina, Italy
| | - Raffaele Capoano
- Department of Surgical Sciences, Sapienza University of Rome, V.le del Policlinico 155, 00161, Rome, Italy
| | - Eugenio Procaccini
- Breast Unit, A.O. U. Università della Campania Luigi Vanvitelli, piazza Luigi Miraglia, 280138, Naples, Italy
| | - Bruno Salvati
- Department of Surgical Sciences, Sapienza University of Rome, V.le del Policlinico 155, 00161, Rome, Italy
| | - Vincenzo Petrozza
- Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so della Repubblica 79, 04100, Latina, Italy
| | | | - Maria Teresa Vietri
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Via Luigi De Crecchio 7, 80138, Naples, Italy
| | - Giacomo Frati
- Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so della Repubblica 79, 04100, Latina, Italy
- Department of AngioCardioNeurology, IRCCS NeuroMed, 86077, Pozzilli, (IS), Italy
| | - Elena De Falco
- Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so della Repubblica 79, 04100, Latina, Italy.
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Tan CMJ, Green P, Tapoulal N, Lewandowski AJ, Leeson P, Herring N. The Role of Neuropeptide Y in Cardiovascular Health and Disease. Front Physiol 2018; 9:1281. [PMID: 30283345 PMCID: PMC6157311 DOI: 10.3389/fphys.2018.01281] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 08/24/2018] [Indexed: 12/20/2022] Open
Abstract
Neuropeptide Y (NPY) is an abundant sympathetic co-transmitter, widely found in the central and peripheral nervous systems and with diverse roles in multiple physiological processes. In the cardiovascular system it is found in neurons supplying the vasculature, cardiomyocytes and endocardium, and is involved in physiological processes including vasoconstriction, cardiac remodeling, and angiogenesis. It is increasingly also implicated in cardiovascular disease pathogenesis, including hypertension, atherosclerosis, ischemia/infarction, arrhythmia, and heart failure. This review will focus on the physiological and pathogenic role of NPY in the cardiovascular system. After summarizing the NPY receptors which predominantly mediate cardiovascular actions, along with their signaling pathways, individual disease processes will be considered. A thorough understanding of these roles may allow therapeutic targeting of NPY and its receptors.
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Affiliation(s)
- Cheryl M J Tan
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Peregrine Green
- Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre, University of Oxford, Oxford, United Kingdom
| | - Nidi Tapoulal
- Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre, University of Oxford, Oxford, United Kingdom
| | - Adam J Lewandowski
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Paul Leeson
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Neil Herring
- Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre, University of Oxford, Oxford, United Kingdom
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12
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Tang X, Liu Y, Xiao Q, Yao Q, Allen M, Wang Y, Gao L, Qi Y, Zhang P. Pathological cyclic strain promotes proliferation of vascular smooth muscle cells via the ACTH/ERK/STAT3 pathway. J Cell Biochem 2018; 119:8260-8270. [DOI: 10.1002/jcb.26839] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/09/2018] [Indexed: 01/10/2023]
Affiliation(s)
- Xia Tang
- Institute of Mechanobiology and Medical EngineeringSchool of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
| | - Yanyan Liu
- Institute of Mechanobiology and Medical EngineeringSchool of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
| | - Qian Xiao
- Institute of Mechanobiology and Medical EngineeringSchool of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
| | - Qingping Yao
- Institute of Mechanobiology and Medical EngineeringSchool of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
| | - Molly Allen
- Department of BioengineeringUniversity of CaliforniaSan DiegoCalifornia
| | - Yingxiao Wang
- Department of BioengineeringUniversity of CaliforniaSan DiegoCalifornia
| | - Lizhi Gao
- Institute of Mechanobiology and Medical EngineeringSchool of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
| | - Yingxin Qi
- Institute of Mechanobiology and Medical EngineeringSchool of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
| | - Ping Zhang
- Institute of Mechanobiology and Medical EngineeringSchool of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
- National Experimental Teaching Demonstration of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghaiChina
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NPY Impairs Cell Viability and Mitochondrial Membrane Potential Through Ca2+ and p38 Signaling Pathways in Neonatal Rat Cardiomyocytes. J Cardiovasc Pharmacol 2018; 70:52-59. [PMID: 28437279 DOI: 10.1097/fjc.0000000000000493] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
NPY is involved in stress cardiomyopathy. However, the associated mechanism for NPY-induced stress cardiomyopathy remains unclear. In this study, we aimed to explore potential cell signaling pathways that are related to NPY-mediated cell viability in neonatal rat cardiomyocytes. We found that NPY induced cell viability suppression in cultured cardiomyocytes in a dose-dependent manner. After NPY treatment, expression of CaN and p-CAMKII increased significantly, and phosphorylation of p38 but not ERK and JNK was changed. Moreover, NPY treatment significantly increased PGC-1α (the key factor of mitochondrial biogenesis and energy metabolism) expression but decreased mitochondrial membrane potential in cultured cardiomyocytes. More importantly, the blockage of CaN, CAMKII, and p38 signaling pathways by their inhibitors could rescue the reduced cell viability and mitochondrial membrane potential in NPY-treated cardiomyocytes. Collectively, our data demonstrated that NPY mediated cell viability and mitochondrial membrane potential in cardiomyocytes through CaN, CAMKII, and p38 signaling pathways.
