Abstract
Amaç
Gebelikte gelişen ve multi-sistemik bir hastalık olan
pre-eklampsi, yılda en az 42.000 anne ölümüne sebep
olan bir patolojidir. Pre-eklampsi patofizyolojisine
ilişkin teoriler, temel olarak yüzeysel plasentasyon ile
ilişkili olduğu düşünülen maternal-fetal immün malperfüzyona
dayanmakta ve pre-eklampsinin nedeni
ise henüz tam olarak aydınlatılamamıştır. Apelin, kan
basıncı regülasyonu ve vasküler fonksiyonları etkileyen,
ayrıca çeşitli fizyolojik görevleri olan bir peptittir.
Bu çalışmada, pre-eklampsi gelişiminde apelin-13’ün
rolünün olup olmadığını değerlendirmek amacıyla
normal ve erken başlangıçlı pre-eklampsili gebelerde,
plazma apelin-13 seviyeleri çalışıldı.
Gereç ve Yöntem
Bu vaka kontrol prospektif çalışma, Kadın Hastalıkları
ve Doğum Servisine başvuran gebelerin içerisinde
toplam 60 gebe çalışmaya dahil edildi. Projedeki
gruplar sağlıklı gebe kontrol (n:30) ve erken başlangıçlı
pre-eklampsi gebe (n:30) olarak dizayn edildi.
Erken başlangıçlı pre-eklampsi grubu 30. haftada
pre-eklampsi tanısı konan erken başlangıçlı pre-eklampsi
gebelerden oluşmakta idi. Katılımcılardan 30.
hafta alınan kan örneklerinden trombosit, serum albümin,
ALT, AST, üre, kreatinin ve plazma apelin-13
değerleri ölçüldü.
Bulgular
Sağlıklı gebe kontrollere göre, erken başlangıçlı
pre-eklampsi gebelerdeki trombosit, serum albümin,
seviyelerindeki azalma ve ALT, AST, üre ve kreatinin
parametrelerindeki artma, istatiksel değerlendirme
açısından anlamlı bulundu (p=0,011; p=0,001;
p=0,006; p=0,05; p=0,001; p=0,003; sırasıyla). Plazma
apelin-13 değeri sağlıklı ve erken başlangıçlı
pre-eklampsi gebeler arasında karşılaştırıldığında anlamlı
bir fark bulunmadı.
Sonuç
30. haftadan sonra gelişen erken başlangıçlı pre-eklampsinin
teşhisinde Apelin-13’ün tanısal değeri bulunmamaktadır.
Keywords
Supporting Institution
Necmettin Erbakan Üniversitesi Bilimsel Araştırma Projeleri Kordinatörlüğü
Project Number
Necmettin Erbakan Üniversitesi Bilimsel Araştırma Projeleri Kordinatörlüğü
References
- 1. Mol BWJ, Roberts CT, Thangaratinam S, Magee LA, De Groot CJM, Hofmeyr GJ. Pre-eclampsia. Lancet. 2016;387(10022):999–1011.
- 2. Chappell LC, Cluver CA, Kingdom J, Tong S. Pre-eclampsia. Lancet. 2021;398(10297):341–54.
- 3. Abraham C, Kusheleva N. Management of preeclampsia and eclampsia. Oxymag. 2019;23(15):10832.
- 4. Burton GJ, Redman CW, Roberts JM, Moffett A. Pre-eclampsia: pathophysiology and clinical implications. BMJ. 2019;366:1–15.
- 5. Kleinz MJ, Davenport AP. Emerging roles of apelin in biology and medicine. Pharmacol Ther. 2005;107(2):198–211.
- 6. Cheng J, Luo X, Huang Z, Chen L. Apelin/APJ system: A potential therapeutic target for endothelial dysfunction-related diseases. J Cell Physiol. 2019;234(8):12149–60.
- 7. Castan-Laurell I, Masri B, Valet P. The apelin/APJ system as a therapeutic target in metabolic diseases. Expert Opin Ther Targets. 2019;23(3):215–25.
