Release date: 2017-07-18
A woman has a child with too much risk and difficulty!
All along, gestational eclampsia and puerperal infection, postpartum hemorrhage, pregnancy and heart disease constitute the four major causes of obstetrics. Pregnancy eclampsia is a rapid illness, and once it occurs, it is often more ill-fated and the mortality rate is extremely high. Therefore, eclampsia also has the title of obstetrics "death curse" [1].
Even more frightening is that the cause of eclampsia has not been known so far. The only effective treatment that can be determined today is the termination of pregnancy [2].
On June 29th, Science published a new study by Professor Bruno Reversade, a developmental biologist at the Institute of Medical Biology, Singapore. The original Elabela, which was previously ignored by scientists because of its small size, was originally a A circulatory hormone secreted by the placenta, the absence of Elabela hormones can lead to symptoms of pre-caries (pre-eclampsia). In addition, the researchers tried to artificially supplement Elabela hormones, and found that the symptoms of pre-eclampsia in pregnant mice can completely disappear [3]!
This is great! This groundbreaking discovery not only reveals the molecular causes of pre-eclampsia, but also provides a potentially effective treatment. Professor Ananth Karumanchi of Harvard Medical School commented: "This is an exciting discovery in this field [4]!"
The earliest eclampsia is also called "pregnancy poisoning", and later together with pregnancy-induced hypertension and pre-eclampsia, collectively referred to as pregnancy-induced hypertension syndrome. At the beginning of the child's paralysis, only elevated blood pressure, slight swelling of the ankle and high protein content in the urine were also called "pre-eclampsia" or "pre-eclampsia". If the control is not proper, the condition will deteriorate rapidly and develop into eclampsia. In a short time, the blood pressure will rise rapidly. In severe cases, convulsions may occur, similar to seizures and even life-threatening [2].
Worldwide, the prevalence of pre-eclampsia accounts for 5% to 10% of all pregnant women. In developing countries, 40%-60% of maternal deaths are associated with pre-eclampsia [2].
The onset of pre-eclampsia may involve a variety of factors including maternal, placental and fetal, including trophoblastic abnormalities, immunoregulatory dysfunction, endothelial cell damage, genetic factors and nutritional factors. But no single factor can explain the etiology and mechanism of all preeclampsia [5].
In 2013, Professor Reversade discovered that the loss of Elabela during embryonic development caused severe heart defects and vascular malformations in zebrafish [6]. Elabela is a polypeptide that consists of only 32 amino acids and is not even called a protein.
This time, Professor Reversade and his team extended Elabela's research to mammals. They found that during the development of the mouse, Elabela was first detected in the early placenta and became more abundant with pregnancy, and Elabela was only present in the blood of pregnant mice. The researchers first suspected that Elabela may be a circulating hormone secreted by the placenta. And they want to know what happens if this hormone is missing during pregnancy.
Sure enough, the researchers found that the absence of Elabela caused vascular abnormalities in the placenta and embryos of the mother. The gene expression profile of hypoxia was shown by RNA analysis of Elabela-deficient mouse placenta. These are the basis of the onset of pre-eclampsia.
The researchers also found that the protein levels and blood pressure levels in the urine of pregnant mice that knocked out the Elabela gene were significantly higher than those of wild-type pregnant mice and non-pregnant mice lacking Elabela, and these symptoms immediately returned to normal after delivery; In addition, the female rat pups lacking Elabela were significantly less important than the control group. These are almost all the symptoms of pre-eclampsia!
Elabela knockout (right) control experiment (upper right, showing embryonic cardiovascular defects and intrauterine growth restriction, right lower, avascular yolk sac pleats)
This finding is simply amazing and exciting, although the researchers are still unclear how the absence of Elabela affects the appearance of pre-eclampsia in mice, but it is certain that the loss of Elabela during pregnancy leads to pre-eclampsia. !
Then there is an important question. What happens if I artificially supplement Elabela hormone in pregnant mice with symptoms of pre-eclampsia?
The results showed that if the Elabela hormone was artificially injected into the pre-eclamptic mice, the proteinuria, hypertension and fetal weight would all return to normal! ! !
In addition, the researchers also found that Elabela hormone is significantly expressed in human trophoblast cells in early pregnancy (cells with nourishing function outside the embryo). In patients with pre-eclampsia, placental defects caused by abnormal trophoblast invasion are important factors in the pathogenesis of pre-eclampsia [6]. Therefore, the researchers again assumed that Elabela hormones may contribute to the migration and invasion of trophoblast cells. In fact, when researchers added Elabela hormone to trophoblast cells in the laboratory, it was found to significantly increase cell invasiveness.
The researchers believe that Elabela secreted by placental trophoblast cells prevents pregnancy-induced hypertension syndrome in two ways. First, Elabela hormone exerts a paracrine effect on fetal endothelial cells (cell-derived hormones regulate the neighboring cells through the intercellular space) to suppress abnormal differentiation; then, Elabela hormone enters the maternal circulatory system to regulate heart and kidney function. For example, it stimulates vasodilation or produces diuretic function.
Elabela acts on fetal endothelial cells to promote normal angiogenesis and enters the circulatory system of pregnant women to prevent the appearance of pre-eclampsia symptoms
Of course, for humans, the absence of Elabela hormones can cause pre-eclampsia, and the artificial supplementation of Elabela hormone is effective for treatment, and clinical trials are needed.
Guillermina Girardi, a researcher on women's health at King's College London, believes that "the hormone secreted by this placenta may be a good choice for improving placental development to prevent and treat pre-eclampsia. I am looking forward to the results being validated in humans."
Professor Karumanchi also said, “Like any big discovery, this research has opened up many new problems, and researchers are now trying to figure out [4].â€
Reference material
[1] http://
[2]https://
[3] http://science.sciencemag.org/content/early/2017/06/28/science.aam6607
[4]http://?articles.view/articleNo/49762/title/Anti-Preeclampsia-Hormone-Discovered/
[5] Fisher S J. Why is placentation abnormal in preeclampsia? [J]. American journal of obstetrics and gynecology, 2015, 213(4): S115-S122.
[6] Chng SC, Ho L, Tian J, et al. ELABELA: a hormone essential for heart development signals via the apelin receptor [J]. Developmental cell, 2013, 27(6): 672-680.
Source: Singularity Network (micro signal geekheal_com)
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