PROJECT SUMMARY
The hypoxia of high-altitude (HA, >2500 m) increases the frequency of fetal growth restriction (FGR) 3-fold.
Reduced uteroplacental perfusion is an important contributor to altitude-associated FGR and is determined, in
part, by reduced vasodilatory sensitivity of the myometrial (MyoA) and uterine arteries (UtA). It is therefore vital
to define mechanisms that defend uteroplacental blood flow and fetal growth under hypoxic conditions. Using a
metabolomic approach we have found maternal and fetal circulating nucleotide metabolites belonging to the
purinergic signaling pathway (i.e., adenosine, ADP, AMP, ATP, UDP, UDP-glucose) to differ between HA and
low altitude (400 m) in Bolivia, we also observed differences in nucleotide abundance when comparing FGR with
uncomplicated pregnancies. Furthermore, our preliminary functional data showed that adenosine vasodilates
MyoA and chorionic plate arteries (CPA), the latter are fetoplacental vessels important for the regulation of fetal
circulation. In addition, confirming the role of these nucleotides, purinergic receptor agonists known to act as
vasconstrictors evoked vasoconstriction in CPA. Thus, we
uteroplacental
response
to
nucleotides that elicit vasoconstriction at
hypothesize that t he residence blunts
vasodilatory responses to vasorelaxant nucleotide metabolites and enhances the vasoconstrictive
HA compared to LA.
hypoxia of HA
Aim 1 will establish the effect of HA
pregnancy on the maternal plasma metabolome by mass spectrometry, determine the effect of vasoactive
metabolites that differ between altitudes on MyoA vasoreactivity by myography and, using a targeted approach,
determine the relationship between the maternal metabolome and UtA blood flow. Aim 2 will determine the effect
of HA on the fetal circulation metabolome, the regulation of CPA vasoreactivity by vasoactive nucleotides, and
establish the relationship of such effects for fetal oxygenation and growth. In both aims, we will measure protein
expression in MyoA and CPA of key purinergic receptors, ectonucleotidases, and enzymes known to participate
in purinergic signaling. Our findings will provide the basis for our future research to identify molecular pathways
that integrate uteroplacental and fetoplacental perfusion and cellular metabolism during pregnancy to maintain
fetal growth.