Periostin promotes extensive neovascularization in placenta accreta spectrum disorders via Notch signaling

Abstract

Objective

Extensive neovascularization, closely linked to massive intraoperative blood loss, is a pathological hallmark of placenta accreta spectrum (PAS) cases. This study aims to explore proteins related to neovascularization and elucidate their regulatory roles in PAS, enhancing our understanding of this condition.

Methods

The isobaric tags for relative and absolute quantitation technique were used to identify and quantify the differentially expressed proteins in placentas from PAS and healthy pregnant women. Immunofluorescence staining and western blot analysis were conducted to determine the protein expression and localization. Gain-of-function experiments were used to conduct cell proliferation and migration assays. In addition, the tube formation assay was performed to evaluate angiogenesis in vitro. The Notch inhibitor DAPT was used to determine the involvement of Notch signaling in angiogenesis in PAS.

Results

Periostin (POSTN) exhibited higher expression in PAS placentas than in normal placentas. Moreover, the overexpression of POSTN in endothelial cells promoted cell proliferation, mobility, and endothelial angiogenesis via the Notch signaling pathway in vitro.

Conclusion

Elevated POSTN expression in PAS is associated with increased angiogenesis, indicating its potential as a molecular marker for significant intraoperative blood loss.

Keywords:

• PAS
• periostin
• placenta accrete
• proteomics
• angiogenesis

Author contributions

RL and MZ participated in the study design. XQ conducted the statistical analysis. RL, XQT, XQ, MH, and WW collected the data. RL drafted the manuscript. All authors approved the final version of the manuscript.

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of the Affiliated Hospital of North Sichuan Medical College (No: 2023ER070-1). All recruited patients were informed and signed the consent forms before the study was initiated.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This work was supported by a Special Project for Municipal and University Strategic Cooperation in Science and Technology of Nanchong (No: 20SXQT0069).