Pub Date : 2025-11-26DOI: 10.1016/j.placenta.2025.11.011
Eleanor A. Medley , Emma Spring , Mia Charifson , Sarah Adelman , Sara Borghi , Yelena Afanasyeva , Eunsil Seok , Mengling Liu , Kurunthachalam Kannan , Shilpi S. Mehta-Lee , Whitney Cowell , Linda G. Kahn
Introduction
Placental development, involving rapid vascularization, is regulated by concentration gradients of numerous growth factors and hormones. Placental growth factor (PlGF) promotes vasculogenesis and angiogenesis in the placenta, while soluble fms-like tyrosine kinase-1 (sFlt-1) inhibits these processes. An elevated ratio of sFlt-1/PlGF in maternal serum is predictive of preeclampsia. Exposure to two classes of ubiquitous endocrine-disrupting chemicals, bisphenols and phthalates, has also been previously linked to preeclampsia development.
Methods
We investigated the relation of urinary concentrations of bisphenols and phthalate metabolites, measured up to three times during pregnancy, with serum concentrations of sFlt-1, PlGF, and their ratio in the New York University Children's Health and Environment Study. Linear mixed models were used to analyze up to three measurements of PlGF and sFlt-1 adjusted for gestational age at the time of serum collection.
Results
We found that higher molar sum concentration of bisphenol A and bisphenol S was associated with lower sFlt-1 (−0.12, 95 % CI: −0.22, −0.03), higher PlGF (0.08, 95 % CI: −0.01, 0.18), and lower sFlt-1/PlGF ratio (−0.12, 95 % CI: −0.21, −0.02). Phthalic acid and metabolites of anti-androgenic and low molecular weight phthalates were similarly associated with higher PlGF and lower sFlt-1/PlGF, but only after 20 weeks of gestation.
Discussion
The unexpected relationship between prenatal bisphenol and phthalate exposure and lower sFlt-1/PlGF warrants further investigation. Our results suggest that the effect of these endocrine-disrupting chemicals on placental health may be more complicated than what is currently understood through these angiogenic biomarkers.
{"title":"Placental angiogenic biomarkers in relation to prenatal bisphenol and phthalate exposure","authors":"Eleanor A. Medley , Emma Spring , Mia Charifson , Sarah Adelman , Sara Borghi , Yelena Afanasyeva , Eunsil Seok , Mengling Liu , Kurunthachalam Kannan , Shilpi S. Mehta-Lee , Whitney Cowell , Linda G. Kahn","doi":"10.1016/j.placenta.2025.11.011","DOIUrl":"10.1016/j.placenta.2025.11.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Placental development, involving rapid vascularization, is regulated by concentration gradients of numerous growth factors and hormones. Placental growth factor (PlGF) promotes vasculogenesis and angiogenesis in the placenta, while soluble fms-like tyrosine kinase-1 (sFlt-1) inhibits these processes. An elevated ratio of sFlt-1/PlGF in maternal serum is predictive of preeclampsia. Exposure to two classes of ubiquitous endocrine-disrupting chemicals, bisphenols and phthalates, has also been previously linked to preeclampsia development.</div></div><div><h3>Methods</h3><div>We investigated the relation of urinary concentrations of bisphenols and phthalate metabolites, measured up to three times during pregnancy, with serum concentrations of sFlt-1, PlGF, and their ratio in the New York University Children's Health and Environment Study. Linear mixed models were used to analyze up to three measurements of PlGF and sFlt-1 adjusted for gestational age at the time of serum collection.</div></div><div><h3>Results</h3><div>We found that higher molar sum concentration of bisphenol A and bisphenol S was associated with lower sFlt-1 (−0.12, 95 % CI: −0.22, −0.03), higher PlGF (0.08, 95 % CI: −0.01, 0.18), and lower sFlt-1/PlGF ratio (−0.12, 95 % CI: −0.21, −0.02). Phthalic acid and metabolites of anti-androgenic and low molecular weight phthalates were similarly associated with higher PlGF and lower sFlt-1/PlGF, but only after 20 weeks of gestation.</div></div><div><h3>Discussion</h3><div>The unexpected relationship between prenatal bisphenol and phthalate exposure and lower sFlt-1/PlGF warrants further investigation. Our results suggest that the effect of these endocrine-disrupting chemicals on placental health may be more complicated than what is currently understood through these angiogenic biomarkers.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"174 ","pages":"Pages 63-70"},"PeriodicalIF":2.5,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687958","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 : 2025-11-24DOI: 10.1016/j.placenta.2025.11.010
Xiaodan Tan , Xing Chen , Duanfang Zhou , Wenjia Guo , Dan Li , Xiaoli Wang , Jiali Liu , Zhe Peng , Lin Chen
Introduction
Preeclampsia (PE) is a pregnancy-specific disorder associated with hypertension and multi-organ dysfunction, posing serious risks to maternal and fetal health. Early detection remains challenging, highlighting the urgent need to identify reliable molecular biomarkers for improved diagnosis and therapeutic intervention.
Methods
We integrated Gene Expression Omnibus (GEO) datasets (GSE10588, GSE25906, and GSE48424) and identified 671 differentially expressed genes (312 upregulated and 359 downregulated). Weighted Gene Co-expression Network Analysis (WGCNA) identified 165 genes highly correlated with PE, of which 74 overlapped with the DEGs. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were conducted on these 74 genes. Additionally, 4 machine learning models were applied to prioritize diagnostic biomarkers.
