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Publication : Placental thromboinflammation impairs embryonic survival by reducing placental thrombomodulin expression.

First Author  Kohli S Year  2021
Journal  Blood Volume  137
Issue  7 Pages  977-982
PubMed ID  32870264 Mgi Jnum  J:303800
Mgi Id  MGI:6512310 Doi  10.1182/blood.2020005225
Citation  Kohli S, et al. (2021) Placental thromboinflammation impairs embryonic survival by reducing placental thrombomodulin expression. Blood 137(7):977-982
abstractText  Excess platelet activation by extracellular vesicles (EVs) results in trophoblast inflammasome activation, interleukin 1beta (IL-1beta) activation, preeclampsia (PE), and partial embryonic lethality. Embryonic thrombomodulin (TM) deficiency, which causes embryonic lethality hallmarked by impaired trophoblast proliferation, has been linked with maternal platelet activation. We hypothesized that placental TM loss, platelet activation, and embryonic lethality are mechanistically linked to trophoblast inflammasome activation. Here, we uncover unidirectional interaction of placental inflammasome activation and reduced placental TM expression: although inflammasome inhibition did not rescue TM-null embryos from lethality, the inflammasome-dependent cytokine IL-1beta reduced trophoblast TM expression and impaired pregnancy outcome. EVs, known to induce placental inflammasome activation, reduced trophoblast TM expression and proliferation. Trophoblast TM expression correlated negatively with IL-1beta expression and positively with platelet numbers and trophoblast proliferation in human PE placentae, implying translational relevance. Soluble TM treatment or placental TM restoration ameliorated the EV-induced PE-like phenotype in mice, preventing placental thromboinflammation and embryonic death. The lethality of TM-null embryos is not a consequence of placental NLRP3 inflammasome activation. Conversely, EV-induced placental inflammasome activation reduces placental TM expression, promoting placental and embryonic demise. These data identify a new function of placental TM in PE and suggest that soluble TM limits thromboinflammatory pregnancy complications.
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