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Louw V, Brownfoot F, Cluver C, Decloedt E, Kellermann T. An LC-MS/MS method for the simultaneous quantitation of sulfasalazine and sulfapyridine in human placenta. J Pharm Biomed Anal 2023; 235:115633. [PMID: 37597383 DOI: 10.1016/j.jpba.2023.115633] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/03/2023] [Accepted: 08/06/2023] [Indexed: 08/21/2023]
Abstract
Sulfasalazine has been identified as a candidate molecule to be investigated as an intervention to treat preterm pre-eclampsia during pregnancy. However, placental exposure of sulfasalazine and its systemically absorbed metabolite, sulfapyridine, is unknown. A robust liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated to simultaneously quantitate these analytes in human placenta with an application to a pilot clinical trial. The placental tissue was homogenised using a water:methanol (1:1, v/v) mixture, followed by sample extraction using both protein precipitation and solid phase extraction. Sulfasalazine-d4 and sulfapyridine-d4 were used as internal standards. An Agilent Poroshell EC-C18 (3.0 ×100 mm, 2.7 µm) column was used for chromatographic separation, with gradient elution employed at a flow rate of 0.450 mL/min over a total run time of seven minutes. The mobile phases consisted of water with 0.1% formic acid (mobile phase A) and acetonitrile:methanol (90:10, v/v) with 0.1% formic acid (mobile phase B). A Shimadzu-8040 mass spectrometer was operated in multiple reaction monitoring (MRM) mode using positive electrospray ionisation (ESI). For both analytes, the assay was validated over the range 30-30,000 ng/mL, or 150-150,000 ng/g. During inter-day validations (n = 18), the average accuracies of quality controls ranged from 101.6% to 112.7% with corresponding precisions of 4.4-6.7% for sulfasalazine, and from 97.4% to 108.4%, with corresponding precisions of 3.7-10.0% for sulfapyridine. No significant matrix effects were observed, and the method proved to be sensitive and specific for both analytes. This study presents the first validated analytical method for quantifying sulfasalazine and sulfapyridine in human placenta as part of a pilot clinical trial to generate preliminary data on its pharmacokinetics and efficacy as in intervention for preterm pre-eclampsia.
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Affiliation(s)
- Vanessa Louw
- Division of Clinical Pharmacology, Department of Medicine, Stellenbosch University, Cape Town, South Africa
| | - Fiona Brownfoot
- Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital Heidelberg, Victoria, Australia
| | - Catherine Cluver
- Mercy Perinatal, Mercy Hospital Heidelberg, Victoria, Australia; Department of Obstetrics and Gynaecology, Stellenbosch University, Cape Town, South Africa
| | - Eric Decloedt
- Division of Clinical Pharmacology, Department of Medicine, Stellenbosch University, Cape Town, South Africa
| | - Tracy Kellermann
- Division of Clinical Pharmacology, Department of Medicine, Stellenbosch University, Cape Town, South Africa.
