Gotowa bibliografia na temat „Placental oxidative stress”

Arachidonic and docosahexaenoic acids (ARA and DHA) are important during pregnancy. However, the effects of dietary supplementation on fetal growth and oxidative stress are inconclusive. We aimed to assess the effect of high ARA and DHA diet during rat gestation on: (1) ARA and DHA availability in plasma and placenta, (2) fetal growth, and (3) placental oxidative stress, analyzing the influence of sex. Experimental diet (ED) was prepared by substituting soybean oil in the control diet (CD) by a fungi/algae-based oil containing ARA and DHA (2:1). Rats were fed with CD or ED during gestation; plasma, placenta, and fetuses were obtained at gestational day 20. DHA, ARA, and their precursors were analyzed in maternal plasma and placenta by gas chromatography/mass spectrophotometry. Fetuses and placentas were weighed, the proportion of fetuses with intrauterine growth restriction (IUGR) determined, and placental lipid and protein oxidation analyzed. ED fetuses exhibited lower body weight compared to CD, being >40% IUGR; fetal weight negatively correlated with maternal plasma ARA, but not DHA. Only ED female placenta exhibited higher lipid and protein oxidation compared to its CD counterparts; lipid peroxidation is negatively associated with fetal weight. In conclusion, high ARA during gestation associates with IUGR, through placental oxidative stress, with females being more susceptible.

As the mediator between the mother and fetus, the placenta allows the most appropriate environment and optimal fetal growth. The placenta of one sex sometimes has a greater ability over the other to respond to and protect against possible maternal insults. Here, we characterized sex differences in the placenta’s morphological features and antioxidant status following dexamethasone (Dx) exposure. Pregnant rats were exposed to Dx or saline. The placenta was histologically and stereologically analyzed. The activity of the antioxidant enzymes, lipid peroxides (TBARS), superoxide anion and nitric oxide (NO) was measured. The decrease in placental zone volumes was more pronounced (p < 0.05) in female placentas. The volume density of PCNA-immunopositive nuclei was reduced (p < 0.05) in both sexes. The reduced (p < 0.05) antioxidant enzyme activities, enhanced TBARS and NO concentration indicate that Dx exposure triggered oxidative stress in the placenta of both fetal sexes, albeit stronger in the placenta of female fetuses. In conclusion, maternal Dx treatment reduced the size and volume of placental zones, altered placental histomorphology, decreased cell proliferation and triggered oxidative stress; however, the placentas of female fetuses exerted more significant responses to the treatment effects. The reduced placental size most probably reduced the transport of nutrients and oxygen, thus resulting in the reduced weight of fetuses, similar in both sexes. The lesser ability of the male placenta to detect and react to maternal exposure to environmental challenges may lead to long-standing health effects.

Placental fatty acid oxidation (FAO) is impaired and lipid storage is increased in pregnancy states associated with chronic oxidative stress. The effect of acute oxidative stress, as seen in pregnancies complicated with asthma, on placental lipid metabolism is unknown. We hypothesized that induction of acute oxidative stress would decrease FAO and increase esterification. We assessed [3H]-palmitate oxidation and esterification in term placental explants from lean women after exposure to hydrogen peroxide (H2O2) for 4 hours. Fatty acid oxidation decreased 16% and 24% in placental explants exposed to 200 ( P = .02) and 400 µM H2O2 ( P = .01), respectively. Esterification was not altered with H2O2 exposure. Neither messenger RNA nor protein expression of key genes involved in FAO (eg, peroxisome proliferator-activated receptor α, carnitine palmitoyl transferase 1b) were altered. Adenosine triphosphate (ATP) levels decreased with induction of oxidative stress, without increasing cytotoxicity. Acute oxidative stress decreased FAO and ATP production in the term placenta without altering fatty acid esterification. As decreases in placental FAO and ATP production are associated with impaired fetal growth, pregnancies exposed to acute oxidative stress may be at risk for fetal growth restriction.

Acute fatty liver of pregnancy (AFLP), characterized by hepatic microvesicular steatosis, is a sudden catastrophic illness occurring almost exclusively in the third trimester of pregnancy. Defective fatty acid oxidation in the fetus has been shown to be associated with this disease. Since the placenta has the same genetic makeup as the fetus and as AFLP patients generally recover following delivery, we hypothesized that the placenta might be involved in pathogenesis of this disease. In an animal model of hepatic microvesicular steatosis (using sodium valproate), we found that microvesicular steatosis results in mitochondrial structural alterations and oxidative stress in subcellular organelles of the liver. In placentas from patients with AFLP, we observed placental mitochondrial dysfunction and oxidative stress in subcellular organelles. In addition, defective placental fatty acid oxidation results in accumulation of toxic mediators such as arachidonic acid. Escape of these mediators into the maternal circulation might affect the maternal liver resulting in microvesicular steatosis.

