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Khabiri P, Rahimi MR, Rashidi I, Nedaei SE. Impacts of an 8-week regimen of aged garlic extract and aerobic exercise on the levels of Fetuin-A and inflammatory markers in the liver and visceral fat tissue of obese male rats. Clin Nutr ESPEN 2023; 58:79-88. [PMID: 38057040 DOI: 10.1016/j.clnesp.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 08/18/2023] [Accepted: 09/06/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND & AIMS Obesity-induced chronic low-grade systemic inflammation is linked to the development of numerous diseases. Fetuin-A is known to affect inflammation and insulin resistance in obesity conditions. Free fatty acid (FFA)-induced proinflammatory cytokine expression in adipocytes occurs only in the presence of both Fetuin-A and toll-like receptor 4 (TLR4) and removing either of them prevented FFA-induced insulin resistance. Aged garlic extract (AGE) and exercise training have anti-inflammatory effects; however, the impact of AGE on Fetuin-A is unknown. We examined the effects of AGE with or without aerobic training (AT) on Fetuin-A and inflammatory markers. METHODS Forty healthy male Sprague Dawley rats were randomly assigned to normal diet (ND) (n = 8) or high-fat diet (HFD) groups (n = 32) and fed for 9 weeks. After 9 weeks ND group continued normal diet, and the HFD group was randomly assigned to the HFD, HFD + AGE (600 mg/kg, once daily), HFD + AT (5 days/week), and HFD + AGE + AT groups that were continued for 8 weeks (n = 8). The significance of differences among groups was assessed using one-way analysis of variance followed by the post-hoc Tukey test. Statistically significant differences were considered for p < 0.05. RESULTS AGE, AT, and AGE + AT significantly decreased body weight, plasma Fetuin-A, HOMA-IR, mRNA and protein levels of Fetuin-A and NFƙB in the liver and mRNA and Protein levels of Fetuin-A, TLR4 and NFƙB in visceral adipose tissue (VAT) compared to HFD. However, only AGE + AT significantly decreased TLR4 protein levels in the liver. CONCLUSION Although AT and AGE reduce Fetuin-A and inflammatory markers, a combination of the two may be more effective at lowering inflammation.
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Affiliation(s)
- Parisa Khabiri
- Department of Exercise Physiology, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, 66177-15175, Iran.
| | - Mohammad Rahman Rahimi
- Department of Exercise Physiology, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, 66177-15175, Iran.
| | - Iraj Rashidi
- Department of Anatomical Sciences, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, 6715847141, Iran.
| | - Seyed Ershad Nedaei
- Department of Physiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, 6715847141, Iran.
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Gerst F, Kemter E, Lorza-Gil E, Kaiser G, Fritz AK, Nano R, Piemonti L, Gauder M, Dahl A, Nadalin S, Königsrainer A, Fend F, Birkenfeld AL, Wagner R, Heni M, Stefan N, Wolf E, Häring HU, Ullrich S. The hepatokine fetuin-A disrupts functional maturation of pancreatic beta cells. Diabetologia 2021; 64:1358-1374. [PMID: 33765181 PMCID: PMC8099843 DOI: 10.1007/s00125-021-05435-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/19/2021] [Indexed: 01/02/2023]
Abstract
AIMS/HYPOTHESIS Neonatal beta cells carry out a programme of postnatal functional maturation to achieve full glucose responsiveness. A partial loss of the mature phenotype of adult beta cells may contribute to a reduction of functional beta cell mass and accelerate the onset of type 2 diabetes. We previously found that fetuin-A, a hepatokine increasingly secreted by the fatty liver and a determinant of type 2 diabetes, inhibits glucose-stimulated insulin secretion (GSIS) of human islets. Since fetuin-A is a ubiquitous fetal glycoprotein that declines peripartum, we examined here whether fetuin-A interferes with the functional maturity of beta cells. METHODS The effects of fetuin-A were assessed during in vitro maturation of porcine neonatal islet cell clusters (NICCs) and in adult human islets. Expression alterations were examined via microarray, RNA sequencing and reverse transcription quantitative real-time PCR (qRT-PCR), proteins were analysed by western blotting and immunostaining, and insulin secretion was quantified in static incubations. RESULTS NICC maturation was accompanied by the gain of glucose-responsive insulin secretion (twofold stimulation), backed up by mRNA upregulation of genes governing beta cell identity and function, such as NEUROD1, UCN3, ABCC8 and CASR (Log2 fold change [Log2FC] > 1.6). An active TGFβ receptor (TGFBR)-SMAD2/3 pathway facilitates NICC maturation, since the TGFBR inhibitor SB431542 counteracted the upregulation of aforementioned genes and de-repressed ALDOB, a gene disallowed in mature beta cells. In fetuin-A-treated NICCs, upregulation of beta cell markers and the onset of glucose responsiveness were suppressed. Concomitantly, SMAD2/3 phosphorylation was inhibited. Transcriptome analysis confirmed inhibitory effects of fetuin-A and SB431542 on TGFβ-1- and SMAD2/3-regulated transcription. However, contrary to SB431542 and regardless of cMYC upregulation, fetuin-A inhibited beta cell proliferation (0.27 ± 0.08% vs 1.0 ± 0.1% Ki67-positive cells in control NICCs). This effect was sustained by reduced expression (Log2FC ≤ -2.4) of FOXM1, CENPA, CDK1 or TOP2A. In agreement, the number of insulin-positive cells was lower in fetuin-A-treated NICCs than in control NICCs (14.4 ± 1.2% and 22.3 ± 1.1%, respectively). In adult human islets fetuin-A abolished glucose responsiveness, i.e. 1.7- and 1.1-fold change over 2.8 mmol/l glucose in control- and fetuin-A-cultured islets, respectively. In addition, fetuin-A reduced SMAD2/3 phosphorylation and suppressed expression of proliferative genes. Of note, in non-diabetic humans, plasma fetuin-A was negatively correlated (p = 0.013) with islet beta cell area. CONCLUSIONS/INTERPRETATION Our results suggest that the perinatal decline of fetuin-A relieves TGFBR signalling in islets, a process that facilitates functional maturation of neonatal beta cells. Functional maturity remains revocable in later life, and the occurrence of a metabolically unhealthy milieu, such as liver steatosis and elevated plasma fetuin-A, can impair both function and adaptive proliferation of beta cells. DATA AVAILABILITY The RNAseq datasets and computer code produced in this study are available in the Gene Expression Omnibus (GEO): GSE144950; https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE144950.
