Preeclampsia: an endothelial cell disorder

Article Abstract:

Preeclampsia, an abnormal condition which occurs during pregnancy is characterized by protein in the urine, swelling (especially of the face and extremities) and high blood pressure. It is a leading cause of poor maternal and fetal outcome. The mechanism causing preeclampsia is not understood, but much attention has been focused on the associated high blood pressure. The cell changes found in the kidneys are unlike the changes found in nonpregnant patients with high blood pressure. A change of focus from the associated blood pressure to the actual physiological changes of preeclampsia may provide a better understanding of the disease process. Poorly functioning endothelial cells, the cells lining the inside of blood vessels, may be responsible for the physiologic changes of preeclampsia. During high blood pressure, blood vessels are constricted. Laboratory studies have shown that injured endothelial cells increase the ability of blood vessels to contract. When endothelial cells are damaged, chemical agents which relax blood vessels are not released. However, fibronectin and factor VIII antigen, agents which act to promote blood clotting, are released. Features of preeclampsia, such as protein leakage from the kidneys into the urine and associated swelling, indicate a loss of endothelial cell functioning. Poor blood flow through the placenta may also release substances into the blood which injure endothelial cells. All the events following endothelial cell injury, such as a poorly functioning clotting mechanism, blood vessel constriction and redistribution of fluid, are involved in the development of preeclampsia during pregnancy.

Causes of, Vascular endothelium, Hypertension in pregnancy, Gestational hypertension

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Lipid peroxidation in pregnancy: new perspectives on preeclampsia

Article Abstract:

Preeclampsia is a complication of pregnancy characterized by high blood pressure, swelling and protein in the urine. The cells that line arteries, endothelial cells, can become dysfunctional, which alters lipid peroxidation, the process of converting unsaturated fatty acids in cells and tissues. Lipid peroxidation plays a role in the development of cardiovascular disease. There is some evidence that preeclampsia patients have higher amounts of the by-products of lipid peroxidation. The role of lipid peroxidation in normal and preeclamptic pregnancy is summarized. Evidence indicates that patients with preeclampsia have factors in their blood which influence the activity of agents that induce blood arteries to constrict, increasing blood pressure. Additional research is needed to determine the precise mechanisms which cause preeclampsia.

Research, Lipid peroxidation

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Fasting serum triglycerides, free fatty acids, and malondialdehyde are increased in preeclampsia, are positively correlated, and decrease within 48 hours post partum

Article Abstract:

Preeclampsia may be associated with increased levels of triglycerides and free fatty acids but not of cholesterol and may be related to a metabolite of lipids (malondialdehyde). Preeclampsia is a serious complication of pregnancy marked by high blood pressure and protein in the urine. Researchers compared blood samples taken before delivery and 24 to 48 hours after delivery from eight women with preeclampsia and nine healthy pregnant women. Triglyceride and free fatty acid blood levels were much higher in preeclamptic women than in normal women before delivery. Triglyceride levels dropped after delivery in both preeclamptic and normal women. Malondialdehyde, a byproduct of fat breakdown, was found to be 50% higher in the blood of preeclamptic women before delivery. Its presence may indicate problems with fat metabolism in preeclampsia.

Abnormalities, Risk factors, Triglycerides, Fatty acid metabolism

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