Institut Cochin, U1016 INSERM, UMR8104 CNRS, Université Paris-Descartes.
Hôpital Européen Georges Pompidou, PARCC, APHP, Paris, France.
J Hypertens. 2018 Jun;36(6):1399-1406. doi: 10.1097/HJH.0000000000001695.
Preeclampsia is a major hypertensive disease caused by pregnancy, inducing proteinuria and increased blood pressure starting from the second half of pregnancy (early preeclampsia) or near the end of pregnancy (late preeclampsia). Pre-symptomatic diagnosis would allow for therapeutic interventions, such as with low-dose aspirin. Among non-invasive methods to explore organ physiology, Doppler ultrasonography (US) and functional blood oxygenation level-dependent (BOLD) MRI (which do not need radioactive contrast agents such as gadolinium) can be used in pregnant women.
In this study, we used US and BOLD MRI to finely characterize the phenotype of preeclampsia induced by the foeto-placental overexpression of the transcription factor storkhead box 1A (STOX1A) in female mice.
We could observe late fetal growth restriction consistent with the placental dysfunction revealed by US and the known association between preeclampsia and intra-uterine growth restriction. On US, uterine and umbilical artery as well as heart and kidney parameters were modified in preeclamptic mice. On BOLD MRI, mean T2* values revealed considerable differences between control and preeclamptic placentas, which suggests altered dynamics of oxygen release and ratio of oxyhemoglobin to deoxyhemoglobin in the model.
These preliminary pre-clinical results suggest that BOLD MRI could be evaluated as a prognostic/diagnostic tool for preeclampsia.
子痫前期是一种由妊娠引起的主要高血压疾病，从妊娠后半期（早发性子痫前期）或妊娠末期（晚发性子痫前期）开始引起蛋白尿和血压升高。症状前诊断可以进行治疗干预，如低剂量阿司匹林治疗。在探索器官生理的非侵入性方法中，多普勒超声（US）和功能血氧水平依赖（BOLD）MRI（不需要放射性造影剂如钆）可用于孕妇。
在这项研究中，我们使用 US 和 BOLD MRI 来精细地表征由转录因子 storkhead box 1A（STOX1A）在雌性小鼠中的胎儿-胎盘过表达引起的子痫前期表型。
我们可以观察到与 US 揭示的胎盘功能障碍一致的晚期胎儿生长受限，以及子痫前期与宫内生长受限之间的已知关联。在 US 上，子宫和脐动脉以及心脏和肾脏参数在子痫前期小鼠中发生改变。在 BOLD MRI 上，平均 T2* 值显示对照和子痫前期胎盘之间存在相当大的差异，这表明模型中氧释放动力学和氧合血红蛋白与脱氧血红蛋白的比值发生了改变。
这些初步的临床前结果表明，BOLD MRI 可以作为子痫前期的预后/诊断工具进行评估。
