Platelet intracellular free calcium concentration in normotensive and hypertensive pregnancies in the human

1. Basal and stimulated platelet intracellular free calcium concentrations were measured in non-pregnant women and in third trimester patients who were either normotensive or who had pregnancy-induced hypertension or pre-eclampsia. There were 15 subjects in each group. 2. A trend for a reduction of the maximal response of platelet calcium levels to stimulation by 5-hydroxytryptamine was seen in pregnant groups compared with nonpregnant subjects, but this was significant only in pre-eclampsia. 3. No significant differences in basal or adenosine 5'-pyrophosphate-stimulated levels of platelet intracellular free calcium concentration were observed between the four groups. 4. These results illustrate that basal platelet calcium levels are unchanged in hypertension of pregnancy. Alterations in basal platelet calcium levels may not be involved in the platelet activation that is a feature of pre-eclampsia.     

The effects of posture on abnormalities of forearm venous tone in women with pregnancy-induced hypertension

1. Forearm venous tone was measured in the left lateral supine position and in response to passive leg elevation in a group of women with pregnancy-induced hypertension and compared with a group of normotensive pregnant women and a group of non-pregnant women. 2. The women with pregnancy-induced hypertension were venoconstricted in the supine position compared with the normal pregnant women (P less than 0.002). There was no difference in forearm venous tone between the women with pregnancy-induced hypertension and the non-pregnant women. 3. In response to passive leg elevation the women with pregnancy-induced hypertension venodilated (P less than 0.002) whereas there was no change in forearm venous tone in the normotensive pregnant women and the non-pregnant women. There was no change in blood pressure in any of the women after 35 min of leg elevation. 4. These results demonstrate that the abnormal venous vasoconstriction that occurs in women with pregnancy-induced hypertension in the supine position is corrected by passive leg elevation, a manoeuvre which leads to an increase in central blood volume.     

Serum from healthy pregnant women reduces oxidative stress in human umbilical vein endothelial cells

This study was conducted to compare the effects of serum from healthy pregnant women and that from pregnant women with pre-eclampsia on oxidative stress in endothelial cells in culture. Human umbilical vein endothelial cells (HUVECs) were incubated with serum from 18 pre-eclamptic, 18 healthy pregnant and 18 healthy non-pregnant women for 24 h. The levels of reduced glutathione (GSH) and lipid peroxides (LPOs) were measured in endothelial cell lysates. Measurement of malondialdehyde in combination with 4-hydroxyalkenals has been used as an indicator of LPOs. Serum from healthy pregnant women decreased significantly the LPO content in HUVECs in comparison with serum from pre-eclamptic women and healthy non-pregnant women (30.7+/-6.6 compared with 39.3+/-10.9 and 41.0+/-12.7 pmol/mg of protein respectively; P<0.003 and P<0.01 respectively). No differences in GSH content between the three groups (18.3+/-2.1 nmol/mg of protein for healthy pregnant, 19.2+/-3.3 nmol/mg for pre-eclamptic and 18.3+/-2.0 nmol/mg for healthy non-pregnant women) were found. Thus serum from normal pregnant women contains a factor(s) that decreases oxidative stress in human endothelial cells. This mechanism might be altered in pre-eclampsia.     

Bovine endothelial cells in culture produce thromboxane as well as prostacyclin.

Bovine aortic endothelial and smooth muscle cells in culture were incubated with arachidonic acid or prostaglandin H2. The amount of prostacyclin nd thromboxane A2 synthesized ws then determined by specific radioimmunoassay for 6-keto-prostaglandin F1 alpha and thromboxane B2. Although smooth muscle cells produced only 6-keto-prostaglandin F1 alpha and thromboxane B2 in a ratio of 5:1 to 10:1. The same ratio of these metabolites of arachidonic acid ws also found when prostaglandin production from endogenous arachidonic acid was stimulated in endothelial cells by the ionophore A23187. Cyclooxygenase inhibitors inhibited the production of both metabolites equally, whereas thromboxane synthetase inhibitors selectively inhibited the production of thromboxane B2. Cells in culture were also incubated with [1-14C]arachidonic acid and the extracted products were identified by two-dimensional thin-layer chromatography. 6-Keto-prostaglandin F1 alpha was the only metabolite produced by smooth muscle cells, but endothelial cells synthesized 6-keto prostaglandin F1 alpha, thromboxane B2, prostaglandin E2, and prostaglandin F2 alpha.     

