Z Geburtshilfe Neonatol 2009; 213(3): 89-95
DOI: 10.1055/s-0029-1224196
Original Paper

© Georg Thieme Verlag KG Stuttgart · New York

Perfusion of the Human Placenta with Red Blood Cells and Xanthine Oxidase Mimics Preeclampsia in-vitro

Die in-vitro Perfusion der menschlichen Plazenta mit Eryhtrozyten und Xanthine Oxidase als in vitro Simulation von PraeeklampsieM. Centlow 1 , K. Junus 1 , H. Nyström 1 , K. May 1 , 4 , I. Larsson 1 , M. G. Olsson 2 , B. Åkerström 2 , R. Sager 3 , H. Schneider 3 , S. R. Hansson 1
  • 1Department of Obstetrics and Gynecology, Lund University Hospital, Lund, Sweden
  • 2Division of Infection Medicine, Lund University, Lund, Sweden
  • 3Department of Obstetrics and Gynecology, Insel Spital, University of Bern, Switzerland
  • 4On leave of absence from Department of Clinical Pharmacology, Ernst Moritz Arndt University of Greifswald, Germany
Further Information

Publication History

Publication Date:
17 June 2009 (online)

Abstract

Background and Purpose: Preeclampsia is a major obstetric problem of unknown etiology. The fact that removal of the placenta is the only cure for preeclampsia, has led to the well-established hypothesis, that the placenta is central in the etiology. Gene profiling and proteomics studies have suggested oxidative stress caused by reperfusion and free oxygen radicals as a potential pathophysiological mechanism in preeclampsia. In this study, the dual placental perfusion model was used in order to evaluate the damaging effects of oxidative stress induced by xanthine/xanthine oxides and free hemoglobin.

Material and Methods: The dual placenta perfusion model is a well-established in vitro model for functional placental studies. Placentas were perfused with medium containing either xanthine/xanthine oxidase or erythrocytes as a source of free hemoglobin. Concentration of free hemoglobin in the medium was measured by means of ELISA. Whole genome microarray technique and bioinformatics were used to evaluate the gene expression profile in the two groups.

Results: Substantial levels of free adult hemoglobin were detected in the perfusions. A total of 58 genes showed altered gene expression, the most altered were hemoglobin α, β and γ, tissue factor pathway inhibitor 2 and superoxide dismutase 2. Bioinformatics revealed that biological processes related to oxidative stress, anti-apoptosis and iron ion binding were significantly altered.

Conclusions: The results suggest that perfusion with xanthine/xanthine oxidase and free hemoglobin induce changes in gene expression similar to what has been described for the preeclamptic placenta.

Zusammenfassung

Hintergrund: Die Aetiologie der Praeeklampsie ist nach wie vor nicht geklärt. Die Tatsache, dass die Erkrankung allein durch die Entfernung der Plazenta geheilt werden kann, hat zu der Hypothese geführt, dass die Plazenta bei der Entstehung einer Praeeklampsie eine zentrale Rolle spielt. Untersuchungen des Genoms sowie Proteoms lassen auf oxidativen Stress infolge von Reperfusion mit Freigabe von reaktiven Sauerstoffmolekülen als potentiellen pathophysiologischen Mechanismus bei der Entwicklung einer Praeeklampsie schliessen. In dieser Arbeit wurde die doppelseitige in-vitro Perfusion eines Kotyledons der menschlichen Plazenta als Model benutzt, um die schädigenden Effekte von oxidativem Stress, hervorgerufen durch Xanthine/Xanthineoxiden und freies Hämoglobin, zu untersuchen.

Material und Methode: Die doppelseitige Perfusion hat sich als Model für in-vitro Studien verschiedener funktioneller Aspekte von meschlichem Plazentagewebe besonders bewährt. Plazenten wurden mit Medium nach Zugabe von Xanthine plus Xanthine Oxidase bzw. von Erythrozyten als Quelle von freiem Hämoglobin perfundiert. Die Konzentration von freiem Hämoglobin wurde im Medium mit einem ELISA gemessen. Gesamt Genom Mikroarray Technik und Methoden der Bioinformatik wurden verwendet, um das Gen Expressionsprofil in beiden Gruppen zu bestimmen.

