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Cherubini M, Erickson S, Padmanaban P, Haberkant P, Stein F, Beltran-Sastre V, Haase K. Flow in fetoplacental-like microvessels in vitro enhances perfusion, barrier function, and matrix stability. SCIENCE ADVANCES 2023; 9:eadj8540. [PMID: 38134282 PMCID: PMC10745711 DOI: 10.1126/sciadv.adj8540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023]
Abstract
Proper placental vascularization is vital for pregnancy outcomes, but assessing it with animal models and human explants has limitations. We introduce a 3D in vitro model of human placenta terminal villi including fetal mesenchyme and vascular endothelium. By coculturing HUVEC, placental fibroblasts, and pericytes in a macrofluidic chip with a flow reservoir, we generate fully perfusable fetal microvessels. Pressure-driven flow facilitates microvessel growth and remodeling, resulting in early formation of interconnected and lasting placental-like vascular networks. Computational fluid dynamics simulations predict shear forces, which increase microtissue stiffness, decrease diffusivity, and enhance barrier function as shear stress rises. Mass spectrometry analysis reveals enhanced protein expression with flow, including matrix stability regulators, proteins associated with actin dynamics, and cytoskeleton organization. Our model provides a powerful tool for deducing complex in vivo parameters, such as shear stress on developing vascularized placental tissue, and holds promise for unraveling gestational disorders related to the vasculature.
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Affiliation(s)
- Marta Cherubini
- European Molecular Biology Laboratory (EMBL), Barcelona, Spain
| | - Scott Erickson
- European Molecular Biology Laboratory (EMBL), Barcelona, Spain
| | | | - Per Haberkant
- Proteomics Core Facility, EMBL Heidelberg, Heidelberg, Germany
| | - Frank Stein
- Proteomics Core Facility, EMBL Heidelberg, Heidelberg, Germany
| | | | - Kristina Haase
- European Molecular Biology Laboratory (EMBL), Barcelona, Spain
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Ana Beatriz DA, Rita MA, Miguel F, Rita GA, Luís GM. Fetal Aortic and Umbilical Doppler Flow Velocity Waveforms in Pregnancy: The Concept of Aortoumbilical Column. Curr Cardiol Rev 2023; 20:CCR-EPUB-135087. [PMID: 38441054 PMCID: PMC11071678 DOI: 10.2174/011573403x255256230919061018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/13/2023] [Accepted: 07/28/2023] [Indexed: 03/06/2024] Open
Abstract
Low impedance within the uteroplacental circulation is crucial for fetal development. Flow velocity waveforms (FVW) have been established for the aortic and umbilical arteries in low-risk pregnancies during the second half of pregnancy, but data regarding early gestation is limited. Both vascular territories exhibit higher impedance patterns in pregnancies complicated by fetal growth restriction (FGR), hypertensive disorders, fetal anemia, and chromosomal abnormalities. Early identification of these complications is critical in obstetric practice, to reduce perinatal morbidity and mortality through prevention and close antenatal surveillance. Available data suggest that aortic and umbilical impedances follow the same variation pattern as pregnancy progresses. This observation implies that both vessels may be considered as a single artery, referred to as the "aortoumbilical column". Our hypothesis posits that changes in the hemodynamic pattern of this column could identify high-risk pregnancies, particularly those complicated by preeclampsia, FGR, intrauterine fetal demise, fetal aneuploidies, and fetal anemia. Understanding vascular embryogenesis and the FVWs of the aortic and umbilical arteries enables comprehension of impedance changes throughout normal pregnancies. The continuous variation in impedance along a single vessel supports our concept of the aortoumbilical column. Deviations from the regular pattern could assist in identifying compromised fetuses during early pregnancy. Further research on normal aortoumbilical column FVW and the development of reference charts is necessary to consider this arterial column as a screening tool in clinical practice.
