Increased soluble VCAM-1 serum levels in preeclampsia are not correlated to urinary excretion or circadian blood pressure rhythm

OBJECTIVE: Soluble vascular cell adhesion molecule-1 (VCAM-1) is known to be elevated in serum of patients with preeclampsia, but there are no data available on the significance of urinary VCAM-1 excretion in preeclampsia. The aim of our study was to uncover possible circadian rhythms of VCAM-1 plasma levels and urinary VCAM-1 excretion in uncomplicated and hypertensive pregnancies and to ascertain their relation to blood pressure. STUDY DESIGN: A total of 10 normotensive and 10 preeclamptic pregnant women were included in this study. Venous blood was collected hourly, and urine samples were taken every 2 h over a period of 24 h. VCAM-1 levels were determined by ELISA. We compared these results with the circadian blood pressure rhythm. RESULTS: The median VCAM-1 plasma levels were significantly (P < 0.01) increased in preeclamptic patients (851.5 ng/mL) in comparison to normotensive pregnant women (659.3 ng/mL) without any circadian rhythm being apparent; however, the urinary excretion of VCAM-1 showed a typical circadian rhythm, with a higher excretion rate during daytime. CONCLUSION: For the first time we have demonstrated that urinary VCAM-1 excretion in pregnancy shows a circadian rhythm without correlation to plasma levels or the circadian blood pressure rhythm. In contrast, VCAM-1 serum levels did not show a diurnal rhythm. We assume that VCAM-1 serum levels do not correlate with systemic blood pressure or urinary excretion.     

Soluble adhesion molecule profile in normal pregnancy and pre-eclampsia

Objective: An exaggerated inflammatory response has been implicated as the cause of endothelial cell dysfunction and the maternal syndrome of pre-eclampsia. Adhesion molecules play a central role in the adherence of leukocytes to endothelial cells and the subsequent migration of white blood cells into perivascular tissue. Cellular forms of adhesion molecules mediate specific steps of leukocyte-endothelial cell interaction, and have been implicated in the pathophysiology of pre-eclampsia. Soluble forms of these molecules can be detected in plasma, and their concentrations are thought to reflect the degree of activation of a particular cell type. Elevations in soluble P-selectin (sP-selectin) reflect platelet activation; changes in soluble L-selectin (sL-selectin) suggest leukocyte activation; and an increase in soluble forms of E-selectin (sE-selectin), vascular cell adhesion molecule 1 (sVCAM-1), intercellular adhesion molecule 1 (sICAM-1) and platelet endothelial cell adhesion molecule (sPECAM-1) indicate endothelial cell activation/dysfunction. The objective of this study was to determine whether normal pregnancy and pre-eclampsia were associated with changes in the concentrations of soluble selectins and members of the immunoglobulin superfamily of adhesion molecules. Study design: A cross-sectional study was conducted to determine the plasma concentrations of sL-selectin, sE-selectin, sP-selectin, sVCAM-1, sICAM-1 and sPECAM-1 in peripheral blood obtained from non-pregnant women (n = 20), normal pregnant women (n = 100) and patients with pre-eclampsia (n = 55). Concentrations of soluble adhesion molecules were determined with enzyme-linked immunoassays. Parametric statistics were used for data analysis. Results: Normal pregnancy was associated with a significant increase in the maternal plasma concentration of sP-selectin, a decrease in sL-selectin, and no change in sE-selectin, sVCAM-1, sICAM-1 and sPECAM-1. In contrast, pre-eclampsia was associated with a significant increase in sP-selectin, sE-selectin and sVCAM-1, a decrease in sL-selectin, but no change in sICAM-1 and sPECAM-1 concentrations. Conclusions: The increased concentration of sP-selectin and decreased sL-selectin, as well as the lack of change in endothelial cell-associated soluble adhesion molecules suggest that pregnancy is associated with platelet and leukocyte activation, but not endothelial cell activation. In contrast, pre-eclampsia appears to be characterized by activation of platelets, leukocytes and endothelial cells.     

