• Современный взгляд практического врача на патогенез поражения почек при преэклампсии
ru К содержанию

Современный взгляд практического врача на патогенез поражения почек при преэклампсии

HEALTH OF WOMAN. 2016.5(111):67–72; doi 10.15574/HW.2016.111.67 
 

Современный взгляд практического врача на патогенез поражения почек при преэклампсии 
 

Веропотвелян П. Н., Цехмистренко И. С., Веропотвелян Н. П.

ОКУ «Межобластной центр медицинской генетики и пренатальной диагностики», г. Кривой Рог

Перинатальный центр, г. Киев


В статье представлены современные данные о патогенезе почечного поражения при преэклампсии (ПЭ), влияние дисбаланса системы sFlt-1/ анти-VEGF на клинические симптомы нефропатии при ПЭ.

Однако несмотря на высокий интерес акушеров и нефрологов к проблеме ПЭ в настоящее время данных о влиянии ПЭ на почечное поражение в значении предвидения сроков развития ПЭ крайне недостаточно – поэтому необходимы дальнейшие исследования по этой теме.


Ключевые слова: преэклампсия, гломерулярное поражение, артериальная гипертензия, васкулоэндотелиальный фактор роста (VEGF), растворимая fms-подобная тирозинкиназа-1 (sFlt-1).


Литература:

1. Ballermann BJ. 2005. Glomerular endothelial cell differentiation. Kidney Int. 67(5):1668–71. http://dx.doi.org/10.1111/j.1523-1755.2005.00260.x; PMid:15840009

2. Yang R, Ogasawara AK, Zioncheck TF, Ren Z, He GW, DeGuzman GG et al. 2002. Exaggerated hypotensive effect of vascular endothelial growth factor in spontaneously hypertensive rats. Hypertension 39(3):815–20. http://dx.doi.org/10.1161/hy0302.105398; PMid:11897770

3. Simon M, Grцne HJ, Jцhren O, Kullmer J, Plate KH, Risau W, Fuchs E. 1995. Expression of vascular endothelial growth factor and its receptors in human renal ontogenesis and in adult kidney. Am. J. Physiol. 268(2, Pt 2):240–50.

4. Garovic VD, Wagner SJ, Petrovic LM, Gray CE, Hall P, Sugimoto H et al. 2007. Glomerular expression of nephrin and synaptopodin, but not podocin, is decreased in kidney sections from women with preeclampsia. Nephrol. Dial. Transplant. 22(4):1136–43.

5. Quaggin SE, Coffman TM. 2007. Toward a mouse model of diabetic nephropathy: is endothelial nitric oxide synthase the missing link? J. Am. Soc. Nephrol. 18(2):364–6.

6. Suga S, Kim YG, Joly A, Puchacz E, Kang DH, Jefferson JA et al. 2001. Vascular endothelial grown factor (VEGF121) protects rats from renal infarction in thrombotic microangiopathy. Kidney Int. 60(4):1297–308. http://dx.doi.org/10.1046/j.1523-1755.2001.00935.x; PMid:11576344

7. Lima F, Khamashta MA, Buchanan NM, Kerslake S, Hunt BJ, Hughes GR. 1996. A study of sixty pregnancies in patients with antiphospholipid syndrome. Clin. Exp. Rheumatol. 14(2):131–6.

8. Robinson ES, Matulonis UA, Ivy P, Berlin ST, Tyburski K, Penson RT, Humphreys BD. 2010. Rapid development of hypertension and proteinuria with cediranib, an oral vascular endothelial grown factor receptor inhibitor. Clin. J. Am. Soc. Nephrol. 5(3):477–83.

9. Okuda Y, Tsurumaru K, Suzuki S, Miyauchi T, Asano M, Hong Y et al. 1998. Hypoxia and endothelin-1 induce VEGF production in human vascular smooth muscle cells. Life Sci. 63(6):477–84. http://dx.doi.org/10.1016/S0024-3205(98)00296-3

10. Strevens H, Wide-Swensson D, Hansen A, Horn T, Ingemarsson I, Larsen S еt al. 2003. Glomerular endotheliosis in normal pregnancy and pre-eclampsia. BJOG: Br. J. Obstet. Gynaecol. 110(9):831–6.

11. Merkusheva LI, Kozlovskaja NL. 2015. Modern understanding of the pathogenesis of renal damage in preeclampsia. Оbstetrics and gynecology 8:12–17.

