Mthembu Mbuso Herald, Sibiya Samukelisiwe, Moodley Jagidesa, Mkhwanazi Nompumelelo P, Naicker Thajasvarie
Department of Obstetrics and Gynaecology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban 4041, South Africa.
HIV Pathogenesis Programme, Doris Duke Medical Research Institute, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa.
Int J Mol Sci. 2025 Aug 1;26(15):7451. doi: 10.3390/ijms26157451.
HIV infection and hypertensive disorders of pregnancy (HDP), particularly preeclampsia (PE) with severe features, are leading causes of maternal mortality worldwide. This study investigates the role of asymmetric dimethylarginine (ADMA) and prostacyclin (PGI2) concentrations in endothelial impairment in normotensive pregnant versus PE women within an HIV endemic setting in KwaZulu-Natal Province, South Africa. The study population ( = 84) was grouped according to pregnancy type, i.e., normotensive ( = 42) and PE ( = 42), and further stratified by HIV status. Clinical factors were maternal age, weight, blood pressure (both systolic and diastolic) levels, and gestational age. Plasma concentrations of ADMA and PGI2 were measured using the enzyme-linked immunoassay (ELISA). Differences in outcomes were analyzed using the Mann-Whitney U and Kruskal-Wallis test together with Dunn's multiple-comparison post hoc test. The non-parametric data were presented as medians and interquartile ranges. Gravidity, gestational age, and systolic and diastolic blood pressures were significantly different across the study groups where < 0.05 was deemed significant. Furthermore, the concentration of ADMA was significantly elevated in PE HIV-positive vs. PE HIV-negative ( = 0.0174) groups. PGI2 did not show a significant difference in PE compared to normotensive pregnancies ( = 0.8826) but was significantly different across all groups ( = 0.0212). An increase in plasma ADMA levels was observed in the preeclampsia HIV-negative group compared to the normotensive HIV-negative group. This is linked to the role played by ADMA in endothelial impairment, a characteristic of PE development. PGI2 levels were decreased in PE compared to the normotensive group regardless of HIV status. These findings draw attention to the importance of endothelial indicators in pathogenesis and possibly early prediction of PE development.
艾滋病毒感染和妊娠高血压疾病（HDP），尤其是伴有严重特征的子痫前期（PE），是全球孕产妇死亡的主要原因。本研究调查了在南非夸祖鲁 - 纳塔尔省艾滋病毒流行地区，正常血压孕妇与子痫前期女性中，不对称二甲基精氨酸（ADMA）和前列环素（PGI2）浓度在内皮功能损害中的作用。研究人群（n = 84）根据妊娠类型分组，即正常血压组（n = 42）和子痫前期组（n = 42），并进一步按艾滋病毒感染状况分层。临床因素包括产妇年龄、体重、血压（收缩压和舒张压）水平以及孕周。采用酶联免疫吸附测定（ELISA）法测定血浆中ADMA和PGI2的浓度。使用曼 - 惠特尼U检验和克鲁斯卡尔 - 沃利斯检验以及邓恩多重比较事后检验分析结果差异。非参数数据以中位数和四分位间距表示。各研究组之间的妊娠次数、孕周以及收缩压和舒张压存在显著差异，其中P < 0.05被视为具有统计学意义。此外，子痫前期艾滋病毒阳性组与子痫前期艾滋病毒阴性组相比，ADMA浓度显著升高（P = 0.0174）。与正常血压妊娠相比，PGI2在子痫前期组中未显示出显著差异（P = 0.8826），但在所有组之间存在显著差异（P = 0.0212）。与正常血压艾滋病毒阴性组相比，子痫前期艾滋病毒阴性组血浆ADMA水平升高。这与ADMA在内皮功能损害中所起的作用有关，而内皮功能损害是子痫前期发展的一个特征。无论艾滋病毒感染状况如何，与正常血压组相比，子痫前期组的PGI2水平均降低。这些发现凸显了内皮指标在子痫前期发病机制以及可能的早期预测中的重要性。
