TY - JOUR
T1 - Oxidative stress and endothelial function in normal pregnancy versus pre-eclampsia, a combined longitudinal and case control study
AU - Mannaerts, Dominique
AU - Faes, Ellen
AU - Gielis, Jan
AU - Van Craenenbroeck, Emeline
AU - Cos, Paul
AU - Spaanderman, Marc
AU - Gyselaers, Wilfried
AU - Cornette, Jerome
AU - Jacquemyn, Yves
PY - 2018/2/27
Y1 - 2018/2/27
N2 - Background: Pre-eclampsia (PE) is related to an impaired endothelial function. Endothelial dysfunction accounts for altered vascular reactivity, activation of the coagulation cascade and loss of vascular integrity. Impaired endothelial function originates from production of inflammatory and cytotoxic factors by the ischemic placenta and results in systemic oxidative stress (OS) and an altered bioavailability of nitric oxide (center dot NO). The free radical center dot NO, is an endogenous endothelium-derived relaxing factor influencing endothelial function. In placental circulation, endothelial release of center dot NO dilates the fetal placental vascular bed, ensuring feto-maternal exchange. The Endopreg study was designed to evaluate in vivo endothelial function and to quantify in vitro OS in normal and pre-eclamptic pregnancies. Methods/design: The study is divided into two arms, a prospective longitudinal study and a matched case control study. In the longitudinal study, pregnant patients >= 18 years old with a singleton pregnancy will be followed throughout pregnancy and until 6 months post-partum. In the case control study, cases with PE will be compared to matched normotensive pregnant women. Maternal blood concentration of superoxide (O-2 center dot) and placental concentration of center dot NO will be determined using EPR (electron paramagnetic resonance). Endothelial function and arterial stiffness will be evaluated using respectively Peripheral Arterial Tonometry (PAT), Flow-Mediated Dilatation (FMD) and applanation tonometry. Placental expression of eNOS (endothelial NOS) will be determined using immune-histochemical staining. Target recruitment will be 110 patients for the longitudinal study and 90 patients in the case-control study. Discussion: The results of Endopreg will provide longitudinal information on in vivo endothelial function and in vitro OS during normal pregnancy and PE. Adoption of these vascular tests in clinical practice potentially predicts patients at risk to develop cardiovascular events later in life after PE pregnancies. center dot NO, O-2 center dot(-) and eNOS measurements provide further inside in the pathophysiology of PE.
AB - Background: Pre-eclampsia (PE) is related to an impaired endothelial function. Endothelial dysfunction accounts for altered vascular reactivity, activation of the coagulation cascade and loss of vascular integrity. Impaired endothelial function originates from production of inflammatory and cytotoxic factors by the ischemic placenta and results in systemic oxidative stress (OS) and an altered bioavailability of nitric oxide (center dot NO). The free radical center dot NO, is an endogenous endothelium-derived relaxing factor influencing endothelial function. In placental circulation, endothelial release of center dot NO dilates the fetal placental vascular bed, ensuring feto-maternal exchange. The Endopreg study was designed to evaluate in vivo endothelial function and to quantify in vitro OS in normal and pre-eclamptic pregnancies. Methods/design: The study is divided into two arms, a prospective longitudinal study and a matched case control study. In the longitudinal study, pregnant patients >= 18 years old with a singleton pregnancy will be followed throughout pregnancy and until 6 months post-partum. In the case control study, cases with PE will be compared to matched normotensive pregnant women. Maternal blood concentration of superoxide (O-2 center dot) and placental concentration of center dot NO will be determined using EPR (electron paramagnetic resonance). Endothelial function and arterial stiffness will be evaluated using respectively Peripheral Arterial Tonometry (PAT), Flow-Mediated Dilatation (FMD) and applanation tonometry. Placental expression of eNOS (endothelial NOS) will be determined using immune-histochemical staining. Target recruitment will be 110 patients for the longitudinal study and 90 patients in the case-control study. Discussion: The results of Endopreg will provide longitudinal information on in vivo endothelial function and in vitro OS during normal pregnancy and PE. Adoption of these vascular tests in clinical practice potentially predicts patients at risk to develop cardiovascular events later in life after PE pregnancies. center dot NO, O-2 center dot(-) and eNOS measurements provide further inside in the pathophysiology of PE.
KW - Pre-eclampsia
KW - Endothelial (dys) function
KW - Oxidative stress
KW - Electron paramagnetic resonance
KW - Nitric oxide
KW - Maternal outcome
KW - UTERINE ARTERY DOPPLER
KW - FLOW-MEDIATED DILATION
KW - HYPERTENSIVE DISORDERS
KW - CARDIOVASCULAR-DISEASE
KW - RISK
KW - WOMEN
KW - ASSOCIATION
KW - PREVENTION
KW - PREDICTION
KW - RATIO
U2 - 10.1186/s12884-018-1685-5
DO - 10.1186/s12884-018-1685-5
M3 - Article
C2 - 29482567
SN - 1471-2393
VL - 18
JO - BMC Pregnancy and Childbirth
JF - BMC Pregnancy and Childbirth
M1 - 60
ER -