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Throughout gestation, the blood vessel network of the placenta is formed sequentially by processes known as vasculogenesis and angiogenesis, which together meet the needs of the growing fetus. Normal placental angiogenesis is critical to support adequate fetal growth and assure the health of the offspring. Proper angiogenesis requires precise regulation of expression of agents that modulate this process; otherwise, pathologies of pregnancy such as preeclampsia may occur. The placenta is composed of different layers of tissue, including the lamellar (LZ), junctional, and glandular zones, each with a vascular morphology attuned to its function. We hypothesized that higher expression of pro-angiogenic factors is associated with increased morphological metrics in the LZ, the major vascularized zone. Thus, we aimed to characterize the major changes in morphology and vascular development in the placenta throughout pregnancy in cats, alongside a compressive analysis of the expression of major angiogenic factors and their receptors in the placenta, with an emphasis on the identification and interaction of different isoforms of the VEGF family. Microscopic analysis of tissue specimens from different stages of pregnancy revealed increased thickness of the LZ, especially during early to mid-gestation, at which time the tissue is composed of abundant materno-fetal interdigitations that appears rich in capillaries. VEGF proteins were detected in placental tissue in both fetal and maternal cells of the placenta, suggesting stimulatory interactions between different cell types to promote growth and angiogenesis. Gene expression analysis of placenta revealed upregulation of the pro-angiogenic factor VEGF-A in mid-pregnancy, followed by a steady decline toward term, consistent with morphologic changes in the LZ. In contrast, another pro-angiogenic factor, PlGF, showed a marked increase toward term; Flt-1, which acts as a receptor or reservoir for PLGF and VEGF A, was also upregulated at late pregnancy. Increased ratios of PLGF:VEGF-A may contribute to LZ proliferation in the last trimester. These findings are consistent with the creation of a proangiogenic placental state during gestation. Overall, we expect that this research will help elucidate mechanisms of placental vascularization, which can be applied to the design of improved strategies to treat vascular complications of pregnancy. Lastly, we applied the tools developed for placental studies to investigate pathologic angiogenesis in cutaneous squamous cell carcinoma (CSCC), a common skin cancer with major economic and medical impacts in humans and veterinary species. The creation of a new blood supply is essential for growth and metastasis of many tumor types. The goal of this study was to measure expression of variants of proteins that stimulate angiogenesis or transmit an angiogenic stimulus in feline CSCC. The results were mixed, with differences detected in expression of some regulatory agents and, for others, unexpectedly lower expression in CSSC compared to controls. Interestingly, the expression of VEGF-A relative to the protein that transmits its signal (KDR) was elevated in CSCC, suggestive of an altered signaling relationship. This finding supports our hypothesis and is consistent with human SCC studies. Our results encourage further studies on angiogenic factor variants in feline CSCC. / PHD

Due to the high metabolic demand and low capacity for energy storage of the brain, neurons are vitally reliant on a constant oxygen supply. Under chronic mild hypoxic conditions (10% oxygen), angiogenesis is induced in the brain in an attempt to restore tissue oxygen tension to normal levels. In brain hypoxia, vascular endothelial growth factor (VEGF) plays a critical role in angiogenesis; however, the role of its homolog placental growth factor (PlGF) is unknown. Using PlGF knockout (PlGF-/-) mice exposed to whole body hypoxia (10% oxygen) for 7, 14 and 21-days, we show that PlGF-/- animals exhibit a delay in the angiogenic response of the brain to hypoxia. PlGF-/- microvessels had a significant increase in fibrinogen accumulation and extravasation, which correlated with disruption of the tight-junction protein claudin-5. These vessels displayed large lumens, were surrounded by reactive astrocytes, lacked mural cell coverage and endothelial VEGF expression, and regressed after 21 days of hypoxia. The lack of PlGF, in combination with reduced VEGF expression levels observed in the brain of PlGF-/- animals during the first 5 days of hypoxia, is likely the cause of the delayed angiogenic response and the prothrombotic phenotype of these mice. In vitro studies conducted to analyze mechanisms involved in the impaired angiogenic phenotype and enhanced astrocytic reactivity to hypoxia of PlGF-/- animals indicated that: i) PlGF-/- mouse brain endothelial cells exhibit alterations in intracellular signaling pathways associated with sprouting (ERK1/2) and vessel branching morphogenesis (GSK-3β) and ii) PlGF-/- astrocytes overexpress VEGF receptor-2 (VEGFR-2) which through activation of the ERK1/2 signaling pathway leads to a more proliferative astrocytic phenotype. These astrocytes were more resistant to oxygen and glucose deprivation (OGD) than PlGF+/+ astrocytes, a characteristic that was shown to be independent of the classical antiapoptotic VEGFR-2-dependent PI3K/Akt pathway. The findings presented in this thesis demonstrated a critical role of PlGF in vascular remodeling in the hypoxic brain.