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Chaiworapongsa T, Romero R, Gotsch F, Suksai M, Gallo DM, Jung E, Krieger A, Chaemsaithong P, Erez O, Tarca AL. Preeclampsia at term can be classified into 2 clusters with different clinical characteristics and outcomes based on angiogenic biomarkers in maternal blood. Am J Obstet Gynecol 2023; 228:569.e1-569.e24. [PMID: 36336082 PMCID: PMC10149598 DOI: 10.1016/j.ajog.2022.11.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND An antiangiogenic state has emerged as a mechanism of disease in preeclampsia. Angiogenic biomarkers are used in the risk assessment of this syndrome, particularly of early disease. The role of an antiangiogenic state in late preeclampsia is unclear. OBJECTIVE This study aimed to determine the prevalence, characteristics, and clinical significance of angiogenic/antiangiogenic factor abnormalities in women with preeclampsia stratified according to gestational age at delivery. STUDY DESIGN Two studies were conducted: (1) a longitudinal nested case-control study comprising women with preeclampsia (n=151) and a control group (n=540); and (2) a case series of patients with preeclampsia (n=452). In patients with preeclampsia, blood was collected at the time of diagnosis. Plasma concentrations of placental growth factor and soluble fms-like tyrosine kinase-1 were determined by enzyme-linked immunosorbent assays. An abnormal angiogenic profile was defined as a plasma ratio of placental growth factor and soluble fms-like tyrosine kinase-1 expressed as a multiple of the median <10th percentile for gestational age based on values derived from the longitudinal study. The proportion of patients diagnosed with preeclampsia who had an abnormal angiogenic profile was determined in the case-series participants and stratified by gestational age at delivery into early (≤34 weeks), intermediate (34.1-36.9 weeks), and term (≥37 weeks) preeclampsia. The demographics, clinical characteristics, and pregnancy outcomes of women with preeclampsia with and without an abnormal angiogenic profile were compared. RESULTS The prevalence of an abnormal angiogenic profile was higher in preterm than in term preeclampsia (for early, intermediate, and term in the case-control study: 90%, 100%, and 39%; for the case series: 98%, 80%, and 55%, respectively). Women with preeclampsia at term who had an abnormal angiogenic profile were more frequently nulliparous (57% vs 35%), less likely to smoke (14% vs 26%), at greater risk for maternal (14% vs 5%) or neonatal (7% vs 1%) complications, and more often had placental lesions consistent with maternal vascular malperfusion (42% vs 23%; all, P<.05) than those without an abnormal profile. Women with preeclampsia at term who had a normal angiogenic profile had a higher frequency of chronic hypertension (36% vs 21%) and were more likely to have class ≥2 obesity (41% vs 23%) than those with an abnormal profile (both, P<.05). CONCLUSION Patients with early preeclampsia had an abnormal angiogenic profile in virtually all cases, whereas only 50% of women with preeclampsia at term had such abnormalities. The profile of angiogenic biomarkers can be used to classify patients with preeclampsia at term, on the basis of mechanisms of disease, into 2 clusters, which have different demographics, clinical characteristics, and risks of adverse maternal and neonatal outcomes. These findings provide a simple approach to classify preeclampsia at term and have implications for future clinical care and research.
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Affiliation(s)
- Tinnakorn Chaiworapongsa
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI.
| | - Roberto Romero
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI; Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI; Detroit Medical Center, Detroit, MI.
| | - Francesca Gotsch
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Manaphat Suksai
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Dahiana M Gallo
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Eunjung Jung
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Arthur Krieger
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI
| | - Piya Chaemsaithong
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI; Department of Obstetrics and Gynecology, Mahidol University, Bangkok, Thailand
| | - Offer Erez
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI; Department of Obstetrics and Gynecology, HaEmek Medical Center, Afula, Israel
| | - Adi L Tarca
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI; Department of Computer Science, Wayne State University College of Engineering, Detroit, MI
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3
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Wang X, Travis OK, Shields CA, Tardo GA, Giachelli C, Nutter CW, Glenn HL, Cooper OG, Davis T, Thomas R, Williams JM, Cornelius DC. NLRP3 inhibition improves maternal hypertension, inflammation, and vascular dysfunction in response to placental ischemia. Am J Physiol Regul Integr Comp Physiol 2023; 324:R556-R567. [PMID: 36847598 PMCID: PMC10069976 DOI: 10.1152/ajpregu.00192.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 03/01/2023]
Abstract
Preeclampsia (PE) is a pregnancy-specific hypertensive disorder with end-organ damage that presents after 20 wk of gestation. PE pathophysiology often includes vascular dysfunction and increased inflammation that continues to damage patient health even after PE resolves. Currently, there is no cure for PE beyond delivery of the fetal-placental unit. Previous clinical studies have identified elevated placental NLRP3 expression in patients with PE and suggest NLRP3 as a potential therapeutic target. In this study, we examined the effect of NLRP3 inhibition on PE pathophysiology in the reduced uterine perfusion pressure (RUPP) model rat using MCC950 (20 mg/kg/day) or esomeprazole (3.5 mg/kg/day). We hypothesized that increased NLRP3 in response to placental ischemia impairs anti-inflammatory IL-33 signaling to induce T-helper 17 cell (TH17) and cytolytic NK cell (cNK) activation, which is known to mediate oxidative stress and vascular dysfunction leading to maternal HTN and intrauterine growth restriction. RUPP rats had significantly higher placental NLRP3 expression, maternal blood pressure, fetal reabsorption rate, vascular resistance, oxidative stress, cNKs and TH17s, and decreased IL-33 compared with normal pregnant (NP) rats. NLRP3 inhibition, with either treatment, significantly reduced placental NLRP3 expression, maternal blood pressure, fetal reabsorption rates, vascular resistance, oxidative stress, cNK, and TH17 populations in RUPP rats. Based on our findings, NLRP3 inhibition reduces PE pathophysiology and esomeprazole may be a potential therapeutic for PE treatment.
