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Boparai RS, Skow RJ, Farooq S, Steinback CD, Davenport MH. Prenatal exercise and cardiovascular health (PEACH) study: The remote effect of aerobic exercise training on conduit artery and resistance vessel function. Appl Physiol Nutr Metab 2021; 46:1459-1468. [PMID: 34161737 DOI: 10.1139/apnm-2020-0902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We assessed the impact of a structured lower-limb aerobic exercise training intervention during pregnancy on brachial artery endothelial function, shear rate and patterns, and forearm blood flow and reactive hyperemia. Twenty-seven pregnant women were recruited and randomized into either a control group (n=11; 31.0 ± 0.7 years), or an exercise intervention group (n=16; 32.6 ± 0.9 years; NCT02948439). The exercise group completed 40 minutes of aerobic exercise (50-70% heart rate reserve) 3-4 times per week, between the second and third trimester of pregnancy. Endothelial function was assessed using flow-mediated dilation (FMD, normalized for shear stress) pre- (16-20 weeks) and post-intervention (34-36 weeks). The exercise training group experienced an attenuated increase in mean arterial pressure (MAP) relative to the control group (∆MAP exercise: +2± 2 mmHg vs. control: +7±3 mmHg; p=0.044) from pre- to post-intervention. % FMD change corrected for shear stress was not different between groups (p=0.460); however, the post occlusion mean flow rate (exercise: 437±32 mL/min vs. control: 364±35 mL/min; p=0.001) and post occlusion anterograde flow rate (exercise: 438±32 mL/min vs. control: 364±46 mL/min;p=0.001) were larger for the exercise training group compared to controls, post-intervention. Although endothelial function was not different between groups, we observed an increase in microcirculatory dilatory capacity, as suggested by the augmented reactive hyperemia in the exercise training group. Novelty: • Endothelial function was not altered with exercise training during pregnancy. • Exercise training did contribute to improved cardiovascular outcomes, which may have been associated with augmented reactive hyperaemia, indicative of increased microcirculatory dilatory capacity.
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Affiliation(s)
- Rakhbeer Singh Boparai
- University of Alberta, Faculty of Kinesiology, Sport, and Recreation, Edmonton, Alberta, Canada;
| | - Rachel J Skow
- University of Alberta, Faculty of Physical Education and Recreation, 8602 112St NW, 1-052 Li Ka Shing Center, Edmonton, Alberta, Canada, T6G 2E3;
| | - Sauleha Farooq
- University of Alberta, Faculty of Kinesiology, Sport, and Recreation, Edmonton, Alberta, Canada;
| | - Craig D Steinback
- University of Alberta, Faculty of Physical Education and Recreation, -1059A Li Ka Shing Centre for Health Research Innovation, 8602-112 St., Edmonton, Alberta, Canada, T6G2E1;
| | - Margie H Davenport
- University of Alberta, Faculty of Kinesiology, Sport, and Recreation, Program for Pregnancy and Postpartum Health, 1-059A Li Ka Shing Center for Health Research Innovation, Edmonton, Alberta, Canada, T6G 2E1;
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Associations of Arginine with Gestational Diabetes Mellitus in a Follow-Up Study. Int J Mol Sci 2020; 21:ijms21217811. [PMID: 33105558 PMCID: PMC7659483 DOI: 10.3390/ijms21217811] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 12/16/2022] Open
Abstract
In the reported study we applied the targeted metabolomic profiling employing high pressure liquid chromatography coupled with triple quadrupole tandem mass spectrometry (HPLC–MS/MS) to understand the pathophysiology of gestational diabetes mellitus (GDM), early identification of women who are at risk of developing GDM, and the differences in recovery postpartum between these women and normoglycemic women. We profiled the peripheral blood from patients during the second trimester of pregnancy and three months, and one year postpartum. In the GDM group Arg, Gln, His, Met, Phe and Ser were downregulated with statistical significance in comparison to normoglycemic (NGT) women. From the analysis of the association of all amino acid profiles of GDM and NGT women, several statistical models predicting diabetic status were formulated and compared with the literature, with the arginine-based model as the most promising of the screened ones (area under the curve (AUC) = 0.749). Our research results have shed light on the critical role of arginine in the development of GDM and may help in precisely distinguishing between GDM and NGT and earlier detection of GDM but also in predicting women with the increased type 2 diabetes mellitus (T2DM) risk.
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Abstract
Supplemental arginine has shown promise as a safe therapeutic option to improve endogenous nitric oxide (NO) regulation in cardiovascular diseases associated with endothelial dysfunction. In clinical studies in adults, L-arginine, an endogenous amino acid, was reported to improve cardiovascular function in hypertension, pulmonary hypertension, preeclampsia, angina, and MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) syndrome. L-citrulline, a natural precursor of L-arginine, is more bioavailable than L-arginine because it avoids hepatic first-pass metabolism and has a longer circulation time. Although not yet well-studied, arginine/citrulline has immense therapeutic potential in some life-threatening diseases in children. However, the optimal clinical development of arginine or citrulline in children requires more information about pharmacokinetics and exposure-response relationships at appropriate ages and under relevant disease states. This article summarizes the preclinical and clinical studies of arginine/citrulline in both adults and children, including currently available pharmacokinetic information. The pharmacology of arginine/citrulline is confounded by several patient-specific factors such as variations in baseline arginine/citrulline due to developmental ages and disease states. Currently available pharmacokinetic studies are insufficient to inform the optimal design of clinical studies, especially in children. Successful bench-to-bedside clinical translation of arginine supplementation awaits information from well-designed pharmacokinetic/pharmacodynamic studies, along with pharmacometric approaches.
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Inhibition of Dimethylarginine Dimethylaminohydrolase 1 Improves the Outcome of Sepsis in Pregnant Mice. Shock 2019; 54:498-506. [DOI: 10.1097/shk.0000000000001490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Nascimento RA, Possomato-Vieira JS, Bonacio GF, Rizzi E, Dias-Junior CA. Reductions of Circulating Nitric Oxide are Followed by Hypertension during Pregnancy and Increased Activity of Matrix Metalloproteinases-2 and -9 in Rats. Cells 2019; 8:cells8111402. [PMID: 31703340 PMCID: PMC6912623 DOI: 10.3390/cells8111402] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 09/03/2019] [Indexed: 12/14/2022] Open
Abstract
Hypertensive pregnancy has been associated with reduced nitric oxide (NO), bioavailability, and increased activity of matrix metalloproteinases (MMPs). However, it is unclear if MMPs activation is regulated by NO during pregnancy. To this end, we examined activity of MMP-2 and MMP-9 in plasma, placenta, uterus and aorta, NO bioavailability, oxidative stress, systolic blood pressure (SBP), and fetal-placental development at the early, middle, and late pregnancy stages in normotensive and Nω-Nitro-L-arginine methyl-ester (L-NAME)-induced hypertensive pregnancy in rats. Reduced MMP-2 activity in uterus, placenta, and aorta and reduced MMP-9 activity in plasma and placenta with concomitant increased NO levels were found in normotensive pregnant rats. By contrast, increased MMP-2 activity in uterus, placenta, and aorta, and increased MMP-9 activity in plasma and placenta with concomitant reduced NO levels were observed in hypertensive pregnant rats. Also, elevated oxidative stress was displayed by hypertensive pregnant rats at the middle and late stages. These findings in the L-NAME-treated pregnant rats were also followed by increases in SBP and associated with fetal growth restrictions at the middle and late pregnancy stages. We concluded that NO bioavailability may regulate MMPs activation during normal and hypertensive pregnancy.
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Affiliation(s)
- Regina A. Nascimento
- Department of Pharmacology, Biosciences Institute of Botucatu, Sao Paulo State University – UNESP, Botucatu, Sao Paulo 18.618-689, Brazil; (R.A.N.); (J.S.P.-V.)
| | - Jose S. Possomato-Vieira
- Department of Pharmacology, Biosciences Institute of Botucatu, Sao Paulo State University – UNESP, Botucatu, Sao Paulo 18.618-689, Brazil; (R.A.N.); (J.S.P.-V.)
| | - Giselle F. Bonacio
- Unit of Biotechnology, University of Ribeirao Preto, UNAERP, Ribeirao Preto, Sao Paulo 14096-900, Brazil; (G.F.B.); (E.R.)
| | - Elen Rizzi
- Unit of Biotechnology, University of Ribeirao Preto, UNAERP, Ribeirao Preto, Sao Paulo 14096-900, Brazil; (G.F.B.); (E.R.)
| | - Carlos A. Dias-Junior
- Department of Pharmacology, Biosciences Institute of Botucatu, Sao Paulo State University – UNESP, Botucatu, Sao Paulo 18.618-689, Brazil; (R.A.N.); (J.S.P.-V.)
