Introdução: Poluição do ar está associada ao aumento da morbidade e mortalidade e essas associações persistem mesmo a baixas concentrações do poluente e a exposições agudas. Objetivos: Avaliar a associação entre componentes de três diferentes fontes do Particulado Total em Suspensão (PTS) e resposta aguda inflamatória, local e sistêmica, em ratos saudáveis. Métodos: PTS proveniente de fonte automativa, industrial e da queima da cana de açúcar foram coletados em filtros de fibra de vidro, extraídos em água destilada por ultrassonificação, e instilados na traquéia de 45 ratos (15 em cada grupo). Vinte microgramas por mililitro dos PTS foram administrados em cada animal. A mesma quantidade de partículas de grafite em água destilada foi utilizada como controle. Marcadores inflamatórios de resposta local e sistêmica foram mensurados 24 horas após a exposição. Resultados: PTS proveniente da fonte automotiva apresentou altas concentrações de enxofre, ferro, chumbo e cobre e produziram efeito adverso local e sistêmico, evidenciado pelo aumento do óxido nítrico exalado (6,22 ppm ± 3,8), do número de plaquetas (743,7 x 103/mm3 ± 73,4), e dos níveis do fibrinogênio (312,1 ± 42,7 mg/dL) e fator VIII (185,1 ± 37,2%), maiores dos que os observados no grupo controle (p < 0,05). O PTS proveniente da queima da cana de açúcar, com altas concentrações de ferro e cobre, e moderadas de enxofre produziram maior estresse oxidativo pulmonar e cardíaco em comparação ao grupo-controle e fonte automotiva (p < 0,05). O PTS gerado a partir da fonte industrial, com significativa concentração de ferro e cobre, e alta quantia de cálcio mostrou maior resposta oxidativa pulmonar e cardíaca em comparação ao grupo-controle, embora com discreta resposta inflamatória sistêmica (p > 0,05). Conclusão: Os resultados mostram que em doses baixas e agudamente, a exposição ao material particulado total em suspensão induz respostas inflamatórias locais e sistêmicas e pode alterar os componentes da hemostasia. Estas respostas foram influenciadas e moduladas pela composição elementar dos materiais analisados. Além disso, estes resultados subsidiam os achados epidemiológicos que associam exposição ao material particulado com morbidade e mortalidade cardiovasculares. / Background: Air pollution is associated with both increased morbidity and mortality. These associations persist even at lower concentrations and shortterm exposure. Objectives: To assess the impact of the components of three different sources of Total Suspended Particles (TSP) on local and systemic inflammatory responses in healthy rats. Methods: TSP from automotive, industrial and biomass burning sources were collected in specific glass-fiber filters, extracted in distilled water by ultrasound and instilled into the trachea of 45 rats (15 in each group). Twenty micrograms for mililiter of TSP were administered to each animal. The same amount of graphite particles (carbon black) in distilled water was used as control. Inflammatory markers of local and systemic responses were measured 24 hours after the exposure. Results: Automotive-generated TSP presented high percentages of sulfur, iron and copper, producing local and systemic adverse effects evidenced by increases in exhaled nitric oxide (6.22 ppm ± 3.8), platelets (743.7 x 103/mm3 ± 73.4), fibrinogen (312.1 ± 42.7 mg/dL) and factor VIII (185.1 ± 37.2 %) levels, which proved higher than those observed in the black carbon group (p < 0,05). Biomass burning TSP with high percentage of iron and copper and moderate levels of sulfur produced the greatest pulmonary and cardiac oxidative stresses compared to the black carbon and automotive groups (p < 0,05). Industry-generated TSP with relevant amounts of iron, copper, and high percentages of calcium showed higher pulmonary and cardiac oxidative responses than those observed for the control group, along with a slightly systemic response (p > 0,05). Conclusion: The results showed that the acute exposure to the total suspended particles at low concentrations induces local and systemic inflammatory responses and can change the hemostasis components. These effects were influenced and modulated by the elementary composition of the analyzed materials. Moreover, these results subsidize the epidemiologycal findings that associate exposure to the particulate matter with cardiovascular morbidity and mortality.