Due to the high metabolic demand and low capacity for energy storage of the brain, neurons are vitally reliant on a constant oxygen supply. Under chronic mild hypoxic conditions (10% oxygen), angiogenesis is induced in the brain in an attempt to restore tissue oxygen tension to normal levels. In brain hypoxia, vascular endothelial growth factor (VEGF) plays a critical role in angiogenesis; however, the role of its homolog placental growth factor (PlGF) is unknown. Using PlGF knockout (PlGF-/-) mice exposed to whole body hypoxia (10% oxygen) for 7, 14 and 21-days, we show that PlGF-/- animals exhibit a delay in the angiogenic response of the brain to hypoxia. PlGF-/- microvessels had a significant increase in fibrinogen accumulation and extravasation, which correlated with disruption of the tight-junction protein claudin-5. These vessels displayed large lumens, were surrounded by reactive astrocytes, lacked mural cell coverage and endothelial VEGF expression, and regressed after 21 days of hypoxia. The lack of PlGF, in combination with reduced VEGF expression levels observed in the brain of PlGF-/- animals during the first 5 days of hypoxia, is likely the cause of the delayed angiogenic response and the prothrombotic phenotype of these mice. In vitro studies conducted to analyze mechanisms involved in the impaired angiogenic phenotype and enhanced astrocytic reactivity to hypoxia of PlGF-/- animals indicated that: i) PlGF-/- mouse brain endothelial cells exhibit alterations in intracellular signaling pathways associated with sprouting (ERK1/2) and vessel branching morphogenesis (GSK-3β) and ii) PlGF-/- astrocytes overexpress VEGF receptor-2 (VEGFR-2) which through activation of the ERK1/2 signaling pathway leads to a more proliferative astrocytic phenotype. These astrocytes were more resistant to oxygen and glucose deprivation (OGD) than PlGF+/+ astrocytes, a characteristic that was shown to be independent of the classical antiapoptotic VEGFR-2-dependent PI3K/Akt pathway. The findings presented in this thesis demonstrated a critical role of PlGF in vascular remodeling in the hypoxic brain.

Due to the high metabolic demand and low capacity for energy storage of the brain, neurons are vitally reliant on a constant oxygen supply. Under chronic mild hypoxic conditions (10% oxygen), angiogenesis is induced in the brain in an attempt to restore tissue oxygen tension to normal levels. In brain hypoxia, vascular endothelial growth factor (VEGF) plays a critical role in angiogenesis; however, the role of its homolog placental growth factor (PlGF) is unknown. Using PlGF knockout (PlGF-/-) mice exposed to whole body hypoxia (10% oxygen) for 7, 14 and 21-days, we show that PlGF-/- animals exhibit a delay in the angiogenic response of the brain to hypoxia. PlGF-/- microvessels had a significant increase in fibrinogen accumulation and extravasation, which correlated with disruption of the tight-junction protein claudin-5. These vessels displayed large lumens, were surrounded by reactive astrocytes, lacked mural cell coverage and endothelial VEGF expression, and regressed after 21 days of hypoxia. The lack of PlGF, in combination with reduced VEGF expression levels observed in the brain of PlGF-/- animals during the first 5 days of hypoxia, is likely the cause of the delayed angiogenic response and the prothrombotic phenotype of these mice. In vitro studies conducted to analyze mechanisms involved in the impaired angiogenic phenotype and enhanced astrocytic reactivity to hypoxia of PlGF-/- animals indicated that: i) PlGF-/- mouse brain endothelial cells exhibit alterations in intracellular signaling pathways associated with sprouting (ERK1/2) and vessel branching morphogenesis (GSK-3β) and ii) PlGF-/- astrocytes overexpress VEGF receptor-2 (VEGFR-2) which through activation of the ERK1/2 signaling pathway leads to a more proliferative astrocytic phenotype. These astrocytes were more resistant to oxygen and glucose deprivation (OGD) than PlGF+/+ astrocytes, a characteristic that was shown to be independent of the classical antiapoptotic VEGFR-2-dependent PI3K/Akt pathway. The findings presented in this thesis demonstrated a critical role of PlGF in vascular remodeling in the hypoxic brain.

