Zeynep KUMRAL, Ece GÜMÜŞOĞLU ACAR, Kübra SEVGİN, Yağmur ERGÜN, Hale GÖKSEVER ÇELİK, Serçin KARAHÜSEYİNOĞLU, Ali BENIAN, Tuba GÜNEL
Cerrahpaşa Medical Journal - 2026;50(1):1-9
Objective: Preeclampsia (PE) is a hypertensive pregnancy disorder accompanied by proteinuria, maternal organ dysfunction, and abnormal placental angiogenesis. The expression differences of genes in decidua basalis and peripheral blood-derived mesenchymal stromal cells (MSCs) are effective in preeclampsia. It was aimed to investigate whether angiogenesis-related MSC transcripts previously implicated in placental vascular dysfunction exhibit differential expression in decidua-derived and peripheral blood-derived MSCs in preeclampsia. Methods: This study covers messenger RNA (mRNA) expression analysis of MSCs from decidua (hDMSCs) (n = 14) and peripheral blood (n = 14) (PBMSCs) obtained from a total of 28 samples containing placenta and peripheral blood samples of PE patients (n = 7, 37.6 +/- 1.53 weeks) and a healthy group (n = 7, 38 +/- 0.92 weeks). Vascular endothelial growth factor A (VEGFAA), metallopeptidase inhibitor 1 (TIMP1), ephrin A3 (EFNA3), and thrombospondin type-1 domain-containing protein 7A (THSD7A) were analyzed for gene expression levels using droplet digital polymerase chain reaction (ddPCR) due to its high sensitivity rate to detect small amounts of samples. Results: In hDMSC samples, expression levels of VEGFAA (fold change (FC) = 5.16), TIMP-1 (FC = 1.68), and EFNA3 (FC = 1.57) were downregulated, and THSD7A was upregulated (FC = 2.56) compared to the healthy group; however, they are not statistically significant. In PBMSC samples, VEGFAA (FC = 4.2), EFNA3 (FC = 1.39), and THSD7A (FC = 1.06) levels were upregulated, while TIMP-1 (FC = 2.4) was downregulated in preeclamptic samples. Vascular endothelial growth factor A was significantly (P < .05) increased (AUC = 0.95, P = .019) in PBMSC of preeclampsia patients. Conclusion: It was aimed to show the relation of MSC-related genes, angiogenesis, and preeclampsia. Vascular endothelial growth factor A elevation in PBMSCs suggests a potential systemic angiogenic response in preeclampsia, rather than concluding its primacy in fetoplacental development. Overall, the findings suggest that MSC-related angiogenic alterations may contribute to the pathophysiology of PE, supporting the need for larger studies to validate these preliminary observations.