Prostaglandin I2 is not a major metabolite of arachidonic acid in cultured endothelial cells from human foreskin microvessels

Prostaglandin I2 (PGI2), a potent vasodilator and inhibitor of platelet aggregation, is a major product of arachidonic acid metabolism in endothelial cells that are derived from large blood vessels (e.g., umbilical veins). We have examined whether PGI2 is also a major product of arachidonic acid metabolism in cultured endothelial cells that are derived from dermal microvessels in human newborn foreskin. Supernatants from confluent monolayers of endothelial cells that had been incubated for 20 min with [3H]arachidonic acid and the calcium ionophore A23187 (10 microM) were assayed for prostaglandin F2 alpha (PGF2 alpha), prostaglandin E2 (PGE2), and 6-keto-prostaglandin F1 alpha (PGF1 alpha) (the stable metabolite of PGI2) by using authentic standards and high performance liquid chromatography. Whereas supernates from stimulated umbilical vein endothelial cells contained 6-keto-PGF 1 alpha much greater than PGF 2 alpha much greater than PGE2, supernates from stimulated foreskin microvessel endothelial cells contained PGF 2 alpha congruent to PGE2 much greater than 6-keto-PGF 1 alpha. Similar results were obtained when supernates from stimulated, unlabeled endothelial cells were analyzed by radioimmunoassay. These data indicate that PGI2 is not a major metabolite of arachidonic acid in cultured endothelial cells from human foreskin microvessels.     

Release of prostacyclin after erythrocyte adhesion to cultured vascular endothelium

Endothelial cell damage is considered to be the initial step in the genesis of thrombosis and atherosclerosis. Recently, the adhesion of erythrocytes from patients with diabetes or sickle cell anemia to endothelial cells was found to be increased and correlated with the severity of vascular complications. We have measured by radioimmunoassay the release of 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) as an index of prostacyclin (PGI2) production, during red cell adhesion to endothelial cells in culture. The amount of 6-keto-PGF1 alpha released after incubation with normal red cells was similar to that observed with buffer (1.07 +/- 0.32 nmol/10(6) endothelial cells). However, after the adhesion of erythrocytes from patients with diabetes or sickle cell anemia, the amount of 6-keto-PGF1 alpha produced was significantly increased (P less than 0.01) and was correlated with the extent of erythrocyte adhesion (P less than 0.05). Tritium-labeled PGI2 was found to bind to erythrocytes, and the binding was time and concentration dependent. PGI2 release was inhibited by the cyclooxygenase inhibitor (flurbiprofen), whereas red cell adhesion remained unchanged. Fibrinogen potentiated erythrocyte adhesion and PGI2 production. The increase in PGI2 production after the adhesion of red cells from patients with diabetes or sickle cell anemia to endothelial cells indicates that endothelium may be damaged by abnormal erythrocyte adhesion.     

Inhibition of prostacyclin by treatment of endothelium with aspirin. Correlation with platelet adherence.

Aspirin treatment of cultured endothelial cells from the umbilical vein increased the adherence of 51Cr-platelets when thrombin was present. If the cyclooxygenase activity of endothelium was inhibited by aspirin, as it is in the platelet, reduction of endogenous prostacyclin (PGI2) production could have been responsible. By correlating thrombin-induced adherence of platelets to endothelial monolayers with PGI2 release (as measured by radioimmunoassay for 6-keto-prostaglandin FI1 alpha [6-keto-PGF1 alpha]), we have demonstrated an inverse relationship between platelet adherence and PGI2 levels. Untreated endothelial monolayers exposed to thrombin and platelets resulted in 4% platelet adherence and 107 nM 6-keto-PGF1 alpha. With 0.1 mM aspirin treatment, which is known to block platelet cyclooxygenase, adherence was 5% and 6-keto-PGF1 alpha decreased to 45 nM. Increasing the aspirin concentration to 1 mM resulted in 44% adherence and less than 3 nM 6-keto-PGF1 alpha. When 25 nM exogenous PGI2 was added to 1 mM aspirin-treated endothelium, adherence returned to 5%. The increase in thrombin-induced platelet adherence to 1 mM aspirin-treated monolayers was reversed 2 h after removal of the aspirin solution. 6-Keto-PGF1 alpha returned to 37% of the untreated monolayer value. Recovery from the aspirin effect did not occur when cycloheximide, an inhibitor of protein synthesis, was present during the 2-h period.     

