Possibilities of preeclampsia prevention: today and tomorrow


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Аннотация

This review is aimed to the discussion of the current and future possibilities of medicine in the prevention of preeclampsia (PE) and placenta-associated pregnancy complications (PAPC). PE remains one of the significant causes of maternal and perinatal morbidity and mortality, and lead to a lot of preterm births. The relevance of the problem of PE and PAPC is determined primarily by the lack of effective treatment for advanced clinical symptoms, as well as the need to terminate the pregnancy in such cases, regardless of gestational age and prognosis for the fetus. In this regard, PE prevention is of great importance for clinical practice. The review presents a modern concept of the pathogenesis of PE, highlights the key points of disorders in the hemostatic system, leading to the development of clinical symptoms and PE. It is also shown that the imbalance between the thromboxane and endothelial prostacyclin levels, as well as between the number of pro- and antiangiogenic factors in pregnant women with PE can be considered as a therapeutic target in the prevention and treatment of PE, and it is reasonable to prescribe antiplatelet agents and anticoagulants for the prevention of PE. Modern systematic reviews and a meta-analysis have shown a certain effectiveness of antiplatelet agents and anticoagulants in the prevention of PAPC. The review highlights the role of deficiency of certain nutrients in the development of PAPC and administration of folate for their prevention. The data presented indicate that today there are PARC prevention methods that can significantly reduce their probability by 17-30% in pregnant women with a high risk of this obstetric pathology. However, a complete prevention and effective treatment of PAPC at the stage of advanced clinical symptoms has not been developed to date, which leads to abortion in the early stages, to perinatal morbidity and mortality. Therefore, the development of new treatments that completely prevent or cure PE would be a major achievement for practical obstetrics. The review presents the main directions of research in this direction, in particular, clinical studies of drugs that can reduce the secretion of sFlt-1 and soluble endoglin, thus curing endothelial dysfunction in PE.

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Авторлар туралы

Vera Gurieva

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: helgin99@gniail.com
Dr. Sci. (Med.), Leading Researcher at the Obstetric Physiological Department