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Affiliation(s)
- Xi Wang
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Olivia K Travis
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Corbin A Shields
- Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - G Ann Tardo
- Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Chelsea Giachelli
- Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Christopher W Nutter
- Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Hannah L Glenn
- Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Olive G Cooper
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Tatiana Davis
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Rashauna Thomas
- Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Jan M Williams
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Denise C Cornelius
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
- Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
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Binder NK, de Alwis N, Beard S, Kadife E, Harper A, Kaitu'u-Lino TJ, Brownfoot FC, Hannan NJ. Sulfasalazine for the treatment of preeclampsia in a nitric oxide synthase antagonist mouse model. Placenta 2023; 132:20-26. [PMID: 36623415 DOI: 10.1016/j.placenta.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 12/08/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Development of a therapeutic that targets the pathophysiological elements of preeclampsia would be a major advance for obstetrics, with potential to save the lives of countless mothers and babies. We recently identified anti-inflammatory drug sulfasalazine as a prospective candidate therapeutic for treatment of preeclampsia. In primary human cells and tissues in vitro, sulfasalazine potently decreased secretion of anti-angiogenic sFlt-1 and sENG, increased production of pro-angiogenic PlGF, mitigated endothelial dysfunction, and promoted whole vessel vasodilation. METHODS Using nitric oxide synthase antagonist Nω-Nitro-l-arginine methyl ester hydrochloride, a preeclampsia-like phenotype was induced in pregnant mice, including high blood pressure, fetal growth restriction, and elevated circulating sFlt-1. Mice were treated with sulfasalazine or vehicle from gestational day (D)13.5, with blood pressure measurements across gestation, fetal measurements at D17.5, and wire myograph assessment of vasoactivity. RESULTS Sulfasalazine had a modest effect on blood pressure, decreasing diastolic and mean blood pressure on D13.5, but not later in gestation, or systolic blood pressure. Sulfasalazine was not able to rescue fetal growth, in male or female fetuses. There was a suggestion of improved vasoactivity with sulfasalazine, but further clarification is required. DISCUSSION In this mouse model of preeclampsia, sulfasalazine did not sustain reductions in blood pressure nor affect fetal parameters of size and weight, both desirable attributes of a viable preeclampsia therapeutic. While these data suggest sulfasalazine might improve vasoactivity, murine toxicity considerations limited the dose range of sulfasalazine that could be tested in the current study.
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Affiliation(s)
- Natalie K Binder
- Therapeutics Discovery and Vascular Function, Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital for Women, Victoria, Australia
| | - Natasha de Alwis
- Therapeutics Discovery and Vascular Function, Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital for Women, Victoria, Australia
| | - Sally Beard
- Therapeutics Discovery and Vascular Function, Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital for Women, Victoria, Australia
| | - Elif Kadife
- Obstetric Diagnostics and Therapeutics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital for Women, Victoria, Australia
| | - Alesia Harper
- Obstetric Diagnostics and Therapeutics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital for Women, Victoria, Australia
| | - Tu'uhevaha J Kaitu'u-Lino
- Diagnostics Discovery and Reverse Translation, Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital for Women, Victoria, Australia
| | - Fiona C Brownfoot
- Obstetric Diagnostics and Therapeutics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital for Women, Victoria, Australia
| | - Natalie J Hannan
- Therapeutics Discovery and Vascular Function, Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital for Women, Victoria, Australia.