The human placenta is key to pregnancy outcome, and the elevated oxidative stress present in many complicated pregnancies contributes to placental dysfunction and suboptimal pregnancy outcomes. We tested the hypothesis that pomegranate juice, which is rich in polyphenolic antioxidants, limits placental trophoblast injury in vivo and in vitro. Pregnant women with singleton pregnancies were randomized at 35∼38 wk gestation to 8 oz/day of pomegranate juice or apple juice (placebo) until the time of delivery. Placental tissues from 12 patients (4 in the pomegranate group and 8 in the control group) were collected for analysis of oxidative stress. The preliminary in vivo results were extended to oxidative stress and cell death assays in vitro. Placental explants and cultured primary human trophoblasts were exposed to pomegranate juice or glucose (control) under defined oxygen tensions and chemical stimuli. We found decreased oxidative stress in term human placentas from women who labored after prenatal ingestion of pomegranate juice compared with apple juice as control. Moreover, pomegranate juice reduced in vitro oxidative stress, apoptosis, and global cell death in term villous explants and primary trophoblast cultures exposed to hypoxia, the hypoxia mimetic cobalt chloride, and the kinase inhibitor staurosporine. Punicalagin, but not ellagic acid, both prominent polyphenols in pomegranate juice, reduced oxidative stress and stimulus-induced apoptosis in cultured syncytiotrophoblasts. We conclude that pomegranate juice reduces placental oxidative stress in vivo and in vitro while limiting stimulus-induced death of human trophoblasts in culture. The polyphenol punicalagin mimics this protective effect. We speculate that antenatal intake of pomegranate may limit placental injury and thereby may confer protection to the exposed fetus.

Oxidative stress (OS) plays a pivotal role in placental development; however, abnormal loads in oxidative stress molecules may overwhelm the placental defense mechanisms and cause pathological situations. The environment in which the mother evolves triggers an exposure of the placental tissue to chemical, physical, and biological agents of OS, with potential pathological consequences. Here we shortly review the physiological and developmental functions of OS in the placenta, and present a series of environmental pollutants inducing placental oxidative stress, for which some insights regarding the underlying mechanisms have been proposed, leading to a recapitulation of the noxious effects of OS of environmental origin upon the human placenta.

Placental oxidative stress plays a key role in the pathophysiology of placenta-related disorders in humans, most notably in preeclampsia (PE) and intrauterine growth restriction (IUGR). Protection from oxidative stress is provided by antioxidant enzymes including superoxide dismutase-1 and 2 (SOD-1 and –2) and catalase (CAT), which convert reactive oxygen species (ROS) to inert products. It has also been proposed that uncoupling protein-2 (UCP2) may limit oxidative stress by reducing ROS production, but little is known of UCP2 expression in placenta. Here we measured placental UCP2, SOD-1, SOD-2 and CAT mRNA expression (by qRT–PCR) in normal gestation and after glucocorticoid-induced IUGR. The latter was included because glucocorticoids can increase oxidative stress in other tissues, and placental glucocorticoid exposure is elevated in both PE and IUGR. Placentas were collected on days 16 and 22 of normal pregnancy (term = day 23) and on day 22 after dexamethasone treatment (0.75 mg/mL in drinking water from day 13). The two morphologically-distinct regions of the placenta, the junctional (JZ) and labyrinth (LZ) zones, were analysed separately because effectively all growth occurs in the LZ over this period. Expression of UCP2 in LZ exceeded that in JZ (P < 0.001) and increased in both zones between days 16 and 22 (LZ: 2.0-fold; JZ: 3.2-fold). Dexamethasone treatment reduced UCP2 in LZ (44%; P < 0.05) but not in JZ. SOD1 and SOD2 increased with gestational age in LZ (P < 0.01) and JZ (P < 0.05), but neither were affected by dexamethasone. CAT expression was higher (2.4-fold, P < 0.001) in LZ compared with JZ but did not change with gestational age or dexamethasone. In summary, these data suggest that endogenous protection against oxidative stress increases in the rat placenta during late pregnancy. Moreover, this protection may be compromised by reduced placental UCP2 expression in a model of glucocorticoid-induced IUGR.

Placental homeostasis is directly linked to fetal well-being and normal fetal growth. Placentas are sensitive to various environmental stressors, including hypoxia, endoplasmic reticulum stress, and oxidative stress. Once placental homeostasis is disrupted, the placenta may rebel against the mother and fetus. Autophagy is an evolutionally conservative mechanism for the maintenance of cellular and organic homeostasis. Evidence suggests that autophagy plays a crucial role throughout pregnancy, including fertilization, placentation, and delivery in human and mouse models. This study reviews the available literature discussing the role of autophagy in preeclampsia.

Vitamin D insufficiency/deficiency during pregnancy has been linked to increased risk of preeclampsia. Placenta dysfunction plays an important role in the pathogenesis of this pregnancy disorder. In this study, we tested the hypothesis that disturbed vitamin D metabolism takes place in preeclamptic placentas. Protein expressions of vitamin D binding protein (VDBP), 25-hydroxylase (CYP2R1), 1α-hydroxylase (CYP27B1), 24-hydroxylase (CYP24A1), and vitamin D receptor (VDR) were examined in placentas from normotensive and preeclamptic pregnancies. By immunostaining we found that in normal placenta VDBP, CYP24A1, and VDR expressions are localized mainly in trophoblasts, whereas CYP2R1 and CYP27B1 expressions are localized mainly in villous core fetal vessel endothelium. Protein expressions of CYP2R1 and VDR are reduced, but CYP27B1 and CYP24A1 expressions are elevated, in preeclamptic compared with normotensive placentas. Because increased oxidative stress is an underlying pathophysiology in placental trophoblasts in preeclampsia, we further determined whether oxidative stress contributes to altered vitamin D metabolic system in placental trophoblasts. Trophoblasts isolated from normal-term placentas were treated with hypoxic-inducing agent CoCl2, and protein expressions of VDBP, CYP2R1, CYP27B1, CYP24A1, and VDR were determined. We found that hypoxia-induced downregulation of VDBP, CYP2R1, and VDR and upregulation of CYP27B1 and CYP24A1 expressions were consistent with that seen in preeclamptic placentas. CuZnSOD expression was also downregulated in trophoblasts treated with CoCl2. These results provide direct evidence of disrupted vitamin D metabolic homeostasis in the preeclamptic placenta and suggest that increased oxidative stress could be a causative factor of altered vitamin D metabolism in preeclamptic placentas.

