A Potential Role of Apelin-13 Against Hepatic Injury and Metabolic Disorders in Preeclampsia Induced by L-NAME
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coatings Article A Potential Role of Apelin-13 against Hepatic Injury and Metabolic Disorders in Preeclampsia Induced by L-NAME Reham Z. Hamza 1,* , Abdel Aziz A. Diab 2, Mansour H. Zahra 2, Mai S. Attia 2, Suzan M. M. Moursi 3 and Najah M. Al-Baqami 4 1 Biology Department, Faculty of Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia 2 Zoology Department, Faculty of Science, Zagazig University, Zagazig 44519, Egypt 3 Medical Physiology Department, Faculty of medicine, Zagazig University, Zagazig 44519, Egypt 4 Department of Biological Sciences, Zoology, King Abdulaziz University, Jeddah 21589, Saudi Arabia * Correspondence: [email protected] or [email protected] or [email protected] Abstract: Background: Hypertensive disorders of pregnancy, gestational hypertension, and preeclamp- sia (PE) are exceptionally challenging, as their pathologies and therapeutic management simulta- neously influence the mother and embryo, sometimes putting their well-beings at odds with each other. Dysregulated lipid and glucose metabolism may be related to some cases of preeclampsia. Fluctuations in serum apelin levels may be attributed to changes in the serum levels of multiple interrelated factors such as insulin, insulin resistance, inflammatory cytokines, and nephritic dam- age. Previous studies demonstrated that apelin is an endogenous active peptide with vasodilatory and antioxidative-stress capabilities. Objective: We investigated the relationships among hepatic, nephrotic, and metabolic injuries in different preeclampsia-like mouse models and the potential effect Citation: Hamza, R.Z.; Diab, A.A.A.; of exogenous apelin administration on hepatic and nephrotic injuries and metabolic disorders in Zahra, M.H.; Attia, M.S.; Moursi, an N-nitro-L-arginine methyl ester (L-NAME) preeclampsia-like Sprague Dawley (SD) rat model. S.M.M.; Al-Baqami, N.M. A Potential Materials and methods: Forty-three adult female and ten adult male SD rats were involved in this Role of Apelin-13 against Hepatic study. The male rats were used to induce pregnancy. The female rats were randomly divided into Injury and Metabolic Disorders in four equal groups: a non-pregnant group, a normal pregnant group, a group treated with L-NAME Preeclampsia Induced by L-NAME. to induce preeclampsia, and a group treated with L-NAME and apelin. In all the groups, maternal Coatings 2021, 11, 391. https:// blood was collected on the 21st day of gestation, and serum samples were used for the determina- doi.org/10.3390/coatings11040391 tion of systolic blood pressure; the serum uric acid, creatinine, nitric oxide (NO), xanthine oxidase, myeloperoxidase, insulin, glucose, cholesterol, triglyceride (TG), aspartate aminotransferase (AST) Academic Editors: Diana Anderson and alanine aspartate aminotransferase (ALT) levels; and the HOMA-insulin resistance (HOMA-IR). and El-Sayed Abd El-Aziz Results: In rats with pre-eclampsia, the systolic blood pressure; the concentrations of serum uric acid, Received: 6 March 2021 creatinine, nitric oxide (NO), xanthine oxidase, myeloperoxidase, blood glucose, serum cholesterol, Accepted: 26 March 2021 triglycerides, AST, and ALT; and the calculated HOMA-IR were significantly increased compared Published: 30 March 2021 to those in the rats in the other groups. Additionally, apelin treatment significantly improved these parameters in the apelin-treated group. Conclusion: This study examined the potential mechanisms Publisher’s Note: MDPI stays neutral whereby apelin may act as a curative candidate to reduce hepatic injury and inhibit kidney damage with regard to jurisdictional claims in and the development of metabolic disorders in an experimental model of preeclampsia. published maps and institutional affil- iations. Keywords: preeclampsia; apelin; kidney diseases; hepatic diseases and metabolism Copyright: © 2021 by the authors. 1. Introduction Licensee MDPI, Basel, Switzerland. Preeclampsia (PE) is a dangerous and potentially life-threatening disease for both the This article is an open access article mother and fetus, so it is very important to improve the standard diagnostic approach distributed under the terms and with complementary treatment to address this problem and develop future treatment conditions of the Creative Commons strategies [1]. Attribution (CC BY) license (https:// The cause of preeclampsia remains incompletely clarified due to the heterogeneous creativecommons.org/licenses/by/ nature of the disease [2]. This ailment is difficult for obstetricians, as there are no compelling 4.0/). Coatings 2021, 11, 391. https://doi.org/10.3390/coatings11040391 https://www.mdpi.com/journal/coatings Coatings 2021, 11, 391 2 of 12 ways to treat or prevent