Evidence for extraplacental sources of circulating angiogenic growth effectors in human pregnancy.

Pregnancy complications such as preeclampsia (PE) and intrauterine growth restriction (IUGR) are associated with reduced blood flow, contributing to placental and fetal hypoxia. Placental hypoxia is thought to cause altered production of angiogenic growth effectors (AGEs), reflected in the circulation of mother and fetus. Vascular endothelial growth factor (VEGF), placental growth factor (PlGF) and their soluble binding protein (sFlt-1) are, in turn, postulated as being causally involved in PE via induction of systemic endothelial cell dysfunction. To dissect the role of AGEs, accurate measurement is of great importance. However, the values of AGEs are highly variable, contributing to heterogeneity in their association (or lack thereof) with preeclampsia. To test the hypothesis that variability may be due to peripheral cell release of AGEs we obtained blood samples from normal healthy pregnant women (n = 90) and the cord blood of a subset of their neonates using standard serum separation and compared results obtained in parallel samples collected into reagents designed to inhibit peripheral cell activation (sodium citrate, theophylline, adenosine and dipyridamole-CTAD). AGEs were measured by ELISA. CTAD collection reduced maternal and fetal free VEGF by 83%, and 98%, respectively. Free PlGF was decreased by 29%, maternal sFlt-1 by >20% and fetal sFlt-1 by 59% in the CTAD-treated vs. serum sample (p < 0.0001). In summary blood collection techniques can profoundly alter measured concentrations of AGEs in mother and fetus. This process is highly variable, contributes to variation reported in the literature, and renders questionable the true impact of alteration in AGEs on pregnancy pathologies.

IFPA Meeting 2012 Workshop Report III: trophoblast deportation, gestational trophoblastic disease, placental insufficiency and fetal growth restriction, trophoblast over-invasion and accreta-related pathologies, placental thrombosis and fibrinolysis.

Workshops are an important part of the IFPA annual meeting as they allow for discussion of specialized topics. At IFPA meeting 2012 there were twelve themed workshops, five of which are summarized in this report. These workshops related to various aspects of placental biology but collectively covered areas of clinical research and pregnancy disorders: 1) trophoblast deportation; 2) gestational trophoblastic disease; 3) placental insufficiency and fetal growth restriction; 4) trophoblast overinvasion and accreta-related pathologies; 5) placental thrombosis and fibrinolysis.

Glucose transporter 3 (GLUT3) protein expression in human placenta across gestation.

Conflicting information regarding expression of GLUT3 protein in the human placenta has been reported and the localization and pattern of expression of GLUT3 protein across gestation has not been clearly defined. The objective of this study was characterization of syncytial GLUT3 protein expression across gestation. We hypothesized that GLUT3 protein is present in the syncytial microvillous membrane and that its expression decreases over gestation. GLUT3 protein was measured in samples from a range of gestational ages (first to third trimester), with human brain and human bowel used as a positive and negative control respectively. As an additional measure of specificity, we transfected BeWo choriocarcinoma cells, a trophoblast cell line expressing GLUT3, with siRNA directed against GLUT3 and analyzed expression by Western blotting. GLUT3 was detected in the syncytiotrophoblast at all gestational ages by immunohistochemistry. Using Western blotting GLUT3 was detected as an integral membrane protein at a molecular weight of ∼50 kDa in microvillous membranes from all trimesters but not in syncytial basal membranes. The identity of the primary antibody target was confirmed by demonstrating that expression of the immunoblotting signal in GLUT3 siRNA-treated BeWo was decreased to 18 ± 6% (mean ± SEM) of that seen in cells transfected with a non-targeting siRNA. GLUT3 expression in microvillous membranes detected by Western blot decreased through the trimesters such that expression in the second trimester (wks 14-26) was 48 ± 7% of that in the first trimester and by the third trimester (wks 31-40) only 34 ± 10% of first trimester expression. In addition, glucose uptake into BeWo cells treated with GLUT3 siRNA was reduced to 60% of that measured in cells treated with the non-targeting siRNA. This suggests that GLUT3-mediated uptake comprises approximately 50% of glucose uptake into BeWo cells. These results confirm the hypothesis that GLUT3 is present in the syncytial microvillous membrane early in gestation and decreases thereafter, supporting the idea that GLUT3 is of greater importance for glucose uptake early in gestation.

Fetal growth restriction: a workshop report.

