Knapen M F, Peters W H, Mulder T P, Merkus H M, Jansen J B, Steegers E A
Department of Obstetrics/Gynaecology, University Hospital St Radboud, Nijmegen, The Netherlands.
Placenta. 1999 Sep;20(7):541-6. doi: 10.1053/plac.1999.0408.
Pre-eclampsia is a major complication of pregnancy with high morbidity and mortality rates. The aetiology is still unclear but impaired detoxification or enhanced levels of reactive (oxygen) metabolites may contribute to the development or maintenance of pre-eclampsia. Glutathione and glutathione-related enzymes, as one of the major detoxificating and free-radical scavenging systems, may play a role in controlling the disease. Seventeen normotensive pregnant women and 24 pre-eclamptic women were investigated prospectively with respect to placental and decidual levels of total glutathione (GSH), glutathione S-transferase activity (GST), selenium-dependent glutathione peroxidase (SeGPX) and total glutathione peroxidase activity (TGPX, both selenium- and non-selenium-dependent GPX). Decidual levels of glutathione and related enzymes were compared with placental levels, and the investigated parameters in pre-eclampsia were compared with those in normotensive pregnancy by the Mann-Whitney U -test. Clinical data were correlated with biochemical parameters by Spearman's correlation test. Glutathione levels were significantly higher in decidua as compared with placenta. Glutathione levels were elevated in pre-eclampsia and HELLP (haemolysis, elevated liver enzymes, low platelets) as compared to normotensive pregnancy for decidua and in the placenta of patients with pre-eclampsia only. Glutathione S-transferase activity was not different between the two groups. In the placenta of patients with pre-eclampsia+HELLP, total glutathione peroxidase activity was elevated versus controls. Selenium-dependent glutathione peroxidase activity was higher in decidua versus placenta and in decidua of pre-eclamptic versus control subjects. Enhanced glutathione concentrations and glutathione peroxidase activities were often found in placenta and decidua in pre-eclampsia, probably as a compensatory mechanism to prevent further damage by peroxides, (oxygen) radicals or other toxins in the placenta or in the feto-placental interface.
子痫前期是一种妊娠的主要并发症，发病率和死亡率都很高。其病因尚不清楚，但解毒功能受损或活性（氧）代谢产物水平升高可能导致子痫前期的发生或持续。谷胱甘肽和谷胱甘肽相关酶作为主要的解毒和自由基清除系统之一，可能在控制该疾病中发挥作用。对17名血压正常的孕妇和24名子痫前期患者进行了前瞻性研究，检测其胎盘和蜕膜中总谷胱甘肽（GSH）、谷胱甘肽S-转移酶活性（GST）、硒依赖性谷胱甘肽过氧化物酶（SeGPX）和总谷胱甘肽过氧化物酶活性（TGPX，包括硒依赖性和非硒依赖性GPX）。将蜕膜中谷胱甘肽及相关酶的水平与胎盘水平进行比较，并通过Mann-Whitney U检验将子痫前期患者的研究参数与血压正常孕妇的参数进行比较。通过Spearman相关性检验将临床数据与生化参数进行相关性分析。与胎盘相比，蜕膜中的谷胱甘肽水平显著更高。与血压正常的妊娠相比，子痫前期和HELLP（溶血、肝酶升高、血小板减少）患者蜕膜中的谷胱甘肽水平升高，仅子痫前期患者的胎盘谷胱甘肽水平升高。两组之间的谷胱甘肽S-转移酶活性没有差异。子痫前期+HELLP患者的胎盘总谷胱甘肽过氧化物酶活性相对于对照组升高。与胎盘相比，蜕膜中的硒依赖性谷胱甘肽过氧化物酶活性更高，子痫前期患者蜕膜中的该酶活性也高于对照组。子痫前期患者的胎盘和蜕膜中常常发现谷胱甘肽浓度和谷胱甘肽过氧化物酶活性增强，这可能是一种补偿机制，以防止胎盘或胎儿-胎盘界面中的过氧化物、（氧）自由基或其他毒素造成进一步损害。
