Circulating endothelial cell adhesion molecules as diagnostic markers for the early identification of pregnant women at risk for development of preeclampsia
Circulating endothelial cell adhesion molecules as diagnostic markers for the early identification of pregnant women at risk for development of preeclampsia
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DOI：
10.1016/s0002-9378(97)70213-8
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发表时间：
1997-08-01
影响因子：
9.8
通讯作者：
Augustin, HG
中科院分区：
文献类型：
--
作者：
Krauss, T;Kuhn, W;Augustin, HG
目的：本研究的目的是确定先兆子痫期间循环内皮细胞粘附分子的水平，并评估其作为早期识别有先兆子痫风险的孕妇的诊断标记物的预测价值。溶血、肝酶升高和血小板低综合征；无并发症的妊娠高血压病；以及正常怀孕的女性。此外，随机收集孕妇的纵向血浆谱以确定循环内皮细胞粘附分子的个体谱。采用夹心酶联免疫吸附测定技术定量可溶性细胞间粘附分子-1 (CD54)、血管细胞粘附分子-1 (CD106)、E-选择素 (CD62E)、血小板内皮细胞粘附分子 (CD31) 和 P-选择素 (CD62P) 的浓度。 结果：血浆细胞间粘附分子-1、血管细胞粘附分子-1、E-选择素和血小板水平与健康对照孕妇相比，先兆子痫女性的内皮细胞粘附分子-1 显着升高。对妊娠期间可溶性血浆细胞间粘附分子-1和血管细胞粘附分子-1水平的纵向分析表明，与对照孕妇和无并发症妊娠高血压综合征的孕妇相比，这些分子（1）在健康孕妇中几乎没有变化，（2）在正常妊娠期间没有变化，（3）在先兆子痫和溶血、肝酶升高和血小板低综合征的女性中显着升高。对孕妇纵向轮廓中可溶性细胞间粘附分子-1和血管细胞粘附分子-1水平的分析发现，在临床症状出现前3至15周，先兆子痫易感女性的血浆中这些分子的水平显着升高。 结论：妊娠期间可溶性细胞间粘附分子-1和血管细胞粘附分子-1测量值升高可被视为主要危险因素。患有先兆子痫的孕妇血浆中这些物质的水平升高支持了原代内皮细胞参与先兆子痫发病机制的概念。尽管目前基于有限的数据库，但健康孕妇血浆中可溶性细胞间粘附分子-1和血管细胞粘附分子-1的水平显着升高，表明这些分子对于尽早识别有先兆子痫风险的女性具有非常高的预测价值。
OBJECTIVE: The aim of the current study was to determine levels of circulating endothelial cell adhesion molecules during preeclampsia and to assess their predictive value as diagnostic markers for the early identification of pregnant women at risk of developing preeclampsia.STUDY DESIGN: Plasma samples were obtained from women with preeclampsia; the syndrome of hemolysis, elevated liver enzymes, and low platelets; uncomplicated pregnancy-induced hypertension; and women with normal pregnancy. In addition, longitudinal plasma profiles of pregnant women were randomly collected to determine individual profiles of circulating endothelial cell adhesion molecules. A sandwich enzyme-linked immunosorbent assay technique was used to quantitate concentrations of soluble intercellular adhesion molecule-1 (CD54), vascular cell adhesion molecule-1 (CD106), E-selectin (CD62E), platelet endothelial cell adhesion molecule (CD31), and P-selectin (CD62P).RESULTS: Plasma levels of intercellular adhesion molecule-1, vascular cell adhesion molecule-1, E-selectin, and platelet endothelial cell adhesion molecule-1 were significantly elevated in women with preeclampsia compared with healthy control pregnant women. Longitudinal analysis of soluble plasma intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 levels during pregnancy revealed that these molecules (1) show little variation in healthy pregnant women, (2) do not vary during normal pregnancy, and (3) are significantly elevated in women with preeclampsia and the syndrome of hemolysis, elevated liver enzymes, and low platelets compared with control pregnant women and those with uncomplicated pregnancy-induced hypertension. Analysis of soluble intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 levels in longitudinal profiles of pregnant women identified significantly elevated levels of these molecules in the plasma of preeclampsia-prone women 3 to 15 weeks before the onset of clinical symptoms.CONCLUSION: Elevated soluble intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 measurements during pregnancy can be considered as major risk factors. Elevated levels of these substances in the plasma of pregnant women with preeclampsia support the concept of a primary endothelial cell involvement in the pathogenesis of preeclampsia. Although currently based on a limited database, significantly elevated levels of soluble intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 in the plasma of otherwise healthy pregnant women suggest a very high predictive value of these molecules for the earliest identification of women at risk of developing preeclampsia.