Sildenafil (Viagra®) blocks inflammatory injury in LPS-induced mouse abortion: A potential prophylactic treatment against acute pregnancy loss?

INTRODUCTION: Recurrent pregnancy losses (RPL) are common women's health issues. Inflammatory and thrombotic events have been associated with RPL including excessive production of cytokines, in particular TNF-α. However, mechanisms behind gestational losses are not yet fully understood. Sildenafil inhibits phosphodiesterase Type-5 (PDE5). This drug increases intracellular cyclic guanosine monophosphate, having vasodilatory and, more recently described, anti-inflammatory properties. PDE5 is present in murine and human uterus and placenta. Sildenafil is already used clinically for treatment of human fetal growth restriction (FGR). Our objective was to determine if Sildenafil alone or in combination with Heparin had protective effects in pregnant Swiss albino challenged to abort by lipopolysaccharide (LPS). METHODS: Treatments (Sildenafil (50 mg/kg/day), Heparin (500 IU/Kg/day) or Sildenafil + Heparin at the same doses) were initiated the morning of copulation plug detection (gestational day (gd0)). On the 15th day of pregnancy, an intra-peritoneal injection of LPS (100 µg/kg) was administered. Untreated, pregnant mice challenged by LPS served as controls. RESULTS: Assessments at 48 h after LPS revealed that Sildenafil + Heparin prevented fetal loss. Early assessments at 2 h after LPS indicated that the pretreatments prevented induction of inflammatory cytokine production (TNF-α, IL-1ß/NF-κß) and preserved placental histopathology. DISCUSSION: Combined Sildenafil + Heparin therapy was superior to either treatment alone in most analyses. The known safety of Sildenafil and Heparin in human pregnancy suggests that usage of these combined agents may be of value for treatment of patients with impending pregnancy loss or prophylactically in women with a history of recurrent miscarriages.

Ação da melatonina sobre a dinâmica sanguínea de ratas prenhes e sobre a histogênese do baço e do timo da prole / The action of melatonin on the blood dynamics of pregnant rats and on the histogenesis of the spleen and thymus of offspring

Investigou-se a influência da melatonina sobre o hemograma de ratas prenhes e dos filhotes e sobre a histogênese e morfometria do baço e do timo dos filhotes. A melatonina foi administrada na dose 0,5mg/kg de peso corporal, dissolvida em 0,1mL de etanol e diluída em 0,3mL de solução salina. Para análise do hematócrito, contagem total de hemácias e contagem total e diferencial dos leucócitos, amostras de sangue foram coletadas no sétimo, 14ºe 21ºdias de prenhez e aos 10 dias de nascimento dos filhotes. Cortes histológicos do baço e do timo da prole foram utilizados para histoquímica e morfometria. A ausência da melatonina promoveu alterações no hemograma apenas no terço final da gestação, sem interferir no hemograma dos filhotes, e induziu modificações morfológicas e morfométricas no timo e no baço nos primeiros dias de vida dos filhotes. Concluiu-se que a melatonina materna é importante para a modulação do hemograma em ratas prenhes e para o desenvolvimento normal do baço e do timo dos filhotes.

We investigated the influence of melatonin on the hemogram of pregnant rats and puppies, and on the histogenesis and morphology of the spleen and thymus of puppies. Melatonin was administered at a dose 0.5mg/kgbody weight, dissolved in 0.1mL of ethanol and diluted in 0.3mL of saline. For hematocrit analysis, total erythrocyte count and total and differential leukocyte count, blood samples were collected on the 7th, 14th and 21st days of pregnancy and the offspring at 10 days of birth. Histological sections of spleen and thymus of the offspring were used for histochemistry and morphometry. The absence of melatonin promoted changes in blood count only in the final third of gestation, without interfering with the hemogram of the puppies, and induced morphological and morphometric changes in the thymus and spleen in the first days of life of the puppies. It was concluded that maternal melatonin is important for the modulation of the blood count in pregnant rats and the normal development of the spleen and thymus of the offspring.