Placental extracellular vesicles from severe preeclamptic women alter calcium homeostasis in cardiomyocytes: An ex vivo study.

Abstract

Women with severe preeclampsia (sPE) exhibit a heightened risk of postpartum cardiovascular disease compared to those with normotensive pregnancies (NTP). While placental extracellular vesicles (EV) play a crucial role in feto-maternal communication, their impact on cardiomyocytes, particularly in the context of sPE, remains unclear. This study investigated the effect of sPE-associated placental EV (sPE-Plex EV) on cardiomyocyte calcium dynamics. We hypothesized that sPE-Plex EV mediates cardiomyocyte dysfunction by disrupting calcium signaling. EV were isolated from plasma and placental explant culture (Plex) using precipitation methods, and confirmed as Plex EV by PLAP activity and electron microscopy. Moreover, confocal microscopy confirmed the uptake of plasma EV in human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM) and Plex EV by human AC-16 cardiomyocytes (hAC-16CM) cells. hiPSC-CM cells treated with sPE-EV and hAC-16CM cells treated with sPE-Plex EV exhibited significantly lower levels of Stromal interaction molecule 1 (STIM1) and Phospholamban (PLN) proteins compared to those treated with normotensive controls EV, as confirmed by western blot analysis. Treatment with sPE-Plex EV also resulted in the downregulation of STIM1 and PLN proteins in murine cardiomyocyte (mCM) cells compared to treatment with NTP-Plex EV. Our findings suggest that both plasma EV and Plex EV from sPE may alter calcium signaling in cardiac cells by downregulating calcium sensor proteins (STIM1 and PLN). Therefore, plasma EV and Plex EV from sPE pregnancies have adverse effects by altering calcium dynamics in hiPSC-CM, hAC-16CM, and mCM compared to normotensive control and potential impairment of cardiomyocyte function ex vivo.