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Subclinical Infection as a Cause of Inflammation in Preeclampsia

López-Jaramillo, Patricio MD, PhD1,2*; Herrera, Julian A MD3; Arenas-Mantilla, Mario MD1; Jáuregui, Isabel E MD1; Mendoza, Mayaris A MD1

American Journal of Therapeutics: July-August 2008 - Volume 15 - Issue 4 - p 373-376
doi: 10.1097/MJT.0b013e318164c149
Proceedings: Fifth Latin American Congress on Hypertension

Preeclampsia, a pregnancy-exclusive hypertensive disorder, is the major cause of maternal and perinatal mortality, with a greater importance in developing countries. The role of inflammation in the pathogenesis of preeclampsia has been the object of recent studies by our group. We have described elevated levels of inflammatory markers (tumor necrosis factor alpha, interleukin-6, and C-reactive protein) in preeclamptic patients and demonstrated that Latin-American women present a higher degree of inflammation than women from developed countries. We have results that suggest that chronic subclinical infections and insulin resistance are the most probable causes of the increased inflammation in preeclampsia. Moreover, we showed that early treatment of urinary and vaginal infections decreased the incidence of preeclampsia. We also have evidence that suggests that inflammation leads to endothelial dysfunction, predisposing women to develop preeclampsia. Increased levels of inflammation markers and endothelial dysfunction are found in the early stages of pregnancy in women who later on develop preeclampsia. Appropriate prenatal care programs, including screening and treatment of urinary, vaginal, and periodontal infections in early pregnancy and prevention of factors that predispose to insulin resistance, such as excessive weight gain during pregnancy, may reduce the incidence of preeclampsia in Latin-American women.

1Vilano Group, Research Institute, Cardiovascular Foundation of Colombia, Floridablanca, Santander, Colombia; 2Research Direction, Medical School, Universidad de Santander (UDES), Bucaramanga, Santander, Colombia; and 3Department of Family Medicine, School of Medicine, Universidad del Valle, Cali, Valle del Cauca, Colombia.

Funding: Colombian Institute for Science and Technology Development “Colciencias” (grant no. 6566-04-18061).

*Address for correspondence: Instituto de Investigaciones, Fundación Cardiovascular de Colombia, Calle 155a #23-58, 3rd Floor, Floridablanca, Santander, Colombia. E-mail: joselopez@fcv.org, jplopezj@hotmail.com

© 2008 Lippincott Williams & Wilkins, Inc.