title: Is there a link between endothelial dysfunction, coagulation activation and nitric oxide synthesis in preeclampsia?
abstract: BACKGROUND
  There may be a relationship between endothelial dysfunction, coagulation activation and nitric oxide (NO) synthesis in women with mild and severe preeclampsia (PE).
  
  
  METHODS
  Plasma thrombomodulin (TM), D-Dimer (D-Di), cyclic guanosine monophosphate (cGMP) and placental nitric oxide synthase activity (NOS) were investigated in 21 normotensive pregnant women (G1), 22 pregnant women with mild PE (G2) and 20 pregnant women with severe PE (G3).
  
  
  RESULTS
  TM and D-Di were significantly increased in G3 compared to G1 (P=0.001 and P=0.006, respectively) and G2 (P=0.001, in both cases). However, there was no significant difference when G1 was compared to G2. For total NOS, calcium independent NOS, calcium dependent NOS no significant difference was observed among the groups studied.
  
  
  CONCLUSIONS
  TM and D-Di levels are raised in women with severe PE compared to normotensive pregnant women and women with mild PE. While increased TM levels may reflect endothelial dysfunction, raised D-Di levels indicate a hypercoagulable state. NO assessed by 2 indirect methods did not show any significant difference among the groups studied. Due to current limitations with in vitro NO measurements and interferences associated with NO bioavailability, particularly in PE, such findings should not be over-interpreted.
authors.affiliation: Faculty of Pharmacy, Universidade Federal de Minas Gerais, Brazil. lucidusse@gmail.br
authors.forename: Luci Maria
authors.initials: LM
authors.lastname: Dusse
authors.forename: Patrícia Nessralla
authors.initials: PN
authors.lastname: Alpoim
authors.forename: Bashir A
authors.initials: BA
authors.lastname: Lwaleed
authors.forename: Lirlândia Pires
authors.initials: LP
authors.lastname: de Sousa
authors.forename: Maria das Graças
authors.initials: Md
authors.lastname: Carvalho
authors.forename: Karina Braga
authors.initials: KB
authors.lastname: Gomes
mesh_terms: D000328:Adult; D001777:Blood Coagulation; D006152:Cyclic GMP / Q000097:blood; D042783:Endothelial Cells / Q000378:metabolism* / Q000473:pathology; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006801:Humans; D009569:Nitric Oxide / Q000096:biosynthesis / Q000097:blood*; D052247:Nitric Oxide Synthase Type II / Q000378:metabolism; D052250:Nitric Oxide Synthase Type III / Q000378:metabolism; D010920:Placenta / Q000378:metabolism* / Q000473:pathology; D011225:Pre-Eclampsia / Q000097:blood* / Q000473:pathology; D011247:Pregnancy; D012720:Severity of Illness Index; D018180:Thrombomodulin / Q000097:blood
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D018180:Thrombomodulin; C036309:fibrin fragment D; D009569:Nitric Oxide; D052247:Nitric Oxide Synthase Type II; D052250:Nitric Oxide Synthase Type III; D006152:Cyclic GMP