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He A, Yip KC, Lu D, Liu J, Zhang Z, Wang X, Liu Y, Wei Y, Zhang Q, Yan R, Gao F, Li R. Construction of a pathway-level model for preeclampsia based on gene expression data. Hypertens Res 2024:10.1038/s41440-024-01753-0. [PMID: 38914704 DOI: 10.1038/s41440-024-01753-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/17/2024] [Accepted: 05/28/2024] [Indexed: 06/26/2024]
Abstract
Preeclampsia (PE) is a heterogeneous disease that seriously affects the health of mothers and fetuses. Lack of detection assays, its diagnosis and intervention are often delayed when the clinical symptoms are atypical. Using personalized pathway-based analysis and machine learning algorithms, we built a PE diagnosis model consisting of nine core pathways using multiple cohorts from the Gene Expression Omnibus database. The model showed an area under the receiver operating characteristic (AUROC) curve of 0.959 with the data from the placental tissue samples in the development cohort. In the two validation cohorts, the AUROCs were 0.898 and 0.876, respectively. The model also performed well with the maternal plasma data in another validation cohort (AUROC: 0.815). Moreover, we identified tyrosine-protein kinase Lck (LCK) as the hub gene in this model and found that LCK and pLCK proteins were downregulated in placentas from PE patients. The pathway-level model for PE can provide a novel direction to develop molecular diagnostic assay and investigate potential mechanisms of PE in future studies.
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Affiliation(s)
- Andong He
- Department of Obstetrics and Gynecology, Jinan University First Affiliated Hospital, Guangzhou, 510630, China
| | - Ka Cheuk Yip
- Department of Obstetrics and Gynecology, Jinan University First Affiliated Hospital, Guangzhou, 510630, China
| | - Daiqiang Lu
- Institute of Molecular and Medical Virology, School of Medicine, Jinan University, Guangzhou, 510632, China
| | - Jia Liu
- Department of Obstetrics and Gynecology, Jinan University First Affiliated Hospital, Guangzhou, 510630, China
| | - Zunhao Zhang
- Department of Pathology, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Xiufang Wang
- Department of Obstetrics and Gynecology, Jinan University First Affiliated Hospital, Guangzhou, 510630, China
| | - Yifeng Liu
- Institute of Molecular and Medical Virology, School of Medicine, Jinan University, Guangzhou, 510632, China
| | - Yiling Wei
- Department of Obstetrics and Gynecology, Jinan University First Affiliated Hospital, Guangzhou, 510630, China
| | - Qiao Zhang
- Institute of Molecular and Medical Virology, School of Medicine, Jinan University, Guangzhou, 510632, China.
| | - Ruiling Yan
- Department of Obstetrics and Gynecology, Jinan University First Affiliated Hospital, Guangzhou, 510630, China.
| | - Feng Gao
- Institute of Molecular and Medical Virology, School of Medicine, Jinan University, Guangzhou, 510632, China.
| | - Ruiman Li
- Department of Obstetrics and Gynecology, Jinan University First Affiliated Hospital, Guangzhou, 510630, China.
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Svigkou A, Katsi V, Kordalis VG, Tsioufis K. The Molecular Basis of the Augmented Cardiovascular Risk in Offspring of Mothers with Hypertensive Disorders of Pregnancy. Int J Mol Sci 2024; 25:5455. [PMID: 38791492 PMCID: PMC11121482 DOI: 10.3390/ijms25105455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/12/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
The review examines the impact of maternal preeclampsia (PE) on the cardiometabolic and cardiovascular health of offspring. PE, a hypertensive disorder of pregnancy, is responsible for 2 to 8% of pregnancy-related complications. It significantly contributes to adverse outcomes for their infants, affecting the time of birth, the birth weight, and cardiometabolic risk factors such as blood pressure, body mass index (BMI), abdominal obesity, lipid profiles, glucose, and insulin. Exposure to PE in utero predisposes offspring to an increased risk of cardiometabolic diseases (CMD) and cardiovascular diseases (CVD) through mechanisms that are not fully understood. The incidence of CMD and CVD is constantly increasing, whereas CVD is the main cause of morbidity and mortality globally. A complex interplay of genes, environment, and developmental programming is a plausible explanation for the development of endothelial dysfunction, which leads to atherosclerosis and CVD. The underlying molecular mechanisms are angiogenic imbalance, inflammation, alterations in the renin-angiotensin-aldosterone system (RAAS), endothelium-derived components, serotonin dysregulation, oxidative stress, and activation of both the hypothalamic-pituitary-adrenal axis and hypothalamic-pituitary-gonadal axis. Moreover, the potential role of epigenetic factors, such as DNA methylation and microRNAs as mediators of these effects is emphasized, suggesting avenues for future research and therapeutic interventions.
