Normotensive placental extracellular vesicles provide long-term protection against hypertension and cardiovascular disease.

BACKGROUND: Women with normotensive pregnancy are at a reduced risk of developing cardiovascular disease postpartum compared with those who experience hypertensive conditions during pregnancy. However, the underlying mechanisms remain poorly understood. During normotensive pregnancy, vast numbers of placental extracellular vesicles are released into the maternal circulation, which protect endothelial cells from activation and alter maternal vascular tone. We hypothesized that placental extracellular vesicles play a mechanistic role in lowering the risk of cardiovascular disease following normotensive pregnancy. OBJECTIVE: This study aimed to investigate the long-term effects of placental extracellular vesicles derived from normotensive term placentae on the cardiovascular system and explore the mechanisms underlying their biological effects. STUDY DESIGN: Spontaneously hypertensive rats were injected with placental extracellular vesicles from normotensive term pregnancies (2 mg/kg each time, n=8) or vehicle control (n=9) at 3 months of age. Blood pressure and cardiac function were regularly monitored from 3 months to 15 months of age. The response of mesenteric resistance arteries to vasoactive substances was investigated to evaluate vascular function. Cardiac remodeling, small artery remodeling, and renal function were investigated to comprehensively assess the impact of placental extracellular vesicles on cardiovascular and renal health. RESULTS: Compared with vehicle-treated control animals, rats treated with normotensive placental extracellular vesicles exhibited a significantly lower increase in blood pressure and improved cardiac function. Furthermore, the vasodilator response to the endothelium-dependent agonist acetylcholine was significantly enhanced in the normotensive placental extracellular vesicle-treated spontaneously hypertensive rats compared with the control. Moreover, treatment with placental extracellular vesicles reduced wall thickening of small renal vessels and attenuated renal fibrosis. CONCLUSION: Placental extracellular vesicles from normotensive term pregnancies have long-lasting protective effects reducing hypertension and mitigating cardiovascular damage in vivo.

Conducting Polymer-Infused Electrospun Fibre Mat Modified by POEGMA Brushes as Antifouling Biointerface.

Biofouling on surfaces, caused by the assimilation of proteins, peptides, lipids and microorganisms, leads to contamination, deterioration and failure of biomedical devices and causes implants rejection. To address these issues, various antifouling strategies have been extensively studied, including polyethylene glycol-based polymer brushes. Conducting polymers-based biointerfaces have emerged as advanced surfaces for interfacing biological tissues and organs with electronics. Antifouling of such biointerfaces is a challenge. In this study, we fabricated electrospun fibre mats from sulphonated polystyrene-block-poly(ethylene-ran-butylene)-block-polystyrene (sSEBS), infused with conducting polymer poly(3,4-ethylenedioxythiophene) (PEDOT) (sSEBS-PEDOT), to produce a conductive (2.06 ± 0.1 S/cm), highly porous, fibre mat that can be used as a biointerface in bioelectronic applications. To afford antifouling, here the poly(oligo (ethylene glycol) methyl ether methacrylate) (POEGMA) brushes were grafted onto the sSEBS-PEDOT conducting fibre mats via surface-initiated atom transfer radical polymerization technique (SI-ATRP). For that, a copolymer of EDOT and an EDOT derivative with SI-ATRP initiating sites, 3,4-ethylenedioxythiophene) methyl 2-bromopropanoate (EDOTBr), was firstly electropolymerized on the sSEBS-PEDOT fibre mat to provide sSEBS-PEDOT/P(EDOT-co-EDOTBr). The POEGMA brushes were grafted from the sSEBS-PEDOT/P(EDOT-co-EDOTBr) and the polymerization kinetics confirmed the successful growth of the brushes. Fibre mats with 10-mers and 30-mers POEGMA brushes were studied for antifouling using a BCA protein assay. The mats with 30-mers grafted brushes exhibited excellent antifouling efficiency, ~82% of proteins repelled, compared to the pristine sSEBS-PEDOT fibre mat. The grafted fibre mats exhibited cell viability >80%, comparable to the standard cell culture plate controls. Such conducting, porous biointerfaces with POEGMA grafted brushes are suitable for applications in various biomedical devices, including biosensors, liquid biopsy, wound healing substrates and drug delivery systems.

Antiphospholipid antibodies do not cause retargeting of placental extracellular vesicles in the maternal body.

Antiphospholipid antibodies (aPL) are autoantibodies that cause pregnancy disorders by a poorly defined mechanism that involves the placenta. The human placenta is covered by a single multinucleated cell, the syncytiotrophoblast, which extrudes vast numbers of extracellular vesicles (EVs) into the maternal blood. Extracellular vesicles are tiny packages of cellular material used by cells for remote signalling. In normal pregnancy, placental EVs assist maternal adaptations to pregnancy. We have previously shown that aPL alter the cargo of placental EVs, increasing the load of danger signals. These changes in EV cargo may explain how aPL contribute to the increased risk of recurrent miscarriage, preeclampsia and stillbirths observed in aPL-affected pregnancies. An additional possibility, that aPL alters the targeting of placental EVs to maternal organs to cause maternal maladaptation to pregnancy was investigated in this study.

