Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
Department of Perinatology, Olmsted Medical Center, Rochester, Minnesota, USA; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA.
Kidney Int. 2021 Mar;99(3):646-656. doi: 10.1016/j.kint.2020.09.034. Epub 2020 Nov 2.
Preeclampsia is a pregnancy-specific hypertensive disorder characterized by proteinuria, and vascular injury in the second half of pregnancy. We hypothesized that endothelium-dependent vascular dysfunction is present in a murine model of preeclampsia based on administration of human preeclamptic sera to interleukin-10-/- mice and studied mechanisms that underlie vascular injury. Pregnant wild type and IL-10-/- mice were injected with either normotensive or severe preeclamptic patient sera (sPE) during gestation. A preeclampsia-like phenotype was confirmed by blood pressure measurements; assessment of albuminuria; measurement of angiogenic factors; demonstration of foot process effacement and endotheliosis in kidney sections; and by accumulation of glycogen in placentas from IL-10-/- mice injected with sPE sera (IL-10-/-sPE). Vasomotor function of isolated aortas was assessed. The IL-10-/-sPE murine model demonstrated significantly augmented aortic contractions to phenylephrine and both impaired endothelium-dependent and, to a lesser extent, endothelium-independent relaxation compared to wild type normotensive mice. Treatment of isolated aortas with indomethacin, a cyclooxygenase inhibitor, improved, but failed to normalize contraction to phenylephrine to that of wild type normotensive mice, suggesting the additional contribution from nitric oxide downregulation and effects of indomethacin-resistant vasoconstricting factors. In contrast, indomethacin normalized relaxation of aortas derived from IL-10-/-sPE mice. Thus, our results identify the role of IL-10 deficiency in dysregulation of the cyclooxygenase pathway and vascular dysfunction in the IL-10-/-sPE murine model of preeclampsia and point towards a possible contribution of nitric oxide dysregulation. These compounds and related mechanisms may serve both as diagnostic markers and therapeutic targets for preventive and treatment strategies in preeclampsia.
子痫前期是一种妊娠特异性高血压疾病,其特征是在妊娠后半期出现蛋白尿和血管损伤。我们假设,基于向白细胞介素-10 缺陷型(IL-10-/-)小鼠给予子痫前期患者血清,在子痫前期的小鼠模型中存在内皮依赖性血管功能障碍,并研究了导致血管损伤的机制。在妊娠期间,将正常血压的或严重子痫前期患者的血清(sPE)注射到野生型和 IL-10-/- 小鼠体内。通过血压测量、白蛋白尿评估、血管生成因子测量、肾脏切片中足突融合和内皮细胞病的表现以及注射 sPE 血清的 IL-10-/- 小鼠胎盘内糖原积累,来确认子痫前期样表型(IL-10-/-sPE)。还评估了分离的主动脉的血管舒缩功能。与野生型正常血压小鼠相比,IL-10-/-sPE 小鼠的主动脉对苯肾上腺素的收缩明显增强,并且内皮依赖性和在较小程度上的非内皮依赖性舒张均受损。用环氧化酶抑制剂吲哚美辛处理分离的主动脉可改善,但不能使苯肾上腺素的收缩恢复到野生型正常血压小鼠的水平,这表明一氧化氮下调和吲哚美辛抵抗性血管收缩因子的作用也有贡献。相比之下,吲哚美辛可使 IL-10-/-sPE 小鼠的主动脉舒张正常化。因此,我们的结果确定了 IL-10 缺乏在子痫前期的 IL-10-/-sPE 小鼠模型中对环氧化酶途径的失调和血管功能障碍的作用,并指出一氧化氮失调可能有贡献。这些化合物和相关机制可能既作为诊断标志物,也作为子痫前期预防和治疗策略的治疗靶点。