Digifab и иммунонейтрализация кардиотонических стероидов при преэклампсии

Background. Elevated levels of Na+/K+-ATPase(NKA)-inhibitory cardiotonic steroids (CTS) including marinobufagenin (MBG) contribute to pathogenesis of preeclampsia (PE) via induction of vasoconstriction and of vascular stiffness. In PE, Digibind (affinity-purified digoxin antibody) exhibits beneficial effects primarily due to immunoneutralization of CTS including MBG. Because Digibind is not available and the only other «clinically-usable» digoxin antibody is DigiFab (BTG International Ltd), we compared DigiFab and Digibind with respect to their ability to interact with CTS in PE plasma and to ex-vivo reverse PE-induced NKA inhibition. Objective. We compared effects of Digibind and Digifab on erythrocyte NKA from patients with PE and normotensive pregnant subjects. Using competitive fluoroimmunoassays based on Eu-labeled DigiFab and Digibind we compared profile of elution digoxin-immunoreactive material following fractionation of PE plasma on reverse-phase HPLC column. Design and methods. 7 patients with PE (28 ± 2 years; gestational age, 39,0 ± 0,5 weeks, urinary protein excretion, 2,12 ± 0,46 g/24 hours, blood pressure 157 ± 5/94 ± 2 mm Hg) and 9 normotensive pregnant subjects (26 ± 1 years; gestational age, 37 ± 1 weeks, blood pressure 112 ± 2/75 ± 3) were studied. Results. PE was associated with substantial inhibition of erythrocyte NKA (1,47 ± 0,17 vs. 2,65 ± 0,16 umol Pi/mL/hr in control group, p