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

本研究的目的是：1）确定在正常妊娠过程中是否存在胎龄内皮细胞功能和/或中性粒细胞活性的关键时期。以及，2）阐明内皮细胞功能和/或中性粒细胞活性在妊娠高血压中的作用。已经清楚：1）在19至22孕周的狭窄年龄范围内，观察到正常孕妇的中性粒细胞中过量的超氧化物产生显著发生。先兆子痫的特征在于存在对内皮细胞具有细胞毒性的血清因子，并且这种活性对内皮细胞具有细胞特异性。3)一种能增强超氧化物生成的中性粒细胞激活剂存在于先兆子痫中。4)在胎盘组织中发现了一种对内皮细胞有细胞毒性的因子;它似乎是一种热不稳定蛋白质，大小约为50，000道尔顿，与血清细胞毒性因子和血清中性粒细胞激活因子相似。这些发现表明，在正常妊娠过程中，循环中性粒细胞功能产生的超氧阴离子可能部分地参与了血管张力的旁分泌控制，通过抑制内皮细胞衍生的血管扩张剂，而在先兆子痫中，它是一种妊娠诱导的疾病，涉及细胞与细胞的相互作用失败，特别是发生在内皮、血小板和白色血细胞之间，以维持妊娠期间微循环系统功能的稳态。

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.