可溶性细胞粘附分子1、促肾上腺皮质激素释放激素及白细胞介素6在妊娠高血压综合征发病中的作用

目的　研究可溶性细胞粘附分子 1(soluble intracellular adhesion m olecule- 1,s ICAM-1)、促肾上腺皮质激素释放激素 (cortictropin- releasing horm one,CRH)及白细胞介素 6 (interleukin-6 ,IL- 6 )在妊娠高血压综合征 (妊高征 )发病中的作用。　方法　测定 81例妊娠 2 6～ 37周孕妇血浆s ICAM- 1、CRH、IL- 6水平 ,其中 2 3例 ,为正常孕妇 (正常妊娠组 ) ;5 8例为妊高征孕妇 (妊高征组 ) :包括轻度 2 1例、中度 19例、重度 18例。用酶联免疫法测定 s ICAM- 1及 IL- 6 ,用放射免疫法测定 CRH。　结果　中、重度妊高征患者的血 s ICAM- 1、CRH、IL- 6水平均显著高于正常对照组 (P<0 .0 5 ) ,轻度妊高征患者与正常组相比虽无统计学差异但有升高的趋势。IL- 6水平与 CRH呈正相关 (r=0 .5 1,P<0 .0 5 )。　结论　妊高征患者血 s ICAM- 1升高表明内皮细胞损伤在妊高征的发病中起重要作用。CRH分泌的异常增加可能与内皮细胞的损伤有关 ,该作用可能是通过促进 IL- 6的分泌实现的     

Investigation of adhesion molecules (sVCAM-1) in serum of nonpregnant women, normotensive pregnant women and in patients with pregnancy complications]

OBJECTIVE: An increased expression of endothelial adhesion molecules combined with neutrophil activation in the placental bed is to be assumed aetiopathogenetically relevant in preeclampsia. MATERIAL AND METHODS: Ranges of sVCAM-1 serum concentrations of both control persons (29 nonpregnant and 25 normotensive pregnant women) and patients with different complications of pregnancy (HELLP-syndrome n = 10, preeclampsia n = 12, gestational hypertension n = 38, diabetes n = 24, growth retardation n = 21) were determined by means of ELISA. Frozen placental samples of 5 normotensive and 10 hypertensive pregnant women were investigated immunhistochemically to study the distribution of VCAM-1 in the placenta. RESULTS: Significantly elevated sVCAM-1 serum levels (p < 0.05) were identified in samples of patients with HELLP syndrome, preeclampsia, diabetes and gestational hypertension compared with serum levels of normotensive pregnant women. The cut-off level (97.5% percentile of normotensive serum levels) was calculated (775 ng/ml). VCAM-1 was localized immunhistochemically at capillaries of villi and main villi. CONCLUSIONS: There are closed relations between elevated serum levels of sVCAM-1 during pregnancy and diseases with vasculopathies of placental bed.     

Maternal endothelial soluble cell adhesion molecules with isolated small for gestational age fetuses: comparison with pre-eclampsia

Objective 1.To evaluate the activation profile of the endothelium in pregnancies complicated by small for gestational age fetuses compared with pre-eclampsia and normal pregnancy, by measuring the plasma levels of soluble adhesion molecules soluble E-selectin, intercellular cell adhesion molecule-1 and vascular cell adhesion molecule-1. 2. To determine whether soluble adhesion molecules were related to the severity of small for gestational age fetuses and pre-eclampsia.
Design Observational study.
Participants Sixteen women with small for gestational age fetuses; 15 women with pre-eclampsia and 15 healthy primigravidae were recruited as controls.
Methods Plasma levels of soluble E-selectin, intercellular cell adhesion molecule-1 and vascular cell adhesion molecule-1 were measured by ELISA.
Results Compared with the healthy controls, soluble E-selectin was significantly increased in both small for gestational age fetuses and pre-eclampsia, whereas intercellular cell adhesion molecule-1 and vascular cell adhesion molecule-1 were increased only in pre-eclampsia. In the small for gestational age fetuses group, soluble E-selectin correlated inversely with the ratio between birthweight and the expected normal birthweight (r=-0.4, P =0.007). In the pre-eclampsia group, a significant correlation was observed between vascular cell adhesion molecule-1 and blood pressure (r=0.54, P =0.039).
Conclusions Endothelial activation, reflected by raised levels of soluble E-selectin, is a feature of small for gestational age fetuses and is correlated with the severity of the disease. Differences in the profile of soluble cell adhesion molecules suggest variations in the degrees of endothelial activation between pre-eclampsia and small for gestational age fetuses.     

