Evaluation of oxidative stress in pregnancy induced hypertension

Evaluation of oxidative stress markers in subtypes of preeclampsia: A systematic review and meta-analysis

Studies about oxidative stress biomarkers revealed different phenotypes between early and late preeclampsia (PE). Despite that, there is extensive evidence of oxidative stress in investigations that combinate forms different of preeclampsia. This study reviews the oxidative stress profile in the PE subtypes and evaluates which markers are altered in the blood and placental tissue. A search was conducted in databases such as MEDLINE, EMBASE, LILACS, and Web of Science without restricting the year and language of publication. The quality of the studies was evaluated by the Newcastle-Ottawa scale and Joanna Briggs Institute for analytical Cross-Sectional Studies. After 13,319 screened records, 65 were included in the systematic review. The markers of stress oxidative of damage and reactive species were those selected, such as malondialdehyde (MDA), lipid peroxide, advanced protein oxidation products, carbonyl protein, 8-hydroxy-2'-deoxyguanosine, total oxidant status, hydrogen peroxide, nitric oxide (NO). We described the antioxidant activity, including the superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione-S-transferase, free glutathione, and total antioxidant capacity (TAC). We results demonstrated that oxidative stress is related to pathophysiology of PE, there were increased lipid peroxidation in the blood and placenta, and in blood a reduction of NO levels and of TAC, like lower enzymatic activity of GPx, CAT in PE, and SOD in mild PE. In addition, altered levels of MDA in the placenta and blood show that placental changes have repercussions on the clinical syndrome and are related to the severity of the disease.

Dopamine in the Pathophysiology of Preeclampsia and Gestational Hypertension: Monoamine Oxidase (MAO) and Catechol-O-methyl Transferase (COMT) as Possible Mechanisms

Purpose of the Review

Hypertension in pregnancy is the global health burden. Amongst the hypertensive disorders of pregnancy, preeclampsia and gestational hypertension are the world's leading disorders that lead to both maternal and fetal morbidity and mortality.

Recent Findings

Dopamine inactive metabolites, namely, monoamine oxidase (MAO) and catechol-O-methyl transferase (COMT), have been reported to be associated with hypertensive disorders of pregnancy such preeclampsia and gestational hypertension.

Summary

This review discusses the involvement of MAO and COMT in the pathophysiology of both conditions in order to have a better understanding on the pathogenesis of both conditions, suggesting promising therapeutic interventions and subsequently reducing maternal and fetal morbidity and mortality.

Improvement of Lead Acetate-Induced Testicular Injury and Sperm Quality Deterioration by Solanum Anomalum Thonn. Ex. Schumach Fruit Extracts in Albino Rats

Objective: This study has investigated the protective role of a natural alternative, Solanum anomalum fruit extract in lead induced testicular toxicity in male albino rats. Materials and methods: Twenty-four mature male albino rats were used, divided into four groups of six rats per group. Group 1 (control rats) were given distilled water (10ml/kg), group 2 received lead acetate solution 60mg/kg, group 3 received lead acetate (60mg/kg) followed by Solanum anomalum (452mg/kg) and group 4 rats were given lead acetate (60mg/kg) followed by Solanum anomalum (678mg/kg) by oral gavage daily for 28 days. Results: Lead treated group showed significant increase in Malondialdehyde MDA (1.58 ± 0.09 to 1.90 ± 0.17 µmol/L of plasma) and decreases in Superoxide dismutase SOD, glutathione peroxidase (482.85 ± 53.43 to 247.18 ± 70.40 U/L of blood), total glutathione (1.11 ± 0.03 to 0.56 ± 0.31 ng/µL) (144.80 ± 7.00 and 122.39 ± 4.63 U/ml of blood), epididymal sperm reserve, testicular sperm count, % sperm motility and % sperm viability. Conclusion: Co-administration of Solanum anomalum significantly reversed the effect of lead with restoration of histoarchitecture of the testes. Solanum anomalum may be a protective modulator of lead -induced testicular injury.

Serum FRAP Levels and Pre-eclampsia among Pregnant Women in a Rural Community of Northern India

INTRODUCTION

There is a balance between the oxidative and the anti-oxidative forces in human body. Some studies document decreased level of anti-oxidant in pre-eclampsia while other studies showed normal level of anti-oxidant in pre-eclampsia and the evidence is equivocal.

