1
|
Akin S, Cekin N. Preeclampsia and STOX1 (storkhead-box protein 1): Molecular evaluation of STOX1 in preeclampsia. Gene 2024; 927:148742. [PMID: 38969244 DOI: 10.1016/j.gene.2024.148742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/13/2024] [Accepted: 07/01/2024] [Indexed: 07/07/2024]
Abstract
Preeclampsia (PE) is clinically defined as a part of pregnancy characterized by hypertension and multiple organ failure. PE is broadly categorized into two types: "placental" and "maternal". Placental PE is associated with fetal growth restriction and adverse maternal and neonatal outcomes. STOX1 (Storkhead box 1), a transcription factor, discovered through a complete transcript analysis of the PE susceptibility locus of 70,000 bp on chromosome 10q22.1. So far, studies investigating the relationship between STOX1 and PE have focused on STOX1 overexpression, STOX1 isoform imbalance, and STOX1 variations that could have clinical consequence. Initially, the Y153H variation of STOX was associated with the placental form of PE. Additionally, studies focusing on the maternal and fetal interface have shown that NODAL and STOX1 variations play a role together in the unsuccessful remodeling of the spiral arteries. Research specifically addressing the overexpression of STOX1 has shown that its disruption of cellular hemoastasis, leading to impaired hypoxia response, disruption of the cellular antioxidant system, and nitroso/redox imbalance. Furthermore, functional studies have been conducted showing that the imbalance between STOX1 isoforms contributes to the pathogenesis of placental PE. Research indicates that STOX1B competes with STOX1A and that the overexpression of STOX1B reverses cellular changes that STOX1A induces to the pathogenesis of PE. In this review, we aimed at elucidating the relationship between STOX1 and PE as well as function of STOX1. In conclusion, based on a comprehensive literature review, numerous studies support the role of STOX1 in the pathogenesis of PE.
Collapse
Affiliation(s)
- Seyda Akin
- Sivas Cumhuriyet University, Faculty of Medicine, Department of Medical Biology, 58140 Sivas, Turkey.
| | - Nilgun Cekin
- Sivas Cumhuriyet University, Faculty of Medicine, Department of Medical Biology, 58140 Sivas, Turkey.
| |
Collapse
|
2
|
Jiao Y, Liu Y, Li H, Song Z, Wang S, Zhang J, Li J, Liu J, Wang P, Chen Y. Value of proteinuria in evaluating the severity of HELLP and its maternal and neonatal outcomes. BMC Pregnancy Childbirth 2023; 23:591. [PMID: 37596554 PMCID: PMC10436574 DOI: 10.1186/s12884-023-05862-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/20/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND HELLP syndrome refers to a group of clinical syndromes characterized by hemolysis, elevated liver enzymes and low platelet, and the evidence on the association between proteinuria and the severity of HELLP and its maternal and neonatal outcomes is rare. METHODS 106 pregnant women were assigned to the proteinuric group (24-hUPro ≥ 0.3 g, 79 cases) and the non-proteinuric group (24-hUPro < 0.3 g, 27 cases). The proteinuric group was further divided into three subgroups: mild group (24-hUPro:0.3-2.0 g, 33 cases), moderate group (24-hUPro:2.0-5.0 g, 21 cases) and severe group (24-hUPro: ≥5.0 g, 25 cases). The general clinical data, laboratory indexes, complications and pregnancy outcome and adverse neonatal outcomes of HELLP with or without proteinuric were analyzed. RESULTS Compared with proteinuric group, the non-albuminuric group or in the three proteinuric subgroups of HELLP pregnant women's, increased proteinuria was associated with earlier onset gestations, higher incidence of abdominal pain, skin jaundice, headache, blurred vision (p < 0.05 respectively), and also the higher levels of ALT, AST, LDH, Fib, APTT, ATII, proportions of tubular urine and lower levels of ALB, PLT (p < 0.05 respectively). In the three subgroups of the proteinuric group, the ratio of fetal growth restriction, cesarean section and postpartum hemorrhage were compared, and the difference was statistically significant (p < 0.05 respectively). Compared with the proteinuric group, the non-proteinuric group had higher birth weight, birth length, and lower SGA, admission rate in NICU (p < 0.05 respectively). In the three subgroups of the proteinuric group, significant differences were identified in the adverse outcomes of newborns (p < 0.05 respectively), and the incidence of adverse outcomes in neonates tended to be higher. Significant differences were identified in birth weight, birth length, and lower SGA and NICU occupancy rate among the three subgroups (p < 0.05 respectively). CONCLUSIONS HELLP syndrome is a severe complication of pregnancy, involving multiple systems of the whole body. It has posed a great challenge to obstetricians for its acute onset, dangerous condition, rapid progress, and great harm. Thus, insights into HELLP syndrome should be gained, and early diagnosis, early treatment and timely termination of pregnancy should be conducted to reduce the incidence of maternal and fetal adverse outcomes and improve maternal and fetal prognosis.
Collapse
Affiliation(s)
- Yan Jiao
- Department of obstetrics and gynecology of Xuzhou Central Hospital, No.199, Jiefang South Road, Xuzhou, Jiangsu, 221009, People's Republic of China
| | - Yan Liu
- Department of Clinical Laboratory, Xuzhou Central Hospital, No.199, Jiefang South Road, Xuzhou, Jiangsu, 221009, People's Republic of China
| | - Hongyuan Li
- Department of neurology, Xuzhou Central Hospital, No.199, Jiefang South Road, Xuzhou, Jiangsu, 221009, People's Republic of China
| | - Zimeng Song
- School of medical technology, Xuzhou Medical University, Xuzhou No.209, Tong Shan Road, Xuzhou, 221000, Jiangsu, People's Republic of China
| | - Shiliang Wang
- Department of obstetrics and gynecology of Xuzhou Central Hospital, No.199, Jiefang South Road, Xuzhou, Jiangsu, 221009, People's Republic of China
| | - Jiao Zhang
- Department of Clinical Laboratory, Xuzhou Central Hospital, No.199, Jiefang South Road, Xuzhou, Jiangsu, 221009, People's Republic of China
| | - Jian Li
- Department of Clinical Laboratory, Xuzhou Central Hospital, No.199, Jiefang South Road, Xuzhou, Jiangsu, 221009, People's Republic of China
| | - Jia Liu
- Department of Clinical Laboratory, Xuzhou Central Hospital, No.199, Jiefang South Road, Xuzhou, Jiangsu, 221009, People's Republic of China
| | - Peng Wang
- Department of Clinical Laboratory, Xuzhou Central Hospital, No.199, Jiefang South Road, Xuzhou, Jiangsu, 221009, People's Republic of China.
| | - Yanhong Chen
- Department of Clinical Laboratory, Xuzhou Central Hospital, No.199, Jiefang South Road, Xuzhou, Jiangsu, 221009, People's Republic of China.
| |
Collapse
|
3
|
Petca A, Miron BC, Pacu I, Dumitrașcu MC, Mehedințu C, Șandru F, Petca RC, Rotar IC. HELLP Syndrome—Holistic Insight into Pathophysiology. Medicina (B Aires) 2022; 58:medicina58020326. [PMID: 35208649 PMCID: PMC8875732 DOI: 10.3390/medicina58020326] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/10/2022] [Accepted: 02/18/2022] [Indexed: 02/07/2023] Open
Abstract
HELLP syndrome, also known as the syndrome of hemolysis, elevated liver enzymes, and low platelets, represents a severe pregnancy complication typically associated with hypertension. It is associated with increased risks of adverse complications for both mother and fetus. HELLP occurs in 0.2–0.8% of pregnancies, and, in 70–80% of cases, it coexists with preeclampsia (PE). Both of these conditions show a familial tendency. A woman with a history of HELLP pregnancy is at high risk for developing this entity in subsequent pregnancies. We cannot nominate a single worldwide genetic cause for the increased risk of HELLP. Combinations of multiple gene variants, each with a moderate risk, with concurrent maternal and environmental factors are thought to be the etiological mechanisms. This review highlights the significant role of understanding the underlying pathophysiological mechanism of HELLP syndrome. A better knowledge of the disease’s course supports early detection, an accurate diagnosis, and proper management of this life-threatening condition.
Collapse
Affiliation(s)
- Aida Petca
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.P.); (M.C.D.); (C.M.); (F.Ș.); (R.-C.P.)
- Department of Obstetrics and Gynecology, Elias University Hospital, 011461 Bucharest, Romania
| | - Bianca Corina Miron
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.P.); (M.C.D.); (C.M.); (F.Ș.); (R.-C.P.)
- Department of Obstetrics and Gynecology, Elias University Hospital, 011461 Bucharest, Romania
- Correspondence: (B.C.M.); (I.P.); Tel.: +40-757-917889 (B.C.M.); +40-722-787327 (I.P.)
| | - Irina Pacu
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.P.); (M.C.D.); (C.M.); (F.Ș.); (R.-C.P.)
- Department of Obstetrics and Gynecology, “Sf. Pantelimon” Emergency Clinical Hospital, 021623 Bucharest, Romania
- Correspondence: (B.C.M.); (I.P.); Tel.: +40-757-917889 (B.C.M.); +40-722-787327 (I.P.)
| | - Mihai Cristian Dumitrașcu
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.P.); (M.C.D.); (C.M.); (F.Ș.); (R.-C.P.)
- Department of Obstetrics and Gynecology, University Emergency Hospital, 050098 Bucharest, Romania
| | - Claudia Mehedințu
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.P.); (M.C.D.); (C.M.); (F.Ș.); (R.-C.P.)
- Department of Obstetrics and Gynecology, Malaxa Clinical Hospital, 022441 Bucharest, Romania
| | - Florica Șandru
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.P.); (M.C.D.); (C.M.); (F.Ș.); (R.-C.P.)
- Department of Dermatology, Elias University Emergency Hospital, 011461 Bucharest, Romania
| | - Răzvan-Cosmin Petca
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.P.); (M.C.D.); (C.M.); (F.Ș.); (R.-C.P.)
- Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 050659 Bucharest, Romania
| | - Ioana Cristina Rotar
- “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
- Department of Obstetrics and Gynecology, Emergency Clinical County Hospital Cluj-Napoca, 400006 Cluj-Napoca, Romania
| |
Collapse
|
4
|
Preeclampsia, Natural History, Genes, and miRNAs Associated with the Syndrome. J Pregnancy 2022; 2022:3851225. [PMID: 35198246 PMCID: PMC8860533 DOI: 10.1155/2022/3851225] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/19/2022] [Indexed: 12/13/2022] Open
Abstract
Preeclampsia (PE) is a hypertensive disease that affects pregnant women after 20 weeks of gestation. This disease is associated with an important risk of maternal and fetal mortality. PE is described as a placental pathology because, after delivery, most women recover normal arterial pressure. Poor invasion of the spiral arteries is a phenomenon well described in PE; this leads to a hypoxic uterine bed and imbalance of antiangiogenic and proangiogenic factors in the uteroplacental region, which in turn triggers the disease phenotype. The causes of the pathology are unclear; nevertheless, numerous approaches, including next-generation sequencing, association, and case control and miRNA studies, have shed light on the genetic/molecular basis of PE. These studies help us better understand the disease to advance new treatment strategies.
Collapse
|
5
|
Wu CT, Kuo CF, Lin CP, Huang YT, Chen SW, Wu HM, Chu PH. Association of family history with incidence and gestational hypertension outcomes of preeclampsia. INTERNATIONAL JOURNAL CARDIOLOGY HYPERTENSION 2021; 9:100084. [PMID: 34013183 PMCID: PMC8113806 DOI: 10.1016/j.ijchy.2021.100084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/15/2021] [Indexed: 11/02/2022]
Abstract
Background Gestational hypertension and preeclampsia are hypertensive disorders related to pregnancy that can cause maternal morbidity and fetal growth retardation. The association of these disorders with family history remains unclear. Objectives To examine the degree of family aggregation of preeclampsia and gestational hypertension in Taiwan. Methods The study was conducted using the data from the National Health Insurance Database of Taiwan. Delivery events in Taiwan from 1999 to 2013 were collected. Preeclampsia was identified based on the hospital diagnosis of index delivery. The family aggregation pattern of preeclampsia was assessed and analyzed using the relationship registered in the database with the patients. Results A total of 60,314 preeclampsia events were identified among 4,091,641 deliveries, accounting for 1.5% of the cohort. The incidence of preeclampsia increased with maternal age. A total of 768 preeclampsia events occurred in mothers who had a sororal history of preeclampsia (n = 20,704), accounting for 1.3% of all preeclampsia events (n = 60,314). Mothers who had a sororal history of preeclampsia had a relative risk (RR) of 2.6 (95% confidence interval [CI]: 2.41-2.80) for preeclampsia compared with mothers who did not have a sororal history of preeclampsia. The RR for gestational hypertension was 2.79 (95% CI: 2.36-3.3) in mothers with a positive sororal history of gestational hypertension. Conclusions Having a sororal history of preeclampsia was a strong risk factor for preeclampsia and gestational hypertension in mothers in Taiwan. The pattern of family aggregation was similar at all maternal ages.