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Affiliation(s)
- De Almeida Ana Beatriz
- Department of Obstetrics and Gynecology, Centro Hospitalar Universitário de Santo António, University of Oporto, Oporto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, University of Oporto, Oporto, Portugal
| | - Morais Ana Rita
- Instituto de Ciências Biomédicas Abel Salazar, University of Oporto, Oporto, Portugal
| | - Ferreira Miguel
- Instituto de Ciências Biomédicas Abel Salazar, University of Oporto, Oporto, Portugal
| | - Gaio Ana Rita
- Department of Mathematics, Faculty of Sciences, University of Oporto, Oporto, Portugal
| | - Guedes-Martins Luís
- Department of Obstetrics and Gynecology, Centro Hospitalar Universitário de Santo António, University of Oporto, Oporto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, University of Oporto, Oporto, Portugal
- Fetal Medicine Centre, Centro Hospitalar Universitário de Santo António, University of Oporto, Oporto, Portugal
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Lin W, Lai Y, Zhuang S, Wei Q, Zhang H, Hu Q, Cheng P, Zhang M, Zhai Y, Wang Q, Han Z, Hou H. The effects of prenatal PM 2.5 oxidative potential exposure on feto-placental vascular resistance and fetal weight: A repeated-measures study. ENVIRONMENTAL RESEARCH 2023; 234:116543. [PMID: 37406720 DOI: 10.1016/j.envres.2023.116543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/27/2023] [Accepted: 07/01/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Feto-placental hemodynamic deterioration is a critical contributing factor to fetal growth restriction. Whether PM2.5 oxidative potential (OP) affects feto-placental hemodynamics and what impact is on estimated fetal weight (EFW) have not been fully elucidated. We sought to evaluate the association of PM2.5 OP with EFW and to explore whether feto-placental vascular impedance hemodynamic change is a possible mediator in this association. METHODS A repeated-measures study was conducted involving sixty pregnant women with at least 26 weeks of follow-up during pregnancy in Guangzhou, China, from September 2017 to October 2018. Daily filter-based PM2.5 samples were prospectively collected from ground monitors, and estimates of OP for PM2.5 and its metallic (OPv-metal) and non-metallic constituents (OPv-nonmental) were determined by dithiothreitol assay. Ultrasound data of fetal growth and umbilical arterial resistance, including estimated fetal weight (EFW), pulsatility index, resistance index, and systolic-to-diastolic ratio, were also obtained during gestation. Generalized estimating equations and polynomial distribution lag models were applied to analyze the associations of maternal exposure to PM2.5 OP with EFW and umbilical artery indices. Causal mediation analysis was used to evaluate the mediating role of umbilical arterial resistance. RESULTS Prenatal exposure to ambient PM2.5 OP was significantly inversely associated with EFW. The magnitudes of effects of OPv-nonmetal on EFW were larger than those of OPv-metal. Significant mediation for the relationship between PM2.5-related OP and EFW by increased impedance in the umbilical artery was observed, with the estimated percent mediated ranging from 31% to 61%. The estimated percent mediated for OPv-nonmetal was higher than those for OPv-metal. CONCLUSIONS Findings suggest that increased impedance in the umbilical artery may be one of the potential mediators of the relationship between PM2.5 oxidative potential exposure and low fetal weight.
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Affiliation(s)
- Weiwei Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
| | - Yuming Lai
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Shuling Zhuang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qiannan Wei
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Hedi Zhang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qiansheng Hu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Peng Cheng
- Institute of Mass Spectrometry and Atmospheric Environment, Guangdong Provincial Engineering, Research Center for On-line Source Apportionment System of Air Pollution, Jinan University, Guangzhou, 510632, China; Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, 510632, China.
| | - Manman Zhang
- Institute of Mass Spectrometry and Atmospheric Environment, Guangdong Provincial Engineering, Research Center for On-line Source Apportionment System of Air Pollution, Jinan University, Guangzhou, 510632, China
| | - Yuhong Zhai
- Guangdong Ecological and Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou, 510308, China
| | - Qingqing Wang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510632, China
| | - Zhenyan Han
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510632, China
| | - Hongying Hou
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510632, China
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Keighley LM, Lynch-Sutherland CF, Almomani SN, Eccles MR, Macaulay EC. Unveiling the hidden players: The crucial role of transposable elements in the placenta and their potential contribution to pre-eclampsia. Placenta 2023; 141:57-64. [PMID: 37301654 DOI: 10.1016/j.placenta.2023.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 05/21/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023]
Abstract
The human placenta is a vital connection between maternal and fetal tissues, allowing for the exchange of molecules and modulation of immune interactions during pregnancy. Interestingly, some of the placenta's unique functions can be attributed to transposable elements (TEs), which are DNA sequences that have mobilised into the genome. Co-option throughout mammalian evolution has led to the generation of TE-derived regulators and TE-derived genes, some of which are expressed in the placenta but silenced in somatic tissues. TE genes encompass both TE-derived genes with a repeat element in the coding region and TE-derived regulatory regions such as alternative promoters and enhancers. Placental-specific TE genes are known to contribute to the placenta's unique functions, and interestingly, they are also expressed in some cancers and share similar functions. There is evidence to support that aberrant activity of TE genes may contribute to placental pathologies, cancer and autoimmunity. In this review, we highlight the crucial roles of TE genes in placental function, and how their dysregulation may lead to pre-eclampsia, a common and dangerous placental condition. We provide a summary of the functional TE genes in the placenta to offer insight into their significance in normal and abnormal human development. Ultimately, this review highlights an opportunity for future research to investigate the potential dysregulation of TE genes in the development of placental pathologies such as pre-eclampsia. Further understanding of TE genes and their role in the placenta could lead to significant improvements in maternal and fetal health.
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Affiliation(s)
- Laura M Keighley
- Department of Pathology, Dunedin School of Medicine, University of Otago, Dunedin, 9054, New Zealand
| | - Chiemi F Lynch-Sutherland
- Department of Pathology, Dunedin School of Medicine, University of Otago, Dunedin, 9054, New Zealand; Maurice Wilkins Centre for Molecular Biodiscovery, Level 2, 3A Symonds Street, Auckland, New Zealand
| | - Suzan N Almomani
- Department of Pathology, Dunedin School of Medicine, University of Otago, Dunedin, 9054, New Zealand; Maurice Wilkins Centre for Molecular Biodiscovery, Level 2, 3A Symonds Street, Auckland, New Zealand
| | - Michael R Eccles
- Department of Pathology, Dunedin School of Medicine, University of Otago, Dunedin, 9054, New Zealand; Maurice Wilkins Centre for Molecular Biodiscovery, Level 2, 3A Symonds Street, Auckland, New Zealand
| | - Erin C Macaulay
- Department of Pathology, Dunedin School of Medicine, University of Otago, Dunedin, 9054, New Zealand.
