Regulation of the Placental Growth Factor Mediated by Sumoylation and Expression of miR-652-3p in Pregnant Women with Early-Onset Preeclampsia.

We studied regulation of the expression of placental growth factor (PlGF) that plays an important role in the trophoblast cells functions and reduced production of which by the placenta is associated with gestational complications. PlGF expression is regulated by transcription factors whose activity is controlled by sumoylation, which is also necessary for the formation of an adequate cellular response to hypoxia. Increased sumoylation and reduced expression of some miRNA targeted to transcription factors VEGF, GCM-1, and UBC9 conjugating SUMO with targets protein were detected in the placenta. Correlations were revealed between changes in the expression of miR-423-3p and miR-652-3p, the level of SUMO 1-4 and UBC9 in the placenta, reduced concentration of PlGF, and increased sFlt-1/PlGF ratio in the blood of pregnant women with early-onset preeclampsia, which attests to the presence of a regulatory mechanism along the axis of miR-652-3p/SUMO-2/3/4/UBC9/GCM-1/PlGF.

Comparative Characteristics of Sialoglycans Expression Disorders in the Placental Barrier Structures in Preeclampsia and Fetal Growth Restriction.

We compared the expression profiles of α2,3- and α2,6-sialoglycans in the glycocalyx of the placental barrier structures in early and late forms of preeclampsia and fetal growth restriction using the method of lectin histochemistry. It was found that the expression of α2,3-sialoglycans in the syncytiotrophoblast and fetal endothelium of the terminal villi of the placenta was reduced in preeclampsia in comparison with normal placenta and, on the contrary, was increased in fetal growth restriction. Significant differences were found in both clinical phenotypes of preeclampsia and fetal growth restriction. Changes in the expression pattern of α2,6-sialoglycans in the endothelium of terminal villi were more pronounced than in syncytiotrophoblast. In early and late-onset preeclampsia, a significant increase in the expression of α2,6-sialoglycans was revealed only in the fetal endothelium; in early fetal growth restriction, the expression of α2,6-sialoglycans was reduced in the endothelium, but increased in syncytiotrophoblast in late fetal growth restriction. The features of the expression of sialoglycans in structures of the placental barrier in preeclampsia and fetal growth restriction were revealed, which may indicate the pathogenetic involvement of sialoglycans in the inflammatory activation cascade in fetal growth restriction, and in preeclampsia, apparently, they are associated with impaired fetal tolerance.

[Analysis of metabolic pathways in intrauterine growth restriction]. / Analiz metabolicheskikh putei pri zaderzhke rosta ploda.

Objective was to analyze metabolic pathways based on a study of the metabolomic profile of pregnant women with intrauterine growth restriction. The metabolic profile of pregnant women with fetal growth restriction has been analyzed using liquid chromatography-mass spectrometry. At the second stage pathways were identified using SMPDB and MetaboAnalyst databases to clarify the relationship between metabolites. Biological networks allow to determine the effect of proteins on the metabolic pathways involved in pathogenesis of IUGR and determine the epigenetic mechanisms of its formation.

Expression of fucosylated glycans in endothelial glycocalyces of placental villi at early and late fetal growth restriction.

The aim of the study was to investigate the content and distribution of fucosylated sugar residues and Lewis Y (LeY) in the endothelial glycocalyx (eGC) in placental tissue at early and late onset fetal growth restriction (FGR). Our findings demonstrated that the changes of the fucosylated glycans of type 2 (H2)/LeY in the vascular endothelium of the villi may reflect alteration of villi maturation, or adaptation to hypoxia through the change of cell proliferation potential and induction angiogenesis. Early onset FGR differs from late onset FGR by a markedly increased LeY expression, being associated with more severe pathological state.

Peculiarities of RIG-1 Expression in Placental Villi in Preeclampsia.