Capillary permeability and extracellular fluid volumes in pregnancy-induced hypertension

1. Capillary permeability was determined by the disappearance rate of Evans Blue dye from plasma in healthy non-pregnant women, normal third-trimester primigravidae and primigravidae with pregnancy-induced hypertension. 2. Extracellular fluid volume was determined from the disappearance curves of injected mannitol in the same subjects and the plasma volume was measured by the Evans Blue dye dilution technique. 3. In normal pregnancy capillary permeability was not altered from that of non-pregnant subjects. Although extracellular fluid volume and plasma volume were increased in normal pregnant compared with non-pregnant women, the distribution of fluid between plasma volume and interstitial fluid volume was unaltered. 4. Women with established pregnancy-induced hypertension had a more rapid Evans Blue disappearance rate and a lower plasma volume than normal pregnant women, independent of the presence of proteinuria. Maternal plasma volume correlated positively and significantly with fetal birth weight in women with pregnancy-induced hypertension, emphasizing the important relationship between maternal plasma volume and fetal outcome. 5. The increased capillary permeability in women with pregnancy-induced hypertension was associated with a reduction in the plasma volume/interstitial fluid volume ratio but a normal extracellular fluid volume, suggesting that the reduced plasma volume did not result from sodium loss but rather from a redistribution of the total extracellular fluid volume. These changes did not differ significantly in subgroups with and without oedema.     

Abnormalities of peripheral venous tone in women with pregnancy-induced hypertension

Forearm venous tone was measured in two groups of pregnant women: one group with pregnancy-induced hypertension and the other group with normal blood pressure. The women with pregnancy-induced hypertension were venoconstricted in the forearm (P less than 0.01) compared with the pregnant women with normal blood pressure. However, there was no difference in venous tone between the women with pregnancy-induced hypertension and non-pregnant women. There was an inverse correlation between mean arterial blood pressure and forearm venous tone (r = -0.581, P less than 0.001) for all the pregnant women studied. Further evaluation of peripheral venous tone may provide valuable information about the pathophysiology and treatment of women with pregnancy-induced hypertension.     

Arachidonic acid and prostaglandin endoperoxide metabolism in isolated rabbit and coronary microvessels and isolated and cultivated coronary microvessel endothelial cells.

Isolated microvessels and isolated and cultured microvessel endothelial cells were prepared from rabbit cardiac muscle. Pathways of arachidonic acid metabolism were determined by measurement of exogenous substrate utilization [( 1-14C]arachidonic acid incorporation and release from intact tissue and cells; [1-14C]prostaglandin H2 (PGH2) metabolism by broken cell preparations) and by quantification of endogenous products (immunoreactive 6-keto-prostaglandin F1 alpha (PGF1 alpha) and prostaglandin E (PGE) release) by selective radioimmunoassay. Rabbit coronary microvessels and derived microvascular endothelial cells (RCME cells) synthesized two major products of the cyclooxygenase pathway: 6-keto-PGF1 alpha (hydrolytic product of prostaglandin I2) and PGE2. A reduced glutathione requiring PGH-E isomerase was demonstrated in coronary microvessels and RCME cells, but not in rabbit circumflex coronary artery or aorta. In addition, a minor amount of a compound exhibiting similar characteristics to 6-keto-PGE1 was found to be produced by microvessels and RCME cells. Measurement of endogenously released prostaglandins indicated that under basal and stimulated conditions, PGE release exceeded that of 6-keto-PGF1 alpha. Microvessels and microvessel endothelial cells derived from cardiac muscle of rabbit exhibit pathways of arachidonate metabolism that are different from those of many large blood vessels and derived endothelial cells.     