<p>Biochemical and epidemiological aspects of pre-eclampsia were investigated, with the main focus on possible pathophysiological differences between early-onset and late-onset disease.</p><p>In pre-eclamptic women poor correlation was found between albumin-creatinine ratio (ACR) in a random urine sample and total amount of albumin in a 24-hour urine collection. <i>(Paper I)</i><b> </b></p><p>In a cohort of women giving birth in Sweden in 1973-82 we estimated the adjusted incidence rate ratio (IRR) for ischaemic heart disease (IHD) during the years 1987–2001. The adjusted IRR for development of IHD was 1.6-2.8 in woman exposed to gestational hypertensive disease during her pregnancy compared with unexposed women. The higher risk represents more severe or recurrent hypertensive disease. <i>(Paper II)</i></p><p>Before delivery, in early-onset pre-eclampsia (24-32 weeks) there were pronounced alterations in plasma concentrations of soluble fms-like tyrosine kinase 1 (sFlt1) and placental growth factor (PlGF), and also a higher placental 8-iso-PGF_2α concentration and an elevated serum ratio of plasminogen-activator inhibitor (PAI)-1 to PAI-2 compared with early controls. In late-onset pre-eclampsia (35-42 weeks) there were only moderate alterations in sFlt1 and PlGF concentrations, and the placental 8-iso-PGF_2α concentration and PAI-1/ PAI-2 ratio were similar to those in late controls. <i>(Papers III, V)</i> There was a rapid postpartum decrease in sFlt1 concentration in all groups. One week postpartum the sFlt1 concentration was persistently higher, however, in women with early-onset pre-eclampsia compared with early controls. <i>(Paper IV)</i></p><p>In conclusion: random ACR cannot replace 24-hour urine collections for quantification of albuminuria in pre-eclamptic women; gestational hypertensive disease, especially severe or recurrent, increases the risk for later IHD; early-onset, but not late-onset pre-eclampsia is associated with pronounced alterations of angiogenesis-related markers and only early-onset pre-eclampsia is associated with placental oxidative stress and an increased PAI-1/ PAI-2 ratio, all suggesting a stronger link between early-onset than late-onset pre-eclampsia and a dysfunctional placenta.</p>

Biochemical and epidemiological aspects of pre-eclampsia were investigated, with the main focus on possible pathophysiological differences between early-onset and late-onset disease. In pre-eclamptic women poor correlation was found between albumin-creatinine ratio (ACR) in a random urine sample and total amount of albumin in a 24-hour urine collection. (Paper I)<b> </b> In a cohort of women giving birth in Sweden in 1973-82 we estimated the adjusted incidence rate ratio (IRR) for ischaemic heart disease (IHD) during the years 1987–2001. The adjusted IRR for development of IHD was 1.6-2.8 in woman exposed to gestational hypertensive disease during her pregnancy compared with unexposed women. The higher risk represents more severe or recurrent hypertensive disease. (Paper II) Before delivery, in early-onset pre-eclampsia (24-32 weeks) there were pronounced alterations in plasma concentrations of soluble fms-like tyrosine kinase 1 (sFlt1) and placental growth factor (PlGF), and also a higher placental 8-iso-PGF2α concentration and an elevated serum ratio of plasminogen-activator inhibitor (PAI)-1 to PAI-2 compared with early controls. In late-onset pre-eclampsia (35-42 weeks) there were only moderate alterations in sFlt1 and PlGF concentrations, and the placental 8-iso-PGF2α concentration and PAI-1/ PAI-2 ratio were similar to those in late controls. (Papers III, V) There was a rapid postpartum decrease in sFlt1 concentration in all groups. One week postpartum the sFlt1 concentration was persistently higher, however, in women with early-onset pre-eclampsia compared with early controls. (Paper IV) In conclusion: random ACR cannot replace 24-hour urine collections for quantification of albuminuria in pre-eclamptic women; gestational hypertensive disease, especially severe or recurrent, increases the risk for later IHD; early-onset, but not late-onset pre-eclampsia is associated with pronounced alterations of angiogenesis-related markers and only early-onset pre-eclampsia is associated with placental oxidative stress and an increased PAI-1/ PAI-2 ratio, all suggesting a stronger link between early-onset than late-onset pre-eclampsia and a dysfunctional placenta.

No description available.

