Szpera-Gozdziewicz Agata, Gozdziewicz Tomasz, Wirstlein Przemysław, Wender-Ozegowska Ewa, Breborowicz Grzegorz H
a Department of Perinatology and Gynecology, Division of Perinatology and Gynecology , Poznan University of Medical Sciences , Poznań , Poland.
b Department of Perinatology and Gynecology, Division of Gynecology , Poznan University of Medical Sciences , Poznań , Poland.
J Matern Fetal Neonatal Med. 2019 Apr;32(7):1219-1223. doi: 10.1080/14767058.2017.1400006. Epub 2017 Nov 13.
The etiology and pathogenesis of pregnancy-related hypertensive disorders is complex and multifactorial. The aim of our study is the investigation of the differences in the autoantibodies against angiotensin II type 1 receptor (AT1-AA) titers among pregnant patients with chronic hypertension, gestational hypertension, and preeclampsia compared to the healthy pregnant women. We created three study groups (preeclampsia [ = 16], chronic hypertension [ = 13], gestational hypertension [ = 17]) and the control group consisting of 17 healthy pregnant women. Every compared group was matched for mother's age, parity, prepregnancy BMI, and gestational age at time of recruitment into study. The autoantibodies titer were assessed using commercially available ELISA kit. We found a statistically higher AT1-AA titer in the group of patients with gestational hypertension (GH) and preeclampsia (PE) compared to healthy normotensive pregnant women (median 9.6 versus 7.8 ng/ml, = .01 and 10.9 ng/ml versus 7.8 ng/ml, = .02, respectively). There was no correlation between blood pressure values and AT1-AA titer in any group. We found no correlation in group with preeclampsia between urinary protein excretion and AT1-AA titer ( = .23, R = 0.32). We assume that pregnancy-related hypertensive disorders might be autoimmune diseases and AT1-AA contribute to the pathophysiology of the disease. Our study may have some therapeutic implications and shows the necessity of new research into the mechanisms involved in the production of AT1-AA. Such investigations might enable to inhibit the formation of these autoantibodies or elaborate another method for AT1-AA removal.
妊娠相关高血压疾病的病因和发病机制复杂且具有多因素性。我们研究的目的是调查慢性高血压孕妇、妊娠期高血压孕妇和子痫前期孕妇与健康孕妇相比，抗血管紧张素II 1型受体自身抗体（AT1-AA）滴度的差异。我们创建了三个研究组（子痫前期组[=16]、慢性高血压组[=13]、妊娠期高血压组[=17]）以及由17名健康孕妇组成的对照组。每个比较组在母亲年龄、产次、孕前体重指数和纳入研究时的孕周方面进行了匹配。使用市售ELISA试剂盒评估自身抗体滴度。我们发现，与血压正常的健康孕妇相比，妊娠期高血压（GH）和子痫前期（PE）患者组的AT1-AA滴度在统计学上更高（中位数分别为9.6对7.8 ng/ml，P = 0.01；10.9 ng/ml对7.8 ng/ml，P = 0.02）。任何组的血压值与AT1-AA滴度之间均无相关性。我们发现在子痫前期组中，尿蛋白排泄与AT1-AA滴度之间无相关性（P = 0.23，R = 0.32）。我们推测妊娠相关高血压疾病可能是自身免疫性疾病，且AT1-AA参与了该疾病的病理生理过程。我们的研究可能具有一些治疗意义，并表明有必要对AT1-AA产生机制进行新的研究。此类研究可能有助于抑制这些自身抗体的形成或研发另一种去除AT1-AA的方法。
