Advances in Clinical and Experimental Medicine

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Advances in Clinical and Experimental Medicine

2013, vol. 22, nr 2, March-April, p. 145–149

Publication type: editorial article

Language: English

Podocytes in Urine, a Novel Biomarker of Preeclampsia?

Podocyty w moczu jako nowy biomarker stanu przedrzucawkowego?

Andrzej Konieczny1,A,B,D,E,F, Andrzej Konieczny2,A,B,D,E,F, Monika Ryba1,D,E,F, Monika Ryba2,D,E,F, Justyna Wartacz1,D,E,F, Justyna Wartacz2,D,E,F, Agnieszka Czyżewska-Buczyńska1,D,E,F, Zbigniew Hruby1,E,F, Zbigniew Hruby2,E,F, Zbigniew Hruby3,E,F, Wojciech Witkiewicz1,E,F, Wojciech Witkiewicz4,E,F, Wojciech Witkiewicz5,E,F

1 WROVASC – Integrated Cardiovascular Centre, Provincial Specialized Hospital, Research and Development Center in Wroclaw, Poland

2 Department of Nephrology, Sub-Department of Diabetology and Transplantation Medicine, Provincial Specialized Hospital, Research and Development Center in Wroclaw, Poland

3 Department of Internal Diseases Nursing, Wroclaw Medical University, Poland

4 Department of Vascular Surgery, Provincial Specialized Hospital, Research and Development Center in Wroclaw, Poland

5 Faculty of Dentistry, Wroclaw Medical University, Poland

Abstract

Preeclampsia is a disorder occurring during pregnancy typically after 20 weeks of gestation. It affects both mother and unborn baby in at least 5–8% of all pregnancies. It is a rapidly progressive condition characterized by high blood pressure and the presence of protein in the urine. The symptoms, such as swelling, sudden weight gain, headaches and vision disturbances, are important signs of preeclampsia which can lead to maternal and infant illness and death. It is estimated that this disorder is responsible for 76,000 maternal and 500,000 infant deaths each year. The main hypothesis explaining the development of preeclampsia is the theory of placental hypoxia/ischemia. An imbalance between vascular endothelial growth factor (VEGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) seems to play a crucial role. Currently there is no way to predict, with certainty whether preeclampsia will develop during a given pregnancy. There is a need for a diagnostic tool which can help to identify and monitor women at risk. There is growing evidence that podocyturia – urinary excretion of viable podocytes may be a useful predictor of preeclampsia. This paper presents facts supporting such a hypothesis.

Streszczenie

Stan przedrzucawkowy to schorzenie pojawiające się podczas ciąży, zwykle po jej 20. tygodniu. Stan ten zagraża zarówno matce, jak i nienarodzonemu jeszcze dziecku, i dotyczy około 5–8% wszystkich ciąż. Stan przedrzucawkowy postępuje gwałtownie i charakteryzuje się współistnieniem nadciśnienia tętniczego i białkomoczu. Objawia się obrzękami, nagłym zwiększeniem masy ciała, bólami głowy i zaburzeniami widzenia, które mogą prowadzić do uszkodzenia płodu, a nawet śmierci matki i dziecka. Ogólnie szacuje się, że każdego roku na świecie z powodu stanu rzucawkowego umiera ok. 76.000 matek i 500.000 nienarodzonych dzieci. Główną hipotezą tłumaczącą powstanie stanu przedrzucawkowego jest teoria niedokrwienia/niedotlenienia łożyska. Kluczową rolę wydaje sięgrać zaburzenie równowagi między czynnikiem wzrostu śródbłonka naczyniowego (VEGF) a receptorem naczyniowego czynnika wzrostu śródbłonka (sFlt-1). Obecnie nie ma pewnej diagnostyki, która pomogłaby zapobiec rozwojowi stanu rzucawkowego. Znalezienie skutecznego narzędzia diagnostycznego, przydatnego w identyfikacji i monitorowaniu osób zagrożonych stanem przedrzucawkowym, wydaje się sprawą wielkiej wagi. Jednym z takich narzędzi z pewnością mogłoby być badanie wydalania podocytów z moczem. Poniższa praca przedstawia dowody na poparcie tej hipotezy.

Key words

hypertension, podocytes, preeclampsia, pregnancy, proteinuria.

Słowa kluczowe

białkomocz, ciąża, nadciśnienie tętnicze, podocyty, stan przedrzucawkowy.

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