Effects of lipoproteins from pre-eclamptic women on umbilical endothelial cell 6-oxo-prostaglandin f1alpha and endothelin 1 synthesis, and nitric oxide synthase 3 mRNA expression

In order to evaluate whether lipid abnormalities may contribute to endothelial dysfunction in pre-eclampsia, the present study examined the in vitro effects of very-low-density lipoprotein (VLDL), low-density lipoprotein (LDL) and high-density lipoprotein (HDL), isolated from women with pre-eclampsia and matched controls, on the endothelial synthesis of 6-oxo-prostaglandin F(1alpha) (6-oxo-PGF(1alpha); a metabolite of prostacyclin) and endothelin 1, and on the expression of nitric oxide synthase 3 (NOS3) mRNA. VLDL, LDL and HDL cholesterol were isolated from 20 pre-eclamptic and 20 age- and gestation-matched normal pregnant women. The lipoproteins (50 microgram/ml) and lipoprotein-free control plasma were incubated for 1, 3 and 6 h at 37 degrees C with a human umbilical endothelial cell line. The synthesis of 6-oxo-PGF(1alpha) and endothelin 1, and NOS3 mRNA expression, were measured at each time point. VLDL from pre-eclamptic women stimulated endothelial cell 6-oxo-PGF(1alpha) synthesis to a lesser extent than that from normal pregnant women (P<0.05). LDL from women with pre-eclampsia also stimulated 6-oxo-PGF(1alpha) synthesis to a lesser extent than LDL from normal pregnant women, but the effect was less sustained. The effect of HDL from women with pre-eclampsia on 6-oxo-PGF(1alpha) synthesis was similar to that of HDL from normal pregnant women. The pre-incubation levels of lipid peroxides in VLDL and LDL were not different between the normal pregnant and pre-eclamptic women, and cannot account for the decrease in 6-oxo-PGF(1alpha) synthesis. VLDL, LDL and HDL from women with pre-eclampsia did not affect endothelial cell synthesis of endothelin 1 or expression of NOS3 mRNA differently from lipoproteins from normal pregnant women. This study suggests that VLDL, and to a lesser extent LDL, from women with pre-eclampsia could potentially contribute to the reduced systemic 6-oxo-PGF(1alpha) synthesis observed in the pre-eclamptic syndrome.     

Expression of inflammation-related genes in endothelial cells is not directly affected by microparticles from preeclamptic patients

BACKGROUND: Inflammation and endothelial dysfunction are prominent in preeclampsia. Microparticles (MPs) may link these processes, as MPs induce the production of pro-inflammatory cytokines by endothelial cells and cause endothelial dysfunction. AIM: To study changes in expression of inflammation-related genes in human endothelial cells in response to MPs from preeclamptic patients. METHODS: Human umbilical vein endothelial cells (HUVECs) were incubated for various time intervals in the absence or presence of isolated MP fractions from preeclamptic patients (n = 3), normotensive pregnant women (n = 3), non-pregnant controls (n = 3), and interleukin (IL)-1alpha as a positive control. Total RNA was isolated and used for multiplex ligation-dependent probe amplification (MLPA) and real-time polymerase chain reaction (PCR). RESULTS: IL-1alpha enhanced the expression of IL-1alpha, IL-2, IL-6, and IL-8; nuclear factor of kappa light chain enhancer in B-cells (NFkappaB)-1, NFkappaB-2, and NFkappaB-inhibitor; cyclin-dependent kinase inhibitor and monocyte chemotactic protein-1; and transiently increased tissue factor expression. RNA expression of inflammation-related genes and genes encoding adhesion receptors, however, were unaffected by any of the MP fractions tested. CONCLUSION: MLPA is a suitable assay to test the inflammatory status of endothelial cells, because incubation with IL-1alpha triggered substantial changes in RNA expression in endothelial cells. Taken together, it seems unlikely that MPs from preeclamptic patients induce endothelial dysfunction by directly affecting the expression of inflammation-related genes in these cells.     

