Pregnancy-induced Hypertension Patients Research Articles

Change of hs–CRP, sVCAM–1, NT–proBNP levels in patients with pregnancy-induced hypertension after therapy with magnesium sulfate and nifudipine

ObjectiveTo investigate the change of the hs–CRP, sVCAM–1, NT–proBNP levels of the patients with pregnancy–induced hypertension (PIH) syndrome. MethodsA total of 200 patients with PIH were divided into mild, moderate and severe group, and 50 healthy pregnancy patients served as the control group. The serum sVCAM–1 levels were detected by enzyme–linked immunosorbent assay, hs–CRP were detected by immunity transmission turbidity, and NT–proBNP levels were determined by the colloidal gold method. Patients were treated with magnesium sulfate and nifudipine and the contrastive analysis was performed before and after treatment. And the pathological changes in placental of PIH patients were detected by hematoxylin–eosin staining at the same time. ResultsThe hs–CRP, sVCAM–1, NT–proBNP levels of patients in the mild, moderate and severe PIH group were significantly higher than that in the control group (P<0.05). The hs–CRP, sVCAM–1, NT–proBNP levels in the severe group were significantly higher than the mild group and the moderate group, the difference was statistically significant (P<0.05). The hs–CRP, sVCAM–1, NT–proBNP of the moderate group were significantly higher than the mild group (P<0.05). There was a positive correlation between hs–CRP, sVCAM–1, NT–proBNP expression levels and the degree of the PIH. The expression of hs–CRP, sVCAM–1, NT–proBNP levels of the moderate and the severe group were significantly decreased (P<0.05). The number of placental villi and interstitial blood vessel in the moderate and severe PIH group were significantly less than the control group (P<0.05). ConclusionsThe increased levels of serum hs–CRP, sVCAM–1, NT–proBNP may be involved in the process of vascular endothelial cell injury of the PIH, and the hs–CRP, sVCAM–1, NT–proBNP can be used as the auxiliary index for diagnosis of PIH and determination of PIH severity.

Meta analysis of correlation of angiotensin-converting enzyme gene deletion/insertion polymorphism and risk of pregnancy-induced hypertension in Chinese women

To investigate the association of the polymorphism of angiotensin-converting enzyme (ACE) gene and pregnancy-induced hypertension (PIH) in Chinese Women. We systematically searched CNKI, Wanfang database, VIP and PubMed from database construction to March 2012 to collect case-control studies. Stata 11.0 was used for meta analysis after evaluating the quality of studies and collecting the data. The association was assessed by odds ratio (OR) with 95% confidence intervals (CIs). Publication bias was analyzed by Begg's funnel plot and Egger's regression test. We identified 11 case-control studies on association between ACE gene polymorphism and PIH, which included 806 PIH patients and 900 controls. Overall, significant association was found between ACE gene polymorphism and PIH risk [for D vs I: OR=2.73, 95% CI (1.64, 4.24), P<0.001; for DD+DI vs II: OR=3.11, 95% CI (1.98, 4.90), P<0.001; for DD vs II: OR=5.00, 95% CI (2.30,10.88), P<0.001; for DI vs II: OR=1.97, 95% CI(1.53, 2.53), P<0.001]. Chinese women with D allele gene deletion have a higher risk of suffering pregnancy induced hypertension syndrome.

Glucocorticoid synthesis-related genes: HSD11B1 and HSD11B2 in hypertensive disorders in pregnancy

Objective: To determine whether polymorphisms of the maternal glucocorticoid-related genes (HSD11B1 and HSD11B2) are associated with pregnancy-induced hypertension (PIH) in a haplotype-based case-control study.Methods: A total of 166 PIH patients and 222 age-matched controls were genotyped, with two single-nucleotide polymorphisms (SNPs) for the HSD11B1 gene (rs2235543 and rs846910) and three SNPs for the HSD11B2 gene (rs12920590, rs45483293 and rs3743729) used as genetic markers. After separation into preeclampsia (PE) and gestational hypertension (GH) subgroups, PIH patients were assessed.Results: Significant differences were noted between PE and control groups (p = 0.022, p = 0.034, respectively) for the frequency of genotypes and alleles for rs846910 of HSD11B1. The frequency of the AA genotype of rs846910 was significantly higher in PIH and PE groups compared to controls. Logistic regression analyses showed that this genotype was a risk factor for PIH and PE (adjusted OR 2.9, 95% CI 1.3–6.5 and adjusted OR 3.2, 95% CI 1.4–7.4, respectively). The frequency of the T–A haplotype established by rs2235543–rs846910 was also significantly higher in PIH and PE groups (p = 0.045, p = 0.042, respectively).Conclusion: rs846910 in the HSD11B1 gene could be a marker for hypertensive disorders during pregnancy. The T–A haplotype constructed by rs2235543–rs846910 was also a useful susceptibility marker for PIH and PE.

