Preeclampsia comprises early-onset (EOPE) and late-onset (LOPE) subtypes with distinct etiologies, placental pathology, and severity, but cellular/metabolic drivers and early biomarkers remain unclear. We integrated placental single-cell RNA-seq, spatial transcriptomics, and spatial metabolomics from EOPE, LOPE, and matched controls, and performed maternal serum metabolomics in a prospective cohort of 199 pregnancies. The scRNA-seq identified 14 cell types; Hofbauer cells and trophoblasts resolved into 7 and 3 subclusters. EOPE placentas showed increased macrophages and extravillous trophoblasts, reduced oxygen-transporting Hofbauer subtypes (HB_1, HB_6), and trophoblasts with heightened HIF-1, VEGF, and IGF signaling. LOPE preserved cellular composition but exhibited stronger inflammatory transcriptional programs. Spatial analyses indicated disrupted oxygen transport in EOPE and perturbed interferon-γ signaling and exosome secretion in LOPE. Metabolically, trophoblasts and Hofbauer cells displayed subtype-specific lipid-transport defects and mitochondrial dysfunction. Three early-pregnancy serum metabolites-phosphatidylcholine PC(22:5/0:0), 3-hydroxybutyric acid, and L-allothreonine-robustly predicted EOPE (AUC > 0.85). This study delineates preeclampsia as a spectrum of placental immune-metabolic disorders. Hofbauer cells and trophoblasts undergo subtype-specific transcriptional and metabolic remodeling in EOPE vs LOPE. Multi-omics-guided, noninvasive biomarkers enable early EOPE risk prediction, informing timely detection and intervention.
{"title":"Subtype specific immune-metabolic reprogramming in preeclampsia revealed by multiomics and serum biomarkers.","authors":"Yixuan Chen, Linlin Wu, Dongni Huang, Xiaoxia Wu, Kan Liu, Bo Sun, Jinying Yang, Baozhen Zhang, Zijun Ouyang, Cuilian Zhang, Lunbo Tan, Jianmin Niu","doi":"10.1038/s41440-025-02504-5","DOIUrl":"https://doi.org/10.1038/s41440-025-02504-5","url":null,"abstract":"<p><p>Preeclampsia comprises early-onset (EOPE) and late-onset (LOPE) subtypes with distinct etiologies, placental pathology, and severity, but cellular/metabolic drivers and early biomarkers remain unclear. We integrated placental single-cell RNA-seq, spatial transcriptomics, and spatial metabolomics from EOPE, LOPE, and matched controls, and performed maternal serum metabolomics in a prospective cohort of 199 pregnancies. The scRNA-seq identified 14 cell types; Hofbauer cells and trophoblasts resolved into 7 and 3 subclusters. EOPE placentas showed increased macrophages and extravillous trophoblasts, reduced oxygen-transporting Hofbauer subtypes (HB_1, HB_6), and trophoblasts with heightened HIF-1, VEGF, and IGF signaling. LOPE preserved cellular composition but exhibited stronger inflammatory transcriptional programs. Spatial analyses indicated disrupted oxygen transport in EOPE and perturbed interferon-γ signaling and exosome secretion in LOPE. Metabolically, trophoblasts and Hofbauer cells displayed subtype-specific lipid-transport defects and mitochondrial dysfunction. Three early-pregnancy serum metabolites-phosphatidylcholine PC(22:5/0:0), 3-hydroxybutyric acid, and L-allothreonine-robustly predicted EOPE (AUC > 0.85). This study delineates preeclampsia as a spectrum of placental immune-metabolic disorders. Hofbauer cells and trophoblasts undergo subtype-specific transcriptional and metabolic remodeling in EOPE vs LOPE. Multi-omics-guided, noninvasive biomarkers enable early EOPE risk prediction, informing timely detection and intervention.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-19DOI: 10.1038/s41440-025-02523-2
Akinori Higaki
{"title":"Atrial electrophysiology in the context of digital hypertension: when interpretability matters.","authors":"Akinori Higaki","doi":"10.1038/s41440-025-02523-2","DOIUrl":"https://doi.org/10.1038/s41440-025-02523-2","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1038/s41440-025-02506-3
Takeshi Fujiwara, Hidehiro Kaneko
{"title":"Adolescent hypertension in Japan: from lifestyle awareness to early intervention.","authors":"Takeshi Fujiwara, Hidehiro Kaneko","doi":"10.1038/s41440-025-02506-3","DOIUrl":"https://doi.org/10.1038/s41440-025-02506-3","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hypertension is a common lifestyle-related disease and is influenced by various factors, including excessive salt intake. Recently, the gut microbiota (GM) has gained attention for its potential involvement in blood pressure regulation; however, polyamine metabolism involvement remains poorly understood. Sixty participants aged ≥40 years from Shika Town, Japan, were stratified into four groups (n = 15 each) based on mean blood pressure and urinary sodium chloride (u-NaCl) excretion. The clinical parameters were evaluated, and fecal samples were analyzed using shotgun metagenomic sequencing to assess the microbial composition and abundance of genes related to arginine-polyamine metabolism. Three major findings were observed: (1) Significant differences in the α-diversity of GM were observed between salt-sensitive and non-salt-sensitive hypertensive groups; (2) The abundance of spermidine synthase (EC 2.5.1.16), a key enzyme in polyamine metabolism with known antihypertensive effects, was significantly higher in normotensive individuals, independent of u-NaCl excretion; and (3) Bacterial species harboring polyamine metabolic enzyme genes, including EC 2.5.1.16, differed significantly between groups, suggesting group-specific microbial metabolic traits. These findings suggest that GM-mediated polyamine metabolism may contribute to the regulation of salt-sensitive blood pressure. While variations in spermidine-producing bacteria and the involvement of EC 2.5.1.16 were observed, these factors alone do not fully account for the intergroup differences related to salt intake. Thus, polyamine metabolism likely plays a part in salt sensitivity, but additional microbial and host factors are also involved. Further studies are needed to validate these findings and to explore microbiota-targeted strategies for the prevention and treatment of hypertension.