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Cao Y, Chen S, Lu J, Zhang M, Shi L, Qin J, Lv J, Li D, Ma L, Zhang Y. BPA induces placental trophoblast proliferation inhibition and fetal growth restriction by inhibiting the expression of SRB1. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:60805-60819. [PMID: 37037937 DOI: 10.1007/s11356-023-26850-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/03/2023] [Indexed: 04/12/2023]
Abstract
Bisphenol-A (BPA) is a common environmental toxicant that is known to be associated with fetal growth restriction (FGR). However, the mechanisms of how BPA induce FGR is poorly characterized. We conducted proteomics to identify the abnormal expression of SRB1 in female placental tissues with high BPA-induced FGR and further verified its decreased expression in human placenta and BeWo cells. Next, the effect of BPA on fetal development was further confirmed in pregnant C57BL/6 mice. The expression of SRB1 was consistently downregulated in human FGR placentas, BPA-exposed trophoblasts and mouse placentas. In addition, we found that SRB1 interacted with PCNA, and BPA exposure indirectly reduced the expression of PCNA and further inhibited placental proliferation. In vitro studies showed that BPA exposure reduced the expression of CDK1, CDK2, cyclin B and phosphorylated Rb in placental trophoblast cells, indicating cell cycle arrest after exposure to BPA. In addition, the expression of γ-H2AX and phosphorylated ATM was upregulated in BPA-exposed trophoblasts, indicating increased DNA damage. Our results indicate that BPA-induced FGR is achieved by reducing the expression of SRB1, inhibiting placental proliferation and increasing DNA damage. Our findings not only explain the mechanism of BPA-associated developmental toxicity but also shed light upon developing novel therapeutic targets.
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Affiliation(s)
- Yuming Cao
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, No 169 of Donghu Road, Wuhan, 430071, Hubei, China
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Gynaecology and Obstetrics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, People's Republic of China
| | - Sihan Chen
- School of Basic Medical Sciences, Wuhan University, Wuhan, China
| | - Jing Lu
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, No 169 of Donghu Road, Wuhan, 430071, Hubei, China
| | - Ming Zhang
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, No 169 of Donghu Road, Wuhan, 430071, Hubei, China
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Lei Shi
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Juling Qin
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jing Lv
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Danyang Li
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ling Ma
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yuanzhen Zhang
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, No 169 of Donghu Road, Wuhan, 430071, Hubei, China.
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, China.
- Department of Gynaecology and Obstetrics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, People's Republic of China.
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Mukherjee I, Singh S, Karmakar A, Kashyap N, Mridha AR, Sharma JB, Luthra K, Sharma RS, Biswas S, Dhar R, Karmakar S. New immune horizons in therapeutics and diagnostic approaches to Preeclampsia. Am J Reprod Immunol 2023; 89:e13670. [PMID: 36565013 DOI: 10.1111/aji.13670] [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: 12/08/2021] [Revised: 11/02/2022] [Accepted: 12/10/2022] [Indexed: 12/25/2022] Open
Abstract
Hypertensive disorders of pregnancy (HDP) are one of the commonest maladies, affecting 5%-10% of pregnancies worldwide. The American College of Obstetricians and Gynecologists (ACOG) identifies four categories of HDP, namely gestational hypertension (GH), Preeclampsia (PE), chronic hypertension (CH), and CH with superimposed PE. PE is a multisystem, heterogeneous disorder that encompasses 2%-8% of all pregnancy-related complications, contributing to about 9% to 26% of maternal deaths in low-income countries and 16% in high-income countries. These translate to 50 000 maternal deaths and over 500 000 fetal deaths worldwide, therefore demanding high priority in understanding clinical presentation, screening, diagnostic criteria, and effective management. PE is accompanied by uteroplacental insufficiency leading to vascular and metabolic changes, vasoconstriction, and end-organ ischemia. PE is diagnosed after 20 weeks of pregnancy in women who were previously normotensive or hypertensive. Besides shallow trophoblast invasion and inadequate remodeling of uterine arteries, dysregulation of the nonimmune system has been the focal point in PE. This results from aberrant immune system activation and imbalanced differentiation of T cells. Further, a failure of tolerance toward the semi-allogenic fetus results due to altered distribution of Tregs such as CD4+FoxP3+ or CD4+CD25+CD127(low) FoxP3+ cells, thereby creating a cytotoxic environment by suboptimal production of immunosuppressive cytokines like IL-10, IL-4, and IL-13. Also, intracellular production of complement protein C5a may result in decreased FoxP3+ regulatory T cells. With immune system dysfunction as a major driver in PE pathogenesis, it is logical that therapeutic targeting of components of the immune system with pharmacologic agents like anti-inflammatory and immune-modulating molecules are either being used or under clinical trial. Cholesterol synthesis inhibitors like Pravastatin may improve placental perfusion in PE, while Eculizumab (monoclonal antibody inhibiting C5) and small molecular inhibitor of C5a, Zilucoplan are under investigation. Monoclonal antibody against IL-17(Secukinumab) has been proposed to alter the Th imbalance in PE. Autologous Treg therapy and immune checkpoint inhibitors like anti-CTLA-4 are emerging as new candidates in immune horizons for PE management in the future.
