title: Angiotensin receptor agonistic autoantibodies induce pre-eclampsia in pregnant mice.
abstract: Pre-eclampsia affects approximately 5% of pregnancies and remains a leading cause of maternal and neonatal mortality and morbidity in the United States and the world. The clinical hallmarks of this maternal disorder include hypertension, proteinuria, endothelial dysfunction and placental defects. Advanced-stage clinical symptoms include cerebral hemorrhage, renal failure and the HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome. An effective treatment of pre-eclampsia is unavailable owing to the poor understanding of the pathogenesis of the disease. Numerous recent studies have shown that women with pre-eclampsia possess autoantibodies, termed AT(1)-AAs, that bind and activate the angiotensin II receptor type 1a (AT(1) receptor). We show here that key features of pre-eclampsia, including hypertension, proteinuria, glomerular endotheliosis (a classical renal lesion of pre-eclampsia), placental abnormalities and small fetus size appeared in pregnant mice after injection with either total IgG or affinity-purified AT(1)-AAs from women with pre-eclampsia. These features were prevented by co-injection with losartan, an AT(1) receptor antagonist, or by an antibody neutralizing seven-amino-acid epitope peptide. Thus, our studies indicate that pre-eclampsia may be a pregnancy-induced autoimmune disease in which key features of the disease result from autoantibody-induced angiotensin receptor activation. This hypothesis has obvious implications regarding pre-eclampsia screening, diagnosis and therapy.
authors.affiliation: Department of Biochemistry, University of Texas-Houston Medical School, 6431 Fannin, Houston, Texas 77030, USA.
authors.forename: Cissy C
authors.initials: CC
authors.lastname: Zhou
authors.forename: Yujin
authors.initials: Y
authors.lastname: Zhang
authors.forename: Roxanna A
authors.initials: RA
authors.lastname: Irani
authors.forename: Hong
authors.initials: H
authors.lastname: Zhang
authors.forename: Tiejuan
authors.initials: T
authors.lastname: Mi
authors.forename: Edwina J
authors.initials: EJ
authors.lastname: Popek
authors.forename: M John
authors.initials: MJ
authors.lastname: Hicks
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ramin
authors.forename: Rodney E
authors.initials: RE
authors.lastname: Kellems
authors.forename: Yang
authors.initials: Y
authors.lastname: Xia
mesh_terms: D000818:Animals; D001323:Autoantibodies / Q000737:chemistry*; D001327:Autoimmune Diseases / Q000378:metabolism; D000939:Epitopes / Q000737:chemistry; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000276:immunology; D007074:Immunoglobulin G / Q000737:chemistry; D007668:Kidney / Q000276:immunology; D051379:Mice; D011225:Pre-Eclampsia / Q000276:immunology* / Q000378:metabolism; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000276:immunology; D011507:Proteinuria / Q000150:complications / Q000276:immunology; D011945:Receptors, Angiotensin / Q000737:chemistry* / Q000378:metabolism
chemical_list: D001323:Autoantibodies; D000939:Epitopes; D007074:Immunoglobulin G; D011945:Receptors, Angiotensin