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Tissue kallikrein activity in pregnancy
S M Khedun1, T Naicker, J Moodley
1Department of Clinical and Experimental Pharmacology, Nelson R Mandela School of Medicine, University of Natal, Durban, South Africa.
The Australian & New Zealand Journal of Obstetrics & Gynaecology
|February 24, 2001
Summary
Tissue kallikrein (TK) activity is significantly lower in pregnant women with hypertensive disorders. This finding suggests TK may play a role in the development of these conditions.
Area of Science:
- Obstetrics and Gynecology
- Renal Physiology
- Biochemistry
Background:
- Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and fetal morbidity.
- The role of tissue kallikrein (TK) in HDP pathophysiology remains incompletely understood.
- Previous studies suggest potential alterations in the kallikrein-kinin system in HDP.
Purpose of the Study:
- To investigate tissue kallikrein (TK) activity in black African women diagnosed with hypertensive disorders of pregnancy.
- To compare TK activity across different pregnancy states: preeclampsia, mild to moderate hypertension, normotensive pregnancy, and healthy non-pregnant women.
Main Methods:
- A cohort of 140 women was divided into four groups: preeclamptic, mild to moderate hypertensive pregnant, normotensive pregnant, and normotensive non-pregnant healthy women.
- Urinary TK activity was measured using a synthetic chromogenic substrate (S-2266).
- Urinary sodium and potassium levels were determined by flame photometry.
Main Results:
- Tissue kallikrein activity was significantly decreased in women with preeclampsia (1.54 +/- 0.95 ngTK/microg protein) and mild to moderate hypertension (2.03 +/- 0.76 ngTK/microg protein) compared to normotensive pregnant women (3.05 +/- 0.83 ngTK/microg protein).
- A significant difference in TK activity was observed between the hypertensive pregnancy groups.
- No significant difference in TK activity was found between normotensive pregnant women and healthy non-pregnant women (3.05 +/- 0.83 vs 3.14 +/- 0.88 ngTK/microg protein).
- Urinary sodium and potassium excretion did not differ significantly across the pregnancy groups.
Conclusions:
- Tissue kallikrein activity is markedly reduced in hypertensive disorders of pregnancy.
- These findings highlight a potential role for the kallikrein-kinin system in the pathogenesis of HDP.
- Further research is warranted to explore therapeutic interventions targeting the kallikrein system in HDP.