Maternal serum nitric oxide levels associated with biochemical and clinical parameters in hypertension in pregnancy

OBJECTIVES: To measure maternal serum concentrations of total nitrites, as an index of nitric oxide synthesis, in normal and hypertensive pregnant women, and to examine the correlation between these concentrations and several variables of clinical interest. STUDY DESIGN: A total of 60 women in four different groups were studied: 10 normotensive pregnant women, 17 pregnant women with preeclampsia, 18 pregnant women with gestational hypertension and 15 pregnant women with chronic hypertension. Serum nitrite levels were determined using the Griess reaction after reduction with nitrate reductase. RESULTS: Serum nitrite levels were higher in preeclamptic women (34.11+/-14 micromol/l, P=0.04), lower in chronic hypertensive women (19.56+/-6.46 micromol/l, P=0.04) and similar in women with gestational hypertension (26.97+/-9.44 micromol/l) in comparison to the control group (25.37+/-7.24 micromol/l). Serum nitrite levels in preeclamptic women had significant positive correlations with hematocrit, fasting insulinemia, and apolipoprotein B and negative correlations with platelet count, serum phosphorus and glucose:insulin ratio. In pregnant women with chronic hypertension a negative correlation was found between serum nitrite levels and active partial thromboplastin time. In pregnant women with gestational hypertension, serum nitrite levels had negative correlations with birthweight and 24-h urine calcium, and positive correlations with mean corspuscular hemoglobin, 24-h urine sodium and maternal age. CONCLUSIONS: We suggest that in women with preeclampsia, a higher maternal nitric oxide level may act as a compensatory mechanism against hemoconcentration and platelet aggregation and that nitric oxide production may be related to some metabolic events. In women with gestational hypertension, higher serum nitrite levels may be related to clinical and biochemical findings common in preeclampsia. In chronic hypertension, a lower maternal nitric oxide level is related to the status of coagulation.     

Neuropeptide Y and nitrite levels in preeclamptic and normotensive gravid women.

OBJECTIVES: Vascular tone is controlled largely by the sympathetic nervous system and is modulated by neuropeptide Y. Preeclampsia is linked to sympathetic overactivity. Nitric oxide can cause vasorelaxation of vessels or decrease sympathetic outflow by activating the baroreceptor reflex. Our purpose in this study was to compare serum levels of neuropeptide Y and nitrite levels in normotensive and preeclamptic gravid women. STUDY DESIGN: Twelve preeclamptic and 12 normotensive women matched for race, body mass index, parity, and gestational age were studied. Neuropeptide Y was measured by using a commercial radioimmunoassay. Nitric oxide was converted to nitrite by using metallic cadmium, and nitrite levels were determined spectrophotometrically by using a colorimetric assay. Data are presented as mean +/- SEM and were compared by using a t test. RESULTS: Neuropeptide Y levels were similar among preeclamptic and normotensive gravid women (33.8 +/- 3.0 and 32.2 +/- 3 pg/mL, respectively). Similarly, there were no differences in nitrite concentrations between preeclamptic and normotensive patients (11.6 +/- 0.8 vs 11.2 +/- 0.4 micromol/L, respectively). We also examined the ratios of neuropeptide Y and nitrite and found no correlation between preeclamptic and normotensive women. CONCLUSION: Peripheral levels of neuropeptide Y or nitrite do not correlate with preeclampsia. Assessment of sympathetic overactivity in preeclampsia requires an alternate model.     

