Monitoring of endothelial activation markers during physiological pregnancy
Authors:
J. Procházková 1; I. Dhaifallah 2; A. Měchurová 3; R. Pilka 2; O. Šimetka 4; L. Slavík 1; J. Úlehlová 1; M. Lubušký 2; M. Procházka 2
Authors place of work:
Hemato-onkologická klinika FN a LF UP, Olomouc, přednosta prof. MUDr. K. Indrák, DrSc.
1; Porodnicko-gynekologická klinika FN a LF UP, Olomouc, přednosta doc. MUDr. R. Pilka, Ph. D.
2; Ústav pro péči o matku a dítě, Praha, ředitel doc. MUDr. J. Feyereisl, CSc.
3; Porodnicko-gynekologická klinika FN, Ostrava, přednosta MUDr. O. Šimetka
4
Published in the journal:
Ceska Gynekol 2010; 75(2): 92-100
Summary
Aim of the study:
To establish endothelial activation markers which could uncover endothelial damage during physiological pregnancy.
Type of study:
Prospective study.
Method:
We examined 403 pregnant women with a physiological pregnancy. Venous blood samples were collected from the women at the beginning of the pregnancy, a second sample was collected in the interval 24-28 weeks gestation. Parameters were examined using methods: t-PA – ELISA, PAI-1 – ELISA, vWF Ag – EIA ePCR – ELISA, MMP-2,9 – ELISA with fluorogenic detection, TIMP-2 – ELISA, endothelial microparticles - flow cytometry.
Results:
The level of vWF antigen increased during the entire course of pregnancy (in the I. trimester the average level was 152,32%, in the II. and III. trimester 173.34% and 216.20% respectively). At the same time, vWf activity also increased (I. trimester average level 130.20%, II. and III. trimester 150.09% and 181.91% respectively). The level of thrombomodulin significantly increased during pregnancy (I. trimester average level 19,05 ng/ml, II. and III. trimester 28,47 ng/ml and 39,86 ng/ml respectively). The level of soluble form of EPCR increased during pregnancy (I. trimester average level 201.76 ng/ml, II. and III. trimester 274.68 ng/ml and 324.07 ng/ml respectively). The level of PAI–1 increased during the entire course of pregnancy (I. trimester average level 36.14 ng/ml, II. and III. trimester 50.07 ng/ml and 60.12 ng/ml respectively). The level of t- PA did not change significantly during the course of pregnancy (I. trimester average level 2.48 ng/ml, II. and III. trimester 2.97 and 3,34 ng/ml respectively). The levels of MMP-2 (I. trimester average level 9043,76 RFU, II. and III. trimester 9315.38 and 8800.27 RFU respectively), MMP-9 (I. trimester average level 8371.90, II. and III. trimester 8290.81 and 7470.50 respectively), TIMP-2 (I. trimester average level 92.5 ng/ml, II. and III. trimester 98.5 and 96.5 ng/ml respectively) or endothelial microparticles (I. trimester average level 3838.38 particles/μl, II. and III. trimester 3836.59 and 3650.59 particles/μl respectively) did not change significantly throughout the individual trimesters.
Conclusion:
We confirmed the hypothesis regarding the significant influence pregnancy has on changes in levels of these markers.
Key words:
endothelium, pregnancy, activation, preeclampsia.
Zdroje
1. Blann, AD. Assessment of endothelial dysfunction: focus on atherothrombotic disease. Pathophysiol Haemostasis Thrombosis 2005, 34.
2. De Caterina, R., Libby, P. Endothelial dysfunctions and vascular disease. Viley and sons: Blackwell Publishing, 2007, p. 3-25.
3. Hoffbrand, AV., Catovsky, D., Tuddenham, EGD. Postgraduate Hematology. Viley and sons: Blackwell Publishing, 2005, p. 787-792.
4. Kvasnička, J. Trombofilie a trombotické stavy v klinické praxi. Praha: Grada Publishing, 2003, s. 40-65.
5. Pecka, M. Laboratorní hematologie v přehledu. Fyziologie a patofyziologie hemostázy. 2004, s. 22-24, 87-97, 113-118.
6. Pilka, R., Hrachovec, P. Matrix metaloproteinázy a menstruace. Čes Gynek 2003, 68, s. 36-40.
7. Šimetka, O., Brychtová, P., Procházková, J., Procházka, M. Laboratorní změny aktivace endotelu u syndromu HELLP. Gynekolog 2008, 2, s. 48-53.
8. Holmes, VA., Wallace, JMW. Haemostasis in normal pregnancy: a balancing act? Biochemical Society Transactions 2005, 33, part 2, p. 428-432.
9. Brenner, B. Haemostatic changes in pregnancy. Thromb Res 2004, 114, p. 409-414.
10. Buffa, MC., Valsecchi, L., Fausto, A. Predictive value of plasma thrombomodulin in preeclampsia and gestational hypertension. Tromb Haemost 1998, 79, p. 1092-1095.
11. Stirling, Y., Woolf, L., North, WR., et al. Haemostasis in normal pregnancy. Thromb Haemost 1984, 52, p. 176-182.
12. Ishii, A., Yamada, R., Hamada, H. t-PA activity in peripheral blond obtained from pregnant women. J Perinat Med 1994, 22, p. 113-117.
13. Bremme, K., Ostlund, E., Almquist, I. Enhanced thrombin generation and fibrinolytic activity in the normal pregnancy and the puerperium. Obstet Gynecol 1992, 80, p. 132-137.
14. Bretelle, F., Sabatier, F., Desprez, D., et al. Circulating microparticles: a marker of procoagulant state in normal pregnancy complicated by preeclamsia or intrauterine growth restriction. Thromb Haemost 2003, 89, p. 486-492.
15. VanWijk, MJ., Svedas, E., Boer, K., et al. Isolated microparticles, but not whole plasma, from women with preeclampsia impair endothelium-dependent relaxation in isolated myometrial arteries from healthy pregnant women. Am J Obstet Gynecol 2002, 187, p. 1686-1693.
16. Raffaetto, JD., Khalil, RA. Matrix metalloproteinases and their inhibitors in vascular remodeling and vascular disease. Biochem Pharmacol 2008, 75(2), p.346-59. Epub 2007 Jul 7. Review.
Štítky
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineČlánok vyšiel v časopise
Czech Gynaecology
2010 Číslo 2
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