Effect of Low-Dose Aspirin on Fetal and Maternal Generation of Thromboxane by Platelets in Women at Risk for Pregnancy-Induced Hypertension

Benigni, Ariela; Gregorini, Gina; Frusca, T.; Chiabrando, Chiara; Ballerini, Sabrina; Valcamonico, Adriana; Orisio, Silvia; Picinelli, A.; Pinciroli, Vittorio; Fanelli, Roberto; Gastaldi, A; Remuzzi, Giuseppe

doi:10.1097/00132582-199004000-00004

Cited by 28 publications

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“…Normal pregnancy is associated with a characteristic change in systemic and renal hemodynamics. The vascular endothelium generates both vasodilators and vaso- constrictors, and a correct balance between these substances may be crucial to the adaptive changes occurring during pregnancy (9). Therefore, AM is believed to be responsible for the marked resistance to the pressor effects of angiotensin II (20) and endothelin, resulting in a modest decrease in blood pressure during the course of a normal pregnancy (21).…”

Section: Discussionmentioning

confidence: 99%

“…The intra-and interassay coefficients of variation (n ¼ 5) were 4.8% and 8.3% respectively. The cross-reactivities of the antibody were 100% with intact hAM(1-52), 10% with hAM(13-52) and hAM (1)(2)(3)(4)(5)(6)(7)(8)(9)(10), and less than 0.1% with hAM(33-52), calcitonin gene-related peptide (CGRP) and amylin. No cross-reactivities were observed with various other vasoactive polypeptides.…”

Section: Radioimmunoassay Of Hammentioning

confidence: 99%

“…irhAM has been shown to circulate in human plasma (4,5), suggesting its role as a vasodilatory hormone, and circulating irhAM is known to be secreted mainly from vascular cells (2). Some papers have reported that the concentration of AM is increased in pregnancy (6,7), similarly to other vasodilatory substances such as prostacyclin and prostaglandin E 2 (8,9). Montuenga et al (10) reported that placental tissues of mouse and rat express high levels of AM and AM receptor.…”

Section: Introductionmentioning

confidence: 99%

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Immunoreactive adrenomedullin (AM) concentration in maternal plasma during human pregnancy and AM expression in placenta

Kobayashi

Kubota²,

T³

et al. 2000

European Journal of Endocrinology

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Adrenomedullin (AM) is a novel vasorelaxant peptide, isolated from human pheochromocytoma. Although AM may be involved in the regulation of the cardiovascular system, a number of other mechanisms are also involved. The present study was undertaken to confirm the presence of AM in human maternal circulation and in placental function during pregnancy. Immunoreactive (ir) AM concentrations in maternal plasma were 3.4 Ϯ 0.7 fmol/ml (mean Ϯ S.E.M.) in the first trimester, 3.3 Ϯ 1.1 fmol/ml in the second trimester, 7.3 Ϯ 2.8 fmol/ml in the third trimester, 4.1 Ϯ 1.9 fmol/ ml in early puerperium and 3.0 Ϯ 0.4 fmol/ml in non-pregnant periods; the concentration in the third trimester was significantly greater than those in other periods. Plasma concentrations of estradiol (E 2 ), progesterone, human placental lactogen (hPL) and human chorionic gonadotropin (hCG) were also measured, using RIA kits. Significant correlations have been demonstrated between the concentrations of irAM and those of E 2 , progesterone and hPL. We therefore examined the expression of AM within the placental tissues using immunohistochemistry and northern blot analysis in order to demonstrate a correlation between the presence of AM in the placenta and maternal plasma. Using immunohistochemistry, we detected AM in the amnion at term and the expression of AM mRNA in human placental tissues using cloned human (h) AM complementary DNA as a probe. This study demonstrates the immunoreactivity of human hAM in maternal plasma during pregnancy, and suggests that hAM in maternal plasma is generated partly from placental tissue.

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Section: Discussionmentioning

confidence: 99%

Section: Radioimmunoassay Of Hammentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Immunoreactive adrenomedullin (AM) concentration in maternal plasma during human pregnancy and AM expression in placenta

Kobayashi

Kubota²,

T³

et al. 2000

European Journal of Endocrinology

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“…Low-dose acetylsalicylic acid therapy inhibits thromboxane more than prostacyclin production, and thereby protects against vasoconstriction and pathologic blood coagulation in the placenta 3,4 .…”

Section: Introductionmentioning

confidence: 99%

Low dose acetylsalicylic acid in prevention of pregnancy-induced hypertension and intrauterine growth retardation in women with bilateral uterine artery notches