Due to the high metabolic demand and low capacity for energy storage of the brain, neurons are vitally reliant on a constant oxygen supply. Under chronic mild hypoxic conditions (10% oxygen), angiogenesis is induced in the brain in an attempt to restore tissue oxygen tension to normal levels. In brain hypoxia, vascular endothelial growth factor (VEGF) plays a critical role in angiogenesis; however, the role of its homolog placental growth factor (PlGF) is unknown. Using PlGF knockout (PlGF-/-) mice exposed to whole body hypoxia (10% oxygen) for 7, 14 and 21-days, we show that PlGF-/- animals exhibit a delay in the angiogenic response of the brain to hypoxia. PlGF-/- microvessels had a significant increase in fibrinogen accumulation and extravasation, which correlated with disruption of the tight-junction protein claudin-5. These vessels displayed large lumens, were surrounded by reactive astrocytes, lacked mural cell coverage and endothelial VEGF expression, and regressed after 21 days of hypoxia. The lack of PlGF, in combination with reduced VEGF expression levels observed in the brain of PlGF-/- animals during the first 5 days of hypoxia, is likely the cause of the delayed angiogenic response and the prothrombotic phenotype of these mice. In vitro studies conducted to analyze mechanisms involved in the impaired angiogenic phenotype and enhanced astrocytic reactivity to hypoxia of PlGF-/- animals indicated that: i) PlGF-/- mouse brain endothelial cells exhibit alterations in intracellular signaling pathways associated with sprouting (ERK1/2) and vessel branching morphogenesis (GSK-3β) and ii) PlGF-/- astrocytes overexpress VEGF receptor-2 (VEGFR-2) which through activation of the ERK1/2 signaling pathway leads to a more proliferative astrocytic phenotype. These astrocytes were more resistant to oxygen and glucose deprivation (OGD) than PlGF+/+ astrocytes, a characteristic that was shown to be independent of the classical antiapoptotic VEGFR-2-dependent PI3K/Akt pathway. The findings presented in this thesis demonstrated a critical role of PlGF in vascular remodeling in the hypoxic brain.

Kardiovaskulära sjukdomar är fortfarande en av de främsta dödsorsakerna i dag. Den främsta orsaken till sjukdomen är skador på hjärtcellerna, som kanske inte kan repareras av sig själva, så att utveckla en ny terapi för att regenerera eller reparera hjärtcellerna är ett viktigt mål inom forskningen om hjärtsjukdomar. Tidigare forskning har visat att vissa kardiogena parakrina faktorer som tillväxtfaktorer eller utsöndrade proteiner kan påverka hjärtats utveckling och regenerering. I den här studien valdes en av de parakrina faktorerna, placentaväxtfaktor (PLGF), ut för att verifiera dess inflytande på kardiomyogenes och vaskulogenes genom in vivo- och in vitro-experiment. Genom in vivo-experiment injicerades humana embryonala stamceller (hESC) som innehöll kemiskt modifierat PLGF mRNA i njurkapselskiktet hos musen, och en månad senare samlades njurarna in och färgades genom sektionering för att bestämma differentieringen av hESC. Genom in vitro-experiment inducerades hESC som avlägsnats PLGF-genen genom CRISPR-Cas9 till tre olika celler (kardiomyocyter, glatta muskelceller och endotelceller) enligt ett etablerat protokoll, och sedan analyserades cellerna med fluorescensaktiverad cellsortering (FACS) för att bestämma differentieringsnivån. Enligt experimenten krävs PLGF för induktion av kärlceller in vitro (endotelceller och glatta muskelceller) och skapandet av in vivo-kärl som genererats från hESCs, och det kan också påverka induktionen av kardiomyocyter i viss utsträckning, vilket krävde ytterligare forskning. Denna studie ger information om PLGF:s kritiska funktioner i kardiomyogenes och vaskulogenes, vilket kan bana väg för utvecklingen av nya terapier för regenerering av hjärtat. / Cardiovascular disease is still a leading cause of mortality nowadays. The main cause of the disease is the damage to heart cells, which may not be repaired by itself so developing a new therapy to regenerate or repair the heart cells is a major goal in cardiac disease research. Through previous research, some cardiogenic paracrine factors like growth factors or secreted proteins may influence heart development and regeneration. In this study, one of the paracrine factors, the placental growth factor (PLGF), was selected to verify its influence on cardiomyogenesis and vasculogenesis through in vivo and in vitro experiments. Through in vivo experiments, human embryonic stem cells(hESCs) containing PLGF mRNA which was modified chemically were injected into the mouse kidney capsule layer, and one month later the kidneys were collected and stained by sectioning to determine the differentiation of hESCs. Through in vitro experiments, hESC which were removed PLGF gene by CRISPR-Cas9 were induced into three different cells (cardiomyocyte, smooth muscle cell, and endothelial cell) followed an established protocol, and then the cells were analyzed by fluorescence-activated cell sorting (FACS) to determine the differentiation level. According to experiments, PLGF is required for the induction of in vitro vascular cells (endothelial cell and smooth muscle cell) and the creation of in vivo vasculature generated from hESCs, and it may also influence cardiomyocyte induction to some extent which needed further research. This study offers information on the critical functions of PLGF in cardiomyogenesis and vasculogenesis, potentially paving the way for the development of new heart regeneration therapies.