Results
GO analysis revealed enrichment in Wnt signaling, ER-to-Golgi vesicle transport, COPII-coated vesicle components, and ubiquitin-protein transferase activity. KEGG analysis indicated significant involvement in cysteine and methionine metabolism and protein processing in the endoplasmic reticulum. Among the top 20 genes from each machine learning model, Glutamate-cysteine ligase modifier subunit (GCLM) was the only overlapping gene. Its downregulation was validated in clinical samples and PE models. Functional experiments showed that lentiviral GCLM overexpression restored GSH/GPX4 levels, enhanced HUVEC viability, and reduced sFLT-1 secretion.
Conclusion
Our study identifies GCLM as a potential biomarker and therapeutic target for PE, offering new insight into its molecular pathogenesis and suggesting clinical relevance for diagnosis and intervention.
{"title":"GCLM as a novel biomarker for preeclampsia: Integrating bioinformatics and mechanistic validation","authors":"Xiaodan Tan , Xing Chen , Duanfang Zhou , Wenjia Guo , Dan Li , Xiaoli Wang , Jiali Liu , Zhe Peng , Lin Chen","doi":"10.1016/j.placenta.2025.11.010","DOIUrl":"10.1016/j.placenta.2025.11.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Preeclampsia (PE) is a pregnancy-specific disorder associated with hypertension and multi-organ dysfunction, posing serious risks to maternal and fetal health. Early detection remains challenging, highlighting the urgent need to identify reliable molecular biomarkers for improved diagnosis and therapeutic intervention.</div></div><div><h3>Methods</h3><div>We integrated Gene Expression Omnibus (GEO) datasets (GSE10588, GSE25906, and GSE48424) and identified 671 differentially expressed genes (312 upregulated and 359 downregulated). Weighted Gene Co-expression Network Analysis (WGCNA) identified 165 genes highly correlated with PE, of which 74 overlapped with the DEGs. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were conducted on these 74 genes. Additionally, 4 machine learning models were applied to prioritize diagnostic biomarkers.</div></div><div><h3>Results</h3><div>GO analysis revealed enrichment in Wnt signaling, ER-to-Golgi vesicle transport, COPII-coated vesicle components, and ubiquitin-protein transferase activity. KEGG analysis indicated significant involvement in cysteine and methionine metabolism and protein processing in the endoplasmic reticulum. Among the top 20 genes from each machine learning model, Glutamate-cysteine ligase modifier subunit (GCLM) was the only overlapping gene. Its downregulation was validated in clinical samples and PE models. Functional experiments showed that lentiviral GCLM overexpression restored GSH/GPX4 levels, enhanced HUVEC viability, and reduced sFLT-1 secretion.</div></div><div><h3>Conclusion</h3><div>Our study identifies GCLM as a potential biomarker and therapeutic target for PE, offering new insight into its molecular pathogenesis and suggesting clinical relevance for diagnosis and intervention.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"174 ","pages":"Pages 76-83"},"PeriodicalIF":2.5,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743861","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 : 2025-11-21DOI: 10.1016/j.placenta.2025.11.008
C.M. van Kammen , F.M. Al Darwish , G.J. Strijkers , B.F. Coolen , L.K. Alles , M.M. Faas , R. Schiffelers , A.T. Lely , F. Terstappen
Background
Placental insufficiency underlies major obstetric complications such as preeclampsia and fetal growth restriction (FGR). The reduced uterine perfusion pressure (RUPP) model is widely used to mimic PE and FGR; however, its impact on placental structure, immune cell regulation, and vascular remodeling in the mesometrial triangle remains poorly examined. This study investigates these processes to clarify the model's relevance for human placenta dysfunction pathology.
Methods
Maternal, fetal, and placental parameters were assessed in pregnant rats at gestational day (GD) 14, 16, 18, and 19, comparing normal pregnant and RUPP groups. Placental morphology was assessed using hematoxylin and eosin staining. Within the mesometrial triangle, uterine natural killer (uNK) cell distribution was evaluated using ANK61 staining, while trophoblast invasion and spiral artery remodeling were assessed by pan-cytokeratin and α-SMA staining, respectively.
Results
Placental macrostructural architecture was preserved in RUPP. However, uNK cell migration from the mesometrial triangle was impaired, with higher ANK61-positive cell presence persisting at GD19. This was accompanied by a reduction in trophoblast invasion depth. Spiral artery remodeling was impaired in RUPP placentas, with a greater proportion of unremodeled vessels and fewer highly remodeled arteries by GD19.
Conclusion
While gross placental structure remains intact in the RUPP model, the key functional adaptations uNK cell migration, trophoblast invasion, and vascular remodeling, are impaired. These findings support the RUPP as a relevant model to study the pathophysiological mechanisms of placental insufficiency. Future research should focus on temporal molecular profiling to elucidate the mechanisms behind impaired uNK cell retention and shallow trophoblast invasion.