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OBJECTIVE: Elevated plasma lipid levels are believed to be probable cause of endothelial cell dysfunction. We planned to measure the changes in the lipid levels in patients of PIH (pregnancy induced hypertension) and compare it with that of normotensive pregnant females. MATERIALS & METHODS: We studied 804 pregnant women. 624 patients studied were of PIH and 180 patients were healthy pregnant women. Lipid levels were estimated in these pregnant women. RESULTS: We found a significant rise in the serum lipid levels in the PIH patients group as compared to normotensive pregnant females, which were highly significant (P 0.05) and total cholesterol. Amongst the different lipoprotein ratios, TC: HDL, LDL: HDL, TG: HDL, and HDL: VLDL ratios were found highly significant (p<0.001) in PIH patients group. CONCLUSION: It is essential that blood lipid concentrations be estimated in pregnant women during antenatal care since it could be useful in early diagnosis and prevention of obstetric complications such as PIH. INTRODUCTION: Pregnancy induced hypertension is recognized since ancient times. It has been described in reviews of Thiagarajha and Chesley1. Hypertension after 20 weeks of pregnancy in a woman with edema and proteinuria without previous history of hypertension is called pregnancy induced hypertension (PIH). When associated with proteinuria, the disorder is termed pre – eclamptic eclampsia/ toxemia and when present without protein in the urine, it is called transient hypertension or gestational hypertension2. Raised blood pressure is present in 5% of entire pregnancies, in 10% of primiparous women and 20 – 25% of women with pervious history of chronic hypertension. It is the major cause of fetomaternal morbidity and mortality3. When blood pressure rises in pregnancy with significant protein in the urine, it is called preeclampsia. It may occur from 20 weeks of pregnancy. It can also occur upto 6 weeks post partum. Delivery of the placenta is the ultimate treatment. It may affect both fetal and mother survival4. Eclampsia is a dangerous complication of pregnancy with a sudden onset and has the features of developing tonic – colonic seizures in a patient who has pre – eclampsia. With increasing age, the risk of developing PIH increases5.

The WHO near miss criteria are appropriate for admission of critically ill pregnant women to intensive care units in China

Background Evaluation of the severity of the pregnant women with suitable admission to the Intensive Care Unit (ICU) is very important for obstetricians. By now there are no criteria for critically ill obstetric patients admitted to the ICU. In this article, we investigated the admission criteria of critically ill patients admitted to the ICU in order to provide a referral basis of reasonable use of the ICU. Methods A retrospective analysis of critically ill pregnant women admitted to the ICU in Perking University Third Hospital in China in the last 6 years (from January 2006 to December 2011) was performed, using acute physiology and chronic health evaluation II (APACHE-II), Marshall and WHO near miss criteria to assess the severity of illness of patients. Results There were 101 critically ill pregnant patients admitted to the ICU. Among them, 25.7% women were complicated with internal or surgical diseases, and 23.8% women were patients of postpartum hemorrhage and 23.8% women were patients of pregnancy-induced hypertension. Sixty-nine cases (68.3%) were administrated with adjunct respiration with a respirator. Sixteen cases (15.8%) required 1-2 types of vasoactive drugs. Fifty-five cases (54.5%) required a hemodynamic monitoring. Seventy-three cases (72.3%) had multiple organ dysfunctions (MODS). The average duration in ICU was (7.5±3.0) days. A total of 12.9%, 23.8% and 74.3% of women were diagnosed as critically ill according to the APACHE-II, Marshall and WHO near miss criteria, respectively. The rate was significantly different according to the three criteria (P&lt;0.01). Conclusions The WHO near miss criteria can correctly reflect the severity of illness of pregnant women, and the WHO near miss criteria are appropriate for admission of critically ill pregnant women to ICU in China.

