Therapeutic Prospects in Preeclampsia - A Mini-Review

Aspirin protects human trophoblast HTR-8/SVneo cells from H2O2-Induced oxidative stress via NADPH/ROS pathway

INTRODUCTION

Pre-eclampsia (PE) is a pregnancy complication that can lead to maternal, fetal, and neonatal deaths in clinical practice. Accumulation of trophoblastic reactive oxygen species (ROS), which could result in oxidative stress and cell apoptosis, is considered to play an important role in PE pathology. It has been reported that aspirin has a positive effect on PE treatment in high-risk pregnant women.

METHODS

In vitro, extravillous trophoblast cell line (HTR-8/SVneo) were treated with hydrogen peroxide (H2O2, 150 μM) after the presence of aspirin (90 and 120 μM) with or without GKT137831 (a Nox4 inhibitor, 20 μM). A series of experiments including CCK-8 assays, flow cytometry, biochemical testing, and Western Blotting etc. verified the protective effects and potential mechanisms of aspirin against oxidative stress-induced damage in PE.

RESULTS

Our results demonstrated that H2O2 induces oxidative stress and apoptosis in HTR8/SVneo cells. However, aspirin pretreatment rescue cell viability and reduce LDH activity of HTR-8/SVneo cells. Aspirin can suppress the ROS overproduction and MDA level while increase SOD content and CAT activity. In addition, aspirin pretreatment significantly alleviated cell apoptosis and suppressed the expression of Nox4 and its subunits (p22phox and p47phox) at protein and mRNA levels. The above results were more obvious after the combination of aspirin with GKT137831.

DISCUSSION

This study demonstrated that aspirin protects human trophoblasts against H2O2-induced oxidative stress and cell apoptosis via suppressing NADPH/ROS pathway. These findings provide novel insights for the application of aspirin as a protective and curative agent against PE.

Oral Magnesium Supplementation for the Prevention of Preeclampsia: a Meta-analysis or Randomized Controlled Trials

Previous studies evaluating the role of magnesium supplementation as a preventative strategy for preeclampsia showed inconsistent results. We performed a meta-analysis or randomized controlled trials (RCTs) to evaluate the influence of oral magnesium supplementation on the incidence of preeclampsia in pregnant women. Relevant studies were obtained by search of Medline, Embase, and Cochrane's Library databases. A random effects model was used to pool the results. Influences of study characteristics of the outcome were evaluated by predefined subgroup analyses. Seven RCTs with 2653 pregnant women were included. Pooled results showed that oral magnesium supplementation during pregnancy significantly reduced the risk of preeclampsia (risk ratio [RR]: 0.76, 95% confidence interval [CI]: 0.59 to 0.98, P = 0.04) with no significant heterogeneity (P for Cochrane's Q test = 0.42, I² = 1%). The result was not significant for the outcome of severe preeclampsia (RR: 0.54, 95% CI: 0.18 to 1.69, P = 0.29; I² = 0%), although only two studies were available. Subgroup analysis showed that oral magnesium supplementation did not significantly reduce the risk of preeclampsia in normal pregnant women (RR: 0.91, 95% CI: 0.67 to 1.25, P = 0.57), but the preventative effect was significant in studies with normal and high-risk pregnant women (RR: 0.54, 95% CI: 0.35 to 0.83, P = 0.005; P for subgroup difference = 0.04). In conclusion, oral supplementation of magnesium may reduce the risk of preeclampsia, which may be more remarkable in high-risk pregnant women.

Atractylenolide inhibits apoptosis and oxidative stress of HTR-8/SVneo cells by activating MAPK/ERK signalling in preeclampsia

BACKGROUND

Preeclampsia (PE) is a severe hypertension-related disorder occurring during pregnancy that leads to significant mortality and morbidity in both the foetus and mother. Atractylenolide (ATL), a traditional Chinese natural agent isolated from the herb Atractylodes macrocephala, exhibits a series of pharmacological activities, including anti-oxidative stress and anti-inflammatory effects.

PURPOSE

The impacts of ATL on apoptosis and oxidative stress in HTR-8/SVneo cells during PE development was investigated.

STUDY DESIGN

We identified ATL by an overlap analysis of the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) database using the keyword 'gestational hypertension' and Traditional Chinese Medicine (Batman-TCM) database using the keyword 'Atractylodes macrocephala'.

METHODS

Cell viability, proliferation, and migration were detected by CCK-8, EdU, and transwell assays. Flow cytometry and 2',7'-dichlorodihydrofluorescein diacetate were used to assess apoptosis and reactive oxygen species (ROS) levels.

RESULTS

EdU and CCK-8 assays demonstrated that ATL significantly enhanced the viability of HTR-8/SVneo cells. Transwell assays showed that ATL remarkably induced the migration of HTR-8/SVneo cells. Moreover, ROS production in HTR-8/SVneo cells was induced by H₂O₂, whilst ATL alleviated this H₂O₂-induced ROS production and apoptosis in cells.

CONCLUSION

ATL attenuated apoptosis and oxidative stress in HTR-8/SVneo cells in PE by activating the MAPK/ERK signalling pathway. ATL has potential to be utilized as a potential therapeutic candidate for PE.

Acute Kidney Injury in Pregnancies Complicated With Preeclampsia or HELLP Syndrome

Acute kidney injury that occurs during pregnancy or in the post-partum period (PR-AKI) is a serious obstetric complication with risk of significant associated maternal and fetal morbidity and mortality. Recent data indicates that the incidence of PR-AKI is increasing, although accurate calculation is limited by the lack of a uniform diagnostic criteria that is validated in pregnancy. Hypertensive and thrombotic microangiopathic disorders of pregnancy have been identified as major contributors to the burden of PR-AKI. As is now accepted regarding preeclampsia, HELLP syndrome and atypical hemolytic uremic syndrome, it is believed that PR-AKI may have long-term renal, cardiovascular and neurocognitive consequences that persist beyond the post-partum period. Further research regarding PR-AKI could be advanced by the development of a pregnancy-specific validated definition and classification system; and the establishment of refined animal models that would allow researchers to further elucidate the mechanisms and sequelae of the disorder.