{"title":"Impaired placental vascular remodeling and persistent uNK cells in the RUPP model: A time-dependent perspective","authors":"C.M. van Kammen , F.M. Al Darwish , G.J. Strijkers , B.F. Coolen , L.K. Alles , M.M. Faas , R. Schiffelers , A.T. Lely , F. Terstappen","doi":"10.1016/j.placenta.2025.11.008","DOIUrl":"10.1016/j.placenta.2025.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Placental insufficiency underlies major obstetric complications such as preeclampsia and fetal growth restriction (FGR). The reduced uterine perfusion pressure (RUPP) model is widely used to mimic PE and FGR; however, its impact on placental structure, immune cell regulation, and vascular remodeling in the mesometrial triangle remains poorly examined. This study investigates these processes to clarify the model's relevance for human placenta dysfunction pathology.</div></div><div><h3>Methods</h3><div>Maternal, fetal, and placental parameters were assessed in pregnant rats at gestational day (GD) 14, 16, 18, and 19, comparing normal pregnant and RUPP groups. Placental morphology was assessed using hematoxylin and eosin staining. Within the mesometrial triangle, uterine natural killer (uNK) cell distribution was evaluated using ANK61 staining, while trophoblast invasion and spiral artery remodeling were assessed by pan-cytokeratin and α-SMA staining, respectively.</div></div><div><h3>Results</h3><div>Placental macrostructural architecture was preserved in RUPP. However, uNK cell migration from the mesometrial triangle was impaired, with higher ANK61-positive cell presence persisting at GD19. This was accompanied by a reduction in trophoblast invasion depth. Spiral artery remodeling was impaired in RUPP placentas, with a greater proportion of unremodeled vessels and fewer highly remodeled arteries by GD19.</div></div><div><h3>Conclusion</h3><div>While gross placental structure remains intact in the RUPP model, the key functional adaptations uNK cell migration, trophoblast invasion, and vascular remodeling, are impaired. These findings support the RUPP as a relevant model to study the pathophysiological mechanisms of placental insufficiency. Future research should focus on temporal molecular profiling to elucidate the mechanisms behind impaired uNK cell retention and shallow trophoblast invasion.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"174 ","pages":"Pages 1-8"},"PeriodicalIF":2.5,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145584492","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 : 2025-11-17DOI: 10.1016/j.placenta.2025.11.007
Aleksandra Stangret , Anna Wnuk , Zbigniew Lewandowski , Marta Chołuj , Marta Skoda , Dariusz Szukiewicz , Włodzimierz Sawicki , Krzysztof Cendrowski
Introduction
Visfatin is a multifunctional adipokine, primarily produced by visceral fat but also expressed in the placenta, where it may contribute to pregnancy regulation. Obesity, advanced maternal age are associated with oxidative stress and inflammation, increasing the risk of pregnancy complications. Understanding placental adaptations to these factors is essential for improving maternal and fetal health outcomes. This study aimed to evaluate the relationship between placental visfatin levels, maternal pre-pregnancy body weight status, age, 3-nitrotyrosine (3-NT) - a biomarker of nitrative stress, to explore potential links between these factors and placental function in an uncomplicated pregnancy.
Methods
This retrospective cohort study analyzed placental tissues collected from 39 parturients immediately after birth. ELISA assays measured term placental visfatin and 3-NT levels. Maternal parameters, including BMI, gestational weight gain, gestational age, and pregnancy-related comorbidities, were recorded. Pearson correlation and multivariate regression analyses were performed to assess associations between visfatin levels, BMI, age, and oxidative stress markers.
Results
Visfatin concentrations were significantly higher in women with pre-pregnancy obesity (p < 0.042). Visfatin correlated with 3-NT levels (r = 0.46; p < 0.003) and maternal age (r = 0.35; p < 0.030). In women ≤35 years, visfatin correlated positively with BMI, independent of gestational age and weight at term (r = 0.42; p < 0.031).
Conclusions
Elevated visfatin concentration in an effectively functioning term placenta may result from maternal pre-pregnancy obesity, maternal age, oxidative and nitrative stress (3-NT). This supports the idea that in physiological pregnancy visfatin contributes to placental processes that sustain and maintain healthy pregnancy outcomes in women with pregnancy risk factors.
{"title":"Adipokine visfatin as a response of an efficient placenta to key pregnancy risk factors","authors":"Aleksandra Stangret , Anna Wnuk , Zbigniew Lewandowski , Marta Chołuj , Marta Skoda , Dariusz Szukiewicz , Włodzimierz Sawicki , Krzysztof Cendrowski","doi":"10.1016/j.placenta.2025.11.007","DOIUrl":"10.1016/j.placenta.2025.11.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Visfatin is a multifunctional adipokine, primarily produced by visceral fat but also expressed in the placenta, where it may contribute to pregnancy regulation. Obesity, advanced maternal age are associated with oxidative stress and inflammation, increasing the risk of pregnancy complications. Understanding placental adaptations to these factors is essential for improving maternal and fetal health outcomes. This study aimed to evaluate the relationship between placental visfatin levels, maternal pre-pregnancy body weight status, age, 3-nitrotyrosine (3-NT) - a biomarker of nitrative stress, to explore potential links between these factors and placental function in an uncomplicated pregnancy.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed placental tissues collected from 39 parturients immediately after birth. ELISA assays measured term placental visfatin and 3-NT levels. Maternal parameters, including BMI, gestational weight gain, gestational age, and pregnancy-related comorbidities, were recorded. Pearson correlation and multivariate regression analyses were performed to assess associations between visfatin levels, BMI, age, and oxidative stress markers.</div></div><div><h3>Results</h3><div>Visfatin concentrations were significantly higher in women with pre-pregnancy obesity (p < 0.042). Visfatin correlated with 3-NT levels (r = 0.46; p < 0.003) and maternal age (r = 0.35; p < 0.030). In women ≤35 years, visfatin correlated positively with BMI, independent of gestational age and weight at term (r = 0.42; p < 0.031).</div></div><div><h3>Conclusions</h3><div>Elevated visfatin concentration in an effectively functioning term placenta may result from maternal pre-pregnancy obesity, maternal age, oxidative and nitrative stress (3-NT). This supports the idea that in physiological pregnancy visfatin contributes to placental processes that sustain and maintain healthy pregnancy outcomes in women with pregnancy risk factors.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"172 ","pages":"Pages 159-166"},"PeriodicalIF":2.5,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564995","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 : 2025-11-17DOI: 10.1016/j.placenta.2025.11.006
Jianhua Li , Xinping Xie , Lin Lu , Bei Gan , Jianying Yan
Introduction
Gestational diabetes mellitus (GDM) disrupts placental trophoblast function through hyperglycemia-induced apoptosis and impaired proliferation. Non-coding RNAs, particularly miR-196a-5p, are implicated in GDM pathogenesis, but their mechanistic roles remain unclear. HOXA7, a homeobox transcription factor, and the MAPK/ERK pathway are critical in cellular regulation, however, their interplay in GDM is unexplored.
