Changes in Microparticle Numbers and Cellular Origin During Pregnancy and Preeclampsia
Changes in Microparticle Numbers and Cellular Origin During Pregnancy and Preeclampsia
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DOI：
10.1080/10641950801955733
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发表时间：
2008-01-01
影响因子：
1.5
通讯作者：
Nieuwland, Rienk
中科院分区：
文献类型：
--
作者：
Lok, Christine A. R.;Van Der Post, Joris A. M.;Nieuwland, Rienk
背景：微粒(MP)是来源于多种细胞的促凝血小泡。越来越多的证据表明，MP在自身免疫、心血管和血栓栓塞性疾病以及炎症性疾病中具有病理生理学意义。因此，我们研究了它们在子痫前期发病过程中的作用，发现子痫前期患者的MP影响内皮依赖性血管扩张。关于妊娠和先兆子痫期间循环MP数量变化的知识尚不清楚。我们纵向确定了这一点，并调查了这些数字是否与先兆子痫的严重程度有关。方法：采集孕妇和子痫前期患者孕期和产后标本。分离MP，并用流式细胞仪进行研究。结果：妊娠期MP在妊娠12周时下降，产后恢复正常。在先兆子痫患者中，MP数量在28周和36周时减少(P均=0.04)。单核细胞来源的MP在28周(p=0.007)、32周(p=0.02)和36周(p=0.01)时升高，而红细胞来源的MP在28周时升高(p=0.04)。胎盘来源的MP在妊娠和先兆子痫中升高。妊娠期胎盘来源的MP与血压呈正相关(r=0.33，p=0.015)。没有发现其他相关性。结论：在妊娠期，MP的数量开始减少，随后趋于正常。胎盘来源的MP增加，可能是因为胎盘的生长。在先兆子痫患者中，PMP数量减少是由于血小板计数减少。单核细胞来源的MP数量的增加反映了单核细胞的激活，这可能是子痫前期全身炎症的一种表现。MP的数量和先兆子痫的严重程度之间缺乏相关性，这表明MP的数量本身并不能解释MP对血管的影响。
Background: Microparticles (MP) are pro-coagulant vesicles derived from various cells. Evidence is accumulating that MP are of pathophysiological relevance in autoimmune, cardiovascular, and thromboembolic diseases and inflammatory disorders. Therefore, their role in the development of preeclampsia was investigated and MP from preeclamptic patients influenced endothelial-dependent vasodilatation. Knowledge about changes in circulating MP numbers during pregnancy and preeclampsia is lacking. We determined this longitudinally and investigated whether these numbers related to the severity of preeclampsia. Methods: Samples were obtained from pregnant women and preeclamptic patients during pregnancy and postpartum. MP were isolated and studied by flow cytometry. Results: During pregnancy, MP were decreased at 12 weeks gestation and then returned to postpartum values. In patients with preeclampsia, MP numbers were reduced at 28 and 36 weeks (both p = 0.04). Monocyte-derived MP were elevated in preeclampsia at 28 (p = 0.007), 32 (p = 0.02), and 36 weeks (p = 0.01), as were erythrocyte-derived MP at 28 weeks (p = 0.04). Placenta-derived MP increased in pregnancy and preeclampsia. During pregnancy, a correlation was present between placenta-derived MP and systolic blood pressure (r = 0.33, p = 0.015). No other correlations were found. Conclusions: During pregnancy, numbers of MP initially decrease and subsequently normalize. Placenta-derived MP increase, possibly because of placental growth. In preeclampsia, reduced numbers of PMP are due to decreased platelet counts. Increased numbers of monocyte-derived MP reflect monocyte activation, which may be an expression of the systemic inflammation in preeclampsia. Lack of correlation between numbers of MP and severity of preeclampsia suggests that MP numbers alone do not explain the reported vascular effects of MP.