Gilbert Jeffrey S, Gilbert Sara A B, Arany Marietta, Granger Joey P
Department of Physiology, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216-4505, USA.
Hypertension. 2009 Feb;53(2):399-403. doi: 10.1161/HYPERTENSIONAHA.108.123513. Epub 2008 Dec 15.
Recent clinical studies indicate that an excess of angiostatic factors, such as soluble endoglin (sEng), is related to the occurrence of preeclampsia. Although recent clinical studies report that sEng is increased in preeclamptic women, the mechanisms underlying its overexpression remain unclear. Evidence suggests that hypoxia and induction of heme oxygenase-1 have opposing effects on sEng expression, the former stimulatory and the latter inhibitory. Hence, we hypothesized that placental ischemia because of reduced uterine perfusion pressure (RUPP) in the pregnant rat would increase sEng expression and decrease heme oxygenase-1. Mean arterial pressure was obtained via arterial catheter, and serum and placental proteins were measured by Western blot. Mean arterial pressure was increased (132+/-3 mm Hg versus 102+/-2 mm Hg; P<0.001), and fetal (2.35+/-0.05 g versus 1.76+/-0.08 g; P<0.001) and placental weight were decreased (0.47+/-0.04 g versus 0.58+/-0.03 g; P<0.01) in the RUPP compared with normal pregnant controls. Serum sEng (0.10+/-0.02 arbitrary pixel units [apu] versus 0.05+/-0.01 apu; P<0.05) and placental endoglin (4.7+/-2.3 apu versus 1.45+/-0.42 apu; P<0.05) were increased along with placental hypoxia inducible factor-1 alpha (1.42+/-0.25 apu versus 0.68+/-0.09 apu; P<0.05) expression in the RUPP versus the normal pregnant dams. Placental HO-1 (1.4+/-0.3 apu versus 2.5+/-0.1 apu; P<0.05) expression decreased in the RUPP compared with normal pregnant dams. The present findings support our hypothesis that placental ischemia because of RUPP increases the expression of sEng and shifts the balance of angiogenic factors in the maternal circulation toward an angiostatic state. The present study provides further evidence that placental ischemia is a strong in vivo stimulus of angiostatic factors during pregnancy.
近期临床研究表明,血管抑制因子过量,如可溶性内皮糖蛋白(sEng),与先兆子痫的发生有关。尽管近期临床研究报告称,先兆子痫女性体内的sEng水平升高,但其过表达的潜在机制仍不清楚。有证据表明,缺氧和血红素加氧酶-1的诱导对sEng表达有相反的作用,前者起刺激作用,后者起抑制作用。因此,我们推测,妊娠大鼠因子宫灌注压(RUPP)降低导致的胎盘缺血会增加sEng表达并降低血红素加氧酶-1。通过动脉导管测量平均动脉压,并用蛋白质免疫印迹法检测血清和胎盘蛋白。与正常妊娠对照组相比,RUPP组的平均动脉压升高(132±3 mmHg对102±2 mmHg;P<0.001),胎儿体重(2.35±0.05 g对1.76±0.08 g;P<0.001)和胎盘重量降低(0.47±0.04 g对0.58±0.03 g;P<0.01)。与正常妊娠母鼠相比,RUPP组血清sEng(0.10±0.02任意像素单位[apu]对0.05±0.01 apu;P<0.05)、胎盘内皮糖蛋白(4.7±2.3 apu对1.45±0.42 apu;P<0.05)以及胎盘缺氧诱导因子-1α(1.42±0.25 apu对0.68±0.09 apu;P<0.05)的表达均随胎盘缺氧而增加。与正常妊娠母鼠相比,RUPP组胎盘HO-1(1.4±0.3 apu对2.5±0.1 apu;P<0.05)的表达降低。目前的研究结果支持了我们的假设,即RUPP导致的胎盘缺血会增加sEng的表达,并使母体循环中血管生成因子的平衡向血管抑制状态转变。本研究进一步证明,胎盘缺血是孕期血管抑制因子的一种强大的体内刺激因素。