Khalil Asma, Jauniaux Eric, Harrington Kevin, Muttukrishna Shanthi
Academic Department of Obstetrics and Gynaecology, EGA Institute for Women's Health, University College, London, UK.
Clin Endocrinol (Oxf). 2009 Jun;70(6):924-31. doi: 10.1111/j.1365-2265.2008.03426.x. Epub 2008 Sep 18.
Levels of inhibin A and activin A are raised in pre-eclampsia (PE) but it is not known if antihypertensive therapy can affect their levels. Our aim was to investigate the effect of the antihypertensive drug alpha-methyldopa on serum, urine and placental concentrations of inhibin A and activin A in women presenting with hypertensive disorders of pregnancy.
This was a cross-sectional study.
We recruited 65 women presenting with PE, 39 with gestational hypertension (GH) and 104 normotensive controls matched for maternal age, gestational age and parity.
Using specific validated ELISAs, serum and urine levels of inhibin A and activin A, and uterine artery Doppler indices, were measured before and 24-48 h after initiating alpha-methyldopa therapy in women with PE, with GH and controls. Protein extracts were obtained from samples of placental tissue from another group of women with PE, GH and controls for the same analysis.
In PE, but not GH, alpha-methyldopa therapy was associated with significantly (P < 0.05) lower levels of both serum and urine inhibin A and activin A. Similarly, in PE but not GH, alpha-methyldopa therapy was associated with lower placental levels of both markers (P < 0.05). There was no significant difference in pulsatility index following treatment in either PE or GH.
Our data indicate that antihypertensive therapy with alpha-methyldopa may have an effect on the synthesis and/or release of placental proteins in pregnancies complicated by PE and that this effect may be independent of its known antihypertensive action.
子痫前期（PE）患者体内抑制素A和激活素A水平升高，但尚不清楚降压治疗是否会影响其水平。我们的目的是研究降压药物α-甲基多巴对患有妊娠高血压疾病的女性血清、尿液和胎盘组织中抑制素A和激活素A浓度的影响。
这是一项横断面研究。
我们招募了65例子痫前期患者、39例妊娠期高血压（GH）患者以及104例血压正常的对照者，这些对照者在年龄、孕周和产次方面与前两组相匹配。
采用经过验证的特异性酶联免疫吸附测定法（ELISA），在接受α-甲基多巴治疗的子痫前期患者、妊娠期高血压患者及对照者中，于治疗前和治疗后24 - 48小时测量血清和尿液中抑制素A和激活素A的水平以及子宫动脉多普勒指数。从另一组患有子痫前期、妊娠期高血压的女性及对照者的胎盘组织样本中提取蛋白质提取物进行同样的分析。
在子痫前期患者中，而非妊娠期高血压患者中，α-甲基多巴治疗与血清和尿液中抑制素A和激活素A水平显著降低（P < (0.05)）相关。同样，在子痫前期患者中，而非妊娠期高血压患者中，α-甲基多巴治疗与两种标志物的胎盘水平降低相关（P < (0.05)）。子痫前期或妊娠期高血压患者治疗后搏动指数无显著差异。
我们的数据表明，α-甲基多巴降压治疗可能对合并子痫前期的妊娠中胎盘蛋白的合成和/或释放有影响，且这种影响可能独立于其已知的降压作用。
