Chaiworapongsa T, Romero R, Yoshimatsu J, Espinoza J, Kim Y M, Park K, Kalache K, Edwin S, Bujold E, Gomez R
Perinatology Research Branch, National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
J Matern Fetal Neonatal Med. 2002 Jul;12(1):19-27. doi: 10.1080/jmf.12.1.19.27.
An exaggerated inflammatory response has been implicated as the cause of endothelial cell dysfunction and the maternal syndrome of pre-eclampsia. Adhesion molecules play a central role in the adherence of leukocytes to endothelial cells and the subsequent migration of white blood cells into perivascular tissue. Cellular forms of adhesion molecules mediate specific steps of leukocyte-endothelial cell interaction, and have been implicated in the pathophysiology of preeclampsia. Soluble forms of these molecules can be detected in plasma, and their concentrations are thought to reflect the degree of activation of a particular cell type. Elevations in soluble P-selectin (sP-selectin) reflect platelet activation; changes in soluble L-selectin (sL-selectin) suggest leukocyte activation; and an increase in soluble forms of E-selectin (sE-selectin), vascular cell adhesion molecule 1 (sVCAM-1), intercellular adhesion molecule 1 (sICAM-1) and platelet endothelial cell adhesion molecule (sPECAM-1) indicate endothelial cell activation/dysfunction. The objective of this study was to determine whether normal pregnancy and pre-eclampsia were associated with changes in the concentrations of soluble selectins and members of the immunoglobulin superfamily of adhesion molecules.
A cross-sectional study was conducted to determine the plasma concentrations of sL-selectin, sE-selectin, sP-selectin, sVCAM-1, sICAM-1 and sPECAM-1 in peripheral blood obtained from non-pregnant women (n = 20), normal pregnant women (n = 100) and patients with pre-eclampsia (n = 55). Concentrations of soluble adhesion molecules were determined with enzyme-linked immunoassays. Parametric statistics were used for data analysis.
Normal pregnancy was associated with a significant increase in the maternal plasma concentration of sP-selectin, a decrease in sL-selectin, and no change in sE-selectin, sVCAM-1, sICAM-1 and sPECAM-1. In contrast, pre-eclampsia was associated with a significant increase in sP-selectin, sE-selectin and sVCAM-1, a decrease in sL-selectin, but no change in sICAM-1 and sPECAM-1 concentrations.
The increased concentration of sP-selectin and decreased sL-selectin, as well as the lack of change in endothelial cell-associated soluble adhesion molecules suggest that pregnancy is associated with platelet and leukocyte activation, but not endothelial cell activation. In contrast, pre-eclampsia appears to be characterized by activation of platelets, leukocytes and endothelial cells.
过度的炎症反应被认为是内皮细胞功能障碍及子痫前期母体综合征的病因。黏附分子在白细胞与内皮细胞的黏附以及随后白细胞向血管周围组织的迁移过程中起核心作用。黏附分子的细胞形式介导白细胞 - 内皮细胞相互作用的特定步骤，并与子痫前期的病理生理学有关。这些分子的可溶性形式可在血浆中检测到，其浓度被认为反映了特定细胞类型的激活程度。可溶性P - 选择素（sP - 选择素）升高反映血小板激活；可溶性L - 选择素（sL - 选择素）变化提示白细胞激活；可溶性E - 选择素（sE - 选择素）、血管细胞黏附分子1（sVCAM - 1）、细胞间黏附分子1（sICAM - 1）和血小板内皮细胞黏附分子（sPECAM - 1）的可溶性形式增加表明内皮细胞激活/功能障碍。本研究的目的是确定正常妊娠和子痫前期是否与可溶性选择素及黏附分子免疫球蛋白超家族成员浓度的变化有关。
进行了一项横断面研究，以测定从非孕妇（n = 20）、正常孕妇（n = 100）和子痫前期患者（n = 55）获取的外周血中sL - 选择素、sE - 选择素、sP - 选择素、sVCAM - 1、sICAM - 1和sPECAM - 1的血浆浓度。采用酶联免疫测定法测定可溶性黏附分子的浓度。使用参数统计进行数据分析。
正常妊娠与母体血浆中sP - 选择素浓度显著升高、sL - 选择素浓度降低以及sE - 选择素、sVCAM - 1、sICAM - 1和sPECAM - 1无变化有关。相比之下，子痫前期与sP - 选择素、sE - 选择素和sVCAM - 1显著升高、sL - 选择素降低有关，但sICAM - 1和sPECAM - 1浓度无变化。
sP - 选择素浓度升高和sL - 选择素降低，以及内皮细胞相关可溶性黏附分子无变化表明妊娠与血小板和白细胞激活有关，但与内皮细胞激活无关。相比之下，子痫前期似乎以血小板、白细胞和内皮细胞激活为特征。