妊高征患者血浆内皮素与降钙素基因相关肽水平的变化

探讨妊高征患者血浆内皮素与降钙素基因相关肽水平的变化方法采用放射免疫法测定６０例妊高征患者及２３例正常妊娠妇女血浆ＥＴ－１与ＣＧＲＰ的水平。结论ＥＴ－１和ＣＧＲＰ可作为判断妊高征病情程度的指标,ＣＧＲＰ与ＣＴ－１在中,重度妊重高征患者的发病中的起相互作拮抗作用。     

Hypertension in pregnancy and endothelial activation: An emerging risk factor for cardiovascular disease

ObjectiveThere is emerging evidence suggesting that women who develop hypertensive disorders of pregnancy should be considered at risk for cardiovascular disease (CVD). Our objective was to determine whether persistent endothelial activation, which represents the earliest step in atherogenesis, is present after delivery in women with a history of hypertensive pregnancies compared to women with normal pregnancies.Study designTwo matched case-control studies were conducted. In the first study, endothelial activation was assessed by the measurement of soluble intercellular adhesion molecules, namely, intercellular adhesion molecules-1 (ICAM-1), vascular cellular adhesion molecules-1 (V-CAM-1), E-selectin and P-selectin in 25 women with hypertensive pregnancies and in a matched control group with an uncomplicated pregnancy one month and three months after delivery. In the second study, adhesion molecules were measured in 20 patients with a history of HELLP syndrome several years after pregnancy and in 20 matched controls.ResultsIncreased levels of soluble adhesion molecules were found in women with hypertensive complications compared to women with uncomplicated pregnancies shortly after delivery. Significant differences were still present, several years after delivery comparing levels of adhesion molecules in women with a history of HELLP syndrome with those found in control patients.ConclusionsPatients with hypertensive pregnancies showed an abnormal activation of the endothelium which persists after pregnancy. This activation was particularly marked in patients experiencing HELLP syndrome. These observations may represent an explanation to the increased risk of CVD later in life in patients experiencing hypertensive pregnancies, especially in women with a history of HELLP syndrome.     

Changes in serum concentrations of tumor necrosis factor alpha and adhesion molecules in normal pregnant women and those with pregnancy-induced hypertension

AIM: To study whether serum tumor necrosis factor alpha gene (TNFalpha) and adhesion molecule levels are indicators of the onset of pregnancy-induced hypertension (PIH), we compared levels of these molecules between normal pregnant women and PIH patients from the first to the third trimester. METHODS: We serially measured serum concentrations of TNFalpha, soluble intercellular adhesion molecule-1 (sICAM-1), soluble E-selectin (sE-selectin), soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble P-selectin (sP-selectin) using enzyme immunoassay kits in 10 normal pregnant women and 10 pregnant women who developed PIH late in gestation. RESULTS: Serum TNFalpha, sICAM-1 and sE-selectin levels in PIH affected women were significantly higher from the first trimester compared with those in normal pregnancy. sVCAM-1 and sP-selectin levels were not significantly changed. CONCLUSION: Serum TNFalpha, sE-selectin and sICAM-1 levels might be effective indicators of the onset of PIH.     

Corticotropin-releasing hormone in maternal and cord plasma in pre-eclampsia.