A. Travkina

Moscow Regional Research Institute of Obstetrics and Gynecology

M. Matveev

Moscow Regional Research Institute of Obstetrics and Gynecology

L. Morokhotova

Moscow Regional Research Institute of Obstetrics and Gynecology

Yu. Kotov

Keldysh Institute of Applied Mathematics

T. Semenova

National Research Nuclear University MEPhI

Әдебиет тізімі

  1. Say L, Chou D., Gemmill A., et al. Global causes of maternal death: a WHO systematic analysis. Lancet. Glob Health. 2014;2:e323-33. doi: 10.1016/S2214-109X(14)70227-X.
  2. Шалина НИ., Михалева Л.М., Симухина М.А. и др. Особенности течения тяжелых форм преэклампсии в современных условиях. Вопросы гинекологии, акушерства и перинатологии. 2017;16(6):16-23.
  3. Sharp A, Jackson R., Cornforth C., et al. A prediction model for short-term neonatal outcomes in severe early-onset fetal growth restriction. Eur J Obstet Gynecol Reprod Biol. 2019;241:109-18. doi: 10.1016/j.ejogrb.2019.08.007.
  4. Lecarpentier E., Haddad B., Goffinet F, Tsatsaris V Medical approaches for managing preeclampsia. Presse Med. 2016;45(7-8 Pt. 1):638-45. doi: 10.1016/j.lpm.2016.04.017.
  5. Walsh S.W. Eicosanoids in preeclampsia. Prostaglandins Leukot. Essent Fatty Acids. 2004;70:223-32. Doi: 10.1016/j. plefa.2003.04.010.
  6. Walsh S.W. Low-dose aspirin: treatment for the imbalance of increased thromboxane and decreased prostacyclin in preeclampsia. Am J Perinatol. 1989;6:124-32. doi: 10.1055/s-2007-999562.
  7. Perneby C, Vahter M., Akesson A., et al. Thromboxane metabolite excretion during pregnancy - influence of preeclampsia and aspirin treatment. Thromb Res. 2011;127:605-6. doi: 10.1016/j.thromres.2011.01.005.
  8. Sibai B.M., Mirro R., Chesney C.M., Leffler C. Low-dose aspirin in pregnancy. Obstet Gynecol. 1989;74:551-55.
  9. Scazzocchio E., Oros D., Diaz D., et al. Impact of aspirin on trophoblastic invasion in women with abnormal uterine artery Doppler at 11-14 weeks: a randomized controlled study Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obstet Gynecol. 2017;49:435-41. doi: 10.1002/uog.17351.
  10. Harker L.A., Kadatz R.A. Mechanism of action of dipyridamole. Thromb Res. 1983;29:39-46. doi: 10.1016/0049-3848(83)90356-0.
  11. Vieillefosse S., Guibourdenche J., Atallah A., et al. Predictive and prognostic factors of preeclampsia: interest of PlGF and sFLT-1. J Gynecol Obstet Biol Reprod. (Paris). 2016;45:999-1008. doi: 10.1016/j.jgyn.2016.02.006.
  12. Li C, Raikwar N.S., Santillan M.K., et al. Aspirin inhibits expression of sFLT1 from human cytotro-phoblasts induced by hypoxia, via cyclo-oxygenase 1. Placenta. 2015;36:446-53. Doi: 10.1016/j. placenta. 2015.01.004
  13. Duley L., Meher S., Hunter K.E., et al. Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev. 2019;2019(10):CD004659. doi: 10.1002/14651858.CD004659.pub3.
  14. Duley L., Henderson-Smart D.J., Meher S., King J.F. Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev. 2007;(2):CD004659. doi: 10.1002/14651858. CD004659.pub2.
  15. Meher S., Duley L., Hunter K., Askie L. Antiplatelet therapy before or after 16 weeks' gestation for preventing preeclampsia: an individual participant data meta-analysis. Am J Obstet Gynecol. 2017;216(2): 121 -28.e2. Doi: 10.1016/j. ajog.2016.10.016.
  16. North R.A., Ferrier C., Gamble G., et al. Prevention of preeclampsia with heparin and antiplatelet drugs in women with renal disease. Aust N Z J Obstet Gynaecol. 1995;35(4):357-62. doi: 10.1111/j.1479-858x.1995.tb05141.x.