Vainio¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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Objective To evaluate the efficacy of low-dose acetylsalicylic acid in the prevention of pregnancy-induced hypertension and intrauterine growth retardation in high-risk pregnancies as determined by transvaginal Doppler ultrasound study of the uterine arteries at 12 to 14 weeks of gestation. Design Randomised, double blind and placebo-controlled trial.Setting The Department of Obstetrics and Gynaecology, Tampere University Hospital, Finland.Population One hundred and twenty pregnant women considered to be at high risk of pre-eclampsia or intrauterine growth retardation were screened by transvaginal Doppler ultrasound at 12 to 14 weeks of gestation. Methods Ninety pregnant women with bilateral notches in the uterine arteries were randomised to receive acetylsalicyclic acid 0.5mg/kg/day (n ¼ 45) or placebo (n ¼ 45) from 12 to 14 weeks of gestation. Main outcome measures Hypertensive disorders of pregnancy and intrauterine growth retardation.Results Forty-three women on acetylsalicyclic acid and 43 on placebo were successfully followed up. The use of acetylsalicyclic acid was associated with a statistically significant reduction in the incidence of pregnancy-induced hypertension (11.6% vs 37.2%, RR ¼ 0.31, 95% CI 0.13 -0.78) and pre-eclampsia (4.7% vs 23.3%, RR ¼ 0.2, 95% CI 0.05 -0.86). The incidence of hypertension before 37 weeks of pregnancy was also significantly reduced (2.3% vs 20.9%, RR ¼ 0.22, 95% CI 0.05 -0.97). The reduction in the incidence of intrauterine growth retardation (2.3% vs 7%) was not statistically significant. Acetylsalicyclic acid was not associated with excess risk of maternal or fetal bleeding. Conclusion In women rated in Doppler velocimetry waveform analysis to be at high risk of pre-eclampsia, low-dose acetylsalicyclic acid reduces the incidence of pregnancy-induced hypertension and especially proteinuric pre-eclampsia.

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“…Seguiram-se publicações de 10 estudos randomizados, com administração de aspirina iniciada até às 16 semanas, entre 1985 e 2005 (Tabela 3). [8][9][10][11][12][13][14][15][16][17][18] Estes trabalhos foram desenhados com utilização precoce de aspirina; nos grupos de estudo foi verificada redução de resultados desfavoráveis nos casos de risco de pré-eclâmpsia, o que acentuará a importância da sua utilização precoce, até às 16 semanas, momento em que deve estar terminada a segunda onda de invasão trofoblástica e completada a remodelação das arteríolas espiraladas. Contudo, estes trabalhos continham um número reduzido de casos e, embora metodologicamente corretos, os seus resultados necessitavam de ser replicados em estudos com maior número de casos.…”

Section: Methodsunclassified

O Papel da Aspirina na Prevenção da Pré-Eclâmpsia: Estado da Arte

Campos

2015

Acta Med Port

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Acta Med Port 2015 Jul-Aug;28(4):517-524 RESUMOIntrodução: O papel do ácido acetilsalicílico (AAS ou aspirina) na prevenção das complicações associadas à pré-eclâmpsia tem sido objeto de estudos e de controvérsias ao longo de 30 anos. Os primeiros trabalhos de investigação acerca do papel da placenta na gé-nese da pré-eclâmpsia surgiram em finais dos anos 70 e assinalavam um aumento da atividade plaquetária e alteração da síntese das prostaglandinas, como consequência da deficiente adaptação da placenta. Ao longo dos últimos 20 anos do século XX, sucederam-se estudos de investigação acerca do papel profilático da aspirina na redução do risco de pré-eclâmpsia. Material e Métodos: Para analisar os trabalhos publicados sobre o uso da aspirina na prevenção da pré-eclâmpsia, bem como sobre a dose mais adequada e momento de administração, foram consultados apenas estudos prospetivos, revisões sistemáticas e meta-análises através das seguintes fontes pesquisa (PubMed, Cochrane, Embase). Os artigos citados foram considerados os mais relevantes. Os trabalhos foram divididos em dois grupos: no primeiro foram incluídos os trabalhos em que a aspirina era administrada até às 16 semanas e o segundo, com início de administração por um período mais alargado. Resultados e Discussão:No primeiro grupo, com menor número de casos, mas com início mais precoce de administração do fár-maco, até às 16 semanas, concluiu-se que a aspirina poderia ter um papel positivo na redução de risco de gravidade da pré-eclâmpsia; o segundo grupo, com maior número de casos nos estudos, mas com condições menos restritas de entrada e de tempo de início do fármaco, teve resultados mais controversos. As meta-análises destes estudos concluíram que os resultados favoráveis estavam associados às condições de e momento da administração. Conclusão: Não existindo ainda alternativas ou fármacos que lhe possam ser associados, a aspirina em baixas doses (80 a 150 mg/ dia) ao deitar, iniciada no 1º trimestre e até às 16 semanas mantém-se um fármaco seguro, que tem contribuído para redução do risco de pré-eclâmpsia precoce, com as consequências que lhe estão associadas. Palavras-chave: Aspirina; Pré-eclâmpsia/prevenção e controlo. ABSTRACT Introduction:The role of acetyl salicylic acid (ASA or aspirin) in preeclampsia prevention and in other complications has been subject to studies and controversies for the last 30 years. The first research results concerning the role of placenta in preeclampsia have been published by the end of seventies and they showed an increase in the platelet activity and a prostaglandin synthesis disturbance, as a consequence of a deficient placentation. In the last twenty years of the XX century important studies were published on the aspirin prophylactic role in preeclampsia risk reduction. Material and Methods:To analyze published studies about Aspirin use for preeclampsia prevention and about the more adequate dosage to be administered, Medline was used for searching the most relevant prospective research papers on this subject in order ...

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Effect of Low-Dose Aspirin on Fetal and Maternal Generation of Thromboxane by Platelets in Women at Risk for Pregnancy-Induced Hypertension

Cited by 28 publications

References 0 publications

Immunoreactive adrenomedullin (AM) concentration in maternal plasma during human pregnancy and AM expression in placenta

Immunoreactive adrenomedullin (AM) concentration in maternal plasma during human pregnancy and AM expression in placenta

Low dose acetylsalicylic acid in prevention of pregnancy-induced hypertension and intrauterine growth retardation in women with bilateral uterine artery notches

O Papel da Aspirina na Prevenção da Pré-Eclâmpsia: Estado da Arte

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