- Correspondence: ; Tel.: +55 14 3880-0214
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Lopes van Balen VA, van Gansewinkel TAG, de Haas S, Spaan JJ, Ghossein‐Doha C, van Kuijk SMJ, van Drongelen J, Cornelis T, Spaanderman MEA. Maternal kidney function during pregnancy: systematic review and meta-analysis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 54:297-307. [PMID: 30288811 PMCID: PMC6772153 DOI: 10.1002/uog.20137] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 05/29/2023]
Abstract
OBJECTIVES To review systematically current literature on kidney function changes during pregnancy, in order to estimate the extent of adaptation over the course of both healthy physiological and complicated singleton pregnancies, and to determine healthy pregnancy reference values. METHODS PubMed (NCBI) and EMBASE (Ovid) electronic databases were searched, from inception to July 2017, for studies on kidney function during uncomplicated and complicated pregnancies. Included studies were required to report a non-pregnant reference value of kidney function (either in a non-pregnant control group or as a prepregnancy or postpartum measurement) and a pregnancy measurement at a predetermined and reported gestational age. Kidney function measures assessed were glomerular filtration rate (GFR) measured by inulin clearance, GFR measured by creatinine clearance and serum creatinine level. Pooled mean differences between pregnancy measurements and reference values were calculated for predefined intervals of gestational age in uncomplicated and complicated pregnancies using a random-effects model described by DerSimonian and Laird. RESULTS Twenty-nine studies met the inclusion criteria and were included in the analysis. As early as the first trimester, GFR was increased by up to 40-50% in physiological pregnancy when compared with non-pregnant values. Inulin clearance in uncomplicated pregnancy was highest at 36-41 weeks, with a 55.6% (53.7; 95% CI, 44.7-62.6 mL/min) increase when compared with non-pregnant values, and creatinine clearance was highest at 15-21 weeks' gestation, with a 37.6% (36.6; 95% CI, 26.2-46.9 mL/min) increase. Decrease in serum creatinine level in uncomplicated pregnancy was most prominent at 15-21 weeks, with a 23.2% (-0.19; 95% CI, -0.23 to -0.15 mg/dL) decrease when compared with non-pregnant values. Eight studies reported on pregnancies complicated by a hypertensive disorder. Meta-regression analysis showed a significant difference in all kidney function parameters when comparing uncomplicated and hypertensive complicated pregnancies. CONCLUSIONS In healthy pregnancy, GFR is increased as early as the first trimester, as compared with non-pregnant values, and the kidneys continue to function at a higher rate throughout gestation. In contrast, kidney function is decreased in hypertensive pregnancy. © 2018 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- V. A. Lopes van Balen
- Department of Obstetrics and Gynaecology, GROW School for Oncology and Developmental BiologyMaastricht University Medical CentreMaastrichtThe Netherlands
| | - T. A. G. van Gansewinkel
- Department of Obstetrics and Gynaecology, GROW School for Oncology and Developmental BiologyMaastricht University Medical CentreMaastrichtThe Netherlands
| | - S. de Haas
- Department of Obstetrics and Gynaecology, GROW School for Oncology and Developmental BiologyMaastricht University Medical CentreMaastrichtThe Netherlands
| | - J. J. Spaan
- Department of Obstetrics and Gynaecology, GROW School for Oncology and Developmental BiologyMaastricht University Medical CentreMaastrichtThe Netherlands
| | - C. Ghossein‐Doha
- Department of Obstetrics and Gynaecology, GROW School for Oncology and Developmental BiologyMaastricht University Medical CentreMaastrichtThe Netherlands
| | - S. M. J. van Kuijk
- Department of Clinical Epidemiology and Medical Technology AssessmentMaastricht University Medical CentreMaastrichtThe Netherlands
| | - J. van Drongelen
- Department of Obstetrics and GynaecologyRadboud University Nijmegen Medical CentreNijmegenThe Netherlands
| | - T. Cornelis
- Department of NephrologyJessa HospitalHasseltBelgium
| | - M. E. A. Spaanderman
- Department of Obstetrics and Gynaecology, GROW School for Oncology and Developmental BiologyMaastricht University Medical CentreMaastrichtThe Netherlands
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Najjar N, McColl ER, Weckman A, Kain KC, Piquette-Miller M. Dysregulation of solute carrier transporters in malaria-infected pregnant mice. Parasite Immunol 2019; 41:e12614. [PMID: 30703256 DOI: 10.1111/pim.12614] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 12/18/2022]
Abstract
AIMS Malaria in pregnancy (MiP) alters the expression of ATP-binding cassette efflux transporters in maternal and foetal tissues, as well as the placenta. Malaria induces oxidative stress, and pregnancy is associated with arginine deficiency. We hypothesized that reducing oxidative stress during MiP by supplementation with L-arginine, a NO precursor, would attenuate transcriptional changes in a second superfamily of transporters, solute carrier (SLC) transporters, and improve pregnancy outcomes. METHODS AND RESULTS Pregnant BALB/c mice receiving L-arginine (1.2%) in water, or water alone, were infected with Plasmodium berghei ANKA on gestational day 13 and sacrificed on gestational day 19. Compared to controls, the mRNA of numerous SLC transporters was downregulated in maternal and foetal tissues, as well as in the placentas of infected mice. While supplementation with L-arginine did improve foetal viability, it did not improve the mRNA expression of oxidative stress markers, transporters nor other indices of foetal and maternal health. Moreover, amino acid uptake transporters were downregulated upon infection, which could potentially contribute to decreased foetal birthweight. CONCLUSIONS Malaria in pregnancy significantly alters the expression of SLC transporters in maternal and foetal tissues as well as the placenta, regardless of L-arginine supplementation. Further studies to investigate methods of reducing oxidative stress in MiP are warranted.
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Affiliation(s)
- Najwa Najjar
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Eliza R McColl
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Andrea Weckman
- Sandra Rotman Centre for Global Health, University Health Network: Toronto General Hospital, Toronto, Ontario, Canada
| | - Kevin C Kain
- Sandra Rotman Centre for Global Health, University Health Network: Toronto General Hospital, Toronto, Ontario, Canada
| | - Micheline Piquette-Miller
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
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Amniotic Fluid Arginine from Gestational Weeks 13 to 15 Is a Predictor of Birth Weight, Length, and Head Circumference. Nutrients 2017; 9:nu9121357. [PMID: 29240677 PMCID: PMC5748807 DOI: 10.3390/nu9121357] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 11/29/2017] [Accepted: 12/12/2017] [Indexed: 11/28/2022] Open
Abstract
Arginine is a constituent of proteins and a precursor for polyamines and nitric oxide, and is essential for placentation, angiogenesis, and growth. Maternal plasma arginine concentrations are found to be lower in pregnancies complicated by fetal growth restriction, and arginine supplementation in later pregnancy is reported to increase birth weight. We measured arginine and the metabolites asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) in the amniotic fluid obtained in pregnancy weeks 13 to 15 from 363 pregnancies with a documented normal outcome and related the concentrations to birth weight, length, and head circumference. Arginine was higher in the amniotic fluid from female (mean 40.8 (SD 10.6) µmol/L) compared to male fetuses (37.4 (SD 11.2) µmol/L, p = 0.003). Despite the gender difference, arginine in the amniotic fluid from gestational weeks 13–15 was the strongest predictor for birth weight, length, and head circumference. ADMA was a strong predictor for birth weight and length, SDMA for birth weight, while Arg/ADMA and Arg/SDMA only predicted head circumference in multiple linear regression models. Due to increased arginine demands, pregnancy is considered a state of relative arginine deficiency. Our findings reflect the importance of a good maternal arginine status in early pregnancy, an observation that should be evaluated in an intervention study.
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Kwiatkowski S, Dołegowska B, Kwiatkowska E, Rzepka R, Marczuk N, Loj B, Torbè A. Maternal endothelial damage as a disorder shared by early preeclampsia, late preeclampsia and intrauterine growth restriction. J Perinat Med 2017; 45:793-802. [PMID: 27865093 DOI: 10.1515/jpm-2016-0178] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 10/12/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Preeclampsia (PE) and intrauterine growth restriction (IUGR) are separate disease entities that have frequently been reported as sharing the same pathogenesis. In both of them, angiogenesis disorders and generalized endothelial damage with an accompanying inflammation are the dominant symptoms. In this study, we attempted to prove that both these processes demonstrate the same profile in early PE, late PE and IUGR patients, while the only difference is in the degree of exacerbation of the lesions. PATIENTS, MATERIALS AND METHODS In 167 patients divided into four groups, three of those with early PE, late PE and IUGR and one control group, fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), high sensitive c-reactive protein (hsCRP) and fibronectin were determined. The behavior of these parameters in each of the groups was studied, and correlations between them were sought for. RESULTS Higher concentrations of sFlt-1, hsCRP and fibronectin and a lower concentration of PlGF were found in the study groups compared to the control group. Significant correlations were observed between the factors concerned. CONCLUSIONS The higher values of disordered angiogenesis markers, endothelial damage markers and inflammatory markers both in the PE and the intrauterine growth restriction (IUGR) groups suggest the existence of shared disorders in the development of these pathologies. The correlations between disordered angiogenesis markers and endothelial damage markers argue in favor of a mutual relationship between these two processes in the development of pathologies evolving as secondary to placental ischemia. The results obtained confirm that the lesion profiles are the same in both PE and IUGR patients, which can be utilized in developing common diagnostic criteria.
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Šplíchal Z, Zlámal F, Máchal J, Lipková J, Pavlová T, Hodická Z, Ventruba P, Vašků A, Bienertová-Vašků J. Comparison of maternal omentin-1 levels and genetic variability between spontaneous term and preterm births. J Matern Fetal Neonatal Med 2017; 31:1689-1695. [PMID: 28440092 DOI: 10.1080/14767058.2017.1323530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To determine maternal omentin-1 levels and genetic variability in the omentin-1 gene in women with spontaneous term and preterm births (PTBs). MATERIALS AND METHODS Maternal serum omentin-1 levels and the role of the omentin-1 Val109Asp (rs2274907) polymorphism were evaluated in 32 women with spontaneous term birth (sTB) and 30 women with spontaneous preterm birth (sPTB) including women with (n = 16) and without (n = 14) preterm premature rupture of membranes (PPROM). RESULTS Maternal omentin-1 levels were significantly lower in women with sPTBs compared to term births during the hospitalization period (p = .015). However, maternal omentin-1 levels were similar in women with sPTBs with and without PPROM (p = .990). Furthermore, the omentin-1 Val109Asp polymorphism was found to have no significant effect on omentin-1 serum levels. In addition, no significant differences in genotype distributions and allelic frequencies between sTB and sPTB were established. CONCLUSIONS High omentin-1 levels in normal sTBs compared to PTBs without significant differences between cases with and without PPROM suggest that omentin-1 plays a potential role in the pathophysiology of PTB but not in the PPROM mechanism itself.