Methods
Clinical samples (blood and placental tissues) from GDM patients and controls were analyzed via miRNA-seq, qRT-PCR, and Western blot. Bioinformatics (TargetScan, miRDB, miRWalk) identified miR-196a-5p targets. Functional validation used HTR8-Svneo trophoblasts under high-glucose (25 mM) conditions, with miR-196a-5p mimics/inhibitors and HOXA7 overexpression and two key functional rescue assays: co-treatment with a miR-196a-5p mimic and HOXA7 overexpression, and co-treatment with a mimic and a MEK activator, including CCK-8, Transwell, flow cytometry, and dual-luciferase reporter analysis. miR-196a-5p was upregulated in GDM patients and directly targeted HOXA7 via three conserved 3′UTR binding sites.
Results
Hyperglycemia suppressed MAPK/ERK phosphorylation, reducing trophoblast proliferation, migration, and invasion while increasing apoptosis. miR-196a-5p-mimic exacerbated these effects, whereas inhibitors or HOXA7 overexpression restored MAPK/ERK activity and cellular functions. Crucially, rescue experiments confirmed that HOXA7 is a necessary mediator for miR-196a-5p′s effects and that activating the MAPK/ERK pathway downstream is sufficient to reverse the induced dysfunction. miR-196a-5p suppresses the MAPK/ERK pathway by specifically regulating HOXA7, thereby reducing proliferation and increasing apoptosis of placental trophoblasts.
Discussion
This study demonstrated that miR-196a-5p with higher expression in GDM suppresses the HOXA7/MAPK/ERK axis to inhibit placental trophoblasts proliferation and promote its apoptosis.
{"title":"miR-196a-5p suppresses the MAPK/ERK pathway by targeting HOXA7 to regulate the proliferation and apoptosis of placental trophoblasts in gestational diabetes","authors":"Jianhua Li , Xinping Xie , Lin Lu , Bei Gan , Jianying Yan","doi":"10.1016/j.placenta.2025.11.006","DOIUrl":"10.1016/j.placenta.2025.11.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Gestational diabetes mellitus (GDM) disrupts placental trophoblast function through hyperglycemia-induced apoptosis and impaired proliferation. Non-coding RNAs, particularly miR-196a-5p, are implicated in GDM pathogenesis, but their mechanistic roles remain unclear. HOXA7, a homeobox transcription factor, and the MAPK/ERK pathway are critical in cellular regulation, however, their interplay in GDM is unexplored.</div></div><div><h3>Methods</h3><div>Clinical samples (blood and placental tissues) from GDM patients and controls were analyzed via miRNA-seq, qRT-PCR, and Western blot. Bioinformatics (TargetScan, miRDB, miRWalk) identified miR-196a-5p targets. Functional validation used HTR8-Svneo trophoblasts under high-glucose (25 mM) conditions, with miR-196a-5p mimics/inhibitors and HOXA7 overexpression and two key functional rescue assays: co-treatment with a miR-196a-5p mimic and HOXA7 overexpression, and co-treatment with a mimic and a MEK activator, including CCK-8, Transwell, flow cytometry, and dual-luciferase reporter analysis. miR-196a-5p was upregulated in GDM patients and directly targeted HOXA7 via three conserved 3′UTR binding sites.</div></div><div><h3>Results</h3><div>Hyperglycemia suppressed MAPK/ERK phosphorylation, reducing trophoblast proliferation, migration, and invasion while increasing apoptosis. miR-196a-5p-mimic exacerbated these effects, whereas inhibitors or HOXA7 overexpression restored MAPK/ERK activity and cellular functions. Crucially, rescue experiments confirmed that HOXA7 is a necessary mediator for miR-196a-5p′s effects and that activating the MAPK/ERK pathway downstream is sufficient to reverse the induced dysfunction. miR-196a-5p suppresses the MAPK/ERK pathway by specifically regulating HOXA7, thereby reducing proliferation and increasing apoptosis of placental trophoblasts.</div></div><div><h3>Discussion</h3><div>This study demonstrated that miR-196a-5p with higher expression in GDM suppresses the HOXA7/MAPK/ERK axis to inhibit placental trophoblasts proliferation and promote its apoptosis.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"172 ","pages":"Pages 167-178"},"PeriodicalIF":2.5,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569087","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 : 2025-11-11DOI: 10.1016/j.placenta.2025.11.001
Eva Manuela Pena-Burgos , María De La Calle , Jose Juan Pozo-Kreilinger , Cecilia García-Díaz , Rebeca Rodríguez Pena , Ángel Vázquez Martín , Rita María Regojo-Zapata
Introduction
Oocyte donation (OD) pregnancies present the highest level of fetal allogenicity, potentially triggering immune dysregulation at the maternal–fetal interface. Triplet pregnancies represent an extreme physiological challenge, yet the immune and vascular adaptations in OD triplets remain poorly understood. This study evaluated immunovascular profiles in triplet pregnancies conceived via OD compared with non-OD and spontaneous conceptions, exploring mechanisms of maladaptation related to high fetal allogenicity.