The expression of RIG-1 in placenta samples was assessed in women of reproductive age with early- and late-onset preeclampsia and cesarean delivery at 27-39 weeks of gestation. The highest expression of RIG-1 was found in the syncytiotrophoblast of placental villi in the group with uncomplicated full-term pregnancy (normal); RIG-1 expression in groups with early- and late-onset preeclampsia was significantly (p<0.01) lower. In decidual cells, RIG-1 expression was also maximum in normal pregnancy and significantly (p<0.01) lower in lateonset preeclampsia. In the endothelium of villous capillaries, the maximum expression was observed in normal full-term pregnancy and in late-onset preeclampsia, while in early-onset preeclampsia this parameter was significantly (p<0.01) lower. It can be assumed that different variants of preeclampsia are mediated by similar pathogenetic mechanisms, including those related to immature molecular profile of the trophoblast and decidual cells, probably due to impaired stem cell activity in the placenta determining higher vulnerability and reduced regeneration capacity of the placental tissue. This is due to the fact that RIG-1 is one of the important signaling molecules that promote activation of stem cell and tissue regeneration.

Change in OncomicroRNA Expression in the Placenta during Preeclampsia.

The expression of microRNA-17, microRNA-181a, and microRNA-519a in the villous tree in preeclampsia was analyzed using chromogenic in situ hybridization technique (CISH). It was found that in early-onset preeclampsia, the expression of microRNA-17 in the syncytiotrophoblast was higher (p<0.05) than in late preeclampsia, and the expression of microRNA-519a was higher (p<0.05) than in women with preterm birth at 26-31 weeks gestation. We revealed higher level of expression of microRNA-181a (p<0.05) in the cytoplasm of the syncytiotrophoblast of intermediate placental villi in the group with premature delivery in comparison with early preeclampsia. In full-term pregnancy, the expression of microRNA-181a in the vascular endothelium of placental villi was higher (p<0.02) than in women with premature deliveries. Analysis of the target genes associated with these microRNAs showed that damage to the trophoblast typical of preeclampsia, especially up to 34 weeks gestation, was accompanied by selective activation of genes participating in invasion and compensatory suppression of oncoprotective genes associated with the development of malignant neoplasms.

Complex Analysis of Total and Fetal DNA and Cytokines in Blood Plasma of Pregnant Women with Preeclampsia.

We performed a complex analysis of total and fetal extracellular DNA, 8 cytokines (IL-2, IL-4, IL-6, IL-8, IL-10, granulocyte-macrophage CSF, IFNγ, and TNFα) in blood plasma obtained from women with preeclampsia prior to labor onset. Total (sensitivity 89.47%, specificity 93.75%) and fetal extracellular DNA (sensitivity 73.68%, specificity 87.5%) were the most accurate parameters determining preeclampsia. We revealed a high correlation (p=3×10-6) between total and fetal extracellular DNA levels in the group of preeclampsia. Preeclampsia significantly increased the levels of macrophage factors IL-10 and IL-6. These cytokines significantly correlated with the levels of total and fetal extracellular DNA in the preeclampsia group. In the control group, such correlations were not observed. These findings obtained suggest that preeclampsia develops upon increased macrophage activity, leading to destruction of the placenta trophoblast cells.

[Features of the urine peptidome under the condition of hypertensive pathologies of pregnancy]. / Osobennosti peptidoma mochi pri gipertenzivnykh patologiiakh beremennykh.

In order to find a peptide panel to differentiate close hypertensive conditions a case-control study was designed for 64 women from 4 groups: preeclampsia (PE), chronic hypertension superimposed with PE, chronic hypertension, and healthy individuals. Chromatography coupled with mass-spectrometry and subsequent bioinformatic analysis showed several patterns in the changes of the urine peptidome. There were 36 peptides common for four groups. Twenty two of them 22 belonged to alpha-1-chain of collagen I, nine peptides were from alpha-1-chain of collagen III, two from alpha-2-chain of collagen I, one from alpha-1/2-chain of collagen I, one from alpha-1-chain of collagen I/XVIII and one from uromodulin. Patients with hypertensive disorders had 34 common peptides: 12 from alpha-1-chain of collagen I, 10 from fibrinogen alpha-chain, eight from alpha-1-chain of collagen III, and 4 per other types of collagen. Comparative analysis revealed 12 peptides, which could be used as a diagnostic panel for confident discrimination of pregnant women with various hypertensive disorders.