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Affiliation(s)
- Zbyněk Šplíchal
- a Department of Pathological Physiology, Faculty of Medicine , Masaryk University , Brno , Czech Republic
| | - Filip Zlámal
- a Department of Pathological Physiology, Faculty of Medicine , Masaryk University , Brno , Czech Republic.,b Research Centre for the Toxic Compounds in the Environment (RECETOX) , Brno , Czech Republic
| | - Jan Máchal
- a Department of Pathological Physiology, Faculty of Medicine , Masaryk University , Brno , Czech Republic
| | - Jolana Lipková
- a Department of Pathological Physiology, Faculty of Medicine , Masaryk University , Brno , Czech Republic
| | - Tereza Pavlová
- a Department of Pathological Physiology, Faculty of Medicine , Masaryk University , Brno , Czech Republic
| | - Zuzana Hodická
- c Department of Obstetrics and Gynaecology , University Hospital Brno , Brno , Czech Republic
| | - Pavel Ventruba
- c Department of Obstetrics and Gynaecology , University Hospital Brno , Brno , Czech Republic
| | - Anna Vašků
- a Department of Pathological Physiology, Faculty of Medicine , Masaryk University , Brno , Czech Republic
| | - Julie Bienertová-Vašků
- a Department of Pathological Physiology, Faculty of Medicine , Masaryk University , Brno , Czech Republic.,b Research Centre for the Toxic Compounds in the Environment (RECETOX) , Brno , Czech Republic
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Ismail AQT. Does placental MDSC-mediated modulation of arginine levels help protect the foetus from auxotrophic pathogens? J Matern Fetal Neonatal Med 2017; 31:1667-1669. [DOI: 10.1080/14767058.2017.1319935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Role of l-Arginine in Oligohydramnios. J Obstet Gynaecol India 2016; 66:279-83. [PMID: 27651617 DOI: 10.1007/s13224-016-0853-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 01/25/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Oligohydramnios is a known obstetric complication which is associated with operative interferences and perinatal morbidity and mortality. l-arginine is a precursor of nitric oxide and may play a role in local vasodilatation. Administration of l-arginine has been suggested to improve amniotic fluid index (AFI) in oligohydramnios. AIMS AND OBJECTIVES To study the effect of l-arginine in optimizing fetal outcome in cases of oligohydramnios. MATERIALS AND METHODS A retrospective study was conducted at Dr L H Hiranandani hospital consisting of 100 antenatal patients diagnosed with oligohydramnios [AFI < 8 cm] remote from term. Patients were evaluated for all antenatal risk factors and were started on l-arginine sachets (3 g, 3 sachets a day). The treatment was continued till an adequate improvement in liquor was noted. However, patients were considered for delivery if the liquor remained <5. Further, mean increase in AFI, intervention delivery interval, and neonatal outcome were studied. RESULTS The mean gestational age at the time of recruitment was 32.3 weeks. The mean AFI noted was 5.421 cm. These patients were delivered at 35 ± 1.1 weeks, and thus, pregnancy could be prolonged by 2.4 ± 1.1 weeks. The mean AFI at the end of therapeutic intervention was 8.753, and thus, an AFI increase of 3.332 cm could be obtained. There was no significant neonatal morbidity in these patients. Significant improvement in liquor volume was obtained in these patients after intervention with l-arginine sachets. CONCLUSION l-arginine supplementation is promising in improving volume of amniotic fluid in cases of oligohydramnios and prolonging pregnancy by a mean of 2.4 weeks, allowing fetal lung maturation thus benefiting the neonatal outcome.
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Facchinetti F, Longo M, Piccinini F, Neri I, Volpe A. L-Arginine Infusion Reduces Blood Pressure in Preeclamptic Women Through Nitric Oxide Release. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/107155769900600407] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- F. Facchinetti
- Department of Gynecology, Obstetrics, and Pediatric Sciences, University of Modena, Modena, Italy
| | | | | | | | - A. Volpe
- Department of Gynecology, Obstetrics, and Pediatric Sciences, University of Modena, Modena, Italy
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Chen J, Gong X, Chen P, Luo K, Zhang X. Effect of L-arginine and sildenafil citrate on intrauterine growth restriction fetuses: a meta-analysis. BMC Pregnancy Childbirth 2016; 16:225. [PMID: 27528012 PMCID: PMC4986189 DOI: 10.1186/s12884-016-1009-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 08/04/2016] [Indexed: 12/02/2022] Open
Abstract
Background Intrauterine growth restriction (IUGR) is associated with perinatal morbidity and mortality. Several clinical trials have reported L-arginine and sildenafil citrate had effect on intrauterine growth restriction fetuses. A meta-analysis of available randomized controlled trials (RCTs) was conducted to investigate the effects of L-arginine and sildenafil citrate on major clinical outcomes of IUGR fetuses. Methods Systematically searched Medline, Embase, the Cochrane Library, and Clinical Trials, references of retrieved articles, and conference proceedings from 1960 to 2015. We included randomized controlled trials assessing the effects of L-arginine and sildenafil citrate on IUGR. Outcomes analyzed were the birth weight, gestational age at labor, Apgar score at 1and 5 min, the ratio of NRDS, the ratio of ICH and neonatal death, etc. Results Ten trials were included. Nine trials (576 patients) compared L-arginine with either placebo or no intervention. In the L-arginine treatment groups of the L-arginine trials, there was a significant increase in fetal birth weight (SMD 0.41, 95 % CI [0.24,0.58]), gestational age (SMD 0.30, 95 % CI [0.07,0.54]); L-arginine treatment group have a significant reduction in the ratio of neonatal respiratory distress syndrome (P = 0.009), intracranial hemorrhage of fetuses (P = 0.002), but the number of included studies and people on these outcomes are small. As only one trial (41 patients) compared sildenafil citrate with placebo, it was too small for reliable conclusions about possible differential effects could be drawn. Conclusions The results of this meta-analysis showed that L-arginine increased birth weight and prolonged gestational age at labor of IUGR fetuses. However, further large-scale RCTs are needed to adequately assess the effect of L-arginine and Sildenafil citrate on clinical outcomes, because the number of study may be small. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-1009-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Juncao Chen
- Division of Neonatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Rd, Changsha, Hunan, 410011, China
| | - Xiaoyuan Gong
- Division of Neonatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Rd, Changsha, Hunan, 410011, China
| | - Pingyang Chen
- Division of Neonatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Rd, Changsha, Hunan, 410011, China.
| | - Kaiju Luo
- Division of Neonatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Rd, Changsha, Hunan, 410011, China
| | - Xiuquan Zhang
- Department Obstetrics and Gynecology and Reproductive Genetics, University of Utah, Salt Lake City, UT, 84132, USA
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Endothelial nitric oxide synthase gene G894T polymorphism and risk assessment for pregnancy-induced hypertension: evidence from 11 700 subjects. Hypertens Res 2016; 39:899-906. [PMID: 27465577 DOI: 10.1038/hr.2016.95] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/11/2016] [Accepted: 06/14/2016] [Indexed: 01/11/2023]
Abstract
Recent studies have reported the association between endothelial nitric oxide synthase (eNOS) gene G894T polymorphism and pregnancy-induced hypertension (PIH). However, the results have been inconsistent. We conducted a comprehensive meta-analysis to explore this association. A total of 36 case-control studies involving 4028 PIH cases and 7672 controls were ultimately included. In the overall analysis, no association was identified between eNOS gene G894T polymorphism and PIH risk in any of the genetic models. In the subgroup analysis, the results showed that T-allele carriers had a higher risk of PIH than those with the G allele in Asians (G vs. T: odds ratio (OR)=0.76, 95% confidence interval (CI)=0.63-0.91, P=0.002; GT+TT vs. GG: OR=1.32, 95% CI=1.09-1.59, P=0.004; TT vs. GT+GG: OR=1.96, 95% CI=1.26-3.06, P=0.003; TT vs. GG: OR=1.99, 95% CI=1.27-3.11, P=0.003; GT vs. GG: OR=1.23, 95% CI=1.05-1.43, P=0.009). For Latin American and African populations, the association between G894T polymorphism and susceptibility to PIH was only observed in the dominant model. However, no association was observed in Europeans and Americans. Therefore, eNOS gene G894T polymorphism was related to PIH risk, especially for Asians.
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16
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Leal CAM, Leal DBR, Adefegha SA, Morsch VM, da Silva JEP, Rezer JFP, Schrekker CML, Abdalla FH, Schetinger MRC. Platelet aggregation and serum adenosine deaminase (ADA) activity in pregnancy associated with diabetes, hypertension and HIV. Cell Biochem Funct 2016; 34:343-50. [PMID: 27273565 DOI: 10.1002/cbf.3197] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 05/12/2016] [Accepted: 05/16/2016] [Indexed: 11/07/2022]
Abstract
Platelet aggregation and adenosine deaminase (ADA) activity were evaluated in pregnant women living with some disease conditions including hypertension, diabetes mellitus and human immunodeficiency virus infection. The subject population is consisted of 15 non-pregnant healthy women [control group (CG)], 15 women with normal pregnancy (NP), 7 women with hypertensive pregnancy (HP), 10 women with gestational diabetes mellitus (GDM) and 12 women with human immunodeficiency virus-infected pregnancy (HIP) groups. The aggregation of platelets was checked using an optical aggregometer, and serum ADA activity was determined using the colorimetric method. After the addition of 5 µM of agonist adenosine diphosphate, the percentage of platelet aggregation was significantly (p < 0·05) increased in NP, HP, GDM and HIP groups when compared with the CG, while the addition of 10 µM of the same agonist caused significant (p < 0·05) elevations in HP, GDM and HIP groups when compared with CG. Furthermore, ADA activity was significantly (p < 0·05) enhanced in NP, HP, GDM and HIP groups when compared with CG. In this study, the increased platelet aggregation and ADA activity in pregnancy and pregnancy-associated diseases suggest that platelet aggregation and ADA activity could serve as peripheral markers for the development of effective therapy in the maintenance of homeostasis and some inflammatory process in these pathophysiological conditions. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Claudio A M Leal
- Programa de Pós-Graduação em Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Daniela B R Leal
- Programa de Pós-Graduação em Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.,Programa de Pós-Graduação em Ciências Farmacêuticas, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Stephen A Adefegha
- Programa de Pós-Graduação em Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.,Department of Biochemistry, Federal University of Technology, Akure, Nigeria
| | - Vera M Morsch
- Programa de Pós-Graduação em Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - José E P da Silva
- Programa de Pós-Graduação em Ciências Farmacêuticas, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.,Departamento de Análises Clínicas e Toxicológicas, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - João F P Rezer
- Programa de Pós-Graduação em Ciências Farmacêuticas, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Clarissa M L Schrekker
- TECNOCAT (Laboratory of Technological Processes and Catalysis), Institute of Chemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Faida H Abdalla
- Programa de Pós-Graduação em Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Maria R C Schetinger
- Programa de Pós-Graduação em Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
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Acauan Filho BJ, Pinheiro da Costa BE, Ogando PB, Vieira MC, Antonello IC, Poli-de-Figueiredo CE. Serum nitrate and NOx levels in preeclampsia are higher than in normal pregnancy. Hypertens Pregnancy 2016; 35:226-33. [PMID: 27003519 DOI: 10.3109/10641955.2016.1139718] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To compare nitric oxide (NO) serum levels in women with and without preeclampsia. METHODS 106 women were classified into preeclampsia group (n = 40) and normotensive group (n = 66). NO content was measured in the serum. Clinical and laboratorial data were recorded for comparison. RESULTS Preeclampsia presented a significant increase in nitrate and NOx levels compared to the control group. Uric acid, gestational age, systolic and diastolic blood pressure, and creatinine showed correlation with nitrates and NOx. CONCLUSION Increase of NO was observed in preeclampsia women. Failure in the mechanism of action, dependent on cyclic GMP, may justify this finding.
