Varas-Godoy Manuel, Acuña-Gallardo Stephanie, Venegas-Duarte Sebastian, Hill Charlotte, Caceres-Verschae Albano, Realini Ornella, Monteiro Lara J, Zavala Gabriela, Khoury Maroun, Romero Roberto, Rice Gregory, Illanes Sebastian E
Laboratory of Reproductive Biology, Center for Biomedical Research, Faculty of Medicine, Universidad de Los Andes, Santiago, Chile.
Department of Obstetrics and Gynaecology, Faculty of Medicine, Universidad de los Andes, Santiago, Chile.
Stem Cells Int. 2019 Jan 27;2019:1916542. doi: 10.1155/2019/1916542. eCollection 2019.
Preeclampsia is a pregnancy-specific disorder defined by the new onset of hypertension and proteinuria after 20 weeks of gestation. Although its precise etiology is still unknown, there is evidence suggesting that it may be a consequence of impaired decidual and stromal cell function. Recently, a stem cell population derived from endometrial tissue and isolated from menstrual effluent called menstrual stem cells (MenSCs) has been identified. MenSCs exhibit important angiogenic and inflammatory properties that may contribute to both normal and pathological complications of implantation and placentation, including preeclampsia. We hypothesized that the angiogenic and inflammatory activity of MenSCs is altered in women who have a past history of preeclampsia and that this phenotype persists postpartum. The primary outcome measures were stromal progenitor cell formation, induction of endothelial tube formation, and release of proinflammatory cytokines. MenSCs obtained from women with a previous normal or preeclamptic pregnancy displayed similar phenotypic characteristics, tri-differentiation capacity, and proliferation. MenSCs derived from women who had preeclampsia on their previous pregnancy had reduced angiogenic capacity (~30% fewer junctions and nodes, < 0.05) and stromal progenitor cell formation (<50% measured at a serial dilution of 1 : 10.000, < 0.05) when compared to controls. , MenSCs obtained from patients with a history of preeclampsia expressed less endoglin and secreted less VEGF but more IL-6 than controls did. These data are consistent with the hypothesis that the angiogenic and inflammatory properties of MenSCs of women with a previous pregnancy complicated by preeclampsia have reduced angiogenic capacity and are more proinflammatory than those of MenSCs of women with a previous normal pregnancy. This altered phenotype of MenSCs observed following preeclampsia could either be present before the development of the pathology, predisposing the endometrial milieu to and consequently leading to limited vascular remodeling, or be a consequence of preeclampsia itself. The former may afford opportunity for targeted therapeutic intervention; the latter, a putative biomarker for future risk of pregnancy complications.
子痫前期是一种妊娠特有的疾病,定义为妊娠20周后新出现的高血压和蛋白尿。尽管其确切病因仍不清楚,但有证据表明它可能是蜕膜和基质细胞功能受损的结果。最近,一种从子宫内膜组织中分离出来的、存在于月经流出物中的干细胞群体——月经干细胞(MenSCs)被鉴定出来。MenSCs具有重要的血管生成和炎症特性,这可能导致着床和胎盘形成的正常及病理并发症,包括子痫前期。我们假设,有子痫前期病史的女性,其MenSCs的血管生成和炎症活性会发生改变,且这种表型在产后持续存在。主要观察指标为基质祖细胞形成、内皮管形成诱导及促炎细胞因子释放。从既往妊娠正常或子痫前期的女性获得的MenSCs表现出相似的表型特征、三向分化能力和增殖能力。与对照组相比,既往妊娠为子痫前期的女性来源的MenSCs的血管生成能力降低(连接点和节点减少约30%,P<0.05),基质祖细胞形成减少(在1∶10000系列稀释时测量减少<50%,P<0.05)。此外,有子痫前期病史的患者来源的MenSCs比对照组表达更少的内皮糖蛋白,分泌更少的血管内皮生长因子(VEGF),但分泌更多的白细胞介素-6(IL-6)。这些数据与以下假设一致:既往妊娠合并子痫前期的女性的MenSCs的血管生成和炎症特性,其血管生成能力降低,且比既往妊娠正常的女性的MenSCs更具促炎性。子痫前期后观察到的MenSCs的这种改变的表型,要么在病理发展之前就已存在,使子宫内膜环境易发生这种情况,从而导致有限的血管重塑,要么是子痫前期本身的结果。前者可能为靶向治疗干预提供机会;后者则是未来妊娠并发症风险的潜在生物标志物。