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PP015. 早发型和晚发型子痫前期患者血浆中脑钠肽/氨基末端脑钠肽前体水平及胎盘表达情况

PP015. Plasma levels and placental expression of BNP/NT-proBNP in early and late onset preeclampsia.

作者信息

Katja Junus, Anna-Karin Wikström, Anders Larsson, Olovsson Matts

出版信息

Pregnancy Hypertens. 2013 Apr;3(2):73. doi: 10.1016/j.preghy.2013.04.043. Epub 2013 Jun 6.

Abstract

INTRODUCTION

Women with preeclampsia (PE) have elevated plasma levels of NT-proBNP. We hypothesized that the placenta may be a source to these elevated levels.

OBJECTIVES

Our objectives were to study the plasma levels of NT-proBNP and the protein and mRNA expression of placental BNP in women with early and late onset PE and controls.

METHODS

Plasma levels of NT-proBNP were measured in women with early (n=18) and late (n=20) onset PE, in two groups of healthy pregnant women in gestational week 24-32 (n=22) and 36-42 (n=14), and in non-pregnant women (n=20). Placental BNP protein and mRNA was studied with immunohistochemistry and qPCR. Placental release of NT-proBNP was studied with tissue culturing.

RESULTS

Women with early (365 (14-9815) pg/ml) and late (176 (33-2547) pg/ml) onset PE had higher levels of NT-proBNP in plasma than their respective controls (p<0.001). A tendency towards higher plasma levels in early compared to late onset PE was observed (p=0.057). 20 out of 25 placental tissue samples had proBNP mRNA, no differences between the study groups were found. BNP protein was found in maternal spiral arteries and syncytiotrophoblasts. NT-proBNP peptide (6-7pg/ml) was present in medium used for placenta cultures.

CONCLUSIONS

Our results suggest that there may be a placental source of NT-proBNP. If this source is responsible for the elevated plasma levels of NT-proBNP in preeclamptic women and what role, if any, BNP/NT-proBNP play in PE pathophysiology remains to be elucidated.

摘要

引言

子痫前期(PE)女性的血浆N末端脑钠肽前体(NT-proBNP)水平升高。我们推测胎盘可能是这些升高水平的来源。

目的

我们的目的是研究早发型和晚发型PE女性以及对照组中NT-proBNP的血浆水平、胎盘脑钠肽(BNP)的蛋白和mRNA表达。

方法

测定早发型(n = 18)和晚发型(n = 20)PE女性、两组妊娠24 - 32周(n = 22)和36 - 42周(n = 14)的健康孕妇以及非孕妇(n = 20)的血浆NT-proBNP水平。采用免疫组织化学和定量聚合酶链反应(qPCR)研究胎盘BNP蛋白和mRNA。通过组织培养研究胎盘NT-proBNP的释放。

结果

早发型(365(14 - 9815)pg/ml)和晚发型(176(33 - 2547)pg/ml)PE女性的血浆NT-proBNP水平高于各自的对照组(p < 0.001)。观察到早发型PE与晚发型PE相比血浆水平有升高趋势(p = 0.057)。25个胎盘组织样本中有20个有proBNP mRNA,各研究组之间未发现差异。在母体螺旋动脉和合体滋养层细胞中发现了BNP蛋白。用于胎盘培养的培养基中存在NT-proBNP肽(6 - 7pg/ml)。

结论

我们的结果表明NT-proBNP可能存在胎盘来源。如果这个来源导致了子痫前期女性血浆NT-proBNP水平升高,以及BNP/NT-proBNP在PE病理生理学中发挥何种作用(如果有的话)仍有待阐明。

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