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Dysfonction de la nitric oxide synthase endothéliale au cours de la pré-éclampsie : rôle du glutathion et du stress oxydant

Abstract : Context: During pre-eclampsia (PE), the defective trophoblastic invasion and remodeling of the uterine spiral arteries leads to poor adaptation of utero-placental circulation associated with hypoxia/reoxygenation phenomena. This induces oxidative stress and an imbalance between angiogenic/antiangiogenic factors (decrease in VEGF and PIGF vs. increase in sFlt1) responsible for abnormal placentation, endothelial dysfunction and systemic inflammation. Endothelial nitric oxide synthase dysfunction (eNOS) and decreased NO bioavailability play a critical role in the pathophysiology of PE. eNOS is the main source of placental NO production, and plays a key role in homeostasis and vascular tone regulation. Recent evidence indicates that eNOS may undergo glutathionylation in the vascular wall, and subsequent uncoupling in a prooxidant environment, this resulting in an increased generation of superoxide anion and a decreased production of NO. Objective: The purpose of this work was to study the consequences of oxidative stress on placental eNOS, in particular its glutathionylation and modification by lipid oxidation products (LPO), in relation to its dysfunction observed during PE. Materials and Methods: The modification of eNOS was studied in placental tissues obtained from preeclampsia-affected (n=13), vs normal pregnant women (n=9) and in HTR-8/SVneo human trophoblasts exposed to hypoxia/reoxygenation (H/R), or by exposure to LPO. Results: Immunofluorescence and confocal microscopy revealed a high glutathionylation of eNOS in PE placentas, reversed by dithiotreitol, which was confirmed by immunoprecipitation and western-blot experiments, with no difference in total eNOS expression between PE and normal pregnancy. Exposure of HTR8 trophoblasts to H/R conditions generates S-glutathionylation of eNOS associated with reduced NO production, and increased superoxide anion generation. NO is necessary for the invasive potential of trophoblasts, since trophoblasts exposed to H/R, or silenced for eNOS by small interfering RNAs (siRNA), showed a decreased migration capacity, which was restored by the NO donor, NOC-18. In the second part of this work, we investigated the presence of LPO in PE placentas, and hypothesized that eNOS could be a target of these agents. We show that LPO such as 4-hydroxynenal (4-HNE), and 4-oxo-2-nonenal (ONE), accumulate in PE placentas, particularly on eNOS, while no changes are observed in normal pregnancy placentas. Proteomics studies on recombinant eNOS show that ONE and 4-HNE modify several epitopes (ONE-Lys, HNE-His, HNE-Cys). The addition of 4-HNE or ONE to HTR8 inhibits NO production and cell migration, restored by the addition of NOC-18. Conclusions and perspectives: These results show that placental eNOS is an important target for oxidative stress during PE, with modifications by S-glutathionylation or adduct formation with ONE or 4-HNE, associated with a decrease in NO production. These changes could contribute to the dysfunction of placental eNOS observed during the PE. In perspective, we plan to study the consequences of oxidative stress and LPO on accelerated placental aging, which may contribute to the pathophysiology of PE, and beyond, of pathological pregnancies.
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Paul Guerby. Dysfonction de la nitric oxide synthase endothéliale au cours de la pré-éclampsie : rôle du glutathion et du stress oxydant. Endocrinologie et métabolisme. Université Paul Sabatier - Toulouse III, 2019. Français. ⟨NNT : 2019TOU30078⟩. ⟨tel-02893766⟩

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