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Binder NK, MacDonald TM, Beard SA, de Alwis N, Tong S, Kaitu’u-Lino TJ, Hannan NJ. Pre-Clinical Investigation of Cardioprotective Beta-Blockers as a Therapeutic Strategy for Preeclampsia. J Clin Med 2021; 10:3384. [PMID: 34362171 PMCID: PMC8348612 DOI: 10.3390/jcm10153384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/23/2021] [Accepted: 07/28/2021] [Indexed: 12/14/2022] Open
Abstract
Despite significant maternal and fetal morbidity, a treatment for preeclampsia currently remains an unmet need in clinical care. As too does the lifelong cardiovascular risks imparted on preeclampsia sufferers. Endothelial dysfunction and end-organ injury are synonymous with both preeclampsia and cardiovascular disease, including heart failure. We propose that beta-blockers, known to improve endothelial dysfunction in the treatment of cardiovascular disease, and specifically known to reduce mortality in the treatment of heart failure, may be beneficial in the treatment of preeclampsia. Here, we assessed whether the beta-blockers carvedilol, bisoprolol, and metoprolol could quench the release of anti-angiogenic factors, promote production of pro-angiogenic factors, reduce markers of inflammation, and reduce endothelial dysfunction using our in vitro pre-clinical preeclampsia models encompassing primary placental tissue and endothelial cells. Here, we show beta-blockers effected a modest reduction in secretion of anti-angiogenic soluble fms-like tyrosine kinase-1 and soluble endoglin and increased expression of pro-angiogenic placental growth factor, vascular endothelial growth factor and adrenomedullin in endothelial cells. Beta-blocker treatment mitigated inflammatory changes occurring after endothelial dysfunction and promoted cytoprotective antioxidant heme oxygenase-1. The positive effects of the beta-blockers were predominantly seen in endothelial cells, with a less consistent response seen in placental cells/tissue. In conclusion, beta-blockers show potential as a novel therapeutic approach in the treatment of preeclampsia and warrant further investigation.
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Affiliation(s)
- Natalie K. Binder
- Translational Obstetrics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg 3084, Australia; (N.K.B.); (T.M.M.); (S.A.B.); (N.d.A.); (S.T.); (T.J.K.-L.)
- Therapeutics Discovery and Vascular Function Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg 3084, Australia
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg 3084, Australia
| | - Teresa M. MacDonald
- Translational Obstetrics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg 3084, Australia; (N.K.B.); (T.M.M.); (S.A.B.); (N.d.A.); (S.T.); (T.J.K.-L.)
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg 3084, Australia
| | - Sally A. Beard
- Translational Obstetrics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg 3084, Australia; (N.K.B.); (T.M.M.); (S.A.B.); (N.d.A.); (S.T.); (T.J.K.-L.)
- Therapeutics Discovery and Vascular Function Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg 3084, Australia
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg 3084, Australia
| | - Natasha de Alwis
- Translational Obstetrics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg 3084, Australia; (N.K.B.); (T.M.M.); (S.A.B.); (N.d.A.); (S.T.); (T.J.K.-L.)
- Therapeutics Discovery and Vascular Function Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg 3084, Australia
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg 3084, Australia
| | - Stephen Tong
- Translational Obstetrics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg 3084, Australia; (N.K.B.); (T.M.M.); (S.A.B.); (N.d.A.); (S.T.); (T.J.K.-L.)
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg 3084, Australia
| | - Tu’uhevaha J. Kaitu’u-Lino
- Translational Obstetrics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg 3084, Australia; (N.K.B.); (T.M.M.); (S.A.B.); (N.d.A.); (S.T.); (T.J.K.-L.)
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg 3084, Australia
- Diagnostics Discovery and Reverse Translation, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg 3084, Australia
| | - Natalie J. Hannan
- Translational Obstetrics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg 3084, Australia; (N.K.B.); (T.M.M.); (S.A.B.); (N.d.A.); (S.T.); (T.J.K.-L.)
- Therapeutics Discovery and Vascular Function Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg 3084, Australia
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg 3084, Australia
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