Five students under the supervision of global experts in Women’s Health, HIV and Preeclampsia – a pregnancy-specific disorder – graduated with PhDs from UKZN’s Obstetrics and Gynaecology (O&G) Discipline and Optics and Imaging Centre (OIC).
Given the O&G Discipline’s mission to improve women’s health, collaboration with the OIC, a biomedical core research microscopy facility within the College of Health Sciences assisted in understanding the synergy of preeclampsia and HIV infection.
Drs Tashlen Abel, Sumeshree Govender, Merantha Moodley, Nitalia Naidoo and Shoohana Singh were supervised by O&G Emeritus Professor Jack Moodley and HIV and Maternal Health Expert, and OIC Head, Professor Thajasvarie (Anita) Naicker.
Abel evaluated the genetic polymorphisms within the vascular endothelial growth factor receptor 2 (VEGFR-2) gene in HIV-infected women diagnosed with preeclampsia. His study found that VEGFR-2 was decreased in preeclampsia and HIV-infected placentae, potentially contributing to both conditions. Highly topical during the time of his study, the research also reviewed and highlighted microRNA dysregulation in preeclampsia, HIV and COVID-19.
With preeclampsia and HIV infection being the main direct and indirect causes of maternal mortality and morbidity in South Africa, Govender’s study provided an extensive review of the expression of single nucleotide polymorphisms within the C1q gene and complement protein C1q plasma concentrations in the synergy of HIV infection comorbid with preeclampsia in women of African ancestry. The findings indicated dysregulation of the complement system, thus affecting the host’s innate defence by exacerbating placental and foetal injury. This study is in line with the United Nations’ Sustainable Development Goal to reduce maternal and perinatal deaths.
Moodley’s study focused on neutrophil extracellular traps (NETs) in the synergy of preeclampsia and HIV infection. It highlighted the role of NETs and neutrophil reverse migration from the placenta as potential early indicators of preeclampsia in HIV-infected women.
While the cause of preeclampsia is unclear, genes and infection may be involved. This led Naidoo to investigate gene polymorphisms and placental immunoexpression of neuropilin-1, a marker of angiogenesis and immune regulation, in HIV-infected preeclamptic African women. Variations in the neuropilin-1 gene showed a higher prevalence of preeclampsia and HIV-complicated preeclampsia, indicating genetic susceptibility. Placental neuropilin-1 immunoexpression was reduced in preeclampsia and HIV infection independently, with a further decrease in synergy.
Singh evaluated the renin angiotensin-aldosterone system on the placenta and placenta bed of preeclamptic, HIV-infected women of African ancestry. Her thesis and publications reported pivotal findings on the renin angiotensin aldosterone system in blood pressure regulation. The study demonstrated differential morphometric immunoexpression of angiotensin 1, 2 and 4 receptors within the placenta and placental bed based on pregnancy type, HIV status, and gestational age. Angiotensin 2 and 4 receptors were downregulated in contrast to angiotensin 1 in the synergy of preeclampsia and HIV infection, thereby affecting cell signalling and function. Singh’s findings are significant as they have the potential to identify an alternative and safer drug development route in the treatment of preeclampsia co-morbid with HIV.
Naicker and Moodley said that they are proud of the high calibre of the students’ studies that is evident in the number of papers they produced.
Words: Lunga Memela
Photographs: Sethu Dlamini
