Teng Yin-Cheng, Lin Qi-De, Lin Jian-Hua, Ding Chuan-Wei, Zuo Ye
Department of Obstetrics and Gynecology, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, China.
J Perinat Med. 2009;37(4):343-8. doi: 10.1515/JPM.2009.060.
Cytokine imbalance might have a pivotal role in hypercoagulability seen in preeclampsia. Our objective was to determine the relationship of blood coagulation related factors in placental tissue and peripheral blood in preeclamptic and normal pregnancies.
We compared mRNA and protein levels of tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), and tissue factor (TF) in the placenta of normal and preeclamptic pregnancies. Placental and peripheral blood t-PA and PAI-1 levels were examined. Trophoblasts were used to study the effects of hypoxia, hypoxia-reperfusion, and inflammatory cytokines on t-PA, PAI-1, tissue factor pathway inhibitor (TFPI), and TF.
PAI-1 and TF mRNA and protein levels were higher in placental tissue of preeclamptic pregnancies and in the peripheral blood of patients with preeclampsia. mRNA and protein secretion of TF, TFPI, PAI-1, but not t-PA, was increased in trophoblast cell culture under hypoxia and hypoxia-reoxygenation. Cell cultures with high levels of tumor necrosis factor-alpha (TNF-alpha) exhibited increased expression and secretion of TF and PAI-1, decreased TFPI, and no significant change of t-PA.
Imbalanced synthesis of t-PA, PAI-1, TFPI, and TF in trophoblasts may contribute to hypercoagulability in patients with preeclampsia.
细胞因子失衡可能在子痫前期出现的高凝状态中起关键作用。我们的目的是确定子痫前期妊娠和正常妊娠中胎盘组织及外周血中凝血相关因子的关系。
我们比较了正常妊娠和子痫前期妊娠胎盘组织中组织型纤溶酶原激活物（t-PA）、纤溶酶原激活物抑制剂-1（PAI-1）和组织因子（TF）的mRNA和蛋白质水平。检测了胎盘和外周血中t-PA和PAI-1水平。利用滋养层细胞研究缺氧、缺氧再灌注及炎性细胞因子对t-PA、PAI-1、组织因子途径抑制物（TFPI）和TF的影响。
子痫前期妊娠胎盘组织及子痫前期患者外周血中PAI-1和TF的mRNA及蛋白质水平较高。在缺氧及缺氧复氧条件下，滋养层细胞培养中TF、TFPI、PAI-1的mRNA及蛋白质分泌增加，但t-PA未增加。肿瘤坏死因子-α（TNF-α）水平高的细胞培养物中TF和PAI-1的表达及分泌增加，TFPI减少，t-PA无显著变化。
滋养层细胞中t-PA、PAI-1、TFPI和TF合成失衡可能导致子痫前期患者出现高凝状态。