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Affiliation(s)
| | - Vasiliki Katsi
- Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, 157 72 Athens, Greece;
| | - Vasilios G. Kordalis
- School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece;
| | - Konstantinos Tsioufis
- Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, 157 72 Athens, Greece;
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3
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Liu Y, Xie Z, Huang Y, Lu X, Yin F. Uterine arteries pulsatility index by Doppler ultrasound in the prediction of preeclampsia: an updated systematic review and meta-analysis. Arch Gynecol Obstet 2024; 309:427-437. [PMID: 37217697 DOI: 10.1007/s00404-023-07044-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/09/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Preeclampsia is a common pregnancy complication with serious potential risks for maternal and neonatal health. Early prediction of preeclampsia is crucial for timely prevention, surveillance, and treatment to improve maternal and neonatal outcomes. This systematic review aimed to summarize the available evidence on the prediction of preeclampsia based on Doppler ultrasound of uterine arteries at different gestational ages. METHODS A systematic literature search and meta-analysis were conducted to evaluate the sensitivity and specificity of the pulsatility index of Doppler ultrasound of uterine arteries for predicting preeclampsia. The timing of ultrasound scans within and beyond 20 weeks of gestational age was compared to assess its effect on the sensitivity and specificity of the pulsatility index. RESULTS This meta-analysis included 27 studies and 81,673 subjects (3309 preeclampsia patients and 78,364 controls). The pulsatility index had moderate sensitivity (0.586) and high specificity for predicting preeclampsia (0.879) (summary point: sensitivity 0.59; 1-specificity 0.12). Subgroup analysis revealed that ultrasound scans performed within 20 weeks of gestational age did not significantly affect the sensitivity and specificity for predicting preeclampsia. The summary receiver operator characteristic curve showed the pulsatility index's optimal range of sensitivity and specificity. CONCLUSIONS The uterine arteries pulsatility index measured by Doppler ultrasound is useful and effective for predicting preeclampsia and should be implemented in the clinical practice. The timing of ultrasound scans at different gestational age ranges does not significantly affect the sensitivity and specificity.
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Affiliation(s)
- Yan Liu
- B Ultrasonic room, The First People's Hospital of Lianyungang, Lianyungang City, 222006, Jiangsu Province, China
| | - Zilu Xie
- Department of Ultrasound Medicine, Jing men no. 2 People's Hospital, Jingmen City, 448000, Hubei Province, China
| | - Yong Huang
- Department of Ultrasound Medicine, Jiangjin Central Hospital, Chongqing, 402260, China
| | - Xin Lu
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an City, 721000, Shaanxi Province, China
| | - Fengling Yin
- Department of Obstetrics and Gynecology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, No. 199 Jiefang South Road, Quanshan District, Xuzhou City, 221000, Jiangsu Province, China.
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4
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Pluta K, Januszewski M, Ziuzia-Januszewska L, Kudan M, Suchocka M, Kuśmierczuk K, Issat T, Jakimiuk AJ. sFlT-1/PlGF ratio as a predictor of preeclampsia in COVID-19 pregnant patients. BMC Pregnancy Childbirth 2024; 24:94. [PMID: 38297191 PMCID: PMC10829318 DOI: 10.1186/s12884-024-06263-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/07/2024] [Indexed: 02/02/2024] Open
Abstract
The association between SARS-CoV-2 infection in pregnancy and preeclampsia is widely debated in numerous studies. The aim of our study was to investigate whether an increased sFlt-1/PlGF ratio is a good marker of preeclampsia in pregnant patients with COVID-19 infection. This single centre prospective study was conducted in the Department of Obstetrics and Gynaecology, at the Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw. The study group consisted of 68 COVID-19 pregnant patients and 57 SARS-CoV-2 negative pregnant controls. Serum sFlt-1/PlGF ratio was assessed. The two groups did not differ in terms of the frequency of IVF, nulliparity, history of hypertension, pre-gestational diabetes and chronic kidney disease. The primary outcome was the diagnosis of preeclampsia. Preeclampsia was diagnosed in 10 patients in both groups. The sFlt-1/PlGF ratio higher than 38, considered highly suggestive of developing preeclampsia, was found in 20 patients in the COVID-19 group and 15 patients in the control group. The odds of developing preeclampsia in patients with sFlt-1/PlGF ratio > 38 was approximately 4-fold higher in COVID-19 group and 11-fold higher in controls. Sflt-1/PlGF ratio does not differ significantly between the SARS-CoV-2-positive and SARS-COV-2-negative pregnant patients. The sFlt-1/PlGF ratio > 38 is associated with higher odds of the diagnosis of preeclampsia in both of these groups, and therefore may serve as its marker regardless of COVID-19 infection status.
