In addition, we have noted increased venous KV2.1, an important player in the HPV response, in FGR ; however, whether altered expression is a cause or effect of disease remains unclear. The lack of an obvious “K+ channelopathy” in FGR suggests the latter is the more likely, but this requires confirmation. Application of KATP channel activators, potent vasodilators
of chorionic plate ABT-263 order arteries and chorionic plate veins, in vessels obtained from pathological pregnancies will be of especial interest. In the pregnancy complication PE (late pregnancy hypertension and proteinuria), adenosine, a nucleoside suggested to modify vascular tone via modified KATP channel function and nitric oxide release, is increased in umbilical venous blood . This may represent a physiological response to maintain a high-flow/low-resistance fetoplacental circulation.
In placentas from pregnancies complicated by diabetes mellitus , KATP function is also impaired. Unfortunately, the application of KATP channel modulators to stimulate arterial/venous vasodilatation has not been documented selleck in PE, FGR, or diabetes mellitus. A more likely trigger leading to abnormal K+ channel activity in FGR is via production of ROS. ROS regulate K+ channel physiological function [48, 24], and increased ROS generation contributes to systemic cardiovascular pathology (e.g., coronary atherosclerosis) . Mills et al. noted acute/chronic ROS-induced modification of isolated fetoplacental vessel reactivity ; similar processes are therefore apparent in the placenta. It is well known that oxidative stress/ROS are increased in PE/FGR,  and therefore the activity of K+ channels present in
the placental vasculature could be altered by increased ROS; unfortunately this tenet has not been directly assessed. Future placental vascular function studies should focus on: (i) demonstrating whether K+ channels’ responses to applied ROS are altered in pathological samples and; (ii) assessing if exposure to pharmacological and/or dietary antioxidant treatments modifies K+ channel activity. Putative K+ channel modulators application to vessels from PE/FGR placentas would also be extremely informative. In summary, these findings highlight the Idoxuridine need for future studies of placental vascular K+ channels to include data from compromised pregnancies to confirm/negate the role of these channels as the primary pathogenic stimulus. Our knowledge of how human fetoplacental blood flow is controlled is rudimentary compared with our understanding of systemic and pulmonary vascular beds. Local factors such as tissue oxygenation are thought to play key roles. Indeed, HFPV has been suggested but not definitively demonstrated. Inconsistent findings in isolated vessel studies have failed to resolve this controversy. K+ channels are expressed in human fetoplacental vascular tissues.