During pregnancy, development of the placenta is interrelated with the oxygen concentration. Embryo development takes place in a low oxygen environment until the beginning of the second trimester when large amounts of oxygen are conveyed to meet the growth requirements. High metabolism and oxidative stress are common in the placenta. Reactive oxidative species sometimes harm placental development, but they are also reported to regulate gene transcription and downstream activities such as trophoblast proliferation, invasion, and angiogenesis. Autophagy and apoptosis are two crucial, interconnected processes in the placenta that are often influenced by oxidative stress. The proper interactions between them play an important role in placental homeostasis. However, an imbalance between the protective and destructive mechanisms of autophagy and apoptosis seems to be linked with pregnancy-related disorders such as miscarriage, preeclampsia, and intrauterine growth restriction. Thus, potential therapies to hold oxidative stress in leash, promote placentation, and avoid unwanted apoptosis are discussed.

Affecting 6-8% of all pregnancies, preeclampsia is the leading cause of maternal morbidity in the western world and is charactensed by hypertension, proteinuria, edema and platelet aggregation. Despite its prevalence and severity, no comprehensive theory or single factor has been suggested to explain the pathophysiology of this multi system disorder of pregnancy, with the only therapies being bed rest, pharmacological symptom management and if necessary early delivery. Oxidative stress plays an important role in the pathophysiology of preeclampsia, resulting from defective trophoblast invasion, reductions in placental perfusion and placental hypoxia/reoxygenation. The inability of endogenous antioxidant systems up regulated in normal pregnancy, to control increased levels of oxidative stress, is suggested as a possible factor in the feed forward generation of reactive oxygen species and placental oxidative stress. That in turn may stimulate increased syncytiotrophoblast apoptosis, endothelial cell activation and the maternal hyper immune response characteristic of preeclampsia. Analysis of the research literature revealed that previous evaluations of placental oxidation and antioxidant enzyme activity in preeclampsia were by no means comprehensive, and exhibited significant inter-study variations. It was the aim of this thesis to clarify the placental oxidative state and the endogenous antioxidant activity of glutathione peroxidase, thioredoxin reductase, thioredoxin and superoxide dismutase in human placentae in an attempt to determine if variations in antioxidant function were due to changes in gene expression or protein oxidation. The findings reported in this thesis indicate the presence of increased levels of oxidative stress in the preeclamptic placenta, associated with significant reductions in antioxidant enzyme capacity. Quantitative real-time PCR analysis of placental samples revealed that deceases in antioxidant capacity in the placenta are more likely to be related to the significant oxidative burden within the tissue rather than reductions in gene expression. A number of animal models exist to investigate components of preeclampsia pathophysiology, however the ability of these models to mimic the oxidative and antioxidant features of preeclampsia remains unclear. The exposure of pregnant rats to N(G)-nitro-L-arginine methyl ester is a widely used model of endothelial cell dysfunction during preeclampsia. It was the aim of this thesis to determine the biochemical characteristics of this model in an attempt to assess its effectiveness in mimicking oxidative changes in the preeclamptic placenta. Although this model is capable of producing a syndiome in rats similar to the disorder in terms of physiology, this is not manifest in terms of placental biochemistry. The importance of selenium in the synthesis of selenobased antioxidants such as glutathione peroxidase and thioredoxin reductase is well documented. Increasing demand for selenium by the developing fetus may be linked to reductions in selenium status during pregnancy. Considering preeclampsia is associated with significant reductions in selenium status it may be hypothesised that reductions in antioxidant function may be linked to selenium inadequacy. The modulation of dietary selenium in pregnant rats was used to determine the importance of selenium during pregnancy and its effect on antioxidant function and placental oxidative stress. The results of this analysis revealed that selenium deficiency causes a pregnancy specific condition similar to preeclampsia. This condition was found to be associated with increased placental oxidative stress and significant reductions in the systemic activity of selenobased antioxidants that could be modified through selenium supplementation. In summary, data obtained in this thesis indicate that placental oxidative stress and reduced antioxidant enzyme activity play a significant role in the pathogenesis of preeclampsia. These studies support the hypothesis that antioxidant sufficiency is crucial in the maintenance of oxidative balance and that antioxidant dysfunction may result in damage to the placenta and the progression of the disease. These novel data further our understanding of the pathophysiology of preeclampsia and provide new insight into the pathogenesis of clinical complications exhibited in this condition, suggesting antioxidant therapy as a possible means for improving the health outcomes of both mother and baby.