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Affiliation(s)
- Indrani Mukherjee
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India.,Amity Institute of Biotechnology (AIB), Amity University, Noida, India
| | - Sunil Singh
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Abhibrato Karmakar
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Neha Kashyap
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Asit Ranjan Mridha
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Jai Bhagwan Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Kalpana Luthra
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Radhey Shyam Sharma
- Ex-Head and Scientist G, Indian Council of Medical Research, New Delhi, India
| | - Subhrajit Biswas
- Amity Institute of Molecular Medicine & Stem Cell Research (AIMMSCR), Amity University, Noida, India
| | - Ruby Dhar
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Subhradip Karmakar
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
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Abstract
Anesthesia for fetal and neonatal surgery requires subspecialized knowledge and expertise. Attention to important anatomic, physiologic, and metabolic differences seen in pregnancy and at birth are essential for the optimal care of these patients. Thorough preoperative evaluations tailored intraoperative strategies and careful postoperative management are critical when devising the anesthetic approach for each of these cases.
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Ninke T, Eifer A, Dieterich HJ. [Fetal and pediatric cardiovascular physiology : Things you should know as an (pediatric) anesthesiologist]. DIE ANAESTHESIOLOGIE 2022; 71:811-820. [PMID: 36053299 DOI: 10.1007/s00101-022-01198-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
Immediately after birth the physiology of the cardiovascular system of the neonate undergoes some significant changes. The first breaths in life and the inflation of the lungs lead to a considerable drop in pulmonary arterial resistance. This results in the closure of the foramen ovale and ductus arteriosus; however, during the first weeks of life a sharp rise in pulmonary vascular resistance caused by hypoxia, hypercapnia and excessive positive pressure ventilation can lead to the reopening of the ductus arteriosus. This may result in subsequent strain of the left heart. In order to anticipate the reopening of the ductus arteriosus, it is recommended to measure the saturation of peripheral oxygen not only preductal (right hand), but also postductal (feet).An excessive volume therapy should be avoided as the neonatal myocardium is hallmarked by low cardiac compliance, reduced contractility and reduced ventricular filling.Until now there is still no uniform definition of hypotension in pediatric patients. Blood pressure values that are measured in awake children or are derived from the 50% age percentile values can thus only be used as approximate values. In all cases it is mandatory to recognize and consistently treat hypotension during pediatric anesthesia in order to prevent postoperative organ damage, particularly of the brain.The transcranial measurement of cerebral regional oxygen saturation (c‑rSO2) by means of near-infrared spectroscopy (NIRS) provides valuable information about regional tissue oxygenation of the brain. This enables conclusions about the state of the multifactorial cerebral perfusion to be drawn. In this way monitoring of the hypoxia sensitive cerebral tissue can be accomplished and should be used in premature infants and neonates. When measuring a baseline in awake patients, a 20% drop of c‑rSO2 from this baseline should be challenged and treated if necessary.
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Affiliation(s)
- T Ninke
- Klinik für Anaesthesiologie, Klinikum Universität München, Campus Innenstadt, Lindwurmstraße 2a, 80377, München, Deutschland.
| | - A Eifer
- Klinik für Anaesthesiologie, Klinikum Universität München, Campus Innenstadt, Lindwurmstraße 2a, 80377, München, Deutschland
| | - H-J Dieterich
- Klinik für Anaesthesiologie, Klinikum Universität München, Campus Innenstadt, Lindwurmstraße 2a, 80377, München, Deutschland
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Xia M, Peng J, Cui C, Gu Q, Zhou L, Wang C, Sun H, Peng J, Wei H. Effect of gestation dietary methionine-to-lysine ratio on methionine metabolism and antioxidant ability of high-prolific sows. ANIMAL NUTRITION (ZHONGGUO XU MU SHOU YI XUE HUI) 2021; 7:849-858. [PMID: 34466689 PMCID: PMC8379670 DOI: 10.1016/j.aninu.2021.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/10/2020] [Accepted: 02/09/2021] [Indexed: 12/20/2022]
Abstract
The uptake and metabolism of methionine (Met) are critical for epigenetic regulation, redox homeostasis, and embryo development. Our previous study showed that appropriate supplementation of dietary Met promoted the birth weight and placental angiogenesis of high-prolific sows. To further explore the metabolic effect of Met on pregnant sows, we have evaluated the influence of dietary Met level on Met metabolism, and the relationship between metabolites of Met and reproductive performance, antioxidant ability, and placental angiogenesis throughout the gestation of high-prolific sows. Sixty sows (the 3rd parity, Large White) were randomly divided into 5 groups that were fed diets with standardized ileal digestible (SID) methionine-to-lysine (Met:Lys) ratios of 0.27 (control), 0.32, 0.37, 0.42, and 0.47 from the mating day (gestational d 0, G0d) until the farrowing day. HPLC-MS/MS analysis was used to simultaneously evaluate the metabolites related to Met, e.g. S-adenosylmethionine (SAM), S-adenosylhomocysteine (SAH), homocysteine (Hcy), cysteine (Cys), and glutathione (GSH). The concentration of SAM and SAH in plasma had significant fluctuations, especially in late pregnancy. Increasing dietary Met supplementation significantly improved the plasma SAM and methylation potential (SAM-to-SAH ratio) at d 114 of pregnancy (G114d). Moreover, a positive association of the plasma SAM concentration at G114d was observed with the litter weight of born alive (P < 0.05; R 2 = 0.58). Furthermore, Hcy concentration in plasma was at the lowest level for 0.37 ratio group at G114d. However, it significantly increased during late pregnancy. Moreover, there were negative correlations between plasma Hcy concentration at G114d (P < 0.05) and the placental vascular density in the fold and stroma (P < 0.05). Compared with the control group, the expression of vascular endothelial growth factor-A (VEGF-A) in the placenta tissue of 0.37 ratio group increased significantly (P < 0.05). Collectively, these findings indicate that dietary Met:Lys ratio (0.37 to 0.57) in the pregnant diet dose not influence the antioxidant ability of the high-prolific sows; however, the improvement of fetal development and placental angiogenesis of high-prolific sows by supplementation of Met are closely associated to the key Met-related metabolite of SAM and Hcy, respectively.
