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Proceedings of the National Academy of Sciences of the United States of America logoLink to Proceedings of the National Academy of Sciences of the United States of America
. 1986 Feb;83(4):1075–1078. doi: 10.1073/pnas.83.4.1075

Magnesium sulfate: rationale for its use in preeclampsia.

K V Watson, C F Moldow, P L Ogburn, H S Jacob
PMCID: PMC323013  PMID: 3513161

Abstract

Preeclampsia is a disorder of pregnancy characterized clinically by hypertension, proteinuria, and edema and characterized pathologically in its late stages by widespread microvascular thrombi. There is evidence from a number of studies that production of prostacyclin (prostaglandin I2, PGI2), a potent vasodilator and inhibitor of platelet aggregation, is deficient in preeclamptic compared to normal pregnancy. Traditional therapy utilizes infusions of large amounts of MgSO4, but the physiologic basis for this is not clear. We studied the effect of MgSO4 on PGI2 release by cultured human umbilical vein endothelial cells (HUVEC) by several methods. By platelet aggregometry, the known antiaggregatory effect of intact HUVEC was enhanced by MgSO4. By radioimmunoassay for 6-keto-PGF1 alpha, the stable metabolite of PGI2, it was shown that MgSO4 amplifies release of PGI2 by HUVEC in a dose-dependent manner, with a peak occurring between 2 and 3 mM. In separate experiments, MgSO4 overcame the enhanced adherence of platelets to HUVEC exhausted by repeated exposure to thrombin. Finally, PGI2 production was 2- to 5-fold greater by HUVEC incubated with plasma obtained from preeclamptic patients undergoing MgSO4 therapy than by HUVEC incubated with pretherapy plasma. We conclude that MgSO4 mediates enhanced production of PGI2 by vascular endothelium, thereby potentially enhancing its thromboresistant properties.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Altura B. M., Altura B. T., Carella A. Magnesium deficiency-induced spasms of umbilical vessels: relation to preeclampsia, hypertension, growth retardation. Science. 1983 Jul 22;221(4608):376–378. doi: 10.1126/science.6867714. [DOI] [PubMed] [Google Scholar]
  2. Bodzenta A., Thomson J. M., Poller L. Prostacyclin activity in amniotic fluid in pre-eclampsia. Lancet. 1980 Sep 20;2(8195 Pt 1):650–650. doi: 10.1016/s0140-6736(80)90324-4. [DOI] [PubMed] [Google Scholar]
  3. Bussolino F., Benedetto C., Massobrio M., Camussi G. Maternal vascular prostacyclin activity in pre-eclampsia. Lancet. 1980 Sep 27;2(8196):702–702. doi: 10.1016/s0140-6736(80)92746-4. [DOI] [PubMed] [Google Scholar]
  4. Czervionke R. L., Hoak J. C., Fry G. L. Effect of aspirin on thrombin-induced adherence of platelets to cultured cells from the blood vessel wall. J Clin Invest. 1978 Oct;62(4):847–856. doi: 10.1172/JCI109197. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Evans S., Frigoletto F. D., Jr, Jewett J. F. Mortality of eclampsia: a case report and the experience of the Massachusetts Maternal Mortality Study, 1954-1982. N Engl J Med. 1983 Dec 29;309(26):1644–1647. doi: 10.1056/NEJM198312293092612. [DOI] [PubMed] [Google Scholar]
  6. Hirata F. The regulation of lipomodulin, a phospholipase inhibitory protein, in rabbit neutrophils by phosphorylation. J Biol Chem. 1981 Aug 10;256(15):7730–7733. [PubMed] [Google Scholar]
  7. Hoak J. C., Czervionke R. L., Fry G. L., Smith J. B. Interaction of thrombin and platelets with the vascular endothelium. Fed Proc. 1980 Jul;39(9):2606–2609. [PubMed] [Google Scholar]
