Abstract-Heme Oxygenase-1 (HO-1) and its metabolite carbon monoxide (CO) promote implantation and placentation.Pregnancy disorders such as preeclampsia and intrauterine growth restriction are linked to both HO-1 diminution and impaired remodeling of maternal spiral arteries (SAs). Here, we investigated whether CO is able to prevent preeclampsia and intrauterine growth restriction through the modulation of uterine natural killer (uNK) cells that are necessary for initiation of SA remodeling. Hmox1 +/− or Hmox1 −/− implantations presented fewer uNK cell numbers and lower expression of uNK-related angiogeneic factors compared with Hmox1 +/+ sites. Quantitative histology revealed that Hmox1 +/− and Hmox1 −/− implantations had shallow SA development that was accompanied by intrauterine growth restriction and gestational hypertension. Application of CO at low dose during early to midgestation prevented intrauterine growth restriction in Hmox1 +/− mothers, this being associated with enhanced in situ proliferation of uNK cells and normalization of angiogenic parameters. Most importantly, CO improved SA remodeling and normalized blood pressure, ensuring a proper fetal growth. Thus, CO emerges as a key molecular player in pregnancy success by modulating uNK cells, which results in promotion of SA remodeling, adequate fetal support/growth, and prevention of hypertension.
Linzke et al Targeting uNK Cells to Suppress Hypertension 581
Materials and Methods
AnimalsFor analysis of implantation sites, Hmox1-competent or Hmox1-deficient BALB/c mice were used. These mice were initially provided by Dr Saw Feng-Yet and bred and maintained in our facility. The progeny obtained from breeding Hmox1 +/− female animals and Hmox1 +/− male animals were genotyped and recorded. C57BL/6 male animals were obtained from Charles River (Sulzfeld, Germany). The mice were maintained in our husbandry with a 12-hour light/ dark cycle and with food and water ad libitum. All experiments were approved by German authorities (Saxony-Anhalt's Ministry 2 -868).Hmox1 For all experiments, the detection of a vaginal plug indicated day 0 of pregnancy. Animals were euthanized on days 8, 10, 12, or 18 of pregnancy. Whole implantation sites for paraffin embedding were kept in 4% paraformaldehyde with 0.1% saccharose for 6 hours. For RNA isolation, tissue of MLAp and DB was carefully washed with cold sterile PBS (pH 7.4), snap frozen, and stored at −80°C. Tissue of MLAp and DB was stored in RPMI 1640 with 10% FBS and 1% penicillin and streptomycin for flow cytometry.
CO InhalationFollowing our standard protocol, Hmox1 +/+ or Hmox1 +/− female animals were exposed to CO (50 ppm) day-long from day 3 to 8 of pregnancy. 5,6 Control animals inhaled the same air mixture without CO. The exposure of animals to mixed air or CO took place in cages placed in a 98-L Plexiglas animal chamber (A-Chamber; BioSpherix, NY). Duration of exposure and dosage was previously tested and established. Both time exposure and dose prevented fetal death without any toxic side effects.
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