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5
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Kadife E, Hannan N, Harper A, Binder N, Beard S, Brownfoot FC. Hydroxychloroquine reduces soluble Flt-1 secretion from human cytotrophoblast, but does not mitigate markers of endothelial dysfunction in vitro. PLoS One 2022; 17:e0271560. [PMID: 36417467 PMCID: PMC9683551 DOI: 10.1371/journal.pone.0271560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/04/2022] [Indexed: 11/26/2022] Open
Abstract
Preeclampsia is a multi-system disease that can have severe, even fatal implications for the mother and fetus. Abnormal placentation can lead to ischaemic tissue injury and placental inflammation. In turn, the placenta releases anti-angiogenic factors into the maternal circulation. These systemically act to neutralise angiogenic factors causing endothelial dysfunction causing preeclampsia. Hydroxychloroquine is an immune modulating drug that is considered safe in pregnancy. There is epidemiological evidence suggesting it may reduce the risk of preeclampsia. Here, we examined the effects hydroxychloroquine on the production and secretion of sFlt-1, soluble endoglin (sENG), placental growth factor (PlGF) and vascular endothelial growth factor (VEGF) in primary human placenta, cytotrophoblasts and umbilical vein endothelial cells (endothelial cell model). Hydroxychloroquine treatment decreased mRNA expression of two sFlt-1 isoforms and its protein secretion. sENG was not reduced. Hydroxychloroquine treatment increased secretion of pro-angiogenic factor PIGF from endothelial cells. It did not significantly reduce the expression of the endothelial cell inflammation marker, ET-1, and inflammation induced expression of the adhesion molecule, VCAM. Hydroxychloroquine could not overcome leukocyte adhesion to endothelial cells. Hydroxychloroquine mitigates features of preeclampsia, but it does not reduce key markers of endothelial dysfunction.
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Affiliation(s)
- Elif Kadife
- Department of Obstetrics and Gynaecology, Obstetric Diagnostics and Therapeutics Group, University of Melbourne, Melbourne, Victoria, Australia
- Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia
| | - Natalie Hannan
- Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, Therapeutics Discovery and Vascular Function in Pregnancy, University of Melbourne, Melbourne, Victoria, Australia
| | - Alesia Harper
- Department of Obstetrics and Gynaecology, Obstetric Diagnostics and Therapeutics Group, University of Melbourne, Melbourne, Victoria, Australia
- Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia
| | - Natalie Binder
- Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, Therapeutics Discovery and Vascular Function in Pregnancy, University of Melbourne, Melbourne, Victoria, Australia
| | - Sally Beard
- Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, Therapeutics Discovery and Vascular Function in Pregnancy, University of Melbourne, Melbourne, Victoria, Australia
| | - Fiona C. Brownfoot
- Department of Obstetrics and Gynaecology, Obstetric Diagnostics and Therapeutics Group, University of Melbourne, Melbourne, Victoria, Australia
- Mercy Perinatal, Mercy Hospital for Women, Melbourne, Victoria, Australia
- * E-mail:
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de Alwis N, Fato BR, Beard S, Binder NK, Kaitu’u-Lino TJ, Onda K, Hannan NJ. Assessment of the Proton Pump Inhibitor, Esomeprazole Magnesium Hydrate and Trihydrate, on Pathophysiological Markers of Preeclampsia in Preclinical Human Models of Disease. Int J Mol Sci 2022; 23:ijms23179533. [PMID: 36076929 PMCID: PMC9455231 DOI: 10.3390/ijms23179533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 12/02/2022] Open
Abstract
Previously, we demonstrated that the proton pump inhibitor, esomeprazole magnesium hydrate (MH), could have potential as a repurposed treatment against preeclampsia, a serious obstetric condition. In this study we investigate the difference in the preclinical effectiveness between 100 µM of esomeprazole MH and its hydration isomer, esomeprazole magnesium trihydrate (MTH). Here, we found that both treatments reduced secretion of sFLT-1 (anti-angiogenic factor) from primary cytotrophoblast, but only esomeprazole MH reduced sFLT-1 secretion from primary human umbilical vein endothelial cells (assessed via ELISA). Both drugs could mitigate expression of the endothelial dysfunction markers, vascular cell adhesion molecule-1 and endothelin-1 (via qPCR). Neither esomeprazole MH nor MTH quenched cytotrophoblast reactive oxygen species production in response to sodium azide (ROS assay). Finally, using wire myography, we demonstrated that both compounds were able to induce vasodilation of human omental arteries at 100 µM. Esomeprazole is safe to use in pregnancy and a candidate treatment for preeclampsia. Using primary human tissues and cells, we validated that esomeprazole is effective in enhancing vascular relaxation, and can reduce key factors associated with preeclampsia, including sFLT-1 and endothelial dysfunction. However, esomeprazole MH was more efficacious than esomeprazole MTH in our in vitro studies.
