Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK.
J Hypertens. 2012 May;30(5):954-9. doi: 10.1097/HJH.0b013e328352573b.
Circulating biomarkers of endothelial dysfunction and inflammation are elevated in late pregnancy in women with preeclampsia. We examined plasma levels of inflammatory cytokines and adhesion molecules in early pregnancy, to assess their ability to predict preeclampsia.
In a prospective longitudinal study, 2600 women with singleton pregnancies and no history of hypertension were recruited at their antenatal hospital (booking) visit at gestational week 12-16. Of these, 49 (1.9%) developed preeclampsia, whereas 74 women matched for age and BMI with uncomplicated pregnancies were selected as controls. A subset of women with risk factors for preeclampsia were sampled again at gestational weeks 16 and 28 (11 cases, 39 controls) and postnatally (six cases, 36 controls).
From multiplex analysis, soluble E-selectin concentrations were higher at 12-16 weeks in women who subsequently developed preeclampsia (15.1 ± 4.9 versus 12.9 ± 4.5 ng/ml, P = 0.02). At gestational week 28, E-selectin concentrations were again higher in women who went on to develop preeclampsia compared with controls (14.4 ± 5.6 versus 10.7 ± 3.5 ng/ml, P = 0.010), whereas levels were not different between the two groups in postpartum samples.
Changes in soluble E-selectin concentration in early pregnancy may reflect underlying pathophysiological processes, potentially providing mechanistic insights into preeclampsia.
子痫前期患者在妊娠晚期循环内皮功能障碍和炎症的生物标志物升高。我们检测了妊娠早期炎症细胞因子和黏附分子的血浆水平，以评估其预测子痫前期的能力。
在一项前瞻性纵向研究中，招募了 2600 名患有单胎妊娠且无高血压病史的女性，在妊娠 12-16 周时在其产前医院（预约）就诊。其中，49 例（1.9%）发生子痫前期，而 74 例年龄和 BMI 与无并发症妊娠相匹配的女性被选为对照组。子痫前期危险因素的部分女性再次在妊娠 16 周和 28 周（11 例，39 例对照）和产后（6 例，36 例对照）取样。
从多重分析来看，随后发生子痫前期的女性在 12-16 周时可溶性 E-选择素浓度较高（15.1±4.9 与 12.9±4.5ng/ml，P=0.02）。在妊娠 28 周时，与对照组相比，再次发生子痫前期的女性 E-选择素浓度更高（14.4±5.6 与 10.7±3.5ng/ml，P=0.010），而两组在产后样本中的水平无差异。
妊娠早期可溶性 E-选择素浓度的变化可能反映了潜在的病理生理过程，为子痫前期提供了潜在的机制见解。