Cerebrospinal fluid nitric oxide level changes in preeclampsia

OBJECTIVE: The purpose of this study was to determine the level of nitric oxide (NO) metabolites, nitrite and nitrate in human cerebrospinal fluid (CSF) and serum and to assess whether there is any relationship among CSF, serum nitrate-nitrite levels and preeclampsia. STUDY DESIGN: Twenty-one preeclamptic and 27 healthy pregnant women as control group who underwent cesarean section (C/S) were included in the study. Before administering local anesthetic for spinal anesthesia, 2 ml CSF and 4 ml venous blood sample were taken. CSF and serum total nitrite, direct nitrite and nitrate levels were determined spectrophotometrically. RESULTS: CSF total nitrite, direct nitrite and nitrate levels were significantly different between the two groups (21.00+/-1.68, 8.28+/-0.89 and 12.71+/-1.08 micromol/l, respectively versus 15.53+/-1.49, 5.57+/-0.39 and 9.96+/-1.45 micromol/l, respectively, P<0.05). Significantly higher serum nitrate level was found (31.84+/-2.31 micromol/l) in the control group compared to the preeclamptic group serum nitrate level (25.06+/-2.02 micromol/l). Statistical comparisons were performed by the Mann-Whitney U-test. CONCLUSION: CSF-NO is significantly higher but serum NO is lower in preeclamptic group compared with control group may suggest independent regulation of NO in the two compartments. The determination of CSF-NO metabolites could be useful to clarify whether increased NO production is predominantly associated with poor perfusion of the brain in preeclampsia.     

Nitric oxide production with preeclampsia

OBJECTIVE: To clarify production of nitric oxide with pre-eclampsia. METHODS: Production of nitric oxide and elimination of its metabolites, nitrite and nitrate, determines ultimately the level of those metabolites in plasma of subjects whose diets lack them. We measured simultaneously plasma levels and renal clearance of nitrite and nitrate in 20 women with preeclampsia and in 21 healthy pregnant women. Fifteen preeclamptic gravidas were receiving antihypertensive medication and five received betamethasone 1-4 days before the study. Subjects were prescribed low nitrite and nitrate diets for 24 hours and fasted overnight before collection of plasma and urine samples. Nitrite and nitrate were measured spectrophotometrically by Griess reaction. RESULTS: Preeclamptic women had significantly higher plasma levels of nitrite and nitrate (18.1+/-6.2 micromol/L versus 13.0+/-4.3 micromol/L, mean+/-standard deviation [SD], P = .009), which because renal clearance did not differ (0.6+/-0.3 versus 0.7+/-0.3 mL/s), indicated increased production of nitric oxide with preeclampsia that was unaffected by antihypertensives or betamethasone. The mean plasma level of endothelin-1 was increased (5.1+/-1.4 versus 3.6+/-1.0 pg/mL, P < .001), and urinary output of the prostacyclin metabolite 2,3-dinor-6-keto-prostaglandin F1alpha was decreased (39.1+/-18.0 versus 61.3+/-35.6 ng/mmol creatinine, P = .019) with preeclampsia. These two endothelial markers showed no relation to plasma nitrite and nitrate. CONCLUSION: Nitric oxide production was increased with preeclampsia. The biologic significance of increased production is unknown, but it might be compensation for the vasoconstriction of preeclampsia.     

Maternal circulating nitrite levels are decreased in both normal normotensive pregnancies and pregnancies with preeclampsia.

OBJECTIVE: To evaluate whether maternal nitric oxide synthesis in pregnancies with preeclampsia is different from that in normal normotensive pregnancies. MATERIALS: Maternal circulating combined nitrate and nitrite levels or nitrite level were compared between 10 normotensive nonpregnant women, 30 normotensive pregnant women (10 first-trimester, 10 second-trimester, and 10 third-trimester pregnancies), 20 normotensive postpartum women (10 at 1 week after delivery, and 10 at 4 weeks after delivery), and 13 preeclamptic women (32 to 40 weeks' gestation). End-products of nitric oxide synthesis were measured from maternal venous blood samples using a fluorometric assay. RESULTS: Maternal circulating nitrite levels in nonpregnant women (1.13 +/- 0.22 microM) were significantly higher than those in the first-trimester pregnant women (0.68 +/- 0.13 microM), second-trimester pregnant women (0.65 +/- 0.13 microM), third-trimester pregnant women (0.48 +/- 0.17 microM), first puerperal week women (0.36 +/- 0.16 microM), and fourth puerperal week women (0.67 +/- 0.17 microM), respectively (p < 0.05). Maternal circulating nitrite level was decreased with advancing gestation, still remained low just after delivery, and was increased 4 weeks later. There was no significant difference in maternal circulating nitrite level between preeclamptic women (0.40 +/- 0.17 microM) and third-trimester pregnant women (0.48 +/- 0.17 microM). However, there were no significant differences in maternal circulating combined nitrate and nitrite levels among the groups. CONCLUSION: These results suggest that the maternal nitric oxide synthesis is not changed in normal normotensive pregnancies and pregnancies with preeclampsia. However, plasma nitrite level, which has stronger spasmolytic activity than the activity of the nitrate, was decreased in both normal normotensive pregnancies and pregnancies with preeclampsia.     