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Affiliation(s)
- Kamil Pluta
- Department of Obstetrics and Gynecology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
| | - Marcin Januszewski
- Department of Obstetrics and Gynecology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
| | - Laura Ziuzia-Januszewska
- Department of Otolaryngology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
| | - Michał Kudan
- Department of Obstetrics and Gynecology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
| | - Maria Suchocka
- Department of Obstetrics and Gynecology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
| | - Kinga Kuśmierczuk
- Department of Obstetrics and Gynecology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
| | - Tadeusz Issat
- Department of Obstetrics and Gynecology, Institute of Mother and Child, Warsaw, Poland
| | - Artur J Jakimiuk
- Department of Obstetrics and Gynecology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland.
- Center for Reproductive Health, Institute of Mother and Child, Warsaw, Poland.
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5
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El Azab EF, Abd El-Kader RG, Elhassan TM, Mohammed Ali SA, Shaaban EIA, El-Eshmawy MA, Hamid DA, El-Beltagy NS, Salem ET, Elsaid AM, Elsalahaty MI, Elshazli RM, Anber N. Association of ACE*(Insertion/Deletion) Variant with the Elevated Risk of Preeclampsia Among Gestational Women. Biochem Genet 2024:10.1007/s10528-023-10620-5. [PMID: 38219243 DOI: 10.1007/s10528-023-10620-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/03/2023] [Indexed: 01/16/2024]
Abstract
The renin-angiotensin-aldosterone system has an indispensable function in the uteroplacental circulation, placental growth, and blood pressure optimization. The angiotensin I converting enzyme (ACE) gene is a critical integrator for electrolyte balance, and water retention, along with inhibiting preeclampsia. The main goal of this pertaining study is to assess the contribution of ACE*(Ins/Del) variant with the susceptibility for preeclampsia with focus on the severity of the disease among gestational hypertensive women. This retrospective study included 225 participants [125 PE gestational women, and 100 normotensive healthy controls] matching with age, and geographical region. PE women classified into 82 early-onset PE women, accompanied with 43 late-onset PE women. Additionally, PE women categorized into 59 mild PE women, together with 66 severe PE women. The genotyping and characterization of ACE*(Ins/Del) variant were applied using the PCR technique. Our findings indicated higher frequency of the ACE*(Del/Del) genotype and ACE*(D allele) with elevated risk of preeclampsia compared to normotensive controls under recessive (OR = 2.09, and p-value = 0.007), and allelic (OR = 1.75, and p-value = 0.012) models. In addition, testing logistic regression revealed that the levels of endothelin-1 and malondialdehyde exposed significant difference for the ACE*(Del/Del) genotype among early-onset and late-onset PE women (p-value = 0.024, and 0.23, respectively). Furthermore, carriers of the ACE*(Del/Del) genotype observed statistically significant with lower sodium concentrations among severe PE women (p-value = 0.034). The ACE*(Del/Del) genotype and ACE*(D allele) were associated with increased risk preeclampsia among gestational women. Furthermore, early-onset PE and late-onset PE were correlated with endothelin-1 and malondialdehyde concentrations among Egyptian women.
