Abstract
Preeclampsia affects one in twelve of the 130 million pregnancies a year. The lack of an effective therapeutic to prevent or treat it is responsible for an annual global cost burden of 100 billion US dollars. Preeclampsia also affects these women later in life as it is a recognised risk factor for cardiovascular disease, stroke and vascular dementia. Our laboratory demonstrated that preeclampsia is associated with high soluble fms-like tyrosine kinase 1 (sFlt-1) and low heme oxygenase-1 (HO1/Hmox1) expression. Here we sought to determine the therapeutic value of a novel H2S-releasing aspirin (MZe786) in HO-1 haploid deficient (Hmox1+/−) pregnant mice in a high sFlt-1 environment. Pregnant Hmox1+/− mice were injected with adenovirus encoding sFlt-1 or control virus at gestation day E11.5. Subsequently, Hmox1+/− dams were treated daily with a number of treatment regimens until E17.5, when maternal and fetal outcomes were assessed. Here we show that HO-1 compromised mice in a high sFlt-1 environment during pregnancy exhibit severe preeclampsia signs and a reduction in antioxidant genes. MZe786 ameliorates preeclampsia by reducing hypertension and renal damage possibly by stimulating antioxidant genes. MZe786 also improved fetal outcome in comparison with aspirin alone and appears to be a better therapeutic agent at preventing preeclampsia than aspirin alone.
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•Partial loss of heme oxygenase-1 under high soluble Flt-1 causes severe preeclampsia compared to high sFlt-1 alone.•MZe786, hydrogen sulfide releasing aspirin prevents preeclampsia by suppressing maternal hypertension and kidney injury.•MZe786 is able to rescue pregnancy and improves fetal outcome despite the persistent high levels of sFlt-1.•MZe786 is a superior therapeutic candidate than aspirin in preventing preeclampsia.