Publication: Polimorfismos genéticos del factor de crecimiento vascular endotelial (VEGF) y del precursor del péptido natriurético B (NPPB) asociados a preeclampsia
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2017-02-07
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Universidad Complutense de Madrid
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Abstract
La preeclampsia es una enfermedad multisistémica, que afecta al 6-8% de los embarazos y permanece como la primera causa de morbimortalidad materno perinatal en los países desarrollados. Está definida por la aparición de hipertensión y proteinuria, a partir de las 20 semanas de gestación; asociada a complicaciones maternas y fetales severas, tales como: insuficiencia renal, insuficiencia hepática, edema cerebral, bajo peso al nacer, prematuridad, y en algunos casos a muerte materno fetal. Se cree actualmente que la preeclampsia se desarrolla en dos etapas. En la primera etapa, se produce una placentación anormal consistente en una invasión superficial del citotrofoblasto y por tanto una insuficiente vascularización placentaria, lo que genera una producción anormal de factores angiogénicos y antiangiogénicos placentarios inducidos por hipoxia. En la segunda etapa, que se desarrolla en la segunda mitad del embarazo, tiene lugar la liberación de estos factores placentarios a la circulación sitémica, causando provocando una disfunción endotelial generalizada. Dado que el VEGF juega un papel fundamental en la vasculogénesis y angiogénesis del embrión y la placenta, participando en el desequilibrio angiogénico/antiangiogénico presente en la preeclampsia, y que los péptidos natruiréticos incrementan sus niveles de forma significativa en mujeres preeclámpticas, en comparación con normotensas; nos hemos planteado estudiar los polimorfismos genéticos de base única presentes en el gen del VEGF (-2578C/A, - 1154G/A y +936C/T) y el polimorfismo de repetición en tándem (TTTC)n del gen NPPB, y su probable relación con el desarrollo de la preeclampsia...
Preeclampsia is a multisystemic disease, which complicates 6-8% of pregnancies and remains a leading cause of maternal and perinatal morbidity and mortality in developed countries. It is defined by the occurrence of hypertension and proteinuria after 20 weeks of gestation; associated with severe maternal and fetal complications, such as: kidney failure, liver failure, cerebral edema, low birth weight, prematurity, and in some cases, maternal and fetal death. It is currently believed that preeclampsia develops in two stages. In the first stage, an abnormal placentation consisting of a shallow cytotrophoblast invasion and, therefore, an insufficient placental vascularization occurs, generating an abnormal production of placental angiogenic and antiangiogenic factors induced by hypoxia. In the second stage, which takes place in the second half of pregnancy, the release of these placental factors acting on maternal endothelium cause systemic endothelial dysfunction. Since VEGF plays a central role in vasculogenesis and angiogenesis of the embryo and placenta, and it is also involved in angiogenesis/antiangiogenesis imbalance present in preeclampsia, and natruiretics peptide levels increased significantly in preeclamptic women compared with normotensive pregnant women; we intend to study the single base polymorphisms of the gene VEGF (-2578C/A, - 1154G/A and + 936C/T) and the tandem repeat polymorphism of the gene NPPB, and its likely relation with preeclampsia...
Preeclampsia is a multisystemic disease, which complicates 6-8% of pregnancies and remains a leading cause of maternal and perinatal morbidity and mortality in developed countries. It is defined by the occurrence of hypertension and proteinuria after 20 weeks of gestation; associated with severe maternal and fetal complications, such as: kidney failure, liver failure, cerebral edema, low birth weight, prematurity, and in some cases, maternal and fetal death. It is currently believed that preeclampsia develops in two stages. In the first stage, an abnormal placentation consisting of a shallow cytotrophoblast invasion and, therefore, an insufficient placental vascularization occurs, generating an abnormal production of placental angiogenic and antiangiogenic factors induced by hypoxia. In the second stage, which takes place in the second half of pregnancy, the release of these placental factors acting on maternal endothelium cause systemic endothelial dysfunction. Since VEGF plays a central role in vasculogenesis and angiogenesis of the embryo and placenta, and it is also involved in angiogenesis/antiangiogenesis imbalance present in preeclampsia, and natruiretics peptide levels increased significantly in preeclamptic women compared with normotensive pregnant women; we intend to study the single base polymorphisms of the gene VEGF (-2578C/A, - 1154G/A and + 936C/T) and the tandem repeat polymorphism of the gene NPPB, and its likely relation with preeclampsia...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Obstetricia y Ginecología, leída el 09-02-2016