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Do Neuroendocrine Peptides and Their Receptors Qualify as Novel Therapeutic Targets in Osteoarthritis? Int J Mol Sci 2018; 19:ijms19020367. [PMID: 29373492 PMCID: PMC5855589 DOI: 10.3390/ijms19020367] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 01/22/2018] [Accepted: 01/23/2018] [Indexed: 01/15/2023] Open
Abstract
Joint tissues like synovium, articular cartilage, meniscus and subchondral bone, are targets for neuropeptides. Resident cells of these tissues express receptors for various neuroendocrine-derived peptides including proopiomelanocortin (POMC)-derived peptides, i.e., α-melanocyte-stimulating hormone (α-MSH), adrenocorticotropin (ACTH) and β-endorphin (β-ED), and sympathetic neuropeptides like vasoactive intestinal peptide (VIP) and neuropeptide y (NPY). Melanocortins attained particular attention due to their immunomodulatory and anti-inflammatory effects in several tissues and organs. In particular, α-MSH, ACTH and specific melanocortin-receptor (MCR) agonists appear to have promising anti-inflammatory actions demonstrated in animal models of experimentally induced arthritis and osteoarthritis (OA). Sympathetic neuropeptides have obtained increasing attention as they have crucial trophic effects that are critical for joint tissue and bone homeostasis. VIP and NPY are implicated in direct and indirect activation of several anabolic signaling pathways in bone and synovial cells. Additionally, pituitary adenylate cyclase-activating polypeptide (PACAP) proved to be chondroprotective and, thus, might be a novel target in OA. Taken together, it appears more and more likely that the anabolic effects of these neuroendocrine peptides or their respective receptor agonists/antagonists may be exploited for the treatment of patients with inflammatory and degenerative joint diseases in the future.
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15
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Xia XW, Zhou YQ, Luo H, Zeng C. Inhibitory effect of D3 dopamine receptors on neuropeptide Y‑induced migration in vascular smooth muscle cells. Mol Med Rep 2017; 16:5606-5610. [PMID: 28849020 DOI: 10.3892/mmr.2017.7271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 06/22/2017] [Indexed: 11/06/2022] Open
Abstract
Abnormal migration of vascular smooth muscle cells (VSMCs) serves an important role in hypertension, atherosclerosis and restenosis following angioplasty, which is regulated numerous hormonal and humoral factors, including neuropeptide Y (NPY) and dopamine. Dopamine and NPY are both sympathetic neurotransmitters, and a previous study reported that NPY increased VSMC proliferation, while dopamine receptor inhibited it. Therefore, the authors wondered whether or not there is an inhibitory effect of dopamine receptor on NPY‑mediated VSMC migration. The present study demonstrated that stimulation with NPY dose‑dependence (10‑10‑10‑7M, 24 h) increased VSMC migration, the stimulatory effect of NPY was via the Y1 receptor. This is because, in the presence of the Y1 receptor antagonist, BIBP3226 (10‑7 M), the stimulatory effect of NPY on VSMC migration was blocked. Activation of the D3 receptor by PD128907 dose‑dependence (10‑11‑10‑8 M) reduced the stimulatory effect of NPY on VSMC migration. The effect of PD128907 was via the D3 receptor, because the inhibitory effect of PD128907 on NPY‑mediated migration was blocked by the D3 receptor antagonist, U99194. The authors' further study suggested that the inhibitory effect of the D3 receptor was via the PKA signaling pathway, in the presence of the PKA inhibitor, 14‑22 (10‑6 M), the inhibitory effect of PD128907 on VSMC migration was blocked. Moreover, the inhibitory effect of PD128907 was imitated by PKA activator, Sp‑cAMP [S], in the presence of Sp‑cAMP [S], the NPY‑mediated stimulatory effect on VSMC migration was abolished. The present study indicated that activation of the D3 receptor inhibits NPY Y1‑mediated migration on VSMCs, PKA is involved in the signaling pathway.