PP101. Preeclampsia and pregnancy induced hypertension and carotid artery atherosclerosis

Recent studies indicated preeclampsia (PE) and pregnancy-induced hypertension (PIH) as risk factors for cardiovascular diseases in young women. Women with a history of preeclampsia face double the risk of a heart disease during the 5-15years after pregnancy. We assessed the impact of these factors on endothelial function, atherosclerotic changes and lipid metabolism in young women with a history of preeclampsia and pregnancy-induced hypertension. The aim of this study was to examine whether women with a history of preeclampsia more often show signs of atherosclerosis compared with control group We analyzed serum levels of total cholesterol (TC), HDL-C, LDL-C and triglycerides (TG). Endothelium-dependent vasodilation and carotid artery intima-media thickness (CA-IMT) were evaluated in 18 patients with a history of PE, 16 with a history of PIH and 17 healthy controls (CN). Inter-group differences were calculated using Student's t-test. We found a worse lipid profile among women with PE and PIH. LDL-C was increased significantly in PE and PIH (PE: 3.17mmol/l [SD 0.50] and PIH: 3.37mmol/l [SD 0.48] vs CN: 2.83mmol/l [SD 0.35], p<0.05); TC and TG were higher in the PE and PIH groups, but not significantly (p>0.05). Compared to controls, endothelium-dependent vasodilation was significantly reduced in PE and PIH patients (10.5% [SD 4.3] and 8.8% [SD 3.1] vs 14.5% [SD 3.6], p<0.05). The mean combined CA-IMT was significantly higher in PE and PIH patients (0.66mm [SD 0.08] and 0.63mm [SD 0.09], respectively vs 0.52mm [SD 0.04]). We conclude that impaired endothelial vasoreactivity and increased CA-IMT are prevalent in women with a history of PE and PIH and are associated with traditional risk factors that strongly suggest that PE and PIH could be non-traditional cardiovascular risk factors.

Chemokine and Free Fatty Acid Levels in Insulin-Resistant State of Successful Pregnancy: A Preliminary Observation

Increased insulin resistance and inflammatory action are observed in pregnancy-induced hypertension (PIH), but similar insulin resistance is observed also in successful pregnancy. To estimate insulin resistance and inflammatory activity in normal pregnancy and PIH, serum concentrations of free fatty acids (FFA; corrected with albumin to estimate unbound FFA), monocyte chemoattractant protein (MCP)-1, and high-molecular weight (HMW) adiponectin were measured in severe PIH patients with a BMI less than 25 kg/m2 and were measured 3 times during the course of pregnancy in women with normal pregnancies. FFA/albumin, MCP-1, and HMW adiponectin concentrations were significantly higher in PIH patients than in women with normal pregnancies. The 3 measurements of FFA/albumin showed a significant increase through the course of uncomplicated pregnancies. In contrast, MCP-1 and HMW adiponectin were significantly decreased during the course of pregnancy. These results suggest that the reduced MCP-1 concentration in normal pregnancy may be a pathway to inhibit the induction of pathological features from physiological insulin resistance and homeostatic inflammation.

8-Hydroxy-2-Deoxyguanosine Staining in Placenta Is Associated With Maternal Serum Uric Acid Levels and Gestational Age at Diagnosis in Pre-Eclampsia

Abnormal activation and/or dysfunction of the maternal vascular endothelium have been implicated as a cause of the placental ischemia and oxidative damage associated with pregnancy-induced hypertension (PIH). To clarify the relationship between systemic oxidative stress and placental damage induced by reactive oxygen species (ROS), we immunostained placentas from 27 PIH pregnancies and 41 normal pregnancies for 8-hydroxy-2-deoxyguanosine (8OHdG). Positive 8OHdG staining was significantly more frequent in the syncytiotrophoblasts from PIH pregnancies compared to normal pregnancies matched for maternal age/gestational age at delivery. Comparison of 8OHdG positive and negative PIH patients revealed that antenatal serum uric acid (UA) was significantly higher, gestational age at delivery was significantly lower and early onset PIH was more frequent in patients with 8OHdG positive staining in the placenta. These results suggest that ROS directly injures the placental syncytiotrophoblast in PIH patients and that elevated UA in PIH patients, at least partly, indicates placental damage induced by ROS. Moreover, the role and significance of ROS injury in the placenta may differ between early onset and late-onset type PIH.