En este trabajo se evaluó la utilidad de una serie de marcadores: triglicéridos, ácido úrico, forma soluble de la tirosín kinasa 1 (sFlt-1), factor de crecimiento placentario (PlGF), múltiplo de la mediana de la proteína plasmática A asociada al embarazo (MoM PAPP-A), antígeno sérico CA125 (CA125), enzima convertidora de angiotensina (ECA) y el estudio ecográfico Doppler, como posibles predictores de preeclampsia en el primer y segundo trimestre de gestación. Se incluyeron un total de 68 gestantes con “riesgo a priori” de desarrollar preeclampsia (diabetes mellitus tipo I, enfermedad renal preexistente, hipertensión crónica sin proteinuria, etc) y un grupo control. De esas 68 gestantes, 8 desarrollaron preeclampsia. La combinación de marcadores más eficiente fue utilizando el PlGF del primer trimestre con un punto de corte ≤37,6 pg/ml, un índice de resistencia ≥0,7 y la ECA≥ 40,4 U/L del segundo trimestre, pudiendo predecir el 87,5% de las gestantes que desarrollarían preeclampsia. / This study evaluated the usefulness of several biomarkers: triglycerides, uric acid, soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), multiple of the median of pregnancy associated plasma protein-A (PAPP-A MoM), serum antigen CA125 (CA125), angiotensin converting enzyme (ACE) and the Doppler ultrasound as predictors of preeclampsia in the first and second trimester of pregnancy. We included a total of 68 pregnant women with "a priori risk" of develop preeclampsia (type I diabetes mellitus, preexisting renal disease, chronic hypertension without proteinuria, etc) and a control group. Of those 68 pregnant women, 8 developed preeclampsia. The most efficient combination of the studied biomarkers was the use of PlGF in the first-trimester with a cut-off ≤37.6 pg/ml, a resistance index ≥0.7 and ACE ≥40,4 U/L in the second trimester which can predict 87,5% of pregnant women who develop preeclampsia.

La placentation humaine est de type hémomonochoriale, le sang maternel est directement en contact avec le syncytiotrophoblaste. Les flux sanguins maternels, dans la chambre intervilleuse, exercent des forces mécaniques de cisaillement (shear stress) sur la surface microvillositaire du syncytiotrophoblaste. Les effets physiologiques du shear stress exercé par les flux sanguins sur l’endothélium vasculaire artériel et veineux ont fait l’objet de nombreux travaux scientifiques. En revanche, les effets biologiques du shear stress sur le syncytiotrophoblaste humain n’ont jamais été explorés. L’objectif de ce travail était premièrement d’évaluer les valeurs du shear stress exercé in vivo sur le syncytiotrophoblaste humain au cours des grossesses normales, puis de mettre au point un modèle de culture primaire dynamique afin de reproduire les conditions physiologique et d’étudier in vitro la réponse biologique du syncytiotrophoblaste au shear stress. En dépit d’un débit sanguin maternel intraplacentaire important, estimé entre 400 et 600 mL.min-1, le shear stress moyen exercée par le syncytiotrophoblaste est estimée entre 0.5±0.2 et 2.3±1.1 dyn.cm-2. Nos résultats montrent cependant que l’intensité du shear stress est très hétérogène tant à l’échelle de la chambre intervilleuse que de la villosité terminale. Nous avons développé un modèle de culture cellulaire dynamique en condition de flux adapté au syncytiotrophoblaste humain. Ce modèle permet d’appliquer un shear stress égal et constant sur toutes les cellules cultivées et reproductible à chaque culture primaire. Aux gammes de shear stress étudiées (1 dyn.cm-2), nous n’avons pas mis en évidence de diminution de la viabilité cellulaire ni de déclenchement des processus précoces d’apoptose en conditions dynamiques comparativement aux conditions statiques. Deux types de chambre de perfusion permettent d’étudier des réponses cellulaires au shear stress à court et long terme selon des temps d’exposition allant de 5 minutes à 24 heures. Ce modèle expérimental a permis de montrer que le syncytiotrophoblaste humain en culture primaire est mécanosensible. La réponse cellulaire à des niveaux de shear stress de 1 dyn.cm-2 est multiple selon les temps d’exposition et le niveau d’intégration étudié. Après 45 minutes de shear stress les taux d’AMP cyclique intracellulaires sont augmentés ce qui a pour effet d’activer