Measurement of the total antioxidant response in preeclampsia with a novel automated method

OBJECTIVES: Preeclampsia is one of the most serious complications of pregnancy. Free radical damage has been implicated in the pathophysiology of this condition. In this study, we aimed to measure the antioxidant capacity in plasma samples from normotensive and preeclamptic pregnant women to evaluate their antioxidant status using a more recently developed automated measurement method. STUDY DESIGN: Our study group contained 42 women, 24 of whom had preeclampsia, while 18 had normotensive pregnancies. We measured the total plasma antioxidant capacity for all patients, as well as the levels of four major individual plasma antioxidant components; albumin, uric acid, ascorbic acid and bilirubin, and as a reciprocal measure, their total plasma peroxide levels. RESULTS: Statistically significant differences (determined using Student's t-test) were noted between the normotensive and the preeclamptic groups for their total antioxidant responses and their vitamin C levels (1.31 +/- 0.12 mmol versus 1.06 +/- 0.41 mmol Trolox eq./L; 30.2 +/- 17.83 micromol/L versus 18.1 +/- 11.37 micromol/L, respectively), which were both considerably reduced in the preeclamptic patients. In contrast, the total plasma peroxide levels were significantly elevated in this group (49.8 +/- 14.3 micromol/L versus 38.8 +/- 9.6 micromol/L). CONCLUSIONS: We found a decreased total antioxidant response in preeclamptic patients using a simple, rapid and reliable automated colorimetric assay, which may suitable for use in any routine clinical biochemistry laboratory, and considerably facilitates the assessment of this useful clinical parameter. We suggest that this novel method may be used as a routine test to evaluate and follow up of the levels of oxidative stress in preeclampsia.     

Neurokinin B peptide serum levels are higher in normotensive pregnant women than in preeclamptic pregnant women

OBJECTIVES: The purpose of this study was to examine neurokinin B levels in serum from preeclamptic and normotensive and to investigate the role of neurokinin B in preeclampsia. STUDY DESIGN: Peripheral and uterine venous blood neurokinin B levels were measured in 14 normotensive and 8 preeclamptic pregnant women by radioimmunoassay. RESULTS: Neurokinin B levels in normotensive women were 4.91 +/- 2.67 nmol/L in peripheral and 5.59 +/- 2.06 nmol/L in uterine blood. In pregnant women with preeclampsia, neurokinin B levels were 2.79 +/- 1.68 nmol/L and 3.20 +/- 1.55 nmol/L, respectively. Neurokinin B levels were significantly higher in normotensive women (P=.032 in peripheral and P=.006 in uterine blood). CONCLUSIONS: Neurokinin B serum levels were higher in normotensive women. Higher neurokinin B concentrations in normotensive pregnant women may be due to the advanced gestational age and/or the result of a negative interaction of other vasoactive substances. The role of neurokinin B in preeclampsia remains to be determined.     

Embryonic Production of Nitric Oxide and Its Role in Implantation: A Pilot Study

PURPOSE: To investigate the ability of human embryos to produce nitric oxide (NO) and correlate its production with embryo quality and pregnancy rate. METHODS: Twenty-three women participated in the study and were submitted to controlled ovarian stimulation and intracytoplasmic sperm injection. Embryos were singularly cultured in medium microdrops of 50 microL and were replaced, by transcervical transfer, at the 2- to 6-cell stage. In the culture media of each embryo the NO production was assessed by monitoring the levels of its stable oxidation products (nitrites/nitrates). RESULTS: All the 23 patients underwent embryo transfer. After microinjection 64 embryos were obtained. The mean number of transferred embryos was 2.61 +/- 0.46 and the pregnancy rate was 26%. The mean nitrite/nitrate concentrations of culture medium of each embryo was significantly higher (5.88 +/- 2.34 micromol/L) than in pure P-1 medium (0.81 +/- 0.21 micromol/L; p < 0.001) demonstrating an embryonic secretion of NO. Comparing pregnant (7.34 +/- 2.72 micromol/L) versus nonpregnant patients (5.53 +/- 1.49 micromol/L; p = 0.022), the mean nitrite/nitrate concentrations were significantly higher. Furthermore, the best quality embryos of pregnant women produced significantly higher nitrite/nitrate concentrations than those of not pregnant patients. CONCLUSIONS: It seems that NO production in nidating embryos is increased and that it may be primarily associated with a better morphology and a better growth potential of developing embryos.     

