title: Does high-density lipoprotein protect vascular function in healthy pregnancy?
abstract: The maternal adaptation to pregnancy includes hyperlipidaemia, oxidative stress and chronic inflammation. In non-pregnant individuals, these processes are usually associated with poor vascular function. However, maternal vascular function is enhanced in pregnancy. It is not understood how this is achieved in the face of the adverse metabolic and inflammatory environment. Research into cardiovascular disease demonstrates that plasma HDL (high-density lipoprotein), by merit of its functionality rather than its plasma concentration, exerts protective effects on the vascular endothelium. HDL has vasodilatory, antioxidant, anti-thrombotic and anti-inflammatory effects, and can protect against endothelial cell damage. In pregnancy, the plasma HDL concentration starts to rise at 10 weeks of gestation, peaking at 20 weeks. The initial rise in plasma HDL occurs around the time of the establishment of the feto-placental circulation, a time when the trophoblast plugs in the maternal spiral arteries are released, generating oxidative stress. Thus there is the intriguing possibility that new HDL of improved function is synthesized around the time of the establishment of the feto-placental circulation. In obese pregnancy and, to a greater extent, in pre-eclampsia, plasma HDL levels are significantly decreased and maternal vascular function is reduced. Wire myography studies have shown an association between the plasma content of apolipoprotein AI, the major protein constituent of HDL, and blood vessel relaxation. These observations lead us to hypothesize that HDL concentration, and function, increases in pregnancy in order to protect the maternal vascular endothelium and that in pre-eclampsia this fails to occur.
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, U.K.
authors.forename: Wan N Wan
authors.initials: WN
authors.lastname: Sulaiman
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, U.K.
authors.forename: Muriel J
authors.initials: MJ
authors.lastname: Caslake
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, U.K.
authors.forename: Christian
authors.initials: C
authors.lastname: Delles
authors.affiliation: Occupational and Environmental Medicine, Linkoping University Hospital, Region Ostergotland, Linkoping, SE-58185, Sweden.
authors.forename: Helen
authors.initials: H
authors.lastname: Karlsson
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, U.K. Internal Medicine, Erasmus Medical Center, Rotterdam, 3000 CA, Netherlands.
authors.forename: Monique T
authors.initials: MT
authors.lastname: Mulder
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, U.K.
authors.forename: Delyth
authors.initials: D
authors.lastname: Graham
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, U.K. Dilys.Freeman@glasgow.ac.uk.
authors.forename: Dilys J
authors.initials: DJ
authors.lastname: Freeman
mesh_terms: D000222:Adaptation, Physiological; D000818:Animals; D016632:Apolipoprotein A-I / Q000097:blood; D001808:Blood Vessels / Q000378:metabolism* / Q000503:physiopathology; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008075:Lipoproteins, HDL / Q000097:blood*; D008431:Maternal-Fetal Exchange; D018384:Oxidative Stress; D021041:Placental Circulation; D011225:Pre-Eclampsia / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control*; D014664:Vasodilation
chemical_list: C505693:APOA1 protein, human; D016632:Apolipoprotein A-I; D018836:Inflammation Mediators; D008075:Lipoproteins, HDL
keywords: apolipoprotein AI; cardiovascular disease; high-density lipoprotein (HDL); pre-eclampsia; pregnancy; vascular function