Collapse
Affiliation(s)
- Chia-Tung Wu
- Department of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan, ROC
| | - Chang-Fu Kuo
- Allergy and Immunology, Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan, ROC.,Division of Rheumatology, Orthopedics, and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Chia-Pin Lin
- Department of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan, ROC
| | - Yu-Tung Huang
- Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan, ROC
| | - Shao-Wei Chen
- Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan, ROC.,Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, Taoyuan City, Taiwan, ROC
| | - Hsien-Ming Wu
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Taoyuan, Taiwan, ROC
| | - Pao-Hsien Chu
- Department of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan, ROC
| |
Collapse
|
6
|
Lokki AI, Teirilä L, Triebwasser M, Daly E, Bhattacharjee A, Uotila L, Llort Asens M, Kurki MI, Perola M, Auro K, Salmon JE, Daly M, Atkinson JP, Laivuori H, Fagerholm S, Meri S. Dysfunction of complement receptors CR3 (CD11b/18) and CR4 (CD11c/18) in pre-eclampsia: a genetic and functional study. BJOG 2021; 128:1282-1291. [PMID: 33539617 DOI: 10.1111/1471-0528.16660] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To study genetic variants and their function within genes coding for complement receptors in pre-eclampsia. DESIGN A case-control study. SETTING Pre-eclampsia is a common vascular disease of pregnancy. The clearance of placenta-derived material is one of the functions of the complement system in pregnancy. POPULATION We genotyped 500 women with pre-eclamptic pregnancies and 190 pregnant women without pre-eclampsia, as controls, from the FINNPEC cohort, and 122 women with pre-eclamptic pregnancies and 1905 controls from the national FINRISK cohort. METHODS The functional consequences of genotypes discovered by targeted exomic sequencing were explored by analysing the binding of the main ligand iC3b to mutated CR3 or CR4, which were transiently expressed on the surface of COS-1 cells. MAIN OUTCOME MEASURES Allele frequencies were compared between pre-eclamptic pregnancies and controls in genetic studies. The functional consequences of selected variants were measured by binding assays. RESULTS The most significantly pre-eclampsia-linked CR3 variant M441K (P = 4.27E-4, OR = 1.401, 95% CI = 1.167-1.682) displayed a trend of increased adhesion to iC3b (P = 0.051). The CR4 variant A251T was found to enhance the adhesion of CR4 to iC3b, whereas W48R resulted in a decrease of the binding of CR4 to iC3b. CONCLUSIONS Results suggest that changes in complement-facilitated phagocytosis are associated with pre-eclampsia. Further studies are needed to ascertain whether aberrant CR3 and CR4 activity leads to altered pro- and anti-inflammatory cytokine responses in individuals carrying the associated variants, and the role of these receptors in pre-eclampsia pathogenesis. TWEETABLE ABSTRACT Genetic variants of complement receptors CR3 and CR4 have functional consequences that are associated with pre-eclampsia.
Collapse
Affiliation(s)
- A I Lokki
- Translational Immunology Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland.,Department of Obstetrics and Gynecology, Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere University, Tampere, Finland
| | - L Teirilä
- Translational Immunology Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland.,Bacteriology and immunology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - M Triebwasser
- Department of Medicine, Division of Rheumatology, Washington University School of Medicine, Saint Louis, MO, USA
| | - E Daly
- Hospital and Harvard Medical School, Boston, MA, USA
| | - A Bhattacharjee
- Herantis Pharma Plc, Espoo, Finland.,Neuroscience Center, HiLife, University of Helsinki, Helsinki, Finland
| | - L Uotila
- Research Services, University of Helsinki, Helsinki, Finland
| | - M Llort Asens
- Molecular and Integrative Biosciences Research Program, Faculty of Bio- and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - M I Kurki
- Neurosurgery of Neuro Center, Kuopio University Hospital, Finland.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - M Perola
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - K Auro
- Department of Government Services, National Institute for Health and Welfare, Helsinki, Finland
| | - J E Salmon
- Hospital for Special Surgery-Weill Cornell Medicine, Department of Medicine, New York, NY, USA
| | - M Daly
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.,Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - J P Atkinson
- Department of Medicine, Division of Rheumatology, Washington University School of Medicine, Saint Louis, MO, USA
| | - H Laivuori
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere University, Tampere, Finland.,Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland.,Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - S Fagerholm
- Molecular and Integrative Biosciences Research Program, Faculty of Bio- and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - S Meri
- Translational Immunology Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland.,Bacteriology and immunology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | -
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
7
|
Ren Z, Gao Y, Gao Y, Liang G, Chen Q, Jiang S, Yang X, Fan C, Wang H, Wang J, Shi YW, Xiao C, Zhong M, Yang X. Distinct placental molecular processes associated with early-onset and late-onset preeclampsia. Am J Cancer Res 2021; 11:5028-5044. [PMID: 33754042 PMCID: PMC7978310 DOI: 10.7150/thno.56141] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/29/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Patients with preeclampsia display a spectrum of onset time and severity of clinical presentation, yet the underlying molecular bases for the early-onset and late-onset clinical subtypes are not known. Although several transcriptome studies have been done on placentae from PE patients, only a small number of differentially expressed genes have been identified due to very small sample sizes and no distinguishing of clinical subtypes. Methods: We carried out RNA-seq on 65 high-quality placenta samples, including 33 from 30 patients and 32 from 30 control subjects, to search for dysregulated genes and the molecular network and pathways they are involved in. Results: We identified two functionally distinct sets of dysregulated genes in the two major subtypes: 2,977 differentially expressed genes in early-onset severe preeclampsia, which are enriched with metabolism-related pathways, notably transporter functions; and 375 differentially expressed genes in late-onset severe preeclampsia, which are enriched with immune-related pathways. We also identified some key transcription factors, which may drive the widespread gene dysregulation in both early-onset and late-onset patients. Conclusion: These results suggest that early-onset and late-onset severe preeclampsia have different molecular mechanisms, whereas the late-onset mild preeclampsia may have no placenta-specific causal factors. A few regulators may be the key drivers of the dysregulated molecular pathways.
Collapse
|
8
|
Zuo Q, Zou Y, Huang S, Wang T, Xu Y, Zhang T, Zhang M, Ge Z, Jiang Z. Aspirin reduces sFlt-1-mediated apoptosis of trophoblast cells in preeclampsia. Mol Hum Reprod 2021; 27:6119638. [PMID: 33493277 DOI: 10.1093/molehr/gaaa089] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 12/02/2020] [Indexed: 01/01/2023] Open
Abstract
Preeclampsia (PE) is a hypertensive disorder that occurs during pregnancy. Low-dose aspirin is used to reduce the occurrence of early-onset PE; however, the mechanisms are not clear. The aim of this study was to reveal the underlying mechanism of aspirin in reducing sFlt-1-mediated apoptosis of trophoblast cells in PE. Serum sFlt-1 and sEng profiles and placental oxidative stress levels were significantly decreased in PE patients treated with aspirin compared with untreated patients without it, whereas serum PLGF and placental SOD profiles were increased in PE patients with aspirin. Aspirin attenuated the role of sFlt-1 in oxidative stress and endothelial dysfunction and reduced apoptosis of trophoblasts by inactivating the NF-κB signalling pathway in HTR-8/SVneo trophoblast cells. Blood pressure, urine protein, swelling of the villous vessels and mitochondrial parameters were noted to be much better after aspirin administrated to sFlt-1 treated pregnant mice. In conclusion, aspirin reverses the endothelial dysfunction and oxidative stress caused by sFlt-1 and thus reduces apoptosis of preeclamptic trophoblasts by inactivating NF-κB signalling pathway.
Collapse
Affiliation(s)
- Qing Zuo
- Department of Obstetrics and Gynaecology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yanfeng Zou
- Department of Obstetrics and Gynaecology, the affiliated Hospital of Yantai Yuhuagnding Hospital of Qingdao University, Yantai, 264000, Shangdong Province, China
| | - Shiyun Huang
- Department of Obstetrics and Gynaecology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Tianjun Wang
- Department of Obstetrics and Gynaecology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yetao Xu
- Department of Obstetrics and Gynaecology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Tingting Zhang
- Department of Obstetrics and Gynaecology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Min Zhang
- Department of Obstetrics and Gynaecology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zhiping Ge
- Department of Obstetrics and Gynaecology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Ziyan Jiang
- Department of Obstetrics and Gynaecology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| |
Collapse
|
9
|
Preeclampsia-Associated lncRNA INHBA-AS1 Regulates the Proliferation, Invasion, and Migration of Placental Trophoblast Cells. MOLECULAR THERAPY-NUCLEIC ACIDS 2020; 22:684-695. [PMID: 33230466 PMCID: PMC7585871 DOI: 10.1016/j.omtn.2020.09.033] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 09/25/2020] [Indexed: 02/06/2023]
Abstract
Preeclampsia is believed to be caused by impaired placentation with insufficient trophoblast invasion, leading to impaired uterine spiral artery remodeling and angiogenesis. However, the underlying molecular mechanism remains unknown. We recently carried out transcriptome profiling of placental long noncoding RNAs (lncRNAs) and identified 383 differentially expressed lncRNAs in early-onset severe preeclampsia. Here, we are reporting our identification of lncRNA INHBA-AS1 as a potential causal factor of preeclampsia and its downstream pathways that may be involved in placentation. We found that INHBA-AS1 was upregulated in patients and positively correlated with clinical severity. We systematically searched for potential INHBA-AS1-binding transcription factors and their targets in databases and found that the targets were enriched with differentially expressed genes in the placentae of patients. We further demonstrated that the lncRNA INHBA-AS1 inhibited the invasion and migration of trophoblast cells through restraining the transcription factor CENPB from binding to the promoter of TNF receptor-associated factor 1 (TRAF1). Therefore, we have identified the dysregulated pathway "INHBA-AS1-CENPB-TRAF1" as a contributor to the pathogenesis of preeclampsia through prohibiting the proliferation, invasion, and migration of trophoblasts during placentation.
Collapse
|
10
|
Trifonova EA, Swarovskaja MG, Serebrova VN, Kutsenko IG, Agarkova LA, Stepanov IA, Zhilyakova OV, Gabidulina TV, Ijoykina EV, Stepanov VA. Genomic and Postgenomic Technologies in Preeclampsia Genetics. RUSS J GENET+ 2020. [DOI: 10.1134/s1022795420050130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
11
|
Miller AK, Azhibekov T, O'Toole JF, Sedor JR, Williams SM, Redline RW, Bruggeman LA. Association of preeclampsia with infant APOL1 genotype in African Americans. BMC MEDICAL GENETICS 2020; 21:110. [PMID: 32434471 PMCID: PMC7238556 DOI: 10.1186/s12881-020-01048-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 05/10/2020] [Indexed: 12/26/2022]
Abstract
Background Black women in the United States and Africa are at an increased risk for preeclampsia. Allelic variants in the gene for apolipoprotein LI, APOL1, are found only in populations of African ancestry, and have been shown to contribute significant risk for kidney disease. Recent studies suggest these APOL1 variants also may contribute risk for preeclampsia. Methods The association of preeclampsia with carriage of APOL1 risk alleles was evaluated in a case-control study of deliveries from black women at a single center in Cleveland, Ohio that included gross and histopathologic evaluations of placental tissues (395 cases and 282 controls). Using logistic regression models, associations between fetal APOL1 genotype and preeclampsia were evaluated using several case definitions based on prematurity and severity of preeclampsia, with uncomplicated term pregnancies as controls. Associations between APOL1 genotype and pathological features were also examined. Results The infant APOL1 genotype was significantly associated with preeclampsia in a dominant inheritance pattern with odds ratio of 1.41 (P=0.029, 95% CI 1.037, 1.926). Stratifying preeclampsia cases by preterm birth, significant associations were detected for both recessive (O.R.=1.70, P=0.038) and additive (O.R.=1.33, P=0.028) inheritance patterns. APOL1 genotype, however, was not significantly associated with pathological changes or other perinatal observations. Conclusions Preeclampsia appears to be another disease associated with APOL1 variants, however, further studies are needed to increase confidence in the mode of inheritance. By understanding the association of APOL1 variants with preeclampsia, genetic screening tests for APOL1 may be useful to predict at-risk pregnancies and targeted interventions may be developed to improve pregnancy outcomes.