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Affiliation(s)
- Felicia Gerst
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University of Tuebingen (IDM), Tuebingen, Germany.
- Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tuebingen, Tuebingen, Germany.
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.
| | - Elisabeth Kemter
- Department of Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, Ludwig Maximilians University, Munich, Germany
| | - Estela Lorza-Gil
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University of Tuebingen (IDM), Tuebingen, Germany
- Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tuebingen, Tuebingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Gabriele Kaiser
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University of Tuebingen (IDM), Tuebingen, Germany
- Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tuebingen, Tuebingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Ann-Kathrin Fritz
- Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tuebingen, Tuebingen, Germany
| | - Rita Nano
- Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Piemonti
- Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marie Gauder
- Quantitative Biology Center (QBiC) Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Andreas Dahl
- Biotechnology Center TU Dresden, Dresden, Germany
| | - Silvio Nadalin
- Department of General, Visceral and Transplant Surgery, University Hospital Tuebingen, Tuebingen, Germany
| | - Alfred Königsrainer
- Department of General, Visceral and Transplant Surgery, University Hospital Tuebingen, Tuebingen, Germany
| | - Falko Fend
- Department of General Pathology and Pathological Anatomy, University Hospital Tuebingen, Tuebingen, Germany
| | - Andreas L Birkenfeld
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University of Tuebingen (IDM), Tuebingen, Germany
- Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tuebingen, Tuebingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Robert Wagner
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University of Tuebingen (IDM), Tuebingen, Germany
- Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tuebingen, Tuebingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Martin Heni
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University of Tuebingen (IDM), Tuebingen, Germany
- Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tuebingen, Tuebingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Norbert Stefan
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University of Tuebingen (IDM), Tuebingen, Germany
- Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tuebingen, Tuebingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Eckhard Wolf
- Department of Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, Ludwig Maximilians University, Munich, Germany
| | - Hans-Ulrich Häring
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University of Tuebingen (IDM), Tuebingen, Germany
- Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tuebingen, Tuebingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Susanne Ullrich
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University of Tuebingen (IDM), Tuebingen, Germany
- Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tuebingen, Tuebingen, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
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Ren G, Kim T, Papizan JB, Okerberg CK, Kothari VM, Zaid H, Bilan PJ, Araya-Ramirez F, Littlefield LA, Bowers RL, Mahurin AJ, Nickles MM, Ludvigsen R, He X, Grandjean PW, Mathews ST. Phosphorylation status of fetuin-A is critical for inhibition of insulin action and is correlated with obesity and insulin resistance. Am J Physiol Endocrinol Metab 2019; 317:E250-E260. [PMID: 31084489 DOI: 10.1152/ajpendo.00089.2018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Fetuin-A (Fet-A), a hepatokine associated with insulin resistance, obesity, and incident type 2 diabetes, is shown to exist in both phosphorylated and dephosphorylated forms in circulation. However, studies on fetuin-A phosphorylation status in insulin-resistant conditions and its functional significance are limited. We demonstrate that serum phosphofetuin-A (Ser312) levels were significantly elevated in high-fat diet-induced obese mice, insulin-resistant Zucker diabetic fatty rats, and in individuals with obesity who are insulin resistant. Unlike serum total fetuin-A, serum phosphofetuin-A was associated with body weight, insulin, and markers of insulin resistance. To characterize potential mechanisms, fetuin-A was purified from Hep3B human hepatoma cells. Hep3B Fet-A was phosphorylated (Ser312) and inhibited insulin-stimulated glucose uptake and glycogen synthesis in L6GLUT4 myoblasts. Furthermore, single (Ser312Ala) and double (Ser312Ala + Ser120Ala) phosphorylation-defective Fet-A mutants were without effect on glucose uptake and glycogen synthesis in L6GLUT4 myoblasts. Together, our studies demonstrate that phosphorylation status of Fet-A (Ser312) is associated with obesity and insulin resistance and raise the possibility that Fet-A phosphorylation may play a role in regulation of insulin action.