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Affiliation(s)
- Eman Fawzy El Azab
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Al-Qurayyat, Saudi Arabia
- Biochemistry Department, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Rabab Gad Abd El-Kader
- Community Health Nursing Department, RAK College of Nursing, RAK Medical and Health Science University, Ras Al-Khaimah, United Arab Emirates
- Community Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Thoraya Mohamed Elhassan
- Department of Clinical Biochemistry, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Sameh A Mohammed Ali
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Beni Suef University, Beni Suef, Egypt
| | - Esraa Ibrahim A Shaaban
- Department of Drug Delivery and Nano Pharmaceutics, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | | | - Dina Abdel Hamid
- Hematology and Bone Marrow Transplant Unit, Children's University Hospital, Mansoura University, Mansoura, Egypt
| | - Nanis S El-Beltagy
- Department of Laboratories, Faculty of Medicine, Children's University Hospital, Mansoura University, Mansoura, Egypt
| | - Eman T Salem
- Department of Basic Sciences, Faculty of Physical Therapy, Horus University-Egypt, New Damietta, 34518, Egypt
| | - Afaf M Elsaid
- Genetic Unit, Children's University Hospital, Mansoura University, Mansoura, Egypt
| | - Mohamed I Elsalahaty
- Biochemistry Division, Department of Chemistry, Faculty of Science, Tanta University, Tanta, Egypt
| | - Rami M Elshazli
- Biochemistry and Molecular Genetics Unit, Department of Basic Sciences, Faculty of Physical Therapy, Horus University-Egypt, New Damietta, 34518, Egypt.
| | - Nahla Anber
- Emergency Hospital, Mansoura University, Mansoura, Egypt
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6
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Schofield LG, Kahl RGS, Rodrigues SL, Fisher JJ, Endacott SK, Delforce SJ, Lumbers ER, Martin JH, Pringle KG. Placental deficiency of the (pro)renin receptor ((P)RR) reduces placental development and functional capacity. Front Cell Dev Biol 2023; 11:1212898. [PMID: 37588662 PMCID: PMC10427116 DOI: 10.3389/fcell.2023.1212898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/17/2023] [Indexed: 08/18/2023] Open
Abstract
The (pro)renin receptor ((P)RR; also known as ATP6AP2) is a multifunctional receptor. The (P)RR activates the tissue renin-angiotensin system (RAS) and is also involved in regulating integral intracellular pathways such as V-ATPase and Wnt/β-catenin signalling. Given this, the (P)RR may be associated with essential pathways in placentation, however its role within the context of pregnancy remains poorly characterised. The first trimester/extravillous trophoblast cell line, HTR-8/SVneo, underwent an siRNA knockdown where they were incubated for 24 h with a negative control siRNA or siRNA targeting ATP6AP2 mRNA. xCELLigence real-time cell analysis was performed to assess the effect of ATP6AP2 mRNA knockdown on HTR-8/SVneo cell proliferation, migration, and invasion. In subsequent experiments, GFP-encoding lentiviral packaged gene-constructs were used to knockdown (P)RR expression in the trophectoderm of C57/BL6/CBA-F1 mouse blastocysts. Blastocysts were incubated for 6 h with vehicle (no-virus), control virus (non-targeting shRNA and GFP), or (P)RR-knockdown virus ((P)RR shRNA and GFP) before transfer into recipient pseudo-pregnant Swiss CD1 female mice. Fetal and placental tissues were collected and assessed at embryonic age (EA) 10 and 18. (P)RR levels were measured in the labyrinth zone of day 18 placentae and stereological Merz grid analysis was performed to determine the volumetric distribution of trophoblasts, fetal capillaries, and the maternal blood space. We showed that a reduction of ATP6AP2 expression in HTR-8/SVneo cells in vitro, impaired trophoblast proliferation, migration, and invasion. In vivo, decreasing placental labyrinth (P)RR expression adversely effected placental physiology, decreasing placental trophoblast number and total surface area available for exchange, while also increasing maternal blood space. Additionally, decreased (P)RR affected placental efficacy evident by the reduced fetal-placental weight ratio. Our study shows that the (P)RR is necessary for appropriate placental development and function.
