Phosphodiesterase Inhibition in the Treatment of Preeclampsia: What Is New?
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Purpose of Review
The present study intends to review the possibility of using phosphodiesterase inhibitors as a treatment option for preeclampsia, addressing potential risks and benefits.
Preeclampsia is the most common hypertensive disorder of pregnancy, often responsible for severe maternal and fetal complications, which can lead to early pregnancy termination and death. Despite the numerous studies, its pathophysiology is still unclear, although it seems to involve a multiplicity of complex factors related to angiogenesis, ineffective vasodilation, oxidative stress, inflammatory cytokines, and endothelial dysfunction. It has been hypothetically suggested that the use of phosphodiesterase inhibitors is capable of improving placental and fetal perfusion, contributing to gestational scenario, by decreasing the symptomatology and severity of this syndrome. In this literature review, it has been found that most of the studies were conducted in animal models, and there is still lack of evidence supporting its use in clinical practice. Research in human indicates conflicting findings; randomized controlled trials were scarce and did not demonstrate any benefit in morbidity or mortality. Data regarding to pathophysiological and interventional research are described and commented in this review.
The use of phosphodiesterase inhibitors in the treatment of preeclampsia is controversial and should not be encouraged taking into account recent data.
KeywordsSildenafil Phosphodiesterase Hypertension, pregnancy-induced Models, animal
Regarding authorship: Anne Brandolt Larré, Bartira Ercília Pinheiro da Costa, Fernando Sontag, and Carlos Eduardo Poli-de-Figueiredo worked at conception, planning, writing the paper, and final version revising. Débora Montenegro Pasin, Nathália Paludo, and Rayssa Ruszkowski do Amaral worked at planning, writing the paper, and final version revising.
Financial Support and Sponsorship
Source of Support
Laboratory of Nephrology receives support from the National Council for Scientific and Technological Development (CNPq), Research Support Foundation of the State of Rio Grande do Sul (FAPERGS), Coordination for the Improvement of Higher Education Personnel (CAPES), and the Pontifical Catholic University of Rio Grande do Sul (PUCRS). Poli-de-Figueiredo is a CNPq researcher.
Compliance with Ethical Standards
Conflict of Interest
None of the authors report any conflict of interest.
Human and Animal Rights
All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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