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dc.contributor.authorKaitu'u-Lino, TJ
dc.contributor.authorBrownfoot, FC
dc.contributor.authorBeard, S
dc.contributor.authorCannon, P
dc.contributor.authorHastie, R
dc.contributor.authorNguyen, TV
dc.contributor.authorBinder, NK
dc.contributor.authorTong, S
dc.contributor.authorHannan, NJ
dc.date.accessioned2020-12-18T03:33:05Z
dc.date.available2020-12-18T03:33:05Z
dc.date.issued2018-02-21
dc.identifierpii: PONE-D-17-20164
dc.identifier.citationKaitu'u-Lino, T. J., Brownfoot, F. C., Beard, S., Cannon, P., Hastie, R., Nguyen, T. V., Binder, N. K., Tong, S. & Hannan, N. J. (2018). Combining metformin and esomeprazole is additive in reducing sFlt-1 secretion and decreasing endothelial dysfunction - implications for treating preeclampsia. PLOS ONE, 13 (2), https://doi.org/10.1371/journal.pone.0188845.
dc.identifier.issn1932-6203
dc.identifier.urihttp://hdl.handle.net/11343/255816
dc.description.abstractINTRODUCTION: The discovery of new treatments that prevent or treat preeclampsia would be a major advance. Antiangiogenic factors soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sENG) are secreted in excess from the placenta, causing hypertension, endothelial dysfunction, and multiorgan injury. We recently identified metformin and esomeprazole as potential treatments for preeclampsia. Both reduce placental and endothelial secretion of sFlt-1 and soluble endoglin, and reduce endothelial dysfunction. OBJECTIVES: We set out to assess whether combining metformin and esomeprazole would additively reduce sFlt-1 and soluble endoglin secretion and reduce endothelial dysfunction (verses drug alone). Metformin and esomeprazole were added to primary placental cells and tissues, and endothelial cells and their effects on sFlt-1 and soluble endoglin secretion were assessed in vitro. Tumor necrosis factor-α (TNF-α) was added to endothelial cells to induce dysfunction in vitro. We examined the ability of metformin + esomeprazole to rescue TNF-α induced vascular cell adhesion molecule-1 (VCAM-1) and Endothelin-1 (ET-1) expression, leukocyte adhesion (markers of endothelial dysfunction). RESULTS: Combining metformin and esomeprazole was additive at reducing sFlt-1 secretion and expression of sFlt-1 e15a mRNA isoform in primary cytotrophoblast, placental explants and endothelial cells. In contrast, no additive reduction in sENG was observed with combined metformin and esomeprazole. The low-dose combination of metformin + esomeprazole additively reduced TNF-α-induced VCAM-1 mRNA, but not VCAM-1 protein expression. There was no additive reduction when combining metformin and esomeprazole on TNF-α induced PBMC adhesion to endothelial cells. However, combining metformin and esomeprazole additively reduced ET-1 mRNA expression. CONCLUSIONS: In conclusion combining metformin and esomeprazole additively reduced secretion of sFlt-1, and markers of endothelial dysfunction. The combination of metformin and esomeprazole may provide a more effective treatment or prevention for preeclampsia compared to either as single agents.
dc.languageEnglish
dc.publisherPUBLIC LIBRARY SCIENCE
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleCombining metformin and esomeprazole is additive in reducing sFlt-1 secretion and decreasing endothelial dysfunction - implications for treating preeclampsia
dc.typeJournal Article
dc.identifier.doi10.1371/journal.pone.0188845
melbourne.affiliation.departmentObstetrics and Gynaecology
melbourne.source.titlePLoS One
melbourne.source.volume13
melbourne.source.issue2
melbourne.identifier.nhmrc1062418
melbourne.identifier.nhmrc1050765
melbourne.identifier.nhmrc1101871
dc.rights.licenseCC BY
melbourne.elementsid1307026
melbourne.contributor.authorCannon, Ping
melbourne.contributor.authorLino, Tu'uhevaha
melbourne.contributor.authorBrownfoot, Fiona
melbourne.contributor.authorHannan, Natalie
melbourne.contributor.authorBeard, Sally
melbourne.contributor.authorHastie, Roxanne
melbourne.contributor.authorBinder, Natalie
melbourne.contributor.authorTong, Stephen
melbourne.contributor.authorNguyen, Tuong-Vi
dc.identifier.eissn1932-6203
melbourne.identifier.fundernameidNHMRC, 1062418
melbourne.identifier.fundernameidNHMRC, 1050765
melbourne.identifier.fundernameidNHMRC, 1101871
melbourne.accessrightsOpen Access


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