Excess syncytiotrophoblast microparticle shedding is a feature of early-onset pre-eclampsia, but not normotensive intrauterine growth restriction
Excess syncytiotrophoblast microparticle shedding is a feature of early-onset pre-eclampsia, but not normotensive intrauterine growth restriction
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DOI：
10.1016/j.placenta.2004.11.007
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发表时间：
2006-01-01
期刊：
影响因子：
3.8
通讯作者：
von Dadelszen, P
中科院分区：
文献类型：
--
作者：
Goswami, D;Tannetta, DS;von Dadelszen, P
理论基础：与正常妊娠相比，子痫前期患者合体滋养层细胞微粒(STBM)进入母体循环的数量更多，被认为是全身炎症反应和内皮细胞损伤的刺激因素，这是母体综合征的特征。STBM的过度脱落可能是由于胎盘不良导致的缺氧造成的，这通常是先兆子痫的一个特征。目的：研究正常血压的胎儿宫内生长受限(NIUGR)中STBM脱落的程度是否与子痫前期相同。方法：一项前瞻性病例对照研究。1)早发性子痫前期(EOPET<；34周)，2)晚发性子痫前期(LOPET>；=34周)，3)NIUGR(NIUGR)，4)匹配正常妊娠(NPC)，5)非妊娠妇女。采用抗滋养层细胞抗体NDOG2的酶联免疫吸附试验检测外周静脉血中STBM水平。非参数分析P<；0.05，有统计学意义。与匹配的正常妊娠(16 ng/ml，n=15；Wilcoxon p=0.005)相比，EOPET与STBM水平升高相关(EOPET中位数：41 ng/ml，n=15)。LOPET(50 ng/m l，n=10)和nIUGR(18 ng/m l，n=8)STBM水平与匹配的正常妊娠(分别为36 ng/m l，n=15和36 ng/m l，n=8)无差异。非妊娠血浆STBM水平为0.49 ng/ml，n=10。结论：EOPET患者STBM水平升高，而nIUGR患者STBM水平无明显变化，进一步证实了STBM在母体综合征发病机制中的作用。(C)2004爱思唯尔有限公司。保留所有权利。
Rationale: Syncytiotrophoblast microparticles (STBM) are shed into the maternal circulation in higher amounts in pre-eclampsia compared to normal pregnancy and are believed to be the stimulus for the systemic inflammatory response and endothelial cell damage which characterises the maternal syndrome. The excess shedding of STBM may be caused by hypoxia as a result of poor placentation, which is often a feature of pre-eclampsia. Similar placental pathology occurs in some cases of normotensive intrauterine growth restriction (nIUGR), but in the absence of maternal disease.Objective: To examine whether the shedding of STBM in nIUGR occurs to the same extent as in pre-eclampsia.Methods: A prospective case-control study in a tertiary referral centre of. 1) women with early-onset pre-eclampsia (EOPET < 34 week), 2) women with late-onset pre-eclampsia (LOPET >= 34 week), 3) women with nIUGR), 4) matched normal pregnant women (NPC), and 5) non-pregnant women. An ELISA using the antitrophoblast antibody NDOG2 was used to measure STBM levels in peripheral venous plasma. Non-parametric analyses were conducted with statistical significance set at p < 0.05.Results: STBM levels rise during normal pregnancy. EOPET was associated with increased STBM levels (EOPET (median): 41 ng/ml, n = 15) compared with matched normal pregnancy (16 ng/ml, n = 15; Wilcoxon p = 0.005). LOPET (50 ng/ml, n = 10) and nIUGR (18 ng/ml, n = 8) STBM levels did not differ from matched normal pregnancy (36 ng/ml, n = 15, and 36 ng/ml, n = 8, respectively). Background levels in non-pregnant plasma were 0.49 ng/ml, n = 10.Conclusions: Increased STBM levels were found in EOPET but not in nIUGR providing further evidence for their role in the pathogenesis of the maternal syndrome. (c) 2004 Elsevier Ltd. All rights reserved.