Plasma aldosterone levels favor positive pregnancy outcomes: Study

UK: In a new study conducted by Mistry HD and team, it was seen that increased aldosterone levels promote anti-inflammatory and pro-angiogenic factors, which may contribute to a favorable pregnancy outcome. The findings of this study were published in Placenta.

Aldosterone has been associated with increased maternal plasma volume, enhanced fetal and placental growth/angiogenesis, and lower maternal blood pressure during pregnancy. Pre-eclampsia patients had low aldosterone levels. Given aldosterone's placental growth qualities during pregnancy, researchers hypothesized that higher aldosterone enhances ex vivo placental function. In the dual human placenta perfusion model, aldosterone was used to examine particular regulatory indicators.

For this study, a single cotyledon was perfused with a trimodal perfusion system that included a control phase (CP; BPM alone) and two successive experimental phases (EP1/EP2; BPM supplemented with 1.5 x 10-9M and 1.5 x 10-7M aldosterone, respectively). Closed circuits of CP and EP1/EP2 lasted 2 hours each. Quality/time control perfusions were done for 360 minutes using BPM alone to separate time-dependent effects from aldosterone-related effects. Control parameters (pH/pO2/pCO2/glucose/lactate/creatinine/antipyrine) were measured perfused. ELISAs were used to detect placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-) in maternal perfusates. The mRNA expression of the aforementioned components was evaluated in post-perfusion tissue using qPCR.

The key findings of this study were as follows:

1. TNF- and IL-10 release increased over time, according to data from quality/time control perfusions.

2. In the trimodal perfusion arrangement, however, aldosterone reduced TNF-secretion (P 0.05, EP1/EP2 vs CP, 120 min) and increased PlGF release (P 0.05, EP1 vs CP, 90/120 min) into the maternal perfusates.

3. mRNA expression followed similar patterns but did not achieve statistical significance.

In conclusion, this study clearly points out the pro-angiogenic and anti-inflammatory effects of aldosterone in pregnant women and its positive impact on the healthy growth of the fetus.

Reference:

Mistry, H. D., Klossner, R., Kallol, S., Lüthi, M. P., Moser, R., Schneider, H., Ontsouka, E. C., Kurlak, L. O., Mohaupt, M. G., & Albrecht, C. (2022). Effects of aldosterone on the human placenta: Insights from placental perfusion studies. Placenta, 123, 32-40. https://doi.org/10.1016/j.placenta.2022.03.129