Influence of Estrogens on Uterine Vascular Adaptation in Normal and Preeclamptic Pregnancies

被引:32
|
作者
Mandala, Maurizio [1 ]
机构
[1] Univ Calabria, Dept Biol Ecol & Earth Sci, I-87036 Arcavacata Di Rende, Italy
关键词
pregnancy; preeclampsia; estrogens; estrogen-receptors; uterine vascular vasodilation; ENDOTHELIAL GROWTH-FACTOR; CA2+-ACTIVATED K+ CHANNEL; NITRIC-OXIDE SYNTHASE; ARTERY BLOOD-FLOW; HUMAN TROPHOBLAST DIFFERENTIATION; MATRIX METALLOPROTEINASE-2 AND-9; NATURAL-KILLER-CELLS; RECEPTOR-ALPHA; OVINE UTERINE; MYOGENIC TONE;
D O I
10.3390/ijms21072592
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
During pregnancy, the maternal cardiovascular system undergoes significant changes, including increased heart rate, cardiac output, plasma volume, and uteroplacental blood flow (UPBF) that are required for a successful pregnancy outcome. The increased UPBF is secondary to profound circumferential growth that extends from the downstream small spiral arteries to the upstream conduit main uterine artery. Although some of the mechanisms underlying uterine vascular remodeling are, in part, known, the factors that drive the remodeling are less clear. That higher circulating levels of estrogens are positively correlated with gestational uterine vascular remodeling suggests their involvement in this process. Estrogens binding to the estrogen receptors expressed in cytotrophoblast cells and in the uterine artery wall stimulate an outward hypertrophic remodeling of uterine vasculature. In preeclampsia, generally lower concentrations of estrogens limit the proper uterine remodeling, thereby reducing UPBF increases and restricting the growth of the fetus. This review aims to report estrogenic regulation of the maternal uterine circulatory adaptation in physiological and pathological pregnancy that favors vasodilation, and to consider the underlying molecular mechanisms by which estrogens regulate uteroplacental hemodynamics.
引用
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页数:18
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