Placental expression of endothelial and inducible nitric oxide synthase and nitric oxide levels in patients with HELLP syndrome

• Published in: American journal of obstetrics and gynecology Vol. 205; no. 3; pp. 236.e1 - 236.e7
• Main Authors: Mazzanti, Laura, Cecati, Monia, PhD, Vignini, Arianna, PhD, D'Eusanio, Sara, MD, Emanuelli, Monica, Giannubilo, Stefano R., MD, PhD, Saccucci, Franca, Tranquilli, Andrea L., MD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01-09-2011
• Subjects: Adult; eNOS; Female; Gestational Age; HELLP; HELLP Syndrome - genetics; HELLP Syndrome - metabolism; Humans; Infant, Newborn; Infant, Premature; iNOS; mRNA; Nitric Oxide - genetics; Nitric Oxide - metabolism; Nitric Oxide Synthase Type II - genetics; Nitric Oxide Synthase Type II - metabolism; Nitric Oxide Synthase Type III - genetics; Nitric Oxide Synthase Type III - metabolism; Obstetrics and Gynecology; Peroxynitrous Acid - genetics; Peroxynitrous Acid - metabolism; placenta; Placenta - metabolism; Platelet Count; Pregnancy; syndrome; NO; eNOS; HELLP; syndrome; iNOS; placenta; mRNA
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2011.04.022

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. Study Design 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. Conclusion 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.