Concept and connotation of oxidative stress in preeclampsia

ABSTRACT

BACKGROUND: Preeclampsia (PE) is a systemic pregnancy-related disorder characterized by hypertension, proteinuria, and edema. Free radicals seem to play an important role in the induction of endothelial dysfunction in PE.

AIM: The aim of the present study was to investigate serum levels of nitric oxide (NO), peroxynitrite (ONOO⁻), paraoxonase (PON-1), malondialdehyde (MDA), and lipid profile in preeclamptic patients compared to the women with normal pregnancy.

MATERIALS AND METHODS: A total of 68 pregnant women were recruited. They were divided into two groups - Group A, 40 women were a newly diagnosed with PE and Group B, 28 women with normal pregnancy. Anthropometric measurements including body mass index and blood pressure in accordance with biochemical measurements including NO, ONOO⁻, PON-1, MDA, and lipid profile were done for preeclamptic pregnant women compared to the controls.

RESULTS: Pregnant women with pre-eclampsia illustrated insignificant differences in the age (31.22±2.87) compared to the age of control P > 0.05. There were significant changes in the body mass index (BMI) , type of delivery and smoking status of pregnant women with pre-eclampsia compared to the control P < 0.05. Both systolic and diastolic blood pressures were high in pregnant women with pre-eclampsia compared to the control P < 0.01. PON-1 and NO serum levels were significantly decreased (P < 0.01) while ONOO− and MDA serum levels were significantly increased in PE compared to the women with normal pregnancy.

Conclusions: This study concluded that PE is associated with the augmentation of oxidative stress and reduction of endogenous antioxidant capacity regarding PON-1.

Keywords

Antioxidant capacity - hypertension - nitric oxide - paraoxonase - peroxynitrite - preeclampsia - proteinuria

