Protein Phosphatase 2A Activation Via ApoER2 in Trophoblasts Drives Preeclampsia in a Mouse Model of the Antiphospholipid Syndrome
Preeclampsia (PE) is a leading cause of morbidity and mortality during pregnancy. The initiating processes in PE are poorly understood, and the only effective intervention is premature delivery, which threatens the well-being of the child. The Antiphospholipid Syndrome (APS), which is characterized...
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Published in | Circulation research Vol. 129; no. 7; pp. 735 - 750 |
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Main Authors | , , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Lippincott Williams & Wilkins
17.09.2021
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Subjects | |
Online Access | Get full text |
ISSN | 0009-7330 1524-4571 1524-4571 |
DOI | 10.1161/CIRCRESAHA.120.318941 |
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Abstract | Preeclampsia (PE) is a leading cause of morbidity and mortality during pregnancy. The initiating processes in PE are poorly understood, and the only effective intervention is premature delivery, which threatens the well-being of the child. The Antiphospholipid Syndrome (APS), which is characterized by circulating antiphospholipid antibodies (aPL), is a common risk factor for PE, and also for fetal demise, premature birth and intrauterine growth restriction. This work presents an animal model of APS-related PE, revealing that aPL administration to pregnant mice induces PE and fetal compromise via ApoER2 in trophoblasts. Mechanistically, via ApoER2, aPL activate PP2A, which upregulates MMP14 and HIF1α, the latter via dephosphorylation of PHD2, leading to increased production of soluble endoglin, which is a known driver of PE. A role for PP2A in PE pathogenesis is revealed, and linkage of PP2A to PHD2 and HIF1α is demonstrated in placentas from both APS patients and women with PE from causes other than APS. As importantly, pharmacologic inhibition of PP2A affords full protection from both aPL-induced PE and the fetal complications. Future research should interrogate how PP2A is activated in PE not associated with APS, and how PP2A can be targeted to combat PE. |
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AbstractList | [Figure: see text].[Figure: see text]. Preeclampsia (PE) is a leading cause of morbidity and mortality during pregnancy. The initiating processes in PE are poorly understood, and the only effective intervention is premature delivery, which threatens the well-being of the child. The Antiphospholipid Syndrome (APS), which is characterized by circulating antiphospholipid antibodies (aPL), is a common risk factor for PE, and also for fetal demise, premature birth and intrauterine growth restriction. This work presents an animal model of APS-related PE, revealing that aPL administration to pregnant mice induces PE and fetal compromise via ApoER2 in trophoblasts. Mechanistically, via ApoER2, aPL activate PP2A, which upregulates MMP14 and HIF1α, the latter via dephosphorylation of PHD2, leading to increased production of soluble endoglin, which is a known driver of PE. A role for PP2A in PE pathogenesis is revealed, and linkage of PP2A to PHD2 and HIF1α is demonstrated in placentas from both APS patients and women with PE from causes other than APS. As importantly, pharmacologic inhibition of PP2A affords full protection from both aPL-induced PE and the fetal complications. Future research should interrogate how PP2A is activated in PE not associated with APS, and how PP2A can be targeted to combat PE. [Figure: see text]. |
Author | Herz, Joachim Natale, David R. Nguyen, An Xu, Lin Shaul, Philip W. Sacharidou, Anastasia Lo, Julie Montalbano, Alina P. Chu, Haiyan Marciano, Denise K. Li, Chun Shen, Yu-Min Hui, David Y. Chambliss, Ken L. Xiao, Xue Natale, Bryony V. Leone, Gustavo W. Abrahams, Vikki M. Salmon, Jane E. Mineo, Chieko |