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Affiliation(s)
- Lachlan G. Schofield
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Mothers and Babies Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Richard G. S. Kahl
- Mothers and Babies Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Samantha L. Rodrigues
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Mothers and Babies Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Joshua J. Fisher
- Mothers and Babies Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Saije K. Endacott
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Mothers and Babies Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Sarah J. Delforce
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Mothers and Babies Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Eugenie R. Lumbers
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Mothers and Babies Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jacinta H. Martin
- School of Environmental and Life Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, NSW, Australia
- Infertility and Reproduction Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Kirsty G. Pringle
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Mothers and Babies Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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7
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Sulyok E, Farkas B, Bodis J. Pathomechanisms of Prenatally Programmed Adult Diseases. Antioxidants (Basel) 2023; 12:1354. [PMID: 37507894 PMCID: PMC10376205 DOI: 10.3390/antiox12071354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/22/2023] [Accepted: 06/25/2023] [Indexed: 07/30/2023] Open
Abstract
Based on epidemiological observations Barker et al. put forward the hypothesis/concept that an adverse intrauterine environment (involving an insufficient nutrient supply, chronic hypoxia, stress, and toxic substances) is an important risk factor for the development of chronic diseases later in life. The fetus responds to the unfavorable environment with adaptive reactions, which ensure survival in the short run, but at the expense of initiating pathological processes leading to adult diseases. In this review, the major mechanisms (including telomere dysfunction, epigenetic modifications, and cardiovascular-renal-endocrine-metabolic reactions) will be outlined, with a particular emphasis on the role of oxidative stress in the fetal origin of adult diseases.
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Affiliation(s)
- Endre Sulyok
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, 7624 Pécs, Hungary
| | - Balint Farkas
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, 7624 Pécs, Hungary
- Department of Obstetrics and Gynecology, School of Medicine, University of Pécs, 7624 Pécs, Hungary
| | - Jozsef Bodis
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, 7624 Pécs, Hungary
- Department of Obstetrics and Gynecology, School of Medicine, University of Pécs, 7624 Pécs, Hungary
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8
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Alexander BT, South AM, August P, Bertagnolli M, Ferranti EP, Grobe JL, Jones EJ, Loria AS, Safdar B, Sequeira-Lopez MLS. Appraising the Preclinical Evidence of the Role of the Renin-Angiotensin-Aldosterone System in Antenatal Programming of Maternal and Offspring Cardiovascular Health Across the Life Course: Moving the Field Forward: A Scientific Statement From the American Heart Association. Hypertension 2023; 80:e75-e89. [PMID: 36951054 PMCID: PMC10242542 DOI: 10.1161/hyp.0000000000000227] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
There is increasing interest in the long-term cardiovascular health of women with complicated pregnancies and their affected offspring. Emerging antenatal risk factors such as preeclampsia appear to increase the risk of hypertension and cardiovascular disease across the life course in both the offspring and women after pregnancy. However, the antenatal programming mechanisms responsible are complex and incompletely understood, with roots in alterations in the development, structure, and function of the kidney, heart, vasculature, and brain. The renin-angiotensin-aldosterone system is a major regulator of maternal-fetal health through the placental interface, as well as kidney and cardiovascular tissue development and function. Renin-angiotensin-aldosterone system dysregulation plays a critical role in the development of pregnancy complications such as preeclampsia and programming of long-term adverse cardiovascular health in both the mother and the offspring. An improved understanding of antenatal renin-angiotensin-aldosterone system programming is crucial to identify at-risk individuals and to facilitate development of novel therapies to prevent and treat disease across the life course. Given the inherent complexities of the renin-angiotensin-aldosterone system, it is imperative that preclinical and translational research studies adhere to best practices to accurately and rigorously measure components of the renin-angiotensin-aldosterone system. This comprehensive synthesis of preclinical and translational scientific evidence of the mechanistic role of the renin-angiotensin-aldosterone system in antenatal programming of hypertension and cardiovascular disease will help (1) to ensure that future research uses best research practices, (2) to identify pressing needs, and (3) to guide future investigations to maximize potential outcomes. This will facilitate more rapid and efficient translation to clinical care and improve health outcomes.