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Affiliation(s)
- Mao Xia
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Jie Peng
- Innovation Institute of Healthy Fariming, College of Animal Sciences and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Chenbin Cui
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Qiongyao Gu
- Department of Chemistry, College of Science, Huazhong Agricultural University, Wuhan 430070, China
| | - Linjie Zhou
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Chao Wang
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Haiqing Sun
- YangXiang Joint Stock Company, Guigang 537000, China
| | - Jian Peng
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Hongkui Wei
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
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Miremberg H, Gindes L, Schreiber L, Raucher Sternfeld A, Bar J, Kovo M. The association between severe fetal congenital heart defects and placental vascular malperfusion lesions. Prenat Diagn 2019; 39:962-967. [PMID: 31254468 DOI: 10.1002/pd.5515] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/23/2019] [Accepted: 06/24/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Studies have shown an association between infant with congenital heart defects (CHD) and the risk of preeclampsia. We aimed to characterize placental histopathology from pregnancies who underwent termination of pregnancy (TOP) because of severe CHD. METHODS This was a case control study. The medical files of all TOPs due to fetal congenital malformations were reviewed. Cases with CHD included hypoplastic left heart, transposition of great arteries, AV canal, tetralogy of Fallot, double outlet RV, and coractation of aorta. The controls included TOPs due to congenital central nervous system defects (CNS group) that were matched in a 1:1 ratio, by gestational age and maternal age. Placental lesions were classified to maternal and fetal vascular malperfusion (MVM and FVM) and inflammatory lesions. RESULTS Higher rates of any MVM or FVM lesion were observed in placentas from the CHD group (n = 32) as compared with the CNS group (n = 32), 40.6% versus 12.5% respectively, p = .02. As compared with the CNS group, the CHD group had more abnormal coiling of umbilical cord (p = .01). CONCLUSION Placental vascular malperfusion lesions are more common in pregnancies complicated with CHD as compared with CNS malformations. These findings support the hypothesis of similar etiopathogenetic factors, contributing to the development of preeclampsia and CHD.
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Affiliation(s)
- Hadas Miremberg
- Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, Israel
| | - Liat Gindes
- Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, Israel
| | - Letizia Schreiber
- Department of Pathology, The Edith Wolfson Medical Center, Holon, Israel
| | | | - Jacob Bar
- Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, Israel
| | - Michal Kovo
- Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, Israel
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Courtney JA, Cnota JF, Jones HN. The Role of Abnormal Placentation in Congenital Heart Disease; Cause, Correlate, or Consequence? Front Physiol 2018; 9:1045. [PMID: 30131711 PMCID: PMC6091057 DOI: 10.3389/fphys.2018.01045] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 07/13/2018] [Indexed: 01/11/2023] Open
Abstract
Congenital heart disease (CHD) is the most common birth defect, affecting ~1% of all live births (van der Linde et al., 2011). Despite improvements in clinical care, it is the leading cause of infant mortality related to birth defects (Yang et al., 2006) and burdens survivors with significant morbidity (Gilboa et al., 2016). Furthermore, CHD accounts for the largest proportion (26.7%) of birth defect-associated hospitalization costs—up to $6.1 billion in 2013 (Arth et al., 2017). Yet after decades of research with a primary focus on genetic etiology, the underlying cause of these defects remains unknown in the majority of cases (Zaidi and Brueckner, 2017). Unexplained CHD may be secondary to undiscovered roles of noncoding genetic, epigenetic, and environmental factors, among others (Russell et al., 2018). Population studies have recently demonstrated that pregnancies complicated by CHD also carry a higher risk of developing pathologies associated with an abnormal placenta including growth disturbances (Puri et al., 2017), preeclampsia (Auger et al., 2015; Brodwall et al., 2016), preterm birth (Laas et al., 2012), and stillbirth (Jorgensen et al., 2014). Both the heart and placenta are vascular organs and develop concurrently; therefore, shared pathways almost certainly direct the development of both. The involvement of placental abnormalities in congenital heart disease, whether causal, commensurate or reactive, is under investigated and given the common developmental window and shared developmental pathways of the heart and placenta and concurrent vasculature development, we propose that further investigation combining clinical data, in vitro, in vivo, and computer modeling is fundamental to our understanding and the potential to develop therapeutics.
