Preeclampsia, Preeclampsia Postpartum
Conditions
Brief summary
The purpose of this investigation is to examine the role of inappropriate mineralocorticoid receptor activation in endothelial dysfunction and vascular inflammation in otherwise healthy women with a history of preeclampsia. The main questions it aims to answer are: 1. Does overactivation of the mineralocorticoid receptor contribute to reduced endothelial function in women who had preeclampsia? 2. To what extent does the mineralocorticoid receptor mediated exaggerated production of inflammatory cytokines in immune cells from women who had preeclampsia? Participants will visit the research laboratory for 2 experimental visits: * Visit 1: Skin blood flow will be measured using a minimally invasive technique (intradermal microdialysis for the local delivery of pharmaceutical agents) to examine blood vessels in a nickel-sized area of the skin. * Visit 2: Endothelial cells will be collected from an antecubital vein.
Interventions
DRUGEplerenone
Local heating: eplerenone is locally and acutely delivered to the cutaneous microvasculature during local heating of the skin to assess endothelium-dependent dilation, L-NAME is added to assess nitric oxide-dependent dilation during this response
Sponsors
Anna Stanhewicz, PhD
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* women who had preeclampsia and women who did not have preeclampsia * 12 weeks to 5 years postpartum * 18-45 years old
Exclusion criteria
* history of hypertension or metabolic disease before pregnancy * history of gestational diabetes * history of gestational hypertension without preeclampsia * skin diseases * current tobacco use * current antihypertensive medication * statin or other cholesterol-lowering medication * currently pregnant * body mass index less than 18.5 kg/m2 * allergy to materials used during the experiment.(e.g. latex), * known allergy to study drugs or salt-supplement
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in microvascular endothelial function following local eplerenone treatment compared to placebo treatment measured by laser-Doppler flowmetry | post 1 hour of skin perfusion | Cutaneous vascular vasodilator response (cutaneous conductance; %max) to local heating of the skin; intradermal microdialysis for the local delivery of eplerenone compared to control (Ringer's solution), followed by L-NAME infusion to quantify NO-dependent response |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mineralocorticoid receptor expression in endothelial cells | a total of 1 time during the study, within ~4 weeks following enrollment | The investigators will quantify expression of the mineralocorticoid receptor in biopsied endothelial cells. |
| Inflammatory response from isolated immune cells | from a blood draw collected at the start of the experimental visit | The investigators will measure inflammatory responses, assessed as inflammatory cytokine release following activation of immune cells in the presence and absence of eplerenone treatment. Cells are collected from a blood draw and treated with eplerenone in a cell culture environment (ex vivo treatment). |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORAnna Reid-Stanhewicz, PhD
University of Iowa
Outcome results
None listed