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Oxidative stress markers in preeclamptic placentas: A systematic review with meta-analysis
Raphaela Costa Ferreira1, Marilene Brandão Tenório Fragoso2, Nassib Bezerra Bueno3
1Instituto de Ciências Biológicas e da Saúde da Universidade Federal de Alagoas (ICBS/UFAL), Maceió, Alagoas, Brazil.
Insights
Oxidative stress (OS) is present in preeclampsia (PE) placentas. This meta-analysis found reduced antioxidant enzyme activity and increased oxidative damage markers, confirming OS in PE placental tissue.
Area of Science:
- Biochemistry
- Pathology
- Reproductive Medicine
Background:
- Oxidative stress (OS) is implicated in various diseases, including preeclampsia (PE), a major cause of maternal and fetal mortality.
- The placenta is a key site for PE pathogenesis, with placental OS considered a critical pathway.
- Understanding OS markers in PE placentas is crucial for disease insight.
Purpose of the Study:
- To determine the presence of OS in preeclamptic placentas.
- To identify specific biomarkers altered in PE placental tissue.
Main Methods:
- A systematic search of MEDLINE (PubMed), Lilacs, and Scopus databases was conducted until May 2020.
- 43 studies were included in the systematic review, and 23 in the meta-analysis.
- Biomarkers assessed included indicators of cell/macromolecule damage (e.g., malondialdehyde, 8-hydroxy-2'-deoxyguanosine) and antioxidant activity (enzymatic and non-enzymatic).
Main Results:
- The meta-analysis confirmed the presence of OS in preeclamptic placentas.
- Key findings include decreased activity of antioxidant enzymes like superoxide dismutase (SOD) and glutathione peroxidase (GPx).
- Increased levels of oxidative damage markers, such as malondialdehyde (MDA) and lipid peroxides, were observed.
Conclusions:
- The study provides strong evidence for oxidative stress in the placenta of women with preeclampsia.
- Altered antioxidant defense mechanisms and increased oxidative damage markers are characteristic of PE placentas.
- These findings support the role of placental OS in the pathophysiology of preeclampsia.
Introduction:
Oxidative stress (OS) is the basis of several diseases. Preeclampsia (PE) is a multisystemic syndrome, considered one of the major causes of maternal and fetal mortality. The placenta is considered the main anatomical pathogenetic substrate for the disease, being the placental OS a likely critical pathway in the pathogenesis of PE. This meta-analysis aimed to verify whether there is OS in the preeclamptic placenta and which markers are altered in this condition.
Methods:
The search was conducted in the following databases: MEDLINE (via PubMed), Lilacs and Scopus. Relevant studies were identified until May 2020. The quality of the studies was evaluated according to the Newcastle-Ottawa scale.
Results:
From the 3998 screened records, 43 were finally included in the systematic review, and 23 in the meta-analysis. The biomarkers evaluated were related to cell and macromolecules' damage, such as malondialdehyde (MDA), 8-hydroxy-2'-deoxyguanosine (8-OH-dG), lipid peroxides, isoprostane, total oxidant status (TOS), carbonylated proteins and some of the reactive oxygen and nitrogen species (RONS), like hydrogen peroxide and nitric oxide. It was also related to antioxidant activity, both enzymatic, including superoxide dismutase (SOD), catalase, glutathione peroxidase (GPx), glutathione S-transferase and total antioxidant status, and non-enzymatic, through quantification of reduced glutathione, vitamin C and E, zinc and copper.
Conclusion:
It was observed that there was OS in the preeclamptic placentas, based on results, like lower activity of some of the enzymes of the antioxidant system (SOD and GPx) as well as the increase in oxidative damage markers (MDA and lipid peroxide), corroborating literature data.
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