The role of Adiponectin, Leptin, TNFα and Resistin in HIV associated Pre-eclampsia

Vineshree Govender, Anita Naicker

Abstract


Hypertensive disorders in pregnancy, in particular, pre-eclampsia remains an enigmatic problemwith global disease burden shared amongst industrialised and non-industrialised countries. It has been estimated that hypertensive disorders complicate 5 – 10% of preganacies. The leading cause of maternal deaths in sub-Saharan Africa is AIDS (43.7%). The Saving Mothers Guidelines for the tri-ennium 2005 – 2007 in South Africa found that hypertensive disorders were directly linked to maternal deaths in 15,7% of cases, of which  83% was represented by deaths from preeclampsia.

 

The relationship between pre-eclampsia and HIV infection is controversial, poorly documented and requires further investigation. Some studies indicate an increased incidence  while others show a decreased  frequency of pre eclampsia based on immune dysfunction being  associated in the physiological changes associated with pre eclampsia and pregnancy. The current thoughts on the aetiology of pre eclampsia also indicates that there is an exaggerated sterile inflammatory response may be involved. Thus the role of  adipose derived proteins have been implicated in enhancing pro-inflammatory responses.  In contrast to HIV infection, preeclampsia is associated with immune hyperreactivity.  HIV infection is also associated with wasting, hence the levels of these hormones may be dyregulated and requires investigation.  Additionally, this dysregulation may serve as a predictor test for the predisposition to pre-eclampsia. This study attempts to elucidate the possible predictor value of adiponectin, resistin, tumor necrosis factor and leptin in the predisposition to the development of pre-eclampsia and to investigate the regulation of these adipose proteins in immunocompromised patients