AuthorAffiliation | Froedtert-Medical College of Wisconsin Cancer Center, Medical College of Wisconsin, Milwaukee (G.W.L.) Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT (V.M.A.) Internal Medicine (Y.-M.S., D.K.M.), University of Texas Southwestern Medical Center, Dallas Biochemistry and Obstetrics and Gynecology (A.P.M.), University of Texas Southwestern Medical Center, Dallas Molecular Genetics (J.H.), University of Texas Southwestern Medical Center, Dallas Obstetrics and Gynecology (J.L.), University of Texas Southwestern Medical Center, Dallas Center for Pulmonary and Vascular Biology, Pediatrics (H.C., A.S., A.N., C.L., K.L.C., P.W.S., C.M.) Medicine, Hospital for Special Surgery, Weill Cornell Medical College, New York (J.E.S.) Population and Data Sciences and Pediatrics (X.X., L.X.), University of Texas Southwestern Medical Center, Dallas Pathology, University of Cincinnati College of Medicine (D.Y.H.) |
AuthorAffiliation_xml | – name: Obstetrics and Gynecology (J.L.), University of Texas Southwestern Medical Center, Dallas – name: Internal Medicine (Y.-M.S., D.K.M.), University of Texas Southwestern Medical Center, Dallas – name: Froedtert-Medical College of Wisconsin Cancer Center, Medical College of Wisconsin, Milwaukee (G.W.L.) – name: Pathology, University of Cincinnati College of Medicine (D.Y.H.) – name: Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT (V.M.A.) – name: Population and Data Sciences and Pediatrics (X.X., L.X.), University of Texas Southwestern Medical Center, Dallas – name: Molecular Genetics (J.H.), University of Texas Southwestern Medical Center, Dallas – name: Biochemistry and Obstetrics and Gynecology (A.P.M.), University of Texas Southwestern Medical Center, Dallas – name: Center for Pulmonary and Vascular Biology, Pediatrics (H.C., A.S., A.N., C.L., K.L.C., P.W.S., C.M.) – name: Medicine, Hospital for Special Surgery, Weill Cornell Medical College, New York (J.E.S.) – name: 5 Froedtert-Medical College of Wisconsin Cancer Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA – name: 12 Biochemistry and Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas – name: 11 Obstetrics and Gynaecology, School of Medicine, Queen’s University, Ontario, Canada – name: 7 Pathology, University of Cincinnati College of Medicine, Cincinnati – name: 10 Obstetrics, Gynecology & Reproductive Science, University of California San Diego, La Jolla, CA 92093, USA – name: 6 Molecular Genetics, University of Texas Southwestern Medical Center, Dallas – name: 9 Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510 USA – name: 8 Cell Biology, University of Texas Southwestern Medical Center, Dallas – name: 3 Internal Medicine, University of Texas Southwestern Medical Center, Dallas – name: 4 Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas – name: 13 Population and Data Sciences and Pediatrics, University of Texas Southwestern Medical Center – name: 2 Medicine, Hospital for Special Surgery, Weill Cornell Medical College, New York – name: 1 Center for Pulmonary and Vascular Biology, Pediatrics, University of Texas Southwestern Medical Center, Dallas |
Author_xml | – sequence: 1 givenname: Haiyan surname: Chu fullname: Chu, Haiyan organization: Center for Pulmonary and Vascular Biology, Pediatrics (H.C., A.S., A.N., C.L., K.L.C., P.W.S., C.M.) – sequence: 2 givenname: Anastasia surname: Sacharidou fullname: Sacharidou, Anastasia organization: Center for Pulmonary and Vascular Biology, Pediatrics (H.C., A.S., A.N., C.L., K.L.C., P.W.S., C.M.) – sequence: 3 givenname: An surname: Nguyen fullname: Nguyen, An organization: Center for Pulmonary and Vascular Biology, Pediatrics (H.C., A.S., A.N., C.L., K.L.C., P.W.S., C.M.) – sequence: 4 givenname: Chun surname: Li fullname: Li, Chun organization: Center for Pulmonary and Vascular Biology, Pediatrics (H.C., A.S., A.N., C.L., K.L.C., P.W.S., C.M.) – sequence: 5 givenname: Ken L. surname: Chambliss fullname: Chambliss, Ken L. organization: Center for Pulmonary and Vascular Biology, Pediatrics (H.C., A.S., A.N., C.L., K.L.C., P.W.S., C.M.) – sequence: 6 givenname: Jane E. surname: Salmon fullname: Salmon, Jane E. organization: Medicine, Hospital for Special Surgery, Weill Cornell Medical College, New York (J.E.S.) – sequence: 7 givenname: Yu-Min surname: Shen fullname: Shen, Yu-Min organization: Internal Medicine (Y.