Dysregulation of Hydrogen Sulfide Producing Enzyme Cystathionine γ-lyase Contributes to Maternal Hypertension and Placental Abnormalities in Preeclampsia

• Published in: Circulation (New York, N.Y.) Vol. 127; no. 25; pp. 2514 - 2522
• Main Authors: Wang, Keqing, Ahmad, Shakil, Cai, Meng, Rennie, Jillian, Fujisawa, Takeshi, Crispi, Fatima, Baily, James, Miller, Mark R, Cudmore, Melissa, Hadoke, Patrick W F, Wang, Rui, Gratacós, Eduard, Buhimschi, Irina A, Buhimschi, Catalin S, Ahmed, Asif
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD American Heart Association, Inc 25.06.2013; Lippincott Williams & Wilkins
• Subjects: Adolescent; Adult; Alkynes - adverse effects; Alkynes - pharmacology; Animals; Antigens, CD - metabolism; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cells, Cultured; Cystathionine gamma-Lyase - metabolism; Disease Models, Animal; Diseases of mother, fetus and pregnancy; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Endoglin; Endothelium, Vascular - cytology; Endothelium, Vascular - metabolism; Female; Fetal Development - drug effects; Fetal Development - physiology; Glycine - adverse effects; Glycine - analogs & derivatives; Glycine - pharmacology; Gynecology. Andrology. Obstetrics; Humans; Hydrogen Sulfide - antagonists & inhibitors; Hydrogen Sulfide - metabolism; Hypertension - chemically induced; Hypertension - etiology; Hypertension - metabolism; Medical sciences; Mice; Mice, Inbred C57BL; Morpholines - pharmacology; Neovascularization, Physiologic - physiology; Organ Culture Techniques; Organothiophosphorus Compounds - pharmacology; Placenta - drug effects; Placenta - metabolism; Placenta - physiopathology; Placenta Diseases - etiology; Placenta Diseases - metabolism; Placenta Diseases - physiopathology; Placenta Growth Factor; Pre-Eclampsia - metabolism; Pre-Eclampsia - physiopathology; Pregnancy; Pregnancy Complications, Cardiovascular - etiology; Pregnancy Complications, Cardiovascular - metabolism; Pregnancy Complications, Cardiovascular - physiopathology; Pregnancy Proteins - metabolism; Pregnancy, Animal; Pregnancy. Fetus. Placenta; Receptors, Cell Surface - metabolism; Vascular Endothelial Growth Factor Receptor-1 - metabolism; Young Adult; Pregnancy disorders; Fetal membrane; Hydrogen; Cardiovascular disease; Lyases; Angiogenesis; Mother; Carbon-sulfur lyases; Anomaly; Cardiology; Protein-tyrosine kinase; Hypertension; fms-like tyrosine kinase-1; Cystathionine γ-lyase; Enzyme; Transferases; Pregnancy toxemia; placental growth factor; Fetal development; Vascular endothelium growth factor; Placenta; hydrogen sulfide; Preeclampsia; vascular endothelial growth factor; Circulatory system; Placenta growth factor; angiogenesis; preeclampsia; fetal development
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/CIRCULATIONAHA.113.001631

BACKGROUND—The exact etiology of preeclampsia is unknown, but there is growing evidence of an imbalance in angiogenic growth factors and abnormal placentation. Hydrogen sulfide (H2S), a gaseous messenger produced mainly by cystathionine γ-lyase (CSE), is a proangiogenic vasodilator. We hypothesized that a reduction in CSE activity may alter the angiogenic balance in pregnancy and induce abnormal placentation and maternal hypertension. METHODS AND RESULTS—Plasma levels of H2S were significantly decreased in women with preeclampsia (P<0.01), which was associated with reduced placental CSE expression as determined by real-time polymerase chain reaction and immunohistochemistry. Inhibition of CSE activity by DL-propargylglycine reduced placental growth factorproduction from first-trimester (8–12 weeks gestation) human placental explants and inhibited trophoblast invasion in vitro. Knockdown of CSE in human umbilical vein endothelial cells by small-interfering RNA increased the release of soluble fms-like tyrosine kinase-1 and soluble endoglin, as assessed by enzyme-linked immunosorbent assay, whereas adenoviral-mediated CSE overexpression in human umbilical vein endothelial cells inhibited their release. Administration of DL-propargylglycine to pregnant mice induced hypertension and liver damage, promoted abnormal labyrinth vascularization in the placenta, and decreased fetal growth. Finally, a slow-releasing H2S-generating compound, GYY4137, inhibited circulating soluble fms-like tyrosine kinase-1 and soluble endoglin levels and restored fetal growth in mice that was compromised by DL-propargylglycine treatment, demonstrating that the effect of CSE inhibitor was attributable to inhibition of H2S production. CONCLUSIONS—These results imply that endogenous H2S is required for healthy placental vasculature and that a decrease in CSE/H2S activity may contribute to the pathogenesis of preeclampsia. (Circulation. 2013;127:2514-2522.)