The concentration of corticotropin-releasing hormone (CRH) in maternal plasma increases greatly during the last trimester of normal pregnancy. This CRH has been proposed to originate from the placenta. We studied plasma immunoreactive CRH in 46 uncomplicated pregnancies, in 10 pregnant women with chronic hypertension, in 17 women with pregnancy-induced hypertension (PIH) and in 24 women with pre-eclampsia, and correlated it to the levels of corticotropin (ACTH) and cortisol. CRH levels were greatly increased in women with pre-eclampsia, less significantly in women with PIH, while no change was found in pregnant women with chronic hypertension. ACTH levels also were increased in pregnancies with pre-eclampsia or PIH and there was a positive correlation between CRH and ACTH levels. CRH levels in cord venous plasma were significantly increased in pregnancies with pre-eclampsia but cortisol did not show any significant increase. These findings suggest that placental release of CRH into the maternal and fetal circulation is increased in pre-eclampsia.     

VCAM-1和IL-6在妊娠高血压综合征发病中的作用

目的:探讨妊娠高血压综合征(妊高征)患者血清中血管细胞粘附分子-1(VCAM-1)和白细胞介素-6(IL-6)水平的变化,及其在妊高征发病中的作用。方法:采用双抗体夹心酶联免疫吸附法(ELISA)测定了49例妊高征患者(其中轻度15例、中度16例及重度18例),35例正常晚期妊娠妇女的血清VCAM-1和IL-6含量。结果:(1)妊高征组血清VCAM-1和IL-6浓度都明显高于正常妊娠组(P<0.05,P<0.01);(2)VCAM-1与IL-6水平呈明显正相关。结论:血清中VCAM-1和IL-6含量的升高可能参与了妊高征血管内皮细胞损伤过程,IL-6可以诱导VCAM-1的表达,2者共同参与了妊高征的发病过程。     

Expression of intercellular adhesion molecule-1 (ICAM-1) on the surface of peripheral blood lymphocytes of pregnant women with pregnancy-induced hypertension

OBJECTIVES: Intercellular adhesion molecule-1 (ICAM-1, CD54) is involved in process of leukocytes adhesion to endothelium as well as in their migration to surrounding tissues. There is much evidence that pregnancy-induced hypertension (PIH) presents a state of endothelial destruction mediated partially by increased ICAM-1 expression on endothelial cells and neutrofils. DESIGN: The aim of this study was to evaluate the expression of ICAM-1 (CD54) molecule on the peripheral blood lymphocytes of pregnant women with PIH studied "in vitro". MATERIALS AND METHODS: Preeclampsia (PE) and transient hypertension (TH) were defined according to USA National Health Institute criteria. The study group consisted of 16 women with preeclampsia (PE), 12 women with transient hypertension (TH) and 9 women with physiological pregnancy. The group of 8 nonpregnant women served as controls. Exclusion criteria were: uterine contractions, infection and steroid therapy before blood sampling. Peripheral blood was obtained by venipuncture. Lymphocytes were isolated and cultured by using standard procedures. Mitogenic doses of phytohaemaglutynin (PHA) were added to each culture. Immunofluorescent marking techniques with anty-CD54 one-step monoclonal antibodies were performed. Analysis was made with FACSCalibur flow-cytometer with 488 nm argon laser using CellQuest programme. The results were described as the percentage of CD54+ lymphocytes and MFI index corresponding density of CD54 molecules on the lymphocyte surface. Statistical analysis was performed using t-Student and U-Mann-Whitney tests. The work was sponsored by KBN 4 P05E 118,15 grant. RESULTS: The percentage of CD54+ lymphocytes in physiological pregnancy compared to nonpregnant women did not differ significantly (56.9 +/- 20.8% vs. 57.2 +/- 14.0%, p = 0.97). The MFI value was increased in pregnant women but in comparison with nonpregnant women did not reach statistical significance (34.7 +/- 35.7 vs. 17.8 +/- 4.3, p = 0.20). The percentage of CD54+ lymphocytes in TH group compared to normal pregnant women did not differ significantly (52.2 +/- 18.6% vs. 56.9 +/- 20.8%, p = 0.58) but MFI value was significantly increased (100.6 +/- 81.5 vs. 34.7 +/- 35.7). In PE group compared to normal pregnant women the percentage of CD54+ lymphocytes as well as MFI value were significantly increased (CD54+: 70.8 +/- 12.9% vs. 56.9 +/- 20.8%, p < 0.05; MFI: 170.8 +/- 91.7 vs. 34.7 +/- 35.7, p < 0.0005). CONCLUSIONS: 1/expression of ICAM-1 molecule on peripheral blood lymphocytes studied "in vitro" during normal pregnancy is not different in comparison to the nonpregnant state, but 2/ in pregnancy complicated with PIH is significantly increased, especially in PE, 3/described changes are a sign of the lymphocyte activation and may be responsible for endothelial destruction observed in PIH.     