{"title":"Gut microbiota-derived polyamine pathways associated with mean blood pressure.","authors":"Yasuo Ikagawa, Shigefumi Okamoto, Kouki Taniguchi, Ren Mizoguchi, Atsushi Hashimoto, Rikako Imamura, Hiroshi Arakawa, Kohei Ogura, Masashi Yanagihara, Hiromasa Tsujiguchi, Akinori Hara, Hiroyuki Nakamura, Kazuyoshi Hosomichi, Shigehiro Karashima","doi":"10.1038/s41440-025-02490-8","DOIUrl":"https://doi.org/10.1038/s41440-025-02490-8","url":null,"abstract":"<p><p>Hypertension is a common lifestyle-related disease and is influenced by various factors, including excessive salt intake. Recently, the gut microbiota (GM) has gained attention for its potential involvement in blood pressure regulation; however, polyamine metabolism involvement remains poorly understood. Sixty participants aged ≥40 years from Shika Town, Japan, were stratified into four groups (n = 15 each) based on mean blood pressure and urinary sodium chloride (u-NaCl) excretion. The clinical parameters were evaluated, and fecal samples were analyzed using shotgun metagenomic sequencing to assess the microbial composition and abundance of genes related to arginine-polyamine metabolism. Three major findings were observed: (1) Significant differences in the α-diversity of GM were observed between salt-sensitive and non-salt-sensitive hypertensive groups; (2) The abundance of spermidine synthase (EC 2.5.1.16), a key enzyme in polyamine metabolism with known antihypertensive effects, was significantly higher in normotensive individuals, independent of u-NaCl excretion; and (3) Bacterial species harboring polyamine metabolic enzyme genes, including EC 2.5.1.16, differed significantly between groups, suggesting group-specific microbial metabolic traits. These findings suggest that GM-mediated polyamine metabolism may contribute to the regulation of salt-sensitive blood pressure. While variations in spermidine-producing bacteria and the involvement of EC 2.5.1.16 were observed, these factors alone do not fully account for the intergroup differences related to salt intake. Thus, polyamine metabolism likely plays a part in salt sensitivity, but additional microbial and host factors are also involved. Further studies are needed to validate these findings and to explore microbiota-targeted strategies for the prevention and treatment of hypertension.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1038/s41440-025-02508-1
Masaki Mogi
{"title":"Lowering blood pressure as a team.","authors":"Masaki Mogi","doi":"10.1038/s41440-025-02508-1","DOIUrl":"https://doi.org/10.1038/s41440-025-02508-1","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1038/s41440-025-02510-7
Hirofumi Tomita, Mitsuru Ohishi, Naoki Nakagawa
{"title":"The \"Hypertension Zero Town\" project in the 47th Annual Scientific Meeting of the Japanese Society of Hypertension.","authors":"Hirofumi Tomita, Mitsuru Ohishi, Naoki Nakagawa","doi":"10.1038/s41440-025-02510-7","DOIUrl":"https://doi.org/10.1038/s41440-025-02510-7","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-17DOI: 10.1038/s41440-025-02493-5
Atsuhiro Ichihara
{"title":"Sustainable challenges create tradition in the Japanese Society of Hypertension.","authors":"Atsuhiro Ichihara","doi":"10.1038/s41440-025-02493-5","DOIUrl":"https://doi.org/10.1038/s41440-025-02493-5","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-17DOI: 10.1038/s41440-025-02507-2
Naoko Tomitani, Yoichi Nozato, Akira Sugawara
{"title":"Highlights from the session \"BP Management and Variability\" at the 2025 Annual Scientific Meeting of the Japanese Society of Hypertension.","authors":"Naoko Tomitani, Yoichi Nozato, Akira Sugawara","doi":"10.1038/s41440-025-02507-2","DOIUrl":"https://doi.org/10.1038/s41440-025-02507-2","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-16DOI: 10.1038/s41440-025-02497-1
Kazuomi Kario
{"title":"Implementation hypertension: a new paradigm for global hypertension control in the JSH 2025, WHO 2025, and AHA/ACC 2025 guideline era.","authors":"Kazuomi Kario","doi":"10.1038/s41440-025-02497-1","DOIUrl":"https://doi.org/10.1038/s41440-025-02497-1","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}