Recombinant human soluble thrombomodulin as an anticoagulation therapy improves recurrent miscarriage and fetal growth restriction due to placental insufficiency - The leading cause of preeclampsia

Placenta. 2018 May:65:1-6. doi: 10.1016/j.placenta.2018.03.006. Epub 2018 Mar 26.

Abstract

Introduction: Placental insufficiency is one of the major risk factors for growth restriction and preeclampsia. The aim of this study is to investigate whether recombinant human Thrombomodulin(r-TM) improves fetal conditions and physiological outcomes.

Methods: We used CBA/J × BALB/C mice as a control and CBA/J × DBA/2 mice - a well-studied model of recurrent spontaneous miscarriage. Pregnant mice received daily subcutaneous injections of r-TM or saline from day 0-15. The fetal resorption rate, fetal weight, and litter size were calculated at day 15. Additionally, we analyzed the mRNA expression of angiogenic factors and the concentration of soluble Flt-1 (sFlt-1) using the ELISA kit.

Results: The rate of fetal resorption in CBA/J × DBA/2 mice treated with r-TM was significantly lower compared with mice without r-TM treatment. Additionally, fetal weight and litter size were also significantly higher in the r-TM treated mice. Fibrinogen deposition in the labyrinth area of the CBA/J × DBA/2 mice treated with r-TM was significantly lower compared with deposits in the mice untreated with r-TM. As well, r-TM significantly increased the gene expression level of VEGF and Flt-1 mRNA in the placentas of the CBA/J × DBA/2 mice. r-TM treatment also significantly decreased the production of sFlt-1 protein in the placentas of preeclampsia-like diseased mice.

Conclusion: r-TM as an anticoagulation therapy has the potential for the medical treatment of recurrent miscarriage and fetal growth restriction due to improved angiogenic factors. Additionally, r-TM treatment has the potential for the recovery of preeclampsia.

Keywords: Angiogenic factor; Preeclampsia; Soluble Flt-1; Thrombomodulin; VEGF.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Habitual / etiology
  • Abortion, Habitual / pathology
  • Abortion, Habitual / physiopathology
  • Abortion, Habitual / prevention & control*
  • Animals
  • Anticoagulants / therapeutic use*
  • Female
  • Fetal Growth Retardation / pathology
  • Fetal Growth Retardation / prevention & control*
  • Humans
  • Male
  • Mice
  • Mice, Inbred BALB C
  • Mice, Inbred CBA
  • Mice, Inbred DBA
  • Placental Insufficiency / drug therapy*
  • Placental Insufficiency / pathology
  • Placental Insufficiency / physiopathology
  • Pre-Eclampsia / drug therapy*
  • Pre-Eclampsia / etiology
  • Pre-Eclampsia / pathology
  • Pregnancy
  • Recombinant Proteins / therapeutic use
  • Thrombomodulin / therapeutic use*

Substances

  • Anticoagulants
  • Recombinant Proteins
  • THBD protein, human
  • Thrombomodulin