López-Jaramillo Patricio, Herrera Julian A, Arenas-Mantilla Mario, Jáuregui Isabel E, Mendoza Mayaris A
Vilano Group, Research Institute, Cardiovascular Foundation of Colombia, Floridablanca, Santander, Colombia.
Am J Ther. 2008 Jul-Aug;15(4):373-6. doi: 10.1097/MJT.0b013e318164c149.
Preeclampsia, a pregnancy-exclusive hypertensive disorder, is the major cause of maternal and perinatal mortality, with a greater importance in developing countries. The role of inflammation in the pathogenesis of preeclampsia has been the object of recent studies by our group. We have described elevated levels of inflammatory markers (tumor necrosis factor alpha, interleukin-6, and C-reactive protein) in preeclamptic patients and demonstrated that Latin-American women present a higher degree of inflammation than women from developed countries. We have results that suggest that chronic subclinical infections and insulin resistance are the most probable causes of the increased inflammation in preeclampsia. Moreover, we showed that early treatment of urinary and vaginal infections decreased the incidence of preeclampsia. We also have evidence that suggests that inflammation leads to endothelial dysfunction, predisposing women to develop preeclampsia. Increased levels of inflammation markers and endothelial dysfunction are found in the early stages of pregnancy in women who later on develop preeclampsia. Appropriate prenatal care programs, including screening and treatment of urinary, vaginal, and periodontal infections in early pregnancy and prevention of factors that predispose to insulin resistance, such as excessive weight gain during pregnancy, may reduce the incidence of preeclampsia in Latin-American women.
子痫前期是一种仅发生于孕期的高血压疾病，是孕产妇和围产儿死亡的主要原因，在发展中国家影响更为严重。炎症在子痫前期发病机制中的作用一直是我们团队近期研究的对象。我们已经描述了子痫前期患者体内炎症标志物（肿瘤坏死因子α、白细胞介素-6和C反应蛋白）水平升高，并证明拉丁美洲女性的炎症程度高于发达国家的女性。我们的研究结果表明，慢性亚临床感染和胰岛素抵抗是子痫前期炎症增加的最可能原因。此外，我们还表明，早期治疗泌尿系统和阴道感染可降低子痫前期的发病率。我们也有证据表明，炎症会导致内皮功能障碍，使女性易患子痫前期。在后来发展为子痫前期的女性怀孕早期，就能发现炎症标志物水平升高和内皮功能障碍。适当的产前保健计划，包括在孕早期筛查和治疗泌尿系统、阴道和牙周感染，以及预防易导致胰岛素抵抗的因素，如孕期体重过度增加，可能会降低拉丁美洲女性子痫前期的发病率。
