Cardiac angiogenic imbalance leads to peripartum cardiomyopathy

Peripartum cardiomyopathy (PPCM) is an often fatal disease that affects pregnant women who are near delivery, and it occurs more frequently in women with pre-eclampsia and/or multiple gestation. The aetiology of PPCM, and why it is associated with pre-eclampsia, remain unknown. Here we show that PPCM is associated with a systemic angiogenic imbalance, accentuated by pre-eclampsia. Mice that lack cardiac PGC-1α, a powerful regulator of angiogenesis, develop profound PPCM. Importantly, the PPCM is entirely rescued by pro-angiogenic therapies. In humans, the placenta in late gestation secretes VEGF inhibitors like soluble FLT1 (sFLT1), and this is accentuated by multiple gestation and pre-eclampsia. This anti-angiogenic environment is accompanied by subclinical cardiac dysfunction, the extent of which correlates with circulating levels of sFLT1. Exogenous sFLT1 alone caused diastolic dysfunction in wild-type mice, and profound systolic dysfunction in mice lacking cardiac PGC-1α. Finally, plasma samples from women with PPCM contained abnormally high levels of sFLT1. These data indicate that PPCM is mainly a vascular disease, caused by excess anti-angiogenic signalling in the peripartum period. The data also explain how late pregnancy poses a threat to cardiac homeostasis, and why pre-eclampsia and multiple gestation are important risk factors for the development of PPCM.     

缺氧预适应小鼠海马脑区VEGF蛋白表达增加

目的 观察重复低氧对小鼠海马组织内血管内皮生长因子(vascular endothelial growth factor,VEGF) 蛋白质表达的影响.方法 小鼠随机分为3组,分别暴露低氧0次(H0),1次(H1),4 次(H4)后取海马组织,应用 Western Blot 技术,检测小鼠海马组织内VEGF的蛋白表达变化.结果 实验发现,H0,H1和H4组海马组织内VEGF均表达,H1组与H0组之间没有差异,H4组显著升高（P<0.05,vs. H0 and H1）.结论 VEGF在急性低氧预适应小鼠海马组织表达增加可能参与预适应的形成及脑保护.     

胎盘促肾上腺皮质激素释放激素研究进展

回顾了关于胎盘促肾上腺皮质激素释放激素研究的最新进展，其内容包括ｐＣＲＨ的合成与分泌、ｐＣＲＨ释放的调节、孕妇血浆ＣＲＨ水平的变化及其对ＨＰＡ轴活动的影响以及ｐＣＲＨ的生物学作用等。作者认为，进一步阐明ｐＣＲＨ的旁分泌，自分泌和长距分泌作用将助于理解妊娠维持，胎儿发育和分娩启动等生理机制。     

妊娠合并癫痫34例临床分析

目的：探讨妊娠合并癫痫的临床表现及处理。方法：回顾性分析妊娠合并癫痫34例的临床表现、处理及结局。结果：妊娠合并癫痫34例中8例孕期未行抗癫痫治疗也未出现癫痫发作,26例行抗癫痫治疗,孕期发作增加5例,发作无增加21例;并发轻度子痫前期3例,胎膜早破1例,早产3例,胎儿宫内生长受限2例;阴道分娩5例,剖宫产29例;新生儿轻度窒息3例,低体重儿2例,新生儿畸形1例。结论：患有癫痫的妇女建议孕前咨询,优化抗癫痫治疗药物,孕前加服叶酸,孕期提倡单药治疗,不建议换药。     

Role of corin in trophoblast invasion and uterine spiral artery remodelling in pregnancy

