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普伐他汀治疗和预防子痫前期。临床前和临床研究。

Pravastatin to treat and prevent preeclampsia. Preclinical and clinical studies.

机构信息

Department of Women and Children's Health, King's College London, United Kingdom.

出版信息

J Reprod Immunol. 2017 Nov;124:15-20. doi: 10.1016/j.jri.2017.09.009. Epub 2017 Sep 29.

Abstract

Pre-eclampsia is a disease of pregnancy affecting 5%-8% of all pregnancies and a leading cause of maternal and fetal mortality. Despite improvements in the diagnosis, there is no effective method for prevention and treatment. While studies in women are of critical importance, investigation of pathological mechanisms in pregnant women is necessarily limited, and the ability to establish cause and effect relationships, difficult. Mouse models have been instrumental in defining pathogenic mechanisms in preeclampsia and in the identification of pravastatin as a potential treatment to prevent pregnancy complications associated with placental dysfunction. Numerous epidemiological studies provided robust evidence demonstrating that pravastatin exposure during pregnancy does not affect fetal development. In addition, pravastatin is hydrophilic and has a limited passage through the placenta, diminishing any safety concerns. Several pilot studies suggest that pravastatin may be a good option to prevent and treat preeclampsia in women. While these studies are promising, the effectiveness of pravastatin to treat preeclampsia needs to be confirmed by randomized clinical trials.

摘要

子痫前期是一种妊娠疾病,影响所有妊娠的 5%-8%,是孕产妇和胎儿死亡的主要原因。尽管在诊断方面有所改善,但目前尚无有效的预防和治疗方法。虽然对女性的研究至关重要,但对孕妇病理机制的研究必然受到限制,并且很难建立因果关系。小鼠模型在确定子痫前期的发病机制以及发现普伐他汀作为一种预防与胎盘功能障碍相关的妊娠并发症的潜在治疗方法方面发挥了重要作用。大量的流行病学研究提供了强有力的证据,证明妊娠期间暴露于普伐他汀不会影响胎儿发育。此外,普伐他汀亲水性强,胎盘透过率有限,降低了任何安全性问题。几项初步研究表明,普伐他汀可能是预防和治疗女性子痫前期的一个不错选择。虽然这些研究很有希望,但普伐他汀治疗子痫前期的有效性仍需通过随机临床试验来证实。

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