title: Placental expression of endothelial and inducible nitric oxide synthase and nitric oxide levels in patients with HELLP syndrome.
abstract: OBJECTIVE
  To determine placental gene expression of endothelial and inducible nitric oxide synthases and measure nitric oxide levels in patients with hemolysis, elevated liver enzyme levels, and low platelet count syndrome.
  
  
  METHODS
  Preterm placentas were obtained from 15 patients with hemolysis, elevated liver enzyme levels, and low platelet count syndrome and 30 controls matched for age, parity, and gestational age. mRNA levels were evaluated by real-time polymerase chain reaction, whereas nitric oxide and peroxynitrite production was measured by a commercially available kit.
  
  
  RESULTS
  Placental gene expression of inducible nitric oxide and endothelial nitric oxide synthases were significantly lower in the hemolysis, elevated liver enzyme levels, and low platelet count syndrome group than in controls, whereas nitric oxide and peroxynitrite production were significantly higher in hemolysis, elevated liver enzyme levels, and low platelet count syndrome compared with controls.
  
  
  CONCLUSIONS
  The reduced endothelial nitric oxide and inducible nitric oxide synthases gene expression in women with hemolysis, elevated liver enzyme levels, and low platelet count syndrome may indicate extreme placental dysfunction that is unable to compensate the endothelial derangement and the related hypertension. The higher nitric oxide formation found in hemolysis, elevated liver enzyme levels, and low platelet count syndrome placentas could be explained as a counteraction to the impaired fetoplacental perfusion, typical of the syndrome.
authors.affiliation: Department of Biochemistry, Biology and Genetics, Università Politecnica Marche, Ancona, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Mazzanti
authors.forename: Monia
authors.initials: M
authors.lastname: Cecati
authors.forename: Arianna
authors.initials: A
authors.lastname: Vignini
authors.forename: Sara
authors.initials: S
authors.lastname: D'Eusanio
authors.forename: Monica
authors.initials: M
authors.lastname: Emanuelli
authors.forename: Stefano R
authors.initials: SR
authors.lastname: Giannubilo
authors.forename: Franca
authors.initials: F
authors.lastname: Saccucci
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Tranquilli
mesh_terms: D000328:Adult; D005260:Female; D005865:Gestational Age; D017359:HELLP Syndrome / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D009569:Nitric Oxide / Q000235:genetics / Q000378:metabolism*; D052247:Nitric Oxide Synthase Type II / Q000235:genetics / Q000378:metabolism*; D052250:Nitric Oxide Synthase Type III / Q000235:genetics / Q000378:metabolism*; D030421:Peroxynitrous Acid / Q000235:genetics / Q000378:metabolism; D010920:Placenta / Q000378:metabolism*; D010976:Platelet Count; D011247:Pregnancy
chemical_list: D030421:Peroxynitrous Acid; D009569:Nitric Oxide; D052247:Nitric Oxide Synthase Type II; D052250:Nitric Oxide Synthase Type III