Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, China.
Eur Rev Med Pharmacol Sci. 2023 Dec;27(24):11961-11974. doi: 10.26355/eurrev_202312_34795.
Cold exposure (CE) before birth is one of the initial stressors that may impact mammalian pregnancy, changing placental and fetal development and affecting the health of the offspring. While glucocorticoids (GCs) participate in the body's response to the stress of CE, the specific mechanisms of their action are unclear. This study aims to determine the effect of CE stress on the placenta and to test whether stress, caused by cold exposure in pregnancy impairs fetal development by changing placental angiogenesis via excessive GC expression.
CE rat model was created by exposing 30 SD rats to cold preconception, or during the first, second, and third weeks of pregnancy. Serum cortisol and soluble fms-like tyrosine kinase-1 (sFlt-1) expression levels, physiological index changes (food intake, body weight change and blood pressure), and pregnancy outcomes (fetal rat weight, number of live fetal rats, and placental weight) were collected at baseline and at different time points after the conception. Protein expression levels of 11 β-hydroxysteroid dehydrogenase 2 (11β-HSD2), glucocorticoid receptor, vascular endothelial growth factor A (VEGF-A), placental growth factor (PIGF), and sFlt-1 in placental tissues were measured by western blotting. Cytokeratin (CK) and laminin (LN) in trophoblasts, and α-actin in vascular smooth muscle of the spiral arteries of pregnant rats after the systemic cold treatment were assessed by immunofluorescence and visualized by fluorescent microscopy. To test the effect of 11β-HSD2 levels on the placental recasting, human first-trimester extravillous trophoblast cells (HTR8/SVneo) underwent knockdown using specific 11β-HSD2 siRNA constructs. Expression levels of 11β-HSD2 were analyzed by quantitative real-time PCR (qPCR) and into HTR8 cells, and the expression levels of the 11β-HSD2 gene in each group were measured using qPCR. Cell migration and invasion was assessed by Transwell migration assay, and sFlt-1 levels in HTR8 cells were measured by ELISA.
CE pre-conception led to consistently increasing serum corticosterone and sFlt-1 levels throughout pregnancy, and persistently increased diastolic blood pressure (DBP) in rat CE model compared to control animals. CE during the second week of gestation (Gp.3) was associated with significantly lower placental weight (p=0.0003). Cold exposure in the third week (Gp.4) was associated with significantly (p=0.001) lower fetal weight. CE pre-conception was associated with significantly decreased placental levels of 11β-HSD2, glucocorticoid receptor, VEGF-A, PIGF, and sFlt-1 proteins and α-actin compared to the control group. Silencing 11β-HSD2 by siRNA led to reduced cell migrations and invasion, and markedly increased expression levels of sFlt-1 in HTR8/SVneo cells (p<0.05).
Pre-conception cold exposure and during early pregnancy leads to increased GCs levels and impaired placental 11β-HSD2 activity. We suggest that the subsequent 11β-HSD2-induced increase in the sFlt-1expression during early pregnancy may affect placental vascular remodeling and change placental morphological structure and function.
产前冷暴露是影响哺乳动物妊娠的初始应激源之一,可改变胎盘和胎儿的发育,并影响后代的健康。虽然糖皮质激素(GCs)参与了机体对产前冷暴露应激的反应,但它们作用的具体机制尚不清楚。本研究旨在确定产前冷暴露对胎盘的影响,并通过改变胎盘血管生成来验证冷暴露是否通过过度表达 GC 而损害胎儿发育。
通过在受孕前、受孕第一、二、三周暴露 30 只 SD 大鼠来建立 CE 大鼠模型。收集基础值和受孕后不同时间点的血清皮质醇和可溶性 fms 样酪氨酸激酶-1(sFlt-1)表达水平、生理指标变化(摄食量、体重变化和血压)以及妊娠结局(胎鼠体重、活胎鼠数和胎盘重量)。通过蛋白质印迹法测量胎盘组织中 11β-羟类固醇脱氢酶 2(11β-HSD2)、糖皮质激素受体、血管内皮生长因子 A(VEGF-A)、胎盘生长因子(PIGF)和 sFlt-1 的蛋白表达水平。通过免疫荧光和荧光显微镜观察大鼠胎盘滋养层细胞中的细胞角蛋白(CK)和层粘连蛋白(LN)以及血管平滑肌中的α-肌动蛋白。为了检测 11β-HSD2 水平对胎盘重塑的影响,用特异性 11β-HSD2 siRNA 构建体对人早孕绒毛外滋养层细胞(HTR8/SVneo)进行敲低。通过 qPCR 分析 HTR8 细胞中 11β-HSD2 的表达水平,并测量每组中 11β-HSD2 基因的表达水平。通过 Transwell 迁移实验评估细胞迁移和侵袭,通过 ELISA 测量 HTR8 细胞中的 sFlt-1 水平。
CE 预受孕导致整个妊娠期间血清皮质酮和 sFlt-1 水平持续升高,并导致大鼠 CE 模型的舒张压(DBP)持续升高。与对照组相比,妊娠第 2 周(Gp.3)的 CE 与胎盘重量显著降低(p=0.0003)相关。妊娠第 3 周(Gp.4)的冷暴露与胎儿体重显著降低(p=0.001)相关。与对照组相比,CE 预受孕导致胎盘 11β-HSD2、糖皮质激素受体、VEGF-A、PIGF 和 sFlt-1 蛋白以及 α-肌动蛋白水平显著降低。用 siRNA 沉默 11β-HSD2 导致 HTR8/SVneo 细胞的迁移和侵袭减少,sFlt-1 表达水平显著增加(p<0.05)。
受孕前冷暴露和妊娠早期导致 GCs 水平升高和胎盘 11β-HSD2 活性受损。我们认为,随后妊娠早期 11β-HSD2 诱导的 sFlt-1 表达增加可能会影响胎盘血管重塑并改变胎盘形态结构和功能。