Nitric oxide in the uteroplacental, fetoplacental, and peripheral circulations in preeclampsia.

OBJECTIVE: Altered production of nitric oxide by the vascular endothelium may influence the pathogenesis of preeclampsia. The aim of this study was to measure circulating levels of nitric oxide metabolites (nitrites) in the uteroplacental, fetoplacental, and peripheral circulation of preeclamptic pregnancies compared with normotensive controls. METHODS: Fifteen women with preeclampsia were compared with 16 women with normotensive pregnancies. At cesarean, blood samples were taken from the uterine vein draining the placental site, the umbilical vein, and the antecubital vein after delivery of the baby but before delivery of the placenta. Plasma nitrites were measured using the Greiss reaction after conversion of plasma nitrates to nitrites using nitrate reductase. RESULTS: Nitric oxide metabolites were higher in the uteroplacental (P < .01), fetoplacental (P < .001), and peripheral (P < .02) circulations in samples from preeclamptic pregnancies compared with control pregnancies. In samples from the fetoplacental circulation only, nitric oxide metabolite levels were negatively correlated with gestational age (r = -.489, P < .01) and birth weight (r = -.544, P < .004). Nitric oxide metabolite levels were not significantly correlated with blood pressure, placental weight, or maternal age. CONCLUSION: In established preeclampsia, production of nitric oxide was higher in the uteroplacental, fetoplacental, and peripheral circulation than in normotensive pregnancies. This increase may be part of a compensatory mechanism to offset the pathologic effects of preeclampsia.     

Adrenomedullin levels in normal and preeclamptic pregnancy at term

OBJECTIVE: To describe maternal plasma levels of adrenomedullin (AM), a hypotensive and natriuretic peptide, in normal and preeclamptic women at term. STUDY DESIGN: Maternal plasma AM levels were determined in 13 preeclamptic and 15 normotensive primigravidas by radioimmunoassay. Plasma samples were obtained with the patients in the lateral recumbent position before the administration of any medications. RESULTS: Women with preeclampsia had significantly elevated AM levels when compared with normotensive controls (42.3 +/- 10.5 pg/mL versus 16.9 +/- 3.1 pg/mL, P < .011). CONCLUSION: In this pilot study, AM levels were significantly increased at term in preeclamptic women.     

Cerebrospinal fluid leptin levels in preeclampsia: relation to maternal serum leptin levels

BACKGROUND: To determine whether cerebrospinal fluid (CSF) and circulating levels of leptin differ between women with preeclampsia and women who had an uncomplicated pregnancy. METHODS: Maternal serum and CSF leptin concentrations obtained in the third trimester of the gestation were compared in 16 women with mild preeclampsia and 23 normotensive pregnant women who underwent cesarean section. Before administering local anesthetic for spinal anesthesia, 2 mL CSF and 4 mL venous blood sample were taken and were stored at -30 degrees C until serum and CSF leptin levels were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: Mean CSF leptin concentrations were not significantly different between the two groups (preeclampsia 9.7 +/- 4.2 ng/mL, normotensive 13.6 +/- 4.3 ng/mL, p = 0.952). Similarly, mean serum leptin concentrations were similar between the two groups (mild preeclampsia 21.7 +/- 7.1 ng/mL, normotensive 18.3 +/- 6.7 ng/mL, p = 0.698). CSF leptin levels are inversely related to the serum leptin concentrations in preeclamptic patients (r = -0.87, p = 0.000). An inverse relationship was also detected between CSF and serum leptin levels in normotensive pregnant subjects (r = -0.66, p = 0.000). CONCLUSIONS: CSF and serum leptin levels were similar in patients with preeclampsia and normotensive pregnant women. However, the CSF leptin was negatively correlated with the serum leptin concentrations in preeclamptic and normotensive control subjects, suggesting that leptin enters the brain by a saturable transport system. Further work is needed to confirm our findings.     

