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The roles of free iron, heme, haemoglobin, and the scavenger proteins haemopexin and alpha-1-microglobulin in preeclampsia and fetal growth restriction
- Source :
- Journal of internal medicineReferences. 290(5)
- Publication Year :
- 2021
-
Abstract
- Background: Preeclampsia (PE) is a complex pregnancy syndrome characterised by maternal hypertension and organ damage after 20 weeks of gestation and is associated with an increased risk of cardiovascular disease later in life. Extracellular haemoglobin (Hb) and its metabolites heme and iron are highly toxic molecules and several defence mechanisms have evolved to protect the tissue. Objectives: We will discuss the roles of free iron, heme, Hb, and the scavenger proteins haemopexin and alpha-1-microglobulin in pregnancies complicated by PE and fetal growth restriction (FGR). Conclusion: In PE, oxidative stress causes syncytiotrophoblast (STB) stress and increased shedding of placental STB-derived extracellular vesicles (STBEV). The level in maternal circulation correlates with the severity of hypertension and supports the involvement of STBEVs in causing maternal symptoms in PE. In PE and FGR, iron homeostasis is changed, and iron levels significantly correlate with the severity of the disease. The normal increase in plasma volume taking place during pregnancy is less for PE and FGR and therefore have a different impact on, for example, iron concentration, compared to normal pregnancy. Excess iron promotes ferroptosis is suggested to play a role in trophoblast stress and lipotoxicity. Non-erythroid α-globin regulates vasodilation through the endothelial nitric oxide synthase pathway, and hypoxia-induced α-globin expression in STBs in PE placentas is suggested to contribute to hypertension in PE. Underlying placental pathology in PE with and without FGR might be amplified by iron and heme overload causing oxidative stress and ferroptosis. As the placenta becomes stressed, the release of STBEVs increases and affects the maternal vasculature. (Less)
- Subjects :
- medicine.medical_specialty
Iron
Placenta
Heme
medicine.disease_cause
Preeclampsia
chemistry.chemical_compound
Hemoglobins
Syncytiotrophoblast
Pre-Eclampsia
alpha-Globins
Hemopexin
Pregnancy
Internal medicine
Alpha-Globulins
Internal Medicine
Medicine
Maternal hypertension
Humans
Fetal Growth Retardation
business.industry
medicine.disease
medicine.anatomical_structure
Endocrinology
Lipotoxicity
chemistry
Hypertension
Female
business
Alpha-1-microglobulin
Oxidative stress
Subjects
Details
- ISSN :
- 13652796
- Volume :
- 290
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Journal of internal medicineReferences
- Accession number :
- edsair.doi.dedup.....05cb00fab8f109efdfe9ac710e984003