In pregnancy, trophoblast invasion and uterine spiral artery remodelling are important for lowering maternal vascular resistance and increasing uteroplacental blood flow. Impaired spiral artery remodelling has been implicated in pre-eclampsia, a major complication of pregnancy, for a long time but the underlying mechanisms remain unclear. Corin (also known as atrial natriuretic peptide-converting enzyme) is a cardiac protease that activates atrial natriuretic peptide (ANP), a cardiac hormone that is important in regulating blood pressure. Unexpectedly, corin expression was detected in the pregnant uterus. Here we identify a new function of corin and ANP in promoting trophoblast invasion and spiral artery remodelling. We show that pregnant corin- or ANP-deficient mice developed high blood pressure and proteinuria, characteristics of pre-eclampsia. In these mice, trophoblast invasion and uterine spiral artery remodelling were markedly impaired. Consistent with this, the ANP potently stimulated human trophoblasts in invading Matrigels. In patients with pre-eclampsia, uterine Corin messenger RNA and protein levels were significantly lower than that in normal pregnancies. Moreover, we have identified Corin gene mutations in pre-eclamptic patients, which decreased corin activity in processing pro-ANP. These results indicate that corin and ANP are essential for physiological changes at the maternal-fetal interface, suggesting that defects in corin and ANP function may contribute to pre-eclampsia.     

2-ME抑制人子宫内膜癌细胞株增殖的研究

目的　探讨2-甲氧雌二醇(2-ME)对人子宫内膜癌细胞株KLE细胞体外增殖和凋亡的抑制作用.方法选用人子宫内膜癌细胞株KLE进行体外培养,实验组加入不同浓度2-ME的培养液,对照组不含2-ME.用四甲基偶氮唑蓝(MTT)比色法观察2-ME对人子宫内膜癌细胞株KLE增殖的抑制作用;药物作用后的克隆形成实验;电子显微镜(电镜)观察细胞形态变化;流式细胞仪(FCM)观察细胞的凋亡率及细胞周期的变化.结果2-ME浓度为10.0～50.0μM时,明显抑制KLE细胞的增殖(P<0.01),并具有时间依赖性和剂量依赖性.2-ME作用后G0/G1期细胞增加,并伴随G0/G1期细胞的增加,出现细胞凋亡峰和凋亡率的升高(P<0.05).电镜下观察到KLE细胞染色体边集、核固缩、凋亡小体.结论2-ME对人子宫内膜癌KLE细胞株增殖有抑制作用,并能促进其凋亡.     

Effect of UPP on the expression of VEGF and its receptors in mouse uterus during peri-implantation

On day 3 of gestation ,one uterine horn of female pregnant mouse was injected intraluminally with 5 μL 0.1μg/mL lactacystin,a specific inhibitor of ubiquitin-pro-teasome pathway (UPP),while the contralateral horn served as control ,Animals were sacrificed by cervical dislocation on day 5,6,7 of gestation ,respectively,Then the number of implanted embryos in each uterine horn was calcuated,and the expression of VEGF and its receptors was examined,The data showed that the number of implanted embryos was decreased significantly after treatment with lactacystin ,The results of RT-PCR and Western blot indicated that expression of VEGF and its receptors at mRNA and protein levels was significantly decreased in the treated uterus,menawhile,the expression of HIF-1α(the α subunit of HIF ,a transcrip-tional factor of VEGF) was reduced at both mRNA and protein levels,These data suggested that the effect of UPP on VEGF expression was realized through regulating HIF-1α expression .In addition ,UPP is likely to take part in the modulation of VEGF receptors expression ,These changes may be one of the reasons for the reduction of implanted embryos.     

血管内皮生长因子在低氧运动中的效应及一氧化氮的介导作用

血管内皮生长因子(VEGF)是内皮细胞特异性的有丝分裂原,具有促进内皮细胞增生、迁移和增加血管通透性等多种重要生物学作用。研究表明,VEGF在发挥这些生物学作用的过程中一氧化氮(NO)起着必不可少的作用。随着高原训练理论研究的不断深入,低氧运动条件下VEGF对机体机能影响的研究倍受关注,其中VEGF和NO关系的探讨有助于低氧运动状况下对VEGF作用机制的进一步阐述。     

VEGF regulates haematopoietic stem cell survival by an internal autocrine loop mechanism

Vascular endothelial growth factor (VEGF) is a principal regulator of blood vessel formation and haematopoiesis, but the mechanisms by which VEGF differentially regulates these processes have been elusive. Here we describe a regulatory loop by which VEGF controls survival of haematopoietic stem cells (HSCs). We observed a reduction in survival, colony formation and in vivo repopulation rates of HSCs after ablation of the VEGF gene in mice. Intracellularly acting small-molecule inhibitors of VEGF receptor (VEGFR) tyrosine kinase dramatically reduced colony formation of HSCs, thus mimicking deletion of the VEGF gene. However, blocking VEGF by administering a soluble VEGFR-1, which acts extracellularly, induced only minor effects. These findings support the involvement in HSC survival of a VEGF-dependent internal autocrine loop mechanism (that is, the mechanism is resistant to inhibitors that fail to penetrate the intracellular compartment). Not only ligands selective for VEGF and VEGFR-2 but also VEGFR-1 agonists rescued survival and repopulation of VEGF-deficient HSCs, revealing a function for VEGFR-1 signalling during haematopoiesis.     

