1995 Fiscal Year Final Research Report Summary
Studies on the cause of HELLP syndrome
| Project/Area Number |
05454443
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Obstetrics and gynecology
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| Research Institution | Hamamatsu University School of Medicine |
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Principal Investigator |
TERAO Tosihiko Hamamatsu University School of Medicine, Professer, 医学部, 教授 (60022852)
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| Co-Investigator(Kenkyū-buntansha) |
KANAYAMA Naohiro Hamamatsu University School of Medicine, Assistant, 医学部附属病院, 講師 (70204550)
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| Project Period (FY) |
1993 – 1995
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| Keywords | HELLP syndrome / sympathetic ganglion / vasospasm / endothelin / cytokines |
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| Research Abstract |
Aim : To determine the role of vasospasm of celiac artery, we have also performed several animal and clinical experiments. Materials and Methods : Immunostaining with anti TNF-alpha, anti neutrophil elastase, anti IL-1, anti IL-8 antibodies was done on hepatic tissues obtained from eclamptic and preeclamptic HELLP syndrome patients to understand the role of neutrophil or some cytokines in tissue damage in such disease. ET-1 was injected in pregnant and nonpregnant rabbits and their different blood parameters were investigated and analyzed. Endotoxin, potassium chloride, and saline solution were superposed on the celiac ganglion in pregnant or non-pregnant rats. Endotoxin was also superposed on bifurcation of the abdominal aorta. The blood pressure, proteinuria and various blood parameters were measured. Results : Periportal hemorrhage and ischemic necrosis with marked infiltration of neutrophils in liver tissues were found in HELLP syndrome cases. Those tissues were stained strongly to TNF-alpha and neutrophil elastase and moderately with polyclonal IL-1beta and IL-8 antibodies indicating that cytokine production induced by vasospasms occurred. Vasoconstriction of the hepatic artery following a bolus injection of 0.25 nmol/kg of ET-1 into the celiac artery occurred in rabbits. HELLP syndrome like biochemical parameters were obtained after the ET-1 injections and stimulation of celiac ganglions. Histological examination of liver tissues treated with injections of endothelin and stimulation of celiac ganglions showed varying degrees of ischemic necrosis of hepatocytes similar to human HELLP syndrome. Conclusion : This study suggests that injections of endothelin-1 and an exogenous stimulation of the celiac ganglion causes an increase in the blood pressure and liver ischemia, resulting in HELLP syndrome-like disease in pregnant and non-pregnant rats. We suggest that ET-1 and abdominal sympathetic nerve might play a causative role in HELLP syndrome.
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