Evidence against a pathogenetic role for endothelin in pre-eclampsia.
OBJECTIVE
To assess whether increased placental or systemic endothelin synthesis has a pathogenic role in pre-eclampsia (gestational proteinuric hypertension).


METHODS
Prospective observations study.


METHODS
19 women with pre-eclampsia and 10 healthy pregnant women were studies. All were in the last trimester.


METHODS
Preproendothelin-1 gene expression by Northern blot analysis and generation of endothelin-1 precursor, big-endothelin-1, and endothelin isoforms, namely endothelin-1, 2 and 3, were assessed by specific radio-immunoassays, in placental tissue. Plasma endothelin-1 levels and urinary excretion of big-endothelin-1 and endothelin-1 were measured.


RESULTS
Placental preproendothelin-1 gene expression and immunoreactive big-endothelin-1 and endothelin-1, 2 and 3, were comparable in placental tissue from pre-eclamptic and normal pregnant women. Plasma levels of endothelin-1 did not differ between pre-eclamptic and normal pregnancies. In contrast, urinary excretion of endothelin-1, which is likely to reflect the renal synthesis of the peptide, was significantly decreased in pre-eclamptic, as compared with normal pregnant women. This was not due to a decreased renal generation of endothelin-1 precursor, since urinary excretion of big-endothelin-1 did not differ between pre-eclamptic and normal pregnancies. These data suggest an increased renal endothelin-1 breakdown in pre-eclampsia.


CONCLUSIONS
Endothelin is unlikely to play a role in the pathogenesis of pre-eclampsia. Instead, an increased renal breakdown may have a role in limiting the negative effects of other vasoactive factors on the renal circulation.
Benigni
A
A
Mario Negri Institute for Pharmacological Research, Bergamo, Italy.
Orisio
S
S
Gaspari
F
F
Frusca
T
T
Amuso
G
G
Remuzzi
G
G
D000328:Adult; D016232:Endothelins / Q000235:genetics / Q000378:metabolism* / Q000652:urine; D005260:Female; D006801:Humans; D007668:Kidney / Q000378:metabolism; D010920:Placenta / Q000378:metabolism; D011225:Pre-Eclampsia / Q000209:etiology / Q000378:metabolism* / Q000652:urine; D011247:Pregnancy; D011446:Prospective Studies; D012313:RNA / Q000378:metabolism
D016232:Endothelins; D012313:RNA