- 8. Hamza RZ, Diab AAA, Zahra MH, Asalah AK, Moursi SMM, Al-Baqami NM, et al. Correlation between Apelin and Some Angiogenic Factors in the Pathogenesis of Preeclampsia: Apelin- 13 as Novel Drug for Treating Preeclampsia and Its Physiological Effects on Placenta. Int J Endocrinol. 2021;2021.
- 9. Wang C, Liu X, Kong D, Qin X, Li Y, Teng X, et al. Apelin as a novel drug for treating preeclampsia. Exp Ther Med. 2017;14(6):5917–23.
- 10. Hamza RZ, Diab AAA, Zahra MH, Asalah AK, Attia MS, Moursi SMM. Ameliorative effect of apelin-13 against renal complications in L-NAME-induced preeclampsia in rats. PeerJ. 2021;9:1–17.
- 11. Gürlek B, Yılmaz A, Durakoğlugil ME, Karakaş S, Kazaz İM, Önal Ö, et al. Evaluation of serum apelin-13 and apelin-36 concentrations in preeclamptic pregnancies. J Obstet Gynaecol Res. 2020;46(1):58–65.
- 12. Bortoff KD, Qiu C, Runyon S, Williams MA, Maitra R. Decreased maternal plasma apelin concentrations in preeclampsia. Hypertens Pregnancy. 2012;31(4):398–404.
- 13. Deniz R, Baykus Y, Ustebay S, Ugur K, Yavuzkir Ş, Aydin S. Evaluation of elabela, apelin and nitric oxide findings in maternal blood of normal pregnant women, pregnant women with pre-eclampsia, severe pre-eclampsia and umbilical arteries and venules of newborns. J Obstet Gynaecol (Lahore). 2019;39(7):907–12.
- 14. Inuzuka H, Nishizawa H, Inagaki A, Suzuki M, Ota S, Miyamura H, et al. Decreased expression of apelin in placentas from severe pre-eclampsia patients. Hypertens Pregnancy. 2013;32(4):410–21.
- 15. Simsek Y, Celik O, Yilmaz E, Karaer A, Dogan C, Aydin S, et al. Serum levels of apelin, salusin-alpha and salusin-beta in normal pregnancy and preeclampsia. J Matern Neonatal Med. 2012;25(9):1705–8.
- 16. Lee DL, Cheng R, Nguyen T, Fan T, Kariyawasam AP, Liu Y, et al. Characterization of apelin, the ligand for the APJ receptor. J Neurochem. 2000;74(1):34–41.
- 17. Colcimen N, Bulut G, Erkec ÖE, Ragbetli MÇ. Investigation of role of vascular endothelial growth factor, Annexin A5 and Apelin by immunohistochemistry nıethod in placenta of preeclampsia patients. Cell Mol Biol. 2017;63(11):42–5.
- 18. Yamaleyeva LM, Chappell MC, Bridget Brosnihan K, Anton L, Caudell DL, Shi S, et al. Downregulation of apelin in the human placental chorionic villi from preeclamptic pregnancies. Am J Physiol - Endocrinol Metab. 2015;309(10):852–60.
- 19. Liao Y-M, Qiao F-Y. Expression of Apelin in placentas of patients with hypertensive disorders complicating pregnancy. Zhonghua Fu Chan Ke Za Zhi. 2007;42(6):382–5.
- 20. Hypertension in Pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obs Gynecol. 2013;122(5):1122–31.
- 21. Kocabas R, Akoz M. The effects of vitamin D supplementation on healthy and hypercholesterolemic rabbits on levels of OSI and paraoxonase. Turk J Biochem. 2018;43(5):549–56.
- 22. Temur M, Yilmaz Ö, Taşgöz FN, Kume T. The evaluation of serum apelin levels in patients complicated with preeclampsia. J Matern Neonatal Med. 2022;35(10):1848-1852.
- 23. Kucur M, Tuten A, Oncul M, Acikgoz AS, Yuksel MA, Imamoglu M, et al. Maternal serum apelin and YKL-40 levels in early and late-onset pre-eclampsia. Hypertens Pregnancy. 2014;33(4):467–75.