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Affiliation(s)
- Jennifer A Courtney
- Molecular and Developmental Biology Graduate Program, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Division of General Pediatric and Thoracic Surgery, Center for Fetal and Placental Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - James F Cnota
- Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Helen N Jones
- Division of General Pediatric and Thoracic Surgery, Center for Fetal and Placental Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
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Denis de Senneville B, Novell A, Arthuis C, Mendes V, Dujardin PA, Patat F, Bouakaz A, Escoffre JM, Perrotin F. Development of a Fluid Dynamic Model for Quantitative Contrast-Enhanced Ultrasound Imaging. IEEE TRANSACTIONS ON MEDICAL IMAGING 2018; 37:372-383. [PMID: 28858788 DOI: 10.1109/tmi.2017.2743099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Contrast-enhanced ultrasound (CEUS) is a non-invasive imaging technique extensively used for blood perfusion imaging of various organs. This modality is based on the acoustic detection of gas-filled microbubble contrast agents used as intravascular flow tracers. Recent efforts aim at quantifying parameters related to the enhancement in the vascular compartment using time-intensity curve (TIC), and at using these latter as indicators for several pathological conditions. However, this quantification is mainly hampered by two reasons: first, the quantification intrinsically solely relies on temporal intensity variation, the explicit spatial transport of the contrast agent being left out. Second, the exact relationship between the acquired US-signal and the local microbubble concentration is hardly accessible. This paper introduces the use of a fluid dynamic model for the analysis of dynamic CEUS (DCEUS), in order to circumvent the two above-mentioned limitations. A new kinetic analysis is proposed in order to quantify the velocity amplitude of the bolus arrival. The efficiency of proposed methodology is evaluated both in-vitro, for the quantitative estimation of microbubble flow rates, and in-vivo, for the classification of placental insufficiency (control versus ligature) of pregnant rats from DCEUS. Besides, for the in-vivo experimental setup, we demonstrated that the proposed approach outperforms the performance of existing TIC-based methods.
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Circadian Variation in the Onset of Placental Abruption. J Pregnancy 2017; 2017:3194814. [PMID: 28163931 PMCID: PMC5253489 DOI: 10.1155/2017/3194814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 11/29/2016] [Accepted: 12/21/2016] [Indexed: 11/17/2022] Open
Abstract
Objective. To determine circadian variation in the onset of placental abruption. Methods. A retrospective study involving 115 placental abruptions, divided into four subgroups based on initial symptoms comprising abdominal pain, vaginal bleeding, both abdominal pain and bleeding, or other symptoms. The time of the initial symptom was considered the disease onset. We analyzed the frequency of disease onset and adverse perinatal outcome including perinatal death relative to the daily four 6-hour intervals. Results. Abdominal pain displayed significant circadian variation regarding the period of onset with higher levels from 0:00 AM to 6:00 AM (65%) compared with 0:00 PM to 6:00 PM (24%, p < 0.01). Vaginal bleeding did not display significant circadian variation (p = 0.45). Adverse perinatal outcome showed significant circadian variation with a higher occurrence of perinatal death from 0:00 AM to 6:00 AM (35%) compared with 0:00 PM to 6:00 PM (0%, p < 0.01). After adjustment using variables of abdominal pain and time period, both variables significantly affected perinatal death (odds ratio: 13.0 and 2.2, resp.). The risk of adverse perinatal outcome increased significantly when abdominal pain occurred, except for the period 0:00 PM to 6:00 PM (OR, 9.5). Conclusion. Placental abruption beginning with abdominal pain has circadian variation.
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Dynamic modeling of uteroplacental blood flow in IUGR indicates vortices and elevated pressure in the intervillous space - a pilot study. Sci Rep 2017; 7:40771. [PMID: 28102332 PMCID: PMC5244422 DOI: 10.1038/srep40771] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 12/12/2016] [Indexed: 01/14/2023] Open
Abstract
Ischemic placental disease is a concept that links intrauterine growth retardation (IUGR) and preeclampsia (PE) back to insufficient remodeling of uterine spiral arteries. The rheological consequences of insufficient remodeling of uterine spiral arteries were hypothesized to mediate the considerably later manifestation of obstetric disease. However, the micro-rheology in the intervillous space (IVS) cannot be examined clinically and rheological animal models of the human IVS do not exist. Thus, an in silico approach was implemented to provide in vivo inaccessible data. The morphology of a spiral artery and the inflow region of the IVS were three-dimensionally reconstructed to provide a morphological stage for the simulations. Advanced high-end supercomputing resources were used to provide blood flow simulations at high spatial resolution. Our simulations revealed turbulent blood flow (high-velocity jets and vortices) combined with elevated blood pressure in the IVS and increased wall shear stress at the villous surface in conjunction with insufficient spiral artery remodeling only. Post-hoc histological analysis of uterine veins showed evidence of increased trophoblast shedding in an IUGR placenta. Our data support that rheological alteration in the IVS is a relevant mechanism linking ischemic placental disease to altered structural integrity and function of the placenta.
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Thornburg KL, Kolahi K, Pierce M, Valent A, Drake R, Louey S. Biological features of placental programming. Placenta 2016; 48 Suppl 1:S47-S53. [PMID: 27817870 DOI: 10.1016/j.placenta.2016.10.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 10/14/2016] [Accepted: 10/17/2016] [Indexed: 01/06/2023]
Abstract
The placenta is a key organ in programming the fetus for later disease. This review outlines nine of many structural and physiological features of the placenta which are associated with adult onset chronic disease. 1) Placental efficiency relates the placental mass to the fetal mass. Ratios at the extremes are related to cardiovascular disease risk later in life. 2) Placental shape predicts a large number of disease outcomes in adults but the regulators of placental shape are not known. 3) Non-human primate studies suggest that at about mid-gestation, the placenta becomes less plastic and less able to compensate for pathological stresses. 4) Recent studies suggest that lipids have an important role in regulating placental metabolism and thus the future health of offspring. 5) Placental inflammation affects nutrient transport to the fetus and programs for later disease. 6) Placental insufficiency leads to inadequate fetal growth and elevated risks for later life disease. 7) Maternal height, fat and muscle mass are important in combination with placental size and shape in predicting adult disease. 8) The placenta makes a host of hormones that influence fetal growth and are related to offspring disease. Unfortunately, our knowledge of placental growth and function lags far behind that of other organs. An investment in understanding placental growth and function will yield enormous benefits to human health because it is a key player in the origins of the most expensive and deadly chronic diseases that humans face.