Affecting 6-8% of all pregnancies, preeclampsia is the leading cause of maternal morbidity in the western world and is charactensed by hypertension, proteinuria, edema and platelet aggregation. Despite its prevalence and severity, no comprehensive theory or single factor has been suggested to explain the pathophysiology of this multi system disorder of pregnancy, with the only therapies being bed rest, pharmacological symptom management and if necessary early delivery. Oxidative stress plays an important role in the pathophysiology of preeclampsia, resulting from defective trophoblast invasion, reductions in placental perfusion and placental hypoxia/reoxygenation. The inability of endogenous antioxidant systems up regulated in normal pregnancy, to control increased levels of oxidative stress, is suggested as a possible factor in the feed forward generation of reactive oxygen species and placental oxidative stress. That in turn may stimulate increased syncytiotrophoblast apoptosis, endothelial cell activation and the maternal hyper immune response characteristic of preeclampsia. Analysis of the research literature revealed that previous evaluations of placental oxidation and antioxidant enzyme activity in preeclampsia were by no means comprehensive, and exhibited significant inter-study variations. It was the aim of this thesis to clarify the placental oxidative state and the endogenous antioxidant activity of glutathione peroxidase, thioredoxin reductase, thioredoxin and superoxide dismutase in human placentae in an attempt to determine if variations in antioxidant function were due to changes in gene expression or protein oxidation. The findings reported in this thesis indicate the presence of increased levels of oxidative stress in the preeclamptic placenta, associated with significant reductions in antioxidant enzyme capacity. Quantitative real-time PCR analysis of placental samples revealed that deceases in antioxidant capacity in the placenta are more likely to be related to the significant oxidative burden within the tissue rather than reductions in gene expression. A number of animal models exist to investigate components of preeclampsia pathophysiology, however the ability of these models to mimic the oxidative and antioxidant features of preeclampsia remains unclear. The exposure of pregnant rats to N(G)-nitro-L-arginine methyl ester is a widely used model of endothelial cell dysfunction during preeclampsia. It was the aim of this thesis to determine the biochemical characteristics of this model in an attempt to assess its effectiveness in mimicking oxidative changes in the preeclamptic placenta. Although this model is capable of producing a syndiome in rats similar to the disorder in terms of physiology, this is not manifest in terms of placental biochemistry. The importance of selenium in the synthesis of selenobased antioxidants such as glutathione peroxidase and thioredoxin reductase is well documented. Increasing demand for selenium by the developing fetus may be linked to reductions in selenium status during pregnancy. Considering preeclampsia is associated with significant reductions in selenium status it may be hypothesised that reductions in antioxidant function may be linked to selenium inadequacy. The modulation of dietaty selenium in pregnant rats was used to determine the importance of selenium during pregnancy and its effect on antioxidant function and placental oxidative stress. The results of this analysis revealed that selenium deficiency causes a pregnancy specific condition similar to preeclampsia. This condition was found to be associated with increased placental oxidative stress and significant reductions in the systemic activity of selenobased antioxidants that could be modified through selenium supplementation. In summary, data obtained in this thesis indicate that placental oxidative stress and reduced antioxidant enzyme activity play a significant role in the pathogenesis of preeclampsia. These studies support the hypothesis that antioxidant sufficiency is crucial in the maintenance of oxidative balance and that antioxidant dysfunction may result in damage to the placenta and the progression of the disease. These novel data further our understanding of the pathophysiology of preeclampsia and provide new insight into the pathogenesis of clinical complications exhibited in this condition, suggesting antioxidant therapy as a possible means for improving the health outcomes of both mother and baby.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Medical Science
Full Text

Affecting 5-7% of all pregnancies, pre-eclampsia is a dangerous complication of pregnancy which poses a serious health risk to both mother and fetus. It is a major cause of maternal and perinatal morbidity and is characterised by hypertension, proteinuria, edema and platelet aggregation. Despite the severity of the disease, no comprehensive theory has been determined to explain the pathogenesis of the disease, with delivery being the only curative treatment of this multisystem disorder of pregnancy. Oxidative stress plays a crucial role in the pathogenesis of pre-eclampsia, which results in placental injury causing a hypoxic environment and eventually levels of anti-oxidants are markedly decreased. This leads to the activation of cell death pathways such as apoptosis and necrosis. The findings reported in this thesis suggest that selenium supplementation could be a potential therapy for treating women who are at risk of developing pre-eclampsia. In this study, selenium supplementation was used to up-regulate the expression of endogenous anti-oxidants, Glutathione Peroxidase (GPx) and Thioredoxin-Reductase (Thx-Red). It has been well documented in the literature that pre-eclampsia is caused by oxidative stress and in an attempt to address this we investigated whether oxidative stress in trophoblast-like cells is protected by selenium supplementation. Trophoblast-like cells, BeWo, JEG-3 and Swan-71 cells were exposed to endogenous stressors such as Rotenone and Antimycin which are able to generate mitochondrial oxidative stress by inhibiting the electron transport chain.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Medical Science
Griffith Health
Full Text

Oxidative stress of the placenta is considered a key intermediary step in the pathogenesis of preeclampsia, but the cause for the stress remains unknown. Ischaemia-reperfusion injury, as a result of intermittent placental perfusion secondary to deficient trophoblast invasion of the endometrial arteries, is a possible mechanism. This thesis therefore tests whether hypoxia-reoxygenation (H/R) in vitro can induce placental oxidative stress, and cause increased apoptosis and production of tumour necrosis factor-α as seen in the preeclamptic placenta. The first aim was to examine the oxidative status of human placental tissues during periods of hypoxia and reoxygenation in vitro. Rapid generation of reactive oxygen species (ROS) was detected using a fluorescent marker when hypoxic villous samples were reoxygenated. The expression of oxidative stress markers including nitrotyrosine residues, 4-hydroxy-2-nonenal adducts, and inducible heat shock protein 72 was greatly increased in villous samples subjected to H/R compared to the controls maintained under constant hypoxia. Furthermore, preloading villous samples with ROS scavengers such as desferrioxamine and α-phenyl-N-tert-butylnitrone significantly reduced the levels of oxidative stress in H/R. Having demonstrated that in vitro H/R is capable of inducing oxidative stress in a reproducible and manipulable manner, investigations were next carried out to study the effects of resultant oxidative stress on apoptosis within the trophoblast. Compared to hypoxic and normoxic controls, there was a significant increase in the release of cytochrome c from mitochondria, activation of caspase , and cleavage of poly (ADP-ribose) polymerase in villous samples subjected to H/R. These events were associated with an increased number of syncytiotrophoblastic nuclei displaying apoptotic changes and increased lactate dehydrogenase release into the medium. The causal relationship between the generation of ROS and these apoptotic changes was revealed by the fact that pre-administration of desferrioxamine attenuated the insult.

