Spectrum of Factors Triggering Endothelial Dysfunction in PIH

• Main Authors: Visala Sree Jammalamadaga, Philips Abraham
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2016-12-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: endothelial dysfuction; ferric reducing ability of plasma; malondialdehyde; nitric oxide; placental growth factor; pregnancy induced hypertension; soluble fms-like tyrosine kinase; tumour necrosis factor; vascular endothelial growth factor
• Online Access: https://jcdr.net/articles/PDF/9023/22113_CE(RA1)_F(T)_PF1(PI_RK)_PFA(NC_AK)_PF2(PAG).pdf

Introduction: Pre-eclampsia (PE) is a major cause of maternal and fetal/neonatal mortality and morbidity. The aetiology and pathogenesis of PE is yet to be completely understood. Evidence shows that, Endothelial Dysfunction (ED) plays a pivotal role in the genesis of this multi-system disorder that develops in PE and eclampsia. Aim: To determine the circulating levels of factors Malondialdehyde (MDA), Ferric Reducing Ability of Plasma-α (FRAP), Tumour Necrosis Factor (TNF-α), sFlt-1, VEGF, PlGF, Nitric Oxide (NO) that influence the ED. Materials and Methods: Study groups consisted of Normotensive pregnant women (N), preeclamptic women (PE) and eclamptic women (E) with 100 subjects in each group in the 3rd trimester of pregnancy. They were investigated for MDA, FRAP, TNF-α, sFlt-1, VEGF, PlGF, NO. Statistical analysis was done using Analysis of Variance (ANOVA). Results: When compared to controls MDA, TNF-α, sFlt-1 levels were found to be significantly high and FRAP, VEGF, PIGF and NO levels were significantly low in PE and E group. E showed a significantly high level of MDA, TNF-α, sFlt-1 and low levels of FRAP, VEGF, PIGF, NO when compared to PE group. Conclusion: Our study substantiated the fact, that oxidative stress, imbalance between anti-angiogenic factors and proangiogenic factors exists in Pregnancy Induced Hypertension (PIH) condition. This imbalance is directly related to the ED, the hallmark of PE. So oxidative stress, VEGF, PlGF and sFlt-1 can be used as markers to analyze the onset and progression of the disease.