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(Hypertension. 2008;51:1066.)
© 2008 American Heart Association, Inc.

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Activation of Local Chorionic Villi Angiotensin II Levels But Not Angiotensin (1-7) in Preeclampsia

Lauren Anton; David C. Merrill; Liomar A.A. Neves; Kathryn Stovall; Patricia E. Gallagher; Debra I. Diz; Cheryl Moorefield; Courtney Gruver; Carlos M. Ferrario; K. Bridget Brosnihan

From the Hypertension and Vascular Research Center (L.A., L.A.A.N., K.S., P.E.G., D.I.D., C.M.F., K.B.B.) and Department of Obstetrics and Gynecology (D.C.M., C.M., C.G.), Wake Forest University School of Medicine, Winston-Salem, NC.

Correspondence to K. Bridget Brosnihan, Hypertension and Vascular Research Center, Wake Forest University School of Medicine, Medical Center Blvd, Winston Salem, NC 27157-1032. E-mail bbrosnih{at}wfubmc.edu

The chorionic villi in the placenta are responsible for the regulation of fetal oxygen and nutrient transport. Although the peripheral renin-angiotensin system is activated during normal pregnancy, the regulation of the local chorionic villi renin-angiotensin system remains unknown. Therefore, placental chorionic villous tissue was collected from nulliparous third-trimester normotensive or preeclamptic subjects and was analyzed for angiotensin peptide content, angiotensinogen, renin, angiotensin-converting enzyme (ACE), ACE2, neprilysin, angiotensin II type 1 (AT₁), angiotensin II type 2, Mas receptor mRNAs, and angiotensin receptor density and subtype. Angiotensin II in chorionic villi was significantly higher in preeclamptic subjects, whereas angiotensin (1-7) was not different. Angiotensinogen and AT₁ receptor gene expression was significantly higher in preeclamptic subjects. No differences were observed in renin, ACE, ACE2, or neprilysin gene expression. Mas receptor mRNA in preeclamptic subjects was decreased. The AT₁ receptor was the predominant receptor subtype in normal and preeclamptic chorionic villi. There was no difference in the density of the AT_1, angiotensin II type 2, and angiotensin (1-7) receptors. These results indicate that enhanced chorionic villous expression of angiotensin II may result from increased angiotensinogen. Elevated angiotensin II, acting through the AT₁ receptor, may favor vasoconstriction in placental chorionic villi and contribute to impaired fetal blood flow and decreased fetal nutrition observed during preeclampsia.

Key Words: preeclampsia • renin angiotensin system • pregnancy • placenta • angiotensin receptors • Mas receptor • angiotensin (1-7)