Preeclampsia (PE) is the leading cause of poor maternal and perinatal outcomes in both developed and developing countries. Even though the condition is treatable in the developed world, mothers from developing countries still suffer dramatic events due to limited resources. There is the need to identify readily available measures in addition to existing biomarkers that can predict PE. Thus, this thesis evaluated suboptimal health status (SHS) and prospective levels of oxidative stress (OS) biomarkers and angiogenic growth mediators (AGMs) with placental anatomy and pathology in normotensive and preeclamptic births in a Ghanaian Population. This longitudinal nested case-control study was based on the Ghanaian Suboptimal Health Status Cohort Study (GHOACS) that recruited 593 normotensive pregnant women (NTN-PW) at baseline (10-20 weeks gestation) from the Komfo Anokye Teaching Hospital between June 2017 and May 2019. Suboptimal health status, a subjective health measure was evaluated using the Suboptimal Health Status Questionnaire-25 (SHSQ-25) at baseline, and participants were subsequently classified into suboptimal health status (SHS) and optimal health status (OHS). Baseline participants were followed at 21-31 weeks, 32-42 weeks of pregnancy and 48 hours-2 weeks postpartum. Of the 593, 488 pregnant mothers aged 18-45 years completed the study and 105 were lost to follow-up. Data on sociodemographic, clinical, obstetric and anthropometric characteristics were collected from participants in addition to urine and venous blood samples. The panel of objective biomarkers of AGMs (placental growth factor [PIGF], vascular endothelial growth factor-A [VEGF-A], soluble endoglin [sEng] and soluble VEGF receptor-1 also known as soluble fms-like tyrosine kinase [sFlt-1]) in addition to OS biomarkers (8-epiprostaglandinF2 alpha [8-epi-PGF2α], 8-hydroxy-2-deoxyguanosine [8-OHdG] and total antioxidant capacity [TAC]) were evaluated across the 4-time sampling periods (10-20, 21-31, 32-42 weeks, and 48 hours-2 weeks postpartum) using ELISA. Placenta tissues were collected after delivery and examined for macroscopical, histopathological and immunohistochemical analyses. Data were analysed using SPSS, GraphPad Prism, XLSTAT and R Core. There were significant associations between SHS and imbalances in AGMs and OS (Study I: cross-sectional). The incidence of PE was high among SHS pregnant women (30.7%) compared to OHS pregnant women (8.8%), and SHS was an independent risk indicator for PE (Study II: longitudinal nested case-control). Compared to using the biomarkers alone, combining biomarkers of AGMs and OS, particularly 8- OHdG/PlGF ratio measured at 21-31 weeks (mid-pregnancy) yielded the best area under the curve, sensitivity, specificity, positive and negative predicted values for predicting the likelihood of SHS and OHS pregnant women developing PE (Study III: longitudinal nested case-control). Placental abnormalities and imbalance in the expression of AGMs and OS were associated more with SHS pregnant mothers who developed PE, particularly early-onset PE than late-onset PE (Study IV: case-control). In contrast to normotensive pregnancy, longitudinal profiling of AGMs and OS showed different patterns across the 4-time sampling periods with significant imbalance among SHS more than OHS mothers who later developed PE. Unlike, the single biomarkers, combined AGMs and OS ratios measured at mid-pregnancy yielded more significant hazard ratios in association with PE development (Study V: longitudinal cohort). Thus, combined evaluation of SHS, biomarkers of AGMs and OS together with placental examination increased the understanding of the aetiology, diagnosis and prognosis of PE, and created a window of opportunity for developing potentially predictive, preventive and personalised medicine in both high-and low-resource maternal and child health settings.

