Inflammation has long been implicated as a key mediator in the onset of parturition in both preterm and term births. Tissue renin-angiotensin systems (RASs) can regulate inflammation. The angiotensin converting enzyme 2 (ACE2)/Angiotensin-(1-7)/Mas receptor anti-inflammatory pathway, has been shown to inhibit the pro-inflammatory cytokines interleukin (IL)-6, IL-8 and tumour necrosis factor (TNF)-α levels and enhance the anti-inflammatory cytokine, IL-10, in pancreatic acinar cells. We aimed to investigate whether activation of the ACE2/Angiotensin-(1-7)/Mas receptor pathway protects against lipopolysaccharide (LPS) induced inflammatory cytokine expression in term fetal membranes.
Term non-labouring choriodecidual explants were treated with AVE0991 (100 µM, Mas receptor agonist) for 24h after which lipopolysaccharide (0.2μg/ml, O55:B5) was introduced for 6h. Tissue and culture medium was collected for analysis (n=12). Levels of IL-1β, IL-6, and IL-10 and TNF-α were measured via qPCR and ELISA.
Low dose LPS treatment of choriodecidual explants enhanced the expression of TNF-α, IL-6, IL-1β and IL-10 relative by 4-15-fold relative to vehicle control explants (all P<0.0001). Similarly, LPS induced a significant increase in the secretion of TNF-α and IL-6 from explants relative to vehicle control explants (P<0.0001 and P=0.001 respectively). Pre-treatment of choriodecidual explants with 100 µM AVE0991 was able to mitigate LPS induced mRNA expression of pro-inflammatory cytokines IL-6 and IL-1β compared with explants pre-treated with 0 µM AVE0991 (P=0.01 and 0.02 respectively). This effect however was not seen with pre-treatment with 10 µM AVE0991. Pre-treatment with both 10 and 100 µM AVE0991 was unable to mitigate the effects of LPS induced inflammation on the mRNA expression and protein secretion of TNF-α or IL-10 mRNA.
These data suggest that the ACE2/Ang-(1-7)/MasR pathway may play a role in regulating inflammation within the choriodecidua during pregnancy and thus pose as a novel therapeutic target to prevent inflammation induced preterm birth.