Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Genetics Institute, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Genetics Institute, Meir Medical Center, Kfar Saba, Israel; Faculty of Life Sciences, Bar Ilan University, Ramat Gan, Israel.
Am J Obstet Gynecol. 2016 Feb;214(2):283.e1-283.e7. doi: 10.1016/j.ajog.2015.08.050. Epub 2015 Aug 28.
Telomeres are nucleoprotein structures, essential for chromosome stability and cell survival. Telomeres are progressively shortened with each cell division and by environmental factors. Telomere loss has been linked to age and stress-induced premature senescence. Dysfunctional telomeres tend to form aggregates, which consist of the end-to-end fusion of telomeres. Telomere elongation is carried out by telomerase, which is a specific reverse transcriptase capable of adding telomeric repeats to chromosome termini. The TERC gene encodes the RNA template of the telomerase. Another compensatory mechanism that is enhanced in response to telomere shortening and senescence is the telomere capture (TC). Telomere shortening and elevated aggregate formation have been observed in trophoblasts from pregnancies complicated with preeclampsia (PE).
We opted to study mechanisms of telomere shortening in trophoblasts from pregnancies complicated with PE and to assess telomere length and homeostasis in fetal cord blood cells from PE pregnancies.
Placental specimens and cord blood samples from uncomplicated pregnancies and from pregnancies complicated with PE were collected. Staining with 4',6-diamidino-2-phenylindole was used to assess nuclear fragmentation: senescence-associated heterochromatin foci (SAHF). Fluorescence in situ hybridization was used to evaluate TERC gene copy number and TC. Telomere length and aggregate formation were assessed in cord blood using quantitative fluorescence in situ hybridization. Nonparametric Kruskal-Wallis and Mann-Whitney U tests were applied to test the differences between the study groups.
Nine samples from pregnant patients with PE without intrauterine growth restriction and 14 samples from uncomplicated pregnancies that served as controls were collected. In cord blood cells, no differences were observed in telomere length, aggregate formation, TERC copy number, TC, or SAHF between PE and controls. In PE trophoblasts the percentage of cells with SAHF was higher in PE trophoblasts compared to controls (56.8 SD = 10.5% vs 35.2 SD = 10.7%, P = .028). The percentage of cells with abnormal TERC copy number was increased in PE trophoblasts compared to controls (31 ± 3.6% vs 12.97 SD = 5%, P = .004) as well as the percentage of cells with TC (27.4 SD = 9.4% vs 16 SD = 4.67%, P = .028).
We suggest that telomere shortening in PE trophoblasts is linked to cellular increased senescence. Alterations in telomere homeostasis mechanisms are present in such cases. These findings support the role of telomeres in the pathogenesis of trophoblastic dysfunction in PE. The lack of telomere shortening, modified telomere homeostasis mechanisms, and increased senescence in cord blood from pregnancies complicated with PE suggests that these processes are probably restricted primarily to the placenta.
端粒是核蛋白结构,对染色体稳定性和细胞存活至关重要。随着细胞分裂和环境因素的影响,端粒逐渐缩短。端粒丢失与年龄和应激诱导的早衰有关。功能失调的端粒往往形成端粒到端粒的融合的聚集物。端粒的延长是由端粒酶完成的,端粒酶是一种能够在染色体末端添加端粒重复序列的特异性逆转录酶。TERC 基因编码端粒酶的 RNA 模板。另一种补偿机制是在端粒缩短和衰老时增强的端粒捕获(TC)。在子痫前期(PE)合并妊娠的胎盘滋养细胞中观察到端粒缩短和聚集物形成增加。
我们选择研究 PE 合并妊娠中滋养细胞端粒缩短的机制,并评估 PE 妊娠胎儿脐带血中的端粒长度和稳定性。
收集了无并发症妊娠和 PE 合并妊娠的胎盘标本和脐带血样本。使用 4',6-二脒基-2-苯基吲哚染色评估核碎片:衰老相关异染色质焦点(SAHF)。荧光原位杂交用于评估 TERC 基因拷贝数和 TC。使用定量荧光原位杂交评估脐带血中端粒长度和聚集物形成。非参数克鲁斯卡尔-沃利斯和曼-惠特尼 U 检验用于检验研究组之间的差异。
共收集了 9 例无宫内生长受限的 PE 孕妇和 14 例作为对照的无并发症妊娠的样本。在脐带血细胞中,PE 与对照组之间端粒长度、聚集物形成、TERC 拷贝数、TC 或 SAHF 无差异。PE 滋养细胞中的 SAHF 细胞百分比高于对照组(PE 滋养细胞为 56.8 ± 10.5%,对照组为 35.2 ± 10.7%,P =.028)。PE 滋养细胞中异常 TERC 拷贝数的细胞百分比高于对照组(31 ± 3.6%比 12.97 ± 5%,P =.004),TC 的细胞百分比也高于对照组(27.4 ± 9.4%比 16 ± 4.67%,P =.028)。
我们认为 PE 滋养细胞中的端粒缩短与细胞衰老增加有关。在这种情况下,端粒稳定性机制的改变是存在的。这些发现支持端粒在 PE 中滋养细胞功能障碍发病机制中的作用。PE 合并妊娠的脐带血中端粒缩短、端粒稳定性机制改变和衰老增加表明,这些过程可能主要局限于胎盘。