Expression of MicroRNA-146a and MicroRNA-155 in Placental Villi in Early- and Late-Onset Preeclampsia.

We studied the expression of microRNA-146a and microRNA-155 in placental villi from 18 women (26-39 weeks of gestation) of reproductive age with early- or late-onset preeclampsia. The reference group consisted of women with physiological pregnancy and full-term gestation and with preterm birth after caesarian section on gestation week 26-31. MicroRNA-146a and microRNA-155 were detected by in situ hybridization with digoxigenin on paraffin sections. It was found that the expression of microRNA-146a in both syncytiotrophoblast of the intermediate villi and syncytial knots was lower at late-onset preeclampsia than at physiologic pregnancy of full-term period (p=0.037 and p=0.001 respectively). The expression of microRNA-155 in syncytiotrophoblast of intermediate placental villi in early-onset preeclampsia was higher than in group with preterm delivery (p=0.003). However, in syncytiotrophoblast of intermediate villi and in syncytial knots, the expression of microRNA-155 was lower at late-onset preeclampsia in comparison with full-term physiological pregnancy (p=0.005). In addition, the expression of microRNA-146a and microRNA-155 did not increase in the later terms in preeclampsia, while in the reference groups demonstrating gradual increase in the expression of these markers with increasing gestational age. Expression microRNA-146a and microRNA-155 little differed in early- and late-onset preeclampsia. These findings suggest that different variants of preeclampsia are probably characterized by common pathogenetic pathways. Damaged trophoblast cannot maintain of microRNAs synthesis at the required level, which determines the formation of a vicious circle in preeclampsia and further progression of the disease.

Ultrastructural Characteristics of Placental Telocytes.

Telocytes of placental villi were studied by electronic microscopy during physiological pregnancy. Ultrastructural features of telocytes indicating their heterogeneity and presence of at least three types of villi depending on their localization and kind were observed. All placental telocytes were characterized by small amount of organelles including mitochondria. Presence of long thin processes, which generated a branching network by contacting with each other, served as a typical feature of telocytes including telocytes of the stroma and intermediate villi. Telocytes were absent in the terminal villi.

[Morphological Features of Mesenhymal Stroma Cells of Chorionic Villi].

Background: Nowadays autologous mesenchymal placental stromal cells (MSCs) may use to treat for various diseases both of the mother and the child. Stroma of the placenta villi is appropriated origin for cell culture isolation. Aim: of the study was to evaluate the possibility for selection and use of placental tissue for mesenchymal stromal cells. Materials and methods: The present study was based on 45 placental samples of women aged 27−38 yy. who underwent surgical delivery at 36−40 weeks of gestation. 30 of these women have been enrolled in the basic group including children with congenital abnormalities (CA). The comparison group consisted of 15 patients with physiological pregnancy. We performed histological examination (with hematoxylin and eosin staining), immunohistochemical examination (with use monoclonal antibodies CD90 (1:25; Abcam, UK), СD105 (1:500; Abcam, UK), CD44 (1:25; Dako), СD73 (1:200, Abcam, UK), and electron microscopy (by microscope Philips/FEI Corporation, Eindhoven, Holland). Eclipse 80i microscope (Nikon Corporation, Japan) was used to examine the immunohistochemical reactions as a brown staining. The evaluation of the intensity of reaction was conducted by NIS-Elements Advanced Research 3.2 program (Czech Republic). Student's t-test and analysis of variance were used to compare the mean values. Differences were considered statistically significant at p<0.05. Results: Interstitial cells of the stroma of the villi with CA had fibroblastic differentiation as revealed degenerative changes of the cells. The histologic examination with hematoxylin and eosin staining revealed significant fibrosis of the stroma of the placenta villi in CA group (p<0,01). Immunohistochemical study of stem and intermediate chorionic villi revealed no significant differences in staining of CD44+, СD90+, СD73+, and CD105+ cells if compared to the control group (p>0.05). Although CD105 expression was significantly lower in the CA group (0.058±0.0049) than in the control group (0.088±0.0039) (p<0.05). However, electron microscopy detected the villi interstitial stromal cells with fibroblastic differentiation in CA group. Conclusions: Thus, it is necessary to exclude placenta with obstetrical history, somatic, and congenital pathology of the mother and the child when selecting the placental cell culture. Moreover, choosing a sample the morphological structure of the placenta should be taken into consideration. However, congenital malformations of the fetus, pathology of the mother cultivate mesenchymal stromal cells of placentas is inappropriate and should be taken advantage of the donor cells.