AIM

The aim of the present study was to assess enzymatic anti-oxidant activities in pre-eclamptic women and compare it with normotensive pregnant women with period of gestation between 28 to 36 weeks.

MATERIALS AND METHODS

A community-based cross-sectional survey was conducted (from November 2012-December 2013) at the Ballabgarh Health and Demographic Surveillance System (HDSS) site which was managed by Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India. All registered pregnant women with period of gestation between 28 weeks - 36 weeks were eligible for inclusion in the study. All eligible pregnant women were contacted through home visit. A total of 217 pregnant women were enrolled out of which 209 blood samples were collected from pregnant women. About three ml of blood from antecubital vein was drawn without use of tourniquet, under aseptic conditions. It was later analysed for the serum anti-oxidative measures {Malanoaldehyde, Vitamin C, Ferric Reducing Ability of Plasma (FRAP) levels}. Data were entered on Epi-Info version 3.5.4. Data management and analysis was carried out in Stata 11. The means were compared using t-test and p-value stated. Categorical data was analysed using chi-square test. Logistic regression was used and adjusted p-value was stated.

RESULTS

A total of 217 pregnant women were eligible for the study and all were enrolled. Out of the 217 blood samples collected, eight samples accidently got destroyed. A total of 28 out of remaining 209 pregnant women (13.4%) had pre-eclampsia. Mean age (SD) was 22.4 (2.3) years, mean height (SD) was 156.6 (6.9) cm, mean weight (SD) was 65.1 (9.7) kg in pre-eclampsia group. In pre-eclampsia group mean serum levels of malanoaldehyde, vitamin C and FRAP was 4.2 (0.26) ng/dl, 0.83 (0.11) mg/dl, 678.0 (35.6) μmol/L. It was 4.5 (0.09) ng/dl,0.88 (0.03) mg/dl, 599.3 (13.3) μmol/L in normotensive pregnant women group respectively. The difference was statistically significant for FRAP levels only.

CONCLUSION

Serum anti-oxidant levels are not raised among women with pre-eclampsia.

The role of glutathione peroxidase maternal serum level in late onset of severe preeclampsia

OBJECTIVE

This study was done to investigate the association between maternal serum glutathione peroxidase (GP) and late onset of severe preeclampsia.

METHODS

Cross-sectional study was undertaken comparing normal pregnancy and severe preeclampsia at 37-42 weeks of gestational age. Maternal venous blood was taken to assess the level of GP.

RESULT

Twenty normal pregnancy and 20 severe preeclampsia patients were investigated. The median (max-min) of GP level for preeclampsia was 4.31 (0.03-327.41) mU/mL significantly lower than in normal pregnancy 318.90 (6.46-694.11) mU/mL (p < 0.001). A receiver operating characteristics (ROC) analysis showed that the cutoff point for GP to differentiate between normal pregnancy and severe preeclampsia was 41.74 mU/mL. Multivariate analysis was done to investigate the impact of BMI and parity showed that a low level of GP will increase the risk of severe preeclampsia.

CONCLUSION

Low level of GP was associated with the diagnosis of severe preeclampsia.

Low serum selenium concentration is associated with preeclampsia in pregnant women from Bangladesh

OBJECTIVES

Preeclampsia is a hypertensive disorder of pregnancy which is one of the leading causes of maternal and perinatal mortality and pre-term delivery, especially in low and middle income countries. Selenium is an important constituent of selenoproteins that act as antioxidant and have several metabolic functions. The present study was conducted to determine serum selenium concentration in preeclampsia patients in order to find out the role of selenium in preeclampsia.

METHODS

This study was conducted as case-control study with 74 preeclampsia patients as cases whose gestation were ≥20 weeks (52 mild and 22 severe patients) and 118 normotensive pregnant women as controls from same gestational period. Detailed patient history was recorded during routine hospital visits. Serum selenium concentration was determined by using atomic absorption spectroscopy. Independent sample t-test and Pearson's correlation test were done for the statistical analysis using the statistical software package SPSS, version 16.

RESULTS

Our study found that mean serum concentration of selenium in preeclampsia patients was significantly lower than that of healthy pregnant women (p<0.05). Further analysis for selenium concentration with disease severity explored that selenium concentration was significantly lower in severe preeclampsia in comparison to mild preeclampsia (p<0.05). We found no significant difference for selenium concentration between rural and urban preeclampsia patients (p>0.05). Pearson's correlation analysis reveals significant negative correlation of selenium with systolic blood pressure (r=-0.419, p=0.001), diastolic blood pressure (r=-0.392, p=0.001), and gestational period (r=-0.218, p=0.001).

