Increased adrenomedullin protein content and mRNA expression in human fetal membranes but not placental tissue in pre-eclampsia

Perfluorobutane sulfonate exposure disrupted human placental cytotrophoblast cell proliferation and invasion involving in dysregulating preeclampsia related genes

We reported that maternal PFBS, an emerging pollutant, exposure is positively associated with preeclampsia which can result from aberrant trophoblasts invasion and subsequent placental ischemia. In this study, we investigated the effects of PFBS on trophoblasts proliferation/invasion and signaling pathways. We exposed a human trophoblast line, HTR8/SVneo, to PFBS. Cell viability, proliferation, and cell cycle were evaluated by the MTS assay, Ki-67 staining, and flow cytometry, respectively. We assessed cell migration and invasion with live-cell imaging-based migration assay and matrigel invasion assay, respectively. Signaling pathways were examined by Western blot, RNA-seq, and qPCR. PFBS exposure interrupted cell proliferation and invasion in a dose-dependent manner. PFBS (100 μM) did not cause cell death but instead significant cell proliferation without cell cycle disruption. PFBS (10 and 100 μM) decreased cell migration and invasion, while PFBS (0.1 μM) significantly increased cell invasion but not migration. Further, RNA-seq analysis identified dysregulated HIF-1α target genes that are relevant to cell proliferation/invasion and preeclampsia, while Western Blot data showed the activation of HIF-1α, but not Notch, ERK1/2, (PI3K)AKT, and P38 pathways. PBFS exposure altered trophoblast cell proliferation/invasion which might be mediated by preeclampsia-related genes, suggesting a possible association between prenatal PFBS exposure and adverse placentation.

Adrenomedullin and pregnancy: perspectives from animal models to humans

A healthy pregnancy requires strict coordination of genetic, physiologic and environmental factors. The relatively common incidence of infertility and pregnancy complications has resulted in increased interest in understanding the mechanisms that underlie normal versus abnormal pregnancy. The peptide hormone adrenomedullin (AM) has recently been the focus of some exciting breakthroughs in the pregnancy field. Supported by mechanistic studies in genetic animal models, there continues to be a growing body of evidence demonstrating the importance of AM protein levels in a variety of human pregnancy complications. With more extensive mechanistic studies and improved consistency in clinical measurements of AM, there is great potential for the development of AM as a clinically-relevant biomarker in pregnancy and pregnancy complications.

Plasma midregional proadrenomedullin in newborn infants: impact of prematurity and perinatal infection

INTRODUCTION

Adrenomedullin (ADM) is one of the strongest endogenous vasodilating hormones. Its stable by-product midregional-proADM (MR-proADM) is an established indicator of systemic infection and cardiovascular compromise in adult patients.

METHODS

A prospective cross-sectional study was performed to investigate the perinatal factors affecting MR-proADM plasma concentrations in 328 newborn infants with a gestational age (GA) between 24 and 41 wk.

RESULTS

Blood samples were obtained in 270 infants from umbilical veins (with additional 108 paired samples from umbilical arteries), and at 2-3 d of life in 183 infants. Paired venous and arterial umbilical cord MR-proADM concentrations were closely related (Spearman's rank order correlation coefficient (R(s)) = 0.825, P < 0.001). MR-proADM concentrations at birth and at 2-3 d were inversely related to GA (R(s) = -0.403 and R(s) = -0.541, respectively) and birth weight (BW; R(s) = -0.421 and R(s) = -0.530, respectively; all P < 0.001). On stepwise regression analysis, clinical chorioamnionitis and umbilical arterial blood base excess retained a significant impact on MR-proADM cord venous blood concentrations. At 2-3 d of life, histologic chorioamnionitis and GA at delivery were significantly associated with MR-proADM levels.

DISCUSSION

As compared with adults, MR-proADM concentrations are elevated in neonates, especially those born very preterm. Immaturity and infection, which both feature low systemic vascular resistance, are related to increased MR-proADM concentrations.

Measurement of mRNA transcripts of very high placental expression in maternal blood as biomarkers of preeclampsia

CONTEXT

mRNA of placental origin in maternal blood shows potential as a clinical biomarker of obstetric diseases such as preeclampsia (PE). We hypothesized that mRNA transcripts very highly expressed in the placenta relative to other tissues will be differentially expressed in PE and be useful as mRNA biomarkers in maternal blood.

OBJECTIVE

Our objective was to identify a panel of genes highly expressed in the placenta and compare their expression in placenta and maternal whole blood from PE vs. control pregnancies.

SETTING

Placental tissue and maternal whole blood specimens were obtained from normotensive controls (n = 15) and pregnancies complicated by severe preterm PE (n = 21).

INTERVENTION

mRNA expression was evaluated by quantitative real-time RT-PCR.

RESULTS

We identified 20 genes exhibiting highest to fourth highest expression in the placenta relative to all other tissues. All genes were detectable in placenta. Nine of the 20 genes were detectable in maternal whole blood. Four of the nine genes detectable in blood (i.e. PLAC3, PLAC4, CRH, and ERVWE1) were significantly increased in both maternal blood and placenta from PE pregnancies. The remaining five genes detectable in maternal blood were unchanged in both blood and placenta from PE pregnancies. Thus, there was complete correlation of gene expression between maternal blood and placenta.

CONCLUSIONS

Circulating mRNA coding genes of high placental expression show strong correlation with transcript levels in preeclamptic placenta. Such transcripts may be promising candidates to screen as mRNA biomarkers of PE in maternal whole blood.

Role of uterine artery Doppler velocimetry indices and plasma adrenomedullin level in women with unexplained recurrent pregnancy loss

AIM

To evaluate uterine artery Doppler flow resistance and plasma adrenomedullin levels in women with unexplained recurrent pregnancy loss (RPL) compared to controls.

MATERIAL & METHODS

Eighty-three women, who attend the department of Obstetrics and Gynecology, Benha University, Egypt, participated in this study (RPL group: n=40, and control group: n=43). Uterine artery Doppler and plasma adrenomedullin (AM) (pg/mL) levels were measured for all women in the mid-luteal phase of a non-pregnant cycle.

RESULTS

Both uterine artery pulsatility index (PI) and AM levels were significantly higher in RPL group compared to controls (2.71 ± 0.259 vs 2.06 ± 0.194 for PI and 287.5 ± 80.4 pg/mL vs 156.1 ± 39.8 pg/mL for AM, P<0.01). Uterine artery PI had a significant positive correlation with plasma AM levels both in the RPL group (r=0.645, P<0.001) and in the control group (r=0.384, P=0.011). Number of previous miscarriages in RPL group was significantly correlated with both uterine artery PI (r=0.838, P=0.015) and plasma AM levels (r=0.509, P=0.001).

CONCLUSIONS

Uterine artery PI may be useful in identifying women with unexplained RPL who have impaired uterine circulation. Plasma AM may serve as a biochemical marker for RPL caused by impaired uterine perfusion.