-M.S., D.K.M.), University of Texas Southwestern Medical Center, Dallas – sequence: 8 givenname: Julie surname: Lo fullname: Lo, Julie organization: Obstetrics and Gynecology (J.L.), University of Texas Southwestern Medical Center, Dallas – sequence: 9 givenname: Gustavo W. surname: Leone fullname: Leone, Gustavo W. organization: Froedtert-Medical College of Wisconsin Cancer Center, Medical College of Wisconsin, Milwaukee (G.W.L.) – sequence: 10 givenname: Joachim surname: Herz fullname: Herz, Joachim organization: Molecular Genetics (J.H.), University of Texas Southwestern Medical Center, Dallas – sequence: 11 givenname: David Y. surname: Hui fullname: Hui, David Y. organization: Pathology, University of Cincinnati College of Medicine (D.Y.H.) – sequence: 12 givenname: Denise K. surname: Marciano fullname: Marciano, Denise K. organization: Internal Medicine (Y.-M.S., D.K.M.), University of Texas Southwestern Medical Center, Dallas – sequence: 13 givenname: Vikki M. surname: Abrahams fullname: Abrahams, Vikki M. organization: Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT (V.M.A.) – sequence: 14 givenname: Bryony V. surname: Natale fullname: Natale, Bryony V. organization: Obstetrics, Gynecology & Reproductive Science, University of California San Diego, La Jolla (B.V.N., D.R.N.) – sequence: 15 givenname: Alina P. surname: Montalbano fullname: Montalbano, Alina P. organization: Biochemistry and Obstetrics and Gynecology (A.P.M.), University of Texas Southwestern Medical Center, Dallas – sequence: 16 givenname: Xue surname: Xiao fullname: Xiao, Xue organization: Population and Data Sciences and Pediatrics (X.X., L.X.), University of Texas Southwestern Medical Center, Dallas – sequence: 17 givenname: Lin surname: Xu fullname: Xu, Lin organization: Population and Data Sciences and Pediatrics (X.X., L.X.), University of Texas Southwestern Medical Center, Dallas – sequence: 18 givenname: David R. surname: Natale fullname: Natale, David R. organization: Obstetrics, Gynecology & Reproductive Science, University of California San Diego, La Jolla (B.V.N., D.R.N.) – sequence: 19 givenname: Philip W. surname: Shaul fullname: Shaul, Philip W. organization: Center for Pulmonary and Vascular Biology, Pediatrics (H.C., A.S., A.N., C.L., K.L.C., P.W.S., C.M.) – sequence: 20 givenname: Chieko surname: Mineo fullname: Mineo, Chieko organization: Center for Pulmonary and Vascular Biology, Pediatrics (H.C., A.S., A.N., C.L., K.L.C., P.W.S., C.M.) |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34404233$$D View this record in MEDLINE/PubMed |
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Keywords | antiphospholipid syndrome placenta endoglin preeclampsia proteinuria trophoblasts |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 H.C. and A.S. designed the experiments, performed the experiments, and analyzed the data. A.N., C.L and B.V.N. performed the experiments and analyzed the data. K.L.C., J.H., G.W.L. and D.Y.H. generated the genetically modified mouse strains and performed their initial characterization. J.E.S. and Y-M.S. recruited the individuals who provided the human IgG-based reagents. J.L. and A.P.M. provided human placentas from APS or PE patients. V.M.A. provided the human trophoblast strain and aided in experimental design. D.K.M. aided in experimental designs related to proteinuria and kidney functions. L.X. and X.X. performed the statistical analyses. D.R.N., P.W.S. and C.M. designed the experiments, analyzed the data and wrote the manuscript. All authors provided feedback on the manuscript. AUTHOR CONTRIBUTIONS Co-first authors Co-senior authors. |
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Snippet | [Figure: see text]. [Figure: see text].[Figure: see text]. Preeclampsia (PE) is a leading cause of morbidity and mortality during pregnancy. The initiating processes in PE are poorly understood, and the only effective... |
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SubjectTerms | Adaptor Proteins, Signal Transducing - metabolism Animals Antibodies, Antiphospholipid - blood Antiphospholipid Syndrome - complications Antiphospholipid Syndrome - metabolism Apoptosis Regulatory Proteins - metabolism Cell Line Female Humans Hypoxia-Inducible Factor 1, alpha Subunit - metabolism LDL-Receptor Related Proteins - metabolism Mice Mice, Inbred C57BL Pre-Eclampsia - etiology Pre-Eclampsia - metabolism Pregnancy Protein Phosphatase 2 - metabolism Trophoblasts - metabolism |
Title | Protein Phosphatase 2A Activation Via ApoER2 in Trophoblasts Drives Preeclampsia in a Mouse Model of the Antiphospholipid Syndrome |
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