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Preeclampsia is a significant contributor to maternal morbidity and mortality, especially in developing countries. In general, 10% of pregnancies have complications of preeclampsia (1). Wardhana’s study from one of the tertiary services in eastern Indonesia demonstrated an up to twice prevalence that of 21% (1106 cases) for two years. The high maternal mortality rate in Indonesia (359 in 2012) shows that this condition is still a big problem in developing countries (2). One of the characteristics of preeclampsia is the occurrence of global vasoconstriction, which shows the possibility of a decrease in NO endothelial production. Studies have indicated that a disorder of transforming growth factor beta 1 (TGF-β1) caused by its binding to sEng can interfere with the activation of nitric oxide synthase (NOS) to produce nitric oxide (NO), along with the vessel vasodilation and angiogenesis leading to vasoconstriction and endothelial dysfunction as the characteristics of preeclampsia (3). L-arginine, as a NO precursor, is a semi-essential amino acid in which production is not enough when the NO requirement increases as in some conditions of pregnancy with specific pathologies. The concentration of L-arginine is known to decrease significantly in preeclampsia compared to normal pregnant women who show the potential for NO production disturbances (4). L-arginine has the role of producing NO as a vasodilator to increase placental blood flow so that it can improve the shallow condition of placental implantation, angiogenesis, and vasoconstriction. However, this hypothesis still requires further research to ensure a better pathogenesis pathway. It is fascinating to know the role of L-arginine in the systemic clinical parameters of preeclampsia such as blood pressure and its local pathogenic pathways in the placenta through the examination of Eng and TGF-β1.

international journal of women's health and reproduction sciences

L-Arginine Protective Effect on Systemic Blood Pressure and Placental Expression of Endoglin, Transforming Growth Factor-β1 in the Preeclampsia Mice Model