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Affiliation(s)
- Guang Ren
- Department of Nutrition and Dietetics, Auburn University , Auburn, Alabama
| | - Teayoun Kim
- Department of Nutrition and Dietetics, Auburn University , Auburn, Alabama
| | - James B Papizan
- Department of Nutrition and Dietetics, Auburn University , Auburn, Alabama
| | - Carl K Okerberg
- Department of Nutrition and Dietetics, Auburn University , Auburn, Alabama
| | - Vishal M Kothari
- Department of Nutrition and Dietetics, Auburn University , Auburn, Alabama
| | - Hilal Zaid
- Cell Biology Program, The Hospital for Sick Children , Toronto , Canada
| | - Phillip J Bilan
- Cell Biology Program, The Hospital for Sick Children , Toronto , Canada
| | | | | | | | - A Jack Mahurin
- School of Kinesiology, Auburn University , Auburn, Alabama
| | - Mary M Nickles
- Department of Nutrition and Dietetics, Samford University , Birmingham, Alabama
| | - Rebecca Ludvigsen
- Department of Nutrition and Dietetics, Auburn University , Auburn, Alabama
| | - Xiaoming He
- Department of Nutrition and Dietetics, Auburn University , Auburn, Alabama
| | | | - Suresh T Mathews
- Department of Nutrition and Dietetics, Auburn University , Auburn, Alabama
- Department of Nutrition and Dietetics, Samford University , Birmingham, Alabama
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Jablonski H, Polan C, Wedemeyer C, Hilken G, Schlepper R, Bachmann HS, Grabellus F, Dudda M, Jäger M, Kauther MD. A single intraperitoneal injection of bovine fetuin-A attenuates bone resorption in a murine calvarial model of particle-induced osteolysis. Bone 2017; 105:262-268. [PMID: 28942123 DOI: 10.1016/j.bone.2017.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 06/13/2017] [Accepted: 09/14/2017] [Indexed: 01/19/2023]
Abstract
Particle-induced osteolysis, which by definition is an aseptic inflammatory reaction to implant-derived wear debris eventually leading to local bone destruction, remains the major reason for long-term failure of orthopedic endoprostheses. Fetuin-A, a 66kDa glycoprotein with diverse functions, is found to be enriched in bone. Besides being an important inhibitor of ectopic calcification, it has been described to influence the production of mediators of inflammation. Furthermore, a regulatory role in bone metabolism has been assigned. In the present study, the influence of a single dose of bovine fetuin-A, intraperitoneally injected in mice subjected to particle-induced osteolysis of the calvaria, was analyzed. Twenty-eight male C57BL/6 mice, twelve weeks of age, were randomly divided into four groups. Groups 2 and 4 were subjected to ultra-high molecular weight polyethylene (UHMWPE) particles placed on their calvariae while groups 1 and 3 were sham-operated. Furthermore, groups 3 and 4 received a single intraperitoneal injection of 20mg bovine fetuin-A while groups 1 and 2 were treated with physiologic saline. After 14days calvarial bone was qualitatively and quantitatively assessed using microcomputed tomography (μCT) and histomorphometrical approaches. Application of fetuin-A led to a reduction of particle-induced osteolysis in terms of visible osteolytic lesions and eroded bone surface. The reduction of bone thickness and bone volume, as elicited by UHMWPE, was alleviated by fetuin-A. In conclusion, fetuin-A was found to exert an anti-resorptive effect on particle-induced osteolysis in-vivo. Thus, fetuin-A could play a potentially osteoprotective role in the treatment of bone metabolic disorders.