Comparison of methods for separating fluorescently labelled placental extracellular vesicles from free stain.

The field of extracellular vesicles (EVs) is relatively new and the methods for EV isolation and quantification are still maturing. For example, there is no consensus on how to separate free stain from labelled EVs. Here we report a comparison of the recovery of labelled EVs following separation from free stain using ultracentrifugation, diafiltration with different devices and a charged size exclusion chromatography column. Of the methods we tested, the charged size exclusion column provided the greatest recovery of labelled EVs.

A pilot study on investigating the role of Salvia miltiorrhiza in fetal growth restriction.

To date there is no effective treatment for pregnancies complicated by fetal growth restriction (FGR). Salvia miltiorrhiza, a traditional Chinese herb has been shown to promote blood flow and improve microcirculatory disturbance. In this pilot study, we evaluated whether S. miltiorrhiza can potentially become a possible therapy for FGR. Nineteen pregnant women with FGR were treated with S. miltiorrhiza and ATP supplementation for an average of 7 days, and 17 cases received ATP supplementation as controls. The estimated fetal weights (EFWs) were measured by ultrasound after treatment, and the birthweights were recorded after birth. After treatment with S. miltiorrhiza, 7 (37%) FGR cases showed an increase in EFW to above the 10th percentile, compared with 4 (23%) FGR cases in controls (odds ratio: 1.896, 95% confidence limits (CLs): 0.44-8.144). At delivery, 10 (53%) FGR cases in the treatment group delivered babies with a birthweight above the 10th percentile, compared with 6 (35%) FGR cases in the control group (odds ratio: 2.037, 95% CL: 0.532-7.793); 80 or 64% FGR cases in the treatment group showed an increase in fetal abdominal circumference (AC) or biparietal diameter (BPD) above the 10th percentile before delivery. While 44 or 30% FGR cases in the control group showed an increase in AC or BPD. No improvement of head circumference (HC) or femur length (FL) was seen. These pilot data suggest the need for multicenter randomized clinical trials on the potential of S. miltiorrhiza to improve perinatal outcome in pregnant women complicated by FGR.

Parity Correlates with the Timing of Developing Endometrial Cancer, But Not Subtype of Endometrial Cancer.

Parity is one of well-known risk factors of endometrial cancer, but it is less clear whether parity is associated with the timing of developing endometrial cancer, and with the incidence of subtype of endometrial cancer. Data on 902 patients including age at diagnosis, age at menarche and menopause, parity and age at last birth from two obstetrics and gynaecology hospitals in China was analysed. 5.6% patients were nulliparous, 53.4% patients had one live birth, 27.7% patients had two live births and 13.3% patients had three or more live births. Patients at diagnosis who had three or more live births were significantly older than patients who were nulliparous or had one or two live births with the median age at diagnosis of 63 versus 51 or 52 or 59 years respectively. The percentage of patients with three or more live births at diagnosis before menopause was significantly lower than patients who were nulliparous, had one live birth or had two live births (10% versus 52%, or 51.9% or 22.4%). Furthermore, time from last birth to endometrial cancer was significantly longer in patients who had three or more live births than patients who had two live births or had one live birth (35 versus 31, or 24 years). However, there was no difference in the incidence of subtypes of endometrial cancer according to parity. Our data suggests parity is negatively correlated with the time onset of endometrial cancer and not associated with the incidence of endometrial cancer subtypes.

Trends in gynaecological cancers in the largest obstetrics and gynaecology hospital in China from 2003 to 2013.

The incidence and the trend of gynaecological cancers have been suggested to vary by ethnicity and geographical regions. Whether the incidence and type of gynaecological cancers in China is different have not been fully investigated. In this study, we reported the trend of gynaecological cancers in China. Data on 13,518 women with gynaecological cancers were collected from the largest obstetrics and gynaecology hospital in China from 2003 to 2013. Data included age at diagnosis and the annual number of women with diagnosed endometrial, ovarian, cervical cancer and other gynaecological cancers. The number of women with diagnosed gynaecological cancers increased by almost sixfold in 2013 compared to that in 2003. It was largely due to the increase of women with newly diagnosed cervical cancer. The percentage of women with endometrial and ovarian cancer within total gynaecological cancers was decreased, whilst the percentage of cervical cancer significantly increased between 2003 and 2013. The mean age of women with endometrial or ovarian cancer at diagnosis was 53 or 48 years, respectively, which was no difference over 11 years. However, the mean age of women with cervical cancer at diagnosis was significantly delayed from 42 years in 2003 to 46 years since 2011. This was also confirmed by the age-specific distribution of gynaecological cancers over 11 years. Our study found that the age onset of endometrial and ovarian cancer has not changed over 11 years. But the age onset of cervical cancer is delayed since 2011 in China.