  17. Козловская Н.Л., Сидорова И.С., Рогов В.А. и др. Состояние эндотелия и тромбоцитов у беременных с хроническим гломерулонефритом и лечебные возможности ацетилсалициловой кислоты и дипиридамола. Терапевтический архив. 5004;76(15);58-64.[Kbzlo vskaya N.L., SidorovI.S., Rogov V.A., et al. Condition of endothelium and platelets in pregnant women with chronic glomerulonephrite and therapeutic capabilities of acetylsalicylic acid and dipyridamol. Terapevticheskiy Archiv. 2004;76(12);58-64. (In Russ.)].
  18. McLaughlin K., Drewlo S., Parker J.D., Kingdom J.C. Current theories on the prevention of severe preeclampsia with low-molecular weight heparin. Hypertension. 2015;66:1098-103. Doi: 10.1161/ HYPERTENSIONAHA.115.05770.
  19. Gris J.C., Chauleur C., Molinari N., et al. Addition of enoxaparin to aspirin for the secondary prevention of placental vascular complications in women with severe preeclampsia. The pilot randomised controlled NOH-PE trial. Thromb Haemost. 2011;106:1053-61. doi: 10.1160/TH11-05-0340.
  20. Rey E., Garneau P, David M., Gauthier R., Leduc L., Michon N., et al. Dalteparin for the prevention of recurrence of placental- mediated complications of pregnancy in women without thrombophilia: a pilot randomized controlled trial. J Thromb Haemost. 2009;7:58-64. doi: 10.1111/j.1538-7836.5008.03530.x.
  21. de Vries J.I., van Pampus M.G., Hague W.M., et al. Low-molecular-weight heparin added to aspirin in the prevention of recurrent early-onset preeclampsia in women with inheritable thrombophilia: theFRUIT-RCT. J ThrombHaemost. 5015;10:64-75. doi: 10.1111/j.1538-7836.2011.04553.x.
  22. Kupferminc M., Rimon E., Many A., et al. Low molecular weight heparin versus no treatment in women with previous severe pregnancy complications and placental findings without thrombophilia. Blood Coagul Fibrinolysis. 5011;55:153-56.
  23. North R.A., Ferrier C., Gamble G., et al. Prevention of preeclampsia with heparin and antiplatelet drugs in women with renal disease. Aust N Z J Obstet Gynaecol. 1995;35:357-62. doi: 10.1111/j.1479-858x.1995.tb05141.x.
  24. van Hoorn M.E., Hague W.M., van Pampus M.G., et al. Low-molecular-weight heparin and aspirin in the prevention of recurrent early-onset pre-eclampsia in women with antiphospholipid antibodies: the FRUIT-RCT. Eur J Obstet Gynecol Reprod Biol. 2016;197:168-73. Doi: 10.1016/j. ejbgrb.5015.15.011.
  25. Martinelli I., Ruggenenti P, Cetin I., et al. Heparin in pregnant women with previous placenta-mediated pregnancy complications: a prospective, randomized, multicenter, controlled clinical trial. Blood. 5015;119:3569-75.
  26. Rodger M.A., Hague W.M., Kingdom J., et al. Antepartum dalteparin versus no antepartum dalteparin for the prevention of pregnancy complications in pregnant women with thrombophilia (TIPPS): a multinational open-label randomised trial. Lancet (London, England). 2014;084:1873-83.
  27. Haddad B., Winer N., Chitrit Y, et al. Enoxaparin and aspirin compared with aspirin alone to prevent placenta-mediated pregnancy complications: a randomized controlled trial. Obstet Gynecol. 2016; 128:1053-63. Doi: 10.1097/ AOG.0000000000001673.
  28. Groom K.M., McCowan L.M., Mackay L.K., et al.Enoxaparin for the prevention of preeclampsiaandintrauterinegrowthrestrictioninwomenwith a history: a randomized trial. Am J ObstetGynecol. 2017;216:296.e1-14. doi: 10.1016/j.ajog.2017.01.014.
  29. Dodd J.M., McLeod A., Windrim R.C., Kingdom J. Antithrombotic therapy for improving maternal or infant health outcomes in women considered at risk of placental dysfunction. Cochrane Database Syst Rev. 2013;7:CD006780. doi: 10.1005/14651858.CD006780.pub3.