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Affiliation(s)
- Breno José Acauan Filho
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Bartira Ercilia Pinheiro da Costa
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Patrícia Barcelos Ogando
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Matias Costa Vieira
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Ivan Carlos Antonello
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Carlos Eduardo Poli-de-Figueiredo
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
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18
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Gong F, Hu C, Lu S, Qian Z, Feng F, Wu Y, Yang H, Sun Y. Associations of Angiotensin-Converting Enzyme Insertion/Deletion, Angiotensin II Receptor A1166C, and Endothelial Nitric Oxide Synthase 4b/a Gene Polymorphisms With Pregnancy Hypertensive Disorders: A Meta-Analysis. J Clin Hypertens (Greenwich) 2015; 17:954-62. [PMID: 26119526 PMCID: PMC8031698 DOI: 10.1111/jch.12606] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/30/2015] [Accepted: 05/01/2015] [Indexed: 11/30/2022]
Abstract
There have been numerous studies concerning the associations of angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D), angiotensin II receptor 1 (AT1R) gene A1166C, and endothelial nitric oxide synthase (eNOS) gene 4b/a polymorphisms with risk of pregnancy hypertensive disorders (PHDs). However, the results are inconsistent. A total of 83 eligible studies (10,354/18,446 cases/controls) were included in this meta-analysis. Pooled odds ratios with corresponding 95% confidence intervals were used to calculate these associations. The effects of ethnicity and types of PHDs were also considered. Results showed significant associations between the ACE gene polymorphism and PHDs in all of the populations except that in Africa. The associations also existed in AT1R, eNOS gene polymorphism and PHDs in part of the gene models in the overall population. These results indicated the ACE gene polymorphism was associated with an increased risk of PHDs, whereas the eNOS and AT1R gene polymorphism only have increased susceptibility to PHDs in part of the gene models.
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Affiliation(s)
- Feng‐Feng Gong
- Department of Epidemiology and Health StatisticsSchool of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- Center for Evidence‐Based PracticeAnhui Medical UniversityHefeiAnhuiChina
| | - Cai‐Yun Hu
- Department of Epidemiology and Health StatisticsSchool of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- Center for Evidence‐Based PracticeAnhui Medical UniversityHefeiAnhuiChina
| | - Shan‐Shan Lu
- Department of Epidemiology and Health StatisticsSchool of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- Center for Evidence‐Based PracticeAnhui Medical UniversityHefeiAnhuiChina
| | - Zhen‐Zhong Qian
- Department of Epidemiology and Health StatisticsSchool of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- Center for Evidence‐Based PracticeAnhui Medical UniversityHefeiAnhuiChina
| | - Fang Feng
- Department of Epidemiology and Health StatisticsSchool of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- Center for Evidence‐Based PracticeAnhui Medical UniversityHefeiAnhuiChina
| | - Yi‐Le Wu
- Department of Epidemiology and Health StatisticsSchool of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- Center for Evidence‐Based PracticeAnhui Medical UniversityHefeiAnhuiChina
| | - Hui‐Yun Yang
- Department of Epidemiology and Health StatisticsSchool of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- Center for Evidence‐Based PracticeAnhui Medical UniversityHefeiAnhuiChina
| | - Ye‐Huan Sun
- Department of Epidemiology and Health StatisticsSchool of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- Center for Evidence‐Based PracticeAnhui Medical UniversityHefeiAnhuiChina
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Abdel Razik M, El-Berry S, Abosereah M, Edris Y, Sharafeldeen A. Prophylactic treatment for preeclampsia in high-risk teenage primigravidae with nitric oxide donors: a pilot study. J Matern Fetal Neonatal Med 2015; 29:2617-20. [PMID: 26456672 DOI: 10.3109/14767058.2015.1094793] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Preeclampsia is associated with significant morbidity and mortality especially in high-risk groups. Impairment of endogenous nitric oxide has been shown to be associated with the disease and prophylactic therapy may ameliorate this condition and improve pregnancy outcome. This study valuated nitric oxide donors prophylactic treatment for preeclampsia in high-risk teenage primigravidae. METHODS The study included three hundred primigravidae aged ≤ 20 years with singleton pregnancy. Abdominal pulsed color Doppler ultrasound was done at 24 weeks gestation and pregnancies with uterine artery diastolic notch were randomly allocated to a control group received placebo vaginal tablets and a study group received isosorbid mononitrate 20 mg tablet once daily applied vaginally until delivery. OUTCOMES Incidence of preeclampsia and maternal, fetal, and neonatal outcome in both groups. RESULTS The study group had significant lower incidence of preeclampsia, preterm birth, intrauterine growth restriction and of neonatal admission to the intensive care (p < 0.05). CONCLUSIONS Nitric oxide donors prophylactic treatment for preeclampsia in high-risk teenage pregnancies decrease the incidence of preeclampsia and improve maternal, fetal, and neonatal outcomes. Further studies on larger sample size are required to confirm these results.
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Affiliation(s)
- Mohamed Abdel Razik
- a Department of Obstetrics and Gynecology , Banha Faculty of Medicine , Banha , Egypt
| | - Seham El-Berry
- a Department of Obstetrics and Gynecology , Banha Faculty of Medicine , Banha , Egypt
| | - Mahmoud Abosereah
- a Department of Obstetrics and Gynecology , Banha Faculty of Medicine , Banha , Egypt
| | - Yehia Edris
- a Department of Obstetrics and Gynecology , Banha Faculty of Medicine , Banha , Egypt
| | - Amrr Sharafeldeen
- a Department of Obstetrics and Gynecology , Banha Faculty of Medicine , Banha , Egypt
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Ibana JA, Cutay SJ, Romero M, Schust DJ. Parallel Expression of Enzyme Inhibitors of CD8T Cell Activity in Tumor Microenvironments and Secretory Endometrium. Reprod Sci 2015; 23:289-301. [PMID: 26335176 DOI: 10.1177/1933719115602762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The divergent requirement for tolerance to support conception and protective response against sexually transmitted infections defines the unique immunological dynamics in the female reproductive tract (FRT). In part, these requirements are achieved by the cyclic modulation of cytolytic CD8T cell function in the FRT that underlie the respective immunosuppressive and immunocompetent milieus during the secretory and proliferative phases of the menstrual cycle. The CD8T cell function can be dampened by exposure to indoleamine 2,3-dioxygenase and/or arginase enzymes. Indeed, these 2 enzymes are known as primary inducers of immune suppression in tumor microenvironments. This review discusses the intriguing parallel expression of these 2 enzymes in tumor microenvironments and in the secretory endometrium. We surmise that investigating the underlying natural mechanisms that suppress and restore the immunocompetence of CD8T cells in the FRT each month may provide valuable insights into ways to artificially recapitulate these mechanisms and inhibit immune suppression in tumor microenvironments.
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Affiliation(s)
- Joyce A Ibana
- Immunopharmacology Research Laboratory, Institute of Biology, College of Science, University of the Philippines, Diliman, Quezon City, Philippines Natural Sciences Research Institute, University of the Philippines, Diliman, Quezon City, Philippines
| | - Sandra Jelyn Cutay
- Immunopharmacology Research Laboratory, Institute of Biology, College of Science, University of the Philippines, Diliman, Quezon City, Philippines
| | - Maevel Romero
- Immunopharmacology Research Laboratory, Institute of Biology, College of Science, University of the Philippines, Diliman, Quezon City, Philippines Natural Sciences Research Institute, University of the Philippines, Diliman, Quezon City, Philippines
| | - Danny Joseph Schust
- Department of Obstetrics, Gynecology and Women's Health, University of Missouri, Columbia, MO, USA
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21
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Wang J, Kotani T, Tsuda H, Mano Y, Sumigama S, Li H, Komatsu K, Miki R, Maruta E, Niwa Y, Mitsui T, Yoshida S, Yamashita M, Tamakoshi K, Kikkawa F. Is the serum l-arginine level during early pregnancy a predictor of pregnancy-induced hypertension? J Clin Biochem Nutr 2015; 57:74-81. [PMID: 26236104 PMCID: PMC4512889 DOI: 10.3164/jcbn.14-104] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 02/05/2015] [Indexed: 12/30/2022] Open
Abstract
The objective of this study was to determine the concentration of serum l-arginine in healthy pregnant women and infant cord blood and to compare them with those in patients with pregnancy-induced hypertension (PIH). The serum concentration of l-arginine in normal pregnant women at early gestation (n = 186) was determined and analyzed based on maternal factors such as the age, pre-pregnancy body mass index (BMI), smoking and alcohol habits before pregnancy. Similarly, the concentration of cord blood of the newborns (n = 142) was also analyzed. These values were compared with those in the PIH group (n = 21). The potential risk factors for PIH were also estimated. The serum concentration of l-arginine at early gestation in normal pregnant women (88.65 ± 19.96 µM) was not affected by the maternal age and BMI before pregnancy. A lower l-arginine concentration at early gestation (<70 µM) significantly elevated PIH risk [adjusted odds ratio (OR) = 4.26, 95% CI 1.29-14.50]. In addition, either women with large body mass before pregnancy (BMI>25 kg/m(2)) or primipara women also showed a significant association with PIH risk [adjusted OR = 10.55 (2.95-40.68); 5.25 (1.72-19.15), respectively]. In conclusion, a lower l-arginine concentration at early gestation, overweight before pregnancy (BMI>25 kg/m(2)) and primipara could predict to the development of PIH.
