Abstract
BackgroundDespite intensive research, the etiopathogenesis of preeclampsia (PE) remains uncertain. Inflammatory and angiogenic factors are thought to play considerable roles in this disease. The objective of this study was to investigate the association between soluble endoglin (sEng), transforming growth factor beta-1 (TGF-β1) and tumor necrosis factor alpha soluble receptors (sTNF-Rs) and the clinical manifestations of PE.MethodsPlasma levels of sEng, TGF-β1 and sTNF-Rs were determined by ELISA in 23 non-pregnant, 21 normotensive pregnant and 43 PE women. PE women were stratified into subgroups according to the severity [mild (n = 12) and severe (n = 31)] and onset-time of the disease [early (n = 19) and late (n = 24)].ResultsPregnancy was associated with higher levels of sEng, sTNF-R1 and sTNF-R2 than the non-pregnant state. Moreover, PE women had higher levels of sEng and sTNF-R1 than normotensive pregnant women. No difference was found in TGF-β1 levels, comparing the three study groups. Late PE had higher levels of sTNF-R1 and sTNF-R2 than early PE. No significant differences were found in sEng and TGF-β1 comparing early and late PE. sEng levels were higher in severe PE than in mild PE and no difference was found for TGF-β1, sTNF-R1 and sTNF-R2 levels. There was a positive correlation among sEng, TNF-R1 and sTNF-2 levels. Logistic regression analysis revealed that primiparity and sEng levels are independently associated with the development of PE. Furthermore, sEng levels are independently associated with the disease severity.ConclusionsThese results suggest that pregnancy is a condition associated with higher levels of anti-angiogenic and pro-inflammatory factors than the non-pregnant state and that PE is associated with an imbalance of these factors in the maternal circulation.
Highlights
Preeclampsia (PE) is a disorder of human pregnancy characterized by hypertension and proteinuria on or after the 20th week of gestation
Our findings suggest that pregnancy is a condition associated with higher levels of anti-angiogenic and pro-inflammatory factors than the non-pregnant state and that PE is associated with an imbalance of these factors in the maternal circulation
Demographic and clinical characteristics No difference in age, body mass index and gestational age at blood sampling among groups was observed, while the gestational weigh gain and number of primiparous women were higher in the PE group (Table 1)
Summary
Preeclampsia (PE) is a disorder of human pregnancy characterized by hypertension and proteinuria on or after the 20th week of gestation. Release of soluble factors from the ischemic placenta into maternal plasma plays a central role in the ensuing endothelial dysfunction, which is the most prominent feature of the disease [4]. Some candidates for these unknown ‘preeclampsia factors’ include pro-inflammatory cytokines, microparticles and anti-angiogenic factors [4,5]. The objective of this study was to investigate the association between soluble endoglin (sEng), transforming growth factor beta-1 (TGF-b1) and tumor necrosis factor alpha soluble receptors (sTNF-Rs) and the clinical manifestations of PE
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