Endothelin-1 (ET-1) as a mediator of pregnancy induced hypertension (PIH)

Pregnancy induced hypertension (PIH) is accompanied by injury and further activation of placental endothelial cells. Activated endothelial cells produce several mediators, among them endothelin-1 (ET-1)--one of the most potent vasoconstrictors. The aim of the study was to examine the ET-1 level in serum of 18 women with PIH and compare it to the group of 16 normotensive pregnant women. ET-1 level, as evaluated by ELISA test, was significantly higher in PIH than in normotensive pregnancy, 33.00 +/- 12.07 vs. 25.00 +/- 5.69 pg/mL (p = 0.005), respectively. It might be concluded, that ET-1 level is a prognostic parameter, indicating the possibility of PIH development.     

肿瘤坏死因子在妊高征发病中的作用

目的：探讨肿瘤坏死因子（ＴＮＦ）在妊高征发病中的作用及其对胎儿生长的影响。方法：应用放射免疫法对正常晚期妊娠妇女１６例（对照组）及妊高征患者４６例（妊高征组）的血浆、羊水和新生儿脐血中ＴＮＦ进行检测。结果：分娩前妊高征组血浆ＴＮＦ水平较对照组高，以中、重度妊高征者增高显著（Ｐ＜０．０５）；产后７２小时妊高征组血浆ＴＮＦ水平下降，与对照组差异无显著性。对照组及轻度妊高征者新生儿脐血ＴＮＦ水平与母血接近，羊水ＴＮＦ水平明显低于母血（Ｐ＜０．０５）；中、重度妊高征者脐血和羊水ＴＮＦ水平均较母血低（Ｐ＜０．０５；Ｐ＜０．０１）。新生儿脐血、羊水中ＴＮＦ水平在两组间差异无显著性。在中、重度妊高征者中，合并胎儿生长迟缓者其羊水和新生儿脐血ＴＮＦ水平明显高于未合并胎儿生长迟缓者。结论：ＴＮＦ可能作为母体对胎儿抗原的异常免疫反应的重要介质，在妊高征的发病中起一定作用。     

Neutrophil activation in preeclampsia and isolated intrauterine growth restriction