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Affiliation(s)
- Jingwen Wang
- Bio-database Institute of Reproductive and Developmental Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Tomomi Kotani
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Hiroyuki Tsuda
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Yukio Mano
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Seiji Sumigama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Hua Li
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Koji Komatsu
- Bio-database Institute of Reproductive and Developmental Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Rika Miki
- Bio-database Institute of Reproductive and Developmental Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Ei Maruta
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Yoshimitsu Niwa
- Royal Bell Clinic, 1-1715 Mizuhiro, Midori-ku, Nagoya 458-0848, Japan
| | - Takashi Mitsui
- Bio-database Institute of Reproductive and Developmental Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Shigeru Yoshida
- Bio-database Institute of Reproductive and Developmental Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Mamoru Yamashita
- Bio-database Institute of Reproductive and Developmental Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Koji Tamakoshi
- Department of Nursing, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya 461-8673, Japan
| | - Fumitaka Kikkawa
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
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Low-molecular-weight heparin protects kidney through an anti-apoptotic mechanism in a rat pre-eclamptic model. Eur J Obstet Gynecol Reprod Biol 2015; 188:51-5. [DOI: 10.1016/j.ejogrb.2015.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 11/14/2014] [Accepted: 02/02/2015] [Indexed: 01/23/2023]
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Sayin N, Kara N, Pirhan D, Vural A, Araz Ersan HB, Tekirdag AI, Polat I, Gulac B, Yilmaz G. Subfoveal Choroidal Thickness in Preeclampsia: Comparison with Normal Pregnant and Nonpregnant Women. Semin Ophthalmol 2013; 29:11-7. [DOI: 10.3109/08820538.2013.839813] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dorniak-Wall T, Grivell RM, Dekker GA, Hague W, Dodd JM. The role of L-arginine in the prevention and treatment of pre-eclampsia: a systematic review of randomised trials. J Hum Hypertens 2013; 28:230-5. [PMID: 24172291 DOI: 10.1038/jhh.2013.100] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 09/09/2013] [Indexed: 12/27/2022]
Abstract
Pre-eclampsia is a significant health issue in pregnancy, complicating between 2-8% of pregnancies. L-arginine is an important mediator of vasodilation with a potential preventative role in pregnancy related hypertensive diseases. We aimed to systematically review randomised trials in the literature assessing the role of L-arginine in prevention and treatment of pre-eclampsia. We searched the Cochrane Controlled Trials Register, PUBMED, and the Australian and International Clinical Trials Registry, to identify randomised trials involving pregnant women where L-arginine was administered for pre-eclampsia to improve maternal and infant health outcomes. We identified eight randomised trials, seven of which were included. The methodological quality was fair, with a combined sample size of 884 women. For women at risk of pre-eclampsia, L-arginine was associated with a reduction in pre-eclampsia (RR: 0.34, 95% CI: 0.21-0.55), when compared with placebo and a reduction in risk of preterm birth (RR: 0.48 and 95% CI: 0.28 to 0.81). For women with established hypertensive disease, L-arginine was associated with a reduction in pre-eclampsia (RR: 0.21; 95% CI: 0.05-0.98). L-arginine may have a role in the prevention and/or treatment of pre-eclampsia. Further well-designed and adequately powered trials are warranted, both in women at risk of pre-eclampsia and in women with established disease.
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Affiliation(s)
- T Dorniak-Wall
- The University of Adelaide, Robinson Institute and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia, Australia
| | - R M Grivell
- 1] The University of Adelaide, Robinson Institute and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia, Australia [2] The Women's and Children's Hospital, Department of Perinatal Medicine, North Adelaide, South Australia, Australia
| | - G A Dekker
- 1] The University of Adelaide, Robinson Institute and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia, Australia [2] The Lyell McEwin Hospital, Department of Obstetrics & Gynaecology, Elizabeth, South Australia, Australia
| | - W Hague
- 1] The University of Adelaide, Robinson Institute and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia, Australia [2] The Women's and Children's Hospital, Department of Perinatal Medicine, North Adelaide, South Australia, Australia
| | - J M Dodd
- 1] The University of Adelaide, Robinson Institute and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia, Australia [2] The Women's and Children's Hospital, Department of Perinatal Medicine, North Adelaide, South Australia, Australia
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Groten T, Schleussner E, Lehmann T, Reister F, Holzer B, Danso KA, Zeillinger R. eNOSI4 and EPHX1 polymorphisms affect maternal susceptibility to preeclampsia: analysis of five polymorphisms predisposing to cardiovascular disease in 279 Caucasian and 241 African women. Arch Gynecol Obstet 2013; 289:581-93. [PMID: 24013430 DOI: 10.1007/s00404-013-2991-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 07/29/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to evaluate possible associations of genetic polymorphisms predisposing to cardiovascular disease with the development and/or the severity of preeclampsia. METHODS A two hospital-based prospective case-control study was performed in Germany and Ghana. 470 blood samples of 250 Caucasian and 220 black African have been genotyped by pyrosequencing and fragment length analysis. We evaluated the distribution of the epoxide hydrolase 1 (EPHX1) polymorphism on exon 3, the endothelial nitric oxide synthase (eNOS) polymorphisms on exon 7 and on intron 4, the angiotensinogen polymorphism on exon 2 and the estrogen receptor 1 polymorphism in intron 1. RESULTS 74 Caucasian and 84 African were classified as preeclampsia with 27 Caucasian developing a hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome and 17 African women experiencing eclampsia. Multivariate logistic regression analysis adjusting for ethnicity, age and parity revealed for carriers of eNOSI4 VNTR4a a 1.7-fold increased (95% CI 1.10-2.711, p = 0.016) risk to develop preeclampsia and a 3.6-fold increase for carriers of the EPHX1 113Tyr (95% CI 1.366-8.750, p = 0.009) to develop severest preeclampsia. CONCLUSION Our finding of eNOSI4 polymorphism predisposing to preeclampsia independently of ethnicity, age and parity supports the concept of NO being involved in the endothelial disorder preeclampsia. Since EPHX1 is highly expressed in the liver, can interact with various signaling pathways and is involved in central nervous system disorders, the association of EPHX1 polymorphism with the HELLP syndrome and eclampsia may hint to EPHX being a further key player in the pathogenesis of preeclampsia.
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Affiliation(s)
- T Groten
- Department of Obstetrics, University Hospital Jena, Bachstrasse 18, 07743, Jena, Germany,
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Miyague AH, Martins WP, Machado JSR, Palei AC, Amaral LM, Teixeira DM, Sandrim VC, Sertorio JTC, Tanus-Santos JE, Duarte G, Cavalli RC. Maternal flow-mediated dilation and nitrite concentration during third trimester of pregnancy and postpartum period. Hypertens Pregnancy 2013; 32:225-34. [PMID: 23782031 DOI: 10.3109/10641955.2013.790412] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To compare maternal flow-mediated dilation (FMD) of the brachial artery and nitrite concentration between third trimester of pregnancy (3rdT) and postpartum (PP) period. Additionally, we will evaluate whether FMD correlates with nitrite concentration in both periods. METHODS Eligibility criteria was healthy women with singleton pregnancy, gestational age >28 weeks, nonsmokers, and no personal or family history of vascular disease. Each women was examined during 3rdT and between 8 and 12 weeks PP to evaluate FMD and nitrite concentration in whole blood. Women not examined in both periods were excluded. Values between both periods were compared using paired t tests. Correlation between FMD and nitrite was examined by Pearson correlation coefficient. Significance level set as p < 0.05. RESULTS We invited 42 pregnant women. Among them, 35 were eligible and 7 of them were excluded for not attending the PP evaluation resulting in 28 participants analyzed. We found no significant change in FMD (10.39 ± 5.57% vs. 8.42 ± 4.21%; p = 0.11; 3rdT vs. PP, respectively) and no significant change in nitrite concentration (257.41 ± 122.95 nmol/L vs. 237.16 ± 90.01 nmol/L; p = 0.28). Baseline brachial artery diameter had a significant reduction (3.11 ± 0.30 to 2.75 ± 0.34 mm; p < 0.01). No significant correlation between FMD and nitrite during 3rdT (r = -0.13; p = 0.50) or PP (r = 0.14; p = 0.48) was found. CONCLUSIONS We did not observe significant changes in both FMD and nitrite concentration between third trimester and the PP period. FMD did not correlate with nitrite in both periods. More studies are needed to confirm our findings.
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Affiliation(s)
- Andre H Miyague
- Departamento de Ginecologia e Obstetricia da Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil.