Collapse
Affiliation(s)
- Anna K Miller
- Department of Genetics and Genome Sciences, Case Western Reserve University School of Medicine, Cleveland, USA
| | - Timur Azhibekov
- Division of Neonatology, Department of Pediatrics, Metro Health Medical Center, Case Western Reserve University School of Medicine, Cleveland, USA
| | - John F O'Toole
- Departments of Inflammation and Immunity and Nephrology, Cleveland Clinic, Case Western Reserve University School of Medicine, Cleveland, USA
| | - John R Sedor
- Departments of Inflammation and Immunity and Nephrology, Cleveland Clinic, Case Western Reserve University School of Medicine, Cleveland, USA.,Department of Physiology and Biophysics, Case Western Reserve University School of Medicine, Cleveland, USA
| | - Scott M Williams
- Department of Genetics and Genome Sciences, Case Western Reserve University School of Medicine, Cleveland, USA.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, USA
| | - Raymond W Redline
- Departments of Pathology and Reproductive Biology, University Hospitals, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Leslie A Bruggeman
- Departments of Inflammation and Immunity and Nephrology, Cleveland Clinic, Case Western Reserve University School of Medicine, Cleveland, USA.
| |
Collapse
|
12
|
Stojanovska V, Zenclussen AC. Innate and Adaptive Immune Responses in HELLP Syndrome. Front Immunol 2020; 11:667. [PMID: 32351511 PMCID: PMC7174768 DOI: 10.3389/fimmu.2020.00667] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/24/2020] [Indexed: 12/11/2022] Open
Abstract
Innate and adaptive immune involvement in hemolysis, elevated liver enzymes and low platelet (HELLP) syndrome is an understudied field, although it is of high clinical importance. This syndrome implies a risk of serious morbidity and mortality to both the mother and the fetus during pregnancy. It was proposed that HELLP syndrome occurs in a circulatory inflammatory milieu, that might in turn participate in a complex interplay between the secreted inflammatory immunomodulators and immune cell surface receptors. Meanwhile, reported immune cell attenuation during HELLP may consequently lead to a prolonged immunoactivation and tissue damage. In this regard, learning more about the immune components of this syndrome should widen the understanding of the HELLP pathophysiology and eventually enable development of novel immune-based therapeutics. This review aims to summarize and discuss the recent and previous findings of the innate and adaptive immune responses during HELLP in order to update the current knowledge of the immune involvement in HELLP pathogenesis.
Collapse
Affiliation(s)
- Violeta Stojanovska
- Experimental Obstetrics and Gynecology, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Ana Claudia Zenclussen
- Experimental Obstetrics and Gynecology, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| |
Collapse
|
13
|
The Roles of Uterine Natural Killer (NK) Cells and KIR/HLA-C Combination in the Development of Preeclampsia: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2020; 2020:4808072. [PMID: 32309433 PMCID: PMC7149372 DOI: 10.1155/2020/4808072] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/18/2020] [Accepted: 03/20/2020] [Indexed: 12/21/2022]
Abstract
Preeclampsia (PE) is termed as a systemic disease that involves multiple organs; however, the exact etiology is still quite unclear. It is believed that the poor remodeling of uterine spiral arteries triggers PE, thereby causing failed placentation and producing inflammatory factors. The decline of blood flow results in lowering the nutrients and oxygen received by the fetus and augmenting the placental pressure in PE. Decidual immune cells, especially uterine natural killer (uNK) cells, are involved in the process of placentation. Decidual NK (dNK) cells significantly contribute to the vascular remodeling through the secretion of cytokines and angiogenic mediators in normal placental development. The abnormal activation of NK cells in both the peripheral blood and the decidua was counted among the causes leading to PE. The correlation existing between maternal killer cell immunoglobulin-like receptor (KIR) and HLA-C in trophoblast cells constitutes a robust evidence for the genetic etiology of PE. The combinations of the two kinds of gene systems, together with the KIR genotype in the mother and the HLA-C group in her fetus, are likely to exactly decide the pregnancy outcome. The women, who have the inappropriate match of KIR/HLA-C, are likely to be prone to the augmented risk of PE. However, the combinations of KIR/HLA-C in PE undergo ethnic changes. The extensive prospective research works in Europe, Asia, and Africa are required for providing more findings in PE patients.
Collapse
|
14
|
Ariff A, Melton PE, Brennecke SP, Moses EK. Analysis of the Epigenome in Multiplex Pre-eclampsia Families Identifies SORD, DGKI, and ICA1 as Novel Candidate Risk Genes. Front Genet 2019; 10:227. [PMID: 30941163 PMCID: PMC6434177 DOI: 10.3389/fgene.2019.00227] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 02/28/2019] [Indexed: 01/04/2023] Open
Abstract
Pre-eclampsia is a serious heritable disorder that affects 5-8% of pregnancies worldwide. While classical genetic studies have identified several susceptibility genes they do not fully explain the heritability of pre-eclampsia. An additional contribution to risk can be quantified by examining the epigenome, in particular the methylome, which is a representation of interactions between environmental and genetic influences on the phenotype. Current array-based epigenetic studies only examine 2-5% of the methylome. Here, we used whole-genome bisulfite sequencing (WGBS) to determine the entire methylome of 13 individuals from two multiplex pre-eclampsia families, comprising one woman with eclampsia, six women with pre-eclampsia, four women with uncomplicated normotensive pregnancies and two male relatives. The analysis of WGBS profiles using two bioinformatics platforms, BSmooth and Bismark, revealed 18,909 differentially methylated CpGs and 4157 differentially methylated regions (DMRs) concordant in females. The methylation patterns support the involvement of previously reported candidate genes, including COL4A1, SLC2A4, PER3, FLT1, GPI, LCT, DDAH1, TGFB3, DLX5, and LRP1B. Statistical analysis of DMRs revealed three novel genes significantly correlated with pre-eclampsia: sorbitol dehydrogenase (SORD, p = 9.98 × 10-6), diacylglycerol kinase iota (DGKI, p = 2.52 × 10-5), and islet cell autoantigen 1 (ICA1, 7.54 × 10-3), demonstrating the potential of WGBS in families for elucidating the role of epigenome in pre-eclampsia and other complex diseases.
Collapse
Affiliation(s)
- Amir Ariff
- The Curtin UWA Centre for Genetic Origins of Health and Disease, Faculty of Health and Medical Sciences, Curtin University, The University of Western Australia, Perth, WA, Australia.,School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Phillip E Melton
- The Curtin UWA Centre for Genetic Origins of Health and Disease, Faculty of Health and Medical Sciences, Curtin University, The University of Western Australia, Perth, WA, Australia.,School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Shaun P Brennecke
- Department of Maternal-Fetal Medicine Pregnancy Research Centre, The Royal Women's Hospital, Melbourne, VIC, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia
| | - Eric K Moses
- The Curtin UWA Centre for Genetic Origins of Health and Disease, Faculty of Health and Medical Sciences, Curtin University, The University of Western Australia, Perth, WA, Australia.,School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.,School of Biomedical Sciences, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia
| |
Collapse
|
15
|
|
16
|
Nonprotein-coding RNAs in Fetal Alcohol Spectrum Disorders. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2018; 157:299-342. [PMID: 29933954 DOI: 10.1016/bs.pmbts.2017.11.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Early developmental exposure to ethanol, a known teratogen, can result in a range of neurodevelopmental disorders, collectively referred to as Fetal Alcohol Spectrum Disorders (FASDs). Changes in the environment, including exposure to teratogens, can result in long term alterations to the epigenetic landscape of a cell, thereby altering gene expression. Noncoding RNAs (ncRNAs) can affect transcription and translation of networks of genes. ncRNAs are dynamically expressed during development and have been identified as a target of alcohol. ncRNAs therefore make for attractive targets for novel therapeutics to address the developmental deficits associated with FASDs.
Collapse
|
17
|
Abstract
Preeclampsia (PE) is a serious hypertensive disorder that affects up to 8% of all pregnancies annually. An established risk factor for PE is family history, clearly demonstrating an underlying genetic component to the disorder. To date, numerous genetic studies, using both the candidate gene and genome-wide approach, have been undertaken to tease out the genetic basis of PE and understand its origins. Such studies have identified some promising candidate genes such as STOX1 and ACVR2A. Nevertheless, researchers face ongoing challenges of replicating these genetic associations in different populations and performing the functional validation of identified genetic variants to determine their causality in the disorder. This chapter will review the genetic approaches used in the study of PE, discuss their limitations and possible confounders, and describe current strategies.
Collapse
Affiliation(s)
- Hannah E J Yong
- Department of Maternal-Fetal Medicine Pregnancy Research Centre, The Royal Women's Hospital, Melbourne, VIC, Australia.
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia.
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, The University of Cambridge, Cambridge, UK.
| | - Padma Murthi
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Shaun P Brennecke
- Department of Maternal-Fetal Medicine Pregnancy Research Centre, The Royal Women's Hospital, Melbourne, VIC, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia
| | - Eric K Moses
- Centre for Genetic Origins of Health and Disease, The University of Western Australia, Perth, Australia
| |
Collapse
|
18
|
|
19
|
Yeon SE, Kim SJ, Kim JH, Chung HY, Na SH, Lee SM. A Case Report of the Nutrition Support for a Patient with HELLP Syndrome. Clin Nutr Res 2017; 6:136-144. [PMID: 28503510 PMCID: PMC5426206 DOI: 10.7762/cnr.2017.6.2.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 04/02/2017] [Accepted: 04/11/2017] [Indexed: 12/05/2022] Open
Abstract
A 30-year-old female patient, 18 weeks gestational age, with no prior medical history was admitted to hospital complaining severe right upper quadrant pain. The patient was admitted to intensive care unit (ICU) after emergency surgery to treat intraperitoneal hemorrhage caused by rupture of liver hematoma. Despite the absence of high blood pressure, the patient was diagnosed with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome on the basis of abnormal levels of blood aspartate aminotransferase/alanine aminotransferase, lactate dehydrogenase, total bilirubin, direct bilirubin, C-reactive protein (CRP) and platelet along with liver damage and proteinuria. While in ICU, the patient was given total parenteral nutrition (TPN) and enteral nutrition (EN) for –20 days because oral feeding was impractical. In the early stage, TPN supply was not sufficient to meet the elevated nutritional demand induced by disease and surgery. Nevertheless, continuous care of nutrition support team enabled satisfactory EN and, subsequently, oral feeding which led to improvement in patient outcome.
Collapse
Affiliation(s)
- Seo Eun Yeon
- Department of Nutrition Care, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Sun Jung Kim
- Department of Nutrition Services, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Ju Hee Kim
- Department of Pharmacy, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Hae-Yun Chung
- Department of Food and Nutrition, Soongeui Women's College, Seoul 04628, Korea
| | - Se Hee Na
- Department of Anesthesiology and Pain Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Song Mi Lee
- Department of Nutrition Care, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| |
Collapse
|
20
|
Emmer PM, Joosten I, Schut MH, Zusterzeel PLM, Hendriks JCM, Steegers EAP. Shift in Expression of HLA-G mRNA Spliceforms in Pregnancies Complicated by Preeclampsia. ACTA ACUST UNITED AC 2016; 11:220-6. [PMID: 15120695 DOI: 10.1016/j.jsgi.2003.10.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Despite emerging data on the in vitro modulatory effects of trophoblast-associated human leukocyte antigen G (HLA-G), its in vivo function needs to be determined. Immunohistochemical studies show a decrease in protein expression of trophoblast HLA-G in preeclampsia. Such a decrease in protein might be the consequence of a shift in HLA-G mRNA spliceform patterns. In an exploratory pilot study we determined trophoblast HLA-G mRNA spliceform distribution in preeclampsia. METHODS Placental samples were collected immediately after cesarean delivery from pregnancies complicated by preeclampsia or the syndrome hemolysis, elevated liver enzymes, and low platelet count (HELLP) and uncomplicated normotensive pregnancies as controls. HLA-G mRNA spliceform distribution was analyzed using a semiquantitative reverse transcriptase polymerase chain reaction procedure. RESULTS Analysis of HLA-G spliceform distribution showed a significant increase in frequency of the G5 form encoding for a soluble HLA-G molecule in preeclampsia. This increase in G5 form was not found in pregnancies complicated by HELLP. CONCLUSION The increased frequency in the expression of the HLA-G G5 spliceform may play a role in the pathophysiology of preeclampsia, in particular through a recently suggested effect of this soluble HLA-G molecule on remodeling of the spiral arteries.