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Affiliation(s)
- Kent L Thornburg
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA; Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, USA; Department of Medicine, Oregon Health and Science University, Portland, OR, USA; Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA; Moore Institute for Nutrition and Wellness, Oregon Health and Science University, Portland, OR, USA.
| | - Kevin Kolahi
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA; Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, USA
| | - Melinda Pierce
- Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA
| | - Amy Valent
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA
| | - Rachel Drake
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA
| | - Samantha Louey
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA; Moore Institute for Nutrition and Wellness, Oregon Health and Science University, Portland, OR, USA
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Rätsep MT, Hickman AF, Croy BA. The Elsevier trophoblast research award lecture: Impacts of placental growth factor and preeclampsia on brain development, behaviour, and cognition. Placenta 2016; 48 Suppl 1:S40-S46. [PMID: 26880207 DOI: 10.1016/j.placenta.2016.02.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 01/19/2016] [Accepted: 02/03/2016] [Indexed: 12/17/2022]
Abstract
Preeclampsia (PE) is a significant gestational disorder affecting 3-5% of all human pregnancies. In many PE pregnancies, maternal plasma is deficient in placental growth factor (PGF), a placentally-produced angiokine. Beyond immediate fetal risks associated with acute termination of the pregnancy, offspring of PE pregnancies (PE-F1) have higher long-term risks for hypertension, stroke, and cognitive impairment compared to F1s from uncomplicated pregnancies. At present, mechanisms that explain PE-F1 gains in postpartum risks are poorly understood. Our laboratory found that mice genetically-deleted for Pgf have altered fetal and adult brain vascular development. This is accompanied by sexually dimorphic alterations in anatomic structure in the adult Pgf-/- brain and impaired cognitive functions. We hypothesize that cerebrovascular and neurological aberrations occur in fetuses exposed to the progressive development of PE and that these brain changes impair cognitive functioning, enhance risk for stroke, elevate severity of stroke, and lead to worse stroke outcomes. These brain and placental outcomes may be linked to down-regulated PGF gene expression in early pre-implantation embryos, prior to gastrulation. This review explores our hypothesis that there are mechanistic links between low PGF detection in maternal plasma prodromal to PE, PE, and altered brain vascular, structural, and functional development amongst PE-F1s. We also include a summary of preliminary outcomes from a pilot study of 7-10 year old children that is the first to report magnetic resonance imaging, magnetic resonance angiography, and functional brain region assessment by eye movement control studies in PE-F1s.
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Affiliation(s)
- Matthew T Rätsep
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada.
| | - Andrew F Hickman
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - B Anne Croy
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
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Meah VL, Cockcroft JR, Backx K, Shave R, Stöhr EJ. Cardiac output and related haemodynamics during pregnancy: a series of meta-analyses. Heart 2016; 102:518-26. [PMID: 26794234 DOI: 10.1136/heartjnl-2015-308476] [Citation(s) in RCA: 186] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 12/11/2015] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Cardiac output, a fundamental parameter of cardiovascular function, has consistently been shown to increase across healthy pregnancy; however, the time course and magnitude of adaptation remains equivocal within published literature. The aim of the present meta-analyses was to comprehensively describe the pattern of change in cardiac output during healthy pregnancy. METHOD A series of meta-analyses of previously published cardiac output data during healthy, singleton pregnancies was completed. PubMed and Scopus databases were searched for studies published between 1996 and 2014. Included studies reported absolute values during a predetermined gestational age (non-pregnant, late first trimester, early and late second trimester, early and late third trimester, early and late postpartum). Cardiac output was measured through echocardiography, impedance cardiography or inert gas rebreathing. Observational data were meta-analysed at each gestational age using a random-effects model. If reported, related haemodynamic variables were evaluated. RESULTS In total, 39 studies were eligible for inclusion, with pooled sample sizes ranging from 259 to 748. Cardiac output increased during pregnancy reaching its peak in the early third trimester, 1.5 L/min (31%) above non-pregnant values. The observed results from this study indicated a non-linear rise to this point. In the early postpartum, cardiac output had returned to non-pregnant values. CONCLUSION The present results suggest that cardiac output peaks in the early third trimester, following a non-linear pattern of adaptation; however, this must be confirmed using longitudinal studies. The findings provide new insight into the normal progression of cardiac output during pregnancy.
