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Understanding Pre-eclampsia: A positive step forward.
- Sumit Kumar Jha (7 December 2005)
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Sumit Kumar Jha, Senior House Officer Addenbrooke's Hospital NHS Trust, Cambridge. UK.
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I read with interest the pilot study and the well-written article on the effects of pre-eclampsia on maternal plasma, cerebrospinal fluid, and umbilical cord urotensin II concentrations. I would agree with the authors that this vasoactive peptide would change our understanding of Hypertensive Disease in pregnancy in years to come. Since its discovery by Yanagisawa in 1988, endothelin-1 (ET-1) has been consistently described as the most potent vasoconstrictor yet discovered. At the present time, urotensin (U II) is being considered the new endothelin by many due to its ultrapotent vasoconstrictive properties. Recently, Patacchini et al. introduced UrantideTM (urotensin II receptor antagonist peptide, (urantideTM)) as a potent U II antagonist, the first reported of its kind. The importance of ET-1 and urotensin as cardiovascular and renal peptides in humans is well established, making these peptides and their antagonists highly important research tools. Interestingly, the authors found overall differences in plasma, CSF and cord UII concentrations between the control and PET groups, which were not statistically significant. There was a significant positive correlation between plasma and CSF, plasma and cord and CSF and cord UII concentrations in the PET group. They also put forward an interesting suggestion: UT expression rather than UII peptide is elevated such that vessels with more receptors become more responsive and hence more constricted resulting in elevated MAP, and suggest further studies. Given the statistical limitations with a very limited number of cased in this pilot study, the authors have come across interesting results and observations. We look forward to similar study in a much larger patient subpopulation to throw more light on the aetiology and pathogenesis of this enigmatic disease state. References: 1. Effects of pre-eclampsia on maternal plasma, cerebrospinal fluid, and umbilical cord urotensin II concentrations: a pilot study: E. Cowley, J. P. Thompson, P. Sharpe, J. Waugh, N. Ali and D. G. Lambert. Br. J. Anaesth. 2005; 95: 495-499 2. R. Patacchini, P. Santicioli, S. Giuliani, P. Grieco, E. Novellino, P. Rovero, and C.A. Maggi, Br. J. Pharmacol, 140, 1155 (2003). 3. Yanagisawa M, Kurihara H, Kimura S, Tomobe Y, Kobayashi M, Mitsui Y, Yazaki Y, Goto K, Masaki T. A novel potent vasoconstrictor peptide produced by vascular endothelial cells. Nature. 1988 Mar 31;332(6163):411–415. 3. Conflict of Interest:None declared |
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