PreImplantation Factor (PIF*) endogenously prevents preeclampsia: Promotes trophoblast invasion and reduces oxidative stress.

Preeclampsia is a unique pregnancy disorder whose patho-physiology is initiated early in gestation, while clinical manifestations typically occur in mid-to-late pregnancy. Thus, prevention should optimally be initiated in early gestation. The intimate interaction between PIF, secreted early by viable embryos, and its host-mother provides insight into putative mechanisms of preeclampsia prevention. PIF is instrumental at the two critical events underlying preeclampsia. At first, shallow implantation leads to impaired placentation, oxidative stress, protein misfolding, and endothelial dysfunction. Later in gestation, hyper-oxygenation due to overflow of maternally derived oxygenated blood compromises the placenta. The first is likely involved in early preeclampsia occurrence due to reduced effectiveness of trophoblast/uterus interaction. The latter is observed with later-onset preeclampsia, caused by a breakdown in placental blood flow regulation. We reported that 1. PIF promotes implantation, endometrium receptivity, trophoblast invasion and increases pro-tolerance trophoblastic HLA-G expression and, 2. PIF protects against oxidative stress and protein misfolding, interacting with specific targets in embryo, 3. PIF regulates systemic immunity to reduce oxidative stress. Using PIF as an early preventative preeclampsia intervention could ameliorate or even prevent the disease, whose current main solution is early delivery.

Immune regulatory and neuroprotective properties of preimplantation factor: From newborn to adult.

Embryonic-maternal interaction from the earliest stages of gestation has a key, sustained role in neurologic development, persisting into adulthood. Early adverse events may be detrimental in adulthood. Protective factors present during gestation could significantly impact post-natal therapy. The role of PreImplantation Factor (PIF) within this context is herein examined. Secreted by viable early embryos, PIF establishes effective embryonic-maternal communication and exerts essential trophic and protective roles by reducing oxidative stress and protein misfolding and by blunting the nocive let-7 microRNA related pathway. PIF's effects on systemic immunity lead to comprehensive immune modulation, not immune suppression. We examine PIF's role in protecting embryos from adverse maternal environment, which can lead to neurological disorders that may only manifest post-nataly: Synthetic PIF successfully translates endogenous PIF features in both pregnant and non-pregnant clinically relevant models. Specifically PIF has neuroprotective effects in neonatal prematurity. In adult relapsing-remitting neuroinflammation, PIF reverses advanced paralysis while promoting neurogenesis. PIF reversed Mycobacterium smegmatis induced brain infection. In graft-vs.-host disease, PIF reduced skin ulceration, liver inflammation and colon ulceration while maintaining beneficial anti-cancer, graft-vs.-leukemia effect. Clinical-grade PIF has high-safety profile even at supraphysiological doses. The FDA awarded Fast-Track designation, and university-sponsored clinical trials for autoimmune disorder are ongoing. Altogether, PIF properties point to its determining regulatory role in immunity, inflammation and transplant acceptance. Specific plans for using PIF for the treatment of complex neurological disorders (ie. traumatic brain injury, progressive paralysis), including neuroprotection from newborn to adult, are presented.

PreImplantation Factor bolsters neuroprotection via modulating Protein Kinase A and Protein Kinase C signaling.

A synthetic peptide (sPIF) analogous to the mammalian embryo-derived PreImplantation Factor (PIF) enables neuroprotection in rodent models of experimental autoimmune encephalomyelitis and perinatal brain injury. The protective effects have been attributed, in part, to sPIF's ability to inhibit the biogenesis of microRNA let-7, which is released from injured cells during central nervous system (CNS) damage and induces neuronal death. Here, we uncover another novel mechanism of sPIF-mediated neuroprotection. Using a clinically relevant rat newborn brain injury model, we demonstrate that sPIF, when subcutaneously administrated, is able to reduce cell death, reverse neuronal loss and restore proper cortical architecture. We show, both in vivo and in vitro, that sPIF activates cyclic AMP dependent protein kinase (PKA) and calcium-dependent protein kinase (PKC) signaling, leading to increased phosphorylation of major neuroprotective substrates GAP-43, BAD and CREB. Phosphorylated CREB in turn facilitates expression of Gap43, Bdnf and Bcl2 known to have important roles in regulating neuronal growth, survival and remodeling. As is the case in sPIF-mediated let-7 repression, we provide evidence that sPIF-mediated PKA/PKC activation is dependent on TLR4 expression. Thus, we propose that sPIF imparts neuroprotection via multiple mechanisms at multiple levels downstream of TLR4. Given the recent FDA fast-track approval of sPIF for clinical trials, its potential clinical application for treating other CNS diseases can be envisioned.