Methods
We conducted a retrospective case–control study of 115 triplet placentas: 29 conceived by OD and 86 by spontaneous conception, artificial insemination, or assisted reproductive technology without OD. Decidua basalis, chorionic villi, and fetal membranes were assessed by immunohistochemistry for immune and vascular markers. Quantitative immunoreactivity scores, qualitative expression patterns, and vascular morphology were compared between groups.
Results
OD placentas showed reduced CD163+ regulatory macrophages, increased CD68+, CD14+ macrophages, CD56+ NK cells, and HLA-DR+ immune cells, moderate PD-L1 expression, scanty CD4+ regulatory T cells, and only scattered CD8+ T cells in decidua basalis. Vascular alterations in OD placentas included muscularized maternal vessels (29.9 %), perivascular immune infiltration, endothelial activation (WT1+, CD15+), and absence of VEGF expression. C4d deposition on villous basal membranes was more frequent in OD placentas, indicating complement activation.
Discussion
OD triplet pregnancies exhibit a distinct immunovascular phenotype compatible with a graft-versus-host-like process. Regulatory immune cell depletion, enrichment of antigen-presenting cells, and vascular maladaptation suggest chronic immune dysregulation, contributing to placental insufficiency and adverse outcomes. These findings highlight the need for closer monitoring and may inform targeted interventions in highly allogeneic pregnancies.
{"title":"Immune and vascular dysregulation at the maternal–fetal interface in oocyte donation triplet pregnancies: unraveling mechanisms of failed immune tolerance","authors":"Eva Manuela Pena-Burgos , María De La Calle , Jose Juan Pozo-Kreilinger , Cecilia García-Díaz , Rebeca Rodríguez Pena , Ángel Vázquez Martín , Rita María Regojo-Zapata","doi":"10.1016/j.placenta.2025.11.001","DOIUrl":"10.1016/j.placenta.2025.11.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Oocyte donation (OD) pregnancies present the highest level of fetal allogenicity, potentially triggering immune dysregulation at the maternal–fetal interface. Triplet pregnancies represent an extreme physiological challenge, yet the immune and vascular adaptations in OD triplets remain poorly understood. This study evaluated immunovascular profiles in triplet pregnancies conceived via OD compared with non-OD and spontaneous conceptions, exploring mechanisms of maladaptation related to high fetal allogenicity.</div></div><div><h3>Methods</h3><div>We conducted a retrospective case–control study of 115 triplet placentas: 29 conceived by OD and 86 by spontaneous conception, artificial insemination, or assisted reproductive technology without OD. Decidua basalis, chorionic villi, and fetal membranes were assessed by immunohistochemistry for immune and vascular markers. Quantitative immunoreactivity scores, qualitative expression patterns, and vascular morphology were compared between groups.</div></div><div><h3>Results</h3><div>OD placentas showed reduced CD163<sup>+</sup> regulatory macrophages, increased CD68<sup>+</sup>, CD14<sup>+</sup> macrophages, CD56<sup>+</sup> NK cells, and HLA-DR<sup>+</sup> immune cells, moderate PD-L1 expression, scanty CD4<sup>+</sup> regulatory T cells, and only scattered CD8<sup>+</sup> T cells in decidua basalis. Vascular alterations in OD placentas included muscularized maternal vessels (29.9 %), perivascular immune infiltration, endothelial activation (WT1<sup>+</sup>, CD15<sup>+</sup>), and absence of VEGF expression. C4d deposition on villous basal membranes was more frequent in OD placentas, indicating complement activation.</div></div><div><h3>Discussion</h3><div>OD triplet pregnancies exhibit a distinct immunovascular phenotype compatible with a graft-versus-host-like process. Regulatory immune cell depletion, enrichment of antigen-presenting cells, and vascular maladaptation suggest chronic immune dysregulation, contributing to placental insufficiency and adverse outcomes. These findings highlight the need for closer monitoring and may inform targeted interventions in highly allogeneic pregnancies.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"174 ","pages":"Pages 203-213"},"PeriodicalIF":2.5,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889582","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 : 2025-11-07DOI: 10.1016/j.placenta.2025.11.005
Mohammed N.H. Ali, Mariia Adler, Magdalena Novotna, Viktor Gala, Cilia Abad, Frantisek Staud, Lukas Cerveny
Objective
Adenosine and other nucleosides are essential regulators of cellular processes, but their specific roles in trophoblast growth and regulation remain incompletely defined. This study investigated the effects of purine and pyrimidine nucleosides on trophoblast proliferation, and further examined whether adenosine influences apoptosis, differentiation, or the expression of its receptors, transporters, and metabolizing enzymes.
