Preeclampsia at term : evidence of disease heterogeneity based on the profile of circulating cytokines and angiogenic factors

Published by Elsevier Inc..

BACKGROUND: Intravascular inflammation and an antiangiogenic state have been implicated in the pathophysiology of preeclampsia. On the basis of the profiles of their angiogenic/antiangiogenic factors, women with preeclampsia at term may be classified into 2 subgroups with different characteristics and prevalence of adverse outcomes. This study was undertaken to examine whether these 2 subgroups of preeclampsia at term also show differences in their profiles of intravascular inflammation.

OBJECTIVE: This study aimed to determine the plasma profiles of cytokines and chemokines in women with preeclampsia at term who had a normal or an abnormal angiogenic profile.

STUDY DESIGN: A nested case-control study was conducted to include women classified into 3 groups: women with an uncomplicated pregnancy (n=213) and women with preeclampsia at term with a normal (n=55) or an abnormal (n=41) angiogenic profile. An abnormal angiogenic profile was defined as a plasma ratio of placental growth factor and soluble fms-like tyrosine kinase-1 multiple of the median <10th percentile for gestational age. Concentrations of cytokines were measured by multiplex immunoassays.

RESULTS: Women with preeclampsia at term and an abnormal angiogenic profile showed evidence of the greatest intravascular inflammation among the study groups. These women had higher plasma concentrations of 5 cytokines (interleukin-6, interleukin-8, interleukin-12/interleukin-23p40, interleukin-15, and interleukin-16) and 7 chemokines (eotaxin, eotaxin-3, interferon-γ inducible protein-10, monocyte chemotactic protein-4, macrophage inflammatory protein-1β, macrophage-derived chemokine, and thymus and activation-regulated chemokine compared to women with an uncomplicated pregnancy. By contrast, women with preeclampsia at term and a normal angiogenic profile, compared to women with an uncomplicated pregnancy, had only a higher plasma concentration of monocyte chemotactic protein-4. A correlation between severity of the antiangiogenic state, blood pressure, and plasma concentrations of a subset of cytokines was observed.

CONCLUSION: Term preeclampsia can be classified into 2 clusters. One is characterized by an antiangiogenic state coupled with an excessive inflammatory process, whereas the other has neither of these features. These findings further support the heterogeneity of preeclampsia at term and may explain the distinct clinical outcomes.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:230

Enthalten in:

American journal of obstetrics and gynecology - 230(2024), 4 vom: 05. Apr., Seite 450.e1-450.e18

Sprache:

Englisch

Beteiligte Personen:

Chaiworapongsa, Tinnakorn [VerfasserIn]
Romero, Roberto [VerfasserIn]
Gomez-Lopez, Nardhy [VerfasserIn]
Suksai, Manaphat [VerfasserIn]
Gallo, Dahiana M [VerfasserIn]
Jung, Eunjung [VerfasserIn]
Berry, Stanley M [VerfasserIn]
Awonuga, Awoniyi [VerfasserIn]
Tarca, Adi L [VerfasserIn]
Bryant, David R [VerfasserIn]

Links:

Volltext

Themen:

144589-93-5
Adverse perinatal outcome
Angiogenesis Inducing Agents
Antiangiogenic factor
Biomarkers
Cytokines
EC 2.7.10.1
Eclampsia
Elevated liver enzymes and low platelet (HELLP) syndrome
Future cardiovascular disease
Hemolysis
Hypertensive disease in pregnancy
Imbalance of angiogenic factors
Journal Article
Maternal morbidity
Monocyte Chemoattractant Proteins
Multiplex
Placenta Growth Factor
Placental growth factor (PlGF)
Soluble fms-like tyrosine kinase-1 (sFlt-1)
Subclassification
Subtype
Vascular Endothelial Growth Factor Receptor-1

Anmerkungen:

Date Completed 05.04.2024

Date Revised 05.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.ajog.2023.10.002

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM363002022