Recent in vitro studies have reported that heme oxygenase-1 (HO-1) downregulates the angiostatic protein sFlt-1 from placental villous explants and that the HO-1 metabolites CO and bilirubin negatively regulates endothelin-1 and reactive oxygen species (ROS). Although sFlt-1, ET-1, and ROS have been implicated in the pathophysiology of hypertension during preeclampsia and in response to placental ischemia in pregnant rats, it is unknown whether chronic induction of HO-1 alters the hypertensive response to placental ischemia. The present study examined the hypothesis that HO-1 induction in a rat model of placental ischemia would beneficially affect blood pressure, angiogenic balance, superoxide, and ET-1 production in the ischemic placenta. To achieve this goal we examined the effects of cobalt protoporphyrin (CoPP), an HO-1 inducer, in the reduced uterine perfusion pressure (RUPP) placental ischemia model and in normal pregnant rats. In response to RUPP treatment, MAP increases 29mmHg (136 ± 7 vs. 106 ± 5 mmHg) which is significantly attenuated by CoPP (118 ± 5 mmHg). While RUPP treatment causes placental sFlt-1/VEGF ratios to alter significantly to an angiostatic balance (1 ± 0.1 vs 1.27 ± 0.2,), treatment with CoPP causes a significant shift in the ratio to an angiogenic balance (0.68 ± 0.1). Placental superoxide increased in RUPP (952.5 ± 278.8 vs 243.9 ± 70.5 RLU/min/mg), but was significantly attenuated by HO-1 induction (482.7 ± 117.4 RLU/min/mg). Also, preproendothelin message was significantly increased in RUPP, which was prevented by CoPP. These data indicate that HO-1, or its metabolites, are potential therapeutics for the treatment of preeclampsia.
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