Immunological Aspects of Eclampsia and Pre-eclampsia

Redman, C. W. G.

doi:10.1007/978-94-011-8039-9_4

Cited by 26 publications

(26 citation statements)

References 125 publications

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“…It has been suggested that the failure of maternal immunomodulation may be the cause of some complications of pregnancy, e.g. pre-eclampsia, intrauterine growth retardation (IUGR) and placental abruption [3,4,8].…”

Section: Discussionmentioning

confidence: 99%

“…After a long pause, which lasts about 6-8 weeks, there is a second very deep physiological invasion of the cytotrophoblast at the beginning of the second trimester, around 14-16 weeks of gestation. The second invasion of the cytotrophoblast to spiral arteries is completed at 18-20 weeks of gestation [3,4].…”

Section: Discussionmentioning

confidence: 99%

“…It has been proposed that the activation of cell-mediated immunity may play a role in the etiology of preeclampsia. Many alterations in the adaptive immune system have been described which could contribute to the development of this syndrome [4][5][6]. During the normal course of pregnancy, the process of immunomodulation increases continuously, but it falls in pre-eclampsia [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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The concentrations of soluble HLA-G protein are elevated during mid-gestation and decreased in pre-eclampsia

Darmochwał-Kolarz

Kolarz

Roliński

et al. 2012

Folia Histochem Cytobiol.

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Abstract:The aim of our study was to investigate the dynamics of the alterations of soluble human leukocyte antigen-G (sHLA-G) concentrations in sera of healthy non-pregnant women, as well as healthy pregnant women and patients with pre-eclampsia. Thirty five patients with pre-eclampsia, 52 healthy pregnant women, and 24 healthy non-pregnant women were included in the study. Sera concentrations of sHLA-G protein were determined using the immunoenzymatic ELISA method. Statistical analysis was performed using ANOVA and Mann--Whitney U tests. The concentrations of sHLA-G protein in sera of pregnant women in the first, as well as the second and third, trimesters of normal pregnancy were significantly higher in comparison with healthy nonpregnant women. The sera concentrations of sHLA-G in pregnant women in the second trimester of pregnancy were significantly higher compared to the first and third trimesters. The concentrations of sHLA-G in sera of patients with pre-eclampsia were significantly lower than in pregnant women in the third trimester of physiological pregnancy. The results of our study suggest that normal physiological pregnancy is associated with elevated sera concentrations of sHLA-G molecule. The increased concentrations of sHLA-G molecule in mid-gestation could suggest a role for the protein in the second phase of a physiological invasion of extravillous cytotrophoblast to spiral arteries. Furthermore, the results could suggest a role for the decreased sera concentrations of sHLA-G in the pathogenesis of pre-eclampsia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The concentrations of soluble HLA-G protein are elevated during mid-gestation and decreased in pre-eclampsia

Darmochwał-Kolarz

Kolarz

Roliński

et al. 2012

Folia Histochem Cytobiol.

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“…Some stud ies [15,16] have suggested an altered adaptation of the maternal immune system to the fetus in determining this pathology. PIH would therefore represent a partial rejec tion of the fetus.…”

Section: Discussionmentioning

confidence: 99%

Cell-Mediated Immunity Imbalance in Pregnancy-Induced Hypertension

Marinoni¹,

Pità²,

Bresadola³

et al. 1994

Gynecol Obstet Invest

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Pregnancy is associated with modifications in the maternal immune system that may be involved in the absence of rejection of the fetoplacental graft characterized by the presence of paternal antigens. This active and specific tolerance towards the fetoplacental unit seems to be compromised in pregnancy-induced hypertension (PIH). To evaluate whether the immunological state in patients with PIH is altered with respect to normal pregnant women we studied 15 patients with PIH, 15 uncomplicated pregnant and 10 healthy nonpregnant women using monoclonal antibodies directed to specific lymphocyte antigen determinants, cytokines (TNF) and soluble molecules (sIL·2R, sCD8). The percentage of CD4 lymphocytes and of natural killer (NK) cells was significantly higher in PIH patients compared to controls (CD4: 42.9 ± 10.5 vs. 32.7 ± 12.5%; p < 0.05; NK: 14.7 ± 6.3 vs. 8.3 ± 3.4%; p < 0.01). However, these values did not differ when compared to normotensive nonpregnant controls (CD4: 53.1 ± 5.9%; NK: 17.2 ± 7.1%). In addition, the soluble IL·2 receptor (sIL-2R) was higher in PIH patients when compared to control patients (725.5 ± 194.2 vs. 482.5 ± 187.2 U/ml; p < 0.01). The immune response observed in normal pregnancies responsible for the tolerance towards the fetoplacental unit seems to be altered in PIH patients as suggested by higher levels of CD4 and NK cells, and sIL-2R. This may lead to a chronic rejection syndrome and be involved in the pathophysiology of PIH.

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“…Aufgrund der unterschiedlichen Erklärungsmodelle wurde die Präeklampsie in der Vergangenheit demzufolge auch als "die Krankheit der Theorien" bezeichnet, die ihren Ursprung in einer fehlerhaften Invasion der Trophoblastzellen in das Myometrium des Uterus haben könnte. Dadurch würde konsekutiv die bei der Prä-eklampsie bekannte plazentare Minderperfusion dafür verantwortlich sein, dass immunogene Substanzen in den mütterli-chen Kreislauf gelangen [40,63] und somit die für die Prä-eklampsie typischen Symptome -die sich besonders durch eine periphere Vaokonstriktion [31] auszeichnen -ausgelöst werden. Gleichzeitig tritt eine Dysbalance zwischen der Thrombozyten-und Gerinnungsaktivierung [42] und einer verminderten Synthese des intravaskulären und vasodilatierend wirkenden Prostazyklins und eine Überproduktion des vasokonstringierend wirkenden Thromboxans auf [11].…”

Section: Introductionunclassified

Prävention der Präeklampsie

Fischer¹,

Steinburg²,

Diedrich³

et al. 2005

Zentralbl Gynakol

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Preeclampsia is accompanied by high fetal and maternal morbidity and mortality and to a high degree responsible for preterm delivery. The pathophysiologic mechanisms underlying this disease remain poorly understood. Accordingly, only few causative or preventive therapeutical strategies are known. One such example for a preventive strategy is the use of aspirin (ASA) which directly affects the imbalance of vasodilative prostacycline and vasoconstrictive thromboxane. Recently, some studies are indicating a preventive effect of vitamin C and E substitution. In contrast, early antihypertensive therapy did not prevent later progression of the disease. Furthermore, sodium restriction, calcium and magnesium substitution, fish oil substitution, or steroid therapy are without any effect regarding the later development of preeclampsia. It is of utmost importance to further elucidate underlying pathophysiological mechanisms to improve therapeutical and preventive strategies.

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Immunological Aspects of Eclampsia and Pre-eclampsia

Cited by 26 publications

References 125 publications

The concentrations of soluble HLA-G protein are elevated during mid-gestation and decreased in pre-eclampsia

The concentrations of soluble HLA-G protein are elevated during mid-gestation and decreased in pre-eclampsia

Cell-Mediated Immunity Imbalance in Pregnancy-Induced Hypertension

Prävention der Präeklampsie

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