Palm Klara, Cluver Catherine, Langenegger Eduard, Tong Stephen, Walker Susan, Imberg Henrik, Hastie Roxanne, Bergman Lina
Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa; Translational Obstetrics Group, Department of Obstetrics and Gynaecology, The University of Melbourne, Victoria, Australia; Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia.
Pregnancy Hypertens. 2024 Dec;38:101168. doi: 10.1016/j.preghy.2024.101168. Epub 2024 Nov 21.
To assess whether plasma concentrations of the circulating inflammatory proteins Interleukin-6 (IL-6), Vascular Cell Adhesion Molecule-1 (VCAM-1) and C-Reactive Protein (CRP) are increased in women with preeclampsia with end-organ complications, compared with women with preeclampsia without end-organ complications.
We used samples from a large prospective biobank collection (Preeclampsia Obstetric Adverse Event biobank), and two large, randomized preeclampsia therapeutic treatment trials. All samples were collected in Cape Town, South Africa. The last plasma sample collected prior to birth was analyzed for IL-6, VCAM-1 and CRP concentrations. We categorized cases according to disease severity and compared circulating levels of these analytes. Covariate adjustment was performed.
183 women were included. Compared with women without end-organ complications (n = 119), those with preeclampsia with two or more end-organ complications (n = 15) had a 4.9-fold (95 % CI, 1.81-13.09, p = 0.001) increase in IL-6 and a 1.7-fold (95 % CI, 1.11-2.72, p = 0.012) increase in VCAM-1 plasma concentrations. Comparing women with two or more end-organ complications to those with one end-organ complication (n = 49), plasma concentrations of IL-6 were 3.2-fold (95 % CI, 1.18-8.39, p = 0.018) increased, while there was no statistically significant difference for VCAM-1 (1.2-fold higher, 95 % CI, 0.79-1.91, p = 0.50). Plasma concentrations of CRP did not differ between the groups.
Plasma concentrations of IL-6 and VCAM-1, but not CRP, were increased among women with preeclampsia and end-organ complications, compared with women without end-organ complications. IL-6 and VCAM-1 could be drivers of disease in preeclampsia and potentially useful to identify women at high risk of severe disease.
评估与无终末器官并发症的子痫前期女性相比，伴有终末器官并发症的子痫前期女性循环炎症蛋白白细胞介素-6（IL-6）、血管细胞黏附分子-1（VCAM-1）和C反应蛋白（CRP）的血浆浓度是否升高。
我们使用了来自一个大型前瞻性生物样本库（子痫前期产科不良事件生物样本库）以及两项大型随机子痫前期治疗试验的样本。所有样本均在南非开普敦采集。分析出生前采集的最后一份血浆样本中的IL-6、VCAM-1和CRP浓度。我们根据疾病严重程度对病例进行分类，并比较这些分析物的循环水平。进行了协变量调整。
纳入了183名女性。与无终末器官并发症的女性（n = 119）相比，患有子痫前期且有两种或更多终末器官并发症的女性（n = 15）的IL-6升高了4.9倍（95%可信区间，1.81 - 13.09，p = 0.001），VCAM-1血浆浓度升高了1.7倍（95%可信区间，1.11 - 2.72，p = 0.012）。将有两种或更多终末器官并发症的女性与有一个终末器官并发症的女性（n = 49）进行比较，IL-6的血浆浓度升高了3.2倍（95%可信区间，1.18 - 8.39，p = 0.018），而VCAM-1无统计学显著差异（高1.2倍，95%可信区间，0.79 - 1.91，p = 0.50）。各亚组间CRP的血浆浓度无差异。
与无终末器官并发症的女性相比，伴有终末器官并发症的子痫前期女性的IL-6和VCAM-1血浆浓度升高，而CRP未升高。IL-6和VCAM-1可能是子痫前期疾病的驱动因素，并且可能有助于识别重症疾病的高危女性。