Methods
Nucleoside-induced proliferation was assessed by measuring metabolic activity, DNA synthesis, total DNA content, and MKI-67 expression in BeWo and JEG-3 cell lines, and by PCNA protein levels in placental explants. Adenosine was further evaluated for its effects on apoptosis, cytotrophoblast differentiation, and gene expression. Apoptosis was assessed via caspase-3 and -8 activity, differentiation by human chorionic gonadotropin (hCG) secretion and ERVW-1 expression, and gene regulation by qPCR analysis of adenosine receptors, nucleoside transporters, and metabolizing enzymes.
Results
All nucleosides promoted proliferation in BeWo and JEG-3 cells, as indicated by increased metabolic activity, DNA synthesis, and total DNA content. For adenosine, MKI-67 expression analysis further confirmed its pro-proliferative effect. In placental explants, only adenosine significantly increased PCNA levels. Furthermore, adenosine did not affect caspase activity, hCG secretion, ERVW-1 expression, or the gene and protein expression of adenosine receptors, transporters, and metabolizing enzymes.
Conclusions
Nucleosides, particularly adenosine, promote trophoblast proliferation. Adenosine has no additional effects on differentiation, apoptosis, or transcriptional changes in genes regulating its signaling or metabolism. Given adenosine's diverse biological roles beyond proliferation, further research is warranted to explore its broader impact on placental function and adaptation, especially under pathological conditions.
{"title":"Adenosine promotes trophoblast proliferation without inducing differentiation or apoptosis","authors":"Mohammed N.H. Ali, Mariia Adler, Magdalena Novotna, Viktor Gala, Cilia Abad, Frantisek Staud, Lukas Cerveny","doi":"10.1016/j.placenta.2025.11.005","DOIUrl":"10.1016/j.placenta.2025.11.005","url":null,"abstract":"<div><h3>Objective</h3><div>Adenosine and other nucleosides are essential regulators of cellular processes, but their specific roles in trophoblast growth and regulation remain incompletely defined. This study investigated the effects of purine and pyrimidine nucleosides on trophoblast proliferation, and further examined whether adenosine influences apoptosis, differentiation, or the expression of its receptors, transporters, and metabolizing enzymes.</div></div><div><h3>Methods</h3><div>Nucleoside-induced proliferation was assessed by measuring metabolic activity, DNA synthesis, total DNA content, and <em>MKI-67</em> expression in BeWo and JEG-3 cell lines, and by PCNA protein levels in placental explants. Adenosine was further evaluated for its effects on apoptosis, cytotrophoblast differentiation, and gene expression. Apoptosis was assessed via caspase-3 and -8 activity, differentiation by human chorionic gonadotropin (hCG) secretion and <em>ERVW-1</em> expression, and gene regulation by qPCR analysis of adenosine receptors, nucleoside transporters, and metabolizing enzymes.</div></div><div><h3>Results</h3><div>All nucleosides promoted proliferation in BeWo and JEG-3 cells, as indicated by increased metabolic activity, DNA synthesis, and total DNA content. For adenosine, <em>MKI-67</em> expression analysis further confirmed its pro-proliferative effect. In placental explants, only adenosine significantly increased PCNA levels. Furthermore, adenosine did not affect caspase activity, hCG secretion, <em>ERVW-1</em> expression, or the gene and protein expression of adenosine receptors, transporters, and metabolizing enzymes.</div></div><div><h3>Conclusions</h3><div>Nucleosides, particularly adenosine, promote trophoblast proliferation. Adenosine has no additional effects on differentiation, apoptosis, or transcriptional changes in genes regulating its signaling or metabolism. Given adenosine's diverse biological roles beyond proliferation, further research is warranted to explore its broader impact on placental function and adaptation, especially under pathological conditions.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"172 ","pages":"Pages 150-158"},"PeriodicalIF":2.5,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145517132","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 : 2025-11-06DOI: 10.1016/j.placenta.2025.11.003
Raymi O. Ramirez , Jennifer J. Kim , Precious Ann Fortes , Carla Janzen , Peggy Sullivan , Sherin U. Devaskar , Kyunghyun Sung
Introduction
This study investigated whether placental structure and function, measured using multiparametric MRI (mpMRI) in early second trimester, are associated with birth weight percentiles. We focused on pregnancies without ischemic placental disease (IPD), excluding cases with preeclampsia, fetal growth restriction (FGR), small for gestational age (SGA), or placental abruption. Clinical and pathological moderators were also examined.
Methods
In this prospective single-center cohort, 199 participants were recruited between 2017 and 2019. Placental MRI was performed at two gestational age (GA) windows: 14–16 weeks (w) and 19–24w. Placental volume, perfusion, and oxygenation were quantified and standardized to 16w for the first imaging timepoint and 20w for the second imaging timepoint. After excluding IPD cases, linear mixed-effects models were used to explore retrospective associations between MRI metrics and birth weight percentiles, adjusting for clinical and histopathological variables.