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Gui S, Jia J, Niu X, Bai Y, Zou H, Deng J, Zhou R. Arginine supplementation for improving maternal and neonatal outcomes in hypertensive disorder of pregnancy: A systematic review. J Renin Angiotensin Aldosterone Syst 2013; 15:88-96. [PMID: 23435582 DOI: 10.1177/1470320313475910] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Shunping Gui
- Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, PR China
| | - Jin Jia
- Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, PR China
| | - Xiaoyu Niu
- Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, PR China
| | - Yi Bai
- Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, PR China
| | - Heng Zou
- Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, PR China
| | - Juelin Deng
- Chinese Evidence-Based Medicine Centre, Sichuan University, PR China
| | - Rong Zhou
- Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, PR China
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Hegde CV. The Use of l-Arginine in the Management of Pre-Eclampsia and Intrauterine Growth Restriction. J Obstet Gynaecol India 2012; 62:1-2. [PMID: 23372281 DOI: 10.1007/s13224-012-0146-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- C V Hegde
- Department of OBS/GYN, T N Medical College, Mumbai, India
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Shaik AP, Sultana A, Bammidi VK, Sampathirao K, Jamil K. A meta-analysis of eNOS and ACE gene polymorphisms and risk of pre-eclampsia in women. J OBSTET GYNAECOL 2011; 31:603-7. [DOI: 10.3109/01443615.2011.598971] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ozturk E, Balat O, Pehlivan S, Ugur MG, Özcan Ç, Sever T, Kul S. Endothelial nitric oxide synthase gene polymorphisms in preeclampsia with or without eclampsia in a Turkish population. J Obstet Gynaecol Res 2011; 37:1778-83. [DOI: 10.1111/j.1447-0756.2011.01606.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Vadillo-Ortega F, Perichart-Perera O, Espino S, Avila-Vergara MA, Ibarra I, Ahued R, Godines M, Parry S, Macones G, Strauss JF. Effect of supplementation during pregnancy with L-arginine and antioxidant vitamins in medical food on pre-eclampsia in high risk population: randomised controlled trial. BMJ 2011; 342:d2901. [PMID: 21596735 PMCID: PMC3100912 DOI: 10.1136/bmj.d2901] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To test the hypothesis that a relative deficiency in L-arginine, the substrate for synthesis of the vasodilatory gas nitric oxide, may be associated with the development of pre-eclampsia in a population at high risk. DESIGN Randomised, blinded, placebo controlled clinical trial. SETTING Tertiary public hospital in Mexico City. PARTICIPANTS Pregnant women with a history of a previous pregnancy complicated by pre-eclampsia, or pre-eclampsia in a first degree relative, and deemed to be at increased risk of recurrence of the disease were studied from week 14-32 of gestation and followed until delivery. INTERVENTIONS Supplementation with a medical food-bars containing L-arginine plus antioxidant vitamins, antioxidant vitamins alone, or placebo-during pregnancy. MAIN OUTCOME MEASURE Development of pre-eclampsia/eclampsia. RESULTS 222 women were allocated to the placebo group, 228 received L-arginine plus antioxidant vitamins, and 222 received antioxidant vitamins alone. Women had 4-8 prenatal visits while receiving the bars. The incidence of pre-eclampsia was reduced significantly (χ(2) = 19.41; P < 0.001) in women randomised to L-arginine plus antioxidant vitamins compared with placebo (absolute risk reduction 0.17 (95% confidence interval 0.12 to 0.21). Antioxidant vitamins alone showed an observed benefit, but this effect was not statistically significant compared with placebo (χ(2) = 3.76; P = 0.052; absolute risk reduction 0.07, 0.005 to 0.15). L-arginine plus antioxidant vitamins compared with antioxidant vitamins alone resulted in a significant effect (P = 0.004; absolute risk reduction 0.09, 0.05 to 0.14). CONCLUSIONS Supplementation during pregnancy with a medical food containing L-arginine and antioxidant vitamins reduced the incidence of pre-eclampsia in a population at high risk of the condition. Antioxidant vitamins alone did not have a protective effect for prevention of pre-eclampsia. Supplementation with L-arginine plus antioxidant vitamins needs to be evaluated in a low risk population to determine the generalisability of the protective effect, and the relative contributions of L-arginine and antioxidant vitamins to the observed effects of the combined treatment need to be determined. Trial registration Clinical trials NCT00469846.
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Affiliation(s)
- Felipe Vadillo-Ortega
- Department of Experimental Medicine, School of Medicine, Universidad Nacional, Autonoma de Mexico, Torre de Investigacion, 3er Piso, Ciudad Universitaria, Mexico, DF 04510.
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Kamat R, Jain V, Bahl A. Serial estimation of flow mediated dilatation in women at risk of hypertensive disorders of pregnancy. Int J Cardiol 2011; 149:17-22. [DOI: 10.1016/j.ijcard.2009.11.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2008] [Revised: 06/23/2009] [Accepted: 11/29/2009] [Indexed: 11/25/2022]
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Won HS, Kim DY, Yang MS, Lee SJ, Shin HH, Park JB. Pregnancy-induced hypertension, but not gestational diabetes mellitus, is a risk factor for venous thromboembolism in pregnancy. Korean Circ J 2011; 41:23-7. [PMID: 21359065 PMCID: PMC3040399 DOI: 10.4070/kcj.2011.41.1.23] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Revised: 05/17/2010] [Accepted: 06/21/2010] [Indexed: 11/23/2022] Open
Abstract
Background and Objectives The aim of this study was to identify the association of pregnancy-induced hypertension (PIH) or gestational diabetes mellitus (GDM) with the development of venous thromboembolism (VTE). Subjects and Methods This was a retrospective study of 57,009 pregnancies during 2002-2008 at Cheil General Hospital, Kwandong University. The diagnosis of VTE {deep vein thrombosis or pulmonary embolism (PE)} was based on clot visualization via ultrasound or computed tomography. Results In total, 27 cases (PE, 20 cases) were detected. The incidence of VTE was 0.47 per 1,000 pregnancies. To determine risk factors associated with pregnancy-induced VTE, univariate analysis using a chi-square test was performed. Cesarean (C)-section, multiple pregnancy, PIH, placenta previa, and assisted reproduction technique (ART) were statistically significant compared to the controls (all, p=0.000). However, age, premature rupture of membrane, and GDM were not statistically related to VTE. Logistic regression analysis was used to calculate the odds ratios for the risk factors. Placenta previa showed a 12.6-fold higher risk, while PIH had a 9.8-fold higher risk for the occurrence of VTE. C-section and ART procedures increased the risk of VTE by 4.2 times compared to that of the controls. Conclusion Placenta previa and PIH were significant risk factors for VTE, whereas the known traditional risk factors of increased age and GDM were not found to be associated with VTE.
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Affiliation(s)
- Hyun Sun Won
- Division of Medicine/Cardiology, Cheil General Hospital, Kwandong University, College of Medicine, Seoul, Korea
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Fernández Celadilla L, Carbajo Rueda M, Muñoz Rodríguez M. Intrauterine Growth Restriction in Spontaneously Hypertensive Rats. Hypertens Pregnancy 2009; 23:275-83. [PMID: 15617627 DOI: 10.1081/prg-200030308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We examined the test profile of changes in systolic blood pressure (SBP), urinary volume, urinary sodium, and protein excretion in normotensive (Sprague Dawley) and spontaneously hypertensive rats (SHR) up to the 18th day of pregnancy. On days 6, 11, and 18 of pregnancy, the number of implantation sites, number of embryos, litter size, placenta, and litter weight were determined. In SHR, SBP (mmHg) increased significantly from the start of the test and remained high throughout the experiment. There was also a significant increase in urine volume (mL per 24 hrs) and urinary sodium excretion (mEq per 24 hrs) but no significant changes in protein excretion rate. The number of implantation sites on day 6 of pregnancy and the number of embryos on day 11 were similar in both groups. Uterus weight in SHR on days 6 and 11 of pregnancy was significantly lower than in normotensive rats. On day 18 of pregnancy in SHR, a substantial decrease in litter weight (7.10 +/- 0.40 vs. 12.00 +/- 0.92 g; p < 0.001) and weight of placenta (2.35 +/- 0.07 vs. 4.74 +/- 0.21 g; p < 0.001) was observed, with no modification in litter size. The hypertension associated with pregnancy in SHR increased urine volume and urinary sodium excretion and decreased weight of uterus, litter, and placenta relative to control rats.
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Affiliation(s)
- Lina Fernández Celadilla
- Departamento de Sanidad Animal (Unidad de Reproducción), Facultad de Veterinaria, Universidad de León, León, Spain.
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Lis CB, Suto T, Conrad K. Importance of Nitric Oxide in Control of Systemic and Renal Hemodynamics During Normal Pregnancy: Studies in the Rat and Implications for Preeclampsia. Hypertens Pregnancy 2009. [DOI: 10.3109/10641959609015699] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ranta VH, Orpana AK, Mikkola TS, Viinikka LU, Ylikorkala RO. Preeclampsia and Expression of Inducible Nitric Oxide Synthase Messenger RNA in Umbilical Vein Endothelial Cells. Hypertens Pregnancy 2009. [DOI: 10.3109/10641959809009604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ahokas RA, Lubarsky SL, Park GC, Friedman SA, Sibai BM. Chronic Nitric Oxide Synthesis Inhibition Does Not Prevent Pregnancy Vasodilation in the Rat. Hypertens Pregnancy 2009. [DOI: 10.3109/10641959809072238] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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38
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Tempfer CB, Dorman K, Deter RL, O'brien WE, Gregg AR. An Endothelial Nitric Oxide Synthase Gene Polymorphism is Associated with Preeclampsia. Hypertens Pregnancy 2009. [DOI: 10.3109/10641950109152647] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Quinton AE, Cook CM, Peek MJ. A Longitudinal Study Using Ultrasound to Assess Flow-Mediated Dilatation in Normal Human Pregnancy. Hypertens Pregnancy 2009; 26:273-81. [PMID: 17710576 DOI: 10.1080/10641950701366841] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To develop normal ranges of endothelial function in normal human pregnancy to use as a screening test for preeclampsia. METHODS In this longitudinal study, women were studied five times during pregnancy and once postpartum using flow-mediated dilatation (FMD). FMD is a noninvasive ultrasound technique used to assess endothelial function. Healthy nonpregnant women were controls. RESULTS FMD increased non-significantly in pregnancy until 32 weeks, when it decreased significantly at 36+ weeks (n = 47). CONCLUSION The fall in FMD in the third trimester has not been previously reported. This indicates the importance of gestational age when assessing FMD as a screening test for preeclampsia.
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Affiliation(s)
- Ann E Quinton
- Discipline of Obstetrics and Gynaecology, The University of Sydney, Nepean Hospital, Penrith, NSW, Australia.
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Levy N, Bramwell G, Wierenga A, Fletcher H, McFarlane-Anderson N. Booking blood pressures and plasma nitrite in Jamaican women with pre-eclampsia. J OBSTET GYNAECOL 2007; 27:383-7. [PMID: 17654191 DOI: 10.1080/01443610701327586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Our objective was to assess the levels of nitric oxide (NO) in pre-eclampsia and to investigate its effect on blood pressure (BP) in the Jamaican population. A total of 103 participants (50 pre-eclampsia, 53 controls) were recruited from the University Hospital of the West Indies (UHWI). Blood samples were collected in the fasting state and trimester BP measurements were obtained from their records. A commercially available kit supplied by Oxford Biomedical Research Inc. (MI, USA) was used to measure plasma levels of NO. All measures of booking BP were significantly higher in women who later developed pre-eclampsia compared with those whose pregnancies remained normotensive (p </= 0.004). Mean plasma nitrite (NO) levels in the cases was 21.9 +/- 5.4 micromol/L (n = 48), significantly higher than that of the controls, 19.2 +/- 5.7 micromol/L (n = 52) p = 0.015. NO levels were not directly associated with the level of BP, p > 0.05. We concluded that in the Jamaican population, booking BP measurements may be predictors of pre-eclampsia and NO production increases in pre-eclampsia but is not related to the height of the BP.