Maternal and fetal angiotensin-converting enzyme gene insertion/deletion polymorphism not associated with pregnancy-induced hypertension in Chinese women

Objective. The study aimed to investigate whether maternal and fetal angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphisms and the incompatibility of maternal and fetal ACE genotype are associated with the risk of pregnancy-induced hypertension (PIH) in Chinese Han women.Methods. Using a case-control mother-baby dyads study, a total of 226 maternal/offspring pairs were selected at Anyang Maternal and Child Health Hospital from January 2008 to December 2009. Maternal venous and cord bloods were obtained for DNA extraction. A polymerase chain reaction was performed on the genomic DNA samples to obtain the ACE gene I/D polymorphism.Results. In the present sample, there is no difference in maternal and fetal ACE genotype or allele frequency between PIH patients and control group (p > 0.05). Furthermore, no significant association was found between the genotype incompatibility of fetal and maternal ACE gene and the risk of PIH (p > 0.05).Conclusion. We did not find fetus ACE gene I/D polymorphism to be associated with the risk of PIH. Nor is there any evidence that the incompatibility of fetal and maternal ACE genotype is associated with PIH in the studied population.

A Comparative Study of Serum Uric Acid Level in Normal Pregnancy, and Pregnancy Induced Hypertension

Hypertension is one of the common complications met with in pregnancy and contributes significantly to the cause of maternal and perinatal morbidity and mortality. The study of uric acid in serum is an interesting problem especially in normal pregnancy and pregnancy induced hypertension (PIH). The present study was carried out at Physiology Department, Shri M. P. Shah Medical College and Guru Gobind Singh Hospital, Jamnagar on Total 80 subjects. Determination of uric acid was carried out by quantitative estimation on colorimetric method by enzymatic uricase method. Results shows that Serum uric acid levels in both the time (predelivery and postdelivery) were statistically significant in Pregnancy induced hypertension than normal pregnancy. Many patients had predisposing factor to development of preeclampsia like primigravida. It is also evident that severity of proteinuria increases with diastolic blood pressure and Levels of serum uric acid did show a high positive correlation with the severity of Pregnancy induced hypertension in relation to hypertension and proteinuria 65% of patients of PIH

Study on the expression of soluble Fas in the placenta of pregnancy induced hypertension (PIH) patients by fluorescent MGB probe real-time PCR

Objective To investigate the the expression of soluble Fas (sFas) in the placenta of pregnancy induced hypertension (PIH) patients after perinatal. Methods Expression of sFas were detected by Fluorescent MGB Probe Real-Time PCR in 34 severe PIH patients and 30 healthy pregnant women served as normal controls.Results Expression of placenta sFas in 34 patients were significantly higher than those in normal controls.Conclusion PIH patients' placenta had higher expressiom of sFas; Detection of sFas may be helpful to value PIH degrade and sFas would be become a indicative markers of cell proliferation and apoptosis during the perinatal period. Key words: Hypertension pregnancy- induced; Soluble Fas(sFas) ; In situ hybridization,fluorescence

A Study of Lipoproteins in Normal and Pregnancy Induced Hypertensive Women in Tertiary Care Hospitals of the North West Frontier Province-Pakistan