The comparison of amino-terminal probrain natriuretic peptide levels in preeclampsia and normotensive pregnancy

OBJECTIVE: The purpose of this study was to evaluate the levels of amino-terminal probrain natriuretic peptide (Nt pro-BNP) in preeclampsia in comparison with normotensive pregnancy. MATERIALS AND METHODS: Women with preeclampsia (proteinuria > or = 300 mg/24 h and at least two readings of systolic blood pressure > or = 140 mm Hg and diastolic blood pressure > or = 90 mm Hg) (n = 32 mild preeclampsia and n = 8 severe preeclampsia) were compared with normotensive women (n = 40). Serum Nt pro-BNP was measured using an electrochemiluminescence immunoassay (ECLIA) method (Nt pro-BNP, Roche) with a Roche modular analytics E170 immunoassay analyzer. Statistical analysis was carried out by the Student t-test, and a P value of <0.05 was accepted as statistically significant. RESULTS: The median serum Nt pro-BNP was 430+/-28.91 pg/mL in preeclampsia. The levels of serum Nt pro-BNP were 74+/-16.82 pg/mL in normotensive pregnant women (P < 0.001) and significantly higher in women with preeclampsia (P < 0.001). CONCLUSION: The higher levels of serum Nt pro-BNP in preeclamptic women may be an indicator of high left-ventricular filling pressure, and indicate left-ventricular diastolic dysfunction.     

Ischemia-modified albumin as an oxidative stress marker in preeclampsia

Objective.?We examined serum ischaemia-modified albumin (IMA) levels in normal pregnant and preeclamptic women. The primary aim of our study was to assess IMA in women with mild and severe preeclampsia.

Methods.?Serum ischaemia-modified albumin levels were measured in 18 normotensive and 36 preeclamptic pregnant women by enzyme linked immuno-sorbent assay. Patients were subdivided as having either mild (n?=?18) or severe preeclampsia (n?=?18). Receiver operating characteristic curve was constructed, and sensitivity and specificity were calculated based on the best cut-off.

Results.?IMA levels were significantly higher in the mild and severe preeclamptic groups than in the control group. IMA with a cut-off point of 0.31 identified women with preeclampsia with sensitivity 80% and specificity 77.8%.

Conclusion.?Our study demonstrates that serum levels of IMA correlate with severity of preeclampsia.     

Lipid and protein oxidation and antioxidant function in women with mild and severe preeclampsia

OBJECT: The aim of this study was to evaluate the lipid and protein oxidation and antioxidant function in preeclampsia patients and in normotensive pregnant women, as well as, to assess an association with the severity of the disease. METHOD: The study was carried out in 30 patients with mild preeclampsia, 30 with severe preeclampsia, and in 50 normotensive pregnant women during the third trimester of pregnancy. Lipid peroxides in serum, placental and decidual tissues and serum protein carbonyls and some of the antioxidants were measured by spectrophotometric methods. One-way analysis of variance, chi-square test and Pearson correlation test were used for the statistical analyses. Logistic regression procedures were used to calculate odds ratios (OR). RESULTS: Lipid peroxides in serum, placenta and decidua basalis and protein carbonyls in serum were significantly increased, and vitamin E and total carotene levels in serum were significantly decreased especially in women with severe preeclampsia compared with mild preeclampsia and controls. A significant correlation was detected between diastolic blood pressure and lipid peroxides in serum, placental and decidual tissues and serum protein carbonyls. Furthermore, there was significant correlation between antioxidant vitamins and lipid and protein oxidation products in severe preeclamptic patients. Also, logistic regression analysis showed that changes in serum, placental and decidual lipid peroxides and serum protein carbonyls, vitamin E and total carotene concentrations were significantly associated with preeclampsia. CONCLUSION: Our findings suggest that lipid and protein oxidation may be an important factor in the pathogenesis of preeclampsia. Since antioxidant vitamins are significantly decreased in both severe and mild preeclamptic pregnants, early supplementation with antioxidants may be beneficial in preeclamptic patients.     

