La disfunción endotelial es una característica fundamental en la fisiopatología de la preeclampsia. En la actualidad, se ha identificado una serie de marcadores que traducen la disfunción endotelial, los cuales se han utilizado para realizar el diagnóstico precoz de la preeclampsia y evaluar su posible pronóstico. Sin embargo, la mayoría de los centros hospitalarios que tratan a pacientes con preeclampsia no tiene acceso a la detección de dichos marcadores. En este sentido, uno de los marcadores indirectos de disfunción endotelial con mayor accesibilidad es la evaluación del frotis de sangre periférica. En este documento se presentan diferentes estudios que prueban la presencia de la disfunción endotelial en la paciente con preeclampsia, así como su impacto en la evolución de la enfermedad.
Centro de Documentación Institucional. [Sitio web]. Linea-miento técnico. Prevención, diagnóstico y manejo de la preeclampsia eclampsia. Cuarta edición. México: Secretaría de Salud; 2007. Disponible en http://www.salud. gob.mx/unidades/cdi/documentos/PREECLAMPSIA_ ECLAMPSIA_lin-2007.pdf
Sánchez-Rodríguez E, Nava-Salazar S. Estado actual de la preeclampsia en México: de lo epidemiológico a sus mecánicos moleculares. Rev Invest Clin 2010;62(3):252-260.
Davidge ST. Oxidative stress and altered endothelial cell function in preeclampsia. Semin Reprod Endocrinol 1998; 16(1):65-73.
Raijmakers MT, Dechend R, Poston L. Oxidative stress and preeclampsia: rationale for antioxidant clinical trials. Hypertension 2004;44(3):374-380.
Sankaralingam S, Arenas IA, Lalu MM, Davidge ST. Pre-eclampsia: current understanding of the molecular basis of vascular dysfunction. Expert Rev Mol Med 2006;8(3):1-20.
Kunsch C, Medford RM. Oxidative stress as a regulator of gene expression in the vasculature. Circ Res 1999;85(8):753-766.
Myatt L, Miodovnik M. Prediction of pre-eclampsia. Semin Perinatol 1999;23(1):45-57.
Smith GC, Pell JP, Walsh D. Pregnancy complications and maternal risk of ischemic heart disease: a retrospective cohort study of 129,290 births. Lancet 2001;357(9273): 2002-2006.
Irgens HU, Reisaeter L, Irgens LM, Lie RT. Long term mortality of mothers and fathers after pre-eclampsia: population based cohort study. BMJ 2001;323(7323):1213-217. Disponible en http://www.ncbi.nlm.nih.gov/pmc/articles/PMC59993/
Sibai BM. Biomarker for hypertension-preeclampsia: are we close yet? Am J Obstet Gynecol 2007;197(1):1-2.
Egbor M, Ansari T, Morris N, Green CJ, Sibbons PD. Morphometric placental villous and vascular abnormalities in early-and late-onset pre-eclampsia with and without fetal growth restriction. BJOG 2006;113(5):580-589. Epub 2006 Mar 27.
Vuorela P, Helske S, Hornig C, Alitalo K, Weich H, Halmesmäki E. Amniotic fluid-soluble vascular endothelial growth factor receptor-1 in preeclampsia. Obstet Gynecol 2000;95 (3):353-357.
Levine RJ, Maynard SE, Qian C, Lim KH, England LJ, Yu KF, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med 2004;350(7):672-683.
Venkatesha S, Toporsian M, Lam C, Hanai J, Mammoto T, Kim YM, Bdolah Y, et al. Soluble endoglin contributes to the pathogenesis of preeclampsia. Nat Med 2006;12(6): 642-649.
Bussolino F, Di Renzo MF, Ziche M, Bocchietto E, Olivero M, Naldini L, et al. Hepatocyte growth factor is a potent angiogenic factor which stimulates endothelial cell motility and growth. J Cell Biol 1992;119(3):629-641.
Drexler H. Endothelial dysfunction: clinical implications. Prog Cardiovasc Dis 1997;39(4):287-324.
Boneti P, Lerman O, Lerman A. Endothelial dysfunction: a marker of atherosclerotic risk. Arterioscler Thromb Vasc Biol 2003;23(2):168-175.
Kawashima S, Mitsuhiro Y. Dysfunction of endothelial nitric oxide and atherosclerosis. Arterioscler Thromb Vasc Biol 2004;24(6):998-1005.
Harrison D. Perspective series: nitric oxide and nitric oxide synthases. J Clin Invest 1997;100:2153-2157.
