Abstract
Preeclampsia (PE) is a pregnancy-specific syndrome characterized by abnormal levels of cytokines and angiogenic factors, playing a role in the disease development. The present study evaluated whether immunological markers are associated with the gestational age and with the disease severity in preeclamptic women. Ninety-five women who developed PE were stratified for gestational age as preterm PE (< 37 weeks) and term PE (≥ 37 weeks of gestation) and compared for disease severity as well as plasma concentration of angiogenic factors and cytokines. The concentrations of placental growth factor (PlGF), vascular endothelial growth factor (VEGF), Fms-like soluble tyrosine kinase (sFlt-1) and soluble endoglin (sEng), as well as the cytokines, tumor necrosis factor-α (TNF-α) and interleukin 10 (IL-10), were determined by enzyme-linked immunosorbent assay (ELISA). The comparison between preeclamptic groups showed a higher percentage of severe cases in preterm PE (82.1%) than in term PE (35.9%). Similarly, the concentrations of TNF-α, sFlt-1, and sEng, as well as TNF-α/IL-10 and sFlt-1/PlGF ratios were significantly higher in the preterm PE group. In contrast, concentrations of PlGF, VEGF, and IL-10 were significantly lower in women with preterm PE. Negative correlations between TNF-α and IL-10 (r = 0.5232) and between PlGF and sFlt1 (r = -0.4158) were detected in the preterm PE. In pregnant women with preterm PE, there is an imbalance between immunological markers, with the predominance of anti-angiogenic factors and TNF-α, associated with adverse maternal clinical outcomes.
Highlights
Pregnancies complicated by preeclampsia (PE), a specific human multisystemic syndrome, are the major cause of maternal and fetal morbidity and mortality worldwide.[1,2] Preeclampsia diagnosis is made through the identification of hypertension and proteinuria from 20 weeks of gestation
In pregnant women with preterm PE, there is an imbalance between immunological markers, with the predominance of anti-angiogenic factors and tumor necrosis factor-α (TNF-α), associated with adverse maternal clinical outcomes
As concentrações de fator de crescimento placentário (PlGF), fator de crescimento endotelial vascular (VEGF), tirosina quinase solúvel semelhante a Fms e endoglina solúvel, bem como as citocinas, fator de necrose tumoral alfa (TNF- α) e interleucina 10 (IL-10), foram determinados porensaio de imunoabsorção enzimática (ELISA, na sigla em inglês)
Summary
Pregnancies complicated by preeclampsia (PE), a specific human multisystemic syndrome, are the major cause of maternal and fetal morbidity and mortality worldwide.[1,2] Preeclampsia diagnosis is made through the identification of hypertension and proteinuria from 20 weeks of gestation. In the absence of proteinuria, the presence of target organ damage, such as maternal neurological or hematological complications; renal insufficiency; and impaired liver function is considered as preeclampsia.[1,3,4]. Preterm PE (identified before 37 weeks) commonly represents a more severe and complicated type of PE than when this disease occurs at term (identified from 37 weeks of gestation).[8,9]
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