Chen B, Longtine MS, Nelson DM. Punicalagin, a polyphenol in pomegranate juice, downregulates p53 and attenuates hypoxia-induced apoptosis in cultured human placental syncytiotrophoblasts. Am J Physiol Endocrinol Metab 305: E1274 -E1280, 2013. First published October 1, 2013; doi:10.1152/ajpendo.00218.2013.-Oxidative stress is associated with placental dysfunction and suboptimal pregnancy outcomes. Therapeutic interventions to limit placental injury from oxidative stress are lacking. Punicalagin is an ellagitannin and a potent antioxidant in pomegranate juice. We showed that both pomegranate juice and punicalagin decrease oxidative stress and apoptosis in cultured syncytiotrophoblasts. p53 is involved in the oxidative stress-induced apoptosis in trophoblasts. We now test the hypothesis that punicalagin limits trophoblast injury in vitro by regulating the levels of p53. We examined the expression of p53, mouse double minute 2 homolog, p21, hypoxia-inducible factor (HIF) âŁ, and selected members of the B cell lymphoma 2 (BCL2) family of proteins in cultured syncytiotrophoblasts exposed to Ő
1% oxygen in the absence or presence of punicalagin. We found that punicalagin attenuated hypoxia-induced apoptosis in syncytiotrophoblasts, as quantified by levels of cleaved poly-ADP ribose polymerase. This protective effect was in part mediated by reduced p53 activity shown by decreased expression of p21, lower HIF1⣠expression, and limited activity of caspases 9 and 3. There was no change in expression of proteins in the BCL2 family, which are also important in apoptosis. The data support a role for downregulation of p53 in the protection of human trophoblasts by punicalagin. placenta; hypoxia-inducible factor âŁ; mouse double minute 2 homolog UP TO 600,000 PREGNANCIES annually in the United States are at risk for preeclampsia, intrauterine growth restriction (IUGR), or both maladies. Preeclampsia and IUGR often share a placental histopathology that includes improper remodeling of the maternal spiral arteries (7,8). The inferred physiological effect of this maladaptation is injury in the chorioallantoic placenta secondary to oxidative stress. Because progressive damage accumulates in villi, placental dysfunction evolves, yielding suboptimal outcomes for mother and fetus. Therapeutic interventions to ameliorate the risk for preeclampsia and IUGR have proven elusive, since low-dose aspirin (37), calcium supplementation (30), L-arginine ingestion (36), and vitamins C and E supplementation have little, if any, benefit (5,9,14,27,29,31,32,38). There is a pressing need to identify new approaches for prophylaxis of placental dysfunction that yield a high benefit-to-risk ratio to improve pregnancy outcomes in women susceptible to pregnancy disorders.Pomegranate, the fruit of Punica granatum, contains compounds that have not only antioxidant activity but also can affect expression of multiple genes (19, 23). Pomegranate juice contains high levels of polyphenols, including ellagitannins, gallotannins, and flavonoids. This juice improves...