Objective:The purpose of this study was to evaluate the effects of Silymarin on vascular endothelial growth factor (VEGF), soluble VEGF Receptor-1 (sVEGFR-1) and Interleukin-1 alpha (IL-1α) levels in placental tissue samples of severely preeclamptic women.
Material and Methods:We conducted an in vitro study in Başkent University Faculty of Medicine, Ankara, Turkey between September 2008 and May 2009. A total of 16 placental tissue samples (8 from severe preeclamptic, and 8 from controls) were analysed. Placental samples were incubated, and VEGF, sVEGFR-1, and IL1-α were measured in culture media using an ELISA kit. The effect of Silymarin on these levels was investigated. Descriptive statistics were initially performed, followed by Mann Whitney U-test and Kruskal-Wallis test to compare means between groups. P values less than 0.05 were considered statistically significant.
Results:Eight patients were included in the severe preeclampsia (SP) group, whereas the remaining 8 patients were included in the control group. There were no significant correlations between gestational age and placental VEGF, sVEGFR-1 and IL-1α after 48 or 72 hours of incubation. Basal VEGF levels were lower in the SP group; however, it did not reach statistical significance. sVEGFR-1 and IL-1α levels were also similar between the SP and control groups (p>0.05). After 48 and 72 hours of incubation, sVEGFR-1 levels in Silymarin-added SP and control placental cultures were lower than in the samples without Silymarin addition; however, this difference also did not reach significance.
Conclusion:Although we could not demonstrate a significant effect on placental cytokines, considering the role of vasospasm, inflammation, angiogenesis, endothelial cell activation, and oxidative stress in preeclampsia, the potential benefits of Silymarin should be evaluated in future trials with a larger sample size. (J Turk Ger Gynecol Assoc 2014; 15: 30-5) Key words: Severe preeclampsia, placenta, vascular endothelial growth factor, Silymarin Received: 17 August, 2013 Accepted: 30 September, 2013 The effect of Silymarin on VEGF, VEGFR-1 and IL-1α levels in placental cultures of severe preeclamptic women After obtaining informed consent, severe preeclamptic women who underwent caesarean section above 30 weeks of gestation were prospectively included in the study. Severe preeclampsia (SP) was defined as new-onset hypertension and proteinuria in a >20 week pregnant woman with one or more of the following features: 1) severely elevated blood pressure (systolic ≥160 mmHg and/or diastolic ≥110 mmHg) measured at least twice with a 6 hour interval; 2) proteinuria ≥5 gr in 24-hour collected urine or ≥2+ in dipstick test; 3) serum creatinine ≥1.2 mg/dL; 4) oliguria (<400 cc in 24 hours); 5) thrombocytopenia (<100,000/mm 3 ); 6) microangiopathic haemolysis (Lactate dehydrogenase (LDH) ≥600 U/L or uncongugated bilirubin ≥1.2 mg/dL); 7) impaired liver function tests (Aspartate serum transaminase ≥ twice normal); 8) foetal growth restriction (FGR); 9) symptoms of cent...