Abstract
Preeclampsia, a hypertensive disorder of pregnancy, confers increased risk of future maternal cardiovascular disease. The mechanisms are largely unknown. Foam cell lesions (acute atherosis) of placenta-supplying decidua basalis spiral arteries, resembling early atherosclerotic lesions, are frequent in preeclampsia. The thesis aimed to study molecular features associated with atherosclerosis both in preeclampsia and in acute atherosis, in order to uncover potential shared mechanisms between these arterial diseases. Biosamples from pregnant women were collected prior to or at caesarean delivery. Decidua basalis tissue was stained with immunohistochemistry, maternal blood was analyzed by enzyme-linked immunosorbent assay, to study vascular and circulating biomarkers in preeclampsia and acute atherosis. Acute atherosis endothelium is damaged, but not activated, differing from atherosclerosis. Acute atherosis foam cells express similar proteins as those in atherosclerosis. Circulating protein misfolding markers are dysregulated (as in atherosclerosis) in women with preeclampsia delivered early preterm and in placental dysfunction, but not in acute atherosis. The thesis uncovered shared and differing local and systemic molecular biomarkers in preeclampsia, acute atherosis, and atherosclerosis.
List of papers
Paper I: Fosheim IK, Alnaes-Katjavivi P, Redman C, Roald B, Staff AC, Størvold GL. Acute atherosis of decidua basalis; characterization of spiral arteries, endothelial status and activation. Placenta. 2019 Jul;82:10-16. DOI: 10.1016/j.placenta.2019.04.006. The article is included in the thesis. Also available at https://doi.org/10.1016/j.placenta.2019.04.006 |
Paper II: Fosheim IK, Johnsen GM, Alnaes-Katjavivi P, Turowski G, Sugulle M, Staff AC. Decidua basalis and acute atherosis: expression of atherosclerotic foam cell associated proteins. Placenta. 2021 Apr;107:1-7.(Corrigendum is also included). DOI: 10.1016/j.placenta.2021.03.001.The article is included in the thesis. Also available at https://doi.org/10.1016/j.placenta.2021.03.001 |
Paper III: Fosheim IK, Jacobsen DP, Sugulle M, Alnaes-Katjavivi P, Fjeldstad HES, Ueland T, Lekva T, Staff AC. Serum amyloid A1 and pregnancy zone protein in pregnancy complications and correlation with markers of placental dysfunction. Manuscript. Published in Am J Obstet Gynecol MFM 2023;5:100794. DOI: 10.1016/j.ajogmf.2022.100794. The paper is included in the thesis. Also available at https://doi.org/10.1016/j.ajogmf.2022.100794 |