Objectives. To evaluate the levels of serum lipoproteins in women with pregnancy-induced hypertension and compare it with the corresponding levels in pregnant women having normal blood pressure. Method. This cross-sectional study was conducted in the three tertiary care hospitals of Peshawar, North West Frontier Province, Pakistan. A total of 206 pregnant women at gestational age of >20 weeks were registered in the study after taking informed consent. All relevant information was recorded on a predesigned questionnaire. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C) and triglyceride (TG) levels were measured in 151 women with pregnancy induced hypertension (PIH) and compared with the corresponding values for a control group of 55 normotensive pregnant women. Result. Cholesterol levels were not statistically different between the patient group and controls. Triglyceride levels were significantly higher in the patient group than in controls. Women who developed hypertension after 20 weeks of gestation had 6.7, 4.2, 40.5, and 39.7% higher concentrations of TC, LDL-C, VLDL-C, and TG, respectively, and 28, 22.4, and 67.6% higher ratios of TC : HDL-C, LDL-C : HDL-C, and TG : HDL-C, respectively, as compared to the control subjects. The mean difference of the concentrations of HDL-C, VLDL-C, and TG, and the ratios TC : HDL-C, LDL-C : HDL-C, TG : HDL-C, and HDL-C : VLDL-C between the patients and control group was statistically significant. Conclusion. The assessment of blood lipids may be helpful in the prevention of complications in PIH patients.

The comparation of oral glucose tolerance test in pregnancy-induced hypertension patients with normal fasting blood-glucose of different age

Objective To discuss the difference of oral glucose tolerance in pregnancy-induced hypertension patients with normal fasting plasma glucose(FPG)of different age.Methods Set pregnancy-induced hypertension patients with normal fasting blood-glacose as observation group and normal pregnant women as control group.Observation group were divided into 5 groups according to their age.Group A:=20 years old(31 patients).Group B:=25 years old(32 patients).Group C:=30 years old(33patients).Group D:=35 years old(34 patients).Group E:=40 years old,and<45 years old(30patients).Results The 2hPG in each observation group were all higher than control,and with the increase of age,the difference were more evident.The difference between group C and group B,group D and group C,group E and group D were statistical significance(P<0.01).The pressure rise rate of 2hPG in each observation group were all higher than control,and with the increase of age,the differene were more evident.The difference between group D and group C,group E and group D were statistical significance(p<0.05).Conclusions The oral glucose tolerance of pregnancy-induced hypertension patients with normal fasting blood-glucose decreases sharply.Age can be considered as a predictor of dysbolism in pregnancyinduced hypertension patients. Key words: Different age; Pregnancy-induced hypertension; Fasting plasma-glucose; Oral glucose tolerance test

ORIGINAL ARTICLE: Leptin Gene (TTTC)n Microsatellite Polymorphism as well as Leptin Receptor R223Q and PPARγ2 P12A Substitutions are not Associated with Hypertensive Disorders in Pregnancy

Citation Wiedemann A, Vocke F, Fitzgerald JS, Markert UR, Jeschke U, Lohse P, Toth B. Leptin gene (TTTC)n microsatellite polymorphism as well as Leptin receptor R223Q and PPARγ2 P12A substitutions are not associated with hypertensive disorders in pregnancy. Am J Reprod Immunol 2010; 63: 310–317Problem Pregnancy‐induced hypertension (PIH) affects up to 15% of all pregnancies. Disturbed placentation is one factor associated with PIH. Leptin and peroxisome proliferator activator receptors (PPAR) seem to play an important role in placentation, fetal development, and blood pressure regulation. Therefore, we investigated polymorphisms in the genes encoding leptin, the leptin receptor, and PPARγ2 in patients with PIH.Method of study In this retrospective case–control study, 103 patients with PIH [gestational hypertension (GH) n = 39; preeclampsia n = 27; eclampsia n = 5; HELLP n = 32] and 100 controls were analyzed for the LEP tetranucleotide repeat (TTTC)n and the leptin receptor (LEPR) R223Q and PPARγ2 P12A substitutions. Statistical analysis was performed using the chi‐square, Mann–Whitney U‐, and Kruskal–Wallis tests (P &lt; 0.05 significant).Results The frequency of the three possible genotypes did not differ significantly between patients and controls [LEP (TTTC)n: P = 0.43; LEPR R223Q: P = 0.94; PPARγ2 P12A: P = 0.94]. However, postpartal diastolic blood pressure of PIH patients was significantly higher in homozygous carriers of the LEPR Q223‐encoding allele as compared with patients carrying the wild‐type allele (P &lt; 0.01).Conclusion Hypertensive disorders in pregnancy were not associated with the LEP, LEPR, and PPARγ2 polymorphisms studied. The role of other variations in the LEP and PPAR genes in the pathophysiology of PIH and in exacerbations are the objective of ongoing research.