Intrauterine growth restriction (IUGR) is associated with significantly increased perinatal morbidity and mortality as well as cardiovascular disease and glucose intolerance in adult life. A number of disorders from genetic to metabolic, vascular, coagulative, autoimmune, as well as infectious, can influence fetal growth by damaging the placenta, leading to IUGR as a result of many possible fetal, placental and maternal disorders. Strict definitions of IUGR and of its severity are needed in order to eventually distinguish among different phenotypes, such as gestational age at onset, degree of growth restriction and presence of hypoxia. This report explores and reviews some of the most recent developments in both clinical and basic research on intrauterine growth restriction, by seeking mechanisms that involve genetic factors, utero-placental nutrient availability and vascular growth factors. New exciting findings on the genomic imprinting defects potentially associated with IUGR, and the placental anomalies associated with the decreased nutrient transport are summarized. Moreover, recent data on angiogenic growth factors as well as new information arising from application of gene chip technologies are discussed.

Second-trimester amniotic fluid interleukin-10 concentration predicts preterm delivery.

OBJECTIVE: Interleukin-6 (IL-6) is an inflammatory cytokine that has been shown to be elevated in the amniotic fluid of patients with preterm labor. On the other hand, interleukin-10 (IL-10) is an anti-inflammatory cytokine that has been shown to inhibit the synthesis of other cytokines. We hypothesized that amniotic fluid IL-10 in the early second trimester is low in patients who subsequently develop preterm labor, and because of its deficiency, excessive inflammatory responses associated with IL-6 elevation lead to preterm labor and delivery. STUDY DESIGN: Amniotic fluid IL-6 and IL-10 levels were measured in 96 women who underwent genetic amniocentesis between 15 and 23 weeks' gestation. Levels of IL-6 and IL-10 were measured by immunoassay and correlated with demographic and pregnancy outcome information. RESULTS: Fifteen patients delivered at or before 36 weeks and 81 patients delivered after 36 weeks. There was an inverse correlation between amniotic fluid IL-10 concentration and gestational age at delivery. Similarly, an inverse correlation also existed between amniotic fluid IL-6 concentration and gestational age at delivery. CONCLUSIONS: Both IL-10 and IL-6 levels in second-trimester amniotic fluid obtained at the time of genetic amniocentesis appeared to be higher in patients who subsequently developed preterm delivery. Therefore, low amniotic fluid IL-10 production during the second trimester does not seem to be an etiology for preterm labor.

Luteal progesterone relates to histological endometrial maturation in fertile women.

To examine the relationship between endometrial histological maturation and reproductive hormones, we studied 11 fertile women, aged 18-37 yr. All participants had had at least 1 previous pregnancy and cycled regularly, every 25-35 days. Women collected daily, first morning voided urine for measurement of estradiol and progesterone metabolite excretion, estrone conjugates (E1c), and pregnanediol glucuronide (Pdg), respectively, throughout the cycle of study. Hormones were normalized for creatinine. Between 7-9 days after home detection of a LH surge (Sure Step), participants underwent an endometrial biopsy using a small bore (Pipelle) catheter. Tissue was prepared for histological and biochemical analyses. The histological analysis is reported herein. Endometrium was dated by 3 authors (N.S., D.H., and S.P.), all of whom were blinded to the participant's identity or timing of biopsy within her cycle. Final dating was agreed upon based upon the method of Noyes et al. E1c and Pdg were integrated throughout the cycle using the trapezoidal rule, and correlations were sought between deviation from expected histology (based upon urinary hormones and LH surge) and integrated hormone values. E1c varied over a 2-fold range in these normal women, from 1196-2040 ng/cycle. Pdg excretion was much more variable, ranging from 22-119 microg/cycle. No relationship could be found between histological lagging of endometrial maturation and lower excretion of E1c. A moderate correlation was observed (Spearman's r = 0.6; P < 0.05) between degree of histological maturation and integrated Pdg. Of two women with evidence of a disparity between gland and stromal development (glands lagging behind stroma by >2 days), one excreted 24 microg Pdg/cycle, the next to lowest value. We conclude that normal fertile women experience a wide range of hormone concentrations in the face of normal endometrial maturation. Progesterone appears to exert a dose-related effect on endometrial maturation, and the techniques we used, although relatively crude clinical measures, appeared to be sufficient to detect this relationship.

Episialin acts as an antiadhesive factor in an in vitro model of human endometrial-blastocyst attachment.

Episialin, which is found on the apical membrane of human endometrial epithelium, has been postulated to act as an antiadhesive factor through the steric hindrance generated by its extensively glycosylated structure. The present studies were designed to test this hypothesis in an in vitro model of endometrial-blastocyst attachment. Episialin was expressed in human endometrial carcinoma cells (HEC-1A > RL95-2), and attachment of JAr choriocarcinoma cells to the endometrial cell monolayers was inversely related to episialin expression. Treatment of endometrial monolayers with type III sialidase increased JAr binding, and this increase was suppressed by HMFG1, a monoclonal antibody specific for episialin. The effects of sialidase appear to have resulted from a contaminant protease rather than from a loss of sialic acid residues, because sialidase preparations other than type III were ineffective. After sialidase treatment, conditioned medium from cells treated with type III sialidase contained more episialin than medium from cells treated with other sialidase preparations. Similar attachment-assay results were obtained using O-sialoglycoprotein endopeptidase; after treatment, the increase in JAr binding (>50%) was suppressed by the antiepisialin antibody. These results demonstrate for the first time that episialin acts as an antiadhesive agent in a model of human endometrial-blastocyst attachment.