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Affiliation(s)
- N Levy
- Department of Basic Medical Sciences, University Hospital of the West Indies, Mona, Kingston, Jamaica
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Medica I, Kastrin A, Peterlin B. Genetic polymorphisms in vasoactive genes and preeclampsia: a meta-analysis. Eur J Obstet Gynecol Reprod Biol 2006; 131:115-26. [PMID: 17112651 DOI: 10.1016/j.ejogrb.2006.10.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2006] [Revised: 09/07/2006] [Accepted: 10/11/2006] [Indexed: 10/23/2022]
Abstract
There are controversies in reports on the association of polymorphisms in endothelial nitric oxide synthase, angiotensinogen, angiotensin receptor type 1 and angiotensin-converting enzyme genes with an increased risk of developing preeclampsia. We performed a systematic search of published case-control studies through the PubMed database up to January 2006, and report the results of a meta-analysis of polymorphisms investigated in more than five studies: Glu298Asp in eNOS gene (9 analyses involving 1055 patients and 1788 controls), Met235Thr in AGT gene (13 analyses involving 1128 patients and 2278 controls), and intron 16 insertion-deletion polymorphism in ACE gene (10 analyses involving 1121 patients and 1361 controls). Statistically significant associations with preeclampsia were identified for the Met235Thr/AGT polymorphism: OR 1.65 (95% CI 1.19, 2.29) if the polymorphism is considered under the dominant genetic model, and OR 1.54 (95% CI 1.12, 2.11) under the recessive model. For insertion-deletion/ACE polymorphism, statistical significance was demonstrated when the polymorphism was considered under the recessive model: OR 1.51 (95% CI 1.17, 1.94). No single polymorphism was identified as having a major effect.
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Affiliation(s)
- Igor Medica
- Division of Medical Genetics, Department of Gynecology and Obstetrics, University Clinical Centre, Ljubljana, Slovenia
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Zhu MJ, Du M, Hess BW, Means WJ, Nathanielsz PW, Ford SP. Maternal nutrient restriction upregulates growth signaling pathways in the cotyledonary artery of cow placentomes. Placenta 2006; 28:361-8. [PMID: 16822544 DOI: 10.1016/j.placenta.2006.04.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2006] [Revised: 03/30/2006] [Accepted: 04/01/2006] [Indexed: 10/24/2022]
Abstract
This study evaluated the role of MAPK/ERK1/2 and/or PI3-K/Akt signaling pathways in modulating bovine placentomal vascularity in response to maternal nutrient restriction. Beef cows were randomly assigned to control fed (Control, n=15, 100% of requirements) or nutrient restricted (NR, n=15, 50% requirements) diets from day 30 to day 125 of gestation. Ten cows from each dietary group were necropsied on day 125 (approximately 45% gestation), and the remaining cows in each diet group were then fed control diets and necropsied on day 250 (approximately 90% gestation). At day 125 of gestation, NR cows exhibited increased (P=0.06) COT vascularity, improved (P<0.05) placentome efficiency (fetal weight/placentomal weight), and increased (P<0.05) phosphorylated Akt and ERK1/2 in COT arteries compared to Control cows. By day 250, however, treatment differences in COT vascularity and phosphorylated Akt and ERK1/2 in COT arteries were lost. On both gestational days, no treatment difference was observed in the levels of phosphorylated Akt or ERK1/2 in CAR arteries. CAR vascularity was similar across treatment on day 125, but tended to be greater (P<0.10) in NR than Control cows on day 250. These data suggest that conceptuses react to an early gestational nutrient restriction by up-regulating COT growth signaling pathways associated with angiogenesis, and that these compensations do not persist to term.
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Affiliation(s)
- M J Zhu
- Center for the Study of Fetal Programming, University of Wyoming, 1000 E. University Avenue, Laramie, WY 82071, USA
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Zheng J, Wen Y, Austin JL, Chen DB. Exogenous Nitric Oxide Stimulates Cell Proliferation via Activation of a Mitogen-Activated Protein Kinase Pathway in Ovine Fetoplacental Artery Endothelial Cells1. Biol Reprod 2006; 74:375-82. [PMID: 16251502 DOI: 10.1095/biolreprod.105.043190] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Sodium nitroprusside (SNP), a nitric oxide (NO) donor and a nitrovasodilator drug used for patients with hypertensive crisis, has been shown to promote angiogenesis. However, direct evidence showing the involvement of NO in the SNP-induced angiogenesis is not available. Accordingly, we assessed whether NO generated from SNP-stimulated ovine fetoplacental artery endothelial (OFPAE) cell proliferation via activation of mitogen-activated protein kinase 3/1 (MAPK3/1, also termed ERK1/2). We observed that SNP dose dependently stimulated (P < 0.05) cell proliferation with a maximal effect at 1 microM and that SNP rapidly (<or=15 min) phosphorylated (P < 0.05) MAPK3/1 but not v-akt murine thymoma viral oncogene homolog 1 (AKT1). Treatment of cells with SNP caused a rapid increase in NO levels in media. These increased NO levels were inhibited (P < 0.05) by 2-phenyl-4,4,5,5 tetramethylimidazoline-1-oxyl 3-oxide (PTIO), a NO scavenger. The SNP-induced cell proliferation and MAPK3/1 phosphorylation were attenuated (P < 0.05) by both PTIO and PD98059, a specific mitogen-activated protein kinase kinase 1 and 2 (MAP2K1/2, also termed MEK1/2) inhibitor. Using a semiquantitative RT-PCR analysis, we also showed that up to 12 h of treatment, SNP and N(G)-monomethyl-L-arginine (L-NMMA, a NOS inhibitor) did not alter mRNA expression of VEGF, FGF2, and their major receptors in OFPAE cells. The SNP's stimulatory effects on OFPAE cell proliferation and MAPK3/1 activation were confirmed in a human placental artery endothelial (HPAE) cell line. These data indicate that exogenous NO generated from SNP is able to stimulate fetoplacental artery endothelial cell proliferation at least partly via activation of the MAP2K1/2/MAPK3/1 cascade. These data also suggest that SNP could potentially be used to modulate placental angiogenesis.
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Affiliation(s)
- Jing Zheng
- Department of Obstetrics and Gynecology, Perinatal Research Laboratories, University of Wisconsin, Madison, Wisconsin 53715, USA.
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Loukovaara MJ, Loukovaara S, Leinonen PJ, Teramo KAW, Andersson SHM. Endothelium-derived nitric oxide metabolites and soluble intercellular adhesion molecule-1 in diabetic and normal pregnancies. Eur J Obstet Gynecol Reprod Biol 2005; 118:160-5. [PMID: 15653196 DOI: 10.1016/j.ejogrb.2004.11.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2004] [Revised: 11/04/2004] [Accepted: 11/16/2004] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Endothelial dysfunction has been demonstrated in adult subjects with diabetes. We studied if maternal diabetes is associated with altered endothelial function in the fetus, as this might shed light on mechanisms by which adult diseases are programmed in utero. STUDY DESIGN Total nitrate/nitrite (NOx) concentration was measured spectrophotometrically with the Griess reagent method. Soluble intercellular adhesion molecule-1 (sICAM-1) concentration was measured by enzyme-linked immunoassay. RESULTS Venous cord serum NOx concentration at birth was highest in pregnancies complicated by type 1 diabetes (29.5+/-1.8 micromol/l, n=63) (P<0.0001 versus controls) and lowest in normal pregnancies (19.0+/-1.0 micromol/l, n=56). The concentration was intermediate in pregnancies complicated by gestational diabetes (23.9+/-2.7 micromol/l, n=24), but not significantly higher than in normal pregnancies (P=0.172). Venous cord serum sICAM-1 concentration did not differ between the three groups (P=0.191). Maternal serum NOx concentration in the third trimester was higher in pregnancies complicated by type 1 diabetes (22.9+/-3.4 micromol/l, n=22) than in normal pregnancies (15.4+/-1.4 micromol/l, n=21) (P=0.049). CONCLUSIONS : Increased cord serum NOx but unaltered sICAM-1 concentration in diabetic pregnancies indicates that maternal diabetes does not cause a general alteration in fetal endothelial function. The increase in cord serum and maternal serum NOx concentration in diabetic pregnancies may be due to abnormalities in insulin-induced nitric oxide release or to a diminished reactivity of the vasculature to the effects of nitric oxide.
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Affiliation(s)
- Mikko J Loukovaara
- Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Haartmaninkatu 2, 00290 Helsinki, Finland.
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Kasapinovic S, McCallum GP, Wiley MJ, Wells PG. The peroxynitrite pathway in development: phenytoin and benzo[a]pyrene embryopathies in inducible nitric oxide synthase knockout mice. Free Radic Biol Med 2004; 37:1703-11. [PMID: 15528029 DOI: 10.1016/j.freeradbiomed.2004.08.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2004] [Revised: 08/05/2004] [Accepted: 08/05/2004] [Indexed: 11/20/2022]
Abstract
Nitric oxide generated by nitric oxide synthases (NOSs) can react with reactive oxygen species (ROS), forming peroxynitrite, which may contribute to the ROS-initiated macromolecular damage implicated in the embryopathic effects of both endogenous and drug-enhanced oxidative stress. Inducible NOS (iNOS) is nonconstitutive in most tissues, and its embryonic expression and developmental importance are unknown. Herein, during organogenesis (Gestational Days 9 and 10), wild-type B6129PF2 embryos in culture were highly susceptible to the ROS-initiating teratogens phenytoin and benzo[a]pyrene, whereas iNOS knockout embryos were substantially but not completely protected (p < .05), implicating iNOS in the embryopathic mechanism. However, in contrast to prostaglandin H synthase-catalyzed teratogen bioactivation and ROS formation, which occurs within the embryo, in vivo iNOS expression was limited to placental tissue. These results suggest that the diffusion of nitric oxide from placental progenitor tissue (ectoplacental cone) to embryonic target tissues contributes to the embryopathic effects of ROS-initiating teratogens in embryo culture, which may constitute a mechanism by which embryonic determinants of ROS-mediated teratogenesis can be modulated by maternal extra-embryonic processes.
