Rimboeck Julia, Gruber Michael, Weigl Marco, Huber Pia, Lunz Dirk, Petermichl Walter
Department of Anesthesiology, University Hospital of Regensburg, 93042 Regensburg, Germany.
University Department of Obstetrics and Gynecology at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, 93049 Regensburg, Germany.
Biomedicines. 2023 Oct 20;11(10):2851. doi: 10.3390/biomedicines11102851.
HELLP syndrome is characterized by hemolysis, elevated liver enzymes, and a low platelet count and poses an increased risk to the pregnant woman and the unborn child. Individual risk factors such as obesity may alter immunocompetence and influence the course of preeclampsia (PE) or HELLP syndrome. Blood samples were collected from 21 pregnant women (7 healthy, 6 with PE, and 8 with HELLP syndrome) and polymorphonuclear neutrophils (PMNs) were subsequently isolated. Production of radical oxygen species (ROS), cell movement, and NETosis were assessed by live-cell imaging. Surface protein expression and oxidative burst were analyzed by flow cytometry. PE and HELLP patients had significantly higher BMI compared to the healthy control group. Depending on the expression of CD11b, CD62L, and CD66b on PMNs, a surface protein activation sum scale (SPASS) was calculated. PMNs from patients with high SPASS values showed prolonged and more targeted migration with delayed ROS production and NETosis. Obesity is associated with a chronic inflammatory state, which in combination with immunological triggers during pregnancy could modulate PMN functions. Pregnant women with higher BMI tend to have higher SPASS values, indicating activation of the innate immune system that could co-trigger PE or HELLP syndrome.
HELLP综合征的特征为溶血、肝酶升高和血小板计数降低，会增加孕妇和未出生胎儿的风险。肥胖等个体风险因素可能会改变免疫能力，并影响先兆子痫（PE）或HELLP综合征的病程。从21名孕妇（7名健康孕妇、6名患有PE和8名患有HELLP综合征）采集血样，随后分离出多形核中性粒细胞（PMN）。通过活细胞成像评估活性氧（ROS）的产生、细胞运动和中性粒细胞胞外诱捕网形成（NETosis）。通过流式细胞术分析表面蛋白表达和氧化爆发。与健康对照组相比，PE和HELLP患者的体重指数（BMI）显著更高。根据PMN上CD11b、CD62L和CD66b的表达情况，计算表面蛋白激活总和量表（SPASS）。SPASS值高的患者的PMN表现出延长且更具靶向性的迁移，ROS产生和NETosis延迟。肥胖与慢性炎症状态相关，这与孕期的免疫触发因素相结合，可能会调节PMN功能。BMI较高的孕妇往往具有较高的SPASS值，表明先天免疫系统被激活，这可能共同引发PE或HELLP综合征。
