Alterations of Oxidative Metabolism at the Pregnancy Attended with Pre-eclampsia

Tinatin Khetsuriani, Tamar Sanikidze, Rusudan Khugashvili

Tbilisi State Medical University, Georgia

Numerous facts suggest that diverse complications of pre-eclampsia are caused by pathological changes in the maternal vascular endothelium. Intensification of oxidative stress and nitric oxide deficiency have been thought to play important role in the development of structural and functional changes in vascular endothelium of maternal organism. Hence, our objective is to identify the role of nitric oxide metabolism and oxidative stress in the mechanism of late toxicosis of pregnant. During the pregnancy with pre-eclampsia a significant rise of oxidized ceruloplasmin indicates to the activation of oxidative processes in the organism and lowered antioxidant defense of blood. Oxidation of ceruloplasmin causes also reduction of its ferroxidative activity, which becomes apparent by drastic decrease of Fe3+-transferrin in blood and accumulation of Fe2+ ions in blood serum. Fe2+ ions are potent promoters of processes of free radical oxidation. Oxidative stress is one of the factors, which favor an activation of nitrosilation by NO of dezoxyhemoglobin converting the latter into nitrosohemoglobin (HbNO). This mechanism results in the reduction of the level of free NO and the restriction of its vascular dilating effect. Under the conditions of oxidative stress nitric oxide can also be converted into cytotoxic peroxinitrite, which has high vascular constrictive activity and contributes to the development of vascular endothelial dysfunction and an increase in resistance characteristic for pre-eclampsia. Thus, results of the present study suggest that during the pregnancy attended with pre-eclampsia, the intensification of free radical oxidation (that reveals in blood by disorder of antioxidant defense ceruloplasmin - Fe3+-transferrin enzymatic system function) and the restriction of physiological function of free NO (that results from its conversion into HbNO complexes and peroxinitrite) contribute to an increase in vascular resistance and the development of endothelial dysfunction.

Keywords:  pregnancy, oxidative metabolism, pre-eclampsia, nitric oxide, manganese, iron