Study On Angiotensin Converting Enzyme And Hypertensive Disorder Complicating Pregnancy

Hypertensive Disorder Complicating Pregnancy ( HDCP ) is a pregnancy-specific disease of reduced organ perfusion secondary to vasospasm and endothelial activation. It affects 7-10% of all pregnancies, and HDCP is a major cause of maternal and fetal mortality. But its etiology remains unknown.It is also well know that renin-angiotensin system(RAS)is a factor in HDCP. Angiotensin- converting enzyme(ACE)plays an important role in blood pressure homeostasis generating angiotensinâ…¡(Angâ…¡),a vasoconstrictor peptide also recently recognized as a growth factor,form angiotensinâ… (Angâ… ).After delivery,most of symptoms disappear or take a turn for the better;even if fetus died in the uterus, symptoms and signs disappear quickly. These results suggested that the feto-placental unit plays a certain role in HDCP. AIM To detect the correlation of ACE with HDCP,and the correlation of HDCP with ACE in gravida,fetus and placenta,in order to explore the pathogenesis of HDCP.WETHODS 1,Polymorphism chain reaction was performed to show the polymorphism of ACE gene in 60 patients with HDCP and the fetus and 54 normal pregnant women and the fetus.2,Radioimmunoassay was used to detect the concentration of ANG II in the maternal blood,cord blood,and placental tissues in 60 patients with HDCP and 54 normal pregnancy.3,(1)The expression of ACE in the placenta and umbilical cord of the HDCP and the control group were respectively examined by Immunohistochemistry .(2)The expression and localization of ACE mRNA in the placenta and umbilical cord of the the HDCP and the control group were respectively examined by in situ hybridization.RESULTS 1,The percentage of the ACE DD , ID and II genotype in the HDCP pregnant women group was significantly different as compared with the control group respectively(P<0.05). The percentage of the ACE DD, ID and II genotype in the HDCP fetus group was not significantly different as compared with the control group respectively(P>0.05).2,ANG II level in the maternal blood of women,placental tissue homogenate and the cord blood with HDCP was significantly higher the normal control group(P<0.05).3,The expression of ACE was increased in the syncytiotrophoblast and endothelial cells of umbilical cord vessels of HDCP women, while the expression of ACE in the syncytiotrophoblast and endothelial cells of umbilical cord vessels decreased in the normal control group(P<0.05).CONCLUSION 1,The Polymorphism of ACE gene in the HDCP pregnant group may have association with the pathogenesis of HDCP. The Polymorphism of ACE gene in the HDCP fetus group may have no association with the pathogenesis of HDCP.2,Angâ…¡may play an important role in the development of HDCP.3,The expression of local ACE in the placenta tissue and umbilical cord play an important role in HDCP and contribute to the development of HDCP.