Le tabagisme actif par la mère expose le fœtus en développement à des agents qui peuvent traverser la barrière placentaire et interférer avec les fonctions placentaires. Un large éventail de fonctions immunologiques, pourrait être compromises. Dans cette étude, nous avons évalué l'effet de l'extrait de la fumée de cigarette (CSE) sur les macrophages isolés à partir de placentas humains (pMφs), qui sont les principaux partenaires de l'immunité de fœto-maternelle innée. J’ai pu montrer que le CSE inhibe la formation des cellules géantes multinucléées (MGC). Cette propriété du CSE est spécifique aux macrophages car la fusion des macrophages dérivés des monocytes est inhibée lors de la formation de granulomes in vitro. J’ai également étudié l'absorption de particules et la production de cytokines par pMφs exposés au CSE. Le CSE a inhibé l'absorption des particules de zymosan, mais pas celle du zymosan opsonisé, ce qui suggère qu’il interfère avec les récepteurs phagocytaires et non phagocytaires. Le CSE augmente la libération de TNF et d'IL-33, et une diminue celle de l'IL-10, ce qui montre que l'équilibre entre les cytokines est affecté par le CSE. En outre, l’expression des métalloprotéinases telles que les MMP-1, MMP-10 et MMP-12, connues pour être impliquées dans le remodelage des tissus et la fusion des macrophages est dérégulée. Enfin, j’ai montré que la nicotine, l'un des principaux composés de tabac, n'a pas affecté les propriétés fonctionnelles des pMφs
Active smoking by the mother exposes the developing fetus to agents that can cross the placental barrier and interfere with placental functions. A wide range of immunological functions, including innate and adaptive immune responses, might be impaired. In this study, we assessed the effect of cigarette smoke extract (CSE) on macrophages isolated from human placentas (pMφs), which are major partners of innate feto-maternal immunity. I showed that CSE significantly inhibited the formation of multinucleated giant cells (MGCs). This property of CSE is specific to macrophages because the fusion of monocyte-derived macrophages is inhibited during the in vitro formation of granulomas. I also investigated particle uptake and cytokine production by pMφs exposed to CSE. CSE inhibited the uptake of zymosan, but not that of opsonized zymosan, suggesting that it interferes with phagocytic receptors, not with the phagocytic machinery of pMφs. CSE increased the release of Tumor Necrosis Factor and interleukin-33, and decreased that of interleukin-10, demonstrating that the balance between inflammatory and anti-inflammatory cytokines is affected by CSE. Furthermore, CSE enhanced the expression of metalloproteinase (MMPs) genes such as MMP-1, MMP-10 and MMP-12, known to be involved in tissue remodeling including macrophage fusion. Finally, I showed that nicotine, one of the major compounds of tobacco, did not affect the functional properties of pMφs

Contexte. Au cours de la pré-éclampsie (PE), le défaut d'invasion trophoblastique et de remodelage des artères utérines spiralées génère une mauvaise adaptation de la circulation utéro-placentaire associée à des phénomènes d'hypoxie/réoxygénation (H/R). Il en résulte un stress oxydant et un déséquilibre des facteurs angiogéniques/antiangiogéniques (diminution du VEGF et PIGF vs augmentation du sFlt1) responsables d'une placentation anormale, une dysfonction endothéliale et une inflammation systémique. Le dysfonctionnement de l'oxyde nitrique synthase endothéliale (eNOS) et la diminution de la biodisponibilité du NO, jouent un rôle critique dans la pathophysiologie de la PE. eNOS est la principale source de production du NO dans le placenta, et elle joue un rôle primordial dans l'homéostasie et la régulation du tonus vasculaire. Des données récentes indiquent que eNOS peut être modifiée au cours du stress oxydant, en particulier par S-glutathionylation, ce qui entraine son découplage avec une génération d'ion superoxyde et une réduction du NO. Objectif. Le but de ce travail a été d'étudier les conséquences du stress oxydant sur la eNOS placentaire, en particulier sa glutathionylation, et les modifications par les produits d'oxydation lipidique (LPO), en relation avec sa dysfonction observée au cours de la PE. Matériels et Méthodes. La modification de eNOS a été étudiée dans des tissus placentaires obtenus à partir de césariennes réalisées chez des patientes pré-éclamptiques (n=13), vs grossesses normales (n=9). Des études complémentaires sont réalisées sur des trophoblastes humains HTR-8/SVneo exposés à un stress oxydant induit par H/R, ou par exposition à des LPO. Résultats : Les études en immunofluorescence et microscopie confocale montrent une importante glutathionylation de eNOS dans les placentas de PE, sensible aux agents réducteurs (dithiotréitol), sans différence d'expression de eNOS totale entre PE et grossesses normales. La S-glutathionylation est confirmée par immunoprécipitation et Western Blot de la eNOS placentaire. L'exposition des trophoblastes HTR8 à des conditions d'H/R, génère une S-glutathionylation d'eNOS associée à une production réduite de NO, et une génération d'ion superoxyde. Le NO est nécessaire pour le potentiel invasif des trophoblastes, comme démontré par l'absence de migration des HTR8 après inhibition spécifique de eNOS par small ARN interference (siRNA), et rétablie après addition d'un donneur de NO, le NOC-18. Les trophoblastes exposés aux variations H/R, montrent des capacités de migration diminuées témoignant d'un potentiel invasif réduit, et rétabli par NOC-18. Dans la deuxième partie de ce travail, nous avons recherché la présence de LPO dans les placentas de PE, et nous avons émis l'hypothèse que eNOS puisse être une cible de ces agents. Nous montrons que les LPO tels que le 4-hydroxynonenal (4-HNE), et le 4-oxo-2-nonenal (ONE), s'accumulent dans les placentas de PE, en particulier sur la eNOS, alors qu'aucune modification n'est observée dans les placentas de grossesse normale. Les études en protéomique sur eNOS recombinante, montrent que ONE et 4-HNE modifient plusieurs épitopes (ONE-Lys, HNE-His, HNE-Cys). L'addition de 4-HNE ou de ONE aux HTR8, inhibe la production de NO et la migration des cellules, restaurée par l'addition de NOC-18. Conclusions et perspectives : Ces résultats montrent que la eNOS placentaire est une cible importante du stress oxydant au cours de la PE, avec des modifications par S-glutathionylation ou par formation d'adduits avec ONE ou 4-HNE, associées à une diminution de la production de NO. Ces modifications pourraient contribuer au dysfonctionnement de la eNOS placentaire observé au cours de la PE. En perspective, nous pourrons étudier les conséquences du stress oxydant et des LPO, sur le vieillissement accéléré du placenta, qui contribueraient à la physiopathologie de la PE
Context: During pre-eclampsia (PE), the defective trophoblastic invasion and remodeling of the uterine spiral arteries leads to poor adaptation of utero-placental circulation associated with hypoxia/reoxygenation phenomena. This induces oxidative stress and an imbalance between angiogenic/antiangiogenic factors (decrease in VEGF and PIGF vs. increase in sFlt1) responsible for abnormal placentation, endothelial dysfunction and systemic inflammation. Endothelial nitric oxide synthase dysfunction (eNOS) and decreased NO bioavailability play a critical role in the pathophysiology of PE. eNOS is the main source of placental NO production, and plays a key role in homeostasis and vascular tone regulation. Recent evidence indicates that eNOS may undergo glutathionylation in the vascular wall, and subsequent uncoupling in a prooxidant environment, this resulting in an increased generation of superoxide anion and a decreased production of NO. Objective: The purpose of this work was to study the consequences of oxidative stress on placental eNOS, in particular its glutathionylation and modification by lipid oxidation products (LPO), in relation to its dysfunction observed during PE. Materials and Methods: The modification of eNOS was studied in placental tissues obtained from preeclampsia-affected (n=13), vs normal pregnant women (n=9) and in HTR-8/SVneo human trophoblasts exposed to hypoxia/reoxygenation (H/R), or by exposure to LPO. Results: Immunofluorescence and confocal microscopy revealed a high glutathionylation of eNOS in PE placentas, reversed by dithiotreitol, which was confirmed by immunoprecipitation and western-blot experiments, with no difference in total eNOS expression between PE and normal pregnancy. Exposure of HTR8 trophoblasts to H/R conditions generates S-glutathionylation of eNOS associated with reduced NO production, and increased superoxide anion generation. NO is necessary for the invasive potential of trophoblasts, since trophoblasts exposed to H/R, or silenced for eNOS by small interfering RNAs (siRNA), showed a decreased migration capacity, which was restored by the NO donor, NOC-18. In the second part of this work, we investigated the presence of LPO in PE placentas, and hypothesized that eNOS could be a target of these agents. We show that LPO such as 4-hydroxynenal (4-HNE), and 4-oxo-2-nonenal (ONE), accumulate in PE placentas, particularly on eNOS, while no changes are observed in normal pregnancy placentas. Proteomics studies on recombinant eNOS show that ONE and 4-HNE modify several epitopes (ONE-Lys, HNE-His, HNE-Cys). The addition of 4-HNE or ONE to HTR8 inhibits NO production and cell migration, restored by the addition of NOC-18. Conclusions and perspectives: These results show that placental eNOS is an important target for oxidative stress during PE, with modifications by S-glutathionylation or adduct formation with ONE or 4-HNE, associated with a decrease in NO production. These changes could contribute to the dysfunction of placental eNOS observed during the PE. In perspective, we plan to study the consequences of oxidative stress and LPO on accelerated placental aging, which may contribute to the pathophysiology of PE, and beyond, of pathological pregnancies