Au cours de la grossesse, une perfusion placentaire adéquate est indispensable au bon développement du fœtus. Dans certaines maladies comme la prééclampsie, celle-ci est altérée, compromettant ainsi la vie du fœtus, mais aussi celle de sa mère. Le retrait du placenta mène à la disparition des symptômes de la prééclampsie, suggérant un rôle central de ce dernier dans la maladie. Le placenta étant dépourvu d’innervation autonome, le tonus vasculaire placentaire doit être sous le contrôle de facteurs humoraux et tissulaires. Les vaisseaux placentaires sont très réactifs aux prostanoïdes. Le rapport thromboxane A2 (TXA2)/prostacycline (PGI2) est fortement augmenté dans les placentas de grossesses avec prééclampsie. De plus, le taux d’isoprostane, marqueur du stress oxydatif, est accru dans les placentas de femmes avec prééclampsie. Finalement, la prééclampsie s’accompagne d’un stress oxydatif placentaire marqué. Les espèces réactives de l’oxygène sont connues d’une part, pour oxyder l’acide arachidonique (AA), formant ainsi des isoprostanes et d’autre part, pour augmenter la production de TXA2 dans différents tissus, suite à l’activation des cyclooxygénases (COXs). Nous proposons que : 1. les prostanoïdes sont parmi les molécules endogènes qui contrôlent le tonus vasculaire placentaire. 2. la maladie modifie la réponse aux isoprostanes dans les vaisseaux placentaires. 3. l’induction d’un stress oxydatif placentaire entraîne une réponse vasoactive par activation de la voie du métabolisme de l’AA. Nous avons tout d’abord montré, dans des placentas obtenus de grossesses normotensives, que l’U-46619, un mimétique de la TXA2, de même que l’isoprostane, 8-iso-prostaglandine E2 (8-isoPGE2), ont augmenté fortement la pression de perfusion dans les cotylédons perfusés in vitro et la tension dans les anneaux d’artères chorioniques suspendus dans des bains à organe isolé. En revanche, dans les artères chorioniques de placentas obtenus de grossesses avec prééclampsie, ces réponses étaient modifiées puisque la réponse maximale à l’U-46619 était augmentée et celle à la 8-isoPGE2 diminuée. D’autre part, nous avons montré que les réponses maximales aux deux prostanoïdes étaient augmentées dans les vaisseaux placentaires de grossesse normale ou avec prééclampsie issus d’une délivrance prématurée par rapport à ceux d’une délivrance à terme. Ceci suggère une évolution de la réactivité des artères placentaires au cours du 3e trimestre de grossesse. En outre, les vaisseaux placentaires ont répondu aux prostanoïdes de façon semblable qu’ils aient été issus d’un accouchement vaginal ou d’une césarienne élective. Ceci indique que les prostanoïdes placentaires n’interviennent pas dans le processus de délivrance. D’un autre côté, l’utilisation de bloqueurs spécifiques des récepteurs TP à la TXA2, le SQ29,548 et l’ICI192,605, et des récepteurs EP à la prostaglandine E2, l’AH6809, nous ont permis de mettre en évidence le fait que l’U-46619 et la 8-isoPGE2 pouvaient agir de façon non-sélective sur l’un ou l’autre des récepteurs. Ces résultats supportent donc nos 2 premières hypothèses : les prostanoïdes font partie des molécules endogènes qui peuvent contrôler le tonus vasculaire placentaire et la prééclampsie modifie la réponse aux isoprostanes dans les artères chorioniques d’une manière compatible avec l’augmentation de la production de ces substances qui elle, est probablement le résultat du stress oxydatif. En revanche, en ce qui concerne les substances capables de jouer la contrepartie vasodilatatrice, l’utilisation d’un inhibiteur des synthases de monoxyde d’azote, le L-NAME, et celle d’inhibiteurs des COXs, l’ibuprofène, l’indométacine et le N-2PIA, ne nous a pas permis de mettre en évidence un quelconque rôle du monoxyde d’azote ou des prostanoïdes vasodilatatrices à ce niveau. Finalement, nous avons montré que l’induction d’un stress oxydatif dans les cotylédons perfusés in vitro et les artères chorioniques entraînait une vasoconstriction marquée. Celle-ci semble résulter de l’action des prostanoïdes puisqu’un blocage des récepteurs TP ou des COXs diminuait significativement la réponse maximale au peroxyde d’hydrogène. Les prostanoïdes impliquées dans la réponse au stress oxydatif proviendraient essentiellement d’une activation des COXs puisque l’étude ne nous permet pas de conclure à une quelconque implication des isoprostanes dans cette réponse. Ces observations confirment donc notre hypothèse que, dans le placenta, le stress oxydatif possède des propriétés vasoactives par activation du métabolisme de l’AA. En résumé, les résultats obtenus dans les placentas de grossesses normotensives et avec prééclampsie suggèrent que les prostanoïdes sont des molécules d’importance dans la régulation du tonus vasculaire placentaire. Le fait que la prééclampsie modifie la réponse aux prostanoïdes pourrait expliquer pourquoi la perfusion