Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
Am J Respir Cell Mol Biol. 2022 Jan;66(1):86-95. doi: 10.1165/rcmb.2021-0307OC.
In preeclamptic pregnancies, a variety of intrauterine alterations lead to abnormal placentation, release of inflammatory and/or antiangiogenic factors, and subsequent fetal growth restriction with significant potential to cause a primary insult to the developing fetal lung. Thus, modulation of the maternal intrauterine environment may be a key therapeutic avenue to prevent preeclampsia-associated developmental lung injury. A biologic therapy of interest is mesenchymal stromal cell-derived extracellular vesicles (MEx), which we have previously shown to ameliorate preeclamptic physiology through intrauterine immunomodulation. To evaluate the therapeutic potential of MEx to improve developmental lung injury in experimental preeclampsia, using the heme oxygenase-1-null mouse () model, preeclamptic pregnant dams were administered intravenous antenatal MEx treatment during each week of pregnancy followed by analysis of fetal and postnatal lung tissues, amniotic fluid protein profiles, and lung explant and amniotic fluid cocultures in comparison with control and untreated preeclamptic pregnancies. We first identified that a preeclamptic intrauterine environment had a significant adverse impact on fetal lung development, including alterations in fetal lung developmental gene profiles in addition to postnatal alveolar and bronchial changes. Amniotic fluid proteomic analysis and fetal lung explant and amniotic fluid cocultures further demonstrated that maternally administered MEx altered the expression of multiple inflammatory mediators in the preeclamptic intrauterine compartment, resulting in the normalization of fetal lung branching morphogenesis and developmental gene expression. Our evaluation of fetal and postnatal parameters overall suggests that antenatal MEx treatment may provide a highly valuable preventative therapeutic modality for amelioration of lung development in preeclamptic disease.
在子痫前期妊娠中,各种宫内改变导致异常胎盘形成、炎症和/或抗血管生成因子释放,以及随后的胎儿生长受限,这对发育中的胎儿肺有很大的潜在损伤。因此,调节母体宫内环境可能是预防子痫前期相关发育性肺损伤的关键治疗途径。一种有前景的生物治疗方法是间充质基质细胞衍生的细胞外囊泡(MEx),我们之前已经证明,通过宫内免疫调节可以改善子痫前期的生理状况。为了评估 MEx 通过改善实验性子痫前期胎儿肺部发育的治疗潜力,我们使用血红素加氧酶-1 敲除小鼠()模型,在子痫前期妊娠期间,每周对胎盘内静脉给予产前 MEx 治疗,然后分析胎儿和产后肺部组织、羊水蛋白谱,以及肺部组织外植体和羊水共培养物,并与对照和未经治疗的子痫前期妊娠进行比较。我们首先确定,子痫前期的宫内环境对胎儿肺部发育有显著的不利影响,包括胎儿肺部发育基因谱的改变,以及产后肺泡和支气管的变化。羊水蛋白质组学分析和胎儿肺部组织外植体和羊水共培养物进一步表明,母体给予 MEx 改变了子痫前期宫内环境中多种炎症介质的表达,导致胎儿肺部分支形态发生和发育基因表达的正常化。我们对胎儿和产后参数的综合评估表明,产前 MEx 治疗可能为改善子痫前期疾病中的肺部发育提供一种非常有价值的预防性治疗方法。
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