Glycaemic regulation of glucose transporter expression and activity in the human placenta.

To determine whether the expression and activity of glucose transporters in human trophoblast are regulated by glucose, syncytiotrophoblast cells, choriocarcinoma cells, and villous fragments were incubated with a range of glucose concentrations (0-20 mM, 24 h). Expression of GLUT1 and GLUT3 glucose transporters was measured by immunoblotting, while glucose transporter activity was determined by [3H]2-deoxyglucose uptake in the cultured cells. GLUT1 expression in syncytial cells was enhanced following incubation in absence of glucose, reduced by incubation in 20 mM glucose but was not altered by incubation at 1 or 12 mM glucose. Transporter activity was inversely related to extracellular glucose over the entire range of concentrations tested (0-20 mM). Incubation of villous fragments in 20 mM glucose produced a limited suppression of GLUT1 expression, but no effects were noted following incubation at 0 or 1 mM glucose. Neither GLUT1 expression in JAr and JEG-3 choriocarcinoma cells nor transport activity in JEG-3 cells was affected by extracellular glucose concentration. Unlike syncytial cells, JAr, JEG-3 and BeWo all expressed GLUT3 protein in addition to GLUT1. These results show that while syncytiotrophoblast GLUT1 expression is altered at the extremes of extracellular glucose concentration, it is refractory to glucose alone at lower concentrations. By contrast, an inverse relationship exists between glucose transporter activity and extracellular glucose. This suggests that there are post-translational regulatory mechanisms which may respond to changes in extracellular glucose concentration.

Guanidine transport in a human choriocarcinoma cell line (JAR).

PURPOSE: Many endogenous substances and xenobiotics are organic cations. Transplacental transport of organic cations is an important determinant of the delivery of these compounds to the fetus. The aim of this study was to determine the mechanisms of organic cation transport using the human choriocarcinoma cell line (JAR) as a model system with [14C]guanidine as a ligand. METHODS: Uptake studies of [14C]guanidine were carried out in JAR cell monolayers on day 2 after plating. RESULTS: [14C]guanidine uptake was temperature dependent, saturable (Km = 167 microM) and inhibited by many organic cations including amiloride, cimetidine, quinine, quinidine and nicotine. [14C]guanidine uptake exhibited a counterflux phenomenon indicative of a carrier-mediated process. The uptake of [14C]guanidine was sodium and pH-independent and could be driven by an inside-negative membrane potential difference. CONCLUSIONS: This is the first demonstration of an electrogenic guanidine transporter in a human cell culture model. This transporter may play a role in the transplacental transport of many clinically used drugs and xenobiotics.

Beta-adrenergic regulation of cyclic AMP synthesis in cultured human syncytiotrophoblast.

Isolated elements of the beta-adrenergic/adenyl cyclase signal transduction system have been studied previously using purified membranes. We used cultured syncytiotrophoblast cells to identify components of this signalling system and the interactions which regulate syncytial adenyl cyclase. Generation of cyclic AMP (cAMP) was stimulated in these cells by both forskolin and isoproterenol but not by dopamine, adenosine, carbachol or prostaglandin E1. Synthesis was also stimulated by treatment with cholera toxin, indicating the involvement of the G-protein, Gs. Somatostatin inhibited isoproterenol- or forskolin-stimulated cAMP generation, an effect which could be blocked by pretreatment of the cells with pertussis toxin, demonstrating the mediation of somatostatin action by Gi. Furthermore, secretion of human chorionic gonadotrophin (hCG) was increased significantly by isoproterenol while somatostatin blocked the isoproterenol-stimulated release of hCG. These results clearly demonstrate that adenyl cyclase in syncytiotrophoblast is controlled by a stimulatory pathway operating through Gs and inhibitory pathway acting through Gi.

Simultaneous preparation of paired, syncytial, microvillous and basal membranes from human placenta.