Embryo maternal dialogue: From pregnancy recognition to proliferation control.

Embryo-maternal dialogue starts shortly after fertilization and is exerted through both local and systemic signaling. We have discovered specific embryo derived pre-implantation factors (PIF), novel peptides that are secreted already at the two cell stage and which modulate cellular immunity. In the fallopian tube the embryo, a partial allograft, is tolerated by the mother. Embryo derived peripheral signaling (PIF) is also detected prior to implantation in maternal sera. This signal may also help prime the endometrium to facilitate implantation. Upon implantation, embryo-endometrial communication becomes direct and highly amplified. When the immune privilege appears to be secured, embryogenesis proper initiates. This requires proliferation/differentiation to be tightly controlled. Knowledge of proliferation promoters is ample while the factors involved in its control remain less understood. We have identified a class of novel proteins/peptides, developmental proteins (DPs), that are present in the embryo before a mature immune system has developed. Their role is to create a balance between pro and antiproliferative forces, to promote normal proliferation while controlling abnormal cell proliferation (i.e. due to carcinogens, toxins, viruses, and ionic radiation). DPs, may also redirect growth towards functionality through differentiation. DPs appear to act through a specific receptor negating growth factors action through promotion of tumor suppressors and inhibition of tumor promoters at 2 minutes, blocking DNA synthesis at ~24 hours, and promoting apoptosis at ~48 hours. When an embryo becomes incompatible with life, DPs may lead to growth arrest, PIF-like compounds decline, the immune system to be restored and the pregnancy is rejected. Final identification and use of PIF and DPs is likely to help both managing early pregnancy disorders and aid in treatment of proliferative disorders due to cancer and viral infection.

Progress in characterization of pre-implantation factor in embryo cultures and in vivo.

PROBLEM: Pre-implantation factor (PIF), a small, embryo-derived peptide is detected in the maternal serum prior to implantation and is associated with successful pregnancy outcome. However, its identity is not known. METHOD OF STUDY: PIF was isolated from mouse embryo conditioned media and from pregnant porcine sera, using high-performance liquid chromatography (HPLC) followed by mass spectrometry. RESULTS: Conditioned culture media was separated by gel filtration chromatography followed by reversed phase chromatography. At each step, PIF activity was determined by the lymphocyte/platelet binding autorosette assay (LPBA). Mass spectrometry yielded a single peak with a mass of 1300 Da. The peptide is, however, present in very low concentrations (fM), which has so far precluded complete identification. Pregnant porcine sera that exhibit potent PIF activity were deproteinated by acetone and further fractionated by reversed phase HPLC. Active fractions contain peptides of molecular masses 523 and 551 Da. CONCLUSION: PIF, likely to be peptides, represents a novel substance related to pregnancy initiation and maintenance.

Embryonic origin of preimplantation factor (PIF): biological activity and partial characterization.

Preimplantation factor (PIF) is detected in the serum of women shortly after fertilization; its origin, however, has not been established. In this study, the embryonal origin of PIF was investigated and partial characterization of the factor was carried out. Culture media from viable human 2-8-cell stage embryos and mouse 2-cell-blastocyst stage embryos were analysed using the lymphocyte/platelet binding assay (LPBA). The assay was performed by combining culture media with donor O+ type blood-derived lymphocytes/platelets, complement and an antibody against CD2. Increased autorosette formation between lymphocytes and platelets (> 9%) was an indication for the presence of PIF. In addition, the effect of platelet-activating factor (PAF) and chaperonin 10 on PIF activity was determined. Partial purification of PIF was carried out using gel filtration and reverse-phase high purification liquid chromatography (HPLC), followed by mass spectrometry. Culture media of single human viable fertilized oocytes were negative for PIF; however, the 10-fold concentrated medium was positive for PIF. In medium in which five or more mouse embryos were cultured, PIF activity was observed starting at the morula stage and was higher by the blastocyst stage. Addition of PAF or chaperonin 10 to the PIF assay did not elicit a specific effect on PIF activity. Chromatographic data suggest that PIF activity is due to low molecular weight proteins. PIF appears to be a low molecular weight protein which is derived from viable preimplantation embryos. It is different from PAF or chaperonin 10. Its final characterization will be valuable for better understanding of maternal recognition of pregnancy and implantation.