  30. Roberge S.,Demers S.,Nicolaides K.H., et al.Prevention of pre-eclampsia by low-molecular-weight heparin in addition to aspirin: a meta-analysis.Ultrasound Obstet Gynecol. 2016;47:548-53. doi: 10.1002/uog.15789.
  31. Rodger M.A., Carrier M., Le Gal G., et al. Metaanalysis of low-molecular-weight heparin to prevent recurrent placenta-mediated pregnancy complications. Blood. 5014;153:855-58.
  32. Rodger M.A., Gris J.C., de Vries J.I., et al. Low-molecular-weight heparin and recurrent placenta-mediated pregnancy complications: a meta-analysis of individual patient data from randomised controlled trials. Lancet (London, England). 501-;388:5-59 41
  33. van Hoorn M.E., Hague W.M., van Pampus M.G., et al. FRUIT Investigators. Low-molecular-weight Heparin and Aspirin in the Prevention of Recurrent Early-Onset Pre-Eclampsia in Women With Antiphospholipid Antibodies: The FRUIT-RCT. Eur J Obstet Gynecol Reprod Biol. 2016;197:168-73. doi: 10.1016/j.ejogrb.2015.12.011.
  34. Martinelli I., Ruggenenti P, Cetin I., et al.; HAPPY Study Group. Heparin in Pregnant Women With Previous Placenta-Mediated Pregnancy Complications: A Prospective, Randomized, Multicenter, Controlled Clinical Trial. Blood. 2012;119(14):3269-75.
  35. Kingdom J.C., Walker M., Proctor L.K., et al. Unfractionated heparin for second trimester placental insufficiency: a pilot randomized trial. J Thromb Haemost. 2011;9:1483-92. doi: 10.1111/j.1538-7836.2011.04407.x.
  36. D'Souza R, Keating S., Walker M., et al. Unfractionated heparin and placental pathology in high-risk pregnancies: secondary analysis of a pilot randomized controlled trial. Placenta. 2014;35:816-23. doi: 10.1016/j. placenta.2014.07.010.
  37. Mello G, Parretti E., Fatini C., et al. low-molecular-weight heparin lowers the recurrence rate of preeclampsia and restores the physiological vascular changes in angiotensin-converting enzyme DD women. Hypertension. 2005;45:86-91. doi: 10.1161/01.HYP0000149950.05182.a3.
  38. Baldus S., Rudolph V., Roiss M., et al. Heparins increase endothelial nitric oxide bioavailability by liberating vessel-immobilized myeloperoxidase. Circulation. 2006;113:1871-78.
  39. Yinon Y, Ben Meir E., Margolis L., et al. Low molecular weight heparin therapy during pregnancy is associated with elevated circulatory levels of placental growth factor. Placenta. 2015;36:121 24. doi: 10.1016/j.placenta.2014.12.008
  40. Hagmann H., Bossung V, Belaidi A.A., et al. Low-molecular weight heparin increases circulating sFlt-1 levels and enhances urinary elimination. PloS One 2014;9:e85258. doi: 10.1371/journal. pone.0085258
  41. Tasatargil A., Ogutman C., Golbasi I., et al. Comparison of the vasodilatory effect of nadroparin, enoxaparin, dalteparin, and unfractioned heparin in human internal mammary artery. J Cardiovasc Pharmacol. 2005;45:550-54. doi: 10.1097/01. fjc.0000159878.66325.fc
  42. Georgescu A., Alexandru N., Nemecz M., et al. Enoxaparin reduces adrenergic contraction of resistance arterioles in aging and in aging associated with diabetes via engagement of MAP kinase pathway. Blood Coagul. Fibrinolysis. 2011;22:310 16. doi: 10.1097/MBC.0b013e328345123d
  43. Sobel M.L., Kingdom J., Drewlo S. Angiogenic response of placental villi to heparin. Obstet Gynecol. 2011;117:1375-83. Doi: 10.1097/ AOG.0b013e31821b5384.
  44. McLaughlin K., Baczyk D., Potts A., et al. Low molecular weight heparin improves endothelial function in pregnant women at high risk of preeclampsia. Hypertension. 2017;69:180-88.
