Haeger M, Unander M, Andersson B, Tarkowski A, Arnestad J P, Bengtsson A
Department of Obstetrics & Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden.
Acta Obstet Gynecol Scand. 1996 Sep;75(8):695-701. doi: 10.3109/00016349609065729.
Complement is activated in preeclampsia and complement products are known to activate macrophages. The aim of this study was to determine whether the macrophage derived cytokines, interleukin-1 beta, interleukin-6 and tumor necrosis factor-alpha, are released in patients with a form of severe preeclampsia characterized by the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome).
Complement activation and plasma levels of cytokines were studied in 11 women with HELLP syndrome and in 11 controls with uncomplicated pregnancies. To further evaluate the connection between complement activation and cytokine release an in vitro study on heparinized whole blood incubated with recombinant C5a was performed.
In the HELLP group, complement anaphylatoxin C5a was increased in plasma at delivery (p < 0.01) and one day after delivery (p < 0.05), terminal C5b-9 complement complex was elevated in plasma at delivery (p < 0.001) and one day after (p < 0.01), plasma levels of interleukin-6 were increased one day after delivery (p < 0.01), and plasma concentrations of tumor necrosis factor-alpha were elevated at delivery (p < 0.01), compared with corresponding levels in controls. All parameters normalized within one week. Interleukin-I beta did not differ between the groups. In vitro, recombinant C5a incubated in whole blood gave a dose-dependent release of interleukin-6. No increased release of interleukin-1 or tumor necrosis factor-alpha was seen after incubation.
Since cytokine release occurs in severe preeclampsia, inflammatory mechanisms may participate in the pathophysiology of severe preeclampsia.
子痫前期患者体内补体被激活，且已知补体产物可激活巨噬细胞。本研究旨在确定巨噬细胞衍生的细胞因子白细胞介素-1β、白细胞介素-6和肿瘤坏死因子-α是否在以溶血、肝酶升高和血小板减少综合征（HELLP综合征）为特征的重度子痫前期患者中释放。
对11例HELLP综合征患者和11例正常妊娠对照者的补体激活情况及细胞因子血浆水平进行研究。为进一步评估补体激活与细胞因子释放之间的联系，对用重组C5a孵育的肝素化全血进行了体外研究。
与对照组相应水平相比，HELLP组患者分娩时血浆中补体过敏毒素C5a升高（p<0.01），分娩后1天也升高（p<0.05）；分娩时血浆中末端C5b-9补体复合物升高（p<0.001），分娩后1天仍升高（p<0.0）；分娩后1天血浆白细胞介素-6水平升高（p<0.01）；分娩时血浆肿瘤坏死因子-α浓度升高（p<0.01）。所有参数在1周内恢复正常。两组间白细胞介素-1β无差异。体外实验中，全血中孵育重组C5a后白细胞介素-6呈剂量依赖性释放。孵育后未观察到白细胞介素-1或肿瘤坏死因子-α释放增加。
由于重度子痫前期患者会出现细胞因子释放，炎症机制可能参与了重度子痫前期的病理生理过程。