Orientador: Leandro Gustavo de Oliveira
Resumo: Introdução: A gestação é uma condição fisiológica que pode apresentar maior suscetibilidade ao desequilíbrio entre fatores pró e antioxidativos, evoluindo assim com dano celular e resposta inflamatória. A autofagia é um processo que elimina organelas e proteínas danificadas do citoplasma, com potente mecanismo anti-inflamatório responsável pela manutenção da homeostase celular. A autofagia pode controlar a inflamação por meio da inibição da ativação do inflamassoma, complexo essencial para a liberação de citocinas pró-inflamatórias. Assim, alterações nesses processos podem relacionar-se com disfunções celulares e doenças sistêmicas. Objetivos: Este projeto teve como objetivo avaliar se a exposição de explantes placentários a diferentes concentrações de peróxido de hidrogênio (H2O2) é capaz de induzir autofagia e levar a ativação do inflamassoma NLRP3. Métodos: Explantes placentários de gestantes normais obtidos após o parto foram cultivados em diferentes concentrações de H2O2 por 4 e 24 h após a avaliação da viabilidade dos mesmos nesses períodos. As enzimas superóxido dismutase (SOD) e catalase foram avaliadas nos sobrenadantes das culturas após 4 h. As expressões gênicas de marcadores de autofagia (LC3-II, beclin-1 e p62), do inflamassoma (NLRP3 e caspase-1) e das citocinas IL-1β, IL-10 e TNF-α foram avaliadas por RT-qPCR. Os níveis de gonadotrofina coriônica (hCG), proteína de choque térmico 70 (Hsp70) e citocinas IL-1β, IL-10 e TNF-α foram determinados por ensaio imunoenz... (Resumo completo, clicar acesso eletrônico abaixo)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Introdução: A gestação é uma condição fisiológica que pode apresentar maior suscetibilidade ao desequilíbrio entre fatores pró e antioxidativos, evoluindo assim com dano celular e resposta inflamatória. A autofagia é um processo que elimina organelas e proteínas danificadas do citoplasma, com potente mecanismo anti-inflamatório responsável pela manutenção da homeostase celular. A autofagia pode controlar a inflamação por meio da inibição da ativação do inflamassoma, complexo essencial para a liberação de citocinas pró-inflamatórias. Assim, alterações nesses processos podem relacionar-se com disfunções celulares e doenças sistêmicas. Objetivos: Este projeto teve como objetivo avaliar se a exposição de explantes placentários a diferentes concentrações de peróxido de hidrogênio (H2O2) é capaz de induzir autofagia e levar a ativação do inflamassoma NLRP3. Métodos: Explantes placentários de gestantes normais obtidos após o parto foram cultivados em diferentes concentrações de H2O2 por 4 e 24 h após a avaliação da viabilidade dos mesmos nesses períodos. As enzimas superóxido dismutase (SOD) e catalase foram avaliadas nos sobrenadantes das culturas após 4 h. As expressões gênicas de marcadores de autofagia (LC3-II, beclin-1 e p62), do inflamassoma (NLRP3 e caspase-1) e das citocinas IL-1β, IL-10 e TNF-α foram avaliadas por RT-qPCR. Os níveis de gonadotrofina coriônica (hCG), proteína de choque térmico 70 (Hsp70) e citocinas IL-1β, IL-10 e TNF-α foram determinados por ensaio imunoenzimático (ELISA) após 24 h de cultura. Resultados: Os níveis de LDH foram crescentes conforme o tempo de cultura, sendo que as culturas de 24 h apresentaram-se com viabilidade celular adequada para o estudo. Os níveis proteicos de catalase e Hsp70, bem como a expressão gênica de LC3-II, beclin-1 e p62 apresentaram níveis crescentes e relacionados às maiores concentrações de H2O2. As concentrações proteicas de SOD, hCG e TNF-α foram maiores nas culturas com 100 µM de H2O2. A expressão gênica de TNF-α, IL-1β, NLRP3 e caspase-1 foram elevadas em 1000 µM de H2O2. Além disso, a expressão proteica de IL-1β também foi maior nessa concentração. As concentrações gênicas e proteicas de IL-10 decresceram de acordo com o aumento da concentração de H2O2. Conclusões: Os resultados obtidos demonstraram que o H2O2 é capaz de induzir o estado de estresse oxidativo placentário, induzir autofagia, ativar o inflamassoma e assim aumentar a produção de citocinas inflamatórias.
Introduction: Pregnancy is a physiological condition characterized by increased susceptibility to oxidative stress, which can lead to cell damage and inflammatory response. Autophagy is a process that removes damaged organelles and proteins from the cytoplasm. It works as potent anti-inflammatory mechanism, responsible for maintaining cellular homeostasis. Autophagy can control inflammatory responses by regulating the activation of inflammasome, an essential complex for pro-inflammatory cytokine release. Objectives: The aim of this study was to evaluate whether placental explants exposure to hydrogen peroxide (H2O2) is able to induce autophagy and inflammasome activation. Methods: Placental explants achieved from normal pregnant women after delivery were cultured in different concentrations of H2O2 for 4 and 24 h after viability evaluation for these periods. Superoxide dismutase (SOD) and catalase were evaluated in culture supernatants after 4 h. Gene expressions of autophagy markers (LC3-II, beclin-1 and p62), inflammasome (NLRP3 and caspase-1) and IL-1β, IL-10 and TNF-α were assessed by RT-qPCR. Levels of chorionic gonadotrophin (hCG), heat shock protein (Hsp70) and IL-1β, IL-10 and TNF-α were determined by enzyme-linked immunosorbent assay (ELISA) after 24 h of culture. Results: LDH levels were increased according to culture time, and the 24 h cultures presented adequate cell viability for the study. The protein levels of catalase and Hsp70, as well as the gene expression of LC3-II, beclin-1 and p62 presented increasing levels and related to the higher concentrations of H2O2. Protein concentrations of SOD, hCG and TNF-α were higher in cultures with 100 μM of H2O2. Gene expression of TNF-α, IL-1β, NLRP3 and caspase-1 were raised in 1000 μM of H2O2. In addition, IL-1β protein expression was also higher at this concentration. Gene and protein concentrations of IL-10 decreased as the H2O2 concentration increased. Conclusions: Our results demonstrate that H2O2 is able to induce a state of placental oxidative stress, induce autophagy, activate the inflammasome and then increase the production of inflammatory cytokines.
FAPESP: 2014/25611-5