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Affiliation(s)
- Natasha de Alwis
- Therapeutics Discovery and Vascular Function Group, Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia
| | - Bianca R. Fato
- Therapeutics Discovery and Vascular Function Group, Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia
| | - Sally Beard
- Therapeutics Discovery and Vascular Function Group, Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia
| | - Natalie K. Binder
- Therapeutics Discovery and Vascular Function Group, Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia
| | - Tu’uhevaha J. Kaitu’u-Lino
- Diagnostics Discovery and Reverse Translation in Pregnancy Group, Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia
| | - Kenji Onda
- Department of Clinical Pharmacology, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo 192-0392, Japan
| | - Natalie J. Hannan
- Therapeutics Discovery and Vascular Function Group, Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia
- Correspondence: ; Tel.: +61-3-8458-4371
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Hussain S, Singh A, Antony B, Klugarová J, Murad MH, Jayraj AS, Langaufová A, Klugar M. Proton Pump Inhibitors Use and Risk of Preeclampsia: A Meta-Analysis. J Clin Med 2022; 11:4675. [PMID: 36012913 PMCID: PMC9410414 DOI: 10.3390/jcm11164675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 12/17/2022] Open
Abstract
Evidence from preclinical studies suggests a preventive effect of proton pump inhibitors (PPIs) in preeclampsia. Recently, several epidemiological studies have described a conflicting association between the use of PPIs during pregnancy and preeclampsia risk. This study aimed to evaluate the association between PPI use and the risk of preeclampsia. We searched databases, including MEDLINE, Embase, Scopus, Web of Science Core Collection, Emcare, CINAHL, and the relevant grey literature from inception until 13 September 2021. Studies reporting the preeclampsia risk with the use of PPIs were eligible for inclusion. Literature screening, data extraction, and the risk of bias assessment were performed independently by two investigators. Random-effect meta-analysis was performed to generate relative risks (RR) and 95% confidence intervals (CI). The risk of preeclampsia and preterm preeclampsia among women receiving PPIs during pregnancy were the primary outcomes of interest. This meta-analysis comprised three studies involving 4,877,565 pregnant women, of whom 119,017 were PPI users. The included studies were judged to have a low risk of bias. The risk of preeclampsia among pregnant women who received PPIs anytime during pregnancy was significantly increased (RR 1.27 (95% CI: 1.23-1.31)), although the increase was trivial in absolute terms (2 per 1000). The subgroup analysis revealed that the risk was increased in each of the three trimesters. The risk of preterm preeclampsia among pregnant women receiving PPIs anytime during pregnancy was not significantly increased (RR 1.04 (95% CI: 0.70-1.55)). The certainty evaluated by GRADE in these estimates was low. PPI use may be associated with a trivial increase in the risk of preeclampsia in pregnant women. There is no evidence supporting that PPI use decreases the risk of preeclampsia or preterm preeclampsia.