OBJECTIVE: Neutrophils have been implicated in the pathogenesis of preeclampsia. Because preeclampsia and intrauterine growth restriction result from similar placental lesions, the aim of this study was to investigate neutrophil activation in isolated intrauterine growth restriction relative to preeclampsia and uncomplicated pregnancy. Polymorphonuclear neutrophil activation was analyzed by measuring cell surface and soluble cell adhesion molecule expressions. STUDY DESIGN: L -Selectin (CD62L ) and CD11b surface expressions on polymorphonuclear neutrophils were analyzed in 13 women with preeclampsia, 11 women with isolated intrauterine growth restriction, and 17 age- and gestation-matched control women by means of a standardized quantitative flow cytometry assay. Serum levels of soluble L -selectin were measured by enzyme-linked immunosorbent assay. RESULTS: Neutrophils from women with isolated intrauterine growth restriction and women with preeclampsia displayed higher levels of CD11b and lower levels of CD62L than did neutrophils from healthy pregnant women. Soluble L -selectin serum levels were significantly increased in the preeclampsia and intrauterine growth restriction groups relative to normal values. No significant difference in the levels of CD11b, CD62L, and soluble L -selectin were observed between women with isolated intrauterine growth restriction and those with preeclampsia. Leukocyte activation was not correlated with disease severity. CONCLUSION: The observed alteration in polymorphonuclear neutrophil adhesion molecule expressions and increased serum soluble L -selectin levels are consistent with activation of peripheral blood neutrophils occurring in isolated intrauterine growth restriction in a manner similar to that seen in preeclampsia. This evidence of neutrophil activation may help to advance our understanding of the disease process in isolated intrauterine growth restriction.     

PIH is associated with an increase of trophoblasts circulating in maternal blood

One of the reason of PIH problems may be due to exposition to placental trophoblast. The objective of the work was to evaluate the number of trophoblast cells deported into maternal peripheral blood of patients with PIH (pregnancy induced hypertension) as compared to normal pregnancy. Trophoblasts have been detected, by cytofluorimetry, in peripheral maternal venous blood of hypertensive woman (15 cases) and normotensive pregnancy (16 cases). Women with PIH had statistically significant (p < 0.005) higher trophoblasts number than that found in normotensive pregnant women without PIH (16 cases). Our results indicate that the increased trophoblasts deportation into peripheral blood could be a marker of the maternal syndrome of PIH.     

肿瘤坏死因子在妊高征发病中的作用

目的 探讨肿瘤坏死因子（ＴＮＦ－α）在妊高征发病中的作用。方法 应用放射免疫（放免）法测定２５例重度妊高征患者（妊高征组）和２５例正常妊娠妇女（正常妊娠组）血清中ＴＮＦ－α含量。用胰酶消化法分离脐静脉内皮细胞,种植在培养板中,一组加ＴＮＦ－α－５００Ｕ／ｍｌ,１０个孔（ＴＮＦ－α组）,一组未加入ＴＮＦ－α;１０个孔（对照组）,孵育４８小时,用放免法测定培养液上清液中内皮素（ＥＴ－１）、６－酮－前列     

Longitudinal evaluation of markers of endothelial cell dysfunction and hemostasis in treated antiphospholipid syndrome and in healthy pregnancy

OBJECTIVE: The purpose of this study was to determine whether primary antiphospholipid syndrome pregnancies are associated with endothelial cell activation in the maternal circulation. STUDY DESIGN: Markers of endothelial cell activation were measured every 4 weeks during pregnancy in the blood of 23 women with primary antiphospholipid syndrome and 19 control subjects. All women with antiphospholipid syndrome received anticoagulant treatment. Plasma concentrations of plasminogen activator inhibitor type 1, tissue plasminogen activator, soluble intercellular adhesion molecule-1, vascular cell adhesion molecule-1, E-selectin, and soluble thrombomodulin were determined by enzyme-linked immunoassay. Concentrations of prothrombin fragments 1+2 and D-dimers were also determined. RESULTS: Three antiphospholipid syndrome pregnancies (13%) were complicated by intrauterine growth restriction and preeclampsia; one antiphospholipid syndrome pregnancy (4%) was complicated by preterm rupture of membranes. Six women with antiphospholipid syndrome (26%) had thrombotic events. Differences in concentrations of endothelial cell activation markers between antiphospholipid syndrome and control pregnancies were not significant. CONCLUSION: Despite poorer pregnancy outcome, there was no evidence of greater endothelial cell activation in antiphospholipid syndrome pregnancies that were treated.     

Elevated soluble adhesion molecules in women with pre-eclampsia. Do cytokines like tumour necrosis factor-alpha and interleukin-1beta cause endothelial activation.