Evaluation of common carotid arterial mechanics in pregnancy-induced hypertension by velocity vector imaging

Objective To evaluate the longitudinal velocity,strain and strain rate of the common carotid artery(CCA)in pregnancy-induced hypertension(PIH)patients using velocity vector imaging (VVI).Methods Twenty-eight patients with PIH and 34 normal pregnant women as the control group were studied.The maximaI velocity(Vs),strain(Smax)and strain rate(SRmax)of the right CCA anterior and posterior wall in systole were measured.Results The systolic longitudinal Vs of both the anterior and posterior wall of the CCA were significantly decreased in PIH group compared with those in the control group[(0.22±0.09)cm/s vs(0.29±0.09)cm/s,P<0.01;(0.24±0.10)cm/s vs(0.34±0.13)cm/s,P<0.01].The systolic longitudinal Smax and SRmax of the CCA anterior and posterior wall were also notably decreased in PIH group compared with those in the control group[Smax:(8.50±4.92)%vs (12.2±6.21)%,P<0.01;(10.11±5.02)%vs(14.21±6.48)%,P<0.05.SRmax:(1.62±1.14)s~(-1)vs(2.24±1.13)s~(-1),P<0.05;(1.91±0.99)s~(-1)vs(2.45±0.97)s~(-1),P<0.05].Conclusions VVI has potential usefulness for assessing vascular mechanics. Key words: Ultrasonography; Carotid artery,common; Hypertension,pregnancy-induced; Velocity vector imaging

Anti-β2 glycoprotein-I antibody increases the risk of pregnancy-induced hypertension: a case-controlled study

The aim of this study was to evaluate whether anti-beta2 glycoprotein-I antibody (anti-beta2GPI) of the IgG or IgM classes is associated with the development of pregnancy-induced hypertension (PIH) or preeclampsia in the Japanese population. In a case-controlled cohort study, peripheral blood was obtained at 8-14 weeks of gestation from a consecutive series of 1155 women. The case group comprised 36 patients who later developed PIH during the pregnancy. Of the 36 PIH patients, 13 had severe PIH, 18 had preeclampsia and 11 had severe preeclampsia. One hundred and eleven age- and parity-matched women whose pregnancies ended in normal delivery without obstetric complications were selected as controls. We found that a titer of anti-beta2GPI IgG>or=1.0 U/ml was a risk factor for severe PIH (P=0.023, OR 5.7 95%CI 1.4-22.8). In addition, titers of anti-beta2GPI IgM>or=1.2 U/ml was found to be a risk factor for PIH (P=0.001, OR 8.8 95%CI 1.6-47.5). In women positive for anti-beta2GPI but negative for lupus anticoagulant, anti-cardiolipin, phosphatidylserine-dependent anti-prothrombin, or kininogen-dependent anti-phosphatidylethanolamine antibodies, the presence of anti-beta2GPI was not a significant risk factor for development of PIH or preeclampsia. In conclusion, the presence of anti-beta2GPI antibody represents a risk factor for developing PIH and severe PIH. This finding supports the utility of anti-beta2GPI determination as one of the laboratory criteria for anti-phospholipid syndrome classification. The usefulness of anti-beta2GPI measurement among women without other anti-phospholipid antibodies requires further study.

The expression, and significance of PTA1 in patients with pregnancy-indnced hypertension syndrome

