Orvosi Hetilap
Volume/Issue:
Volume 151: Issue 52
Nitric oxide and preeclampsia
Authors: Zoltán Kukor 1 and Sándor Valent 2
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  • 1 Semmelweis Egyetem, Általános Orvostudományi Kar Orvosi Vegytani Molekuláris Biológiai és Patobiokémiai Intézet Budapest Tűzoltó u. 37–47. 1094
  • 2 Semmelweis Egyetem, Általános Orvostudományi Kar II. Szülészeti és Nőgyógyászati Klinika Budapest
DOI:
https://doi.org/10.1556/oh.2010.29012
Page Count:
2125–2135
Publication Date:
01 Dec 2010
Online Publication Date:
11 Dec 2010
Article Category:
Research Article
Open access

A praeeclampsia a legveszélyesebb terhességi kórképek közé tartozik, egyike a vezető terhességi halálokoknak. A betegség kialakulása a placentához köthető. A patomechanizmusban kulcsszerepet tulajdonítanak az elégtelen NO-szintézisnek. A placentában az endothelialis izoforma (eNOS) a jellemző, ennek ismert zavarait foglaljuk össze. Csökkentheti a NO-szintézist szubsztrát- (arginin), kofaktor- (tetrahidrobiopterin, BH4) és kalciumhiány. Praeeclampsiában nőhet a nem észteresített szabad zsírsavak (FFA), a szolubilis VEGF-receptor (sVEGFR), az aszimmetrikus dimetil-arginin, a reaktív oxigéngyökök és a glükóz szérumszintje. Ezek különböző útvonalakon csökkentik a NO mennyiségét. Ismert a praeeclampticus placenták egy részében az enzim csökkent BH4 iránti affinitása, ami a NO-szintézis csökkenésén túl emelkedett szuperoxid-termelést is okozhat. A praeeclampsiához – nem kellően bizonyítottan – eNOS-polimorfizmusokat is társítottak (D298E, –786T→C). A dohányzásnak preventív hatása van praeeclampsia ellen. A hatásmechanizmus nem tisztázott, a NO-szintézisre fokuszálva is ellentmondásokkal teli. A dohányfüst az eNOS expresszióját csökkenti, az aktivitását emelő Ser1177 és az enzimaktivitást gátló Thr495-foszforilációt egyaránt fokozza. Az oxidatív stresszel a NO-szint közvetlenül csökken. A dohányzás csökkenti az FFA-szintet, ami az eNOS-aktivitás növekedését okozhatja. A dohányzás CO-ot termel, ami részben NO-mimikáló hatásával pótolhatja a NO-t. Orv. Hetil., 2010, 151, 2125–2135.

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Cover Orvosi Hetilap
Orvosi Hetilap
Print ISSN:
0030-6002
Online ISSN:
1788-6120
Keywords:
praeeclampsia; nitrogén-monoxid-szintáz; dohányzás; preeclampsia; nitric oxide synthase; smoking

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