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Affiliation(s)
- Xue-Wei Xia
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing Institute of Cardiology, Chongqing Cardiovascular Clinical Research Center, Chongqing 400042, P.R. China
| | - Yong-Qiao Zhou
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing Institute of Cardiology, Chongqing Cardiovascular Clinical Research Center, Chongqing 400042, P.R. China
| | - Hao Luo
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing Institute of Cardiology, Chongqing Cardiovascular Clinical Research Center, Chongqing 400042, P.R. China
| | - Chunyu Zeng
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing Institute of Cardiology, Chongqing Cardiovascular Clinical Research Center, Chongqing 400042, P.R. China
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16
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Jiang ZQ, Zhou YL, Chen X, Li LY, Liang SY, Lin S, Shu MQ. Different effects of neuropeptide Y on proliferation of vascular smooth muscle cells via regulation of Geminin. Mol Cell Biochem 2017; 433:205-211. [PMID: 28386846 DOI: 10.1007/s11010-017-3028-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 04/01/2017] [Indexed: 12/19/2022]
Abstract
The proliferation-promoting effect of neuropeptide Y (NPY) always functions in low-serum-cultured vascular smooth muscle cells (VSMCs), and the phenotypic switch of VSMCs is regulated by concentrations of serum. Whether the property of the NPY proliferative effect in VSMCs relies on phenotype of VSMCs is unclear. We aimed to explore the role of NPY on proliferation of different VSMC phenotypes in the pathogenesis of atherosclerosis. By stimulating A10 cells with 200 nM NPY in 0.5 or 10% serum, 3H-thymidine and 5-ethynyl-2'-deoxyuridine (EdU) and CCK8 measurements were used to detect VSMC proliferation. RT-PCR and Flow cytometry were performed to detect the factors involved in different properties of the NPY proliferative effect in VSMCs. Instead of facilitating proliferation, NPY had no significant effect on the growth of VSMCs when cultured in 10% serum (VSMCs stayed at synthetic states). The underlying mechanism may be involved in down-regulation of Y1 receptor (P < 0.05 vs. Vehicle) and up-regulation of Geminin (P < 0.05 vs. Vehicle) in 10% serum-cultured VSMCs co-incubated with 200 nM NPY. Besides, modulation of Geminin was effectively blocked by the Y1 receptor antagonist. The stimulation of NPY on proliferation of VSMCs could be a double-edged sword in the development of atherosclerosis and thus provides new knowledge for therapy of atherosclerosis.
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Affiliation(s)
- Zhou-Qin Jiang
- Department of Cardiology, Southwest Hospital, Third Military Medical University, No. 30 Gaotanyan, Shapingba, Chongqing, 400038, China
| | - You-Li Zhou
- Department of Cardiology, Southwest Hospital, Third Military Medical University, No. 30 Gaotanyan, Shapingba, Chongqing, 400038, China
| | - Xia Chen
- Department of Cardiology, Southwest Hospital, Third Military Medical University, No. 30 Gaotanyan, Shapingba, Chongqing, 400038, China
| | - Lin-Yu Li
- Department of Cardiology, Southwest Hospital, Third Military Medical University, No. 30 Gaotanyan, Shapingba, Chongqing, 400038, China
| | - Shi-Yu Liang
- Department of Cardiology, Southwest Hospital, Third Military Medical University, No. 30 Gaotanyan, Shapingba, Chongqing, 400038, China
| | - Shu Lin
- Department of Cardiology, Southwest Hospital, Third Military Medical University, No. 30 Gaotanyan, Shapingba, Chongqing, 400038, China. .,School of Health Science, IIIawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Mao-Qin Shu
- Department of Cardiology, Southwest Hospital, Third Military Medical University, No. 30 Gaotanyan, Shapingba, Chongqing, 400038, China.
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Song J, Li Y, An R. Vitamin D restores angiogenic balance and decreases tumor necrosis factor-α in a rat model of pre-eclampsia. J Obstet Gynaecol Res 2016; 43:42-49. [PMID: 27862673 DOI: 10.1111/jog.13186] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 08/21/2016] [Indexed: 12/29/2022]
Abstract
AIM Deficiency of vitamin D is correlated with pre-eclampsia (PE), a hypertensive disorder of pregnancy, and is characterized by angiogenic imbalance and inflammation. The aim of this study was to investigate whether vitamin D supplementation can restore the angiogenic balance and ameliorate inflammation in a rat model of PE. METHODS PE was induced using l-nitroarginine methylester. Normal pregnant and PE-induced rats were supplemented with vitamin D on gestation days 14-19. RESULTS Blood pressure was significantly increased in PE-induced rats compared with normal pregnant rats (P < 0.05), and vitamin D supplementation ameliorated this difference. In addition, rats from the PE group had lower vascular endothelial growth factor (VEGF; P < 0.01), and higher plasma-soluble FMS-like tyrosine kinase-1 (sFlt-1) and tumor necrosis factor-α (TNF-α; P < 0.01 for both) compared with the normal pregnant group. The vitamin D treatment group had significantly increased VEGF, and reduced sFlt-1 and TNF-α compared with the untreated PE group. Moreover, vitamin D supplementation was able to reduce the oxidative stress by lowering the plasma oxidative stress marker malondialdehyde. CONCLUSION Vitamin D supplementation plays an important role in restoring angiogenic balance and reducing inflammation in pregnancy-induced hypertension.
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Affiliation(s)
- Jing Song
- Department of Gynecology and Obstetrics, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Gynecology and Obstetrics, Fourth Clinical Hospital of Harbin Medical University, Harbin, China
| | - Yue Li
- Department of Gynecology, Hospital of Heilongjiang Province, Nangang Branch, Harbin, China
| | - Ruifang An
- Department of Gynecology and Obstetrics, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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