Ergebnisse: Beachtliche Mengen freien Erwachsenen Hämoglobins wurden in den Perfusionen gemessen. Insgesamt fanden sich Expressionsveränderungen bei 58 Genen, mit den stärksten Veränderungen bei α-, ß- und γ-Hämoglobin, Gewebefaktor Reaktion Inhibitor 2 und bei Superoxiddismutase. Die Auswertung mit Hilfe von Bioinformatik ergab, dass biologische Prozesse im Zusammenhang mit oxidativem Stress, Anti-Apoptose und Bindung von Eisenionen signifikant verändert waren.

Konklusionen: Die Ergebnisse zeigen, dass durch die Perfusion mit Xanthine/Xanthineoxidase sowie freiem Hämoglobin Veränderungen in der Genexpression verursacht werden, die den in Plazentagewebe von Praeeklampsien beschriebenen Befunden ähneln.

Literatur

  • 1 Roberts JM, Cooper DW. Pathogenesis and genetics of pre-eclampsia.  Lancet. 2001;  357 53-56
  • 2 Stevens JM. Gynaecology from ancient Egypt: The papyrus Kahun: A translation of the oldest treatise on gynaecology that has survived from the ancient world.  Med J Aust. 1975;  2 949-952
  • 3 Lipstein H, Lee CC, Crupi RS. A current concept of eclampsia.  Am J Emerg Med. 2003;  21 223-226
  • 4 Brosens JJ, Pijnenborg R, Brosens IA. The myometrial junctional zone spiral arteries in normal and abnormal pregnancies.  Am J Obstet Gynecol. 2002;  187 1416-1423
  • 5 Roberts JM, Hubel CA. Is oxidative stress the link in the two-stage model of pre-eclampsia?.  Lancet. 1999;  354 788-789
  • 6 Shennan AH, Poston L, Chappell LC. et al . Prevention of pre-eclampsia.  Lancet. 2001;  357 1534
  • 7 Hung TH, Skepper JN, Charnock-Jones DS. et al . Hypoxia-reoxygenation: a potent inducer of apoptotic changes in the human placenta and possible etiological factor in preeclampsia.  Circ Res. 2002;  90 1274-1281
  • 8 Centlow M, Carninci P, Nemeth K. et al . Placental expression profiling in preeclampsia: local overproduction of hemoglobin may drive pathological changes.  Fertil Steril. 2008;  90 1834-1843
  • 9 Schneider H, Huch A. Dual in vitro perfusion of an isolated lobe of human placenta: method and instrumentation.  Contrib Gynecol Obstet. 1985;  13 40-47
  • 10 Myatt L, Cui X. Oxidative stress in the placenta.  Histochem Cell Biology. 2004;  122 369-382
  • 11 Poston L, Raijmakers M. Trophoblast oxidative stress, antioxidants and pregnancy outcome-a review.  Placenta. 2004;  25 S72-S78
  • 12 Di Santo S, Malek A, Sager R. et al . Trophoblast viability in perfused term placental tissue and explant cultures limited to 7–24 h.  Placenta. 2003;  24 882-894
  • 13 Guller S, Ma Y, Malek A. et al . Differential release of plasminogen activators during dual perfusion of human placenta: implications in preeclampsia.  Placenta. 2007;  28 278-285
  • 14 Di Santo S, Sager R, Andres AC. et al . Dual In Vitro Perfusion of an Isolated Cotyledon as a Model to Study the Implication of Changes in the Third Trimester Placenta on Preeclampsia.  Placenta. 2007;  28 S23-S32
  • 15 Hansson SR, Chen Y, Brodszki J. et al . Gene expression profiling of human placentas from preeclamptic and normotensive pregnancies.  Mol Hum Reprod. 2006;  12 169-179
  • 16 Saal LH, Troein C, Vallon-Christersson J. et al . BioArray Software Environment (BASE): a platform for comprehensive management and analysis of microarray data.  Genome biology. 2002;  3 SOFTWARE0003
  • 17 Elbashir MI, Nilson BH, Akesson P. et al . Antibody response in immunized rabbits measured with bacterial immunoglobulin-binding proteins.  J Immunol Methods. 1990;  135 171-179
  • 18 Genbacev O, Zhou Y, Ludlow JW. et al . Regulation of human placental development by oxygen tension.  Science. 1997;  277 1669-1672
