Amaral Lorena M, Faulkner Jessica L, Elfarra Jamil, Cornelius Denise C, Cunningham Mark W, Ibrahim Tarek, Vaka Venkata Ramana, McKenzie Jessica, LaMarca Babbette
From the Department of Pharmacology (L.M.A., M.W.C., T.I., V.R.V., B.L.), Department of Obstetrics and Gynecology (J.E.), and Departments of Emergency Medicine and Pharmacology (D.C.C.), University of Mississippi Medical Center, Jackson; Department of Vascular Biology Center, Augusta University, GA (J.L.F.); and Department of Biological Sciences, Mississippi College, Clinton (J.M.).
Hypertension. 2017 Dec;70(6):1250-1255. doi: 10.1161/HYPERTENSIONAHA.117.09969. Epub 2017 Oct 30.
Preeclampsia is characterized by elevated TNF-α (tumor necrosis factor-α), antiangiogenic factors, such as sFlt-1 (soluble vascular endothelial growth factor receptor 1), increased uterine artery resistance index, and decreased of NO during pregnancy. Previously we showed that 17-hydroxyprogesterone caproate (17-OHPC) administered into reduced uterine perfusion pressure (RUPP) rats on day 18 of gestation improved hypertension without improving pup weight. We hypothesized that earlier administration of 17-OHPC on day 15 of gestation could improve pathophysiology of preeclampsia and fetal outcomes in response to placental ischemia. Carotid catheters were inserted on day 18, and mean arterial blood pressure and samples were collected on day 19. Mean arterial blood pressure in normal pregnant rats was 102±2, 105±2 in normal pregnant+day 15 of gestation (GD15) 17-OHPC, 127±2 in RUPP and 112±1 mm Hg in RUPP+GD15 17-OHPC, <0.05. Pup weight and litter size were improved from 1.9±0.05, 10.1±1.4 in RUPP to 2.1±0.07 g and 13.2±0.6 in RUPP+GD15 17-OHPC, <0.05. Uterine artery resistance index was 0.8±0.03 in RUPP, which was decreased to 0.6±0.04 in RUPP+GD15 17-OHPC, <0.05. Plasma TNF-α levels were 164±34 in RUPP and blunted to 29±9 pg/mL in RUPP+GD15 17-OHPC, <0.05. Plasma nitrate-nitrite levels were 10.8±2.3 in RUPP rats and significantly increased to 25.5±5.2 µmol/L in RUPP+GD15 17-OHPC, <0.05. sFlt-1 levels were 386±141 in RUPP rats, which were reduced to 110.2±11 in RUPP+17-OHPC, <0.05. These data indicate that GD15 17-OHPC improves pathophysiology in RUPP rats, possibly via improving sFlt-1 reduced NO during pregnancy.
子痫前期的特征是肿瘤坏死因子-α(TNF-α)升高、抗血管生成因子如可溶性血管内皮生长因子受体1(sFlt-1)增加、子宫动脉阻力指数升高以及孕期一氧化氮(NO)减少。此前我们发现,在妊娠第18天给子宫灌注压降低(RUPP)大鼠注射己酸17-羟孕酮(17-OHPC)可改善高血压,但不能改善幼崽体重。我们推测,在妊娠第15天更早给予17-OHPC可改善子痫前期的病理生理及胎盘缺血后的胎儿结局。在第18天插入颈动脉导管,在第19天测量平均动脉血压并采集样本。正常妊娠大鼠的平均动脉血压为102±2 mmHg,正常妊娠+妊娠第15天(GD15)给予17-OHPC的大鼠为105±2 mmHg,RUPP大鼠为127±2 mmHg,RUPP+GD15给予17-OHPC的大鼠为112±1 mmHg,P<0.05。幼崽体重和窝仔数从RUPP组的1.9±0.05 g、10.1±1.4只改善至RUPP+GD15给予17-OHPC组的2.1±0.07 g和13.2±0.6只,P<0.05。RUPP大鼠的子宫动脉阻力指数为0.8±0.03,在RUPP+GD15给予17-OHPC组降至0.6±0.04,P<0.05。RUPP大鼠血浆TNF-α水平为164±34 pg/mL,在RUPP+GD15给予17-OHPC组降至29±9 pg/mL,P<0.05。RUPP大鼠血浆硝酸盐-亚硝酸盐水平为10.8±2.3 μmol/L,在RUPP+GD15给予17-OHPC组显著升高至25.5±5.2 μmol/L,P<0.05。RUPP大鼠sFlt-1水平为386±141 pg/mL,在RUPP+17-OHPC组降至110.2±11 pg/mL,P<0.05。这些数据表明,GD15给予17-OHPC可改善RUPP大鼠的病理生理,可能通过改善孕期sFlt-1降低的NO实现。