Duarte-Mote J, Espinosa-López RF, Díaz-Meza S, Sán-chez-Rojas G, Lee Eng-Castro VEL, Mijangos-Chávez J, Barragán-Garfias JA. Óxido nítrico: metabolismo e implicaciones clínicas. Med Int Mex 2008;24(6):397-406. Disponible en http://www.nietoeditores.com.mx/download/med%20interna/Nov-Dic2008/Med%20Int-397-406.pdf
Duarte-Mote J, Díaz-Meza S, Rubio-Gutiérrez J, Lee Eng-Castro VE, Fernández-Policaripio LY, Castro-Bravo J, et al. Preeclampsia y disfunción endotelial. Bases fisiopato-lógicas. Med Int Mex 2006;22(3):220-230. Disponible en http://www.medigraphic.com/pdfs/medintmex/mim-2006/mim063j.pdf
Briones-Garduño JC, Herrera-Villalobos JE. Presencia del equi-nocito en el síndrome de preeclampsia-eclampsia ¿Manifestación subclínica del síndrome? Cir Ciruj 2003;71(6):455-459.
Wikström AK, Nash P, Eriksson UJ, Olovsson MH. Evidence of increased oxidative stress and a change in the plasmi-nogen activator inhibitor (PAI)-1 to PAI-2 ratio in early-onset but not late-onset preeclampsia. Am J Obstet Gynecol 2009; 201(6):597.e1-597.e8. Epub 2009 Aug 15.
Baker AM, Klein RL, Moss KL, Haeri S, Boggess K. Maternal serum dyslipidemia occurs early in pregnancy in women with mild but not severe preeclampsia. Am J Obstet Gynecol 2009;201(3):293.e1-293.e4.
Ryu S, Huppmann AR, Sambangi N, Takacs P, Kauma SW. Increased leukocyte adhesion to vascular endothelium in preeclampsia is inhibited by antioxidants. Am J Obstet Gynecol 2007;196(4):400.e1-400.e8.
Bilodeau JF, Hubel CA. Current concepts in the use of antioxidants for the treatment of preeclampsia. J Obstet Gynaecol Can 2003;25(9):742-750.
Aydin S, Benian A, Madazli R, Uludag S, Uzun H, Kaya S. Plasma malondialdehyde, superoxide dismutase, sE-selectin, fibronectin, endothelin-1 and nitric oxide levels in women with preeclampsia. Eur J Obstet Gynecol Reprod Biol 2004;113(1):21-25.
McKinney ET, Shouri R, Hunt RS, Ahokas RA, Sibai BM. Plasma, urinary, and salivary 8-epi-prostaglandin f2alpha levels in normotensive and preeclamptic pregnancies. Am J Obstet Gynecol 2000;183(4):874-877.
Walsh SW, Vaughan JE, Wang Y, Roberts LJ 2nd. Placental isoprostane is significantly increased in preeclampsia. FASEB J 2000;14(10):1289-1296.
Boutet M, Roland L, Thomas N, Bilodeau JF. Specific systemic antioxidant response to preeclampsia in late pregnancy: the study of intracellular glutathione peroxidases in maternal and fetal blood. Am J Obstet Gynecol 2009; 200(5):530.e1-530.e7. Epub 2009 Mar 14.
Llurba E, Gratacos E, Martín-Gallan P, Cabero L, Domínguez C. A comprehensive study of oxidative stress and anti-oxidant status in preeclampsia and normal pregnancy. Free Radic Biol Med 2004;37(4):557-570.
Diedrich F, Renner A, Rath W, Kuhn W, Wieland E. Lipid hydroperoxides and free radical scavenging enzyme activities in preeclampsia and HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome: no evidence for circulating primary products of lipid peroxidation. Am J Obstet Gynecol 2001;185(1):166-172.
Kumar CA, Das UN. Lipid peroxides, antioxidants and nitric oxide in patients with preeclampsia and essential hypertension. Med Sci Monit 2000;6(5):901-907.
Wang Y, Gu Y, Zhang Y, Lewis DF. Evidence of endothelial dysfunction in preeclampsia: decreased endothelial nitric oxide synthase expression is associated with increased cell permeability in endothelial cells from preeclampsia. Am J Obstet Gynecol 2004;190(3):817-824.
Woywodt A, Streiber F, de Groot K, Regelsberger H, Haller H, Haubitz M. Circulating endothelial cells as markers for ANCA-associated small-vessel vasculitis. Lancet 2003;361(9353):206-210.
