Correlation between placental bed biopsy findings, vascular cell adhesion molecule and fibronectin levels in pre‐eclampsia

Abstract

Objective To determine the correlation between placental bed biopsy findings, and blood levels of the vascular cell adhesion molecule (VCAM-1) and fibronectin in pre-eclampsia/eclampsia, and to evaluate the relationship between these variables and severity of the disease.Design A prospective case-control study.Setting Department of Obstetrics and Gynaecology, Cerrahpasa Medical Faculty, Istanbul.Sample Thirty-five women with pre-eclampsideclampsia were compared with 25 healthy women with uncomplicated pregnancies. Twenty-one placental bed biopsies from pre-eclamptic pregnancies were compared with 17 from normal pregnancies.Main outcome measures Peripheral venous blood levels of VCAM-1 and fibronectin, measured by enzyme-linked immunoassay and radial immune diffusion technique.Results In pre-eclampsideclampsia, blood VCAM-1 and fibronectin levels were higher than in normal pregnancy. Levels of both fibronectin and VCAM-1 correlated significantly with the diastolic blood pressure (r = 0.49 and r = 0.65, P < 0.001). There was also a significant direct linear correlation between plasma fibronectin and VCAM-1 levels ( r = 0.57, P < 0.001). Normotensive women all had normal placental bed biopsy findings and the incidence of pathological placental bed biopsy findings increased with the severity of the pre-eclampsia. ConclusionInadequate trophoblastic invasion of spiral arteries, and elevated levels VCAM-1 and fibronectin were found in women with pre-eclampsia. The magnitude of defective trophoblastic invasion, and blood levels of VCAM-1 and fibronectin correlate with the clinical severity of pre-eclampsia.

Hyperhomocyst(e)inemia and Elevated Soluble Vascular Cell Adhesion Molecule-1 Concentrations Are Associated with an Increased Risk of Preeclampsia

“…Notably, most of the inconsistencies have occurred among those studies that sought to assess maternal sVCAM-1 concentrations in pre-diagnostic blood samples [19,[21][22][23]. Results from case-control studies [17][18]20], where sVCAM-1 concentrations were determined in blood samples collected after the diagnosis of preeclampsia, have been more consistent. In their study, Higgins et al [22] noted no difference in maternal plasma sVCAM-1 concentrations (plasma samples were collected between 18 and 24 weeks' gestation).…”

“…In a large study (where maternal blood samples were collected early in pregnancy), Krauss et al [21] reported that mean maternal sVCAM-1 concentrations were statistically significantly elevated in women who subsequently developed preeclampsia. Results from case-control studies, where maternal sVCAM-1 concentrations were determined in blood samples collected after the clinical manifestation of preeclampsia, have consistently [17,18,20] indicated a positive association between the analyte and preeclampsia risk. Hence, on balance, available literature concerning the relation between sVCAM-1 concentrations and preeclampsia, though not as consistent as reports concerning the relation between tHcy concentrations and preeclampsia risk, suggest that elevated sVCAM-1 may be associated with preeclampsia.…”

Correlation of VCAM-1 expression in serum, cord blood, and placental tissue with gestational hypertension associated with fetal growth restriction in women from Xingtai Hebei, China

“…For example, ECAM-1 facilitates in the adhesion of trophoblast to the vascular endothelium during early pregnancy and mediates trophoblastic vascular invasion during the remodeling of placental vasculature; mediates the adhesion between the placental villi, cells in the decidual tissue, and peripheral blood leukocytes; and sustains the non-activation of decidual lymphocytes, preventing the immunological rejection of the fetus by the mother. Madazli et al (2000) reported a significant increase in the fibronectin and VCAM-1 levels in women with GH, which was correlated with the diastolic blood pressure. Krauss et al (1997) theorized that the increase in serum VCAM-1 levels reflected the activation of endothelial cells, but not cell injury, the factor responsible for predicting the development of GH and IUGR.…”

Associação entre a Incisura Diastólica das Artérias Uterinas e a Histologia do Leito Placentário em Grávidas com Pré-eclâmpsia

“…Os fragmentos eram assim categorizados quando não apresentavam presença de decídua e miométrio adjacente no mesmo plano de corte, ambos infiltrados, de forma inequívoca, por citotrofoblasto multinucleado. A nossa perda foi semelhante à citada na literatura por alguns autores 12,17,20 , embora um estudo 10 tenha tido uma perda de apenas 23%.…”