Department of Maternal-Fetal Medicine, Pregnancy Research Centre, The Royal Women's Hospital, Parkville, Victoria, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia.
Department of Maternal-Fetal Medicine, Pregnancy Research Centre, The Royal Women's Hospital, Parkville, Victoria, Australia.
Am J Pathol. 2016 Dec;186(12):3217-3224. doi: 10.1016/j.ajpath.2016.08.010. Epub 2016 Oct 15.
Preeclampsia (PE), a serious hypertensive disorder of pregnancy, remains a leading cause of perinatal morbidity and mortality worldwide. Perturbed trophoblast function and impaired placental development early in pregnancy are key features. Low-dose acetylsalicylic acid (LDA) administered before 16 weeks' gestation significantly reduces the risk for PE. However, the exact mechanisms of action of LDA, particularly on trophoblast function, are unclear. We hypothesized that LDA influences placental trophoblast function and reverses PE-associated abnormalities. This study aimed to determine the effects of serum from normotensive women and from those with PE with or without LDA treatment on a model of placental syncytium. On cytokine profiling, LDA increased placental growth factor production and selectively restored PE serum-induced alterations in levels of cytokines [activated leukocyte cell adhesion molecule, CXCL-16, and ErbB3] to those in normotensive serum-treated cells. PE serum-induced increases in the apoptotic markers P53 mRNA expression, IKBKE mRNA expression, caspase 3 activity, and decreased BIRC8 mRNA expression, were attenuated by LDA treatment. LDA treatment also reduced abnormal differentiation caused by PE serum administration. Possible mechanisms by which LDA influences PE-affected trophoblast cells in vitro are by modulating cytokine secretion, reducing apoptosis to levels seen in normotensive serum-treated cells, and preventing the premature trophoblast differentiation commonly observed in PE.
子痫前期 (PE) 是一种严重的妊娠高血压疾病,仍然是全球围产期发病率和死亡率的主要原因。妊娠早期胎盘滋养层功能障碍和胎盘发育不良是其主要特征。在妊娠 16 周前给予低剂量阿司匹林 (LDA) 可显著降低 PE 的风险。然而,LDA 的作用机制,特别是对滋养层功能的影响,尚不清楚。我们假设 LDA 影响胎盘滋养层功能并逆转与 PE 相关的异常。本研究旨在确定来自正常血压女性和来自患有或不患有 LDA 治疗的 PE 女性的血清对胎盘合体滋养层模型的影响。在细胞因子谱分析中,LDA 增加了胎盘生长因子的产生,并选择性地将 PE 血清诱导的细胞因子水平改变[活化白细胞细胞黏附分子、CXCL-16 和 ErbB3]恢复到正常血压血清处理细胞的水平。LDA 治疗还减弱了 PE 血清诱导的凋亡标志物 P53 mRNA 表达、IKBKE mRNA 表达、半胱天冬酶 3 活性的增加,以及 BIRC8 mRNA 表达的降低。LDA 治疗还减少了由 PE 血清给药引起的异常分化。LDA 影响体外 PE 影响的滋养层细胞的可能机制是通过调节细胞因子分泌、将凋亡减少到正常血压血清处理细胞的水平,并防止 PE 中常见的滋养层过早分化。