Department of Pharmacology.
Department of Obstetrics & Gynecology.
JCI Insight. 2018 Oct 4;3(19):99403. doi: 10.1172/jci.insight.99403.
Copeptin, a marker of arginine vasopressin (AVP) secretion, is elevated throughout human pregnancies complicated by preeclampsia (PE), and AVP infusion throughout gestation is sufficient to induce the major phenotypes of PE in mice. Thus, we hypothesized a role for AVP in the pathogenesis of PE. AVP infusion into pregnant C57BL/6J mice resulted in hypertension, renal glomerular endotheliosis, intrauterine growth restriction, decreased placental growth factor (PGF), altered placental morphology, placental oxidative stress, and placental gene expression consistent with human PE. Interestingly, these changes occurred despite a lack of placental hypoxia or elevations in placental fms-like tyrosine kinase-1 (FLT1). Coinfusion of AVP receptor antagonists and time-restricted infusion of AVP uncovered a mid-gestational role for the AVPR1A receptor in the observed renal pathologies, versus mid- and late-gestational roles for the AVPR2 receptor in the blood pressure and fetal phenotypes. These findings demonstrate that AVP is sufficient to initiate phenotypes of PE in the absence of placental hypoxia, and indicate that AVP may mechanistically (independently, and possibly synergistically with hypoxia) contribute to the development of clinical signs of PE in specific subtypes of human PE. Additionally, they identify divergent and gestational time-specific signaling mechanisms that mediate the development of PE phenotypes in response to AVP.
copeptin,精氨酸加压素 (AVP) 分泌的标志物,在所有妊娠合并先兆子痫 (PE) 的患者中均升高,而整个孕期的 AVP 输注足以在小鼠中诱导 PE 的主要表型。因此,我们假设 AVP 在 PE 的发病机制中起作用。将 AVP 输注到怀孕的 C57BL/6J 小鼠中会导致高血压、肾小球内皮细胞病、宫内生长受限、胎盘生长因子 (PGF) 减少、胎盘形态改变、胎盘氧化应激和胎盘基因表达与人类 PE 一致。有趣的是,尽管胎盘没有缺氧或胎盘 fms 样酪氨酸激酶-1 (FLT1) 升高,但这些变化仍会发生。AVP 受体拮抗剂的共输注和 AVP 的限时输注揭示了 AVPR1A 受体在观察到的肾脏病理中的中期妊娠作用,而 AVPR2 受体在血压和胎儿表型中的中晚期妊娠作用。这些发现表明,在没有胎盘缺氧的情况下,AVP 足以引发 PE 的表型,并表明 AVP 可能通过机制(独立于,并且可能与缺氧协同)导致特定类型的人类 PE 中出现 PE 的临床体征。此外,它们还确定了不同的和妊娠时间特异性的信号转导机制,这些机制介导了对 AVP 的反应中 PE 表型的发展。