Cerebrospinal fluıd adrenomedullin levels in patients with preeclampsia

Amaç

The concentration of adrenomedullin (AM) in cerebrospinal fluid (CSE) is lower than that in plasma, and while plasma adrenomedullin increases in pıegnancy, no change in CSF concentration is seen. To investigate the possibility that adrenomedullin is involved in the pathophysiology of preedampsia. we measured its concentration in maternal CSE in normal pregnancies and in pregnancies complicated by preeclampsia.

Yöntem

We studied 12 normotensive pregnant women, and 12 patients with preeclampsia. in all subjects, CSF samples were collected during spinal anesthesia at cesarean section. Spinal anesthesia was performed to the patients in a seated position from the 4-5th lumbar space with 25 G Quincke needle. Before the aclministration of local anesthetic to the subdural space, 2 ml of CSF was taken from the patient. AM was assayed on CSF samples using a reverse-phase high-performance liquid chromalography (HPLC). Mann-Whitney U-test was used in the statistical analysis and P<.05 was considered as significant.

Bulgular

Mean AM levels in patients with preeclampsia (28.51 ± 0.8 pg/L) were significantly higher than in patients with normotensive pregnancies (18.03 ± 0.4 pg/'L; P <0.O5).

Sonuç

 This first clinical in vivo study on CSF adrenomedullin levels showed that this peptide may be involved in pathophysiology of preeclampsia. Increased CSF-AM levels in patients with preeclampsia may indicate a compensatory defense response against increased in cerebral parenchymal microvessels resistance or may reflect the degree of endothelial cell damage. The control of AM levels in CSF might he a target that could be considered in therapeutic strategies for preeclampsia.

Anahtar Kelimeler

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