Differences of glycocalyx composition in the structural elements of placenta in preeclampsia.

INTRODUCTION: Glycans expressed in the fetal-maternal interface were shown to exert immunomodulating effects and to mediate interactions between the cells. The aim of this study was to investigate alterations in the structure of carbohydrate chains of glycocalyx in placental tissue in pregnancies complicated with preeclampsia (PE). METHODS: A histochemical analysis of placental tissues was performed with a panel of biotinylated lectins. We analyzed placental tissues in women who had severe or moderate PE and compared them to placentas from women with normal pregnancies. RESULTS: There was decreased content of terminal residues of α(2,6)-linked sialic acid (as stained by SNA lectin) in the carbohydrate chains of glycocalyx of the endothelium of placental terminal villi in patients with moderate preeclampsia. The composition of the glycocalyx of syncytiotrophoblast in patients of this group did not differ from the control group. Amount of the glycans with terminal ß-Gal- (ECL) and α-mannosyl residues (ConA) in the syncytiotrophoblast and capillary endothelium of the placenta was significantly higher in the group with severe PE compared to the control group. The increased content of sialoglycans with α(2,6)-linked sialic acids residues were discovered in the syncytium, and the decreased content of α(2,3)-linked sialic acids residues - in the endothelium of terminal villi in preeclampsia. DISCUSSION: The most prominent alteration of the glycocalyx composition was found in the placentas of women with severe preeclampsia. It is likely that the modified glycome of syncytiotrophoblast and capillary endothelium may play an important role in pathogenesis of preeclampsia.

An untargeted approach for the analysis of the urine peptidome of women with preeclampsia.

Preeclampsia (PE) is a pregnancy complication characterized by high blood pressure and proteinuria. The disorder usually occurs after the 20th week of pregnancy and gets worse over time. PE increases the risk of poor outcomes for both the mother and the baby. In the study we applied LC-MS/MS method for the analysis of the urine peptidome of women with PE. Samples were prepared using size-exclusion chromatography method which gives more than twice peptides identities if compared with solid phase extraction. Thirty urine samples from women with mild and severe preeclampsia and the control group were analyzed. In total 1786 peptides were identified using complementary search engines (Mascot, MaxQuant and PEAKS). A high level of agreement in peptide identification was observed with previously published data. Label-free data comparison resulted in 35 peptides which reliably distinguished a particular PE group (severe or mild) from controls. Our results revealed unique identifications (correlate to alpha-1-antitrypsin, collagen alpha-1(I) chain, collagen alpha-1 (III) chain, and uromodulin, for instance) that can potentially serve as early indicators of PE.

Specific Features of TLR4 Expression in Structural Elements of Placenta in Patients with Preeclampsia.

We studied the expression of TLR4 (Toll-like receptor 4) in the syncytiotrophoblast and vascular endothelial cells of terminal and stem placental villi in severe preeclampsia and normal pregnancy. In women of both groups, the expression of TLR4 was higher in the syncytiotrophoblast that in placental endothelial cells. In patients with severe preeclampsia, TLR4 expression in endothelial cells of terminal villi was 1.3-fold lower than in normal pregnancy. Lower TLR4 expression in the terminal villi endothelium in preeclampsia can underlie impaired recognition of damaging molecules with subsequent development of endothelial dysfunction and changes in immunological tolerance.

[MicroRNAs As An Important Precursors of Diagnostic Obstetric Pathology].