Collapse
Affiliation(s)
- Peter M Emmer
- Departments of Department of Blood Transfusion and Transplantation Immunology, University Medical Center Nijmegen, The Netherlands
| | | | | | | | | | | |
Collapse
|
21
|
Exome sequencing in pooled DNA samples to identify maternal pre-eclampsia risk variants. Sci Rep 2016; 6:29085. [PMID: 27384325 PMCID: PMC4935848 DOI: 10.1038/srep29085] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 06/14/2016] [Indexed: 02/04/2023] Open
Abstract
Pre-eclampsia is a common pregnancy disorder that is a major cause for maternal and perinatal mortality and morbidity. Variants predisposing to pre-eclampsia might be under negative evolutionary selection that is likely to keep their population frequencies low. We exome sequenced samples from a hundred Finnish pre-eclamptic women in pools of ten to screen for low-frequency, large-effect risk variants for pre-eclampsia. After filtering and additional genotyping steps, we selected 28 low-frequency missense, nonsense and splice site variants that were enriched in the pre-eclampsia pools compared to reference data, and genotyped the variants in 1353 pre-eclamptic and 699 non-pre-eclamptic women to test the association of them with pre-eclampsia and quantitative traits relevant for the disease. Genotypes from the SISu project (n = 6118 exome sequenced Finnish samples) were included in the binary trait association analysis as a population reference to increase statistical power. In these analyses, none of the variants tested reached genome-wide significance. In conclusion, the genetic risk for pre-eclampsia is likely complex even in a population isolate like Finland, and larger sample sizes will be necessary to detect risk variants.
Collapse
|
22
|
Refined phenotyping identifies links between preeclampsia and related diseases in a Norwegian preeclampsia family cohort. J Hypertens 2016; 33:2294-302. [PMID: 26259119 PMCID: PMC4596487 DOI: 10.1097/hjh.0000000000000696] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Preeclampsia is a complex genetic disease of pregnancy with a heterogenous presentation, unknown cause and potential severe outcomes for both mother and child. Preeclamptic women have increased risk for atherothrombotic cardiovascular disease. We aimed to identify heritabilities and phenotypic correlations of preeclampsia and related conditions in the Norwegian Preeclampsia Family Biobank. METHODS By applying a variance components model, a total of 493 individuals (from 138 families with increased occurrence of preeclampsia) were classified according to 30 disease-related phenotypes. RESULTS Of parous women, 75.7% (263/338) had experienced preeclampsia and 35.7% of women with and 22.4% without preeclampsia delivered children small for gestational age (SGA). We identified 11 phenotypes as heritable. The increased occurrence of preeclampsia was reflected by the presence [heritability (H2r) = 0.60)] and severity (H2r = 0.15) of preeclampsia and being born in a preeclamptic pregnancy (H2r = 0.25). Other heritable phenotypes identified included SGA (H2r = 0.40), chronic hypertension (H2r = 0.57), severity of atherothrombotic cardiovascular disease (H2r = 0.31), BMI (H2r = 0.60) and pulmonary disease (H2r = 0.91). The heritable phenotype preeclampsia overlapped with SGA (P = 0.03), whereas pulmonary disease was phenotypically correlated with atherothrombotic cardiovascular disease (P < 0.01), SGA (P = 0.02) and BMI (P = 0.02). CONCLUSION This is the first study identifying the H2r of a range of health-related conditions in preeclamptic families. Our study demonstrates how refinement of phenotypes leads to better H2r estimation and the identification of a biological relationship between preeclampsia and related traits.
Collapse
|
23
|
Harmon AC, Cornelius DC, Amaral LM, Faulkner JL, Cunningham MW, Wallace K, LaMarca B. The role of inflammation in the pathology of preeclampsia. Clin Sci (Lond) 2016; 130:409-19. [PMID: 26846579 PMCID: PMC5484393 DOI: 10.1042/cs20150702] [Citation(s) in RCA: 389] [Impact Index Per Article: 43.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Preeclampsia (PE) affects 5-7% of all pregnancies in the United States and is the leading cause of maternal and prenatal morbidity. PE is associated with hypertension after week 20 of gestation, decreased renal function and small-for-gestational-age babies. Women with PE exhibit chronic inflammation and production of autoantibodies. It is hypothesized that during PE, placental ischaemia occurs as a result of shallow trophoblast invasion which is associated with an immune imbalance where pro-inflammatory CD4(+) T-cells are increased and T regulatory cells (Tregs) are decreased. This imbalance leads to chronic inflammation characterized by oxidative stress, pro-inflammatory cytokines and autoantibodies. Studies conducted in our laboratory have demonstrated the importance of this immune imbalance in causing hypertension in response to placental ischaemia in pregnant rats. These studies confirm that increased CD4(+) T-cells and decreased Tregs during pregnancy leads to elevated inflammatory cytokines, endothelin (ET-1), reactive oxygen species (ROS) and agonistic autoantibodies to the angiotensin II (Ang II), type 1 receptor (AT1-AA). All of these factors taken together play an important role in increasing the blood pressure during pregnancy. Specifically, this review focuses on the decrease in Tregs, and their associated regulatory cytokine interleukin (IL)-10, which is seen in response to placental ischaemia during pregnancy. This study will also examine the effect of regulatory immune cell repopulation on the pathophysiology of PE. These studies show that restoring the balance of the immune system through increasing Tregs, either by adoptive transfer or by infusing IL-10, reduces the blood pressure and pathophysiology associated with placental ischaemia in pregnant rats.
Collapse
Affiliation(s)
- Ashlyn C Harmon
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A
| | - Denise C Cornelius
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A
| | - Lorena M Amaral
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A
| | - Jessica L Faulkner
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A
| | - Mark W Cunningham
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A
| | - Kedra Wallace
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A
| | - Babbette LaMarca
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A.
| |
Collapse
|
24
|
El-Agwany AS, Abdelsadek AA. A rare case of normotensive HELLP syndrome complicated with massive ascites: Spontaneous resolution. EGYPTIAN JOURNAL OF ANAESTHESIA 2016. [DOI: 10.1016/j.egja.2015.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
25
|
Roten LT, Thomsen LCV, Gundersen AS, Fenstad MH, Odland ML, Strand KM, Solberg P, Tappert C, Araya E, Bærheim G, Lyslo I, Tollaksen K, Bjørge L, Austgulen R. The Norwegian preeclampsia family cohort study: a new resource for investigating genetic aspects and heritability of preeclampsia and related phenotypes. BMC Pregnancy Childbirth 2015; 15:319. [PMID: 26625711 PMCID: PMC4666119 DOI: 10.1186/s12884-015-0754-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 11/21/2015] [Indexed: 12/27/2022] Open
Abstract
Background Preeclampsia is a major pregnancy complication without curative treatment available. A Norwegian Preeclampsia Family Cohort was established to provide a new resource for genetic and molecular studies aiming to improve the understanding of the complex pathophysiology of preeclampsia. Methods Participants were recruited from five Norwegian hospitals after diagnoses of preeclampsia registered in the Medical birth registry of Norway were verified according to the study’s inclusion criteria. Detailed obstetric information and information on personal and family disease history focusing on cardiovascular health was collected. At attendance anthropometric measurements were registered and blood samples were drawn. The software package SPSS 19.0 for Windows was used to compute descriptive statistics such as mean and SD. P-values were computed based on t-test statistics for normally distributed variables. Nonparametrical methods (chi square) were used for categorical variables. Results A cohort consisting of 496 participants (355 females and 141 males) representing 137 families with increased occurrence of preeclampsia has been established, and blood samples are available for 477 participants. Descriptive analyses showed that about 60 % of the index women’s pregnancies with birth data registered were preeclamptic according to modern diagnosis criteria. We also found that about 41 % of the index women experienced more than one preeclamptic pregnancy. In addition, the descriptive analyses confirmed that preeclamptic pregnancies are more often accompanied with delivery complications. Conclusion The data and biological samples collected in this Norwegian Preeclampsia Family Cohort will provide an important basis for future research. Identification of preeclampsia susceptibility genes and new biomarkers may contribute to more efficient strategies to identify mothers “at risk” and contribute to development of novel preventative therapies.
Collapse
Affiliation(s)
- Linda Tømmerdal Roten
- Department of Laboratory Medicine, Children's and Women's Health, the Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway. .,Central Norway Regional Health Authority, 7501, Stjørdal, Norway.
| | - Liv Cecilie Vestrheim Thomsen
- Department of Obstetrics and Gynecology, Haukeland University Hospital, 5058, Bergen, Norway. .,Department of Clinical Medicine, University of Bergen, 5020, Bergen, Norway.
| | - Astrid Solberg Gundersen
- The Regional Biobank of Central Norway, St. Olavs Hospital, Trondheim, Norway. .,Department of Cancer Research and Molecular Medicine, NTNU, 7491, Trondheim, Norway.
| | - Mona Høysæter Fenstad
- Department of Cancer Research and Molecular Medicine, NTNU, 7491, Trondheim, Norway. .,Department of Immunology and Transfusion Medicine, St. Olavs Hospital, 7006, Trondheim, Norway.
| | - Maria Lisa Odland
- Department of Cancer Research and Molecular Medicine, NTNU, 7491, Trondheim, Norway.
| | - Kristin Melheim Strand
- Department of Laboratory Medicine, Children's and Women's Health, the Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway.
| | - Per Solberg
- Department of Obstetrics and Gynecology, Levanger Hospital, 7601, Levanger, Norway.
| | - Christian Tappert
- Department of Obstetrics and Gynecology, St. Olavs Hospital, 7006, Trondheim, Norway.
| | - Elisabeth Araya
- Department of Obstetrics and Gynecology, St. Olavs Hospital, 7006, Trondheim, Norway.
| | - Gunhild Bærheim
- Department of Obstetrics and Gynecology, Stavanger University Hospital, 4068, Stavanger, Norway.
| | - Ingvill Lyslo
- Department of Obstetrics and Gynecology, Stavanger University Hospital, 4068, Stavanger, Norway.
| | - Kjersti Tollaksen
- Department of Obstetrics and Gynecology, Stavanger University Hospital, 4068, Stavanger, Norway.
| | - Line Bjørge
- Department of Obstetrics and Gynecology, Haukeland University Hospital, 5058, Bergen, Norway. .,Department of Clinical Medicine, University of Bergen, 5020, Bergen, Norway.
| | - Rigmor Austgulen
- Department of Cancer Research and Molecular Medicine, NTNU, 7491, Trondheim, Norway.
| |
Collapse
|
26
|
Single nucleotide polymorphisms near the inhibin beta B gene on 2q14 are associated with pre-eclampsia in Han Chinese women. Eur J Obstet Gynecol Reprod Biol 2015; 193:127-31. [DOI: 10.1016/j.ejogrb.2015.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/11/2015] [Accepted: 04/02/2015] [Indexed: 11/24/2022]
|
27
|
Solomon BD, Bodian DL, Khromykh A, Mora GG, Lanpher BC, Iyer RK, Baveja R, Vockley JG, Niederhuber JE. Expanding the phenotypic spectrum in EP300-related Rubinstein-Taybi syndrome. Am J Med Genet A 2015; 167A:1111-6. [PMID: 25712426 DOI: 10.1002/ajmg.a.36883] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 10/23/2014] [Indexed: 01/14/2023]
Abstract
Rubinstein-Taybi syndrome (RSTS) can be caused by heterozygous mutations or deletions involving CREBBP or, less commonly, EP300. To date, only 15 patients with EP300 mutations have been clinically described. Frequently reported manifestations in these patients include characteristic facial and limb features, varying degrees of neurocognitive dysfunction, and maternal preeclampsia. Other congenital anomalies are less frequently reported. We describe a child found to have a de novo EP300 mutation (c.4933C>T, predicted to result in p.Arg1645X) through research-based whole-genome sequencing of the family trio. The child's presentation involved dysmorphic features as well as unilateral renal agenesis, a myelomeningocele, and minor genitourinary anomalies. The involvement of congenital anomalies in all 16 clinically described patients with EP300 mutations (25% of which have been identified by "hypothesis free" methods, including microarray, exome, and whole-genome sequencing) is reviewed. In summary, genitourinary anomalies have been identified in 38%, cardiovascular anomalies in 25%, spinal/vertebral anomalies in 19%, other skeletal anomalies in 19%, brain anomalies in 13%, and renal anomalies in 6%. Our patient expands the phenotypic spectrum in EP300-related RSTS; this case demonstrates the evolving practice of clinical genomics related to increasing availability of genomic sequencing methods.