12. Al-Jameil N, Aziz Khan F, Fareed M, Tabassum H. 2014. A brief overview of preeclampsia. J Clin Med Res. 6(1):1–7.

13. James PR, Nelson-Piercy C. 2004. Management of hypertension before, during and after pregnancy. Heart. 90(12):1499–504. http://dx.doi.org/10.1136/hrt.2004.035444; PMid:15547046 PMCid:PMC1768605

14. Liu S, Joseph KS, Liston RM, Bartholomew S, Walker M, Leуn JA et al. 2011. Maternal Health Study Group of Canadian Perinatal Surveillance System (Public Health Agency of Canada). Incidence, risk factors, and associated complications of eclampsia. Obstet. Gynecol. 118(5):987–94.

15. Uzan J, Carbonnel M, Piconne O, Asmar R, Ayoubi JM. 2011. Preeclampsia: pathophysiology, diagnosis and management. Vasc. Health Risk Manag. 7:467–74.

16. Sidorova IS, Nikitinа NA. 2015. Features of the pathogenesis of preeclampsia endotheliosis. Оbstetrics and gynecology 1:72–78.

17. Levine RJ, Maynard SE, Qian C, Lim KH, England LJ, Yu KF et al. 2004. Circulating angiogenic factors and the risk of preeclampsia. N. Engl. J. Med. 350(7):672–83.

18. Maynard SE, Min JY, Lim KH et al. 2003. Excess placental soluble fms-like tyrosine kinase 1 (sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia. J. Clin. Invest. 111(5):649–58.

19. Karumanchi SA, Maynard SE, Stillman IE, Epstein FH, Sukhatme VP. 2005. Preeclampsia: a renal perspective. Kidney Int. 67(6):2101–13. http://dx.doi.org/10.1111/j.1523-1755.2005.00316.x; PMid:15882253

20. Eremina V, Sood M, Haigh J, Nagy A, Lajoie G, Ferrara N et al. 2003. Glomerular-specific alterations of VEGF-A expression lead to distinct congenital and acquired renal diseases. J. Clin. Invest. 111(5):707–16.

21. Chappal LC, Enye St, Seed P, Briley AL, Poston L, Shennan AH. 2008. Adverse perinatal outcomes and risk factors for preeclampsia in women with chronic hypertension: a prospective study. Hypertension. 51(4):1002–9. http://dx.doi.org/10.1161/HYPERTENSIONAHA.107.107565; PMid:18259010

22. Aita K, Etoh M, Hamada H, Yokoyama C, Takahashi A, Suzuki T et al. 2009. Acute and transient podocyte loss and proteinuria in preeclamsia. Nephron. Clin. Pract. 112(2):65–70.

23. Garovic VD, Wagner SJ, Turner ST, Rosenthal DW, Watson WJ, Brost BC et al. 2007. Urinary podocyte excretion as a marker for preeclampsia. Am. J. Obstet. Gynecol. 196(4):320. 1–7.

24. Craici IM, Wagner SJ, Bailey KR, Fitz-Gibbon PD, Wood-Wentz CM, Turner ST et al. 2013. Podocyturia predates proteinuria and clinical features of preeclampsia: longitudinal prospective study. Hypertension. 61(6):1289–96. http://dx.doi.org/10.1161/HYPERTENSIONAHA.113.01115; PMid:23529165 PMCid:PMC3713793

25. Cohen AW, Burton NG. 1979. Nephrotic syndrome due to preeclamptic nephropathy in hydatidiform mole and coexistent fetus. Obstet. Gynecol. 53(1):130–13.

26. Mьller-Deile J, Worthmann K, Saleem M, Tossidou I, Haller H, Schiffer M. 2009. The balance of autocrine VEGF-A and VEGF-C determines podocyte survival. Am. J. Physiol. Renal Physiol. 297(6):1656–67.

27. Mith МС, Moran P, Ward MK, Davison JM. 2008. Assessment of glomerular filtration rate during pregnancy using the MDRD formula. BJOG: Br. J. Obstet. Gynaecol. 115(1):109–12.

28. Scaffer NK, Dill LV, Cadden JF. 1943. Uric acid clearance in normal pregnancy and preeclampsia. J. Clin. Invest. 22(2):201–6. http://dx.doi.org/10.1172/JCI101383; PMid:16694994 PMCid:PMC435227

29. Burger D, Touyz RM. 2012. Cellular biomarkers of endothelial health: microparticles, endothelial progenitor cells, and circulating endothelial cells. J. Am. Soc. Hypertens. 6(2):85–99. http://dx.doi.org/10.1016/j.jash.2011.11.003

30. Nisell H, Lintu H, Lunell NO, Mцllerstrцm G, Pettersson E. 1995. Blood pressure and renal function seven years after pregnancy complicated by hypertension. Br. J. Obstet. Gynaecol. 102(11):876–81.

