Determination of cytokines, Hsp70 and hemeoxygenase-1 in the plasma of pre-eclampsic pregnant women submitted to treatment with magnesium sulfate

• Grant number: 20/06092-8
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): September 01, 2020
• Effective date (End): August 31, 2021
• Field of knowledge: Health Sciences - Medicine - Maternal and Child Health
• Principal Investigator: Maria Terezinha Serrão Peraçoli
• Grantee: Patrícia Braga da Silva
• Host Institution: Instituto de Biociências (IBB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Preeclampsia is a specific manifestation of pregnancy characterized by an intense systemic inflammatory response, arteriolar spasm and endothelial dysfunction, resulting from genetic, immunological and endocrine factors. Between 10 and 15% of maternal deaths are associated with hypertensive diseases of pregnancy, 10% of which are associated with eclampsia, defined as manifestation of generalized tonic-clonic seizures and/or coma, in pregnant women with gestational hypertension or pre-eclampsia, in the absence of neurological diseases. Evidence in the literature shows that magnesium sulfate is the medication of choice for the prevention and treatment of eclampsia. Considering the importance of immunomodulatory substances in the pathophysiology of preeclampsia and the recognized therapeutic effect of magnesium sulfate in the prevention and treatment of eclampsia, the present study aims to evaluate the modulating effect of magnesium sulfate on the systemic inflammatory response in pregnant women with pre-eclampsia, diagnosed with impending eclampsia or eclampsia. Thirty pre-eclamptic pregnant women with gestational age over 24 weeks and presenting signs and symptoms of impending eclampsia or eclampsia will be evaluated. The pregnant women will be randomized for treatment with two magnesium sulphate regimens, 15 of which will be treated with Zuspan regimen and the other 15 with the modified Zuspan regimen. After the patient is included in the study, the blood sample will be collected before starting the administration of the initial dose of each magnesium sulfate regimen. The blood will be collected again after 24h and 48h of treatment. The plasma obtained in each period will be used to determine Interleukin (IL) -1 beta (IL-1²), IL-6, IL-10, tumor necrosis factor-alpha (TNF-±), heat shock protein (Hsp70) and the hemeoxygenase-1 (HO-1) enzyme. The results will be analyzed by parametric or non-parametric tests, with a significance level of 5%.