Collapse
Affiliation(s)
- Benjamin D Solomon
- Inova Translational Medicine Institute, Inova Health System, Falls Church, Virginia; Department of Pediatrics, Inova Health System, Falls Church, Virginia; Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Ferreira LC, Gomes CEM, Araújo ACP, Bezerra PF, Duggal P, Jeronimo SMB. Association between ACVR2A and early-onset preeclampsia: replication study in a Northeastern Brazilian population. Placenta 2014; 36:186-90. [PMID: 25499008 DOI: 10.1016/j.placenta.2014.11.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 10/31/2014] [Accepted: 11/10/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Preeclampsia is a complex and heterogeneous disease with increased risk of maternal mortality, especially for earlier gestational onset. There is a great inconsistency regarding the genetics of preeclampsia across the literature. The gene Activin A receptor, type IIA (ACVR2A), was reported as associated to preeclampsia in Australian/New Zealand and Norwegian populations. The goal of this study was to validate this genetic association in a Brazilian population. METHODS We performed a case-control study using 693 controls and 613 cases (443 preeclampsia, 64 eclampsia and 106 HELLP syndrome), from a Northeastern Brazilian population. Five single nucleotide polymorphisms (SNPs) in ACVR2A were tested for association through multiple logistic regression models. RESULTS There was no statistical association with preeclampsia (per se), eclampsia or HELLP. However, by grouping preeclampsia in accordance to the gestational age at delivery, SNPs rs1424954 (OR = 1.86; 95% CI, 1.25-2.78; p = 0.002) and rs1014064 (OR = 1.77; 95% CI, 1.21-2.60; p = 0.004) were significantly associated with early onset preeclampsia (gestational age ≤ 34 weeks). The risk haplotype had a frequency of 0.468 in early preeclampsia compared to 0.316 in controls (p = 0.0008 and permuted p = 0.002). DISCUSSION Activin A receptors are important in decidualization, trophoblast invasion and placentation processes during pregnancy. The gene ACVR2A was associated with the more severe early onset preeclampsia. This finding supports the hypothesis of different pathogenic mechanisms contributing to the early- and late-onset preeclampsia.
Collapse
Affiliation(s)
- L C Ferreira
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, Brazil; Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Brazil
| | - C E M Gomes
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Brazil; Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - A C P Araújo
- Department of Obstetrics and Gynecology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - P F Bezerra
- Maternidade Escola Januário Cicco, Federal University of Rio Grande do Norte, Natal, Brazil
| | - P Duggal
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - S M B Jeronimo
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, Brazil; Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Brazil; Institute of Science and Technology of Tropical Diseases (INCT-DT), Brazil.
| |
Collapse
|
29
|
Kawasaki K, Kondoh E, Chigusa Y, Ujita M, Murakami R, Mogami H, Brown JB, Okuno Y, Konishi I. Reliable pre-eclampsia pathways based on multiple independent microarray data sets. Mol Hum Reprod 2014; 21:217-24. [PMID: 25323968 DOI: 10.1093/molehr/gau096] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Pre-eclampsia is a multifactorial disorder characterized by heterogeneous clinical manifestations. Gene expression profiling of preeclamptic placenta have provided different and even opposite results, partly due to data compromised by various experimental artefacts. Here we aimed to identify reliable pre-eclampsia-specific pathways using multiple independent microarray data sets. Gene expression data of control and preeclamptic placentas were obtained from Gene Expression Omnibus. Single-sample gene-set enrichment analysis was performed to generate gene-set activation scores of 9707 pathways obtained from the Molecular Signatures Database. Candidate pathways were identified by t-test-based screening using data sets, GSE10588, GSE14722 and GSE25906. Additionally, recursive feature elimination was applied to arrive at a further reduced set of pathways. To assess the validity of the pre-eclampsia pathways, a statistically-validated protocol was executed using five data sets including two independent other validation data sets, GSE30186, GSE44711. Quantitative real-time PCR was performed for genes in a panel of potential pre-eclampsia pathways using placentas of 20 women with normal or severe preeclamptic singleton pregnancies (n = 10, respectively). A panel of ten pathways were found to discriminate women with pre-eclampsia from controls with high accuracy. Among these were pathways not previously associated with pre-eclampsia, such as the GABA receptor pathway, as well as pathways that have already been linked to pre-eclampsia, such as the glutathione and CDKN1C pathways. mRNA expression of GABRA3 (GABA receptor pathway), GCLC and GCLM (glutathione metabolic pathway), and CDKN1C was significantly reduced in the preeclamptic placentas. In conclusion, ten accurate and reliable pre-eclampsia pathways were identified based on multiple independent microarray data sets. A pathway-based classification may be a worthwhile approach to elucidate the pathogenesis of pre-eclampsia.
Collapse
Affiliation(s)
- Kaoru Kawasaki
- Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan
| | - Eiji Kondoh
- Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan
| | | | - Mari Ujita
- Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan
| | - Ryusuke Murakami
- Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan
| | - Haruta Mogami
- Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan
| | - J B Brown
- Department of Clinical System Onco-Informatics, Kyoto University, Kyoto, Japan
| | - Yasushi Okuno
- Department of Clinical System Onco-Informatics, Kyoto University, Kyoto, Japan
| | - Ikuo Konishi
- Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan
| |
Collapse
|
30
|
Fong FM, Sahemey MK, Hamedi G, Eyitayo R, Yates D, Kuan V, Thangaratinam S, Walton RT. Maternal genotype and severe preeclampsia: a HuGE review. Am J Epidemiol 2014; 180:335-45. [PMID: 25028703 DOI: 10.1093/aje/kwu151] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Severe preeclampsia is a common cause of maternal and perinatal morbidity worldwide. The disease clusters in families; however, individual genetic studies have produced inconsistent results. We conducted a review to examine relationships between maternal genotype and severe preeclampsia. We searched the MEDLINE and Embase databases for prospective and retrospective cohort and case-control studies reporting associations between genes and severe preeclampsia. Four reviewers independently undertook study selection, quality assessment, and data extraction. We performed random-effects meta-analyses by genotype and predefined functional gene group (thrombophilic, vasoactive, metabolic, immune, and cell signalling). Fifty-seven studies evaluated 50 genotypes in 5,049 cases and 16,989 controls. Meta-analysis showed a higher risk of severe preeclampsia with coagulation factor V gene (proaccelerin, labile factor) (F5) polymorphism rs6025 (odds ratio = 1.90, 95% confidence interval: 1.42, 2.54; 23 studies, I(2) = 29%), coagulation factor II (thrombin) gene (F2) mutation G20210A (rs1799963) (odds ratio = 2.01, 95% confidence interval: 1.14, 3.55, 9 studies, I(2) = 0%), leptin receptor gene (LEPR) polymorphism rs1137100 (odds ratio = 1.75, 95% confidence interval: 1.15, 2.65; 2 studies, I(2) = 0%), and the thrombophilic gene group (odds ratio = 1.87, 95% confidence interval: 1.43, 2.45, I(2) = 27%). There were no associations with other gene groups. There was moderate heterogeneity between studies and potential for bias from poor-quality genotyping and inconsistent definition of phenotype. Further studies with robust methods should investigate genetic factors that might potentially be used to stratify pregnancies according to risk of complications.
Collapse
|
31
|
Genetic aspects of preeclampsia and the HELLP syndrome. J Pregnancy 2014; 2014:910751. [PMID: 24991435 PMCID: PMC4060423 DOI: 10.1155/2014/910751] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 02/27/2014] [Accepted: 04/01/2014] [Indexed: 12/20/2022] Open
Abstract
Both preeclampsia and the HELLP syndrome have their origin in the placenta. The aim of this study is to review genetic factors involved in development of preeclampsia and the HELLP syndrome using literature search in PubMed. A familial cohort links chromosomes 2q, 5q, and 13q to preeclampsia. The chromosome 12q is coupled with the HELLP syndrome. The STOX1 gene, the ERAP1 and 2 genes, the syncytin envelope gene, and the −670 Fas receptor polymorphisms are involved in the development of preeclampsia. The ACVR2A gene on chromosome 2q22 is also implicated. The toll-like receptor-4 (TLR-4) and factor V Leiden mutation participate both in development of preeclampsia and the HELLP syndrome. Carriers of the TT and the CC genotype of the MTHFR C677T polymorphism seem to have an increased risk of the HELLP syndrome. The placental levels of VEGF mRNA are reduced both in women with preeclampsia and in women with the HELLP syndrome. The BclI polymorphism is engaged in development of the HELLP syndrome but not in development of severe preeclampsia. The ACE I/D polymorphism affects uteroplacental and umbilical artery blood flows in women with preeclampsia. In women with preeclampsia and the HELLP syndrome several genes in the placenta are deregulated. Preeclampsia and the HELLP syndrome are multiplex genetic diseases.
Collapse
|
32
|
Kaartokallio T, Klemetti MM, Timonen A, Uotila J, Heinonen S, Kajantie E, Kere J, Kivinen K, Pouta A, Lakkisto P, Laivuori H. Microsatellite polymorphism in the heme oxygenase-1 promoter is associated with nonsevere and late-onset preeclampsia. Hypertension 2014; 64:172-7. [PMID: 24799610 DOI: 10.1161/hypertensionaha.114.03337] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Preeclampsia is a serious and phenotypically heterogeneous vascular pregnancy disorder. Heme oxygenase-1 (HO-1) is a stress response enzyme that may protect the maternal endothelium and facilitate adequate metabolic adaptation to pregnancy by its antioxidant and anti-inflammatory functions. HO-1 stress response is modulated by HO-1 gene (HMOX1) polymorphisms. Individuals with the long allele of a guanine-thymine (GTn) microsatellite repeat located in the promoter region of HMOX1 have a higher risk of cardiometabolic diseases compared with those with the short allele. We investigated whether the long GTn allele of HMOX1 is associated with subtypes of preeclampsia. The GTn repeat was genotyped in 759 patients and in 779 controls from the Finnish Genetics of Preeclampsia Consortium (FINNPEC) cohort using DNA fragment analysis. In subtype analyses, the long-long (LL) genotype was associated with nonsevere (additive model: odds ratio [OR], 1.94; 95% confidence interval [CI], 1.13-3.31; recessive model: OR, 1.39; 95% CI, 1.02-1.89) and late-onset (additive model: OR, 1.44; 95% CI, 1.02-2.05; recessive model: OR, 1.28; 95% CI, 1.02-1.59) preeclampsia and with preeclampsia without a small-for-gestational-age infant (recessive model: OR, 1.27; 95% CI, 1.02-1.58). The long allele was associated with nonsevere (OR, 1.35; 95% CI, 1.07-1.70) and late-onset (OR, 1.21; 95% CI, 1.03-1.42) preeclampsia and with preeclampsia without a small-for-gestational-age infant (OR, 1.19; 95% CI, 1.02-1.40). Moreover, both the LL genotype and the long allele were associated with preeclampsia in women who had smoked during pregnancy. In conclusion, the GTn long allele seems to predispose to late-onset, less severe form of preeclampsia. This finding supports the role of HO-1 in the pathogenesis of preeclampsia and suggests that the HO-1 pathway may provide a potential target for the treatment of preeclampsia.
