Laskowska Marzena, Laskowska Katarzyna, Oleszczuk Jan
Chair and Department of Obstetrics and Perinatology, Medical University of Lublin , Poland.
J Matern Fetal Neonatal Med. 2015 Jan;28(1):26-32. doi: 10.3109/14767058.2014.900036. Epub 2014 Apr 9.
The aim of present study was to assess the maternal serum endothelial nitric oxide synthase (eNOS), NOSTRIN (eNOS-trafficking inducer) and asymmetric dimethylarginine (ADMA) levels in pregnancies with intrauterine growth restriction (IUGR) in the presence or absence of preeclampsia and to compare the results with preeclamptic pregnant women with appropriate-for-gestational-age weight infants.
The study was performed on 65 normotensive pregnant women with isolated IUGR, 64 preeclamptic women with IUGR, 51 preeclamptic women with normal intrauterine fetal growth and 65 healthy normotensive pregnant women with singleton uncomplicated pregnancies. Severe preeclampsia was defined as blood pressure> 160/110 mmHg with proteinuria> 5 g in a 24-h urinary protein excretion. IUGR were classified when the weight of the fetus was below the 10th centiles with disturbed placental function and abnormal ultrasonographic examination. The diagnosis was confirmed by the infant's weight at birth. The maternal serum eNOS, NOSTRIN and ADMA concentrations were determined using a sandwich enzyme-linked immunosorbent assays.
There were no statistically significant differences in the eNOS and NOSTRIN levels between studied groups of women. Increased levels of ADMA in both preeclamptic groups and in women with pregnancies complicated by isolated IUGR were observed.
Our results allow the conclusion that impaired NO bioavailability in pregnancies complicated by severe preeclampsia and/or IUGR result not from a reduced level or activity of eNOS or from its disturbed intracellular transport, but from increased ADMA levels, an endogenous inhibitor of the enzyme eNOS.
本研究旨在评估子痫前期存在或不存在时,宫内生长受限(IUGR)孕妇的母体血清内皮型一氧化氮合酶(eNOS)、NOSTRIN(eNOS转运诱导剂)和不对称二甲基精氨酸(ADMA)水平,并将结果与孕周体重适宜的子痫前期孕妇进行比较。
本研究对65例单纯IUGR的血压正常孕妇、64例IUGR的子痫前期孕妇、51例宫内胎儿生长正常的子痫前期孕妇以及65例单胎妊娠无并发症的健康血压正常孕妇进行。重度子痫前期定义为收缩压>160/110 mmHg且24小时尿蛋白排泄量>5 g。当胎儿体重低于第10百分位数且胎盘功能紊乱和超声检查异常时,诊断为IUGR。通过婴儿出生时的体重确诊。使用夹心酶联免疫吸附测定法测定母体血清eNOS、NOSTRIN和ADMA浓度。
研究组女性之间的eNOS和NOSTRIN水平无统计学显著差异。观察到子痫前期组和单纯IUGR妊娠女性的ADMA水平均升高。
我们的结果表明,重度子痫前期和/或IUGR妊娠中NO生物利用度受损并非源于eNOS水平或活性降低或其细胞内转运紊乱,而是源于内源性eNOS酶抑制剂ADMA水平升高。