Biomarkers of oxidative stress in pre-eclampsia

Pre-eclampsia is associated with oxidative stress, confirmed by measurement of biomarkers and relevant antioxidant enzymes in the placenta and maternal circulation. Studies in vitro have described the pathways by which placental ischaemia can lead to oxidative stress as well as endoplasmic reticulum stress, which is coupled to synthesis of reactive oxygen species. However, clinical trials of antioxidants vitamins C and E, with an associated increase of plasma vitamins C and E concentrations have shown no benefit in prevention of the disorder, which may infer lack of a mechanistic role. Before oxidative stress is dismissed as an irrelevant accompaniment to pre-eclampsia further studies of proven biomarkers of oxidative stress are required to determine whether vitamins C and E supplementation leads to evidence of reversal of oxidative processes and tissue damage. If not, alternative antioxidant strategies may be worthy of consideration.