Control of cell proliferation by embryonal-origin factors.

Embryogenesis can be paralleled and contrasted with cancerous cell proliferation; both embryogenesis and cancer are associated with extremely rapid cell proliferation. However, unlike cancer, embryogenesis is characterized by a delicate balance of proliferative and anti-proliferative processes. We have found two chromatographically separated fractions derived from human embryonal neural tissue extracts that significantly suppress the proliferation of human breast cancer cells. The reduction in cell number was time dependent, with maximal inhibition (70%) observed after 4 days of incubation while maintaining cell viability. The anti-proliferative effect was also evidenced by decreased [3H]-thymidine incorporation. Significant inhibition of proliferation of osteosarcoma, fibrosarcoma, and Balb/c 3T3 cell lines was also obtained with a low concentration of the active fractions. Embryonal factors inhibited mouse and rat cell lines, indicating cross-species effectiveness. The SDS-PAGE of the biologically active approximately 10.7 kDa region revealed several protein bands, while the biologically active approximately 4.5 kDa fraction contained only weakly stainable bands. Thus, the embryo contains factors that control the proliferation of malignant cells. These potent and possibly novel compounds should be investigated for their potential therapeutic role in cancer and other proliferative disorders.

Response of human ovarian carcinoma cell lines to antiprogestin mifepristone.

The effects of antiprogestin mifepristone (MF) on the growth, progesterone receptor expression and cell cycle kinetics of several human ovarian epithelial carcinoma (OEC) cell lines were evaluated. MF, a synthetic antiprogestin, has been shown to have some antiproliferative activity in breast tumors and in the endometrium, but its efficacy in ovarian carcinomas has not been explored previously. Continuous exposure of OEC cells to MF resulted in a dose- and time-dependent growth inhibition, as determined by MTT assay. Growth inhibition was apparent by day three following addition of MF to cultures in vitro. All cell lines used in this study expressed a progesterone receptor (PR). MF down regulated PR expression on these cells. Changes in the cell cycle kinetics of OEC cells exposed to MF correlated with the observed antiproliferative effects. MF blocked cells in a G0/G1 phase of the cell cycle and thus reduced the number of cells in the S phase. The efficacy of MF was compared with that of taxol and tamoxifen in the same human OEC cell lines. Continuous exposure of OEC cells to tamoxifen resulted in a varied cytostatic response and a transient change in the cell cycle. Taxol inhibited growth of some but not all of the cell lines. These results indicate that PR-positive human OEC cells are sensitive to MF in vitro and that MF may be an active agent against ovarian epithelial tumors.

Development and validation of an assay for measuring preimplantation factor (PIF) of embryonal origin.

PROBLEM: Tests to determine presence of embryos prior to implantation are needed. METHODS: Sera from women after embryo transfer were tested for preimplantation factor (PIF) using the lymphocyte/platelet binding assay. Autorosettes were counted using blood type O+ donor lymphocytes and platelets incubated with blinded serum in the presence of antiCD2 antibody and rabbit complement. Human chorion gonadotropin (hCG) concentrations were determined 7 days later and compared with results of the lymphocyte/platelet assay. Implantation was confirmed by ultrasonographic evidence of presence of an intrauterine gestational sac. The roles of platelet activating factor (PAF) and chaperonin 10 in the observed phenomena were studied experimentally. RESULTS: Significantly more lymphocyte/platelet rosette formations were observed when sera from women who successfully implanted were compared to sera from women who failed to implant. Neither PAF nor chaparonin added to the tested sera controls influenced the percentage of lymphocyte/platelets rosettes. CONCLUSIONS: PIF is a likely candidate to be the next frontier of diagnosing the presence of viable preimplantation embryos in vivo.