la voie de signalisation intracellulaire PKA-CREB. Cette augmentation d’AMP cyclique est secondaire à la synthèse et la libération de prostaglandine E2 qui, par une boucle de régulation autocrine stimule l’adenylate cyclase. L’augmentation de la synthèse/libération de PGE2 est dépendante de l’augmentation rapide du calcium intracellulaire sous shear stress. L’exposition au shear stress de 24 heures stimule l’expression et la sécrétion du PlGF, un facteur de croissance indispensable à l’angiogenèse placentaire et pour l’adaptation maternelle à la grossesse sur le plan vasculaire. Nos travaux montrent que l’augmentation de l’AMPc intracellulaire et l’activation de la PKA contribuent à la phosphorylation de CREB, facteur de transcription régulant l’expression du PlGF. / Human placentation is hemomonochorial, maternal blood circulates in direct contact with the syncytiotrophoblast. In the intervillous space, the maternal blood exerts frictional mechanical forces (shear stress) on the microvillous surface of the syncytiotrophoblast. Flowing blood constantly exerts a shear stress, on the endothelial cells lining blood vessel walls, and the endothelial cells respond to shear stress by changing their morphology, function, and gene expression. The effects of shear stress on the human syncytiotrophoblast and its biological functions have never been studied. The objectives of this study were (1) to determine in silico the physiological values of shear stress exerted on human syncytiotrophoblast during normal pregnancies, (2) to develop a model reproducing in vitro the shear stress on human syncytiotrophoblast and (3) to study in vitro the biological response of human syncytiotrophoblast to shear stress. The 2D numerical simulations showed that the shear stress applied to the syncytiotrophoblast is highly heterogeneous in the intervillous space. In spite of high intraplacental maternal blood flow rates (400-600mL.min-1), the estimated average values of shear stress are relatively low (0.5±0.2 to 2.3±1.1 dyn.cm-2). To study the shear stress-induced cellular responses during exposure times ranging from 5 minutes to 24 hours we have developed two dynamic cell culture models adapted to the human syncytiotrophoblast. We found no evidence of decreased cell viability or early processes of apoptosis in dynamic conditions (1 dyn.cm-2, 24h) compared to static conditions. Shear stress (1 dyn.cm-2) triggers intracellular calcium flux, which increases the synthesis and release of PGE2. The enhanced intracellular cAMP in FSS conditions was blocked by COX1/COX2 inhibitors, suggesting that the increase in PGE2 production could activate the cAMP/PKA pathway in an autocrine/paracrine fashion. FSS activates the cAMP/PKA pathway leading to upregulation of PlGF in human STB. Shear stress-induced phosphorylation of CREB and upregulation of PlGF were prevented by inhibition of PKA with H89 (3 μM). The syncytiotrophoblast of the human placenta is a mechanosenstive tissue.

The aim of this thesis was to establish methods for selected PAPP-A (Pregnancy- Associated Plasma Protein A) gene polymorphisms analysis and to study genetic background of PAPP-A and biochemical background of PAPP-A and PlGF (Placental Growth Factor) in relation to risk pregnancy. Secondly, the aim was to establish method for two-dimensional (2D) electrophoresis of amniotic fluid. Methods for analysis of ten PAPP-A gene polymorphisms were established. These polymorphisms, PAPP-A and PlGF levels were studied in together 165 women in third trimester pregnancies complicated with threatening preterm labor (n=98), preeclampsia (n=35), IUGR (Intrauterine Growth Restriction) (n=34) and ICP (Intrahepatic Cholestasis of Pregnancy) (n=15). 114 healthy pregnant women served as controls. The method for 2D electrophoresis of amniotic fluid was established. Preeclamptic patients had significantly higher frequency of TT genotype of Cys327Cys (C/T) PAPP-A gene polymorphism compared to controls. Patients with ICP had increased serum levels of PAPP-A compared to controls, in patients with threatening preterm labor PAPP-A levels were rather decreased. PlGF levels did not differ from control group in patients with ICP and threatening preterm labor. Positive correlation was found between PAPP-A and PlGF in group of...