- 24. Cobellis L, De Falco M, Mastrogiacomo A, Giraldi D, Dattilo D, Scaffa C, et al. Modulation of apelin and APJ receptor in normal and preeclampsia-complicated placentas. Histol Histopathol. 2007;22(1–3):1–8.
Abstract
Objective
Pre-eclampsia, a multi-systemic disease that develops
during pregnancy, is a pathology that causes at
least 42.000 maternal deaths per year. Theories
regarding the pathophysiology of pre-eclampsia are
mainly based on maternal-fetal (paternal) immune
malperfusion, which is thought to be associated
with superficial placentation, and the cause of preeclampsia
has not yet been fully elucidated. Apelin is
a peptide that affects blood pressure regulation and
vascular functions, and also has various physiological
functions. In this study, plasma apelin-13 levels were
studied in normal and development of early-onset
pre-eclampsia pregnant women to evaluate whether
apelin-13 has a role in the development of early-onset
pre-eclampsia.
Material and Method
In this case-control prospective study, a total of 60
pregnant women who applied to the Obstetrics and
Gynecology Service were included in the study.
The groups in the project were designed as healthy
pregnant control (n: 30) and the development of
early-onset pre-eclampsia pregnant (n: 30). The
development of early-onset pre-eclampsia group
consisted of the development of early-onset preeclampsia
pregnant women diagnosed with preeclampsia
at the 30th week. Platelet, serum albumin,
ALT, AST, urea, creatinine and plasma apelin-13
values were measured from the blood samples taken
from the participants at the 30th week.
Results
Compared to healthy pregnant controls, the decreases
in platelet and serum albumin levels, and the increases
in ALT, AST, urea, and creatinine parameters in the
development of early-onset pre-eclampsia pregnant
women were statistically significant (p=0,011;
p=0,001; p=0,006; p=0,05; p=0,001; p=0,003;
respectively). When the plasma apelin-13 value was
compared between healthy and the development
of early-onset pre-eclampsia pregnant women, no
significant difference was found.
Conclusion
Apelin-13 has no diagnostic value in the diagnosis of
development of early-onset pre-eclampsia developing
after the 30th week.
Keywords
Project Number
Necmettin Erbakan Üniversitesi Bilimsel Araştırma Projeleri Kordinatörlüğü
References
- 1. Mol BWJ, Roberts CT, Thangaratinam S, Magee LA, De Groot CJM, Hofmeyr GJ. Pre-eclampsia. Lancet. 2016;387(10022):999–1011.
- 2. Chappell LC, Cluver CA, Kingdom J, Tong S. Pre-eclampsia. Lancet. 2021;398(10297):341–54.
- 3. Abraham C, Kusheleva N. Management of preeclampsia and eclampsia. Oxymag. 2019;23(15):10832.
- 4. Burton GJ, Redman CW, Roberts JM, Moffett A. Pre-eclampsia: pathophysiology and clinical implications. BMJ. 2019;366:1–15.
- 5. Kleinz MJ, Davenport AP. Emerging roles of apelin in biology and medicine. Pharmacol Ther. 2005;107(2):198–211.
- 6. Cheng J, Luo X, Huang Z, Chen L. Apelin/APJ system: A potential therapeutic target for endothelial dysfunction-related diseases. J Cell Physiol. 2019;234(8):12149–60.
- 7. Castan-Laurell I, Masri B, Valet P. The apelin/APJ system as a therapeutic target in metabolic diseases. Expert Opin Ther Targets. 2019;23(3):215–25.
- 8. Hamza RZ, Diab AAA, Zahra MH, Asalah AK, Moursi SMM, Al-Baqami NM, et al. Correlation between Apelin and Some Angiogenic Factors in the Pathogenesis of Preeclampsia: Apelin- 13 as Novel Drug for Treating Preeclampsia and Its Physiological Effects on Placenta. Int J Endocrinol. 2021;2021.
- 9. Wang C, Liu X, Kong D, Qin X, Li Y, Teng X, et al. Apelin as a novel drug for treating preeclampsia. Exp Ther Med. 2017;14(6):5917–23.
