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血清及胎盘晚期糖基化终末产物及其受体表达与子痫前期发病机制的相关性

[Correlation of the expressions of advanced glycation end products and its receptor in serum and placenta with the pathogenesis of preeclampsia].

作者信息

Xian Na, Chen Weiping, Zhang Yan, Li Jing, Zhang Ning, Ye Yuanhua

机构信息

Department of Obstetrics, Affiliated Hospital of Qingdao University, Qingdao 266003, China.

Department of Obstetrics, Affiliated Hospital of Qingdao University, Qingdao 266003, China; Email:

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2015 Jul;50(7):493-9.

Abstract

OBJECTIVE

To investigate the correlation of the expressions of advanced glycation end products (AGE) and the receptor for advanced glycation end products (RAGE) in serum and placenta with the pathogenesis of preeclampsia.

METHODS

From December 2013 to June 2014, 32 women with severe preeclampsia who received cesarean section in the Affiliated Hospital of Qingdao University were recruited in the study, defined as the severe preeclampsia group. 30 healthy pregnant women who received cesarean section in the same hospital were recruited as the control group. ELISA was used to measure the maternal serum AGE, soluble receptor for advanced glycation end products (sRAGE) and tumor necrosis factor-α (TNF-α) in these women. Furthermore, ELISA was also used to measure AGE and TNF-α in the placenta. The localizations of AGE and RAGE protein in placentas were detected by immunohistochemical SP method. RAGE and TNF-α mRNA expression in placentas were measured by real-time quantitative PCR. AGE, RAGE and TNF-α protein expression in placentas were measured by western blot, respectively.

RESULTS

(1) The serum levels of AGE, sRAGE and TNF-α in the severe preeclampsia group were (538 ± 75), (367 ± 86) and (322 ± 40) ng/L, respectively. They were significantly higher than those in the control group [(454 ± 50), (286 ± 35) and (270 ± 35) ng/L, respectively] (P < 0.05). The levels of AGE showed positive correlation with the levels of TNF-α (r = 0.588, P < 0.05), while the levels of sRAGE showed no correlation with TNF-α (r = -0.041, P > 0.05). (2) In the severe preeclampsia group, the levels of AGE and TNF-α in placentas were (500 ± 82) and (334 ± 57) ng/L, which were higher than those in the control group [(431 ± 74) and (263 ± 46) ng/L, respectively] (P < 0.05). The levels of AGE showed positive correlation with the levels of TNF-ɑ (r = 0.406, P < 0.05). (3) AGE and RAGE protein mainly located in the syncytiotrophoblasts, macrophages and vascular endothelial cells in the placentas of the two groups. AGE expressed mainly in the cytoplasm, and RAGE expressed in the cytoplasm and cell membranes. (4) RAGE and TNF-α mRNA expression in the placentas of the severe preeclampsia group were 12.6 ± 4.6 and 10.4 ± 2.4, which were significantly higher than those in the control group (0.9 ± 0.4 and 3.5 ± 0.9, P < 0.01). (5) The expressions of AGE, RAGE and TNF-α protein in placentas of the severe preeclampsia group were 0.68 ± 0.06, 0.82 ± 0.08 and 0.76 ± 0.08. All were significantly higher than those of the control group (0.46 ± 0.05, 0.42 ± 0.09 and 0.52 ± 0.07; P < 0.01).

CONCLUSIONS

The levels of AGE and RAGE in serum and placentas elevated in the severe preeclampsia group, and the expression of TNF-α also elevated. These indicated that AGE and RAGE might be involved in the systemic inflammatory response and local inflammatory response in placentas, and then caused the preeclampsia.

摘要

目的

探讨血清及胎盘组织中晚期糖基化终末产物(AGE)及其受体(RAGE)的表达与子痫前期发病机制的相关性。

方法

选取2013年12月至2014年6月在青岛大学附属医院行剖宫产术的32例重度子痫前期患者作为重度子痫前期组,选取同期在该院行剖宫产术的30例正常孕妇作为对照组。采用酶联免疫吸附测定(ELISA)法检测两组孕妇血清中AGE、可溶性晚期糖基化终末产物受体(sRAGE)及肿瘤坏死因子-α(TNF-α)水平;同时采用ELISA法检测胎盘组织中AGE及TNF-α水平。采用免疫组织化学SP法检测胎盘组织中AGE和RAGE蛋白的定位;采用实时定量聚合酶链反应(PCR)检测胎盘组织中RAGE和TNF-α mRNA的表达;采用蛋白质免疫印迹法检测胎盘组织中AGE、RAGE和TNF-α蛋白的表达。

结果

(1)重度子痫前期组孕妇血清中AGE、sRAGE及TNF-α水平分别为(538±75)、(367±86)、(322±40)ng/L,均显著高于对照组的(454±50)、(286±35)、(270±35)ng/L(P<0.05)。血清中AGE水平与TNF-α水平呈正相关(r=0.588,P<0.05),而sRAGE水平与TNF-α水平无相关性(r=-0.041,P>0.05)。(2)重度子痫前期组胎盘组织中AGE及TNF-α水平分别为(500±82)、(334±57)ng/L,均高于对照组的(431±74)、(263±46)ng/L(P<0.05)。胎盘组织中AGE水平与TNF-α水平呈正相关(r=0.406,P<0.05)。(3)两组胎盘组织中AGE和RAGE蛋白主要定位在合体滋养层细胞、巨噬细胞及血管内皮细胞。AGE主要在细胞质中表达,RAGE在细胞质及细胞膜均有表达。(4)重度子痫前期组胎盘组织中RAGE和TNF-α mRNA表达水平分别为12.6±4.6、10.4±2.4,显著高于对照组的0.9±0.4、3.5±0.9(P<0.01)。(5)重度子痫前期组胎盘组织中AGE、RAGE和TNF-α蛋白表达水平分别为0.68±0.06、0.82±0.08、0.76±0.08,均显著高于对照组的0.46±0.05、0.42±0.09、0.52±0.07(P<0.01)。

结论

重度子痫前期组孕妇血清及胎盘组织中AGE和RAGE水平升高,TNF-α表达也升高,提示AGE和RAGE可能参与子痫前期的全身炎症反应及胎盘局部炎症反应,进而导致子痫前期的发生。

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