Department of Pharmacology, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
Center of Toxicological Assistance (CEATOX), Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
Oxid Med Cell Longev. 2018 Sep 30;2018:6035868. doi: 10.1155/2018/6035868. eCollection 2018.
Preeclampsia is the major cause of maternal and fetal deaths worldwide. Circulating biomarker concentrations to predict preeclampsia must be determined. Therefore, the objective was to evaluate heme oxygenase-1 (HO-1) concentration in both plasma and urine samples from pregnant women before the development of preeclampsia and to identify a potential biomarker for preeclampsia development. We performed a case-control study nested in a prospective study cohort at University Hospital of the Ribeirao Preto Medical School, University of São Paulo (HCFMRP-USP), Ribeirao Preto, Brazil. Of 1400 pregnant women evaluated at 20-25 weeks of gestation, 460 delivered in hospitals outside our institution. Of 940 pregnant women who completed the protocol, 30 developed preeclampsia (cases, 14 cases of severe preeclampsia and 16 cases of mild preeclampsia). Healthy pregnant women (controls, = 90) were randomly selected from the remaining 910 participants. HO-1 concentration was evaluated in plasma/urine samples by using a commercial enzyme-linked immunosorbent assay kit. We found similar HO-1 levels in the plasma and urine for case and control groups. In the subgrouped preeclampsia, lower plasma HO-1 levels were found in mild compared with severe preeclampsia. We conclude that plasma HO-1 levels were not altered at 20-25 weeks of gestation before the manifestation of preeclampsia symptoms. Pregnant women who subsequently develop severe preeclampsia show higher expression of HO-1. This may be indicative of important underlying pathophysiologic mechanisms that differentiate between mild and severe preeclampsia and may possibly be related to a higher prooxidative status even before the development of clinical symptoms.
子痫前期是全球孕产妇和胎儿死亡的主要原因。必须确定预测子痫前期的循环生物标志物浓度。因此，本研究的目的是评估血红素加氧酶-1（HO-1）在发生子痫前期之前孕妇血浆和尿液样本中的浓度，并确定子痫前期发展的潜在生物标志物。我们在巴西圣保罗大学里贝朗普雷图医学院附属医院（HCFMRP-USP）进行了一项病例对照研究，该研究嵌套在一项前瞻性研究队列中。在对 1400 名 20-25 周妊娠的孕妇进行评估中，有 460 名孕妇在我院以外的医院分娩。在完成方案的 940 名孕妇中，有 30 名孕妇发生子痫前期（病例组，14 例重度子痫前期和 16 例轻度子痫前期）。从其余 910 名参与者中随机选择健康孕妇（对照组，n=90）。使用商业酶联免疫吸附测定试剂盒评估血浆/尿液样本中的 HO-1 浓度。我们发现病例组和对照组的血浆和尿液中的 HO-1 水平相似。在子痫前期亚组中，与重度子痫前期相比，轻度子痫前期的血浆 HO-1 水平较低。我们得出结论，在子痫前期症状出现前的 20-25 周妊娠时，血浆 HO-1 水平没有改变。随后发生重度子痫前期的孕妇表现出更高的 HO-1 表达。这可能表明在轻度和重度子痫前期之间存在重要的潜在病理生理机制，并且可能与甚至在临床症状出现之前更高的促氧化状态有关。
