Metformina: revisão dos usos clínicos e potencial para tratamento da pré-eclâmpsia

Abstract

Preeclampsia (PE) is known as the multifactorial inheritance disease and the pathogenesis is not fully elucidated. It is characterized by an increase in blood pressure associated with proteinuria or damage to maternal organs, usually after the 20th week of pregnancy. Metformin is a drug of choice for type 2 diabetes mellitus (DM2) and has been associated with other therapeutic effects such as prevention and treatment of PE. Evidence demonstrates the action of metformin on the production of soluble tyrosine kinase-1 type fms (sFlt-1) and soluble endogline (sEng), improvement of endothelial dysfunction, improvement of angiogenesis, regulation of the mitochondrial electron transport chain and regulation of AMP-activated protein kinase (AMPK). All of these factors have been associated with PE. This study aimed to search the scientific literature on the history and general characteristics of metformin, its use in DM2, gestational diabetes mellitus, polycystic ovary syndrome, hirsutism, non-alcoholic fatty liver disease, as well as the anti-tumor, anti-aging effects, cardiovascular protector and metformin neuroprotector. The main focus was on known mechanisms on the pathophysiology of PE and on the findings that support the potential use of metformin for the prevention and treatment of PE. Evidence of the effect of metformin on PE is demonstrated in several studies, however, more research needs to be carried out to understand the pathology of PE and the mechanisms of action of metformin.