Takeda-Matsubara Yuko, Matsubara Keiichi, Ochi Hiroshi, Ito Masaharu, Iwai Masaru, Horiuchi Masatsugu
Department of Obstetrics and Gynecology, Ehime University School of Medicine, Ehime, Japan.
Am J Hypertens. 2003 Dec;16(12):993-9. doi: 10.1016/j.amjhyper.2003.07.020.
The normal suppression of vascular sensitivity to angiotensin II (Ang II) in pregnancy is lost in pregnancy-induced hypertension (PIH). To examine the mechanism, we investigated Ang II receptor subtype 1 (AT1R) and 2 (AT2R) expression in human umbilical vein endothelial cells (HUVEC) and vascular smooth muscle cells (VSMC).
The HUVEC and VSMC were incubated with serum from normal pregnant women and PIH patients for 0 to 12 h. The AT1R and AT2R mRNA were semiquantified as the ratio to glyceraldehyde-3-phosphate dehydrogenase mRNA, using multiplex reverse transcription-polymerase chain reaction. The AT1R expression was also evaluated by immunocytochemistry.
Serum from PIH patients significantly increased AT1R mRNA of HUVEC (1.48 +/- 0.44) after a 12-h incubation compared with that from normal pregnant women (0.25 +/- 0.14). On the other hand, AT2R mRNA of HUVEC incubated with serum from PIH patients (0.14 +/- 0.02) was significantly decreased compared with HUVEC incubated with serum from normal pregnant women (0.31 +/- 0.08). The AT1R mRNA of VSMC was significantly increased by serum from both PIH patients and normal pregnant women. The AT1R-to-AT2R mRNA ratio increased by serum from PIH patients was significantly reduced by anti-tumor necrosis factor-alpha (TNF-alpha) antibody (20 microg/mL). Valsartan (an AT1R antagonist, at 1 to 10 nmol/L) significantly increased AT2R mRNA of HUVEC. Also, immunocytochemistry demonstrated that endothelial AT1R expression was strongly increased by PIH sera and reduced by anti-TNF-alpha antibody.
Endothelial AT1R expression is increased and AT2R expression is decreased in PIH. The TNF-alpha is related to the pathogenesis of PIH by reduced AT2R mRNA through an increase of AT1R mRNA.
妊娠诱导的高血压(PIH)患者失去了孕期血管对血管紧张素II(Ang II)敏感性的正常抑制。为研究其机制,我们调查了人脐静脉内皮细胞(HUVEC)和血管平滑肌细胞(VSMC)中血管紧张素II 1型受体(AT1R)和2型受体(AT2R)的表达。
将HUVEC和VSMC与正常孕妇及PIH患者的血清孵育0至12小时。使用多重逆转录聚合酶链反应,将AT1R和AT2R mRNA以与甘油醛-3-磷酸脱氢酶mRNA的比率进行半定量。AT1R表达也通过免疫细胞化学进行评估。
与正常孕妇血清孵育后的HUVEC相比,PIH患者血清孵育12小时后,HUVEC的AT1R mRNA显著增加(1.48±0.44),而正常孕妇血清孵育后的HUVEC为(0.25±0.14)。另一方面,与正常孕妇血清孵育的HUVEC相比,PIH患者血清孵育的HUVEC的AT2R mRNA(0.14±0.02)显著降低,正常孕妇血清孵育的HUVEC为(0.31±0.08)。PIH患者和正常孕妇的血清均使VSMC的AT1R mRNA显著增加。PIH患者血清增加的AT1R与AT2R mRNA比率被抗肿瘤坏死因子-α(TNF-α)抗体(20μg/mL)显著降低。缬沙坦(一种AT1R拮抗剂,浓度为1至10 nmol/L)显著增加HUVEC的AT2R mRNA。此外,免疫细胞化学表明,PIH血清可使内皮AT1R表达强烈增加,而抗TNF-α抗体可使其降低。
PIH患者内皮AT1R表达增加,AT2R表达降低。TNF-α通过增加AT1R mRNA导致AT2R mRNA减少,与PIH的发病机制有关。