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2011 ; 2011
(3
): 59-64
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IL-6-induced pathophysiology during pre-eclampsia: potential therapeutic role for
magnesium sulfate?
#MMPMID22140321
Lamarca B
; Brewer J
; Wallace K
Int J Interferon Cytokine Mediat Res
2011[Jul]; 2011
(3
): 59-64
PMID22140321
show ga
Pre-eclampsia is defined as new onset hypertension with proteinuria during
pregnancy. Pre-eclampsia is also characterized by endothelial cell activation and
dysfunction and intrauterine growth restriction. Preeclamptic women display a
chronic inflammatory response characterized by elevated inflammatory cytokines,
circulating monocytes, neutrophils, and T and B lymphocytes secreting
autoantibodies that activate the angiotensin II type I receptor (AT1-AA).
Although the pathophysiology of pre-eclampsia is becoming more defined, the
genesis of the disease is still largely unknown. Furthermore, the only treatment
for extreme forms of the disease is bed rest and administration of magnesium
sulfate to sustain the pregnancy a few days prior to early delivery of the fetus,
which can lead to devastating neurological and physical effects for the newborn.
Administration of magnesium sulfate is routinely given without adverse effects.
The focus of this review is to discuss the cascade of events leading to
cytokines, specifically interleukin-6 (IL-6), in stimulating vasoactive
substances such as AT1-AA (Figure 1) and to examine the mechanism whereby
administration of magnesium sulfate can be beneficial during pre-eclampsia. One
area is to decrease vascular resistance index parameters determined by Doppler
velocimetry. Another potential area of benefit with magnesium sulfate
administration may be to decrease inflammatory responses or decrease
cardiovascular mechanisms stimulated by overexpression of inflammatory cytokines
in response to placental ischemia or animal models of elevated IL-6 during
pregnancy. Further studies identifying IL-6-driven mechanisms playing a role in
the development of hypertension during pregnancy and how administration of
magnesium sulfate can suppress them are critical to improve decisions affecting
patient care in women with pre-eclampsia. The results of these types of studies
will be advantageous to further our knowledge of the pathophysiological
ramifications associated with pre-eclampsia and to further therapeutic
development for this disease.
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