Objective To explore the relationship of the expression, regulation and adhesion of PTA1 in pregnancy induced hypertension(PIH). Methods The expression,regulation and adhesion of PTA1 on vascular en- dothelial cells incubated by sera from 10 PIH patients and 10 normal pregnant women repectively was detected by flow cytometry. Results The positive rate of PTA1 15.51% (24h) and 6.32 % (48h) in PIH group is significantly higher than that 7.81% (24h) and 4.72 % (48h) in normal pregnant woman group( P < 0.01 ). After the incubation with platelets,the positive rate of PTA1 6.64% (24h) and 4.13% (48h) in PIH group is lower than before(P< 0.05). The PTA1 expression 8.11% (24h) and 4.28% (48h) in PIH group is much lower after blocking with PTA1/IgG than that before(P < 0.01 ). Conclusion There are some abnormal stimulated factors in PIH patients, which activate vascular endothelial cells. PTA1 plays an important role in the adhesion of platelets to vascular en- dothelial cells, PTA1 is closely related to the progress of PIH which indicates that PTA1 directly or indirectly takes part in the pathophysiologic consequences of PIH. Key words: Gestosis,EPH; Platelet activating factor; E selectin; Flow cytometry

Thrombophilic mutations in pre‐eclampsia and pregnancy‐induced hypertension

The aim of the present study was to determine the existence or prevalence of thrombophilic markers such as Factor V Leiden, prothrombin G20210A, protein S, protein C, activated protein C and anti-thrombin in pre-eclampsia and pregnancy-induced hypertensive patients. Blood samples were collected from a total number of 124 women at the maternity unit, University of Malaya Medical Center. These included 49 patients with pre-eclampsia, 63 patients with pregnancy-induced hypertension and 12 normal pregnant women. DNA was extracted from the blood samples. Factor V Leiden (Taq I) and prothrombin G20210A (Hind III) genotyping was done on polymerase chain reaction-restriction fragment length polymorphism. Anti-thrombin activity and the concentrations of protein C, protein S and activated protein C were measured using the IL Coagulation System (Hemosil). Of the 124 subjects, one pre-eclampsia patient was homozygous for Factor V Leiden mutation but prothrombin G20210A mutation was not present in any of the subjects. The subject with Factor V Leiden mutation also had a low activated protein C resistance and a low protein S concentration. Factor V Leiden mutation is present in the Asian population and may very well serve as one of the genetic factors responsible for pre-eclampsia and other adverse pregnancy outcomes.

Haplotype-Based Case-Control Study of Estrogen Receptor α (ESR1) Gene and Pregnancy-Induced Hypertension

Hypotheses about pregnancy-induced hypertension (PIH) have been proposed to explain the vascular damage that characterizes this disease. Reports indicate that estrogens and estrogen receptors play important physiological roles in cardiovascular diseases. There have been studies examining the association between coronary artery disease and the estrogen receptor alpha (ESR1) gene. The aim of the present work was to assess the association between PIH and single-nucleotide polymorphisms (SNPs) in the human ESR1 gene, by conducting a haplotype-based case-control study. Based on a database search at the web site of the National Center of Biotechnology Information, we chose five SNPs in the human ESR1 gene, and performed an association study using 95 PIH patients and 200 age-matched non-PIH subjects. The frequency of rs2881766 genotypes and alleles differed significantly between the two groups. There was no significant difference in overall distribution of genotypes or alleles of the other four SNPs. The T allele of rs2881766 was significantly more prevalent in the PIH group than in the non-PIH group. Haplotype-based case-control analysis revealed that there was a significant difference in overall distribution of the combinations rs2881766-rs1643821-rs988328 and rs2881766-rs1643821 between the PIH group and the non-PIH group (all or body mass index [BMI]-matched). One susceptibility haplotype for PIH and two resistance haplotypes for PIH were revealed by comparison between the PIH group and the non-PIH (BMI-matched) control group. In conclusion, the T allele of rs2881766 could be a useful genetic marker of PIH. The G-A-T haplotype of rs2881766-rs1643821-rs988328 and the G-A haplotype of rs2881766-rs1643821 appear to be resistance markers of PIH.

The significance of P-selectin in patients with pregnancy induced hypertension

目的 探讨妊娠高血压综合征患者外周血P-选择素的表达与意义.方法 用流式细胞术检测30例妊娠高血压综合征患者、20例正常妊娠者与15例正常人外周血P-选择素表达.结果 妊娠高血压综合征患者外周血P-选择索表达为(18.63±8.92)%,明显高于正常妊娠组(3.25±1.73)%(P＜0.01)和正常对照组(2.78±1.04)%(P＜0.01).结论 妊娠高血压综合征患者存在P-选择素的高度表达。