  45. D'Souza R., Keating S., Walker M., et al. Unfractionated heparin and placental pathology in high-risk pregnancies: secondary analysis of a pilot randomized controlled trial. Placenta. 2014;35:816-23. Doi: 10.1016/j. placenta.2014.07.0W
  46. Williams PJ., Bulmer J.N., Innes B.A., Broughton Pipkin F Possible roles for folic acid in the regulation of trophoblast invasion and placental development in normal early human pregnancy. Biol Reprod. 2011;84:1148-53. Doi: 10.1095/ biolreprod.110.088351.
  47. Mignini L.E., Latthe PM., Villar J., et al. Mapping the theories of preeclampsia: the role of homocysteine. Obstet. Gynecol. 2005;105:411-25. Doi: W.W97/01.AOG.0000151117.52952.b6.
  48. Makedos G., Papanicolaou A., Hitoglou A., et al. Homocysteine, folic acid and B12 serum levels in pregnancy complicated with preeclampsia. Arch Gynecol Obstet. 2007;275:121-24. doi: 10.1007/ s00404-006-0223-2.
  49. Ray J.G., Laskin C.A. Folic acid and homocysteine metabolic defects and the risk of placenta abruption, pre-eclampsia and spontaneous pregnancy loss: a systematic review. Placenta. 1999;20:519-29. doi: 10.1053/plac.1999.0417.
  50. Пустотина О.А., Ахмедова А.Э. Роль фолатов в развитии осложнений беременности. Эффективная фармакотерапия. Акушерство и гинекология. 2014;3(35):66-74.
  51. Holm PI., Hustad S., Ueland PM., et al. Modulation of the homocysteinebetaine relationship by methylenetetrahydrofolate reductase 677 C>t genotypes and B-vitamin status in a large-scale epidemiological study J Clin Endocrinol Metab. 2007;92(4):1535-41. Doi: 10.1053/ plac.1999.0417.
  52. Pietrzik K., Bailey L., Shane B. Folic acid and L-5-methyltetrahydrofolate: comparison of clinical pharmacokinetics and pharmacodynamics. Clin Pharmacokinet. 2010;49(8):535-48. doi: 10.2165/11532990-000000000-00000.
  53. Приказ Министерства здравоохранения РФ от 12 ноября 2012 г № 572н «Об утверждении Порядка оказания медицинской помощи по профилю „акушерство и гинекология» (за исключением использования вспомогательных репродуктивных технологий. [Order of the Ministry of Health of the Russian Federation N. 572n of 12 November 2012 «On Approval of the Procedure for the Provision of Medical Care in the Profile of Obstetrics and Gynaecology» (Except for the Use of Assisted Reproductive Technologies). URL: www. rosminzdrav.ru/documents/5828prikazminzdravar ossiiot 14noyabrya4014g574n. (In Russ.)].
  54. Prinz-Langenohl R., Bramswig S., Tobolski O., et al. [6S]-5-methyltetrahydrofolate increases plasma folate more effectively than folic acid in women with the homozygous or wild-type 677C>T polymorphism of methylenetetrahydrofolate reductase. Br J Pharmacol. 2009;158(8):2014-21. doi: 10.1111/j.1476-5381.2009.00492.x.
  55. Obeid R., Holzgreve W., Pietrzik K. Is 5-methyltetrahydrofolate an alternative to folic acid for the prevention of neural tube defects? J Perinat Med. 2013;41(5):469-83. doi: 10.1515/jpm-2012-0256.
  56. Lamers Y., Prinz-Langenohl R., Moser R., Pietrzik K. Supplementation with [6S]-5-methyltetrahydrofolate or folic acid equally reduces plasma total homocysteine concentrations in healthy women. Am J Clin Nutr. 2004;79(3):473-78. doi: 10.1093/ajcn/79.3.473.
  57. Громова О.А., Торшин И.Ю., Лиманова О.А. Омега-3 полиненасыщенные жирные кислоты и активные фолаты - перспективы комплексного применения для нутрициальной поддержки беременности и профилактики пороков развития. Гинекология. 2013;2:71-7. [Gromova O.A., Torshin I.J., Limanova O.A. Omega-3 polyunsaturated fatty acids and active folates -prospects of complex application for nutritial support of pregnancy and prevention of developmental defects. Gynecologiya. 2013;2:71-7. (In Russ.)].