The effects of placental extracts from normotensive and preeclamptic women on vasoconstriction and oxidative metabolism

OBJECTIVE: A circulating factor derived from the placenta has been implicated in the pathogenesis of preeclampsia. The aim of this study was to determine whether placental extracts from normotensive women and women with preeclampsia increase oxidative metabolism and histamine-induced vasoconstriction in porcine carotid artery. STUDY DESIGN: Placental extracts from normotensive women and women with preeclampsia were applied to porcine carotid artery, and oxidative metabolism was measured. Histamine-induced isometric force responses were also determined in the absence and presence of placental extracts. RESULTS: Application of placental extracts to porcine carotid artery caused a fall in oxygen tension, which reflects increased consumption. Extracts from placentas taken from women with preeclampsia caused a greater fall than those from normotensive women (0.117 +/- 0.026 vs 0.018 +/- 0.0024 micromol oxygen per milligram; P < or =.01). Histamine-induced contractions were potentiated by extracts from preeclampsia but not from those of women without hypertension. The maximal steady-state force values were 13,137 +/- 3647, 12,921 +/- 3684, and 21,673 +/- 7189 N/m(-2) for control, normotensive, and preeclamptic samples at 10-micromol/L histamine (P < or =.05, compared with control placental extracts). CONCLUSIONS: Placental extracts from women with preeclampsia cause a greater stimulation of porcine artery oxygen consumption and exacerbation of histamine-induced vasoconstriction than extracts from normotensive women.     

Bioactivity of serum hCG in preeclampsia

OBJECTIVE: To compare hCG levels, obtained by biologic and immunologic means, in women with normal pregnancies and women with preeclampsia. METHODS: Peripheral blood samples from women in the third trimester with preeclampsia (n = 30) or normal pregnancies (n = 30) were assayed for immunoactive and bioactive hCG (mouse Leydig cell testosterone production assay). RESULTS: Serum bioactive hCG levels tended to be lower than normal, and immunoactive hCG levels tended to be higher in women with preeclampsia, but the differences were not statistically significant. However, the ratio of bioactive to immunoactive hCG was significantly lower than normal for preeclamptic women (0.70 +/- 0.28 vs. 1.15 +/- 0.35 for normotensive pregnant women [mean +/- standard deviation], P <.001). CONCLUSION: The ratio of bioactive to immunoreactive serum hCG is lower among preeclamptic than among normotensive pregnant women.     

Relation between serum uric acid and plasma adenosine levels in women with preeclampsia

The aim of this study was to examine the relationship between plasma adenosine and serum uric acid levels in women with preeclampsia. Maternal arterial blood sampling was performed to measure serum uric acid and plasma adenosine levels in 20 pregnant women complicated by preeclampsia and 22 normal pregnant women at 33-38 weeks of gestation. The average plasma adenosine levels were 0.31 +/- 0.12 micromol/l in the normal pregnant group and 0.45 +/- 0.11 micromol/l in the preeclampsia group. The mean serum uric acid level in women with preeclampsia was 5.9 +/- 0.60 mg/dl, significantly higher than in the normal pregnant women (4.4 +/- 0.69 mg/dl). Positive correlations were found between serum uric acid and plasma adenosine levels in both the group with (r(2) = 0.38, p < 0.05) and the group without (r(2) = 0.54, p < 0.05) preeclampsia. There was also a significant correlation between serum uric acid and plasma adenosine levels on the whole (r(2) = 0.59, p < 0.05). Our results suggest that increased adenosine is a contributing source of preeclamptic hyperuricemia.     

Hyperhomocysteinaemia: a risk factor for preeclampsia?