Grundmann M, Woywodt A, Kirsch T, Hollwitz B, Oehler K, Erdbruegger U, et al. Circulating endothelial cells: a marker of vascular damage in patients with preeclampsia. Am J Obstet Gynecol 2008;198(3):317.e1-317.e5. Epub 2008 Feb 20.
Gómez Bravo-Topete E, Morales-Esquivel JG, Briones- Vega CG. Dímero D en preeclampsia-eclampsia. Cir Ciruj 2002;70(2):98-101.
Dekker GA, Sibai BM, Etiology and pathogenesis of preeclampsia. Current concepts. Am J Obstet Gynecol 1998; 179(5):1359-1375.
Verduzco RL, González PE, Manffrini MF, López AB. Dímero D en diferentes etapas de la toxemia del embarazo. Estudio piloto. Ginecol Obstet Mex 1998;66(2):77-80.
Takacs P, Kauma SW, Sholley MM, Walsh SW, Dinsmoor MJ, Green K. Increased circulating lipid peroxides in severe preeclampsia activate NF-κB and upregulate ICAM-1 in vascular endothelial cells. FASEB J 2001;15(29): 279-281. Epub 2000 Dec 8.
Kauma S, Takacs P, Scordalakes C, Walsh S, Green K, Peng T. Increased endothelial monocyte chemoattractant protein-1 and interleukin-8 in preeclampsia. Obstet Gynecol 2002;100(4):706-714.
Takacs P, Green KL, Nikaeo A, Kauma SW. Increased vascular endothelial cell production of interleukin-6 in severe preeclampsia. Am J Obstet Gynecol 2003;188 (3):740-744.
Libby P. Inflammation in atherosclerosis. Nature 2002;420 (6917):868-874.
Centers for Disease Control and Prevention. Maternal mortality–United States, 1982-1996. MMWR Morb Mortal Wkly Rep 1998;47(34):705-707.
Benedetti TJ, Kates R, Williams V. Hemodynamic observations in severe preeclampsia complicated by pulmonary edema. Am J Obstet Gynecol 1985;152(3):330-334.
Drislane FW, Wang AM. Multifocal cerebral hemorrhage in eclampsia and severe preeclampsia. J Neurol 1997; 244(3):194-198.
Morriss MC, Twickler DM, Hatab MR, Clarke GD, Peshock RM, Cunningham FG. Cerebral blood flow and cranial mag-netic resonance imaging in eclampsia and severe pre-eclampsia. Obstet Gynecol 1997;89(4):561-568.
Cunningham FG, Fernández CO, Hernández C. Blindness associated with preeclampsia and eclampsia. Am J Obstet Gynecol 1995;172(4 Pt 1):1291-1298.
Dekker GA, van-Geijn HP. Endothelial dysfunction in pre-eclampsia. Part I. Primary prevention, therapeutic perspec-tives. J Perinat Med 1996;24(2):99-117.
Velasco-Murillo V, Pozos-Cavazos JL, Cardona-Pérez JA. Prevención y tratamiento de la preeclampsia-eclampsia. De la teoría a la práctica. Rev Med IMSS 2000;38(2):139-147.
Ballegeer VC, Spitz B, De Baene LA, Van Assche AF, Hidajat M, Criel AM. Platelet activation and vascular damage in gestacional hypertension. Am J Obstet Gynecol 1992; 166(2):629-633.
Gómez Bravo-Topete E, Briones-Garduño JC, Díaz de Leon-Ponce M, Ávila-Esquivel F, Briones-Vega CG. Frotis de sangre periférica y alteración orgánica en la preeclampsia-eclampsia. Cir Ciruj 2000;68(4):159-163.
Briones-Garduño JC, Díaz de León-Ponce M, Gómez Bravo-Topete E, Ávila-Esquivel F, Ochoa Ruiz-Esparza C, Briones-Vega CG, et al. Medición de fuga capilar en la preeclampsia-eclampsia. Cir Ciruj 2000;68 (5):194-197.
Díaz de León-Ponce M, Briones-Garduño JC, Meneses-Calderón J, Moreno-Santillán AA. Microangiopatía trombó-tica y hemólisis intravascular en hipertensión del embarazo. La mentira del síndrome de HELLP. Cir Ciruj 2006;74(3):211-215.
Espinosa MM, Díaz de León PM, Yáñez MI, Neniger CHJH, Colmenares MI. Microangiopatía trombótica y hemólisis intravascular en la toxemia. Rev Med IMSS 1982;20(1):35-41.