placentaire est altérée chez ces patientes. En outre, il apparaît évident qu’il existe un lien étroit entre le stress oxydatif et la voie de synthèse des prostanoïdes placentaires. Cependant d’autres études sont nécessaires pour mieux comprendre la nature de ce lien, qui pourrait, d’une certaine façon, jouer un rôle important dans le développement de la prééclampsie. / Throughout pregnancy, appropriate placental perfusion is essential for the fœtus to grow properly. In disease such as preeclampsia, placental perfusion is impaired, compromising the fœtus and mother’s lives. Placenta delivery leads to a complete disappearance of the clinical symptoms of preeclampsia. This suggests that the placenta plays a central role in the disease. Placenta being devoid of autonomous innervation, placental vascular tone needs to be under the control of humoral and tissular factors; placental arteries are very reactive to prostanoids. The thromboxane A2 (TXA2)/prostacyclin (PGI2) ratio is increased in placenta from preeclamptic women. Furthermore, in placenta from preeclamptic pregnancies, isoprostane rate is increased, which is a marker of oxidative stress. Finally, preeclampsia is characterised by an important oxidative stress. Reactive oxygen species are known to form isoprostane through the oxidation of arachidonic acid (AA) and to increase TXA2 production in various tissues following an activation of the cyclooxygenases (COXs). We postulate that: 1. prostanoids are among the endogenous molecules that control placental vascular tone. 2. preeclampsia alters responses to isoprostanes in placental vessels. 3. induced placental oxidative stress leads to vasoactive responses through the activation of the AA metabolism. We first showed in placentas from normotensive pregnancies that the TXA2 mimetic U-46619 and the isoprostane 8-isoprostaglandin E2 (8-isoPGE2) markedly increased perfusion pressure in in vitro perfused cotyledons, as well as tension in isolated chorionic arteries. However, in placentas obtained from women with preeclampsia, those responses were altered in chorionic arteries. Indeed, maximal response to U-46619 was raised by preeclampsia, while the one to 8-isoPGE2 was decreased. We then showed that preterm delivery increased maximal responses to both prostanoids compared to term delivery. This observation suggests that placental arteries reactivity evolves along the 3rd trimester of pregnancy. Nevertheless, it appeared that delivery mode had no effect on vascular responses to prostanoids, suggesting that placental prostanoids are not involved in the delivery process. The use of specific blockers of the TXA2 TP receptors, SQ29,548 and ICI192,605, and of the prostaglandin E2 EP receptors, AH6809, revealed that U-46619 and 8-isoPGE2 could mediate their effects by acting on both receptors in a non-selective manner. Therefore, these results support our two first postulates: prostanoids could be the endogenous substances controlling the placental vascular tone and preeclampsia alters responses to isoprostanes in chorionic artery rings in a way compatible with the increased production of these substances possibly through the associated oxidative stress. Moreover, we were unable to identify any vasodilator substances capable of counteracting the effects of vasoconstrictors in the placental circulation. Indeed, blocker of nitric oxide synthases, L-NAME, as well as blockers of COXs, ibuprofen, indometacin and N-2PIA, did not reveal any effect of nitric oxide and vasodilator prostanoids at this level. Finally, we showed that induction of oxidative stress in in vitro perfused cotyledons and in isolated chorionic artery rings led to marked vasoconstriction. This would result from the action of prostanoids since a blockade of TP receptors or COXs significantly decreased maximal response to hydrogen peroxide. Prostanoids involved in this response would essentially come from COX activation. Indeed, the present results did not show any concrete involvement of isoprostane substances in the response to oxidative stress. Consequently, these observations confirm our hypothesis that, in the placenta, oxidative stress presents some vasoactive properties through the activation of the AA metabolism. In summary, results obtained in placentas from normotensive and preeclamptic pregnancies suggest that prostanoids are important in the regulation of the placental vascular tone. Furthermore, responses to prostanoids in chorionic arteries are altered by preeclampsia, which could explain why the placental perfusion is impaired in the disease. Moreover, it seems clear that there is a close relationship between oxidative stress and synthesis of placental prostanoids. However, more investigations are needed to better understand the nature of this relationship, which, in some way, could play an important role in the development of preeclampsia.