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Affiliation(s)
- Salman Hussain
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic, Kamenice 5, 62500 Brno, Czech Republic
| | - Ambrish Singh
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS 7000, Australia
| | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS 7000, Australia
| | - Jitka Klugarová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic, Kamenice 5, 62500 Brno, Czech Republic
| | - M. Hassan Murad
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Aarthi S. Jayraj
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Alena Langaufová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic, Kamenice 5, 62500 Brno, Czech Republic
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic, Kamenice 5, 62500 Brno, Czech Republic
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Dunleavy JEM, Dinh DT, Filby CE, Green E, Hofstee P, Pini T, Rivers N, Skerrett-Byrne DA, Wijayarathna R, Winstanley YE, Zhou W, Richani D. Reproductive biology research down under: highlights from the Australian and New Zealand Annual Meeting of the Society for Reproductive Biology, 2021. Reprod Fertil Dev 2022; 34:855-866. [PMID: 35836362 DOI: 10.1071/rd22115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/17/2022] [Indexed: 11/23/2022] Open
Abstract
Against the backdrop of a global pandemic, the Society for Reproductive Biology (SRB) 2021 meeting reunited the Australian and New Zealand reproductive research community for the first time since 2019 and was the first virtual SRB meeting. Despite the recent global research disruptions, the conference revealed significant advancements in reproductive research, the importance of which span human health, agriculture, and conservation. A core theme was novel technologies, including the use of medical microrobots for therapeutic and sperm delivery, diagnostic hyperspectral imaging, and hydrogel condoms with potential beyond contraception. The importance of challenging the contraceptive status quo was further highlighted with innovations in gene therapies, non-hormonal female contraceptives, epigenetic semen analysis, and in applying evolutionary theory to suppress pest population reproduction. How best to support pregnancies, particularly in the context of global trends of increasing maternal age, was also discussed, with several promising therapies for improved outcomes in assisted reproductive technology, pre-eclampsia, and pre-term birth prevention. The unique insights gained via non-model species was another key focus and presented research emphasised the importance of studying diverse systems to understand fundamental aspects of reproductive biology and evolution. Finally, the meeting highlighted how to effectively translate reproductive research into policy and industry practice.
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Affiliation(s)
- Jessica E M Dunleavy
- School of BioSciences, Faculty of Science, The University of Melbourne, Parkville, Vic. 3010, Australia
| | - Doan Thao Dinh
- Robinson Research Institute, School of Biomedicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA 5006, Australia
| | - Caitlin E Filby
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Vic. 3168, Australia; and Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Clayton, Vic. 3168, Australia
| | - Ella Green
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, SA 5006, Australia
| | - Pierre Hofstee
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Taylor Pini
- School of Veterinary Science, The University of Queensland, Gatton, Qld 4343, Australia
| | - Nicola Rivers
- Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Clayton, Vic. 3168, Australia
| | - David A Skerrett-Byrne
- School of Environmental and Life Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW 2308, Australia; and Infertility and Reproduction Research Program, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Rukmali Wijayarathna
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, Vic. 3168, Australia; and Department of Molecular and Translational Sciences, School of Clinical Sciences, Monash University, Clayton, Vic. 3800, Australia
| | - Yasmyn E Winstanley
- Robinson Research Institute, School of Biomedicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA 5006, Australia
| | - Wei Zhou
- Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Vic. 3010, Australia; and Gynaecology Research Centre, Royal Women's Hospital, Parkville, Vic. 3052, Australia
| | - Dulama Richani
- Fertility & Research Centre, School of Women's and Children's Health, University of New South Wales, Sydney, NSW 2031, Australia
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9
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de Alwis N, Beard S, Binder NK, Pritchard N, Tong S, Kaitu'u-Lino TJ, Hannan NJ. Placental DAAM2 is unaltered in preeclampsia, but upregulated by treatment with proton pump inhibitors. Pregnancy Hypertens 2022; 30:13-20. [DOI: 10.1016/j.preghy.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/24/2022]
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10
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Neuman RI, Baars MD, Saleh L, Broekhuizen M, Nieboer D, Cornette J, Schoenmakers S, Verhoeven M, Koch BCP, Russcher H, van den Berg SAA, van den Meiracker AH, Visser W, Danser AHJ. Omeprazole Administration in Preterm Preeclampsia: a Randomized Controlled Trial to Study Its Effect on sFlt-1 (Soluble Fms-Like Tyrosine Kinase-1), PlGF (Placental Growth Factor), and ET-1 (Endothelin-1). Hypertension 2022; 79:1297-1307. [PMID: 35341328 PMCID: PMC9093236 DOI: 10.1161/hypertensionaha.122.19070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Low sFlt-1 (soluble Fms-like tyrosine kinase-1) and ET-1 (endothelin-1) levels have been reported in preeclamptic women using proton pump inhibitors.
