Adoptive transfer of CD4+ T cells from women with preeclampsia with or without a history of COVID during pregnancy contribute to hypertension, AT1-AA, and neurovascular dysfunction in pregnant rats

Abstract

Objective: Preeclampsia (PE) is characterized by new onset hypertension during pregnancy and is associated with chronic inflammation and neurovascular dysfunction. The inflammation in PE includes activated CD4+ T cells and B cells producing agonistic antibodies against the angiotensin II type 1 receptor (AT1AA) which has also been shown to be produced in patients with COVID-19 (CV) infection. Interestingly, having had CV during pregnancy increases the incidence of a PE-like phenotype in that pregnancy. Both PE and CV have long lasting neurological implications and we have shown that AT1AA mediates neurovascular dysfunction in PE. Moreover, we have shown that CD4+ T cells from women with PE induce a PE syndrome in pregnant athymic nude recipient rats. Although CD4+T cells have been shown to contribute to neurovascular dysfunction, we do not know the role of CD4+ T cells in contributing to neurovascular dysfunction in PE or in patients with a history (Hx) CV during pregnancy. Therefore, we sought examine a role for CD4+ T cells from PE with or without a CV Hx to contribute to AT1AA in pregnancy as well as hypertension and cerebrovascular dysfunction postpartum. We utilized adoptive transfer of placental CD4+ T cells from PE and normotensive (NT) patients with or without a CV Hx during pregnancy into athymic nude recipient rats and determined the presence of a PE phenotype during pregnancy or postpartum. Methods: CD4+ T cells were isolated from placentas of normal pregnant (NP), PE, CV Hx normotensive (CV Hx NT), and Hx of CV with PE (CV Hx PE) at delivery. One million CD4+ T cells were injected i.p. into gestational day (GD) 12 nude athymic rats. At GD19 blood samples were collected to measure AT1AA by cardiomyocyte assay. At three months postpartum, MAP and CBF were measured by arterial catheter and laser Doppler flowmetry. A two-way ANOVA was used for statistical analysis. Results: In pregnant recipient rats, AT1AA was increased in PE (8±2 ΔBPM, n=4) and CV Hx PE (4±2 ΔBPM, n=4) compared to NP (-3±2 ΔBPM, n=4, p<0.05) and CV Hx NT (2±2 ΔBPM, n=2) respectively. At 3 months postpartum, MAP was increased in PE (115±2 mmHg, n=5) and CV Hx PE (111±4, n=4) compared to NP (99±3 mmHg, n=4 p<0.05) and CV Hx NT (100±4, n=5). PE and CV Hx PE had impaired autoregulation of CBF compared to CV Hx NT and NP rats. Conclusion: Our findings indicate that CD4+ T cells from PE or CV HX PE patients cause AT1-AA in pregnancy as well as hypertension and impaired CBF 3 months postpartum. Collectively, the data demonstrates that CD4+ T cells cause hypertension and inflammation in PE or CV Hx PE and may contribute to neurovascular dysfunction in patients with previous PE or CV Hx PE during pregnancy. RO1HD067541-06, P20GM121334, and AHA 19CDA34670055 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.