<p>Inflammation and oxidative stress may be involved in atherogenesis. This thesis describes clinical studies of prostaglandin F_2α (PGF_2α), an inflammatory mediator, and the isoprostane 8-iso-PGF_2α, a reliable indicator of oxidative stress, and cytokine-related inflammatory mediators and indicators in healthy subjects and in a population-based cohort of Swedish men. </p><p>PGF_2α and 8-iso-PGF_2α formation in healthy subjects varied considerably between days with a mean intra-individual coefficient of variation of 41 % and 42 %, respectively. A morning urine sample reflected the basal level of 8-iso-PGF_2α formation as accurately as a 24-hour urine collection, and represents a more practical alternative to the 24-hour urine collection in clinical studies. PGF_2α formation (as measured by urinary 15-keto-dihydro-PGF_2α) was increased in patients with type 2 diabetes and in smokers independent of other cardiovascular risk factors. These results indicated an on-going cyclooxygenase (COX)-mediated inflammatory reaction related to these conditions. Further, an increased formation of isoprostanes (as measured by urinary 8-iso-PGF_2α) was found in patients with type 2 diabetes and in smokers, indicating a high level of oxidative stress in these men. The smokers had also increased levels of the cytokine interleukin-6, indicating an on-going cytokine-related inflammatory reaction. The inflammatory indicators C-reactive protein and serum amyloid A were related to overweight but not independently associated to type 2 diabetes. High levels of serum selenium in middle-aged men predicted reduced formation of PGF_2α and 8-iso-PGF_2α 27 years later.</p><p>In summary, low-grade, chronic COX-mediated and possibly cytokine-related inflammation, and oxidative stress, seem to be joint features of type 2 diabetes and smoking, two major risk factors of atherosclerosis, in elderly men. Inflammation and oxidative stress may represent a possible common pathogenetic link between established risk factors for atherosclerosis and atherogenesis.</p>

<p>In the present thesis dietary markers for intake of milk fat, associations between intake of milk fat and risk factors for coronary heart disease (CHD), and the effects of supplementation with conjugated linoleic acid (CLA) to healthy humans are investigated.</p><p>The dietary fat quality is one of the main lifestyle factors affecting risk for CHD. When studying the associations between diet and health it is important to have accurate dietary information. Objective dietary markers increase the possibilities to interpret dietary surveys.</p><p>In a study of 62 men we demonstrated that the milk fatty acid pentadecanoic acid (15:0) measured in serum lipids can be used as marker for intake of fat from milk products. In the same study we observed inverse correlations between intake of milk fat and certain risk factors for CHD, especially anthropometric variables.</p><p>To further investigate these findings we supplemented humans with CLA, naturally present in milk. CLA has in animals and <i>in vitro</i> been ascribed positive effects on adiposity and glucose and lipid metabolism. When supplementing humans with CLA we observed a slight decrease in body fat, but no effects on other anthropometric variables or serum lipids. However, markers of lipid peroxidation and inflammation increased. From a second supplementation study we concluded that CLA <i>trans </i>10, <i>cis </i>12 induced lipid peroxidation more than did a mixture of isomers.</p><p>We conclude that the inverse associations between milk fat intake and CHD risk factors, and the effects of CLA, are interesting and need further investigation. However, according to current knowledge, the general population is still advised to have a limited intake of total and saturated fat and to instead choose unsaturated fats. In addition, there is to date no medical reasons for humans to take CLA as supplements.</p>