CONCLUSION

Our study found that preeclampsia patients have decreased serum selenium concentration than the healthy pregnant women.

GSTA1 gene variation associated with gestational hypertension and its involvement in pregnancy-related pathogenic conditions

OBJECTIVE(S)

Glutathione S-transferases (GSTs) are the main phase II enzymes involved in the cellular detoxification. Through phase I and phase II detoxification reactions, the cell is able to detoxify endogenous and exogenous toxic compounds. In this study, we focused our attention on the GSTA1*-69C/T gene polymorphism (rs3957357) in order to explore its involvement in the genetic predisposition to gestational hypertension (GH).

STUDY DESIGN

The case-control population consists of 195 subjects. The genotyping of the GSTA1*-69C/T was performed by using an RFLP-PCR technique. We calculated odds ratios (ORs), adjusted for the confounding variables, to estimate the association between GSTA1 and GH.

RESULTS

Significant allelic differences in GSTA1*-69C/T are present between GH women and pregnant women without cardiovascular complications (p<0.05). Specifically, we observed that the dominant genetic model best explains the observed genetic association, according to the Akaike information criterion and the Bayesian information criterion.

CONCLUSION(S)

Our study highlighted a significant association between the GSTA1 gene and the risk of GH in Italian patients. In particular, the -69C/T variant was significantly associated with disease risk. Since previous studies indicated that this GSTA1 polymorphism is associated with different pregnancy-related conditions, our finding supports the notion that GSTA1 may play a key role during pregnancy.

Oxidative stress and antioxidant status of pregnant rural women in north-west Nigeria: prospective cohort study

BACKGROUND/OBJECTIVE

This research was undertaken to determine the oxidative stress and antioxidant status of pregnant northern Nigerian women.

METHODS

Prospective cohort study. The study was done at General Hospital, Dawakin Kudu LGA, Kano. Kano has a population of 9.2 million and predominantly Muslims. Two hundred consecutive women presenting for antenatal care and 100 apparently normal controls. Ethical approval was obtained. Socio-demographic and clinical information were obtained via interviewer-administered questionnaires from 200 consecutive pregnant women who presented for antenatal care. Serum levels of vitamins A, C, E and malondialdehyde were determined. Data was analyzed with SPSS version 16.0 statistical software. Descriptive statistics was used. Means were compared using analysis of variance (ANOVA). Associations between trimesters and oxidative stress/antioxidant status were tested using chi-square test and p < 0.05 was considered statistically significant.

RESULT

The mean serum vitamin A, E and C levels were 13.39 ± 9.44 µg/dl, 0.35 ± 0.51 mg/dl and 5.99 ± 3.95 µ/dl respectively (below normal limits). The prevalence of vitamins A, C and E deficiency were 65.5%, 79.5% and 51% respectively. The mean serum levels of malondialdehyde was 4.04 ± 0.91 nmol/l (pregnant) and 1.84 ± 0.40 nmol/l (non-pregnant) (p = 0.001). There was strong negative correlation between serum levels of malondialdehyde and vitamins A, C and E.

CONCLUSION

Vitamins A, C, E deficiency and oxidative stress is a problem among Northern Nigeria pregnant women, therefore the value of antioxidant vitamin supplementation should be explored.

Oxidative stress increased in pregnant women with iodine deficiency

Iodine is an essential element trace for the synthesis of maternal thyroid hormones needed to support normal fetal development; it also acts as an antioxidant directly or induce antioxidant enzymes indirectly. Iodine deficiency and oxidative stress are associated with pregnancy complications. This study aimed to assess the urinary iodine concentration and its relationship with the antioxidant and oxidative stress status during gestation. Pregnant women were consecutively recruited from an obstetric clinic during all gestation trimesters, and urinary iodine concentration, antioxidant, and oxidative stress were determined. Results showed that 70 % of pregnant women have optimal iodine levels (150-200 μg/L), while approximately 30 % showed mild iodine deficiency (50-99 μg/L). Oxidative stress was significantly higher, and the antioxidant status was also compromised as evidenced by decreased total antioxidant status and superoxide dismutase (SOD) activity in pregnant women with mild iodine deficiency than pregnant women with optimal iodine levels. Significant positive correlations were noted between optimal iodine levels and total antioxidant status. Oxidative stress was significantly correlated with mild iodine deficiency. However, no significant correlation was found between iodine levels and SOD and catalase activities. In conclusion, for the first time, these data suggest a correlation between iodine levels and the antioxidant status during pregnancy.

