Muttukrishna S, Hyett J, Paine M, Moodley J, Groome N, Rodeck C
Department of Obstetrics and Gynaecology, Royal Free University College Medical School, London, UK.
Clin Endocrinol (Oxf). 2006 Apr;64(4):469-73. doi: 10.1111/j.1365-2265.2006.02476.x.
The aims of this study were to investigate if (i) urinary concentrations of activin A and inhibin A are altered in pre-eclampsia (PE) and (ii) to study the relationship between uterine vein and peripheral vein concentrations of these hormones in PE patients.
In a retrospective study, maternal peripheral vein and uterine vein serum and maternal urine samples collected at the time of delivery were analysed. There were three groups of patients; (i) group 1: term normal pregnancies (n = 19) (ii) group 2: patients who developed PE < or = 37 weeks (n = 17) and (iii) group 3: patients who developed PE 37-40 weeks (n = 8). Serum and urinary activin A, follistatin, inhibin A and pro alpha C and urinary creatinine levels were measured using enzyme immunoassays in the laboratory.
Normal pregnant urine samples had very low levels of activin A and inhibin A. Both groups 2 and 3 PE patients had significantly higher levels of inhibin A (P < 0.001) and activin A (P < 0.001) compared to the controls. Pro-alpha C was not altered and follistatin was below the detection limit of the assay in the urine. Maternal peripheral serum activin A and inhibin A were significantly higher in groups 2 (P < 0.001) and 3 (P < 0.05) patients compared to the controls. Pro-alpha C-containing inhibins were higher in group 2 patients (P < 0.05) compared to the controls in the peripheral circulation. Uterine vein serum activin A and inhibin A levels were also significantly higher in groups 2 (P < 0.001) and 3 (P < 0.05) patients compared to the controls. There was a highly significant positive correlation between peripheral and uterine vein serum concentrations of activin A, follistatin, inhibin A and pro alpha C, suggesting the same source for these proteins in PE.
Urinary activin A and inhibin A are raised in groups 2 and 3 PE patients. The magnitude of rise (> 25-fold) suggests these proteins may rise in patients before the onset of the clinical symptoms of PE. Uterine vein levels of these proteins are also raised in PE.
本研究旨在调查（i）子痫前期（PE）患者尿中激活素A和抑制素A的浓度是否发生改变，以及（ii）研究PE患者子宫静脉和外周静脉中这些激素浓度之间的关系。
在一项回顾性研究中，对分娩时采集的母体外周静脉和子宫静脉血清以及母体尿液样本进行分析。有三组患者：（i）第1组：足月正常妊娠（n = 19）；（ii）第2组：孕周小于或等于37周发生PE的患者（n = 17）；（iii）第3组：孕周37 - 40周发生PE的患者（n = 8）。在实验室中使用酶免疫分析法测量血清和尿液中的激活素A、卵泡抑素、抑制素A、前αC以及尿肌酐水平。
正常妊娠尿液样本中激活素A和抑制素A的水平非常低。与对照组相比，第2组和第3组PE患者的抑制素A（P < 0.001）和激活素A（P < 0.001）水平均显著升高。前αC未发生改变，尿液中的卵泡抑素低于检测限。与对照组相比，第2组（P < 0.001）和第3组（P < 0.05）患者的母体外周血清激活素A和抑制素A显著升高。在第2组患者的外周循环中，含前αC的抑制素高于对照组（P < 0.05）。与对照组相比，第2组（P < 0.001）和第3组（P < 0.05）患者的子宫静脉血清激活素A和抑制素A水平也显著升高。激活素A、卵泡抑素、抑制素A和前αC的外周静脉和子宫静脉血清浓度之间存在高度显著的正相关，表明这些蛋白质在PE中有相同的来源。
第2组和第3组PE患者尿中激活素A和抑制素A升高。升高幅度（> 25倍）表明这些蛋白质可能在PE临床症状出现之前就在患者体内升高。PE患者子宫静脉中这些蛋白质的水平也升高。