Excessive placental secretion of neurokinin B during the third trimester causes pre-eclampsia

Pre-eclampsia is a principal cause of maternal morbidity and mortality, affecting 5-10% of first pregnancies worldwide. Manifestations include increased blood pressure, proteinuria, coagulopathy and peripheral and cerebral oedema. Although the aetiology and pathogenesis remain to be elucidated, the placenta is undoubtedly involved, as termination of pregnancy eradicates the disease. Here we have cloned a complementary DNA from human placental messenger RNA encoding a precursor protein of 121 amino acids which gives rise to a mature peptide identical to the neuropeptide neurokinin B (NKB) of other mammalian species. In female rats, concentrations of NKB several-fold above that of an animal 20 days into pregnancy caused substantial pressor activity. In human pregnancy, the expression of NKB was confined to the outer syncytiotrophoblast of the placenta, significant concentrations of NKB could be detected in plasma as early as week 9, and plasma concentrations of NKB were grossly elevated in pregnancy-induced hypertension and pre-eclampsia. We conclude that elevated levels of NKB in early pregnancy may be an indicator of hypertension and pre-eclampsia, and that treatment with certain neurokinin receptor antagonists may be useful in alleviating the symptoms.     

Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis.

Inefficient vascular supply and the resultant reduction in tissue oxygen tension often lead to neovascularization in order to satisfy the needs of the tissue. Examples include the compensatory development of collateral blood vessels in ischaemic tissues that are otherwise quiescent for angiogenesis and angiogenesis associated with the healing of hypoxic wounds. But the presumptive hypoxia-induced angiogenic factors that mediate this feedback response have not been identified. Here we show that vascular endothelial growth factor (VEGF; also known as vascular permeability factor) probably functions as a hypoxia-inducible angiogenic factor. VEGF messenger RNA levels are dramatically increased within a few hours of exposing different cell cultures to hypoxia and return to background when normal oxygen supply is resumed. In situ analysis of tumour specimens undergoing neovascularization show that the production of VEGF is specifically induced in a subset of glioblastoma cells distinguished by their immediate proximity to necrotic foci (presumably hypoxic regions) and the clustering of capillaries alongside VEGF-producing cells.     

手术前后血管内皮生长因子、血小板活化因子水平与非小细胞肺癌的关系

目的：探讨非小细胞肺癌患者手术前、后血清血管内皮生长因子（VEGF）、外周血血小板活化标志物的动态变化规律及其与非小细胞肺癌（NSCLC）的关系。方法：用EUSA法检测120例非小细胞肺癌患者手术前、后血清VEGF水平和60例健康体检者VEGF水平；同时用流式细胞术（FCM）检测其外周血血小板活化标志物水平。结果：①NSCLC患者手术前、后VEGF水平和血小板活化标志物水平均显著高于正常对照组（P〈0．01）；②NSCLC患者手术后第7天血清VEGF水平显著高于术前和术后第1天水平（P〈0．01）；而血小板活化标志粉水平则相反；③NSCLC患者血清VEGF和外周血血小板活化标志物水平与有无淋巴结转移和TNM分期有密切关系（P〈0．05）。结论：NSCLC患者血清中VEGF和外周血血小板活化标志物水平都升高。且与NSCLC的分期有密切关系．它们可作为动态检测NSCLC患者病情进展、判断预后的拳考指标。     