Effect of angiotensin-converting enzyme inhibitors on glomerular eicosanoid production in normotensive and spontaneously hypertensive rats.

1. This study was designed to examine the production of certain eicosanoids (prostaglandin E2), prostacyclin (as 6-keto-prostaglandin F1 alpha) and thromboxane A2 (as thromboxane B2) by glomeruli isolated from normotensive Wistar-Kyoto and spontaneously hypertensive rats both before and after the administration of one of three angiotensin-converting enzyme inhibitors, captopril, enalapril or fosinopril, for 10 days. 2. Measurements of glomerular eicosanoid production were made under basal conditions and in the presence of excess exogenous arachidonic acid. 3. The production of prostaglandin E2, 6-keto-prostaglandin F1 alpha and thromboxane B2 was greater by glomeruli from untreated spontaneous hypertensive rats (prostaglandin E2 2.24 +/- 0.41, 6-keto-prostaglandin F1 alpha 1.20 +/- 0.13 and thromboxane B2 2.75 +/- 0.43 ng 10 min-1 mg-1 of protein) than by those from Wistar-Kyoto rats (prostaglandin E2 1.41 +/- 0.28, 6-keto-prostaglandin F1 alpha 0.98 +/- 0.11 and thromboxane B2 1.29 +/- 0.24 ng 10 min-1 mg-1 of protein) under basal conditions. However, these differences only achieved statistical significance for thromboxane B2 (P less than 0.01). Similar strain-related differences were noted in the presence of arachidonic acid. 4. The ratio of glomerular (prostaglandin E2 + prostacyclin)/thromboxane A2 production was significantly lower in spontaneously hypertensive rats than in their normotensive counterparts under basal conditions with values of 1.3 +/- 0.18 and 2.2 +/- 0.20, respectively (P less than 0.01). 5. Angiotensin-converting enzyme inhibitors induced significant changes in the glomerular production of some eicosanoids, which differed both between strains and with the nature of the inhibitor.(ABSTRACT TRUNCATED AT 250 WORDS)     

脐血流监测对妊娠期高血压疾病孕妇妊娠结局的意义探讨

目的探讨妊娠期高血压患者胎儿脐动脉血流阻力指标对围产儿结局的影响。方法用粘度仪检测正常妊娠孕妇及妊娠期高血压孕妇血浆粘度(PV);用离心机检测红细胞压积(HCT)等;统计分析其妊娠中期(20~27周)及妊娠晚期(28~36周),并测定收缩期最大血流速度和舒张期血流速度的比值(S/D)和脉搏指数(PI)、阻力指数(RI)。探讨血液流变学各值与胎儿脐动脉血流指标相关性。结果妊娠高血压组妊娠中、晚期S/D、PI及RI值与正常妊娠组比较均有统计学差异。随着病情进展,中度、重度妊娠高血压组RI、PI值逐渐升高。妊娠期高血压病患者血液HCT、PV等值与胎儿脐动脉血流阻力指标各值呈正相关。结论 HCT、PV对妊娠期高血压病的发生、发展、严重程度及脐动脉血流阻力指标可能有重要影响。多项指标监测妊娠期高血压病患者血液流变学及胎儿脐动脉血流动力学,可提高预测妊娠期高血压症发生、发展及严重程度及其对围产儿预后影响的准确性。     