• References

• 1 Hansson SR, Nääv Å, Erlandsson L. Oxidative stress in preeclampsia and the role of free fetal hemoglobin. Front Physiol 2014;5:516.
• 2 Navaratnam K, Alfirevic A, Jorgensen A, Alfirevic Z. Aspirin non-responsiveness in pregnant women at high-risk of pre-eclampsia. Eur J Obstet Gynecol Reprod Biol 2018;221:144-50.
• 3 Schneider H. Placental dysfunction as a key element in the pathogenesis of preeclampsia. Dev Period Med 2017;21:309-16.
• 4 Al-Kuraishy HM, Al-Gareeb AI. Eustress and malondialdehyde (MDA): Role of Panax ginseng: Randomized placebo controlled study. Iran J Psychiatry 2017;12:194-200.
• 5 de Lucca L, Rodrigues F, Jantsch LB, Kober H, Neme WS, Gallarreta FM, et al. Delta-aminolevulinate dehydratase activity and oxidative stress markers in preeclampsia. Biomed Pharmacother 2016;84:224-9.
• 6 Motta-Mejia C, Kandzija N, Zhang W, Mhlomi V, Cerdeira AS, Burdujan A, et al. Placental vesicles carry active endothelial nitric oxide synthase and their activity is reduced in preeclampsia. Hypertension 2017;70:372-81.
• 7 Chen J, Gao Q, Jiang L, Feng X, Zhu X, Fan X, et al. The NOX2-derived reactive oxygen species damaged endothelial nitric oxide system via suppressed BKCa/SKCa in preeclampsia. Hypertens Res 2017;40:457-64.
• 8 Gupta AK, Holzgreve W, Hahn S. Decrease in lipid levels of syncytiotrophoblast micro-particles reduced their potential to inhibit endothelial cell proliferation. Arch Gynecol Obstet 2008;277:115-9.
• 9 Nasifah I, Soeharto S, Nooryanto M. Effects of anti-lipid peroxidation of Punica granatum fruit extract in endothelial cells induced by plasma of severe pre-eclamptic patients. J Ayurveda Integr Med 2017;8:215-7.
• 10 Perkins AV. Endogenous anti-oxidants in pregnancy and preeclampsia. Aust N Z J Obstet Gynaecol 2006;46:77-83.
• 11 Isbilen E, Yilmaz H, Arzu Ergen H, Unlucerci Y, Isbir T, Gurdol F, et al. Association of paraoxonase 55 and 192 gene polymorphisms on serum homocysteine concentrations in preeclampsia. Folia Biol (Praha) 2009;55:35-40.
• 12 Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972;18:499-502.
• 13 Zamora-Kapoor A, Nelson LA, Buchwald DS, Walker LR, Mueller BA. Pre-eclampsia in American Indians/Alaska natives and whites: The significance of body mass index. Matern Child Health J 2016;20:2233-8.
• 14 Wei J, Liu CX, Gong TT, Wu QJ, Wu L. Cigarette smoking during pregnancy and preeclampsia risk: A systematic review and meta-analysis of prospective studies. Oncotarget 2015;6:43667-78.
• 15 Peres GM, Mariana M, Cairrão E. Pre-eclampsia and eclampsia: An update on the pharmacological treatment applied in Portugal. J Cardiovasc Dev Dis 2018;5. pii: E3.
• 16 Al-Kuraishy HM, Al-Gareeb AI, Al-Buhadilly AK. Rosuvastatin improves vaspin serum levels in obese patients with acute coronary syndrome. Diseases 2018;6. pii: E9.
• 17 Baumfeld Y, Novack L, Wiznitzer A, Sheiner E, Henkin Y, Sherf M, et al. Pre-conception dyslipidemia is associated with development of preeclampsia and gestational diabetes mellitus. PLoS One 2015;10:e0139164.
• 18 Chung WH, To WW. Outcome of pregnancy with new onset proteinuria and progression to pre-eclampsia: A retrospective analysis. Pregnancy Hypertens 2017. pii: S2210-7789 (17) 30129-0.
• 19 Chen Q, Lau S, Tong M, Wei J, Shen F, Zhao J, et al. Serum uric acid may not be involved in the development of preeclampsia. J Hum Hypertens 2016;30:136-40.
• 20 Laughon SK, Catov J, Powers RW, Roberts JM, Gandley RE. First trimester uric acid and adverse pregnancy outcomes. Am J Hypertens 2011;24:489-95.
• 21 Bharadwaj SK, Vishnu Bhat B, Vickneswaran V, Adhisivam B, Bobby Z, Habeebullah S, et al. Oxidative stress, antioxidant status and neurodevelopmental outcome in neonates born to pre-eclamptic mothers. Indian J Pediatr 2018;85:351-57.
• 22 Demir B, Demir S, Atamer Y, Guven S, Atamer A, Kocyigit Y, et al. Serum levels of lipids, lipoproteins and paraoxonase activity in pre-eclampsia. J Int Med Res 2011;39:1427-31.
• 23 Genc H, Uzun H, Benian A, Simsek G, Gelisgen R, Madazli R, et al. Evaluation of oxidative stress markers in first trimester for assessment of preeclampsia risk. Arch Gynecol Obstet 2011;284:1367-73.
• 24 Yaghmaei M, Hashemi M, Azarian A, Moazeni-Roodi A, Mokhtari M, Naghavai A, et al. Association of L55M and Q192R polymorphisms of paraoxonase-1 gene with preeclampsia. Arch Med Res 2011;42:324-8.
• 25 Sarandöl E, Safak O, Dirican M, Uncu G. Oxidizability of apolipoprotein B-containing lipoproteins and serum paraoxonase/arylesterase activities in preeclampsia. Clin Biochem 2004;37:990-6.
• 26 Kim YJ, Park H, Lee HY, Ahn YM, Ha EH, Suh SH, et al. Paraoxonase gene polymorphism, serum lipid, and oxidized low-density lipoprotein in preeclampsia. Eur J Obstet Gynecol Reprod Biol 2007;133:47-52.
• 27 Li H, Förstermann U. Nitric oxide in the pathogenesis of vascular disease. J Pathol 2000;190:244-54.
• 28 Xie Z, Dong Y, Zhang M, Cui MZ, Cohen RA, Riek U, et al. Activation of protein kinase C zeta by peroxynitrite regulates LKB1-dependent AMP-activated protein kinase in cultured endothelial cells. J Biol Chem 2006;281:6366-75.
• 29 Gomes A, Costa D, Lima JL, Fernandes E. Antioxidant activity of beta-blockers: An effect mediated by scavenging reactive oxygen and nitrogen species? Bioorg Med Chem 2006;14:4568-77.
• 30 Sucak A, Kanat-Pektas M, Gungor T, Mollamahmutoglu L. Leptin levels and antihypertensive treatment in preeclampsia. Singapore Med J 2010;51:39-43.