Inflammation and oxidative stress may be involved in atherogenesis. This thesis describes clinical studies of prostaglandin F2α (PGF2α), an inflammatory mediator, and the isoprostane 8-iso-PGF2α, a reliable indicator of oxidative stress, and cytokine-related inflammatory mediators and indicators in healthy subjects and in a population-based cohort of Swedish men. PGF2α and 8-iso-PGF2α formation in healthy subjects varied considerably between days with a mean intra-individual coefficient of variation of 41 % and 42 %, respectively. A morning urine sample reflected the basal level of 8-iso-PGF2α formation as accurately as a 24-hour urine collection, and represents a more practical alternative to the 24-hour urine collection in clinical studies. PGF2α formation (as measured by urinary 15-keto-dihydro-PGF2α) was increased in patients with type 2 diabetes and in smokers independent of other cardiovascular risk factors. These results indicated an on-going cyclooxygenase (COX)-mediated inflammatory reaction related to these conditions. Further, an increased formation of isoprostanes (as measured by urinary 8-iso-PGF2α) was found in patients with type 2 diabetes and in smokers, indicating a high level of oxidative stress in these men. The smokers had also increased levels of the cytokine interleukin-6, indicating an on-going cytokine-related inflammatory reaction. The inflammatory indicators C-reactive protein and serum amyloid A were related to overweight but not independently associated to type 2 diabetes. High levels of serum selenium in middle-aged men predicted reduced formation of PGF2α and 8-iso-PGF2α 27 years later. In summary, low-grade, chronic COX-mediated and possibly cytokine-related inflammation, and oxidative stress, seem to be joint features of type 2 diabetes and smoking, two major risk factors of atherosclerosis, in elderly men. Inflammation and oxidative stress may represent a possible common pathogenetic link between established risk factors for atherosclerosis and atherogenesis.

In the present thesis dietary markers for intake of milk fat, associations between intake of milk fat and risk factors for coronary heart disease (CHD), and the effects of supplementation with conjugated linoleic acid (CLA) to healthy humans are investigated. The dietary fat quality is one of the main lifestyle factors affecting risk for CHD. When studying the associations between diet and health it is important to have accurate dietary information. Objective dietary markers increase the possibilities to interpret dietary surveys. In a study of 62 men we demonstrated that the milk fatty acid pentadecanoic acid (15:0) measured in serum lipids can be used as marker for intake of fat from milk products. In the same study we observed inverse correlations between intake of milk fat and certain risk factors for CHD, especially anthropometric variables. To further investigate these findings we supplemented humans with CLA, naturally present in milk. CLA has in animals and in vitro been ascribed positive effects on adiposity and glucose and lipid metabolism. When supplementing humans with CLA we observed a slight decrease in body fat, but no effects on other anthropometric variables or serum lipids. However, markers of lipid peroxidation and inflammation increased. From a second supplementation study we concluded that CLA trans 10, cis 12 induced lipid peroxidation more than did a mixture of isomers. We conclude that the inverse associations between milk fat intake and CHD risk factors, and the effects of CLA, are interesting and need further investigation. However, according to current knowledge, the general population is still advised to have a limited intake of total and saturated fat and to instead choose unsaturated fats. In addition, there is to date no medical reasons for humans to take CLA as supplements.