Arsenic is a naturally occurring element with exposures in various work settings. Arsenic exposure can occur environmentally, particularly through drinking contaminated water and ingestion of some foods. The most toxic forms are inorganic arsenic, iAs (trivalent, pentavalent), and its metabolites, as well as the highly toxic arsine gas, the latter causing hemolysis. There are also organic arsenicals in food, particularly seafood, of little or no known toxicity. Inorganic arsenic is well absorbed through ingestion and respiration and is quickly cleared from the blood, distributed throughout the body (including across the placenta), metabolized in the liver, and excreted in the urine with metabolites monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA). Most of it is excreted with a half-life of days. Inorganic arsenic disrupts numerous enzyme systems, causes oxidative stress and induces alterations in gene expression. Acute severe poisoning, rarely seen in occupational settings, is life-threatening, usually presenting with gastrointestinal symptoms and severe diarrhea that can progress to cardio-pulmonary collapse, requiring treatment in intensive care, with chelating medication. Chronic iAs exposure can lead to characteristic skin lesions, increased cancer risks (particularly skin, lung, bladder), and other cardiovascular, neurological, endocrine and reproductive adverse health effects. Assessment involves history, physical exam and urine arsenic (can be a spot sample corrected for creatinine), speciating the sample for inorganic species. This urine arsenic biomarker assesses current exposures. Treatment and prevention focus on identifying and eliminating or decreasing exposure, both in the workplace and environment.