Serum Lipid Peroxidation and Antioxidant Potential Levels in Hyperemesis Gravidarum

ABSTRACT

Hyperemesis gravidarum (HEG) is a severe form of nausea and vomiting with unknown etiology. Recent studies have suggested that there might be an etiologic role for Helicobacter pylori (HP) in HEG. HP is a Gram-negative bacterium that colonizes the gastric mucosa, increases the generation of reactive oxygen species (ROS), and decreases plasma antioxidants such as ascorbic acid. The aim of this study was to investigate plasma ROS activities and antioxidant status, and their relationship with HP infection, in HEG womens. Twenty-five HEG women, 20 gestational age- and gravida-matched healthy pregnant controls, and 15 nonpregnant women were examined for specific immunoglobulin G (IgG) against HP, serum malondialdehyde (MDA) as a measure of lipid peroxidation, and activity of antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CT). Compared with controls, the seropositivity of HP for IgG was significantly higher (P < 0.01) in pregnancies with HEG. When three study groups (including both HP + and HP- patients) were compared with each other with respect to the study parameters, MDA concentration increased significantly in pregnant women when compared with control group (nonpregnant women; p < 0.01), as well as in HEG compared with healthy pregnant women (p < 0.01). The SOD, GSH-Px, and CT activity were increased in the group of normal pregnant women versus the nonpregnant group (p < 0.01), but decreased significantly in the group of HEG pregnant women (p < 0.01). Serum MDA levels and SOD, GSH-Px, and CT activity were not affected by the seropositivity of HP for IgG in either group (p > 0.05). The results of the present study suggest that HEG is an oxidative stress condition, as reflected by the increased ROS activity and decreased antioxidant status, regardless of HP infection.

KEYWORDS

Hyperemesis gravidarum - Helicobacter pylori - lipid peroxidation - oxidative stress

