title: Pathophysiological basis for the prophylaxis of preeclampsia through early supplementation with antioxidant vitamins.
abstract: Preeclampsia (PE) is a multisystem disorder that remains a major cause of maternal and foetal morbidity and death. To date, no treatment has been found that prevents the development of the disease. Endothelial dysfunction is considered to underlie its clinical manifestations, such as maternal hypertension, proteinuria, and edema; however, the precise biochemical pathways involved remain unclear. A current hypothesis invokes the occurrence of oxidative stress as pathogenically important, as suggested by the fact that in PE, the placental and circulating levels of lipid peroxidation products (F2-isoprostanes and malondialdehyde [MDA]) are increased and endothelial cells are activated. A potential mechanism for endothelial dysfunction may occur via nuclear transcription factor kappa B (NF-kappaB) activation by oxidative stress. Alternatively, the idea that the antiangiogenic placental soluble fms-like tyrosine kinase 1 factor (sFlt1) is involved in the pathogenesis of this disease is just emerging; however, other pathophysiological events seem to precede its increased production. This review is focused on evidence providing a pathophysiological basis for the beneficial effect of early antioxidant therapy in the prevention of PE, mainly supported by the biological effects of vitamins C and E.
authors.affiliation: Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Independencia 1027, Casilla 70058, Santiago 7, Chile. rrodrigo@med.uchile.cl
authors.forename: Ramón
authors.initials: R
authors.lastname: Rodrigo
authors.forename: Mauro
authors.initials: M
authors.lastname: Parra
authors.forename: Cleofina
authors.initials: C
authors.lastname: Bosco
authors.forename: Virginia
authors.initials: V
authors.lastname: Fernández
authors.forename: Pilar
authors.initials: P
authors.lastname: Barja
authors.forename: José
authors.initials: J
authors.lastname: Guajardo
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Messina
mesh_terms: D000818:Animals; D000975:Antioxidants / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D018384:Oxidative Stress / Q000187:drug effects*; D010920:Placenta / Q000187:drug effects* / Q000201:enzymology / Q000378:metabolism; D011225:Pre-Eclampsia / Q000201:enzymology / Q000378:metabolism / Q000517:prevention & control*; D011247:Pregnancy; D013997:Time Factors; D014815:Vitamins / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D014815:Vitamins