it, and the antenatal considerations include a troublesome harmony between the danger to the woman of continuing the pregnancy and the danger to the infant from preterm birth [3]. Despite the serious health, social, and economic costs of preeclampsia, no treatments are available to prevent, stabilize, or cure the disease. The only treatment is to end preg- nancy by delivery of the baby and placenta, which itself is related to dangers associated with premature birth [4]. Liver disorders of PE may be increased liver enzymes, low platelets (HELLP), acute fatty liver, hyperemesis gravidarum, intrahepatic cholestasis, and autoimmune liver [5]. In addition to control the mother’s metabolism, adipocytokines have been involved in pregnancy difficulties, including PE [6]. Apelin is a peptide hormone acting on Angiotensin II receptor-like - 1 (APJ) which is expressed in multiple tissues including the liver [7]. Apelin has been recognized as a novel adipocytokine, discharged in significant amounts by adipose tissue in a directed way. In this regard, apelin is upregulated by obesity and hyperinsulinemia in people and mice [8]. Apelin causes endothelium dependent vasorelaxation by setting off the release of NO, and it increases myocardial contractility [9,10]. In view of its angiogenic action, apelin discharged by adipocytes is likely to stimulate blood vessel growth, leading to increase growth of adipose tissue [8,11]. The hyperproduction of apelin observed in obesity has been proposed to be an adap- tive response that attempts to prevent the onset of obesity related disorders. Thus, research has focused on the potential link of apelin with obesity related insulin resistance [12,13]. APJ mRNA expression was identified in regions of the brain critical for the control of fluid homeostasis, so apelin may play a role in the regulation of water balance [7]. Sörhede Winzell et al. [14] reported that apelin inhibited insulin secretion in pancreatic islets in mice, suggesting a link with glucose homeostasis. A 14-day apelin treatment in mice was shown to regulate adiposity and to increase uncoupling protein expression [15], proposing a role of apelin in energy metabolism. Some studied documented also that apelin has anti-inflammatory effects by decreasing the mRNA level of IL- 6 and TNF- α [16]. It addi- tionally inhibits release of ROS in adipocytes and promotes an expression of antioxidative enzymes [17]. Notably, Zhou et al. [18] found that Fc-apelin greatly reduced macrophage infiltration and liver tissue injury by histology, which is in agreement with the observed reduction of serum ALT. Therefore, we designed this study to explore the possible effects of apelin-13 (a 13- amino-acid oligopeptide that is the ligand for the apelin receptor (also known as the APJ receptor) on renal functions in an L-NAME-induced rat model of preeclampsia and to identify the possible involved mechanisms. 2. Materials and Methods This study was carried out in the Faculty of Medicine, Zagazig University and in- volved 60 healthy adult albino rats (50 healthy females and 10 adult males for fertiliza- tion), which were obtained from the animal house of the Faculty of Veterinary Medicine, Zagazig University. Rats were kept in steel cages under hygienic conditions, fed a commer- cial diet with free access to water, and kept at room temperature on a 12 h light/dark cycle. The experimental methodology was conducted in accordance with the guidelines for the care and use of experimental animals and was reviewed and approved by the ZU-IACUC committee (approval number ZU-IACUC/1/F/78/2019). Induction of pregnancy: The estrous cycles of rats were investigated for 2 consecutive weeks. Unstained vaginal secretions were directly viewed every morning under a light microscope at 40× magnification, and the phases of the estrus cycle were detected by investigating the vaginal cytology. The estrus phase was determined by increasing the number of cornified or irregular-shaped epithelial cells in the vaginal smear. Rats in estrous stage were placed with a mature male rat in a separate cage. After mating, female rats were isolated to confirm copulation in the next morning by the presence of Coatings 2021, 11, 391 3 of 12 a copulation plug or sperms in the vaginal smear. The presence of sperms indicates the first day of gestation [19]. Seven rats from the forty did not get pregnant and have been excluded from the study. Forty three pregnant rats were randomly divided into four groups: Group 1 (normal non pregnant group; n = 10): Rats have been injected with saline solution (0.5 mL/kg body weight) subcutaneously daily. Group 2 (normal pregnant group; n = 10): Rats have been injected subcutaneously with saline as placebo from day 9 to 20 of gestation. Group 3 (PE-induced group; n = 12): Rats were injected subcutaneously with L-NAME (Sigma Aldrich Co.,