(6)妊娠高血圧腎症患者の内皮機能正常化を目標とした栄養管理に関する基礎および臨床的研究(<特集>第58回シンポジウム1「妊娠と栄養・代謝-妊娠中の適切な栄養管理をめざして-」)

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Preeclampsia is characterized as increase in vascular resistance and permeability, and the disorder of blood coagulation. Its pathophysiology might involve the dysfunction of endothelium-derived relaxing factors, such as nitric oxide (NO), prostacyclin and endothelium-derived hyperpolarizing factor (EDHF). It was found that the activity of NO and prostacyclin (not but EDHF) might be reduced in omental resistance arteries obtained from preeclamptic women. On further investigation, the reduced activity of NO might be mainly caused by impaired action of cGMP (the second messenger of NO), while reduced action of prostacyclin might be caused by decrease in its production. However, EDHF might be preserved, suggesting that it might be compensate for these disorders. From these results the endothelial dysfunction seen in preeclampsia, which is so called "endothelial cell activation" might be specific (since it is different from endothelial dysfunction in other pathological state, such as hypertension and diabetes). Recently, it was found that the administration of folic acid or L-arginine might improve the endothelial dysfunction in patients complicated by hypertension or diabetes. We here investigated whether or not folic acid or L-arginine improves the dysfunction of endothelium in animal model whose endothelial function is damaged, and oral administration of folic acid plus L-arginine increases endothelial function in high risk pregnant women. The reduced production and activity of NO was seen in mesenteric resistance artery obtained from nitroglycerin (NTG) administrated rabbit. L-arginine plus 5-methylte-trahydrofolate, activated folic acid could improve their reduction, being possibly dependent on endothelial NO synthase (eNOS) uncoupling in resistance artery of NTG rabbit. An oral supplementation of L-arginine plus folic acid also might recover the reduced endothelial function in high risk pregnant women using flow-mediated vasodilatation of brachial artery by reactive hyperemia. From these results, it was suggested that the administration of L-arginine plus folic acid might improve the endothelial dysfunction by possibly blocking eNOS uncoupling in women complicated with preeclampsia.
2006-09-01

(6)妊娠高血圧腎症患者の内皮機能正常化を目標とした栄養管理に関する基礎および臨床的研究(<特集>第58回シンポジウム1「妊娠と栄養・代謝-妊娠中の適切な栄養管理をめざして-」)

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