Au cours de la grossesse, une perfusion placentaire adéquate est indispensable au bon développement du fœtus. Dans certaines maladies comme la prééclampsie, celle-ci est altérée, compromettant ainsi la vie du fœtus, mais aussi celle de sa mère. Le retrait du placenta mène à la disparition des symptômes de la prééclampsie, suggérant un rôle central de ce dernier dans la maladie. Le placenta étant dépourvu d’innervation autonome, le tonus vasculaire placentaire doit être sous le contrôle de facteurs humoraux et tissulaires. Les vaisseaux placentaires sont très réactifs aux prostanoïdes. Le rapport thromboxane A2 (TXA2)/prostacycline (PGI2) est fortement augmenté dans les placentas de grossesses avec prééclampsie. De plus, le taux d’isoprostane, marqueur du stress oxydatif, est accru dans les placentas de femmes avec prééclampsie. Finalement, la prééclampsie s’accompagne d’un stress oxydatif placentaire marqué. Les espèces réactives de l’oxygène sont connues d’une part, pour oxyder l’acide arachidonique (AA), formant ainsi des isoprostanes et d’autre part, pour augmenter la production de TXA2 dans différents tissus, suite à l’activation des cyclooxygénases (COXs). Nous proposons que : 1. les prostanoïdes sont parmi les molécules endogènes qui contrôlent le tonus vasculaire placentaire. 2. la maladie modifie la réponse aux isoprostanes dans les vaisseaux placentaires. 3. l’induction d’un stress oxydatif placentaire entraîne une réponse vasoactive par activation de la voie du métabolisme de l’AA. Nous avons tout d’abord montré, dans des placentas obtenus de grossesses normotensives, que l’U-46619, un mimétique de la TXA2, de même que l’isoprostane, 8-iso-prostaglandine E2 (8-isoPGE2), ont augmenté fortement la pression de perfusion dans les cotylédons perfusés in vitro et la tension dans les anneaux d’artères chorioniques suspendus dans des bains à organe isolé. En revanche, dans les artères chorioniques de placentas obtenus de grossesses avec prééclampsie, ces réponses étaient modifiées puisque la réponse maximale à l’U-46619 était augmentée et celle à la 8-isoPGE2 diminuée. D’autre part, nous avons montré que les réponses maximales aux deux prostanoïdes étaient augmentées dans les vaisseaux placentaires de grossesse normale ou avec prééclampsie issus d’une délivrance prématurée par rapport à ceux d’une délivrance à terme. Ceci suggère une évolution de la réactivité des artères placentaires au cours du 3e trimestre de grossesse. En outre, les vaisseaux placentaires ont répondu aux prostanoïdes de façon semblable qu’ils aient été issus d’un accouchement vaginal ou d’une césarienne élective. Ceci indique que les prostanoïdes placentaires n’interviennent pas dans le processus de délivrance. D’un autre côté, l’utilisation de bloqueurs spécifiques des récepteurs TP à la TXA2, le SQ29,548 et l’ICI192,605, et des récepteurs EP à la prostaglandine E2, l’AH6809, nous ont permis de mettre en évidence le fait que l’U-46619 et la 8-isoPGE2 pouvaient agir de façon non-sélective sur l’un ou l’autre des récepteurs. Ces résultats supportent donc nos 2 premières hypothèses : les prostanoïdes font partie des molécules endogènes qui peuvent contrôler le tonus vasculaire placentaire et la prééclampsie modifie la réponse aux isoprostanes dans les artères chorioniques d’une manière compatible avec l’augmentation de la production de ces substances qui elle, est probablement le résultat du stress oxydatif. En revanche, en ce qui concerne les substances capables de jouer la contrepartie vasodilatatrice, l’utilisation d’un inhibiteur des synthases de monoxyde d’azote, le L-NAME, et celle d’inhibiteurs des COXs, l’ibuprofène, l’indométacine et le N-2PIA, ne nous a pas permis de mettre en évidence un quelconque rôle du monoxyde d’azote ou des prostanoïdes vasodilatatrices à ce niveau. Finalement, nous avons montré que l’induction d’un stress oxydatif dans les cotylédons perfusés in vitro et les artères chorioniques entraînait une vasoconstriction marquée. Celle-ci semble résulter de l’action des prostanoïdes puisqu’un blocage des récepteurs TP ou des COXs diminuait significativement la réponse maximale au peroxyde d’hydrogène. Les prostanoïdes impliquées dans la réponse au stress oxydatif proviendraient essentiellement d’une activation des COXs puisque l’étude ne nous permet pas de conclure à une quelconque implication des isoprostanes dans cette réponse. Ces observations confirment donc notre hypothèse que, dans le placenta, le stress oxydatif possède des propriétés vasoactives par activation du métabolisme de l’AA. En résumé, les résultats obtenus dans les placentas de grossesses normotensives et avec prééclampsie suggèrent que les prostanoïdes sont des molécules d’importance dans la régulation du tonus vasculaire placentaire. Le fait que la prééclampsie modifie la réponse aux prostanoïdes pourrait expliquer pourquoi la perfusion