17-Hydroxyprogesterone Caproate as a Potential Therapeutic to Add to the Management of Preeclampsia

Preeclampsia (PE) is a complex disorder, occurring during the third trimester of gestation characterized by hypertension with proteinuria, increased uterine artery resistance (UARI), elevated inflammatory cytokines and endothelial dysfunction during pregnancy. 17-hydroxyprogesterone caproate (17-OHPC), a synthetic hormone called progestogen or progestin, is already approved by US Food and Drug Administration (FDA)and used for the prevention of subsequent preterm labor not complicated by PE. There is limited information for the use of 17-OHPC to manage or treat preeclampsia. In fact, this progestin is not used in the management of PE and there are no studies, other than ours in recent years, evaluating the efficacy of 17-OHPC to improve symptoms of preeclampsia. Therefore, this mini review reflects on our preclinical experiments with the use of 17-OHPC for the management of preeclampsia (PE). We have recently published that PE is a state of progesterone deficiency. 17-OHPC administered on gestation day 18 (GD18) to Reduced UterinePerfusion Pressure (RUPP) rats reduced renal and placental endothelin-1 (ET-1), TNF-alpha and IL-6, most recently, increased vascular endothelial nitric oxide synthase (eNOS) expression and nitrate-nitrite levels while improving blood pressure in response to placental ischemia. These data suggest that 17-OHPC improves pregnancy outcomes during placental ischemia and should be considered for addition to the management of PE.