31. Kearney JB, Kappas NC, Ellerstrom C, DiPaola FW, Bautch VL. 2004. The VEGF receptor flt-1 (VEGFR-1) is a positive modulator of vascular sprout formation and branching morphogenesis. Blood. 103(12):4527–35.

32. Muller-Deile J, Schiffer M. 2011. Renal involvement in preeclampsia: similarities to VEGF ablation therapy. J. Pregnancy. 2011:176973.

33. Ballermann BJ. 2005. Glomerular endothelial cell differentiation. Kidney Int. 67(5):1668–71. http://dx.doi.org/10.1111/j.1523-1755.2005.00260.x; PMid:15840009

34. George EM, Granger JP. 2011. Endothelin: key mediator of hypertension in preeclampsia. Am. J. Hypertens. 24(9):964–9.

35. Sezer SD, Kьзьk M, Yenisey C, Yьksel H, Odabasi AR, Tьrkmen MK. 2012. Comparison of angiogenic and anti-angiogenic factors in maternal and umbilical cord blood in early-and late-onset pre-eclampsia. Gynecol. Endocrinol. 28(8):628–32.

36. Rodie V, Freeman DJ, Sattar N, Greer IA. 2004. Pre-eclampsia and cardiovascular disease: metabolic syndrome of pregnancy? Atherosclerosis. 175(2):189–202. http://dx.doi.org/10.1016/j.atherosclerosis.2004.01.038

37. Vikse BE, Irgens LM, Leivestad T, Skjaerven R, Iversen BM. 2008. Preeclampsia and the risk of end-stage renal diseasе. N. Engl. J. Med. 359(8):800–9.

38. Noris M, Perico N, Remuzzi G. 2005. Mechanisms of disease: pre-eclampsia. Nat. Clin. Pract. Nephrol. 1(2):98–114.

39. Abbate M, Zoja C, Remuzzi G. 2006. How does proteinuria cause progressive renal damage? J. Am. Soc. Nephrol. 17(11):2974–84.

40. Nakagawa T, Lan HY, Zhu HJ, Kang DH, Schreiner GF, Johnson RJ. 2004. Differential regulation of VEGF by TGF-beta and hypoxia in rat proximal tubular cells. Am. J. Physiol. Renal Physiol. 287(4):658–64.

41. Reiter L, Brown MA, Whitworth JA. 1994. Hypertension in pregnancy: the incidence of underlying renal disease and essential hypertension. Am. J. Kidney Dis. 24(6):883–7. http://dx.doi.org/10.1016/S0272-6386(12)81055-9

42. Duley L, Gьlmezoglu AM, Henderson-Smart DJ, Chou D. 2010. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst. Rev. 11:CD000025.

43. Stillman IE, Karumanchi SA. 2007. The glomerular injury of preeclampsia. J. Am. Soc. Nephrol. 18(8):2281–4.

44. Yang JC, Haworth L, Steinberg SM, Rosenberg SA, Novotny W. 2002. A randomized double-blind placebo controlled trial of bevacizumab (anti-VEGF antibody) demonstrating a prolongation in time to progression in patients with metastatic renal cancer. Proc. Am. Soc. Clin. Oncol. 21:15.

45. Eremina V, Sood M, Haigh J, Nagy A, Lajoie G, Ferrara N et al. 2003. Glomerular-specific alterations of VEGF-A expression lead to distinct congenital and acquired renal diseases. J. Clin. Invest. 111(5):707–16.

46. Li B, Ogasawara AK, Yang R, Wei W, He GW, Zioncheck TF et al. 2002. KDR (VEGF receptor 2) is the major mediator for the hypotensive effect of VEGF. Hypertension. 39(6):1095–100. http://dx.doi.org/10.1161/01.HYP.0000018588.56950.7A; PMid:12052848

47. Hay JE. 2008. Liver disease in pregnancy. Hepatology. 47(3):1067–76. http://dx.doi.org/10.1002/hep.22130; PMid:18265410

48. Hagmann Н et al. 2012. The Promise of Angiogenic Markers for the Early Diagnosis and Prediction of Preeclampsia. Clinical Chemistry. 58(5):837–845 (2012).

49. Karumanchi SA et al. 2005. Preeclampsia: a renal perspective. Kidney International. 67:2101–2113. http://dx.doi.org/10.1111/j.1523-1755.2005.00316.x; PMid:15882253

50. Craici IM et al. 2014. Advances in the pathophysiology of preeclampsia and related podocyte injury. Kidney International. 86:275–285. http://dx.doi.org/10.1038/ki.2014.17; PMid:24573315 PMCid:PMC4117806