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Affiliation(s)
- Sonja Kasapinovic
- Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
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Gandley RE, Tyurin VA, Huang W, Arroyo A, Daftary A, Harger G, Jiang J, Pitt B, Taylor RN, Hubel CA, Kagan VE. S-nitrosoalbumin-mediated relaxation is enhanced by ascorbate and copper: effects in pregnancy and preeclampsia plasma. Hypertension 2004; 45:21-7. [PMID: 15569857 DOI: 10.1161/01.hyp.0000150158.42620.3e] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
S-nitrosoalbumin (SNO-Alb) is a major reservoir of releasable nitric oxide (NO) in plasma. In preeclampsia, a pregnancy-specific disorder associated with endothelial dysfunction, we previously found significant elevations in plasma SNO-Alb concentrations and decreased plasma ascorbate (Asc) levels. This increased SNO-Alb may result from low-plasma Asc if Asc, along with transition metals (eg, copper [Cu]) are necessary for release of NO from S-nitrosothiols. We propose that vasodilator effects of SNO-Alb, mediated by release of NO, are fully realized only when Asc/Cu availability is sufficient. Relaxation responses to SNO-Alb or the control reduced human serum albumin (SH-Alb), and responses to pooled plasma from normal or preeclamptic pregnancies were examined in isolated mouse arteries. Arteries preconstricted with phenylephrine were exposed to SNO-Alb or SH-Alb at physiologically relevant concentrations. When free Cu was added in excess (10 mumol/L), NO release was not dependent on Asc. However, when Cu was added at lower (physiological) levels, NO release was dependent on Asc. The addition of Asc and Cu to SNO-Alb stimulated vasodilatory responses in isolated arteries >90%, whereas no change in the SH-Alb (5%) response was observed. Preeclampsia plasma with higher levels of SNO-Alb caused arteries to relax 44.1+/-4.7%, whereas normal pregnancy plasma caused 11.9+/-4.2% relaxation (P=0.007). These data indicate that SNO-Alb alone or in plasma can act as a potent vasodilator, and that sufficient Asc/Cu promotes this action. We suggest that the higher circulating levels of SNO-Alb, in women with preeclampsia, reflect a deficiency in Asc/Cu-mediated release of NO from SNO-Alb.
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Affiliation(s)
- Robin E Gandley
- Magee-Womens Research Institute and Department of Environmental and Occupational Health, University of Pittsburgh, 204 Craft Ave, Pittsburgh, PA 15213, USA.
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Tranquilli AL, Giannubilo SR, Bezzeccheri V, Ciavattini A, Scagnoli C, Mazzanti L. Amniotic levels of nitric oxide and vascular endothelial growth factor in pregnancy with subsequent intrauterine fetal death. Eur J Obstet Gynecol Reprod Biol 2004; 114:162-5. [PMID: 15140509 DOI: 10.1016/j.ejogrb.2003.10.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2003] [Revised: 10/09/2003] [Accepted: 10/28/2003] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Nitric oxide (NO) and vascular endothelial growth factor (VEGF) regulate angiogenesis and seem involved in the early stages of placentation. If angiogenesis is reduced, this may lead to poor placentation and fetal death. This study was aimed to determine whether VEGF and NO are associated to subsequent fetal death. STUDY DESIGN We retrospectively assessed NO and VEGF on midtrimetster amniotic fluid from seven women who had subsequently had intrauterine fetal death before 20 weeks, and compared the results with those of 14 controls matched for age and gestation. All women had undergone amniocentesis for maternal age. All were at 16 weeks of gestation. None had shown chromosomal abnormalities. Results (mean+/-S.D.) were tested for statistics with Student's t-test with significance at P<0.05. RESULTS Women with subsequent fetal death had both amniotic NO and VEGF lower than women with normal pregnancy (NO 3.28+/-1.20 microg/mg creatinine versus 6.02+/-1.57 microg/mg creatinine, P<0.05; VEGF 210.10+/-69.55 pg/ml versus 255.05+/-88.66 pg/ml). CONCLUSIONS An early reduction of both NO and VEGF may be responsible of an impaired placental vascular development and endothelial regulation that may lead to fetal death.
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Affiliation(s)
- Andrea L Tranquilli
- Department of Obstetrics and Gynecology, Polytechnic University of Marche, Salesi Hospital, via Corridoni 11, 60123 Ancona, Italy.
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Contreras F, Fouillioux C, Bolivar A, Betancourt MC, Colmenares Y, Rivero M, Israili ZH, Velasco M. Endothelium and hypertensive disorders in pregnancy. Am J Ther 2004; 10:415-22. [PMID: 14624279 DOI: 10.1097/00045391-200311000-00007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pregnancy-induced hypertension is one of the complications that obstetricians fear most due to its sudden appearance, its changing clinical presentation, its rapid evolution, and its association with high fetal and maternal morbidity and mortality. Because of these reasons, preeclampsia has been studied widely. But although the search for answers to many questions about its etiopathogenesis and physiopathology has led to numerous researches, after many years of studies and efforts there still exist obscure and enigmatic aspects about them. Today, various risk factors for the development of this entity have been identified, and a combination of different hypotheses has been proposed to try to find an approximation to the real solution for this problem, which could probably lead to better therapeutic management.
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Affiliation(s)
- Freddy Contreras
- Unit of Clinical Pharmacology, José Maria Vargas School of Medicine, Central University of Venezuela, Caracas, Venezuela
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Alexander BT, Llinas MT, Kruckeberg WC, Granger JP. L-arginine attenuates hypertension in pregnant rats with reduced uterine perfusion pressure. Hypertension 2004; 43:832-6. [PMID: 14769812 DOI: 10.1161/01.hyp.0000119192.32360.a9] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A chronic reduction in uterine perfusion pressure in the pregnant rat is associated with significant elevations in mean arterial pressure, proteinuria, and reductions in kidney function as is chronic nitric oxide blockade, suggesting that nitric oxide deficiency may contribute to the clinical manifestations of preeclampsia. The purpose of this study was to determine whether supplementation with L-arginine, the precursor for nitric oxide, attenuates the hypertension produced in response to a chronic reduction in uterine perfusion pressure in the pregnant rat. Reduced uterine perfusion was initiated at day 14 of gestation with arterial pressure determined at day 19 of gestation in conscious, chronically instrumented rats. Arterial pressure was significantly elevated in pregnant rats with chronic reductions in uterine perfusion as compared with pregnant control rats (132+/-2 versus 109+/-2 mm Hg, P<0.01, respectively). Treatment with L-arginine (2%) in the drinking water was initiated at day 10 of gestation. l-arginine supplementation resulted in a significant decrease in arterial pressure in both pregnant rats with reduced uterine perfusion pressure (113+/-2 mm Hg treated, P<0.01 versus untreated pregnant with reduced uterine perfusion pressure) and pregnant control (97+/-3 mm Hg treated, P<0.01 versus untreated pregnant) rats. However, supplementation with L-arginine decreased blood pressure by 19 mm Hg in pregnant with reduced uterine perfusion pressure (untreated versus treated) as compared with 12 mm Hg in pregnant (untreated versus treated) rats. Thus, these results suggest that l-arginine supplementation may be beneficial in attenuating the hypertension in preeclampsia.
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Affiliation(s)
- Barbara T Alexander
- Department of Physiology and Biophysics, and the Center for Excellence in Cardiovascular-Renal Research Center, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA
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Orshal JM, Khalil RA. Reduced endothelial NO-cGMP-mediated vascular relaxation and hypertension in IL-6-infused pregnant rats. Hypertension 2004; 43:434-44. [PMID: 14707155 DOI: 10.1161/01.hyp.0000113044.46326.98] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Placental ischemia during pregnancy is associated with increased plasma cytokines such as interleukin-6 (IL-6), which may contribute to increased vascular resistance and hypertension of pregnancy. We tested the hypothesis that an increase in plasma IL-6 during pregnancy is associated with impaired endothelium-dependent relaxation, enhanced vascular contraction, and hypertension. Systolic blood pressure was measured in virgin and pregnant Sprague-Dawley rats non-treated or infused with IL-6 (200 ng/kg per day for 5 days). Isometric contraction was measured in isolated aortic strips, and endothelial nitric oxide (NO) synthase (eNOS) was measured in aortic homogenate using Western blots. Blood pressure was greater in IL-6-infused (146+/-3) than in control pregnant rats (117+/-2 mm Hg). In endothelium-intact vascular strips, phenylephrine (Phe) caused greater increase in active stress in IL-6-infused (maximum: 10.6+/-0.6) than in control pregnant rats (maximum: 4.1+/-0.3x10(4) N/m2). Acetylcholine (ACh)-induced relaxation of Phe contraction and vascular eNOS protein and nitrite/nitrate production were less in IL-6-infused than in control pregnant rats. N(omega)-nitro-L-arginine methyl ester (10(-4) mol/L), inhibitor of NOS, or 1H-[1,2,4]oxadiazolo[4,3]-quinoxalin-1-one (10(-5) mol/L), inhibitor of cGMP production in smooth muscle, inhibited ACh-induced relaxation and enhanced Phe-induced stress in control but not IL-6-infused pregnant rats. Endothelium removal enhanced Phe-induced stress in control but not in IL-6-infused pregnant rats. The blood pressure and vascular Phe-induced contraction, ACh relaxation, and eNOS protein were not different between control and IL-6-infused virgin rats. Thus, an endothelium-dependent NO-cGMP-mediated relaxation pathway is inhibited in systemic vessels of pregnant rats infused with IL-6. The results support a role for IL-6 as a possible mediator of the increased vascular resistance during hypertension of pregnancy.
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Affiliation(s)
- Julia M Orshal
- Department of Medicine, Veterans Affairs Medical Center, West Roxbury, Mass, USA
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