妊娠期高血压病患者血液流变学与脐血流阻力指标的关系

目的：探讨妊娠期高血压病患者血液流变学与胎儿脐动脉血流阻力指标的相关性和对围产儿结局的影响。方法：用粘度仪检测正常妊娠孕妇及妊娠期高血压病孕妇全血比粘度高切（BVH）、全血比粘度低切（BVL）、全血还原比粘度（BRV）、血浆粘度（PV）;用离心机检测红细胞压积（HCT）;应用彩色多普勒超声检测胎儿脐动脉血流阻力指标,探讨妊娠期高血压病患者血液流变学各值与胎儿脐动脉血流阻力指标各值的相关性。结果：妊娠期高血压病患者血液流变学各值与胎儿脐动脉血流阻力指标各值呈正相关。子痫前期组围产儿结局不良发生率明显高于妊娠高血压组（P〈0.01）及正常妊娠组（P〈0.01）。结论：HCT、BVH、BVL、PV对妊娠期高血压病的发生、发展、严重程度及脐动脉血流阻力指标可能有重要影响。多项指标监测妊娠期高血压病患者血液流变学及胎儿脐动脉血流动力学,可提高预测妊娠期高血压病发生、发展及严重程度及其对围产儿预后影响的准确性。     

Do heart rate and velocity variability derived from umbilical artery velocity waveforms change prior to clinical pregnancy-induced hypertension?

OBJECTIVE: To investigate the hypothesis that alterations in heart rate variability, peak systolic velocity variability and time-averaged velocity variability in the human umbilical artery may predict early signs of dysfunctional fetal-placental coupling in pregnancies that later develop pregnancy-induced hypertension. METHODS: Doppler flow velocity recordings from the umbilical artery were performed at 10-20 weeks of gestation in 12 nulliparous women who subsequently developed pregnancy-induced hypertension. From umbilical artery velocity waveforms of at least 12 s in duration we determined absolute values and beat-to-beat variability in fetal heart rate, peak systolic and time-averaged velocity and compared these findings with those in normal nulliparous pregnant women matched for gestational age. RESULTS: Absolute values for fetal heart rate, peak systolic and time-averaged velocity as well as beat-to-beat variability in fetal heart rate did not differ significantly between women later developing pregnancy-induced hypertension and normal controls. However, variability in peak systolic velocity and time-averaged velocity were decreased in women who subsequently developed pregnancy-induced hypertension. CONCLUSIONS: Whereas fetal heart rate variability was similar, umbilical artery flow velocity variability was reduced in women developing pregnancy-induced hypertension compared with controls. It is proposed from this study that variability of the umbilical artery flow velocity is associated with mechanical changes in the vascular bed of women who later develop pregnancy-induced hypertension.     

The effect of pregnancy on the control of lipolysis in fat cells isolated from human adipose tissue.

1. Lipolysis has been estimated by measuring the release of glycerol in isolated adipose tissue cells obtained from women in early prognancy, late pregnancy and 1 - 3 days post partum and from non-pregnant women. 2. Adipocytes of women at the end of pregnancy exhibited higher rates of lipolysis in response to adrenaline (1.5 - 15 muM) plus phentolamine (13 muM) than those of non-pregnant women or those in early pregnancy. 3. Lipolysis in response to adrenaline plus phentolamine in fat cells from women 1 - 3 days post partum was reduced compared to that at the end of gestation but was enhanced relative to that in the non-pregnant or early pregnant state. 4. Basal lipolysis also tended to be greatest at term. 5. Under conditions where the production of cyclic AMP was not rate limiting for the stimulation of lipolysis, that is in the presence of dibutyryl cyclic AMP (1 mM) or adrenaline (15 muM) plus phentolamine (13 muM) plus caffeine (1 mM), the release of glycerol in cells from women at term and in the puerperium was greater than that in women in the non-pregnant or early pregnant state. 6. Cell levels of cyclic AMP rose after incubation with adrenaline (6 muM) plus phentolamine or adrenaline (15 muM) plus phentolamine plus caffeine (1 mM) but were similar in all four groups of women. 7. It is concluded that the observed enhancement of lipolysis demonstrated in fat cells from women at the end of pregnancy reflects an increase in hormone-sensitive lipase activity rather than a modification of hormone receptor site sensitivity or of the rates of synthesis or breakdown of cyclic AMP. 8. This increase in adipose tissue lipolysis at the end of gestation could contribute to the reported rise in plasma nonesterified fatty acids in the final weeks of pregnancy.     