MicroRNAs (miRs) are the class of short nucleotide sequences (21-27 nucleotides) RNA, non-coding protein synthesis. miRs are known as effective posttranscriptional negative regulators of gene expression with specific binding sites of targeted messenger RNA (mRNA) in the cytoplasm, providing translational repression or degradation of the target miR transcript. In this review we studied the role of miRNAs in the development of a physiological pregnancy and obstetric complications. The placenta is a unique organ which provides modulation of the immune system of the maternal organism during pregnancy including miRs which determine immunological tolerance of the body to the tissues of the fetus. Thus the "placental" miRs in maternal circulation may be the potential biomarker revealed at various obstetric pathology on the early stages before clinical manifestation of the diseases.

Detection of Antibodies In Vitro Binding to Endothelial Cells in the Sera from Women with Normal Pregnancy and Preeclampsia.

Activity of serum antibodies in vitro binding to endothelial cells in women with normal pregnancy and preeclampsia was studied. Flow cytometry detected peculiarities of antibody binding to endothelial cells in health and disease. Detection of antiendothelial antibodies in trimesters II and III can be diagnostically important in preeclampsia.

Role of innate immunity in pregnant patients with vulvovaginal infections in the development of intrauterine infection in the newborn.

A total of 115 pregnant women were examined: 59 patients with opportunistic vulvovaginal infections and 56 without infection. Congenital immunity parameters (TLR-2, NF-κB, and IL-2 receptors in placental tissue) were studied by immunohistochemical methods. Realization of congenital infection was associated with activation of IL-6 receptors and TLR-2 in the placenta and an increase of NF-κB level. These changes seemed to reflect the strained status of congenital immunity and were responsible for the intensity of local inflammatory response.

Association of ESR1 gene polymorphism with preterm rupture of fetal membranes.

We examined 179 patients with and without preterm rupture of fetal membranes. The mothers and their newborns have been genotyped by two polymorphic loci of estrogen receptor α (ESR1) gene: -397T > C[PvuII] (rs2234693) and -351A > G[XbaI] (rs9340799). The CG haplotype of the fetus should be regarded as a risk factor of preterm rupture of fetal membranes, while haplotype TA as a protective factor. Genotype -351A/A is a marker of the protective haplotype in the fetus, while genotype -397C/C is a marker of the risk haplotype, which can be used in combined analysis of both markers. These data attest to an important role of fetal genotype in the formation of genetic predisposition to preterm rupture of fetal membranes.

The expression of matrix metalloproteinases in placental tissue depends on the severity of undifferentiated connective tissue dysplasia.

Immunohistochemical study of MMP-2 and MMP-9 expression in placental tissue of pregnant patients with undifferentiated connective tissue dysplasia of different severity showed that more severe condition was associated with higher expression of these MMP, this underlying the development of pregnancy and labor complications. The most pronounced elevation of the studied MMP levels was found in the basal plate decidual cells in women with undifferentiated connective tissue dysplasia of more than 18 score.

[Clinico-morphological and molecular-genetic characteristic of the miometrium with failure of the uterine scar after the Cesarean section at women with undifferentiated forms of connective tissue dysplasia].

Connective tissue state, its strength, is actual problem especially in the moment of labor because the weakness of labor activity or accelerated labor can be in depending on its consistency and elasticity. In addition, connective tissue is very important in the involution of the uterus after labor or wounds healing. Clinico-morphological and molecular-genetic investigation of 90 patients with undifferentiated forms of connective tissue dysplasia (uCTD) has been done. Reparation of tissue at patients with uCTD had a number of peculiarities, such as fibromuscular scar formation by substitution mechanisms with the laminin deficiency in the basic capillar membrane and extracellular matrix, accumulation of III and IV types of collagen, low expression of VEGF in the stromal cell and polymorphism of the alpha estrogen receptor gene. This immunohistochemical changes correlated with focuses of connective tissue disorganization as mucoid swelling, fibrinoid changes and hyalinosis, as well pathology of the microvasculature, resulted in chronic ischemia of the tissue. The disorganization is connected with disturbed reparation as a result of the genetically determined polymorphism of alpha and beta estrogen receptors. uCTD in pregnant women is prognostically significant for selection of way of delivery.