Protective effect of Cymbopogon citratus on hydrogen peroxide-induced oxidative stress in the reproductive system of male rats

Cymbopogon citratus (C. citratus) has antioxidant, anti-inflammatory, and chemoprotective properties. This study was conducted to evaluate the protective effect of C. citratus aqueous extract against hydrogen peroxide (H2O2)-induced oxidative stress and injury in the reproductive system of male rats. The twenty-five rats used in this study were divided into five groups, comprised of five rats each. The control group received standard food and drink. The H2O2 group received standard food and water with 0.5% H2O2. The rats in the H2O2 + C. citratus group and H2O2 + vitamin E group received standard food, H2O2, and C. citratus [100 mg·kg(-1) body weight (bw)], or vitamin E as an antioxidant reference (500 mg·kg(-1) bw), respectively. The C. citratus group was given C. citratus (100 mg·kg(-1) bw) in addition to the standard food and drink. The treatments were administered for 30 days. The H2O2 treatment significantly (P < 0.05) decreased body, testicular, and epididymal weight, as well as glutathione (GSH) level, but markedly increased malonaldehyde (MDA) in serum and testes homogenates. The rats treated with H2O2 exhibited testicular degeneration and significant reduction in sperm viability, motility, count, and rate of normal sperm. The C. citratus, vitamin E, and H2O2 treatment significantly (P < 0.05) increased the body, testicular, and epididymal weight, testosterone level, the values of the various sperm characteristics, and GSH. However, this treatment markedly reduced MDA in serum and testes homogenates, as well as testicular histopathological alterations in the H2O2-treated rats. The C. citratus aqueous extract reduced oxidative stress and protected male rats against H2O2-induced reproductive system injury.

Biochemical profile and outcome in normal and high risk subjects

The present study was carried out to assess the biochemical profile and outcome of pregnancy and study the adverse consequences if any, among normal and high risk pregnant women. The study group included 182 normal and 168 high risk cases attending to private and Government Hospitals in Bangalore. The high risk groups were: Pregnancy induced hypertension (PIH), gestational diabetes mellitus (GDM), Adolescents and anemic cases. Lipid peroxidation was enhanced in PIH and GDM groups (5.56 nmol/ml and 3.98 nmol/ml) MDA values as compared to other groups. Vitamin E levels were significantly (p< 0.05) lower in PIH group (0.38 mg/dl) as compared to other groups. Caesarean as a mode of delivery indicating more number of complications were higher among GDM (61.9%) followed by PIH group. Incidences of low birth weight were observed more in PIH group. The study revealed occurrence of oxidative stress and adverse outcome among high risk pregnancy groups.

Total serum vitamin C concentration in pregnant women: implications for a healthy pregnancy

OBJECTIVES: total serum vitamin C (L-ascorbic acid) concentration was measured in 90 pregnant women, 30 in each trimester (age range 18-35 years) and a control group of age-matched non-pregnant women. METHODS: total serum vitamin C concentration was measured using the 2.4-dinitrophenylhydrazine method which involves the conversion of vitamin C to dehydroascorbic acid in the presence of copper (II) ions and subsequent measurement of the resulting bis-hydrazone at 540nm. RESULTS: the total vitamin C concentration in the first trimester was 2.55 ± 0.82 mg/dl and 2.32 ± 0.40 mg/dl and 0.77 ± 0.10 mg/dl in the second and third trimesters respectively. Relative to serum total vitamin C concentration in the controls (3.15 ± 0.13 mg/dl) these values are significantly lower (p < 0.05). CONCLUSIONS: low serum vitamin C in pregnancy may indicate utilization of this vitamin to mop up the excess reactive oxygen species and maintain its normal homeostasis. Therefore, Vitamin C supplementation during pregnancy is recommended in order to boost the body's low vitamin C level and prevent the predisposition to low birth weight babies, premature delivery and pre-eclamsia all of which are known to be associated with sub-optimal vitamin C levels during pregnancy.