N-acetylcysteine restores nitric oxide-mediated effects in the fetoplacental circulation of preeclamptic patients.

Abstract

OBJECTIVE:

Preeclampsia is associated with an imbalance between oxidants and antioxidants, resulting in reduced effects of the endothelium-derived, relaxing-factor nitric oxide (NO). Antioxidants, like N-acetylcysteine (NAC), remove reactive oxygen species, resulting in an improvement of endothelial function. We aimed to investigate the effect of NAC on the NO-pathway in the human fetoplacental circulation in preeclampsia and control pregnancies.

STUDY DESIGN:

The NO-pathway was investigated by use of the NO-synthase inhibitor L-NAME in an ex vivo cotyledon perfusion model.

RESULTS:

At baseline, fetoplacental arterial pressure was comparable in preeclamptic pregnancies (n=8) and control pregnancies (n=8), and increased dose-dependently after L-NAME. The maximal L-NAME-induced rise in fetoplacental arterial pressure was attenuated in preeclamptic versus control pregnancies (20.8 +/- 2.0 mm Hg vs 36.7 +/- 3.5 mm Hg, P<.05). Addition of NAC increased the L-NAME-induced rise in fetoplacental arterial pressure to 36.4 +/- 3.4 mm Hg in preeclampsia pregnancies (P<.05) and to 49.2 +/- 2.6 mm Hg in control pregnancies (P<.05).

CONCLUSION:

Preeclampsia is associated with a dysfunction of the NO-pathway. N-acetylcysteine increases NO-mediated effects in the fetoplacental circulation in preeclamptic placentas as well as in healthy control placentas.

• Authors: Tanya M Bisseling, Eva Maria Roes, Maarten T M Raijmakers, Eric A P Steegers, Wilbert H M Peters, Paul Smits
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 191 Issue 1 Pg. 328-33 (Jul 2004) ISSN: 0002-9378 [Print] United States
• PMID: 15295387 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Nitric Oxide
• Acetylcysteine

Topics

• Acetylcysteine (pharmacology)
• Dose-Response Relationship, Drug
• Endothelium, Vascular (drug effects)
• Female
• Humans
• In Vitro Techniques
• Nitric Oxide (physiology)
• Placenta (drug effects, physiology)
• Placental Circulation (drug effects, physiology)
• Pre-Eclampsia (physiopathology)
• Pregnancy