  • 19 Zuwala-Jagiello J. Haemoglobin scavenger receptor: function in relation to disease.  Acta biochimica Polonica. 2006;  53 257-268
  • 20 Balla J, Vercellotti GM, Jeney V. et al . Heme, heme oxygenase, and ferritin: how the vascular endothelium survives (and dies) in an iron-rich environment.  Antioxid Redox Signal. 2007;  9 2119-2137
  • 21 Balla G, Vercellotti GM, Muller-Eberhard U. et al . Exposure of endothelial cells to free heme potentiates damage mediated by granulocytes and toxic oxygen species.  Laboratory investigation; a journal of technical methods and pathology. 1991;  64 648-655
  • 22 Wagener, Feldman E, de Witte T. et al . Heme induces the expression of adhesion molecules ICAM-1, VCAM-1, and E selectin in vascular endothelial cells.  Proceedings of the Society for Experimental Biology and Medicine Society for Experimental Biology and Medicine (New York, NY. 1997;  216 456-463
  • 23 Wagener FA, Eggert A, Boerman OC. et al . Heme is a potent inducer of inflammation in mice and is counteracted by heme oxygenase.  Blood. 2001;  98 1802-1811
  • 24 Hube F, Reverdiau P, Iochmann S. et al . Demonstration of a tissue factor pathway inhibitor 2 messenger RNA synthesis by pure villous cytotrophoblast cells isolated from term human placentas.  Biol Reprod. 2003;  68 1888-1894
  • 25 Kempaiah P, Kisiel W. Human tissue factor pathway inhibitor-2 induces caspase-mediated apoptosis in a human fibrosarcoma cell line.  Apoptosis. 2008;  13 702-715
  • 26 Ogawa M, Yanoma S, Nagashima Y. et al . Paradoxical discrepancy between the serum level and the placental intensity of PP5/TFPI-2 in preeclampsia and/or intrauterine growth restriction: possible interaction and correlation with glypican-3 hold the key.  Placenta. 2007;  28 224-232
  • 27 Jauniaux E, Watson A, Bao Y. et al . Onset of maternal arterial blood flow and placental oxidative stress.  Am J Pathol. 2000;  157 2111-2122
  • 28 Hempstock J, Bao Y, Bar-Isaac M. et al . Intralobular differences in antioxidants enzyme expression and activity reflect the pattern of maternal arterial blood flow within the human placenta.  Placenta. 2003;  24 517-523
  • 29 Tsoi SC, Cale JM, Bird IM. et al . cDNA microarray analysis of gene expression profiles in human placenta: up-regulation of the transcript encoding muscle subunit of glycogen phosphorylase in preeclampsia.  J Soc Gynecol Investig. 2003;  10 496-502
  • 30 Reimer T, Koczan D, Gerber B. et al . Microarray analysis of differentially expressed genes in placental tissue of pre-eclampsia: up-regulation of obesity-related genes.  Mol Hum Reprod. 2002;  8 674-680
  • 31 Nishizawa H, Pryor-Koishi K, Kato T. et al . Microarray analysis of differentially expressed fetal genes in placental tissue derived from early and late onset severe pre-eclampsia.  Placenta. 2007;  28 487-497
  • 32 Gack S, Marme A, Marme F. et al . Preeclampsia: increased expression of soluble ADAM 12.  Journal of molecular medicine (Berlin, Germany). 2005;  83 887-896
  • 33 Pang ZJ, Xing FQ. Comparative profiling of metabolism-related gene expression in pre-eclamptic and normal pregnancies.  Arch Gynecol Obstet. 2004;  269 91-95
  • 34 Benian A, Uzun H, Aydin S. et al . Placental stem cell markers in pre-eclampsia.  Int J Gynaecol Obstet. 2008;  100 228-233

Correspondence

M. Centlow

Lund University Hospital

Department of Obstetrics and Gynecology

BMC C14

22185 Lund Sweden

Phone: +46/46222 30 11

Fax: +46/46222 07 48

Email: magnus.centlow@med.lu.se

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