Abstract
Objectives: Premature birth, defined as less than 37 weeks gestation, affects approximately 12% of all live births around the world. Advances in neonatal care have resulted in the increased survival of infants born prematurely. Although prematurity is a known risk factor for different cardiovascular diseases, little is known about the pathophysiology of vasculature during premature gestation and angiopoietic factors network during premature birth. Aims: The objective of this study was to determine whether the profile of several pro-angiogenic and anti-angiogenic factors in umbilical cord blood (UCB) is different in healthy appropriate-for-gestational-age preterm newborns and normal term babies. The second aim of this study was to investigate the microRNA (miRNAs) expression profile in UCB from preterm labor and to detect miRNAs potentially taking part in control of angogenesis-related processes (Angio-MiRs). Methods: Using an immunobead Luminex assay, we simultaneously measured the concentration of Angiogenin, Angiopoietin-1, FGF-acidic, FGF-basic, PDGF-aa, PlGF, VEGF, VEGF-D, Endostatin, Thrombospondin-2, NGF, BDNF, GDNF, and NT-4 in UCB samples collected from the preterm (n = 27) and term (n = 52) delivery. In addition, the global microRNA expression in peripheral blood mononuclear cells (PBMCs) circulating in such UCB samples was examined in this study using microarray MiRNA technique. Results: The concentrations of five from eight measured pro-angiogenic factors (VEGF, Angiopoietin-1, PDGF-AA, FGF-a, and FGF-b) were significantly lower in UCB from preterm newborns. On the contrary, two angiostatic factors (Endostatin and Thrombospondin-2) were significantly up-regulated in preterm UCB. Among analyzed neurotrophins in preterm newborns, the elevated UCB concentration was found only in the case of GDNF, whereas BDNF was significantly reduced. Moreover, two angiopoietic factors, VEGF-D and PlGF, and two neurotrophins, NT4 and NGF, did not differ in concentration in preterm and term babies. We also discovered that among the significantly down-regulated miRNAs, there were several classical Angio-MiRs (inter alia MiR-125, MiR-126, MiR-145, MiR-150, or MiR155), which are involved in angiogenesis regulation in newborn after preterm delivery. Conclusions: This is the first report of simultaneous measurements of several angiopoietic factors in UCB collected from infants during preterm and term labor. Here, we observed that several pro-angiogenic factors were at lower concentration in UCB collected from preterm newborns than term babies. In contrast, the two measured angiostatic factors, Endostatin and Thrombospondin-2, were significantly higher in UCB from preterm babies. This can suggest that distinct pathophysiological contributions from differentially expressed various angiopoietic factors may determine the clinical outcomes after preterm birth. Especially, our angiogenesis-related molecules analysis indicates that preterm birth of healthy, appropriate-for-gestational-age newborns is an “anti-angiogenic state” that may provide an increased risk for improper development and function of cardiovascular system in the adulthood. This work also contributes to a better understanding of the role of miRNAs potentially involved in angiogenesis control in preterm newborns.
Highlights
Preterm birth rates range from 7% to 18% worldwide [1]
Our findings demonstrated that these angiopoietic factors that biologically cooperate together, Vascular endothelial growth factor (VEGF)-A and Angiopoietin-1, were both affected by premature birth, as they were significantly decreased in umbilical cord blood (UCB) samples from preterm infants population and could exert abnormal humoral effects on cardiovascular system
These results may suggest that the analyzed circulating angiopoietic factors found to be abnormally secreted to the newborn’s UCB may contribute to the angiogenesis-related pathological processes observed in clinical practice with children and adults born prematurely
Summary
Preterm birth rates range from 7% to 18% worldwide [1]. Despite considerable efforts, the incidence of preterm birth is still rising. Multiple reports have defined a distinct cardiovascular phenotype of subjects born preterm, including altered cardiovascular structure and function [4], reduced exercise capacity [5], as well as increased risk of stroke and the development of other circulatory disorders [6]. Kajantie et al reported that preterm women born before 34 weeks, compared to term, have around a 2-fold increase in coronary heart disease as observed in a cohort study of people born in Helsinki [12]. The results from these studies indicate that preterm birth, like poor fetal growth with birth at term, may program an increase in later cardiovascular risk. The mechanisms behind these malfunctions in subjects born preterm are mostly unclear, but may in part be explained by interrupted cardiovascular system development and maturation occurring during fetal growth and resulting in deficits in vascular regulation in postnatal life
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