Endothelial dysfunction, vasospasm and edema in pre-eclampsia
THE CONTEXT
Pre-eclampsia is characterized by endothelial dysfunction and vasospasm. The passage describes contributing mechanisms and probable explanations for edema.
Endothelial dysfunction and vascular imbalance
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Endothelial dysfunction results from oxidative stress and inflammatory mediators.
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Vasospasm results from an imbalance between vasodilators—PGI2 and nitric oxide—and vasoconstrictors—angiotensin-II, TXA2 and endothelin-1.
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There is also an imbalance between angiogenic factors, PlGF and VEGF, and antiangiogenic factors, sFit-1 and endoglin.
Probable mechanisms of edema
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The cause of excessive fluid accumulation in extracellular tissue spaces is not clear.
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A proposed sequence is increased oxidative stress, followed by endothelial injury and increased capillary permeability.
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Leaky capillaries and decreased blood osmotic pressure are probable explanations for edema.