The placenta integrates the maternal and fetal circulations, allowing for the efficient delivery of oxygen and nutrients which is required for normal fetal growth. This specialized prenatal organ creates a bridge from developing fetus to the maternal uterine wall through the umbilical cord. The placenta, which first starts to develop from cells of fetal origin, gradually invades the mother's uterus wall and consists of maternal and fetal tissue. Fetal tissue predominantly comprises of blood vessels embedded in the fetal stroma and chorionic villi formed by trophoblastic cells (Ventura Ferreira et al., 2018). The cyclic endometrium undergoes extensive tissue remodeling to prepare the embryo for implantation (Senapati et al., 2018). Following the embedding of the embryo in the uterus, major changes occur in the endometrium, the extracellular matrix disintegrating and remodeling. Trophoblast invasion, the proliferation of villous cytotrophoblasts, and remodeling of spiral arteries play a critical role in early placentation (Senapati et al., 2018; Ventura Ferreira et al., 2018). The interactions of uterine wall components, such as the extracellular matrix, that regulate cellular responses and provide the structural integrity of human tissue have an essential role in the regulation of these factors (Shi et al., 2020).
Collagen is known to be one of the most abundant components in the extracellular matrix (Cohen et al., 2006). The collagen family consists of 29 members, each with specific subgroups to form fibrils, networks, or beaded filaments. Collagen IV, which preserves tissue integrity, mediates cell adhesion and migration, and forms a three-dimensional scaffold for the cell, is abundantly expressed in the basement membranes (Ricard-Blum, 2011). It is well known that peptides produced from collagen have an anti-oxidative effect on cellular metabolism (Rozanova et al., 2012; Togashi et al., 2002).
Magnesium sulfate (MgSO4) has been used to prevent and treat placental diseases such as preeclampsia and intrauterine growth restriction, as well as used as a tocolytic drug to prevent premature delivery (Chiarello et al., 2018; Roman et al., 2013). It has recently attracted much interest because it suppresses oxidative stress (Agarwal et al., 2013). Furthermore, it has the potential to inhibit inflammatory responses (Roman et al., 2013). The current information shows that magnesium (Mg+ 2) has advantageous to both the mother and the fetus (Citu et al., 2022; Qu et al., 2022).
Changes in extracellular matrix elements, especially in the Collagen IV expression level, may have effects on cell proliferation and apoptosis. However, it is not known exactly what changes occur in the extracellular matrix at the level of collagen IV expression in patients using magnesium as a supplement. The current study aimed to determine whether Mg+ 2 may affect collagen IV levels regarding anti-oxidative stress and anti-inflammatory action.