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Affiliation(s)
- Rugina I Neuman
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine (R.I.N., L.S., M.B., A.H.v.d.M., W.V., A.H.J.D.).,Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands. (R.I.N., M.D.B., L.S., J.C., S.S., W.V.)
| | - Milan D Baars
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands. (R.I.N., M.D.B., L.S., J.C., S.S., W.V.)
| | - Langeza Saleh
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine (R.I.N., L.S., M.B., A.H.v.d.M., W.V., A.H.J.D.).,Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands. (R.I.N., M.D.B., L.S., J.C., S.S., W.V.)
| | - Michelle Broekhuizen
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine (R.I.N., L.S., M.B., A.H.v.d.M., W.V., A.H.J.D.).,Department of Pediatrics, Division of Neonatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. (M.B.)
| | - Daan Nieboer
- Department of Biochemical Statistics, Erasmus MC University Medical Center, Rotterdam, The Netherlands. (D.N.)
| | - Jérôme Cornette
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands. (R.I.N., M.D.B., L.S., J.C., S.S., W.V.)
| | - Sam Schoenmakers
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands. (R.I.N., M.D.B., L.S., J.C., S.S., W.V.)
| | - Michel Verhoeven
- Department of Pharmacy, Erasmus MC University Medical Center, Rotterdam, The Netherlands. (M.V., B.C.P.K.)
| | - Birgit C P Koch
- Department of Pharmacy, Erasmus MC University Medical Center, Rotterdam, The Netherlands. (M.V., B.C.P.K.)
| | - Henk Russcher
- Department of Clinical Chemistry, Erasmus MC University Medical Center, Rotterdam, The Netherlands. (H.R., S.A.A.v.d.B.)
| | - Sjoerd A A van den Berg
- Department of Clinical Chemistry, Erasmus MC University Medical Center, Rotterdam, The Netherlands. (H.R., S.A.A.v.d.B.).,Department of Internal Medicine, Division of Endocrinology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. (S.A.A.v.d.B.)
| | - Anton H van den Meiracker
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine (R.I.N., L.S., M.B., A.H.v.d.M., W.V., A.H.J.D.)
| | - Willy Visser
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine (R.I.N., L.S., M.B., A.H.v.d.M., W.V., A.H.J.D.).,Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands. (R.I.N., M.D.B., L.S., J.C., S.S., W.V.)
| | - A H Jan Danser
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine (R.I.N., L.S., M.B., A.H.v.d.M., W.V., A.H.J.D.)
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11
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Esomeprazole inhibits hypoxia/endothelial dysfunction–induced autophagy in preeclampsia. Cell Tissue Res 2022; 388:181-194. [PMID: 35091806 PMCID: PMC8976802 DOI: 10.1007/s00441-022-03587-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
Abstract
Preeclampsia (PE) affects 3 to 5% of pregnant women worldwide and is associated with fetal and maternal morbidity and mortality. Although a complete understanding of PE remains elusive, it has been widely accepted that a dysfunction of the placenta plays a key role in the pathogenesis of PE. In this study, we investigated the role of excessive placental autophagy during PE pathogenesis and explored whether esomeprazole ameliorates PE by inhibiting the autophagy in the placenta. The PE cellular model was established by treating the cells’ L-NAME and hypoxia. The PE mice model was established by L-NAME administration and was confirmed by the increased systolic blood pressure (SBP) and urinary protein detected. The autophagy and key proteins were detected in human placental tissue, in cells, and in the mice model by Western blot and immunofluorescence staining. Results showed that excessive autophagy could be detected in human PE placental tissue, in the PE cellular model, and in the PE mice model. Hypoxia induces autophagy by activating AMPKα and inhibiting mTOR in vivo and in vitro. Esomeprazole inhibits L‐NAME-induced autophagy in mice by inhibiting AMPKα and activating mTOR. In conclusion, this study demonstrates that the excessive autophagy induced by the SIRT1/AMPKα-mTOR pathway plays a significant role in the pathogenesis of PE. However, esomeprazole treatment inhibits AMPKα but activates mTOR, resulting in the inhibition of autophagy in the placenta and, therefore, mitigates PE symptoms.
