Cvitic Silvija, Desoye Gernot, Hiden Ursula
Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria ; Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Harrachgasse 21, 8010 Graz, Austria.
Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria.
Biomed Res Int. 2014;2014:145846. doi: 10.1155/2014/145846. Epub 2014 Sep 2.
The placental vasculature rapidly expands during the course of pregnancy in order to sustain the growing needs of the fetus. Angiogenesis and vascular growth are stimulated and regulated by a variety of growth factors expressed in the placenta or present in the fetal circulation. Like in tumors, hypoxia is a major regulator of angiogenesis because of its ability to stimulate expression of various proangiogenic factors. Chronic fetal hypoxia is often found in pregnancies complicated by maternal diabetes as a result of fetal hyperglycaemia and hyperinsulinemia. Both are associated with altered levels of hormones, growth factors, and proinflammatory cytokines, which may act in a proangiogenic manner and, hence, affect placental angiogenesis and vascular development. Indeed, the placenta in diabetes is characterized by hypervascularisation, demonstrating high placental plasticity in response to diabetic metabolic derangements. This review describes the major regulators of placental angiogenesis and how the diabetic environment in utero alters their expression. In the light of hypervascularized diabetic placenta, the focus was placed on proangiogenic factors.
胎盘血管系统在孕期迅速扩张，以满足胎儿不断增长的需求。胎盘表达的或胎儿循环中存在的多种生长因子刺激并调节血管生成和血管生长。与肿瘤一样，缺氧是血管生成的主要调节因子，因为它能够刺激各种促血管生成因子的表达。慢性胎儿缺氧常见于合并母体糖尿病的妊娠中，这是胎儿高血糖和高胰岛素血症的结果。两者都与激素、生长因子和促炎细胞因子水平的改变有关，这些因子可能以促血管生成的方式起作用，从而影响胎盘血管生成和血管发育。事实上，糖尿病患者的胎盘以血管过度增生为特征，表明胎盘对糖尿病代谢紊乱具有高度可塑性。这篇综述描述了胎盘血管生成的主要调节因子，以及子宫内的糖尿病环境如何改变它们的表达。鉴于糖尿病胎盘血管过度增生，重点关注促血管生成因子。