- 10. Hamza RZ, Diab AAA, Zahra MH, Asalah AK, Attia MS, Moursi SMM. Ameliorative effect of apelin-13 against renal complications in L-NAME-induced preeclampsia in rats. PeerJ. 2021;9:1–17.
- 11. Gürlek B, Yılmaz A, Durakoğlugil ME, Karakaş S, Kazaz İM, Önal Ö, et al. Evaluation of serum apelin-13 and apelin-36 concentrations in preeclamptic pregnancies. J Obstet Gynaecol Res. 2020;46(1):58–65.
- 12. Bortoff KD, Qiu C, Runyon S, Williams MA, Maitra R. Decreased maternal plasma apelin concentrations in preeclampsia. Hypertens Pregnancy. 2012;31(4):398–404.
- 13. Deniz R, Baykus Y, Ustebay S, Ugur K, Yavuzkir Ş, Aydin S. Evaluation of elabela, apelin and nitric oxide findings in maternal blood of normal pregnant women, pregnant women with pre-eclampsia, severe pre-eclampsia and umbilical arteries and venules of newborns. J Obstet Gynaecol (Lahore). 2019;39(7):907–12.
- 14. Inuzuka H, Nishizawa H, Inagaki A, Suzuki M, Ota S, Miyamura H, et al. Decreased expression of apelin in placentas from severe pre-eclampsia patients. Hypertens Pregnancy. 2013;32(4):410–21.
- 15. Simsek Y, Celik O, Yilmaz E, Karaer A, Dogan C, Aydin S, et al. Serum levels of apelin, salusin-alpha and salusin-beta in normal pregnancy and preeclampsia. J Matern Neonatal Med. 2012;25(9):1705–8.
- 16. Lee DL, Cheng R, Nguyen T, Fan T, Kariyawasam AP, Liu Y, et al. Characterization of apelin, the ligand for the APJ receptor. J Neurochem. 2000;74(1):34–41.
- 17. Colcimen N, Bulut G, Erkec ÖE, Ragbetli MÇ. Investigation of role of vascular endothelial growth factor, Annexin A5 and Apelin by immunohistochemistry nıethod in placenta of preeclampsia patients. Cell Mol Biol. 2017;63(11):42–5.
- 18. Yamaleyeva LM, Chappell MC, Bridget Brosnihan K, Anton L, Caudell DL, Shi S, et al. Downregulation of apelin in the human placental chorionic villi from preeclamptic pregnancies. Am J Physiol - Endocrinol Metab. 2015;309(10):852–60.
- 19. Liao Y-M, Qiao F-Y. Expression of Apelin in placentas of patients with hypertensive disorders complicating pregnancy. Zhonghua Fu Chan Ke Za Zhi. 2007;42(6):382–5.
- 20. Hypertension in Pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obs Gynecol. 2013;122(5):1122–31.
- 21. Kocabas R, Akoz M. The effects of vitamin D supplementation on healthy and hypercholesterolemic rabbits on levels of OSI and paraoxonase. Turk J Biochem. 2018;43(5):549–56.
- 22. Temur M, Yilmaz Ö, Taşgöz FN, Kume T. The evaluation of serum apelin levels in patients complicated with preeclampsia. J Matern Neonatal Med. 2022;35(10):1848-1852.
- 23. Kucur M, Tuten A, Oncul M, Acikgoz AS, Yuksel MA, Imamoglu M, et al. Maternal serum apelin and YKL-40 levels in early and late-onset pre-eclampsia. Hypertens Pregnancy. 2014;33(4):467–75.
- 24. Cobellis L, De Falco M, Mastrogiacomo A, Giraldi D, Dattilo D, Scaffa C, et al. Modulation of apelin and APJ receptor in normal and preeclampsia-complicated placentas. Histol Histopathol. 2007;22(1–3):1–8.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Articles |
| Authors | |
| Project Number | Necmettin Erbakan Üniversitesi Bilimsel Araştırma Projeleri Kordinatörlüğü |
| Publication Date | June 22, 2023 |
| Submission Date | January 24, 2023 |
| Acceptance Date | May 24, 2023 |
| Published in Issue | Year 2023 Volume: 30 Issue: 2 |
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/Medical Journal of Süleyman Demirel University is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International.