微小循環機能からみた妊娠時の血圧調節機構とその病的逸脱過程に関する研究

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The aim of this study were 1) To determine whether or not there would be critical periods in gestational age of endothelial cell function and/or neutrophil activity during the normal course of pregnancy. And, 2) To clarify the role of endothelial cell function and/or neutrophil activity in pregnancy-related hypertension.In the present study, it is cleared that 1) Excessive superoxide production in neutrophils from a subset of normal pregnant women is observed to occure significantly at the narrow age range of 19 to 22 gestational weeks.2) Preeclampsia is characterized by the presence of a serum factor cytotoxic to endothelial cells, and this activity has a cellular specificity for endothelial cells. 3) A neutrophil activator that enhances superoxide production is present in preeclampsia. 4) A factor cytotoxic to endothelial cells is demonstrated in placental tissues ; it seemed to be a heat-labile protein approximately 50,000 dalton in size, similar to both the serum cytotoxic factor and the serum neutrophil activator.These findings suggest that during the normal course of pregnancy, the production of superoxide anion from the function of circulating neutrophils may take, in part, paracrine control of vascular tone, through inhibiting endothelial cell-derived vasodilators, and that in preeclampsia, it is a pregnancy-induced disease involving cell-to-cell interaction failure, particularly occurring between the endothelium, platelet, and white blood cell, to maintain homeostasis of microcirculation system function during pregnancy.