REFERENCES

• 1 Broussard C N, Richter J E. Nausea and vomiting of pregnancy.  Gastroenterol Clin North Am. 1998;  27 123-151
• 2 Goodwin T M. Hyperemesis gravidarum.  Clin Obstet Gynecol. 1998;  41 597-605
• 3 Hod M, Orvieto R, Kaplan B, Friedman S, Ovadia J. Hyperemesis gravidarum: a review.  J Reprod Med. 1994;  39 605-612
• 4 Jacoby E B, Porter K B. Helicobacter pylori infection and persistent hyperemesis gravidarum.  Am J Perinatol. 1999;  16 85-88
• 5 Koçak I, Akcan Y, Üstün C, Demirel C, Cengiz L, Yanik F F. Helicobacter pylori seropositivity in patients with hyperemesis gravidarum.  Int J Gynaecol Obstet. 1999;  66 251-254
• 6 Cevrioglu A S, Altindis M, Yilmazer M, Fenkci I V, Ellidokuz E, Kose S. Efficient and non-invasive method for investigating Helicobacter pylori in gravida with hyperemesis gravidarum: Helicobacter pylori stool antigen test.  J Obstet Gynaecol Res. 2004;  30 136-141
• 7 Frigo P, Lang C, Reisenberger K, Kölbl H, Hirchl A M. Hyperemesis gravidarum associated with Helicobacter pylori seropositivity.  Obstet Gynecol. 1998;  91 615-617
• 8 El Younis C M, Abulafia O, Sherer D M. Rapid marked response of severe hyperemesis gravidarum to oral erythromycin.  Am J Perinatol. 1998;  15 533-534
• 9 Wang Y, Walsh S W, Guo J, Zhang J. The imbalance between tromboxane and prostacyclin in preeclampsia is associated with an imbalance between lipid peroxides and vitamin E in maternal blood.  Am J Obstet Gynecol. 1991;  165 1695-1700
• 10 Biri A, Kavutcu M, Bozkurt N, Devrim E, Nurlu N, Durak I. Investigation of free radical scavenging enzyme activities and lipid peroxidation in human placental tissues with miscarriage.  J Soc Gynecol Investig. 2006;  13 384-388
• 11 Maseki M, Nishagaki I, Hagihara M, Tomoda Y, Yagi K. Lipid peroxide levels and lipid serum contents of serum lipoprotein fractions of pregnant subjects with and without preeclampsia.  Clin Chim Acta. 1981;  155 155-160
• 12 Walsh S W, Wang Y. Deficient glutathione peroxidase activity in preeclampsia is associated with increased placental production of tromboxane and lipid peroxides.  Am J Obstet Gynecol. 1993;  169 1456-1461
• 13 Agarwal A, Gupta S, Sharma R K. Role of oxidative stress in female reproduction.  Reprod Biol Endocrinol. 2005;  14 28
• 14 Van Stuijvenberg M E, Schabort I, Labadarios D, Nel J T. The nutritional status and treatment of patients with hyperemesis gravidarum.  Am J Obstet Gynecol. 1995;  172 1585-1591
• 15 Davidge S T, Hubel C A, Brayden R D, Capeless E C, McLaughlin M K. Sera antioxidant activity in uncomplicated and preeclamptic pregnancies.  Obstet Gynecol. 1992;  79 897-901
• 16 Fait V, Sela S, Ophir E et al.. Hyperemesis gravidarum is associated with oxidative stress.  Am J Perinatol. 2002;  19 93-98
• 17 Sun Y, Oberley L W, Li Y. A simple method for clinical assay of superoxide dismutase.  Clin Chem. 1998;  34 497-500
• 18 Durak I, Yurtarslani Z, Canbolat O, Akyol O. A methodological approach to superoxide dismutase (SOD) activity assay based on inhibition of nitroblue tetrazolium (NBT) reduction.  Clin Chim Acta. 1993;  214 103-104
• 19 Aebi Y. Catalase in vitro.  Methods Enzymol. 1984;  105 121-126
• 20 Paglia D E, Valentine W N. Studies on the quantitative and qualitative characterization of erythrocyte glutathione peroxidase.  J Lab Clin Med. 1967;  70 158-169
• 21 Little R E, Gladen B C. Levels of lipid peroxides in uncomplicated pregnancy: a review of the literature.  Reprod Toxicol. 1999;  13 347-352
• 22 Wang Y P, Walsh S W, Guo J D, Zhang J Y. Maternal levels of prostacyclin, thromboxane, vitamin E, and lipid peroxides throughout normal pregnancy.  Am J Obstet Gynecol. 1991;  165(6 pt 1) 1690-1694
• 23 Mizumoto Y, Okuyama T, Endo R et al.. Studies on hypogeusia in hyperemesis gravidarum.  Nippon Sanka Fujinka Gakkai Zasshi. 1994;  46 35-41
• 24 Erdem A, Arslan M, Erdem M, Yildirim G, Himmetoglu O. Detection of Helicobacter pylori seropositivity in hyperemesis gravidarum and correlation with symptoms.  Am J Perinatol. 2002;  19 87-92
• 25 Jacobson G F, Autry A M, Somer-Shely T L, Pieper K L, Kirby R S. Helicobacter pylori seropositivity and hyperemesis gravidarum.  J Reprod Med. 2003;  48 578-582
• 26 Berker B, Soylemez F, Cengiz S D, Kose S K. Serologic assay of Helicobacter pylori infection. Is it useful in hyperemesis gravidarum?.  J Reprod Med. 2003;  48 809-812
• 27 Jain A, Sangal L, Basal E, Kaushal G P, Agarwal S K. Anti-inflammatory effects of erythromycin and tetracycline on Propionibacterium acnes induced production of chemotactic factors and reactive oxygen species by human neutrophils.  Dermatol Online J. 2002;  8 2-8
• 28 Lapenna D, De Gioia S, Mezzetti A et al.. H2-receptor antagonists are scavengers of oxygen radicals.  Eur J Clin Invest. 1994;  24 476-481