Placenta · 2026
Preeclampsia-associated changes in umbilical cord stromal VEGFR-2 and EV-mediated in vitro angiogenesis.
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Alptekin Ibrahim, Alptekin Bilge, Erkan Ezel, Celikkan Ferda Topal, Hendem Derya Uyan, Dastouri Mohammadreza, Akyol Mesut, Sahin Dilek, Can Alp
Аннотация
INTRODUCTION: Preeclampsia (PE) is associated with abnormal placental development, vascular dysfunction, and increased maternal-fetal morbidity. VEGFR-2 is a key mediator of angiogenesis; however, its expression in umbilical cord (UC) stromal compartments, particularly in early-onset (EOPE) and late-onset PE (LOPE), remains insufficiently characterized. We investigated VEGFR-2 expression in distinct UC stromal regions and assessed the angiogenic capacity of human UC-derived multipotent stromal cells (hUC-MSCs) and their extracellular vesicles (EVs).
METHODS: UC samples from 66 pregnant women were classified as control, EOPE, or LOPE. Cases with intrauterine growth restriction and maternal comorbidities were excluded to minimize potential confounding. Morphometric analysis, immunofluorescence, qRT-PCR, and in vitro HUVEC tube formation assays were performed.
RESULTS: PE cases showed significantly increased umbilical artery lumen area and artery lumen index compared with healthy term controls, with no significant differences between EOPE and LOPE. VEGFR-2 expression showed marked regional heterogeneity, with lower levels in the subepithelial stroma than in intervascular and perivascular regions. Although stromal VEGFR-2 protein levels did not differ significantly between PE and control tissues, median signals in the intervascular and perivascular regions were approximately 15-38% lower in PE groups, accompanied by reduced VEGFR-2 mRNA expression. PE-derived hUC-MSCs also exhibited decreased VEGFR-2 expression and reduced angiogenic capacity, while their EVs showed impaired in vitro HUVEC tube formation activity.
CONCLUSION: PE is associated with altered UC vascular morphology and impaired VEGFR-2-related angiogenic activity in hUC-MSCs and their EVs. These alterations appear largely independent of whether PE develops early or late in pregnancy.
METHODS: UC samples from 66 pregnant women were classified as control, EOPE, or LOPE. Cases with intrauterine growth restriction and maternal comorbidities were excluded to minimize potential confounding. Morphometric analysis, immunofluorescence, qRT-PCR, and in vitro HUVEC tube formation assays were performed.
RESULTS: PE cases showed significantly increased umbilical artery lumen area and artery lumen index compared with healthy term controls, with no significant differences between EOPE and LOPE. VEGFR-2 expression showed marked regional heterogeneity, with lower levels in the subepithelial stroma than in intervascular and perivascular regions. Although stromal VEGFR-2 protein levels did not differ significantly between PE and control tissues, median signals in the intervascular and perivascular regions were approximately 15-38% lower in PE groups, accompanied by reduced VEGFR-2 mRNA expression. PE-derived hUC-MSCs also exhibited decreased VEGFR-2 expression and reduced angiogenic capacity, while their EVs showed impaired in vitro HUVEC tube formation activity.
CONCLUSION: PE is associated with altered UC vascular morphology and impaired VEGFR-2-related angiogenic activity in hUC-MSCs and their EVs. These alterations appear largely independent of whether PE develops early or late in pregnancy.