Corneal avascularity is due to soluble VEGF receptor-1

Corneal avascularity-the absence of blood vessels in the cornea-is required for optical clarity and optimal vision, and has led to the cornea being widely used for validating pro- and anti-angiogenic therapeutic strategies for many disorders. But the molecular underpinnings of the avascular phenotype have until now remained obscure and are all the more remarkable given the presence in the cornea of vascular endothelial growth factor (VEGF)-A, a potent stimulator of angiogenesis, and the proximity of the cornea to vascularized tissues. Here we show that the cornea expresses soluble VEGF receptor-1 (sVEGFR-1; also known as sflt-1) and that suppression of this endogenous VEGF-A trap by neutralizing antibodies, RNA interference or Cre-lox-mediated gene disruption abolishes corneal avascularity in mice. The spontaneously vascularized corneas of corn1 and Pax6+/- mice and Pax6+/- patients with aniridia are deficient in sflt-1, and recombinant sflt-1 administration restores corneal avascularity in corn1 and Pax6+/- mice. Manatees, the only known creatures uniformly to have vascularized corneas, do not express sflt-1, whereas the avascular corneas of dugongs, also members of the order Sirenia, elephants, the closest extant terrestrial phylogenetic relatives of manatees, and other marine mammals (dolphins and whales) contain sflt-1, indicating that it has a crucial, evolutionarily conserved role. The recognition that sflt-1 is essential for preserving the avascular ambit of the cornea can rationally guide its use as a platform for angiogenic modulators, supports its use in treating neovascular diseases, and might provide insight into the immunological privilege of the cornea.     

MCP-1在子痫前期患者胎盘组织及血清中的表达及意义

通过比较单核细胞趋化蛋白-1（MCP-1）在正常孕妇和子痫前期患者胎盘及血清中的表达,探讨MCP-1在子痫前期发病机制中的作用。选取30例正常晚孕妇女、30例轻度子痫前期患者和30例重度子痫前期患者进行研究。采用免疫组织化学S P法检测MCP-1在胎盘组织中的表达;采用酶联免疫吸附法（ELISA）检测血清MCP-1水平。结果：子痫前期患者胎盘组织和血清中MCP-1的表达均高于正常妊娠组,差异有统计学意义（P〈0.01）,且随着病情加重而递增;子痫前期患者胎盘组织MCP-1表达与血清MCP-1水平呈显著正相关（r=0.725,P〈0.01）。结果表明,MCP-1在子痫前期患者胎盘与血清中的表达均升高,提示MCP-1在子痫前期的发生、发展中可能起着重要的作用。     

广州地区孕妇血清和胎儿脐血清叶酸、维生素B_(12)、锌、铜、铁水平的初步探讨

测定53例妊娠晚期妇女血清和胎儿脐血清叶酸,维生素B_(12)锌、铜和铁值。显示新生儿出生体重与母体血清维生素B_(12)呈正相关(r=0.335,P<0.05),与其自身脐血清叶酸,锌和铁值均呈正相关(r=0.431,P<0.01;r=0.321,P<0.05;r=0.482,p<0.01)。说明本地区妇女妊娠期此类营养物质无明显缺乏,不必常规补克,而应制定合理的孕妇膳食方案。     

SHARP1 suppresses breast cancer metastasis by promoting degradation of hypoxia-inducible factors

The molecular determinants of malignant cell behaviours in breast cancer remain only partially understood. Here we show that SHARP1 (also known as BHLHE41 or DEC2) is a crucial regulator of the invasive and metastatic phenotype in triple-negative breast cancer (TNBC), one of the most aggressive types of breast cancer. SHARP1 is regulated by the p63 metastasis suppressor and inhibits TNBC aggressiveness through inhibition of hypoxia-inducible factor 1α (HIF-1α) and HIF-2α (HIFs). SHARP1 opposes HIF-dependent TNBC cell migration in vitro, and invasive or metastatic behaviours in vivo. SHARP1 is required, and sufficient, to limit expression of HIF-target genes. In primary TNBC, endogenous SHARP1 levels are inversely correlated with those of HIF targets. Mechanistically, SHARP1 binds to HIFs and promotes HIF proteasomal degradation by serving as the HIF-presenting factor to the proteasome. This process is independent of pVHL (von Hippel-Lindau tumour suppressor), hypoxia and the ubiquitination machinery. SHARP1 therefore determines the intrinsic instability of HIF proteins to act in parallel to, and cooperate with, oxygen levels. This work sheds light on the mechanisms and pathways by which TNBC acquires invasiveness and metastatic propensity.