placentaire est altérée chez ces patientes. En outre, il apparaît évident qu’il existe un lien étroit entre le stress oxydatif et la voie de synthèse des prostanoïdes placentaires. Cependant d’autres études sont nécessaires pour mieux comprendre la nature de ce lien, qui pourrait, d’une certaine façon, jouer un rôle important dans le développement de la prééclampsie. / Throughout pregnancy, appropriate placental perfusion is essential for the fœtus to grow properly. In disease such as preeclampsia, placental perfusion is impaired, compromising the fœtus and mother’s lives. Placenta delivery leads to a complete disappearance of the clinical symptoms of preeclampsia. This suggests that the placenta plays a central role in the disease. Placenta being devoid of autonomous innervation, placental vascular tone needs to be under the control of humoral and tissular factors; placental arteries are very reactive to prostanoids. The thromboxane A2 (TXA2)/prostacyclin (PGI2) ratio is increased in placenta from preeclamptic women. Furthermore, in placenta from preeclamptic pregnancies, isoprostane rate is increased, which is a marker of oxidative stress. Finally, preeclampsia is characterised by an important oxidative stress. Reactive oxygen species are known to form isoprostane through the oxidation of arachidonic acid (AA) and to increase TXA2 production in various tissues following an activation of the cyclooxygenases (COXs). We postulate that: 1. prostanoids are among the endogenous molecules that control placental vascular tone. 2. preeclampsia alters responses to isoprostanes in placental vessels. 3. induced placental oxidative stress leads to vasoactive responses through the activation of the AA metabolism. We first showed in placentas from normotensive pregnancies that the TXA2 mimetic U-46619 and the isoprostane 8-isoprostaglandin E2 (8-isoPGE2) markedly increased perfusion pressure in in vitro perfused cotyledons, as well as tension in isolated chorionic arteries. However, in placentas obtained from women with preeclampsia, those responses were altered in chorionic arteries. Indeed, maximal response to U-46619 was raised by preeclampsia, while the one to 8-isoPGE2 was decreased. We then showed that preterm delivery increased maximal responses to both prostanoids compared to term delivery. This observation suggests that placental arteries reactivity evolves along the 3rd trimester of pregnancy. Nevertheless, it appeared that delivery mode had no effect on vascular responses to prostanoids, suggesting that placental prostanoids are not involved in the delivery process. The use of specific blockers of the TXA2 TP receptors, SQ29,548 and ICI192,605, and of the prostaglandin E2 EP receptors, AH6809, revealed that U-46619 and 8-isoPGE2 could mediate their effects by acting on both receptors in a non-selective manner. Therefore, these results support our two first postulates: prostanoids could be the endogenous substances controlling the placental vascular tone and preeclampsia alters responses to isoprostanes in chorionic artery rings in a way compatible with the increased production of these substances possibly through the associated oxidative stress. Moreover, we were unable to identify any vasodilator substances capable of counteracting the effects of vasoconstrictors in the placental circulation. Indeed, blocker of nitric oxide synthases, L-NAME, as well as blockers of COXs, ibuprofen, indometacin and N-2PIA, did not reveal any effect of nitric oxide and vasodilator prostanoids at this level. Finally, we showed that induction of oxidative stress in in vitro perfused cotyledons and in isolated chorionic artery rings led to marked vasoconstriction. This would result from the action of prostanoids since a blockade of TP receptors or COXs significantly decreased maximal response to hydrogen peroxide. Prostanoids involved in this response would essentially come from COX activation. Indeed, the present results did not show any concrete involvement of isoprostane substances in the response to oxidative stress. Consequently, these observations confirm our hypothesis that, in the placenta, oxidative stress presents some vasoactive properties through the activation of the AA metabolism. In summary, results obtained in placentas from normotensive and preeclamptic pregnancies suggest that prostanoids are important in the regulation of the placental vascular tone. Furthermore, responses to prostanoids in chorionic arteries are altered by preeclampsia, which could explain why the placental perfusion is impaired in the disease. Moreover, it seems clear that there is a close relationship between oxidative stress and synthesis of placental prostanoids. However, more investigations are needed to better understand the nature of this relationship, which, in some way, could play an important role in the development of preeclampsia.