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12
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Deng Z, Lu D. Letter by Lu et al. regarding article, "Esomeprazole and sulfasalazine in combination additively reduce sFlt-1 secretion and diminish endothelial dysfunction: potential for a combination treatment for preeclampsia". Hypertens Pregnancy 2022; 41:51-52. [PMID: 34978249 DOI: 10.1080/10641955.2021.2024224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Zhuo Deng
- The Department of Obstetrics and Gynecology, Subei People's Hospital, Yangzhou, PR China.,The First Clinical College, Dalian Medical University, Dalian, PR China.,Department of Obstetrics and Gynecology, College of Clinical Medicine, Yangzhou University, Yangzhou, PR China
| | - Dan Lu
- The Department of Obstetrics and Gynecology, Subei People's Hospital, Yangzhou, PR China.,The First Clinical College, Dalian Medical University, Dalian, PR China.,Department of Obstetrics and Gynecology, College of Clinical Medicine, Yangzhou University, Yangzhou, PR China
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13
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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: 1.0] [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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14
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Liu TH, Tao WC, Liang QE, Tu WQ, Xiao Y, Chen LG. Gut Microbiota-Related Evidence Provides New Insights Into the Association Between Activating Transcription Factor 4 and Development of Salt-Induced Hypertension in Mice. Front Cell Dev Biol 2020; 8:585995. [PMID: 33282868 PMCID: PMC7691383 DOI: 10.3389/fcell.2020.585995] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/19/2020] [Indexed: 12/21/2022] Open
Abstract
Activating transcription factor 4 (ATF4), which regulates genes associated with endoplasmic reticulum stress, apoptosis, autophagy, the gut microbiome, and metabolism, has been implicated in many diseases. However, its mechanistic role in hypertension remains unclear. In the present study, we investigated its role in salt-sensitive hypertensive mice. Wild-type (WT) C57BL/6J mice were used to establish Atf4 knockout (KO) and overexpression mice using CRISPR-Cas9 and lentiviral overexpression vectors. Then, fecal microbiota transplantation (FMT) from Atf4 ± mice and vitamin K2 (VK2) supplementation were separately carried out in high-salt-diet (8% NaCl)-induced mice for 4 weeks. We found that Atf4 KO inhibited and Atf4 overexpression enhanced the increase in blood pressure and endothelial dysfunction induced by high salt intake in mice, while regulating the gut microbiota composition and VK2 expression. It was further verified that ATF4 is involved in the regulation of salt-sensitive hypertension and vascular endothelial function, which is achieved through association with gut microbiota and may be related to VK2 and different bacteria such as Dubosiella. In addition, we found that VK2 supplementation prevents the development of salt-sensitive hypertension and maintains vascular endothelial function; moreover, VK2 supplementation increases the abundance of intestinal Dubosiella and downregulates the relative expression of Atf4 in the thoracic aorta of mice. We conclude that ATF4 plays an important role in regulating gut microbiota and VK2 production, providing new insights into the association between ATF4 and development of salt-induced hypertension in mice, meanwhile contributing to the development for a new preventive strategy of hypertension.
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Affiliation(s)
- Tian-Hao Liu
- College of Chinese Medicine, Jinan University, Guangzhou, China.,Institute of Integrative Chinese and Western Medicine, Jinan University, Guangzhou, China
| | - Wen-Cong Tao
- College of Chinese Medicine, Jinan University, Guangzhou, China.,Institute of Integrative Chinese and Western Medicine, Jinan University, Guangzhou, China
| | - Qiu-Er Liang
- College of Chinese Medicine, Jinan University, Guangzhou, China.,Institute of Integrative Chinese and Western Medicine, Jinan University, Guangzhou, China
| | - Wan-Qing Tu
- College of Chinese Medicine, Jinan University, Guangzhou, China.,Institute of Integrative Chinese and Western Medicine, Jinan University, Guangzhou, China
| | - Ya Xiao
- College of Chinese Medicine, Jinan University, Guangzhou, China.,Institute of Integrative Chinese and Western Medicine, Jinan University, Guangzhou, China
| | - Li-Guo Chen
- College of Chinese Medicine, Jinan University, Guangzhou, China.,Institute of Integrative Chinese and Western Medicine, Jinan University, Guangzhou, China
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