Results
Early second trimester mpMRI showed significant associations between placental volume (positive association) and perfusion (negative association) as early as 16w GA to birthweight percentiles (p < 0.05). The nonlinear three-way interaction between the change of mpMRI parameters between 16w and 20w GA ( w GA) was consistently positively associated to birth weight percentiles regardless of clinical and pathological factors (p < 0.05).
Discussion
Early second trimester mpMRI markers (volume and perfusion) at 16w and 20w GA are associated with birth weight outcomes, suggesting utility in early pregnancy monitoring. The three-way interaction between the mpMRI markers may serve as a composite marker for identifying variation in fetal growth trajectories.
{"title":"Association between MRI-derived early second trimester placental physiology and birth weight percentiles in pregnancies without ischemic placenta disease (IPD)","authors":"Raymi O. Ramirez , Jennifer J. Kim , Precious Ann Fortes , Carla Janzen , Peggy Sullivan , Sherin U. Devaskar , Kyunghyun Sung","doi":"10.1016/j.placenta.2025.11.003","DOIUrl":"10.1016/j.placenta.2025.11.003","url":null,"abstract":"<div><h3>Introduction</h3><div>This study investigated whether placental structure and function, measured using multiparametric MRI (mpMRI) in early second trimester, are associated with birth weight percentiles. We focused on pregnancies without ischemic placental disease (IPD), excluding cases with preeclampsia, fetal growth restriction (FGR), small for gestational age (SGA), or placental abruption. Clinical and pathological moderators were also examined.</div></div><div><h3>Methods</h3><div>In this prospective single-center cohort, 199 participants were recruited between 2017 and 2019. Placental MRI was performed at two gestational age (GA) windows: 14–16 weeks (w) and 19–24w. Placental volume, perfusion, and oxygenation were quantified and standardized to 16w for the first imaging timepoint and 20w for the second imaging timepoint. After excluding IPD cases, linear mixed-effects models were used to explore retrospective associations between MRI metrics and birth weight percentiles, adjusting for clinical and histopathological variables.</div></div><div><h3>Results</h3><div>Early second trimester mpMRI showed significant associations between placental volume (positive association) and perfusion (negative association) as early as 16w GA to birthweight percentiles (p < 0.05). The nonlinear three-way interaction between the change of mpMRI parameters between 16w and 20w GA (<span><math><mrow><mo>Δ</mo></mrow></math></span> w GA) was consistently positively associated to birth weight percentiles regardless of clinical and pathological factors (p < 0.05).</div></div><div><h3>Discussion</h3><div>Early second trimester mpMRI markers (volume and perfusion) at 16w and 20w GA are associated with birth weight outcomes, suggesting utility in early pregnancy monitoring. The three-way interaction between the mpMRI markers may serve as a composite marker for identifying variation in fetal growth trajectories.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"172 ","pages":"Pages 120-130"},"PeriodicalIF":2.5,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145506472","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 : 2025-11-06DOI: 10.1016/j.placenta.2025.11.004
Kenean Getaneh Tlaye, So Pui Kin, Gashaw Garedew Woldeamanuel, Bo Wah Leung, Liona C Poon, Chi Chiu Wang
Introduction: The human placenta plays central role in preeclampsia (PE) pathogenesis and may modulate the effectiveness of prophylactic low-dose aspirin (LDA). In this study, we optimized and validated LC-MS/MS method to quantify the residual acetylsalicylic acid (ASA), salicylic acid (SA), and gentisic acid (GA) in the placenta of LDA exposed women.
Methods: Analytes were extracted from the placenta using acetonitrile with 0.1 % formic acid (v/v). Stable deuterated isotopes i.e., ASA-d4, SA-d4, and GA-d3 were used as an internal standard (IS) for ASA, SA, and GA respectively. The multiple reaction monitoring (MRM) mode with ion transitions of m/z 178.9 → 93.2, 182.9 → 97, 136.9 → 92.9, 140.9 → 96.9, 152.9 → 108.9, and 154.9 → 110.9 were used for ASA, ASA-d4, SA, SA-d4, GA, and GA-d3, respectively.
Results: The developed method was successfully applied to analyze ASA, SA, and GA residuals in the placenta of aspirin responder (R) and non-responder (NR) women who had been taking LDA for PE prevention. Slightly higher yet non-significant increment of ASA and SA was seen in R placenta. Following LDA, ASA and GA were found to be rarely detected and short-lived, while SA was the most abundant and retained in the placenta for an extended duration.
Conclusion: The method allows the determination of ASA, SA, and GA from human placenta. The difference in aspirin responsiveness among women at high risk for PE may be driven by other pharmacokinetic, pharmacodynamic, or pharmacogenomic variabilities, rather than by differences in the placental concentration of ASA.