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9
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Wai JY, Wood EM, Hornaday KK, Slater DM. Potential molecular and cellular mechanisms for adverse placental outcomes in pregnancies complicated by SARS-CoV-2 infection-A scoping review. PLoS One 2023; 18:e0283453. [PMID: 36952548 PMCID: PMC10035918 DOI: 10.1371/journal.pone.0283453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 03/08/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Emerging evidence suggests that SARS-CoV-2 infection during pregnancy can result in placental damage and poor placental outcomes. However, the mechanisms by which SARS-CoV-2 infection leads to placental damage are not well understood. With a rapid expansion of literature on this topic, it is critical to assess the quality and synthesize the current state of literature. The objective of this scoping review is to highlight underlying mechanisms of SARS-CoV-2 mediated placental pathology in pregnant individuals and identify literature gaps regarding molecular and cellular mechanisms of poor placental outcomes. METHODS The review was conducted and reported following the recommendations of the PRISMA extension for Scoping Reviews. The study protocol was registered with Open Science Framework (https://osf.io/p563s/). Five databases (MEDLINE, EMBASE, Scopus, CINAHL, PubMed) were searched for studies published between September 2019 until April 2022. Studies assessing placental outcomes with respect to SARS-CoV-2 infection in pregnancy were eligible for inclusion. Outcomes of interest included histopathology, and molecular or cellular analysis. All records were uploaded into Covidence and extracted using the Joanna Briggs Institute method. Studies were assessed for risk of bias using the Newcastle Ottawa scale and a narrative synthesis of results was generated. RESULTS Twenty-seven studies reporting on molecular and/or cellular mechanisms of SARS-CoV-2 mediated placental outcomes were included in this review. SARS-CoV-2 infection was associated with perturbations in the ACE2 pathway, inflammatory mediators and immune cell populations and mitochondrial function in placentas. CONCLUSIONS Our findings suggest that changes in the ACE2 pathway, mitochondrial dysfunction, and/or inflammatory processes may lead to placental damage observed in SARS-CoV-2 infection during pregnancy. More research is needed to understand the role of these pathways further, in addition to data collection related to trimester, severity, and strain.
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Affiliation(s)
- Janelle Y Wai
- Department of Physiology and Pharmacology, Cumming School of Medicine at the University of Calgary, Calgary, Canada
| | - Eilidh M Wood
- Department of Physiology and Pharmacology, Cumming School of Medicine at the University of Calgary, Calgary, Canada
| | - Kylie K Hornaday
- Department of Physiology and Pharmacology, Cumming School of Medicine at the University of Calgary, Calgary, Canada
| | - Donna M Slater
- Department of Physiology and Pharmacology, Cumming School of Medicine at the University of Calgary, Calgary, Canada
- Department of Obstetrics and Gynecology in the Cumming School of Medicine at the University of Calgary, Calgary, Canada
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10
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Reliability of Rodent and Rabbit Models in Preeclampsia Research. Int J Mol Sci 2022; 23:ijms232214344. [PMID: 36430816 PMCID: PMC9696504 DOI: 10.3390/ijms232214344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/14/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
In vivo studies on the pathology of gestation, including preeclampsia, often use small mammals such as rabbits or rodents, i.e., mice, rats, hamsters, and guinea pigs. The key advantage of these animals is their short reproductive cycle; in addition, similar to humans, they also develop a haemochorial placenta and present a similar transformation of maternal spiral arteries. Interestingly, pregnant dams also demonstrate a similar reaction to inflammatory factors and placentally derived antiangiogenic factors, i.e., soluble fms-like tyrosine kinase 1 (sFlt-1) or soluble endoglin-1 (sEng), as preeclamptic women: all animals present an increase in blood pressure and usually proteinuria. These constitute the classical duet that allows for the recognition of preeclampsia. However, the time of initiation of maternal vessel remodelling and the depth of trophoblast invasion differs between rabbits, rodents, and humans. Unfortunately, at present, no known animal replicates a human pregnancy exactly, and hence, the use of rabbit and rodent models is restricted to the investigation of individual aspects of human gestation only. This article compares the process of placentation in rodents, rabbits, and humans, which should be considered when planning experiments on preeclampsia; these aspects might determine the success, or failure, of the study. The report also reviews the rodent and rabbit models used to investigate certain aspects of the pathomechanism of human preeclampsia, especially those related to incorrect trophoblast invasion, placental hypoxia, inflammation, or maternal endothelial dysfunction.
