Abstract

Vascular endothelial growth factor receptor 2 (VEGFR-2), the primary receptor for VEGF, is crucial for normal endothelial function. sFlt-1, a truncated and soluble form of VEGFR-1 which binds and inhibits VEGF, is increased in preeclampsia and is positively regulated by low oxygen. Here, we investigated the effects of sFlt-1 and hypoxia on VEGFR-2 expression and signaling in the human placenta. VEGFR-2 transcript and protein levels were significantly decreased in preeclamptic placentae compared to controls (1.82 and 1.85 fold, respectively). An inverse correlation was observed for VEGFR-2 and sFlt-1 levels in both singleton and twin placentae from patients with preeclampsia. Immunofluorescence analyses revealed co-localization of VEGFR-2 and sFlt-1 in placental vasculature and co-immunoprecipitation analyses confirmed VEGFR-2 and sFlt-1 interaction only in preeclamptic placentae compared to age-matched controls. VEGFR-2 transcript and protein levels from explants cultured in 3% O2 were significantly decreased compared to those incubated at 20% O2 (5.9 and 12.47 fold, respectively). Also, VEGFR-2 transcript levels were significantly decreased in early first trimester placentae (low oxygen environment) compared to late first trimester placentae (2.05 fold). We next explored whether sFlt-1 directly affects VEGFR-2 expression. Treatment of first trimester placental explants with sFlt-1 resulted in significantly decreased levels of VEGFR-2 (2.03 fold) and downstream signaling proteins phospho-ERK (1.60 fold) and phospho-Akt (1.64 fold). Our findings show a novel hypoxia-induced and PE-related down-regulation of VEGFR-2 in the human placenta. sFlt-1, which is known to be increased in hypoxic conditions and PE, directly attenuates VEGFR-2 expression and signaling. A direct interaction between sFlt-1 and VEGFR-2 may represent an important mechanism in VEGFR-2 regulation, inhibition of VEGFR-2-mediated processes in placentation and a novel platform to examine the onset of preeclampsia.

Highlights

  • Preeclampsia is a severe complication of pregnancy characterised by increased maternal blood pressure, proteinuria, and end organ disease due to systemic vascular/endothelial dysfunction

  • Vascular endothelial growth factor receptor 2 (VEGFR-2) transcript levels were significantly decreased 1.82 fold in PE compared with preterm control (PTC) placentae (0.8660.12 versus 1.5760.23, P,0.05), in close approximation with the differences observed at the protein level

  • VEGFR-2 is a receptor tyrosine kinase that is expressed in endothelial cells and in the trophoblast layer of the human placenta; its regulation of expression in the human placenta has not yet been reported

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Summary

Introduction

Preeclampsia is a severe complication of pregnancy characterised by increased maternal blood pressure, proteinuria, and end organ disease due to systemic vascular/endothelial dysfunction. Soluble VEGF receptor-1 (sFlt-1) has been recognized as an important factor that is involved in the pathogenesis of preeclampsia through inducing vascular dysfunction [1]. It has been shown that placentae from patients with severe preeclampsia secrete excess sFlt-1 accompanied by markedly increased maternal sFlt-1 serums levels [1]. The primary mechanism by which sFlt-1 alters angiogenesis and induces endothelial dysfunction is thought to be by sequestering its endogenous ligands decreasing their bioavailability. SFlt-1 is a truncated splice variant of VEGF receptor-1 (VEGFR-1), a transmembrane receptor tyrosine kinase that binds both vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) with high affinity. It has been reported that in-vivo, sFlt-1 exists as several isoforms with various molecular weights between 100 and 145 kDa [3,4]

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