{"title":"Determination of residue aspirin and its bioactive metabolites in human placenta: Application to high-risk to preeclampsia women received prophylactic low-dose aspirin.","authors":"Kenean Getaneh Tlaye, So Pui Kin, Gashaw Garedew Woldeamanuel, Bo Wah Leung, Liona C Poon, Chi Chiu Wang","doi":"10.1016/j.placenta.2025.11.004","DOIUrl":"https://doi.org/10.1016/j.placenta.2025.11.004","url":null,"abstract":"<p><strong>Introduction: </strong>The human placenta plays central role in preeclampsia (PE) pathogenesis and may modulate the effectiveness of prophylactic low-dose aspirin (LDA). In this study, we optimized and validated LC-MS/MS method to quantify the residual acetylsalicylic acid (ASA), salicylic acid (SA), and gentisic acid (GA) in the placenta of LDA exposed women.</p><p><strong>Methods: </strong>Analytes were extracted from the placenta using acetonitrile with 0.1 % formic acid (v/v). Stable deuterated isotopes i.e., ASA-d4, SA-d4, and GA-d3 were used as an internal standard (IS) for ASA, SA, and GA respectively. The multiple reaction monitoring (MRM) mode with ion transitions of m/z 178.9 → 93.2, 182.9 → 97, 136.9 → 92.9, 140.9 → 96.9, 152.9 → 108.9, and 154.9 → 110.9 were used for ASA, ASA-d4, SA, SA-d4, GA, and GA-d3, respectively.</p><p><strong>Results: </strong>The developed method was successfully applied to analyze ASA, SA, and GA residuals in the placenta of aspirin responder (R) and non-responder (NR) women who had been taking LDA for PE prevention. Slightly higher yet non-significant increment of ASA and SA was seen in R placenta. Following LDA, ASA and GA were found to be rarely detected and short-lived, while SA was the most abundant and retained in the placenta for an extended duration.</p><p><strong>Conclusion: </strong>The method allows the determination of ASA, SA, and GA from human placenta. The difference in aspirin responsiveness among women at high risk for PE may be driven by other pharmacokinetic, pharmacodynamic, or pharmacogenomic variabilities, rather than by differences in the placental concentration of ASA.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145506442","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 : 2025-11-04DOI: 10.1016/j.placenta.2025.11.002
Diana M. Betancourt , Mariángeles Noto Llana , Ailín N. Garófalo , Sebastián H. Sarnacki , M. Cristina Cerquetti , Nairobi Hernández Bridón , M. Carolina Pustovrh , Mónica N. Giacomodonato
Introduction
Salmonella Abortusequi is a host-restricted equine pathogen and a major cause of abortion in mares, threatening reproductive health and industry sustainability. This study was aimed to identify factors that adversely affect placental function, contributing to the development of fetal growth restriction (FGR) and neonatal mortality.
Methods
CF1 virgin female mice received a pregestational intragastric dose of Salmonella Abortusequi (108 CFU/mouse). On gestational day 18 (GD18), pregnant females were sacrificed, and maternal tissues and fetoplacental units were collected. In a separate group, pregnancy proceeded to term for neonatal outcome assessment.
Results
Salmonella Abortusequi infection impaired placental morphometry and efficiency, leading to FGR and increased neonatal mortality. Offspring from infected dams had persistently low body weight and 40.3 % mortality rate during the first postnatal week. Molecular detection of the invA gene confirmed bacterial presence in fetoplacental units at GD18 and prolonged persistence in maternal spleen and liver up to 90 days post-inoculation. Infection significantly reduced placental claudin-4 gene and protein expression, suggesting a disruption of placental barrier integrity.
Discussion
This study demonstrates that a pregestational infection with Salmonella Abortusequi can exert long-term consequences not only on placental development and fetal growth, but also on neonatal viability and early postnatal development. Importantly, these findings highlight the potential impact of subclinical maternal infections as contributors to reproductive failure and early-life morbidity.
{"title":"Placental dysfunction and neonatal mortality induced by Salmonella Abortusequi in a murine model of pregestational infection","authors":"Diana M. Betancourt , Mariángeles Noto Llana , Ailín N. Garófalo , Sebastián H. Sarnacki , M. Cristina Cerquetti , Nairobi Hernández Bridón , M. Carolina Pustovrh , Mónica N. Giacomodonato","doi":"10.1016/j.placenta.2025.11.002","DOIUrl":"10.1016/j.placenta.2025.11.002","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Salmonella</em> Abortusequi is a host-restricted equine pathogen and a major cause of abortion in mares, threatening reproductive health and industry sustainability. This study was aimed to identify factors that adversely affect placental function, contributing to the development of fetal growth restriction (FGR) and neonatal mortality.</div></div><div><h3>Methods</h3><div>CF1 virgin female mice received a pregestational intragastric dose of <em>Salmonella</em> Abortusequi (10<sup>8</sup> CFU/mouse). On gestational day 18 (GD18), pregnant females were sacrificed, and maternal tissues and fetoplacental units were collected. In a separate group, pregnancy proceeded to term for neonatal outcome assessment.</div></div><div><h3>Results</h3><div><em>Salmonella</em> Abortusequi infection impaired placental morphometry and efficiency, leading to FGR and increased neonatal mortality. Offspring from infected dams had persistently low body weight and 40.3 % mortality rate during the first postnatal week. Molecular detection of the <em>invA</em> gene confirmed bacterial presence in fetoplacental units at GD18 and prolonged persistence in maternal spleen and liver up to 90 days post-inoculation. Infection significantly reduced placental claudin-4 gene and protein expression, suggesting a disruption of placental barrier integrity.</div></div><div><h3>Discussion</h3><div>This study demonstrates that a pregestational infection with <em>Salmonella</em> Abortusequi can exert long-term consequences not only on placental development and fetal growth, but also on neonatal viability and early postnatal development. Importantly, these findings highlight the potential impact of subclinical maternal infections as contributors to reproductive failure and early-life morbidity.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"172 ","pages":"Pages 139-149"},"PeriodicalIF":2.5,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145517130","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}