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Affiliation(s)
- Heidrun Jablonski
- University Hospital Essen, Department of Orthopedics and Trauma Surgery, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany.
| | - Christina Polan
- University Hospital Essen, Department of Orthopedics and Trauma Surgery, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany
| | - Christian Wedemeyer
- St. Barbara Hospital, Department of Orthopedic and Trauma Surgery, Barbarastrasse 1, 45964 Gladbeck, Germany
| | - Gero Hilken
- University Hospital Essen, Central Animal Laboratory, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany
| | - Rüdiger Schlepper
- University Hospital Essen, Department of Orthopedics and Trauma Surgery, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany
| | - Hagen Sjard Bachmann
- University Hospital Essen, Institute of Pharmacogenetics, University Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany
| | - Florian Grabellus
- University Hospital Essen, Institute for Pathology, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany
| | - Marcel Dudda
- University Hospital Essen, Department of Orthopedics and Trauma Surgery, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany
| | - Marcus Jäger
- University Hospital Essen, Department of Orthopedics and Trauma Surgery, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany
| | - Max Daniel Kauther
- University Hospital Essen, Department of Orthopedics and Trauma Surgery, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany
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Sun J, Luo J, Ruan Y, Xiu L, Fang B, Zhang H, Wang M, Chen H. Free Fatty Acids Activate Renin-Angiotensin System in 3T3-L1 Adipocytes through Nuclear Factor-kappa B Pathway. J Diabetes Res 2016; 2016:1587594. [PMID: 26881238 PMCID: PMC4736205 DOI: 10.1155/2016/1587594] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 10/20/2015] [Indexed: 01/22/2023] Open
Abstract
The activity of a local renin-angiotensin system (RAS) in the adipose tissue is closely associated with obesity-related diseases. However, the mechanism of RAS activation in adipose tissue is still unknown. In the current study, we found that palmitic acid (PA), one kind of free fatty acid, induced the activity of RAS in 3T3-L1 adipocytes. In the presence of fetuin A (Fet A), PA upregulated the expression of angiotensinogen (AGT) and angiotensin type 1 receptor (AT1R) and stimulated the secretion of angiotensin II (ANG II) in 3T3-L1 adipocytes. Moreover, the activation of RAS in 3T3-L1 adipocytes was blocked when we blocked Toll-like receptor 4 (TLR4) signaling pathway using TAK242 or NF-κB signaling pathway using BAY117082. Together, our results have identified critical molecular mechanisms linking PA/TLR4/NF-κB signaling pathway to the activity of the local renin-angiotensin system in adipose tissue.
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Affiliation(s)
- Jia Sun
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jinhua Luo
- Department of Geratology, The Affiliated Hospital of Guangdong Medical College, Guangdong Medical College, Zhanjiang, Guangdong, China
| | - Yuting Ruan
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Liangchang Xiu
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical College, Dongguan, Guangdong, China
| | - Bimei Fang
- Second Clinical School of Medicine, Southern Medical University, Guangzhou, China
| | - Hua Zhang
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ming Wang
- Nephrology Center of Integrated Traditional Chinese and Western Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- *Ming Wang: and
| | - Hong Chen
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- *Hong Chen:
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Gomez LM, Anton L, Srinivas SK, Elovitz MA, Parry S. Effects of increased fetuin-A in human trophoblast cells and associated pregnancy outcomes. Am J Obstet Gynecol 2012; 207:484.e1-8. [PMID: 23108067 DOI: 10.1016/j.ajog.2012.10.872] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 09/17/2012] [Accepted: 10/15/2012] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The purpose of this study was to determine whether fetuin-A affects trophoblast viability and invasion, whether growth factors that bind receptors that activate tyrosine kinase are impaired by fetuin-A, and whether elevated maternal serum fetuin-A levels are associated with adverse pregnancy outcomes. STUDY DESIGN We studied viability and invasion in first-trimester extravillous trophoblast cells that were exposed to fetuin-A, insulin-like growth factor, and placental growth factor. Insulin receptor substrates expression was assessed. We compared serum fetuin-A levels in 111 preeclampsia cases and 95 controls. RESULTS Fetuin-A reduced extravillous trophoblast cell viability and invasion in the presence or absence of growth factors. Fetuin-A reduced insulin receptor substrate-1 and tyrosine phosphorylated insulin receptor substrate-1 expression in extravillous trophoblast cells that had been treated with insulin-like growth factor. Elevated serum fetuin-A levels were more prevalent in preeclampsia cases than control subjects, even after we controlled for diabetes mellitus, hypertension, and obesity. CONCLUSION Fetuin-A may decrease trophoblast viability and invasion caused by the inhibition of receptor tyrosine kinase activity. Elevated serum levels of fetuin-A may be associated with preeclampsia.
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Affiliation(s)
- Luis M Gomez
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Tennessee Health Sciences Center, Memphis, TN, USA
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