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Affiliation(s)
- Victoria L Meah
- Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
| | | | - Karianne Backx
- Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
| | - Rob Shave
- Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
| | - Eric J Stöhr
- Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
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Mohammed R, Cavallaro G, Kessels CGA, Villamor E. Functional differences between the arteries perfusing gas exchange and nutritional membranes in the late chicken embryo. J Comp Physiol B 2015; 185:783-96. [PMID: 26119481 PMCID: PMC4568027 DOI: 10.1007/s00360-015-0917-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 05/28/2015] [Accepted: 06/10/2015] [Indexed: 11/30/2022]
Abstract
The chicken extraembryonic arterial system comprises the allantoic arteries, which irrigate the gas exchange organ (the chorioallantoic membrane, CAM) and the yolk sac (YS) artery, which irrigates the nutritional organ (the YS membrane). We compared, using wire myography, the reactivity of allantoic and YS arteries from 19-day chicken embryos (total incubation 21 days). The contractions induced by KCl, the adrenergic agonists norepinephrine (NE, nonselective), phenylephrine (α1), and oxymetazoline (α2), electric field stimulation (EFS), serotonin, U46619 (TP receptor agonist), and endothelin (ET)-1 and the relaxations induced by acetylcholine (ACh), sodium nitroprusside (SNP, NO donor), forskolin (adenylate cyclase activator), and isoproterenol (β-adrenergic agonist) were investigated. Extraembryonic allantoic arteries did not show α-adrenergic-mediated contraction (either elicited by exogenous agonists or EFS) or ACh-induced (endothelium-dependent) relaxation, whereas these responses were present in YS arteries. Interestingly, the intraembryonic segment of the allantoic artery showed EFS- and α-adrenergic-induced contraction and ACh-mediated relaxation. Moreover, glyoxylic acid staining showed the presence of catecholamine-containing nerves in the YS and the intraembryonic allantoic artery, but not in the extraembryonic allantoic artery. Isoproterenol- and forskolin-induced relaxation and ET-1-induced contraction were higher in YS than in allantoic arteries, whereas serotonin- and U46619-induced contraction and SNP-induced relaxation did not significantly differ between the two arteries. In conclusion, our study demonstrates a different pattern of reactivity in the arteries perfusing the gas exchange and the nutritional membranes of the chicken embryo.
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Affiliation(s)
- Riazudin Mohammed
- Department of Pediatrics, Maastricht University Medical Center (MUMC+), Research Institute Growth and Development (GROW) and Cardiovascular Research Institute Maastricht (CARIM), University of Maastricht, P. Debyelaan 25, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Giacomo Cavallaro
- Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Carolina G A Kessels
- Department of Pediatrics, Maastricht University Medical Center (MUMC+), Research Institute Growth and Development (GROW) and Cardiovascular Research Institute Maastricht (CARIM), University of Maastricht, P. Debyelaan 25, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Eduardo Villamor
- Department of Pediatrics, Maastricht University Medical Center (MUMC+), Research Institute Growth and Development (GROW) and Cardiovascular Research Institute Maastricht (CARIM), University of Maastricht, P. Debyelaan 25, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
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Iriyama T, Sun K, Parchim NF, Li J, Zhao C, Song A, Hart LA, Blackwell SC, Sibai BM, Chan LNL, Chan TS, Hicks MJ, Blackburn MR, Kellems RE, Xia Y. Elevated placental adenosine signaling contributes to the pathogenesis of preeclampsia. Circulation 2014; 131:730-41. [PMID: 25538227 DOI: 10.1161/circulationaha.114.013740] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Preeclampsia is a prevalent hypertensive disorder of pregnancy and a leading cause of maternal and neonatal morbidity and mortality worldwide. This pathogenic condition is speculated to be caused by placental abnormalities that contribute to the maternal syndrome. However, the specific factors and signaling pathways that lead to impaired placentas and maternal disease development remain elusive. METHODS AND RESULTS Using 2 independent animal models of preeclampsia (genetically engineered pregnant mice with elevated adenosine exclusively in placentas and a pathogenic autoantibody-induced preeclampsia mouse model), we demonstrated that chronically elevated placental adenosine was sufficient to induce hallmark features of preeclampsia, including hypertension, proteinuria, small fetuses, and impaired placental vasculature. Genetic and pharmacological approaches revealed that elevated placental adenosine coupled with excessive A₂B adenosine receptor (ADORA2B) signaling contributed to the development of these features of preeclampsia. Mechanistically, we provided both human and mouse evidence that elevated placental CD73 is a key enzyme causing increased placental adenosine, thereby contributing to preeclampsia. CONCLUSIONS We determined that elevated placental adenosine signaling is a previously unrecognized pathogenic factor for preeclampsia. Moreover, our findings revealed the molecular basis underlying the elevation of placental adenosine and the detrimental role of excess placental adenosine in the pathophysiology of preeclampsia, and thereby, we highlight novel therapeutic targets.
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Affiliation(s)
- Takayuki Iriyama
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.)
| | - Kaiqi Sun
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.)
| | - Nicholas F Parchim
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.)
| | - Jessica Li
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.)
| | - Cheng Zhao
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.)
| | - Anren Song
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.)
| | - Laura A Hart
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.)
| | - Sean C Blackwell
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.)
| | - Baha M Sibai
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.)
| | - Lee-Nien L Chan
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.)
| | - Teh-Sheng Chan
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.)
| | - M John Hicks
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.)
| | - Michael R Blackburn
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.)
| | - Rodney E Kellems
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.)
| | - Yang Xia
- From Departments of Biochemistry and Molecular Biology (T.I., K.S., N.F.P., J.L., C.Z., A.S., M.R.B., R.E.K., Y.X.) and Department of Obstetrics, Gynecology, and Reproductive Sciences (L.A.H., S.C.B., B.M.S.), University of Texas Medical School at Houston: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan (T.I.); Graduate School of Biomedical Sciences, University of Texas, Houston (K.S., N.F.P., M.R.B, R.E.K., Y.X.); Department of Urology (C.Z.), Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, (L-N. L.C., T.-S.C.); and Department of Pathology, Texas Children's Hospital, Houston (M.J.H.).
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