Collapse
Affiliation(s)
- Tea Kaartokallio
- From the Haartman Institute, Medical Genetics (T.K., M.M.K., A.T., J.K., H.L.), Research Programs Unit, Molecular Neurology (A.T.), Department of Clinical Chemistry (P.L.), and Institute for Molecular Medicine Finland (H.L.), University of Helsinki, Helsinki, Finland; Departments of Obstetrics and Gynecology (M.M.K., H.L.) and Clinical Chemistry (P.L.), Helsinki University Central Hospital, Helsinki, Finland; Department of Obstetrics and Gynecology, South-Karelia Central Hospital, Lappeenranta, Finland (M.M.K.); Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland (J.U.); Department of Obstetrics and Gynecology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland (S.H.); Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland (E.K.); Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland (A.P.); Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland (E.K.); Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (E.K., A.P.); Department of Biosciences and Nutrition, and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden (J.K.); Folkhälsan Institute of Genetics, Helsinki, Finland (J.K.); Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom (K.K.); and Minerva Institute for Medical Research, Helsinki, Finland (P.L.).
| | - Miira M Klemetti
- From the Haartman Institute, Medical Genetics (T.K., M.M.K., A.T., J.K., H.L.), Research Programs Unit, Molecular Neurology (A.T.), Department of Clinical Chemistry (P.L.), and Institute for Molecular Medicine Finland (H.L.), University of Helsinki, Helsinki, Finland; Departments of Obstetrics and Gynecology (M.M.K., H.L.) and Clinical Chemistry (P.L.), Helsinki University Central Hospital, Helsinki, Finland; Department of Obstetrics and Gynecology, South-Karelia Central Hospital, Lappeenranta, Finland (M.M.K.); Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland (J.U.); Department of Obstetrics and Gynecology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland (S.H.); Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland (E.K.); Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland (A.P.); Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland (E.K.); Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (E.K., A.P.); Department of Biosciences and Nutrition, and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden (J.K.); Folkhälsan Institute of Genetics, Helsinki, Finland (J.K.); Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom (K.K.); and Minerva Institute for Medical Research, Helsinki, Finland (P.L.)
| | - Anni Timonen
- From the Haartman Institute, Medical Genetics (T.K., M.M.K., A.T., J.K., H.L.), Research Programs Unit, Molecular Neurology (A.T.), Department of Clinical Chemistry (P.L.), and Institute for Molecular Medicine Finland (H.L.), University of Helsinki, Helsinki, Finland; Departments of Obstetrics and Gynecology (M.M.K., H.L.) and Clinical Chemistry (P.L.), Helsinki University Central Hospital, Helsinki, Finland; Department of Obstetrics and Gynecology, South-Karelia Central Hospital, Lappeenranta, Finland (M.M.K.); Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland (J.U.); Department of Obstetrics and Gynecology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland (S.H.); Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland (E.K.); Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland (A.P.); Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland (E.K.); Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (E.K., A.P.); Department of Biosciences and Nutrition, and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden (J.K.); Folkhälsan Institute of Genetics, Helsinki, Finland (J.K.); Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom (K.K.); and Minerva Institute for Medical Research, Helsinki, Finland (P.L.)
| | - Jukka Uotila
- From the Haartman Institute, Medical Genetics (T.K., M.M.K., A.T., J.K., H.L.), Research Programs Unit, Molecular Neurology (A.T.), Department of Clinical Chemistry (P.L.), and Institute for Molecular Medicine Finland (H.L.), University of Helsinki, Helsinki, Finland; Departments of Obstetrics and Gynecology (M.M.K., H.L.) and Clinical Chemistry (P.L.), Helsinki University Central Hospital, Helsinki, Finland; Department of Obstetrics and Gynecology, South-Karelia Central Hospital, Lappeenranta, Finland (M.M.K.); Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland (J.U.); Department of Obstetrics and Gynecology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland (S.H.); Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland (E.K.); Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland (A.P.); Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland (E.K.); Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (E.K., A.P.); Department of Biosciences and Nutrition, and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden (J.K.); Folkhälsan Institute of Genetics, Helsinki, Finland (J.K.); Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom (K.K.); and Minerva Institute for Medical Research, Helsinki, Finland (P.L.)
| | - Seppo Heinonen
- From the Haartman Institute, Medical Genetics (T.K., M.M.K., A.T., J.K., H.L.), Research Programs Unit, Molecular Neurology (A.T.), Department of Clinical Chemistry (P.L.), and Institute for Molecular Medicine Finland (H.L.), University of Helsinki, Helsinki, Finland; Departments of Obstetrics and Gynecology (M.M.K., H.L.) and Clinical Chemistry (P.L.), Helsinki University Central Hospital, Helsinki, Finland; Department of Obstetrics and Gynecology, South-Karelia Central Hospital, Lappeenranta, Finland (M.M.K.); Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland (J.U.); Department of Obstetrics and Gynecology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland (S.H.); Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland (E.K.); Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland (A.P.); Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland (E.K.); Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (E.K., A.P.); Department of Biosciences and Nutrition, and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden (J.K.); Folkhälsan Institute of Genetics, Helsinki, Finland (J.K.); Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom (K.K.); and Minerva Institute for Medical Research, Helsinki, Finland (P.L.)
| | - Eero Kajantie
- From the Haartman Institute, Medical Genetics (T.K., M.M.K., A.T., J.K., H.L.), Research Programs Unit, Molecular Neurology (A.T.), Department of Clinical Chemistry (P.L.), and Institute for Molecular Medicine Finland (H.L.), University of Helsinki, Helsinki, Finland; Departments of Obstetrics and Gynecology (M.M.K., H.L.) and Clinical Chemistry (P.L.), Helsinki University Central Hospital, Helsinki, Finland; Department of Obstetrics and Gynecology, South-Karelia Central Hospital, Lappeenranta, Finland (M.M.K.); Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland (J.U.); Department of Obstetrics and Gynecology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland (S.H.); Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland (E.K.); Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland (A.P.); Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland (E.K.); Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (E.K., A.P.); Department of Biosciences and Nutrition, and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden (J.K.); Folkhälsan Institute of Genetics, Helsinki, Finland (J.K.); Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom (K.K.); and Minerva Institute for Medical Research, Helsinki, Finland (P.L.)
| | - Juha Kere
- From the Haartman Institute, Medical Genetics (T.K., M.M.K., A.T., J.K., H.L.), Research Programs Unit, Molecular Neurology (A.T.), Department of Clinical Chemistry (P.L.), and Institute for Molecular Medicine Finland (H.L.), University of Helsinki, Helsinki, Finland; Departments of Obstetrics and Gynecology (M.M.K., H.L.) and Clinical Chemistry (P.L.), Helsinki University Central Hospital, Helsinki, Finland; Department of Obstetrics and Gynecology, South-Karelia Central Hospital, Lappeenranta, Finland (M.M.K.); Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland (J.U.); Department of Obstetrics and Gynecology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland (S.H.); Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland (E.K.); Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland (A.P.); Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland (E.K.); Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (E.K., A.P.); Department of Biosciences and Nutrition, and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden (J.K.); Folkhälsan Institute of Genetics, Helsinki, Finland (J.K.); Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom (K.K.); and Minerva Institute for Medical Research, Helsinki, Finland (P.L.)
| | - Katja Kivinen
- From the Haartman Institute, Medical Genetics (T.K., M.M.K., A.T., J.K., H.L.), Research Programs Unit, Molecular Neurology (A.T.), Department of Clinical Chemistry (P.L.), and Institute for Molecular Medicine Finland (H.L.), University of Helsinki, Helsinki, Finland; Departments of Obstetrics and Gynecology (M.M.K., H.L.) and Clinical Chemistry (P.L.), Helsinki University Central Hospital, Helsinki, Finland; Department of Obstetrics and Gynecology, South-Karelia Central Hospital, Lappeenranta, Finland (M.M.K.); Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland (J.U.); Department of Obstetrics and Gynecology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland (S.H.); Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland (E.K.); Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland (A.P.); Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland (E.K.); Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (E.K., A.P.); Department of Biosciences and Nutrition, and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden (J.K.); Folkhälsan Institute of Genetics, Helsinki, Finland (J.K.); Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom (K.K.); and Minerva Institute for Medical Research, Helsinki, Finland (P.L.)
| | - Anneli Pouta
- From the Haartman Institute, Medical Genetics (T.K., M.M.K., A.T., J.K., H.L.), Research Programs Unit, Molecular Neurology (A.T.), Department of Clinical Chemistry (P.L.), and Institute for Molecular Medicine Finland (H.L.), University of Helsinki, Helsinki, Finland; Departments of Obstetrics and Gynecology (M.M.K., H.L.) and Clinical Chemistry (P.L.), Helsinki University Central Hospital, Helsinki, Finland; Department of Obstetrics and Gynecology, South-Karelia Central Hospital, Lappeenranta, Finland (M.M.K.); Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland (J.U.); Department of Obstetrics and Gynecology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland (S.H.); Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland (E.K.); Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland (A.P.); Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland (E.K.); Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (E.K., A.P.); Department of Biosciences and Nutrition, and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden (J.K.); Folkhälsan Institute of Genetics, Helsinki, Finland (J.K.); Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom (K.K.); and Minerva Institute for Medical Research, Helsinki, Finland (P.L.)
| | - Päivi Lakkisto
- From the Haartman Institute, Medical Genetics (T.K., M.M.K., A.T., J.K., H.L.), Research Programs Unit, Molecular Neurology (A.T.), Department of Clinical Chemistry (P.L.), and Institute for Molecular Medicine Finland (H.L.), University of Helsinki, Helsinki, Finland; Departments of Obstetrics and Gynecology (M.M.K., H.L.) and Clinical Chemistry (P.L.), Helsinki University Central Hospital, Helsinki, Finland; Department of Obstetrics and Gynecology, South-Karelia Central Hospital, Lappeenranta, Finland (M.M.K.); Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland (J.U.); Department of Obstetrics and Gynecology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland (S.H.); Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland (E.K.); Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland (A.P.); Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland (E.K.); Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (E.K., A.P.); Department of Biosciences and Nutrition, and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden (J.K.); Folkhälsan Institute of Genetics, Helsinki, Finland (J.K.); Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom (K.K.); and Minerva Institute for Medical Research, Helsinki, Finland (P.L.)
| | - Hannele Laivuori
- From the Haartman Institute, Medical Genetics (T.K., M.M.K., A.T., J.K., H.L.), Research Programs Unit, Molecular Neurology (A.T.), Department of Clinical Chemistry (P.L.), and Institute for Molecular Medicine Finland (H.L.), University of Helsinki, Helsinki, Finland; Departments of Obstetrics and Gynecology (M.M.K., H.L.) and Clinical Chemistry (P.L.), Helsinki University Central Hospital, Helsinki, Finland; Department of Obstetrics and Gynecology, South-Karelia Central Hospital, Lappeenranta, Finland (M.M.K.); Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland (J.U.); Department of Obstetrics and Gynecology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland (S.H.); Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland (E.K.); Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland (A.P.); Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland (E.K.); Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland (E.K., A.P.); Department of Biosciences and Nutrition, and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden (J.K.); Folkhälsan Institute of Genetics, Helsinki, Finland (J.K.); Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom (K.K.); and Minerva Institute for Medical Research, Helsinki, Finland (P.L.)
| |
Collapse
|
33
|
Morgan L, McGinnis R, Steinthorsdottir V, Svyatova G, Zakhidova N, Lee WK, Iversen AC, Magnus P, Walker J, Casas JP, Sultanov S, Laivuori H. InterPregGen: genetic studies of pre-eclampsia in three continents. NORSK EPIDEMIOLOGI 2014; 24:141-146. [PMID: 26568652 PMCID: PMC4641320 DOI: 10.5324/nje.v24i1-2.1815] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Pre-eclampsia is a major cause of maternal and fetal mortality in pregnancy. The identification of genetic variants which predispose to pre-eclampsia demands large DNA collections from affected mothers and babies and controls, with reliable supporting phenotypic data. The InterPregGen study has assembled a consortium of researchers from Europe, Central Asia and South America with the aim of elucidating the genetic architecture of pre-eclampsia. The MoBa collection is playing a vital role in this collaborative venture, which has the potential to provide new insights into the causes of pre-eclampsia, and provide a rational basis for novel approaches to prevention and treatment.
Collapse
Affiliation(s)
- Linda Morgan
- School of Life Sciences, University of Nottingham, UK
| | | | | | - Gulnara Svyatova
- Scientific Centre of Obstetrics, Gynaecology and Perinatology of Ministry of Health, Kazakhstan
| | | | - Wai Kwong Lee
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, UK
| | - Ann-Charlotte Iversen
- Department of Cancer Research and Molecular Medicine and Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Norway
| | - Per Magnus
- Norwegian Institute of Public Health, Norway
| | - James Walker
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, UK
| | - Juan Pablo Casas
- London School of Hygiene and Tropical Medicine and University College London, UK
| | - Saidazim Sultanov
- Republic Specialized Scientific-Practical Medical Centre of Obstetrics and Gynaecology, Uzbekistan
| | - Hannele Laivuori
- Haartman Institute, Medical Genetics, University of Helsinki, Finland
| |
Collapse
|
34
|
Al-Jameil N, Aziz Khan F, Fareed Khan M, Tabassum H. A brief overview of preeclampsia. J Clin Med Res 2013; 6:1-7. [PMID: 24400024 PMCID: PMC3881982 DOI: 10.4021/jocmr1682w] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2013] [Indexed: 01/13/2023] Open
Abstract
Preeclampsia (PE) is a leading cause of maternal mortality and morbidity worldwide. It occurs in women with first or multiple pregnancies and is characterized by new onset hypertension and proteinuria. Improper placentation is mainly responsible for the disease. If PE remains untreated, it moves towards more serious condition known as eclampsia. Hypertension, diabetes mellitus, proteinuria, obesity, family history, nulliparity, multiple pregnancies and thrombotic vascular disease contribute as the risk factors for PE. PE triggered metabolic stress causes vascular injury, thus contributing to the development of cardiovascular disease (CVD) and/or chronic kidney disease (CKD) in future. This risk appears to be increased especially in women with a history of recurrent PE and eclampsia. Clinically increased serum levels of sFlt-1 and decreased placental growth factor (PIGF) and vascular endothelial growth factor (VEGF) represent the severe condition of PE. The clinical findings of sever PE are assorted by the presence of systemic endothelial dysfunction, microangiopathy, the liver (hemolysis, elevated liver function tests and low platelet count, namely HELLP syndrome) and the kidney (proteinuria). The early detection of PE is one of the most important goals in obstetrics.