  58. Kulkarni A., Dangat K., Kale A., et al. Effects of altered maternal folic acid, vitamin B12 and docosahexaenoic acid on placental global DNA methylation patterns in Wistar rats. PLoS One. 2011;6(3):e17706. doi: 10.1371/journal. pone.0017706.
  59. Brownfoot F.C., Hastie R., Hannan N.J., et al. Metformin as a prevention and treatment for preeclampsia: effects on soluble fms-like tyrosine kinase 1 and soluble endoglin secretion and endothelial dysfunction. Am J Obstet Gynecol. 2016;214(3):356.e1-356.e15. Doi: 10.1016/j. ajog.2015.12.019.
  60. Romero R., Erez O., Huttemann M., et al. Metformin, the aspirin of the 21st century: its role in gestational diabetes mellitus, prevention of preeclampsia and cancer, and the promotion of longevity. Am J Obstet Gynecol. 2017;217(3):282-302. Doi: 10.1016/j. ajog.2017.06.003.
  61. Kaitu'u-Lino T.J., Brownfoot F.C., Beard S., et al. Combining metformin and esomeprazoie is additive in reducing sFit-1 secretion and decreasing endotheiiai dysfunction - implications for treating preeciampsia. PLoS. One. 2018;13(2):e0188845. doi: 10.1371/journai.pone.0188845.
  62. Kaiafat E, Sukur Y.E., Abdi A., et ai. Metformin for prevention of hypertensive disorders of pregnancy in women with gestational diabetes or obesity: systematic review and meta-anaiysis of randomized trials. Ultrasound Obstet Gynecol. 2018;52(6):706-14. doi: 10.1002/uog.19084.
  63. Alqudah A., McKinley M.C., McNally R., et al. Risk of pre-eclampsia in women taking metformin: a systematic review and meta-analysis. Diabet Med. 2018;35(2):160-72. doi: 10.1111/dme.13523.
  64. Costantine M.M., Tamayo E., Lu F, et al. Using pravastatin to improve the vascular reactivity in a mouse model of soluble fms-like tyrosine kinase- 1 -induced preeclampsia. Obstet Gynecol. 2010;116:114-20. Doi: 10.1097/ AOG.0b013e3181e10ebd.
  65. Fox K.A., Longo M., Tamayo E., et al. Effects of pravastatin on mediators of vascular function in a mouse model of soluble Fms-like tyrosine kinase-1-induced preeclampsia. Am J Obstet Gynecol. 2011;205:366.e1-5. Doi: 10.1016/j. ajog.2011.06.083.
  66. Kumasawa K., Ikawa M., Kidoya H., et al. Pravastatin induces placental growth factor (PGF) and ameliorates preeclampsia in a mouse model. Proc Natl Acad Sci USA 2011;108:1451-55. doi: 10.1073/pnas.1011293108.
  67. Bauer A.J., Banek C.T., Needham K., et al. Pravastatin attenuates hypertension, oxidative stress, and angiogenic imbalance in rat model of placental ischemia-induced hypertension. Hypertension. 2012;61:1103-10.
  68. Brownfoot F.C., Tong S., Hannan N.J., et al. Effects of simvastatin, rosuvastatin and pravastatin on soluble fms-like tyrosine kinase 1 (sFlt-1) and soluble endoglin (sENG) secretion from human umbilical vein endothelial cells, primary trophoblast cells and placenta. BMC Pregnancy Childbirth. 2016;16:117.
  69. Costantine М. М., Cleary K., Flebert M. F, et al. Safety and pharmacokinetics of pravastatin used for the prevention of preeclampsia in high-risk pregnant women: a pilot randomized controlled trial. Am J Obstet Gynecol. 2016;214(6):720.e 1 -720.e 17. doi: 10.1016/j.ajog. 2015.12.038.
  70. Esteve- Valverde E., Ferrer-Oliveras R., Gil-Aliberas N., et al. Pravastatin for Preventing and Treating Preeclampsia: A Systematic Review. Obstet Gynecol Surv. 2018;73(1 ):40-55. Doi: 10.1097/ OGX. 0000000000000522.

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