Serum nitric oxide and homocysteine as biomarkers of ectopic pregnancy

Kavitha Meiyappan, Pooja Dhiman, Soundravally Rajendiren, Krishnalatha Thayagarajan, Soundara Raghavan S

Abstract


Background: Aim of current study was to evaluate the role of serum homocysteine and nitric oxide in the diagnosis of ectopic pregnancy.

Methods: The study included 32 patients with ruptured ectopic, 29 miscarriage patients and 30 normal pregnant women as controls. Fasting plasma homocysteine, serum folate, vitamin B12 levels and nitric oxide levels were estimated at the time of admission.

Results: Plasma homocysteine levels were significantly lower in patients with ectopic pregnancy than normal pregnancy. Nitric oxide levels were significantly lower in patients with abortion.

Conclusions: Patients with abortion have decreased circulating nitric oxide levels in serum while those with ectopic pregnancies have decreased homocysteine levels. 


Keywords


Ectopic, Homocysteine, Nitric, Abortion, Fallopian

Full Text:

PDF

References


Khaskeli M, Baloch S, Baloch AS. Risk factors in early pregnancy complications. J Coll Physicians Surg Pak. 2010;20(11):744-7.

Murray H, Baakdah H, Bardell T, Tulandi T. Diagnosis and treatment of ectopic pregnancy. Can Med Assoc J. 2005;173(8):905-12.

Shaw JLV, Dey SK, Critchley HOD, Horne AW. Current knowledge of the aetiology of human tubal ectopic pregnancy. Hum Reprod Update. 2010;16(4):432-44.

Lauzikiene D, Drasutiene GS, Mecejus G, Zakareviciene J. Serum folate & homocysteine concentrations in women with the first early spontaneous pregnancy loss. Acta Medica Lituanica. 2003;10(4);207-12.

Cartwright J, Duncan WC, Critchley HOD, Horne AW. Serum biomarkers of tubal ectopic pregnancy: current candidates and future possibilities. Reproduction. 2009;138:9-22.

Sladek SM, Magness RR, Conrad KP. Nitric oxide and pregnancy. Am J Physiol. 1997 Feb;272(2 Pt 2):R441-63.

Norman JE, Cameron IT. Nitric oxide in human uterus. Rev Reprod. 1996;1:61-8.

Sydow K, Schwedhelm E, Arakawan N, Bode-Böger SM, Tsikas D, Hornig B, et al. ADMA and oxidative stress are responsible for endothelial dysfunction in hyperhomocysteinemia: effects of L-arginine and B vitamins. Cardiovasc Res. 2003;57:244-52.

Baban RS. Oxidative stress in recurrent pregnancy loss women. Saudi Med J. 2010;31(7):759-63.

Paradisi R, Fabbri R, Battaglia C, Facchinetti F, Venturoli S. Nitric oxide levels in women with missed and threatened abortion: results of a pilot study. Fertil Steril. 2007 Sep;88(3):744-8.

Marinoni E, Di Iorio R, Lucchini C, Di Netta T, Letizia C, Cosmi EV. Adrenomedullin and nitric oxide synthase at the maternal-decidual interface in early spontaneous abortion. J Reprod Med. 2004 Mar;49(3):153-61.

Dixon RE, Hwang SJ, Hennig GW, Ramsey KH, Schripsema JH, Sanders KM, et al. Chlamydia infection causes loss of pacemaker cells and inhibits oocyte transport in the mouse oviduct. Biol Reprod. 2009;80:665-73.

Stuhlinger MC, Tsao PS, Her JH, Kimoto M, Balint RF, Cooke JP. Homocysteine impairs the nitric oxide synthase pathway: role of asymmetric dimethylarginine. Circulation. 2001;104:2569-75.

Zhang X, Li H, Jin H, Ebin Z, Brodsky S, Goligorsky MS. Effects of homocysteine on endothelial nitric oxide production. Am J Physiol Renal Physiol. 2000 Oct;279(4):F671-8.

Refaat B, Simpson H, Britton E, Biswas J, Wells M, Aplin JD, et al. Why does the fallopian tube fail in ectopic pregnancy? The role of activins, inducible nitric oxide synthase, and MUC1 in ectopic implantation. Fertil Steril. 2012 May;97(5):1115-23.

Al-Azemi M, Refaat B, Amer S, Ola B, Chapman N, Ledger W. The expression of inducible nitric oxide synthase in the human fallopian tube during the menstrual cycle and in ectopic pregnancy. Fertil Steril. 2010 Aug;94(3):833-40.

Nelen WL, Blom HJ, Steegers EA, den Heijer M, Thomas CM, Eskes TK. Homocysteine and folate levels as risk factors for recurrent early pregnancy loss. Obstet Gynecol. 2000;95(4):519-24.

D’Uva M, Di Micco P, Strina I, Alviggi C, Iannuzzo M, Ranieri A, et al. Hyperhomocysteinemia in women with unexplained sterility or recurrent early pregnancy loss from Southern Italy: a preliminary report. Thromb J. 2007 Jul;5:10.

Kumar KS, Govindaiah V, Naushad SE, Devi RR, Jyothy A. Plasma homocysteine levels correlated to interactions between folate status and methylene tetrahydrofolate reductase gene mutation in women with unexplained recurrent pregnancy loss. J Obstet Gynecol. 2003 Jan;23(1):55-8.

Sütterlin M, Bussen S, Ruppert D, Steck T. Serum levels of folate and cobalamin in women with recurrent spontaneous abortion. Hum Reprod. 1997 Oct;12(10):2292-6.

Nelen WL, Blom HJ, Steegers EA, den Heijer M, Thomas CM, Eskes TK. Homocysteine and folate levels as risk factors for recurrent early pregnancy loss. Obstet Gynecol. 2000;95(4):519-24.

Hübner U, Alwan A, Jouma M, Tabbaa M, Schorr H, Herrmann W. Low serum vitamin B12 is associated with recurrent pregnancy loss in Syrian women. Clin Chem Lab Med. 2008;46(9):1265-9.

Hoffman ML, Scoccia B, Kurczynski TW, Shulman LP, Gao W. Abnormal folate metabolism as a risk factor for first-trimester spontaneous abortion. J Reprod Med. 2008 Mar;53(3):207-12.

Woo CW, Cheung F, Chan VW, Siow YL. Homocysteine stimulates inducible nitric oxide synthase expression in macrophages: antagonizing effect of ginkgolides and bilobalide. Mol Cell Biochem. 2003 Jan;243(1-2):37-47.

Lee SJ, Kim KM, Namkoong S, Kim CK, Kang YC, Lee H, et al. Nitric oxide inhibition of homocysteine-induced human endothelial cell apoptosis by down-regulation of p53-dependent noxa expression through the formation of S-nitrosohomocysteine. J Biol Chem. 2005;280:5781-8.