Serum digoxin-like substances in pregnancy-induced hypertension

1. Endogenous digoxin-like immunoreactivity (EDLI) was measured in the serum of 85 normotensive pregnant (NTP) women and 77 women with pregnancy-induced hypertension (PIH) by a radioimmunoassay (New England Nuclear). All women were in the third trimester. 2. EDLI, which was undetectable in serum from non-pregnant women, was present in NTP and PIH and was significantly higher in PIH. EDLI correlated with gestational age in NTP, but not in PIH. 3. Ouabain-sensitive Na+ transport was estimated in normal peripheral blood leucocytes after incubation with sera from 50 NTP and 42 PIH women. Significant inhibition of active Na+ transport occurred only with the serum of hypertensive patients without proteinuria. 4. EDLI did not correlate with the effect of the sera on active Na+ transport. The radioimmunoassay therefore provides a poor index of Na+ transport inhibitory activity in PIH.     

The Effect of Pregnancy on the Control of Lipolysis in Fat Cells Isolated from Human Adipose Tissue

Abstract. 1. Lipolysis has been estimated by measuring the release of glycerol in isolated adipose tissue cells obtained from women in early prognancy, late pregnancy and 1–3 days post partum and from non-pregnant women. 2. Adipocytes of women at the end of pregnancy exhibited higher rates of lipolysis in response to adrenaline (1. 5–15 μM) plus phentolamine (13 μM) than those of non-pregnant women or those in early pregnancy. 3. Lipolysis in response to adrenaline plus phentolamine in fat cells from women 1–3 days post partum was reduced compared to that at the end of gestation but was enhanced relative to that in the non-pregnant or early pregnant state. 4. Basal lipolysis also tended to be greatest at term. 5. Under conditions where the production of cyclic AMP was not rate limiting for the stimulation of lipolysis, that is in the presence of dibutyryl cyclic AMP (1 mM) or adrenaline (15 yM) plus phentolamine (13 μM) plus caffeine (1 mM), the release of glycerol in cells from women at term and in the puerperium was greater than that in women in the non-pregnant or early pregnant state. 6. Cell levels of cyclic AMP rose after incubation with adrenaline (6 μM) plus phentolamine or adrenaline (15 μM) plus phentolamine plus caffeine (1 mM) but were similar in all four groups of women. 7. It is concluded that the observed enhancement of lipolysis demonstrated in fat cells from women at the end of pregnancy reflects an increase in hormone-sensitive lipase activity rather than a modification of hormone receptor site sensitivity or of the rates of synthesis or breakdown of cyclic AMP. 8. This increase in adipose tissue lipolysis at the end of gestation could contribute to the reported rise in plasma nonesterified fatty acids in the final weeks of pregnancy.     

Serum levels of adhesion molecules in women with pregnancy-induced hypertension

In a matched pair study, we investigated the serum levels of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), platelet endothelial cell adhesion moleculae-1 (PECAM-1) and P-selectin in 40 nulliparous patients with pregnancy-induced hypertension (PIH) and in 40 normotensive pregnant controls by using an enzyme-linked immunosorbent assay (ELISA). Multivariate logistic regression models were used to analyze the influence of elevated serum levels of adhesion molecules on the occurrence of PIH and on the association with the severe form of the disease. The median serum levels of ICAM-1, VCAM-1 and PECAM-1 were significantly elevated in women with PIH compared to controls (296 and 222 ng/ml, p = 0.003, 633 and 505 ng/ml, p = 0.02 and 7.7 and 6.6 ng/ml, p < 0.0001, respectively), whereas the differences of the median serum levels of P-selectin were not significantly between groups. In a multivariate logistic regression model, the serum levels of ICAM-1 and PECAM-1 revealed a significant influence on the occurrence of PIH versus healthy pregnant women (p = 0.04 and p = 0.006, respectively), whereas VCAM-1 and P-selectin serum levels were not associated with the occurrence of pregnancy-induced hypertension (p = 0.3 and p = 0.2, respectively). In a multivariate logistic regression model, the serum levels of PECAM-1 were associated with severe disease (p = 0.002). Our data indicate that the expression of ICAM-1 and PECAM-1 is upregulated in patients with pregnancy-induced hypertension. Elevated serum levels of PECAM-1 were associated with the development of severe disease.