OBJECTIVE: The purpose of the present study was to evaluate the clinical significance of tumour necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) for endothelial cell activation in pre-eclampsia. Therefore, we determined and compared the correlations between these cytokines and circulating adhesion molecules in the sera of pre-eclamptic pregnant women, normotensive pregnant women and nonpregnant women. METHODS: The soluble adhesion molecules VCAM-1, ICAM-1, E-selectin, and P-selectin were determined in the serum of 38 pre-eclamptic pregnant women and 40 normotensive pregnant and nonpregnant controls using ELISA-techniques. We correlated these serum concentrations with the serum levels of TNF-alpha and IL-1beta, respectively, also determined by ELISA. RESULTS: Elevated serum levels of VCAM-1 and E-selectin could be detected in pre-eclamptic patients, with and without HELLP-syndrome. In contrast, no increased serum concentration of ICAM-1, P-selectin, TNF-alpha and IL-1beta were found in these patients. While significant correlation between VCAM-1 and E-selectin could be determined (r=0.604; p<0.001) no unambiguous correlations, however, were found between TNF-alpha or between IL-1beta and the examined adhesion molecules or the selectins. CONCLUSIONS: In contrast to in vitro investigations on cultured umbilical vein endothelium, our experimental results indicate that the cytokines TNF-alpha and IL-1beta can not explain endothelial cell activation, and that their measurement in serum is not useful for the detection of pre-eclampsia.     

川芎嗪对妊娠高血压综合征患者脐静脉内皮细胞粘附分子表 …

目的 探讨妊娠高血压综合征（妊高征）患者血浆诱导培养的脐静脉内皮细胞（ＨＵＶＥＣ）表面细胞间粘附分子－１（ＩＣＡＭ－１）、血管细胞粘附分子－１（ＶＣＡＭ－１）的表达以及川芎嗪对其的影响。方法 采用胶原酶、胰蛋白酶混合灌注消化法，对正常妊娠妇女（正常妊娠组）、妊高征患者（妊高征组）的ＨＵＶＥＣ进行培养，待细胞融合成单层后，加或不加川芎嗪进行预处理，并以正常未妊娠妇女（对照组）作为对照。再加入上述３组     

Normal expression of cell adhesion molecules in placentae from women with systemic lupus erythematosus and the antiphospholipid syndrome

Pregnant women with active systemic lupus erythematosus (SLE) and/or the antiphospholipid syndrome (APS) are prone to recurrent miscarriage, pre-eclampsia, intrauterine growth restriction and premature delivery. Placental dysfunction may account for these complications yet the mechanisms remain uncertain. Amongst these, an inflammatory response in the placental vasculature could play a role, involving recruitment of neutrophils and platelets and the increased endothelial expression of cell adhesion molecules (CAM), central to the recruitment process. The aim of this study was primarily to investigate CAM expression in the fetoplacental vasculature in women with SLE/APS. Circulating maternal concentrations of soluble CAM were also elucidated.There were no differences in CAM immunostaining in placentae from patients with SLE and/or APS compared with controls. In both patients and controls moderate immunostaining for the intercellular adhesion molecule-1 (ICAM-1) was observed in placental vascular endothelium and mild immunostaining was present in the placental villous stroma. Strong immunostaining for platelet endothelial CAM (PECAM) occured in the placental vascular endothelium whereas P-selectin was mildly expressed in the stem vessel endothelium only. Vascular CAM-1 (VCAM-1) and E-selectin were undetectable in either study or control placentae. In contrast, ICAM-1 and VCAM-1 but not E-selectin, as assessed by immunoassay (ELISA), were elevated in maternal serum from SLE/APS patients compared with controls. This study suggests that upregulation of CAM expression and subsequent activation of neutrophil and/or platelet activity within the placental villous tree is unlikely to be a mechanism by which the adverse pregnancy outcome arises in SLE/APS pregnancies. However, maternal endothelial cell activation (ECA) may play a more important role.