Collapse
Affiliation(s)
- Noura Al-Jameil
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Farah Aziz Khan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mohammad Fareed Khan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Hajera Tabassum
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
35
|
Yong HEJ, Murthi P, Borg A, Kalionis B, Moses EK, Brennecke SP, Keogh RJ. Increased decidual mRNA expression levels of candidate maternal pre-eclampsia susceptibility genes are associated with clinical severity. Placenta 2013; 35:117-24. [PMID: 24331737 DOI: 10.1016/j.placenta.2013.11.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 10/31/2013] [Accepted: 11/17/2013] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Pre-eclampsia (PE) has a familial association, with daughters of women who had PE during pregnancy having more than twice the risk of developing PE themselves. Through genome-wide linkage and genetic association studies in PE-affected families and large population samples, we previously identified the following as positional candidate maternal susceptibility genes for PE; ACVR1, INHA, INHBB, ERAP1, ERAP2, LNPEP, COL4A1 and COL4A2. The aims of this study were to determine mRNA expression levels of previously identified candidate maternal pre-eclampsia susceptibility genes from normotensive and severe PE (SPE) pregnancies and correlate mRNA expression levels with the clinical severity of SPE. METHODS Third trimester decidual tissues were collected from both normotensive (n = 21) and SPE pregnancies (n = 24) and mRNA expression levels were determined by real-time PCR. Gene expression was then correlated with several parameters of clinical severity in SPE. Statistical significance was determined by Mann-Whitney U test and Spearman's Correlation. RESULTS The data demonstrate significantly increased decidual mRNA expression levels of ACVR1, INHBB, ERAP1, ERAP2, LNPEP, COL4A1 and COL4A2 in SPE (p < 0.05). Increased mRNA expression levels of several genes - INHA, INHBB, COL4A1 and COL4A2 were correlated with earlier onset of PE and earlier delivery of the fetus (p < 0.05). CONCLUSION These results suggest altered expression of maternal susceptibility genes may play roles in PE development and the course of disease severity.
Collapse
Affiliation(s)
- H E J Yong
- Department of Perinatal Medicine Pregnancy Research Centre and University of Melbourne, Department of Obstetrics and Gynaecology, Royal Women's Hospital, Locked Bag 300, Corner Grattan Street and Flemington Road, Parkville 3052, Victoria, Australia.
| | - P Murthi
- Department of Perinatal Medicine Pregnancy Research Centre and University of Melbourne, Department of Obstetrics and Gynaecology, Royal Women's Hospital, Locked Bag 300, Corner Grattan Street and Flemington Road, Parkville 3052, Victoria, Australia.
| | - A Borg
- Department of Perinatal Medicine Pregnancy Research Centre and University of Melbourne, Department of Obstetrics and Gynaecology, Royal Women's Hospital, Locked Bag 300, Corner Grattan Street and Flemington Road, Parkville 3052, Victoria, Australia.
| | - B Kalionis
- Department of Perinatal Medicine Pregnancy Research Centre and University of Melbourne, Department of Obstetrics and Gynaecology, Royal Women's Hospital, Locked Bag 300, Corner Grattan Street and Flemington Road, Parkville 3052, Victoria, Australia.
| | - E K Moses
- Centre for Genetic Origins of Health and Disease, University of Western Australia, 35 Stirling Highway, Crawley 6009, Western Australia, Australia.
| | - S P Brennecke
- Department of Perinatal Medicine Pregnancy Research Centre and University of Melbourne, Department of Obstetrics and Gynaecology, Royal Women's Hospital, Locked Bag 300, Corner Grattan Street and Flemington Road, Parkville 3052, Victoria, Australia.
| | - R J Keogh
- Department of Perinatal Medicine Pregnancy Research Centre and University of Melbourne, Department of Obstetrics and Gynaecology, Royal Women's Hospital, Locked Bag 300, Corner Grattan Street and Flemington Road, Parkville 3052, Victoria, Australia.
| |
Collapse
|
36
|
Woods SA, Robinson HB, Kohler LJ, Agamanolis D, Sterbenz G, Khalifa M. Exome sequencing identifies a novel EP300 frame shift mutation in a patient with features that overlap Cornelia de Lange syndrome. Am J Med Genet A 2013; 164A:251-8. [PMID: 24352918 DOI: 10.1002/ajmg.a.36237] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 08/25/2013] [Indexed: 12/20/2022]
Abstract
Rubinstein-Taybi syndrome (RTS) and Cornelia de Lange syndrome (CdLS) are genetically heterogeneous multiple anomalies syndromes, each having a distinctive facial gestalt. Two genes (CREBBP and EP300) are known to cause RTS, and five (NIPBL, SMC1A, SMC3, RAD21, and HDAC8) have been associated with CdLS. A diagnosis of RTS or CdLS is molecularly confirmed in only 65% of clinically identified cases, suggesting that additional causative genes exist for both conditions. In addition, although EP300 and CREBBP encode homologous proteins and perform similar functions, only eight EP300 positive RTS patients have been reported, suggesting that patients with EP300 mutations might be escaping clinical recognition. We report on a child with multiple congenital abnormalities and intellectual disability whose facial features and complex phenotype resemble CdLS. However, no mutations in CdLS-related genes were identified. Rather, a novel EP300 mutation was found on whole exome sequencing. Possible links between EP300 and genes causing CdLS are evident in the literature. Both EP300 and HDAC8 are involved in the regulation of TP53 transcriptional activity. In addition, p300 and other chromatin associated proteins, including NIPBL, SMCA1, and SMC3, have been found at enhancer regions in different cell types. It is therefore possible that EP300 and CdLS-related genes are involved in additional shared pathways, producing overlapping phenotypes. As whole exome sequencing becomes more widely utilized, the diverse phenotypes associated with EP300 mutations should be better understood. In the meantime, testing for EP300 mutations in those with features of CdLS may be warranted.
Collapse
Affiliation(s)
- Susan A Woods
- Department of Genetics, Akron Children's Hospital, Akron, Ohio
| | | | | | | | | | | |
Collapse
|
37
|
van Dijk M, Oudejans C. (Epi)genetics of pregnancy-associated diseases. Front Genet 2013; 4:180. [PMID: 24058367 PMCID: PMC3767913 DOI: 10.3389/fgene.2013.00180] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 08/27/2013] [Indexed: 01/04/2023] Open
Abstract
This review describes the current knowledge regarding genetics and epigenetics of pregnancy-associated diseases with placental origin. We discuss the effect on genetic linkage analyses when the fetal genotype determines the maternal phenotype. Secondly, the genes identified by genome-wide linkage studies to be associated with pre-eclampsia (ACVR2A, STOX1) and the HELLP-syndrome (LINC-HELLP) are discussed regarding their potential functions in the etiology of disease. Furthermore, susceptibility genes identified by candidate gene approaches (e.g., CORIN) are described. Next, we focus on the additional challenges that come when epigenetics also play a role in disease inheritance. We discuss the maternal transmission of the chromosome 10q22 pre-eclampsia linkage region containing the STOX1 gene and provide further evidence for the role of epigenetics in pre-eclampsia based on the cdkn1c mouse model of pre-eclampsia. Finally, we provide recommendations to unravel the genetics of pregnancy-associated diseases, specifically regarding clear definitions of patient groups and sufficient patient numbers, and the potential usefulness of (epi)genetic data in early non-invasive biomarker development.
Collapse
Affiliation(s)
- Marie van Dijk
- Molecular Biology Laboratory, Department of Clinical Chemistry, VU University Medical Center Amsterdam, Netherlands ; Institute for Cardiovascular Research VU, VU University Medical Center Amsterdam, Netherlands
| | | |
Collapse
|
38
|
A follow-up linkage study of Finnish pre-eclampsia families identifies a new fetal susceptibility locus on chromosome 18. Eur J Hum Genet 2013; 21:1024-6. [PMID: 23386034 DOI: 10.1038/ejhg.2013.6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 12/20/2012] [Accepted: 01/10/2013] [Indexed: 11/08/2022] Open
Abstract
Pre-eclampsia is a common vascular disorder of pregnancy. It originates in the placenta and targets the maternal endothelium. According to epidemiological research, >50% of the liability to this disorder can be accounted for by genetic factors. Both maternal and fetal genes contribute to the risk, but especially the fetal genetic risk profile is still poorly understood. We have previously detected linkage signals in multiplex Finnish families on chromosomes 2p25, 4q32, and 9p13 using maternal phenotypes. We performed a linkage analysis using updated maternal phenotypes and an unprecedented linkage analysis using fetal phenotypes. Markers genotyped were available from 237 individuals in 15 Finnish families, including 72 affected mothers and 49 affected fetuses. The MERLIN software was used for sample and marker quality control and linkage analysis. The results were compared against the original ones obtained by using the GENEHUNTER 2.1 software. The previous identification of the maternal susceptibility locus to a genetic location at 21.70 cM near marker D2S168 on chromosome 2 was confirmed by using both maternal and fetal phenotypes (maternal non-parametric linkage (NPL) score 3.79, P=0.00008, LOD (logarithm (base 10) of odds)=2.20 and fetal NPL score 2.95, P=0.002, LOD=1.71). As a novel finding, we present a suggestive linkage to chromosome 18 at 86.80 cM near marker D18S64 (NPL score 2.51, P=0.006, LOD=1.20) using the fetal phenotype. We propose that chromosome 18 may harbor a new fetal susceptibility locus for pre-eclampsia.
Collapse
|
39
|
Searching for genes involved in hypertension development in special populations: children and pre-eclamptic women. Where are we standing now? Clin Chem Lab Med 2013; 51:2253-69. [DOI: 10.1515/cclm-2013-0405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 07/23/2013] [Indexed: 01/02/2023]
|
40
|
Abildgaard U, Heimdal K. Pathogenesis of the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP): a review. Eur J Obstet Gynecol Reprod Biol 2012; 166:117-23. [PMID: 23107053 DOI: 10.1016/j.ejogrb.2012.09.026] [Citation(s) in RCA: 147] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 08/28/2012] [Accepted: 09/30/2012] [Indexed: 12/31/2022]
Abstract
HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome is serious for the mother and the offspring. HELLP occurs in 0.2-0.8% of pregnancies and in 70-80% of cases it coexists with preeclampsia (PE). This review concerns the pathogenetic mechanisms of HELLP syndrome with an emphasis on differences between HELLP and early onset PE. The syndromes show a familial tendency. A previous HELLP pregnancy is associated with an increased risk of HELLP as well as PE in subsequent pregnancies, indicating related etiologies. No single world-wide genetic cause for excessive risk of HELLP or PE has been identified. Combinations of multiple gene variants, each with a moderate risk, with contributing effects of maternal and environmental factors, are probable etiological mechanisms. Immunological maladaptation is the most probable trigger of the insult to the invading trophoblast. This insult occurs early in the first trimester, as indicated by marker molecules in maternal blood. The levels of fetal messenger RNAs in maternal blood at gestational weeks 15-20 are significantly more abnormal in HELLP than in PE, suggesting that the insult is more extensive in HELLP. High levels of HLA-DR in maternal blood in women with HELLP may suggest a similarity to the rejection reaction. In third trimester placentas, gene derangement is more extensive in HELLP. Anti-angiogenic factors released into maternal blood induce the maternal syndromes. Maternal blood levels of anti-angiogenic sFlt1 are similar, but endoglin and Fas Ligand levels are possibly higher in HELLP than in PE. These factors trigger the vascular endothelium, resulting in an enhanced inflammatory response which is stronger in HELLP. Activated coagulation and complement, with high levels of activated leucocytes, inflammatory cytokines, TNF-α, and active von Willebrand factor, induce thrombotic microangiopathy with platelet-fibrin thrombi in microvessels. The angiopathy results in consumption of circulating platelets, causes hemolysis in affected microvessels and reduces portal blood flow in the liver. Placental Fas Ligand damages hepatocytes, resulting in periportal necrosis. In about one half of women with HELLP, activation of coagulation factors and platelets precipitates disseminated intravascular coagulation, which in a minority becomes uncompensated and contributes to life-threatening multiorgan failure.
