Papel do sistema renina-angiotensina sobre a função vascular e plaquetária na gravidez normal e associada à hipertensão

Abstract

During pregnancy the systemic maternal circulation adapts to facilitate uteroplacental perfusion and the renin-angiotensin system (RAS) plays an important role in this adaptation. The objective of this study was to investigate the contribution of RAS on the maternal cardiovascular regulation at the end of pregnancy as well as the L-arginine-NO-cGMP pathway in platelets from normotensive and spontaneously hypertensive rats (SHR). Mesenteric arterial bed (MAB) and platelets were obtained in the 20th day of pregnancy from female SHR (SHR-P) and normotensive controls (P) or age-matched non-pregnant rats (SHRNP and NP). The systolic blood pressure in P and SHR-P rats was reduced at the end of pregnancy. The vasodilator effects of angiotensin II and angiotensin 1-7, evaluated in norepinephrine preconstricted MAB, were higher in SHR-P than in other groups. Endothelial nitric oxide synthase (NOS) expression in MAB was evaluated by Western Blotting and was increased in P and SHR-P compared to their non-pregnant counterparts. Angiotensinconverting enzyme (ACE) and AT1 receptor expressions were increased in MAB from SHRNP compared to normotensive groups and the pregnancy reduced their expressions in SHR. On the other hand, ACE2 expression was higher in MAB from hypertensive than normotensive groups. Oxidative damage, evaluated by formation of thiobarbituric acid reaction substances (TBARS), was reduced in the pregnant groups compared to their nonpregnant counterparts. Superoxide dismutase activity was reduced in SHR-P compared to non-pregnant group. Pregnancy increased catalase activity in normotensive rats and increased glutathione peroxidase activity in SHR. In the platelet suspension, intraplatelet NOS activity measured by the conversion of L-[3H]-arginine to L-[3H]-citruline was reduced in P compared to NP, despite unchanged in L-arginine influx. The expressions of endothelial and inducible NOS, evaluated by Western Blotting, were decreased during pregnancy in normotensive rats. Paradoxically, cGMP levels were similar between NP and P, as well as phosphodiesterase5 (PDE5) expression and platelet aggregation induced by ADP. In SHR, L-arginine influx was reduced in SHR-P compared to SHR-NP. SHR-P had impaired NOS activity and reduced inducible NOS expression compared with SHR-NP. Soluble guanylate cyclase and PDE5 expressions were lower in SHR-P compared to SHR-NP while no differences were noted in cGMP levels between groups. However, increased levels of cGMP levels were observed in SHR-P compared to normotensive groups and platelet aggregability remained unaltered. The results suggest that the reduction of blood pressure to normal values at the end of pregnancy in SHR may be related to an increased NO production and vasorelaxation to Ang II and Ang 1-7 associated with decreased expression of vascular ACE and AT1 receptors and oxidative status. Morover, this study reveals the presence of L-arginine-NO-cGMP pathway in rat platelets. Despite reduced platelet NO bioavailability in pregnant hypertensive rats, platelet aggregability remains unaltered, which may be related to increased levels of cGMP and reduced expression of PDE5.