Abstract 275: Tissue Transglutaminase Stabilizes Placental AT1 Receptor and Contributes to Pathophysiology in Preeclampsia

Abstract

Preeclampsia (PE) is a serious hypertensive disease of pregnancy associated with the presence of the major angiotensin receptor AT1-agnostic autoantibodies (AT1-AAs) that cause the defining PE features when introduced into pregnant mice. To understand AT1-AA-mediated receptor activation in PE, we explored the role of tissue transglutaminases (TG2), the most ubiquitous member of a group of enzymes modifying proteins by catalyzing the formation of ε-(γ-glutamyl)-lysine isopeptide bonds. TG2, a versatile protein that can also function as a G protein, is enriched in the syncytiotrophoblasts of placenta, the key organ in PE pathogenesis. Western blot analysis and IHC-IF double staining initially revealed that TG2 and transglutaminase (TG)-mediated isopeptide modification levels are increased approximately 2X in PE vs normotensive (NT) placental tissue (n=4 or 5, p<0.05). Next, we identified a similar increase in PE plasma TG activity (NT=3.1±0.5, mild PE=5.4±0.6, severe PE=9.1±0.7milliunit/ml, n=26-29, p<0.01), and the increased plasma TG activity is positively correlated with the key disease features including blood pressure and proteinuria (r 2 >0.5, p<0.01). We also found a higher level of AT1 receptor with isopeptide modification in PE placentas by immunoprecipitation and IF colocalization. A pathogenic role for TG2 in PE is suggested by in vivo experiments in which TG inhibitor cystamine, or siRNA-mediated TG2 knockdown, significantly attenuated AT1-AA-induced PE features in pregnant mice including hypertension (PE=160±6 vs PE+cystamine=133±3mmHg, p<0.01, n=6; PE+control siRNA=161±3 vs PE+ TG2 siRNA=137±7mmHg, p<0.05, n=5-6), proteinuria (PE=133±21 vs PE+cystamine=58±12ng albumin/mg creatine, p<0.01, n=6; PE+control siRNA=102±51 vs PE+ TG2 siRNA=26±6ng albumin/mg creatine, p<0.05, n=4), and placental isopeptide modification. In trophoblasts, AT1-AA stimulation enhanced the interaction between AT1 receptor and TG2, and resulted in increased AT1 receptor stabilization via isopeptide modification, which is further confirmed by mutagenesis studies. Taken together, our results not only identify a pathogenic role of TG2 in PE, but also shed light on a previously unrecognized mechanism of TG2-mediated GPCR stabilization.