Valentina Pastén1, Cristian A Carvajal2,3,4, Alejandra Tapia-Castillo1,5,6, Carlos E Fardella1,5,6, Andrea Leiva7,8. 1. Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. 2. Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. ccarvajm@uc.cl. 3. Millennium Institute on Immunology and Immunotherapy (IMII-ICM), Santiago, Chile. ccarvajm@uc.cl. 4. Centro Traslacional de Endocrinología UC (CETREN), Santiago, Chile. ccarvajm@uc.cl. 5. Millennium Institute on Immunology and Immunotherapy (IMII-ICM), Santiago, Chile. 6. Centro Traslacional de Endocrinología UC (CETREN), Santiago, Chile. 7. Division of Obstetrics and Gynecology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. andrea.leiva@uss.cl. 8. School of Medical Technology, Health Sciences Faculty, Universidad San Sebastian, Santiago, Chile. andrea.leiva@uss.cl.
Abstract
BACKGROUND: During pregnancy, the renin-angiotensin-aldosterone system (RAAS) undergoes major changes to preserve normal blood pressure (BP) and placental blood flow and to ensure a good pregnancy outcome. Abnormal aldosterone-renin metabolism is a risk factor for arterial hypertension and cardiovascular risk, but its association with pathological conditions in pregnancy remains unknown. Moreover, potential biomarkers associated with these pathological conditions should be identified. AIM: To study a cohort of normotensive pregnant women according to their serum aldosterone and plasma renin levels and assay their small extracellular vesicles (sEVs) and a specific protein cargo (LCN2, AT1R). METHODS: A cohort of 54 normotensive pregnant women at term gestation was included. We determined the BP, serum aldosterone, and plasma renin concentrations. In a subgroup, we isolated their plasma sEVs and semiquantitated two EV proteins (AT1R and LCN2). RESULTS: We set a normal range of aldosterone and renin based on the interquartile range. We identified 5/54 (9%) pregnant women with elevated aldosterone and low renin levels and 5/54 (9%) other pregnant women with low aldosterone and elevated renin levels. No differences were found in sEV-LCN2 or sEV-AT1R. CONCLUSION: We found that 18% of normotensive pregnant women had either high aldosterone or high renin levels, suggesting a subclinical status similar to primary aldosteronism or hyperreninemia, respectively. Both could evolve to pathological conditions by affecting the maternal vascular and renal physiology and further the BP. sEVs and their specific cargo should be further studied to clarify their role as potential biomarkers of RAAS alterations in pregnant women.
BACKGROUND: During pregnancy, the renin-angiotensin-aldosterone system (RAAS) undergoes major changes to preserve normal blood pressure (BP) and placental blood flow and to ensure a good pregnancy outcome. Abnormal aldosterone-renin metabolism is a risk factor for arterial hypertension and cardiovascular risk, but its association with pathological conditions in pregnancy remains unknown. Moreover, potential biomarkers associated with these pathological conditions should be identified. AIM: To study a cohort of normotensive pregnant women according to their serum aldosterone and plasma renin levels and assay their small extracellular vesicles (sEVs) and a specific protein cargo (LCN2, AT1R). METHODS: A cohort of 54 normotensive pregnant women at term gestation was included. We determined the BP, serum aldosterone, and plasma renin concentrations. In a subgroup, we isolated their plasma sEVs and semiquantitated two EV proteins (AT1R and LCN2). RESULTS: We set a normal range of aldosterone and renin based on the interquartile range. We identified 5/54 (9%) pregnant women with elevated aldosterone and low renin levels and 5/54 (9%) other pregnant women with low aldosterone and elevated renin levels. No differences were found in sEV-LCN2 or sEV-AT1R. CONCLUSION: We found that 18% of normotensive pregnant women had either high aldosterone or high renin levels, suggesting a subclinical status similar to primary aldosteronism or hyperreninemia, respectively. Both could evolve to pathological conditions by affecting the maternal vascular and renal physiology and further the BP. sEVs and their specific cargo should be further studied to clarify their role as potential biomarkers of RAAS alterations in pregnant women.
Authors: Carine Gennari-Moser; Geneviève Escher; Simea Kramer; Bernhard Dick; Nicole Eisele; Marc Baumann; Luigi Raio; Felix J Frey; Daniel Surbek; Markus G Mohaupt Journal: Hypertension Date: 2013-12-02 Impact factor: 10.190
Authors: Matthew A Sparks; Steven D Crowley; Susan B Gurley; Maria Mirotsou; Thomas M Coffman Journal: Compr Physiol Date: 2014-07 Impact factor: 9.090