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Vidal MS, Lintao RCV, Severino MEL, Tantengco OAG, Menon R. Spontaneous preterm birth: Involvement of multiple feto-maternal tissues and organ systems, differing mechanisms, and pathways. Front Endocrinol (Lausanne) 2022; 13:1015622. [PMID: 36313741 PMCID: PMC9606232 DOI: 10.3389/fendo.2022.1015622] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
Survivors of preterm birth struggle with multitudes of disabilities due to improper in utero programming of various tissues and organ systems contributing to adult-onset diseases at a very early stage of their lives. Therefore, the persistent rates of low birth weight (birth weight < 2,500 grams), as well as rates of neonatal and maternal morbidities and mortalities, need to be addressed. Active research throughout the years has provided us with multiple theories regarding the risk factors, initiators, biomarkers, and clinical manifestations of spontaneous preterm birth. Fetal organs, like the placenta and fetal membranes, and maternal tissues and organs, like the decidua, myometrium, and cervix, have all been shown to uniquely respond to specific exogenous or endogenous risk factors. These uniquely contribute to dynamic changes at the molecular and cellular levels to effect preterm labor pathways leading to delivery. Multiple intervention targets in these different tissues and organs have been successfully tested in preclinical trials to reduce the individual impacts on promoting preterm birth. However, these preclinical trial data have not been effectively translated into developing biomarkers of high-risk individuals for an early diagnosis of the disease. This becomes more evident when examining the current global rate of preterm birth, which remains staggeringly high despite years of research. We postulate that studying each tissue and organ in silos, as how the majority of research has been conducted in the past years, is unlikely to address the network interaction between various systems leading to a synchronized activity during either term or preterm labor and delivery. To address current limitations, this review proposes an integrated approach to studying various tissues and organs involved in the maintenance of normal pregnancy, promotion of normal parturition, and more importantly, contributions towards preterm birth. We also stress the need for biological models that allows for concomitant observation and analysis of interactions, rather than focusing on these tissues and organ in silos.
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Affiliation(s)
- Manuel S. Vidal
- Department of Biochemistry and Molecular Biology, College of Medicine, University of the Philippines, Manila, Philippines
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Ryan C. V. Lintao
- Department of Biochemistry and Molecular Biology, College of Medicine, University of the Philippines, Manila, Philippines
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Mary Elise L. Severino
- Department of Biochemistry and Molecular Biology, College of Medicine, University of the Philippines, Manila, Philippines
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Ourlad Alzeus G. Tantengco
- Department of Biochemistry and Molecular Biology, College of Medicine, University of the Philippines, Manila, Philippines
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Ramkumar Menon
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, United States
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Abdolrazaghnejad A, Miraj S. Can Coronavirus Disease 2019 Effect on Human Reproduction? Adv Biomed Res 2022; 11:55. [PMID: 35982865 PMCID: PMC9379922 DOI: 10.4103/abr.abr_236_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 01/05/2022] [Accepted: 01/19/2022] [Indexed: 11/04/2022] Open
Abstract
Since the main role in the pathogenesis of the coronavirus is attributed to the angiotensin-converting enzyme (ACE) receptor, it could possibly be a hypothesis in the differential sex-based pathogenesis of the coronavirus. The virus inserts its genetic material into the cell through its ACE2 receptors and replicates it by intracellular proteins. ACE2 receptors are highly expressed in cell membranes of various tissues in the body, including cardiovascular, gastrointestinal, renal, macrophage cells, and especially on the surface of type 2 pneumocytes in the lungs, ovaries, uterus, vagina, placenta, and testes. Therefore, cells having a higher expression of the ACE2 may be a specific target for coronavirus binding and infectivity. Due to the increase of infections in males, concerns have been appeared about the potential impact of coronavirus disease 2019 (COVID-19) on their fertility and reproductive organs. Thus, it is necessary to investigate if COVID-19 disturbs female and male fertility, so this review aimed to study the comprehensive evidences on the association of COVID-19 with human reproduction.
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Affiliation(s)
- Ali Abdolrazaghnejad
- Department of Emergency Medicine, Khatam-Al-Anbia Hospital, Clinical Immunology Research Center at Zahedan University of Medical Sciences, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Sepideh Miraj
- Department of Obstetrics and Gynecology, Nekouei-Hedayati-Forghani Hospital, Qom University of Medical Sciences, Qom, Iran,Address for correspondence: Dr. Sepideh Miraj, Associate Professor of Infertility and IVF, Department of Obstetrics and Gynecology, Nekouei-Hedayati-Forghani Hospital, Qom University of Medical Sciences, Qom, Iran. E-mail:
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