Collapse
|
41
|
van Dijk M, Thulluru HK, Mulders J, Michel OJ, Poutsma A, Windhorst S, Kleiverda G, Sie D, Lachmeijer AMA, Oudejans CBM. HELLP babies link a novel lincRNA to the trophoblast cell cycle. J Clin Invest 2012; 122:4003-11. [PMID: 23093777 DOI: 10.1172/jci65171] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 09/13/2012] [Indexed: 01/27/2023] Open
Abstract
The HELLP syndrome is a pregnancy-associated disease inducing hemolysis, elevated liver enzymes, and low platelets in the mother. Although the HELLP symptoms occur in the third trimester in the mother, the origin of the disease can be found in the first trimester fetal placenta. A locus for the HELLP syndrome is present on chromosome 12q23 near PAH. Here, by multipoint nonparametric linkage, pedigree structure allele sharing, and haplotype association analysis of affected sisters and cousins, we demonstrate that the HELLP locus is in an intergenic region on 12q23.2 between PMCH and IGF1. We identified a novel long intergenic noncoding RNA (lincRNA) transcript of 205,012 bases with (peri)nuclear expression in the extravillous trophoblast using strand-specific RT-PCR complemented with RACE and FISH. siRNA-mediated knockdown followed by RNA-sequencing, revealed that the HELLP lincRNA activated a large set of genes that are involved in the cell cycle. Furthermore, blocking potential mutation sites identified in HELLP families decreased the invasion capacity of extravillous trophoblasts. This is the first large noncoding gene to be linked to a Mendelian disorder with autosomal-recessive inheritance.
Collapse
Affiliation(s)
- Marie van Dijk
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Troy A, Sharpless NE. Genetic "lnc"-age of noncoding RNAs to human disease. J Clin Invest 2012; 122:3837-40. [PMID: 23093789 DOI: 10.1172/jci66645] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The list of functions of long noncoding RNAs (lncRNAs) in human tissues is rapidly growing. To further underscore their critical role in human health, two reports in this issue of JCI associate altered expression of novel lncRNAs with the heritable syndromes HELLP and brachydactyly type E.
Collapse
Affiliation(s)
- Andrew Troy
- Department of Medicine and Genetics, The Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599-7295, USA
| | | |
Collapse
|
43
|
Molecular genetics of preeclampsia and HELLP syndrome - a review. Biochim Biophys Acta Mol Basis Dis 2012; 1822:1960-9. [PMID: 22917566 DOI: 10.1016/j.bbadis.2012.08.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 08/06/2012] [Accepted: 08/07/2012] [Indexed: 11/24/2022]
Abstract
Preeclampsia is characterised by new onset hypertension and proteinuria and is a major obstetrical problem for both mother and foetus. Haemolysis elevated liver enzymes and low platelets (HELLP) syndrome is an obstetrical emergency and most cases occur in the presence of preeclampsia. Preeclampsia and HELLP are complicated syndromes with a wide variety in severity of clinical symptoms and gestational age at onset. The pathophysiology depends not only on periconceptional conditions and the foetal and placental genotype, but also on the capability of the maternal system to deal with pregnancy. Genetically, preeclampsia is a complex disorder and despite numerous efforts no clear mode of inheritance has been established. A minor fraction of HELLP cases is caused by foetal homozygous LCHAD deficiency, but for most cases the genetic background has not been elucidated yet. At least 178 genes have been described in relation to preeclampsia or HELLP syndrome. Confined placental mosaicism (CPM) is documented to cause early onset preeclampsia in some cases; the overall contribution of CPM to the occurrence of preeclampsia has not been adequately investigated yet. This article is part of a Special Issue entitled: Molecular Genetics of Human Reproductive Failure.
Collapse
|
44
|
Williams PJ, Morgan L. The role of genetics in pre-eclampsia and potential pharmacogenomic interventions. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2012; 5:37-51. [PMID: 23226061 PMCID: PMC3513227 DOI: 10.2147/pgpm.s23141] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Indexed: 01/23/2023]
Abstract
The pregnancy-specific condition pre-eclampsia not only affects the health of mother and baby during pregnancy but also has long-term consequences, increasing the chances of cardiovascular disease in later life. It is accepted that pre-eclampsia has a placental origin, but the pathogenic mechanisms leading to the systemic endothelial dysfunction characteristic of the disorder remain to be determined. In this review we discuss some key factors regarded as important in the development of pre-eclampsia, including immune maladaptation, inadequate placentation, oxidative stress, and thrombosis. Genetic factors influence all of these proposed pathophysiological mechanisms. The inherited nature of pre-eclampsia has been known for many years, and extensive genetic studies have been undertaken in this area. Genetic research offers an attractive strategy for studying the pathogenesis of pre-eclampsia as it avoids the ethical and practical difficulties of conducting basic science research during the preclinical phase of pre-eclampsia when the underlying pathological changes occur. Although pharmacogenomic studies have not yet been conducted in pre-eclampsia, a number of studies investigating treatment for essential hypertension are of relevance to therapies used in pre-eclampsia. The pharmacogenomics of antiplatelet agents, alpha and beta blockers, calcium channel blockers, and magnesium sulfate are discussed in relation to the treatment and prevention of pre-eclampsia. Pharmacogenomics offers the prospect of individualized patient treatment, ensuring swift introduction of optimal treatment whilst minimizing the use of inappropriate or ineffective drugs, thereby reducing the risk of harmful effects to both mother and baby.
Collapse
|
45
|
Di Gaetano C, Marozio L, Voglino F, Guarrera S, Tancredi A, Gibbone E, Benedetto C, Gasparini M, Piazza A, Matullo G. Role of the 12q24.12 locus in the onset of preeclampsia: an Italian case-control study. J Matern Fetal Neonatal Med 2011; 25:1228-32. [PMID: 22082154 DOI: 10.3109/14767058.2011.636097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The 12q24.12 locus has been reported to be involved in the control of many traits and also in severe diseases such as cardiovascular disease, hypertension and some immune-related disease. To our knowledge, no study has been published so far investigating the role of this locus in the pathogenesis of preeclampsia (PE). METHODS We genotyped four single nucleotide polymorphisms (SNPs) in 12q24.12 locus in 198 preeclamptic, 224 chronic hypertensive and 265 normotensive women from Italy, to test the contribution polymorphisms/haplotypes on the onset of preeclampsia and their association with chronic hypertension. RESULTS No association was observed for any single SNP, while a common haplotype CGTG (21% in normotensive women) revealed a possible protective effect (OR 0.64, 95% CI 0.42-0.97) against preeclampsia. CONCLUSIONS Our data suggest that a common haplotype within 12q24.12 locus may be associated with a protective effect against preeclampsia. This observation may be linked with the potential role of this region in the control of microcirculation. To the best of our knowledge, our study is the first one that links the 12q24.12 locus with this life-threatening perinatal complication of unknown etiology. Further physiological and functional studies are needed to clarify the molecular mechanisms and pathways of preeclampsia.
Collapse
Affiliation(s)
- Cornelia Di Gaetano
- Department of Genetics, Biology and Biochemistry, University of Turin, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Founds SA. Bridging global gene expression candidates in first trimester placentas with susceptibility loci from linkage studies of preeclampsia. J Perinat Med 2011; 39:361-8. [PMID: 21692683 DOI: 10.1515/jpm.2011.045] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Preeclampsia is as a leading cause of maternal and perinatal morbidity and mortality. Prevention, early identification, and individualized treatments may become feasible if reliable early biomarkers can be developed. Towards a systems biology framework, this review synthesizes prior linkage studies and genome scans of preeclampsia with candidates identified in a global gene expression microarray analysis of chorionic villus sampling (CVS) specimens from women who subsequently developed preeclampsia. Nearly 40% of these CVS candidate genes occurred in previously identified susceptibility loci for preeclampsia. Integration of genetic epidemiologic and functional gene expression data could help to elucidate preeclampsia as a complex disease resulting from multiple maternal and fetal/placental factors that each contributes a greater or lesser effect. These loci and related candidate genes are set to substantially improve insights into the first trimester pathogenesis of this pregnancy disorder.
Collapse
Affiliation(s)
- Sandra A Founds
- Department of Health Promotion and Development, School of Nursing, Member, Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA 15261, USA.
| |
Collapse
|
47
|
Pre-eclampsia: Risk factors and causal models. Best Pract Res Clin Obstet Gynaecol 2011; 25:329-42. [DOI: 10.1016/j.bpobgyn.2011.01.007] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 11/24/2010] [Accepted: 01/24/2011] [Indexed: 11/18/2022]
|
48
|
Dekker G, Robillard PY, Roberts C. The etiology of preeclampsia: the role of the father. J Reprod Immunol 2011; 89:126-32. [PMID: 21529966 DOI: 10.1016/j.jri.2010.12.010] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Revised: 11/29/2010] [Accepted: 12/20/2010] [Indexed: 11/24/2022]
Abstract
Preeclampsia is often considered as simply a maternal disease with variable degrees of fetal involvement. More and more the unique immunogenetic maternal-paternal relationship is appreciated, and also the specific 'genetic conflict' that is characteristic of haemochorial placentation. From that perspective, pre-eclampsia can be seen as a disease of an individual couple with primarily maternal and fetal manifestations. The maternal and fetal genomes perform different roles during development. Heritable paternal, rather than maternal, imprinting of the genome is necessary for normal trophoblast development. Large population studies have estimated that 35% of the variance in susceptibility to preeclampsia is attributable to maternal genetic effects; 20% to fetal genetic effects (with similar contributions of both parents), 13% to the couple effect, less than 1% to the shared sibling environment and 32% to unmeasured factors. Not one of these large population studies focussed on the paternal contribution to preeclampsia, which is demonstrated by (1) the effect of the length of the sexual relationship; (2) the concept of primipaternity versus primigravidity; and (3) the existence of the so-called 'dangerous' father, as demonstrated in various large population studies. It is currently unknown how the father exerts this effect. Possible mechanisms include seminal cytokine levels and their effect on maternal immune deviation, specific paternal HLA characteristics and specific paternal single nucleotide polymorphisms (SNPs), in particular in the paternally expressed genes affecting placentation. Several large cohort studies, including the large international SCOPE consortium, have identified paternal SNPs with strong associations with preeclampsia.
Collapse
Affiliation(s)
- Gus Dekker
- Discipline of Obstetrics and Gynaecology, University of Adelaide, Adelaide, South Australia 5005, Australia.
| | | | | |
Collapse
|
49
|
Williams PJ, Broughton Pipkin F. The genetics of pre-eclampsia and other hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol 2011; 25:405-17. [PMID: 21429808 PMCID: PMC3145161 DOI: 10.1016/j.bpobgyn.2011.02.007] [Citation(s) in RCA: 169] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 02/25/2011] [Indexed: 12/17/2022]
Abstract
Hypertension is the most frequent medical complication occurring during pregnancy. In this chapter, we aim to address the genetic contribution to these disorders, with specific focus on pre-eclampsia. The pathogenic mechanisms underlying pre-eclampsia remain to be elucidated; however, immune maladaptation, inadequate placental development and trophoblast invasion, placental ischaemia, oxidative stress and thrombosis are all thought to represent key factors in the development of disease. Furthermore, all of these components have genetic factors that may be involved in the pathogenic changes occurring. The familial nature of pre-eclampsia has been known for many years and, as such, extensive genetic research has been carried out in this area using strategies that include candidate gene studies and linkage analysis. Interactions between fetal and maternal genotypes, the effect of environmental factors, and epistasis will also be considered.
Collapse
Affiliation(s)
- Paula J Williams
- Human Genetics Research Group, School of Molecular and Medical Sciences, University of Nottingham, Queen's Medical Centre, UK.
| | | |
Collapse
|
50
|
STOX1: Key player in trophoblast dysfunction underlying early onset preeclampsia with growth retardation. J Pregnancy 2010; 2011:521826. [PMID: 21490791 PMCID: PMC3066643 DOI: 10.1155/2011/521826] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Accepted: 11/02/2010] [Indexed: 12/15/2022] Open
Abstract
Currently, only two preeclampsia susceptibility genes (ACVR2A, STOX1) have been identified within confirmed regions with significant genome-wide linkage, although many genetic screens in multiple populations have been performed. In this paper, we focus on the STOX1 gene. The epigenetic status of this gene is discussed explaining the maternal transmission of the STOX1 susceptibility allele observed in preeclamptic families. The known upstream regulation and downstream effector genes of the transcription factor STOX1 are described. Finally, we propose a model in which we combine the cell type-specific and allele-specific effects of STOX1. This includes intrinsic effects (differential CpG island methylation) and extrinsic effects (regulation of effector genes).
Collapse
|