Preimplantation factor (PIF) predicts subsequent pregnancy loss.

PROBLEM: To evaluate the ability of preimplantation factor (PIF) measured in the lymphocyte/platelet binding assay (LPBA) to predict subsequent spontaneous abortion. METHOD: Serum from 57 women experiencing first trimester pregnancy losses were studied using the LPBA (46 women conceived after in vitro fertilization and embryo transfer for treatment of infertility and 11 with a history of unexplained recurrent spontaneous abortion conceived spontaneously). The assay employs a combination of heat inactivated sera with donor O+ lymphocytes and platelets, complement and an antibody against CD2. Chromosome analysis was performed on 32 of the abortuses. Results of PIF assay were compared between karyotypically normal and abnormal abortuses. RESULTS: PIF assay was negative in all 57 women at the time of abortion. Among 12 karyotypically normal abortuses only 1 woman (8%) had an initial positive PIF, 11 (92%) had negative PIF. Serial PIF assays were performed on 15 women. PIF assay became negative a minimum of two weeks prior to demonstration of intrauterine demise at a time when hCG concentrations remained elevated. A trend to subnormal was seen in women with normal when compared to those with abnormal abortus karyotype, but the numbers were too small to reach statistical significance (P = 0.09). CONCLUSION: Measurement of PIF throughout the first trimester of pregnancy predicts subsequent pregnancy loss.

Peroxidase activity and glutathione content in the human first-trimester placenta and decidua.

OBJECTIVE: Recently, a novel pathway of xenobiotic oxidation by peroxidase in the placenta at term was described. Herein, we aim to determine the potential of the first-trimester placenta and decidua to activate carcinogens and mutagens by peroxidase and to scavenge free radicals by glutathione. METHODS: Placental and decidual peroxidase activity was measured using a sensitive, quantitative colorimetric kinetic assay, with O-phenylenediamine dihydrochloride (OPD) as substrate and H2O2 as co-substrate. Glutathione levels were measured using a colorimetric assay. RESULTS: Peroxidase activity in cytosolic and CaCl2-extracted (membrane-bound) fractions was inhibited by a specific inhibitor, NaN3. The membrane-bound peroxidase activity was maximal at 12 weeks of gestation while cytosolic peroxidase activity did not change. Placental glutathione content remained unchanged during the first trimester. Decidual and placental peroxidase activities were similar; however decidual glutathione content was 15-fold lower, resulting in a higher decidual peroxidase activity/glutathione ratio (p < 0.03). CONCLUSIONS: We report for the first time that peroxidase may be an important pathway for xenobiotic activation at the maternal-embryonal interface. It remains to be established whether the low glutathione content limits the ability of the decidua but not placenta to protect against genomic damage induced through xenobiotic oxidation.

First-trimester villous placenta has high prorenin and active renin concentrations.

OBJECTIVE: Term villous placental concentrations of prorenin are known to be very low, whereas those of decidua and fetal membranes are high. It has been demonstrated that prorenin synthesis is modulated by hormones in other reproductive tissues, thus suggesting a means for paracrine regulation in the placenta. This study was performed to test the hypothesis that placental tissue prorenin concentrations may be influenced by gestational age and are temporally related to alterations in the hormonal milieu. STUDY DESIGN: Decidua and villous placental tissue were obtained from term and first-trimester human pregnancies, and concentrations of prorenin, active renin, prolactin, and human chorionic gonadotropin were measured. Values were compared between gestational periods, and relationships between renin and hormone values were analyzed. RESULTS: Prorenin concentrations in first-trimester placenta were nearly 200-fold higher than at term. The proportion of active renin was higher with early gestation. Decidual prorenin and active renin concentrations were similar in both groups. Placental prorenin correlated with chorionic gonadotropin but not prolactin in both groups. CONCLUSIONS: This study demonstrates large differences in placenta prorenin and active renin in villous placental tissue between first-trimester and term gestation tissues, yet these differences were not observed in decidual tissues. The contrast in placental prorenin values observed at the extremes of pregnancy parallel those of placental human chorionic gonadotropin.