Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, MS.
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS.
Am J Obstet Gynecol MFM. 2021 Jan;3(1):100275. doi: 10.1016/j.ajogmf.2020.100275. Epub 2020 Oct 27.
Preeclampsia is characterized by a new onset of hypertension during pregnancy and is associated with autoantibodies against the angiotensin II type 1 receptor and oxidative stress. There is growing evidence for mitochondrial dysfunction in preeclampsia, however, the culprits for mitochondrial dysfunction are still being defined. We previously demonstrated that angiotensin II type 1 autoantibodies cause renal, placental, and endothelial mitochondrial dysfunction in pregnant rats. However, the role of the angiotensin II type 1 autoantibodies in endothelial mitochondrial function in response to sera from preeclamptics is unknown. Thus, we hypothesized that circulating factors, such as the angiotensin II type 1 autoantibodies, during preeclampsia would negatively impact the vascular endothelial mitochondrial function in human umbilical vein endothelial cells.
The objective of the study was to determine a role for circulating angiotensin II type 1 autoantibodies to cause endothelial mitochondrial reactive oxygen species and dysfunction in preeclampsia compared to normal pregnant controls.
Immediately after delivery, sera was collected from preeclamptic patients and normal pregnant controls. The mitochondrial reactive oxygen species were determined from the cells treated overnight with 10% sera from either the control or preeclamptic patients with and without the antiotension II type 1 autoantibodies inhibitor peptide ('n7AAc').
Preeclampsia patients at <34 weeks' gestation exhibited an elevated mean arterial blood pressure. Cells treated with serum from the preeclampsia patients at <34 weeks gestational age showed significantly (P<0.05) greater mitochondrial oxidative stress and reduced respiration than cells treated with the control sera, and these abnormalities were restored with 'n7AAc'.
This study demonstrates that endothelial mitochondrial dysfunction occurs in response to circulating factors, especially in response to serum from preterm preeclampsia patients, and can be restored by blocking circulating angiotensin II type 1 autoantibodies, thereby indicating a potential new therapeutic target for preeclampsia.
子痫前期的特征是妊娠期间新发生的高血压,并与血管紧张素 II 型 1 受体自身抗体和氧化应激有关。越来越多的证据表明子痫前期存在线粒体功能障碍,然而,导致线粒体功能障碍的罪魁祸首仍在确定之中。我们之前的研究表明,血管紧张素 II 型 1 型自身抗体导致妊娠大鼠的肾脏、胎盘和内皮线粒体功能障碍。然而,子痫前期患者血清中血管紧张素 II 型 1 型自身抗体对内皮线粒体功能的作用尚不清楚。因此,我们假设循环因子,如血管紧张素 II 型 1 型自身抗体,在子痫前期会对人脐静脉内皮细胞的血管内皮线粒体功能产生负面影响。
本研究的目的是确定循环血管紧张素 II 型 1 型自身抗体在子痫前期引起内皮线粒体活性氧和功能障碍中的作用,与正常妊娠对照组进行比较。
分娩后立即从子痫前期患者和正常妊娠对照组中采集血清。用 10%来自对照组或子痫前期患者的血清处理细胞过夜,然后用或不用血管紧张素 II 型 1 型自身抗体抑制剂肽('n7AAc'),测定细胞的线粒体活性氧。
<34 周妊娠的子痫前期患者表现出平均动脉血压升高。用来自<34 周妊娠的子痫前期患者的血清处理的细胞显示出明显(P<0.05)更高的线粒体氧化应激和降低的呼吸,而用对照血清处理的细胞则没有,这些异常用 'n7AAc'恢复。
本研究表明,内皮线粒体功能障碍是对循环因子的反应,特别是对来自早产子痫前期患者的血清的反应,并且可以通过阻断循环血管紧张素 II 型 1 型自身抗体来恢复,从而为子痫前期提供了一个新的潜在治疗靶点。