  8. Jaffe E. A., Hoyer L. W., Nachman R. L. Synthesis of antihemophilic factor antigen by cultured human endothelial cells. J Clin Invest. 1973 Nov;52(11):2757–2764. doi: 10.1172/JCI107471. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. LOWRY O. H., ROSEBROUGH N. J., FARR A. L., RANDALL R. J. Protein measurement with the Folin phenol reagent. J Biol Chem. 1951 Nov;193(1):265–275. [PubMed] [Google Scholar]
  10. Levine B. S., Coburn J. W. Magnesium, the mimic/antagonist to calcium. N Engl J Med. 1984 May 10;310(19):1253–1255. doi: 10.1056/NEJM198405103101910. [DOI] [PubMed] [Google Scholar]
  11. Lindheimer M. D., Katz A. I. Pathophysiology of preeclampsia. Annu Rev Med. 1981;32:273–289. doi: 10.1146/annurev.me.32.020181.001421. [DOI] [PubMed] [Google Scholar]
  12. McKay D. G. Disseminated intravascular coagulation and experimental disease models in pregnancy. Perspect Nephrol Hypertens. 1976;5:401–409. [PubMed] [Google Scholar]
  13. Moncada S., Vane J. R. Arachidonic acid metabolites and the interactions between platelets and blood-vessel walls. N Engl J Med. 1979 May 17;300(20):1142–1147. doi: 10.1056/NEJM197905173002006. [DOI] [PubMed] [Google Scholar]
  14. Ogburn P. L., Jr, Williams P. P., Johnson S. B., Holman R. T. Serum arachidonic acid levels in normal and preeclamptic pregnancies. Am J Obstet Gynecol. 1984 Jan 1;148(1):5–9. doi: 10.1016/s0002-9378(84)80023-x. [DOI] [PubMed] [Google Scholar]
  15. Redman C. W., Allington M. J., Bolton F. G., Stirrat G. M. Plasma-beta-thromboglobulin in pre-eclampsia. Lancet. 1977 Jul 30;2(8031):248–248. doi: 10.1016/s0140-6736(77)92863-x. [DOI] [PubMed] [Google Scholar]
  16. Remuzzi G., Marchesi D., Zoja C., Muratore D., Mecca G., Misiani R., Rossi E., Barbato M., Capetta P., Donati M. B. Reduced umbilical and placental vascular prostacyclin in severe pre-eclampsia. Prostaglandins. 1980 Jul;20(1):105–110. doi: 10.1016/0090-6980(80)90010-6. [DOI] [PubMed] [Google Scholar]
  17. Remuzzi G., Rossi E., Misiani R., Marchesi D., Mecca G., de Gaetano G., Donati M. B. Prostacyclin and thrombotic microangiopathy. Semin Thromb Hemost. 1980;6(4):391–394. doi: 10.1055/s-2007-1005110. [DOI] [PubMed] [Google Scholar]
  18. Rákóczi I., Tallián F., Bagdány S., Gáti I. Platelet life-span in normal pregnancy and pre-eclampsia as determined by a non-radioisotope technique. Thromb Res. 1979;15(3-4):553–556. doi: 10.1016/0049-3848(79)90161-0. [DOI] [PubMed] [Google Scholar]
  19. Sacks T., Moldow C. F., Craddock P. R., Bowers T. K., Jacob H. S. Oxygen radicals mediate endothelial cell damage by complement-stimulated granulocytes. An in vitro model of immune vascular damage. J Clin Invest. 1978 May;61(5):1161–1167. doi: 10.1172/JCI109031. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Shier W. T. Serum stimulation of phospholipase A2 and prostaglandin release in 3T3 cells is associated with platelet-derived growth-promoting activity. Proc Natl Acad Sci U S A. 1980 Jan;77(1):137–141. doi: 10.1073/pnas.77.1.137. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Turlapaty P. D., Altura B. M. Magnesium deficiency produces spasms of coronary arteries: relationship to etiology of sudden death ischemic heart disease. Science. 1980 Apr 11;208(4440):198–200. doi: 10.1126/science.7361117. [DOI] [PubMed] [Google Scholar]
  22. Weksler B. B., Marcus A. J., Jaffe E. A. Synthesis of prostaglandin I2 (prostacyclin) by cultured human and bovine endothelial cells. Proc Natl Acad Sci U S A. 1977 Sep;74(9):3922–3926. doi: 10.1073/pnas.74.9.3922. [DOI] [PMC free article] [PubMed] [Google Scholar]

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