The elevation in circulating anti-angiogenic factors is independent of markers of neutrophil activation in preeclampsia

• DOI: 10.1007/s10456-012-9261-5
• Publication Date: 2012-03-07T17:21:16Z
• Authors: Wenda Ramma; Irina A. Buhimschi; Guomao Zhao; Antonette T. Dulay; Unzila Ali Nayeri; Catalin S. Buhimschi; Asif Ahmed
• Keywords: Adult; /dk/atira/pure/subjectarea/asjc/1300/1314; Cancer Research; Original Paper; Physiology; Clinical Biochemistry; Enzyme-Linked Immunosorbent Assay; Neutrophil Activation; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Pre-Eclampsia; Pregnancy; Humans; Angiogenesis Inducing Agents; Female; /dk/atira/pure/subjectarea/asjc/1300/1308; /dk/atira/pure/subjectarea/asjc/1300/1306

Severe preeclampsia is associated with increased neutrophil activation and elevated serum soluble endoglin (sEng) and soluble Flt-1 (sFlt-1) in the maternal circulation. To dissect the contribution of systemic inflammation and anti-angiogenic factors in preeclampsia, we investigated the relationships between the circulating markers of neutrophil activation and anti-angiogenic factors in severe preeclampsia or systemic inflammatory state during pregnancy.Serum sEng, sFlt-1, placenta growth factor, interleukin-6 (IL-6), calprotectin, and plasma α-defensins concentrations were measured by ELISA in 88 women of similar gestational age stratified as: severe preeclampsia (sPE, n = 45), maternal systemic inflammatory response (SIR, n = 16) secondary to chorioamnionitis, pyelonephritis or appendicitis; and normotensive controls (CRL, n = 27). Neutrophil activation occurred in sPE and SIR, as α-defensins and calprotectin concentrations were two-fold higher in both groups compared to CRL (P < 0.05 for each). IL-6 concentrations were highest in SIR (P < 0.001), but were higher in sPE than in CRL (P < 0.01). sFlt-1 (P < 0.001) and sEng (P < 0.001) were ≈20-fold higher in sPE compared to CRL, but were not elevated in SIR. In women with sPE, anti-angiogenic factors were not correlated with markers of neutrophil activation (α-defensins, calprotectin) or inflammation (IL-6).Increased systemic inflammation in sPE and SIR does not correlate with increased anti-angiogenic factors, which were specifically elevated in sPE indicating that excessive systemic inflammation is unlikely to be the main contributor to severe preeclampsia.