Preeclampsia represents one of the most frequent complications of pregnancy, however, little is known about its aetiology. Damage of the endothelial layer lining the blood vessel wall is thought to play an important role in the pathophysiology of preeclampsia, accordingly, mild hyperhomocysteinaemia has been reported to be more prevalent among preeclamptic women. Therefore, we investigated the role of hyperhomocysteinaemia in preeclampsia by measuring plasma levels of homocysteine and studying the prevalence of the 677(C-->T) polymorphism in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene, which may lead to reduced MTHFR enzyme activity and subsequently to higher plasma homocysteine levels.Plasma samples of 10 healthy non-pregnant women, 10 normotensive pregnant women, and 20 women with preeclampsia were analysed for total homocysteine levels by high performance liquid chromatography. Furthermore, 167 Dutch non-pregnant women previously hospitalised for preeclampsia and 403 population-based controls were analysed for the 677(C-->T) polymorphism by polymerase chain reaction followed by restriction fragment length polymorphism analysis (PCR/RFLP).In normotensive pregnancy homocysteine levels were lower compared with levels in healthy non-pregnant controls (8.4 versus 13.7micromol/l, P<0.001). Women with preeclampsia showed higher concentrations than women during normotensive pregnancy (13.3 versus 8.4micromol/l, P<0.02). However, levels of homocysteine in preeclampsia were comparable to those found in healthy non-pregnant women. PCR/RFLP showed no significant difference in the incidence of the 677(C-->T) polymorphism in the MTHFR gene between preeclamptic women with or without HELLP syndrome and controls (13 and 9% homozygous for the less common T-allele, respectively; OR 1.5, 95% CI 0.8-2.6, P=0.17).In contrast with previous reports, we cannot confirm that mild hyperhomocysteinaemia is a risk factor for preeclampsia. Pregnancy induced hyperhomocysteinaemia found in preeclampsia might better be explained by fluctuations in plasma volume than by the presence of the 677(C-->T) polymorphism in the MTHFR gene.     

Serum soluble Fas levels in preeclampsia

OBJECTIVE: To determine if serum soluble Fas levels are altered in women with preeclampsia. METHODS: Thirty-four pregnant women with preeclampsia and 34 normotensive pregnant women were studied. Subjects were matched as much as possible for demographics. Preeclampsia was defined as proteinuric hypertension. Serum soluble Fas levels were measured by enzyme-linked immunoassay. Two-tailed Student t test, chi(2) test, Pearson correlation coefficients, and analysis of variance with post hoc test were used for statistical analyses. RESULTS: Mean serum soluble Fas levels were significantly higher in preeclamptic than normotensive women (10.59 +/- 0.68 U/mL versus 5.65 +/- 0.35 U/mL, P <.001). CONCLUSION: Elevated serum soluble Fas is associated with preeclampsia. Such elevation might indicate protection of maternal T-lymphocyte apoptosis and consequently lead to the maternal immune intolerance noted in preeclampsia.     

Plasma IL-4, IL-8, IL-12, interferon-γ and CRP levels in pregnant women with preeclampsia,and their relation with severity of disease and fetal birth weight

Objective: The aim of the present study was to evaluate the hypothesis that preeclampsia is associated with increased systemic inflammatory responses of Th1-type as well as decreased Th2-type responses compared with normal pregnancy. We also sought to determine whether there was a correlation between these markers with severity of preeclampsia and fetal birth weight. Methods: The study population consisted of maternal age, gestational age, and body mass index matched 138 pregnant women; 56 normotensive healthy pregnant women (group 1), 42 women with mild preeclampsia (group 2), 40 women with severe preeclampsia (group 3). Results: Plasma interleukin (IL)-8 and C-reactive protein (CRP) levels were significantly higher in group 3 than group 1 (p?<?0.05). Plasma IL-4, IL-12, and interferon (IFN)-γ levels were similar in all groups. Although plasma IL-8 and CRP levels of mild preeclamptic group were higher than control group and lower than severe preeclamptic group, the differences were not statistically significant. There was a positive correlation between IL-12 and fetal birth weight in severe preeclamptic group (p?<?0.05). Conclusions: Elevated maternal serum pro-inflammatory cytokine IL-8 and CRP in severe preeclamptic women compared with normal pregnant women supports the hypothesis that preeclampsia is associated with increased inflammatory responses.