A method for the simultaneous preparation of microvillous and basal membrane vesicles from human placental syncytiotrophoblast is described. Mg2(+)-aggregated basal membranes are separated from microvillous membranes by low-speed centrifugation after initial homogenization and centrifugation steps. Microvillous membranes (MVM) are obtained from the low speed supernatant while basal membranes (BM) contained in the Mg2(+)-aggregated material are resuspended and further purified on a sucrose step gradient. MVM and BM prepared by this method were enriched 20-fold and 11-fold as determined by the membrane marker enzymes, alkaline phosphatase (MVM) and adenylate cyclase (BM). There was minimal cross-contamination of the two isolated plasma membrane fractions and the yields obtained were 26% (MVM) and 21% (BM) compared to the initial homogenate. The MVM and BM fractions were free from contamination by mitochondrial or lysosomal membranes and showed only minor contamination by microsomal membranes. The two membrane fractions were also tested for the presence of non-syncytial plasma membranes by electrophoretic immunoblotting. Contamination of both MVM and BM by fibroblast, endothelial, macrophage and cytotrophoblast plasma membranes amounted to less than 15% of the total membrane protein as determined by immunoblotting. Vesicle orientation, determined from the latency of specific concanavalin A binding, was 88 +/- 4% right-side out for MVM and 73 +/- 12% right-side out for BM. This simple preparative procedure produces a high yield of both MVM and BM from human placenta. The analytical data demonstrates that 'paired' MVM and BM fractions derived from the same placental tissue have a high purity in terms not only of contamination by intracellular membranes, but also in terms of contamination by non-syncytial plasma membranes.

Human placental mitochondrial respiration and its regulation by adenine nucleotides.

Respiratory parameters were studied in mitochondria from human placenta. Respiratory control and ADP/O ratios were low in this preparation. The adenine nucleotide content of placental mitochondria was found to be only one quarter of that found for adult uterine muscle tissue mitochondria prepared in the same way. Loading placental mitochondria with adenine nucleotides by incubation in the presence of ATP produced increased respiratory control ratios but no improvement in ADP/O ratios. Our evidence is consistent with the developmental changes shown to occur in rat liver, in which an increased concentration of adenine nucleotides is responsible for changes in respiratory parameters.

Mechanical and metabolic viability of a placental perfusion system in vitro under oxygenated and anoxic conditions.

In vitro dual circuit perfusion of the placenta with well-oxygenated medium results in the continuous and stable consumption of oxygen and glucose over a 2-h perfusion period. This is reflected in a stable production of lactate and an energy charge which is higher at the end of the perfusion period than that seen in fresh placental tissue immediately after vaginal delivery. Anoxic perfusion causes an increase in glucose consumption which is more than twofold higher than that seen in the oxygenated perfusion, resulting finally in placental uptake of glucose not only from the maternal but also from the fetal circulation. Lactate production is increased during the anoxic perfusion, while the final tissue energy charge value lies between the values observed for fresh tissue and for the oxygenated perfusion. The shift to anaerobic metabolism shown by placental tissue in anoxic conditions enables continued functioning of the tissue over the 2-h perfusion period but it appears that under anoxic conditions the tissue may incur an energy debt not observed in oxygenated perfusions.

Altered imprinting of rat liver monoamine oxidase by o, p'-DDT and methoxychlor.

Neonatal administration of o,p'-DDT [1, 1, 1-trichloro-2-(o-chlorophenyl-2-(chlorophenyl)ethane] or methoxychlor resulted in elevated levels of sex-differentiated hepatic monoamine oxidase activities in adult rats, but not in prepubertal animals. Exposure to these hormonally active xenobiotics may have changed the brain hormone environment during the critical period of development, resulting in endocrine alterations that were reflected by latent but permanent increases in hepatic monoamine oxidase activities, i.e. "altered imprinting". Hepatic glutathione S-transferases and cytochrome P-450 content also underwent sex differentiation, but neonatal treatment with o,p'-DDT or methoxychlor did not alter levels in adult rats. However, glutathione S-transferase activities and cytochrome P-450 content were higher in prepubertal animals treated neonatally with o,p'-DDT. In contrast to monoamine oxidase, effects on glutathione S-transferase activities and cytochrome P-450 content were attributed to induction by these xenobiotics.

Endocrine regulation of rat serum cholinesterase activity.

Enzymological and endocrine studies of rat serum cholinesterase (CHE) suggest that this enzyme is subject to a complex and specific form of regulation. Adult CHE activity levels are 3-fold higher in adult females than in males. Gonadectomy and/or hypophysectomy abolish these sex differences. Androgen and estrogen replacement to gonadectomized but not to hypophysectomized animals reverses this action. Adrenalectomy produces no significant changes in serum CHE levels in either male or female rats. An ectopic pituitary plus the appropriate steroid cannot reverse the effect of hypophysectomy. The catalytic properties of CHE alter concurrently with isozyme changes and are reflected in the changes in the ratio of hydrolysis of the butyryl and acetyl substrates. Androgens and estrogens, acting through the hypothalamic-hypophyseal axis, appear to modulate the synthesis of specific CHE isozymes.