Markers of Endothelial Injury and Dysfunction in Early- and Late-Onset Preeclampsia

Abstract

With regard to differences in the clinical symptoms of preeclampsia (PE), the degree of endothelial dysfunction may differ between early and late-onset preeclampsia (EOP and LOP). The authors of this study examined it by assessing the endothelial injury level in women with EOP (20 patients) and LOP (20 patients) and in normotensive pregnant women (20 patients) in their late second and third trimesters of pregnancy, using the two markers—the serum concentration of hyaluronan (HA) and the serum level of soluble vascular cell adhesion molecule-1 (sVCAM-1). The serum concentrations of HA and sVCAM-1 did not differ significantly between the EOP and LOP patients. However, these were statistically higher than that of the control group participants (p < 0.05; p < 0.001). A significant correlation between the levels of HA and sVCAM-1 was found both in the entire group of patients with preeclampsia (p = 0.0277) and in women with late-onset disease (p = 0.0364), but not in the patients with early-onset preeclampsia (p = 0.331). The obtained results indicated a comparable level of endothelial injury in the two types of PE. The presence of a similar degree of endothelial injury in patients with EOP and LOP should create awareness among all clinicians about the possible fatal complications in both groups of patients with PE.

Endothelial Dysfunction in Pregnancy Complications

“…However, some controversies concern the difference in the levels of sVCAM-1 in patients with EOP and LOP. In the earlier study, sVCAM-1 was found to be lower in LOP compared to EOP [39], whereas more recent studies did not show such a difference [11,40]. Moreover, the rs3181092 polymorphism of VCAM-1 was found to be associated with an increased risk of PE [41].…”

“…(1) a predisposition to PE in pregnant women with a primary endothelial dysfunction and (2) a secondary endothelial injury as a consequence of a primary impaired placental perfusion, the two main phenomena in the pathophysiology of PE [9][10][11].…”

“…Biomedicines 2021, 9, x FOR PEER REVIEW 4 of 26 ones, may be explained by this phenomenon [11,17,18]. The most characteristic clinical consequences of endothelial damage are: (1) proteinuria, (2) oedema, and (3) hypertension.…”

Special Issue “Reproductive Health Concerns for Women”

“…The outcome of early-onset is believed to be worse compared to that of late-onset. However, Kornacki's group attempted to compare the difference of the endothelial injury between the early-onset and late-onset preeclampsia [21]. It is interesting to find that there is no statistically significant difference of degree for endothelial injury, using serum concentrations of hyaluronan and serum level of soluble vascular cell adhesion molecule-1 (sVCAM-1) as tools [21].…”

“…However, Kornacki's group attempted to compare the difference of the endothelial injury between the early-onset and late-onset preeclampsia [21]. It is interesting to find that there is no statistically significant difference of degree for endothelial injury, using serum concentrations of hyaluronan and serum level of soluble vascular cell adhesion molecule-1 (sVCAM-1) as tools [21]. Finally, Vega et al found that women with IgM antibodies against the phosphatidylserine-prothrombin complex (aPS/PT) titers having higher pulse wave velocity (PWV) levels [22].…”