Maternal endothelial soluble cell adhesion molecules with isolated small for gestational age fetuses: comparison with pre-eclampsia

Abstract

Objective 1.To evaluate the activation profile of the endothelium in pregnancies complicated by small for gestational age fetuses compared with pre-eclampsia and normal pregnancy, by measuring the plasma levels of soluble adhesion molecules soluble E-selectin, intercellular cell adhesion molecule-1 and vascular cell adhesion molecule-1. 2. To determine whether soluble adhesion molecules were related to the severity of small for gestational age fetuses and pre-eclampsia. Design Observational study. Participants Sixteen women with small for gestational age fetuses; 15 women with pre-eclampsia and 15 healthy primigravidae were recruited as controls. Methods Plasma levels of soluble E-selectin, intercellular cell adhesion molecule-1 and vascular cell adhesion molecule-1 were measured by ELISA. Results Compared with the healthy controls, soluble E-selectin was significantly increased in both small for gestational age fetuses and pre-eclampsia, whereas intercellular cell adhesion molecule-1 and vascular cell adhesion molecule-1 were increased only in pre-eclampsia. In the small for gestational age fetuses group, soluble E-selectin correlated inversely with the ratio between birthweight and the expected normal birthweight (r ¼ -0.4, P ¼ 0.007). In the pre-eclampsia group, a significant correlation was observed between vascular cell adhesion molecule-1 and blood pressure (r ¼ 0.54, P ¼ 0.039). Conclusions Endothelial activation, reflected by raised levels of soluble E-selectin, is a feature of small for gestational age fetuses and is correlated with the severity of the disease. Differences in the profile of soluble cell adhesion molecules suggest variations in the degrees of endothelial activation between pre-eclampsia and small for gestational age fetuses.

Early pregnancy soluble E-selectin concentrations and risk of preeclampsia

“…Previous studies have reported that levels of angiogenic factors correlate with severity of disease, and one might expect the same of E-selectin levels. Bretelle et al [33] reported that E-selectin levels at term were elevated in normotensive women with small for gestational age (SGA) babies, as well as in those with preeclampsia. Further studies, comparing E-selectin levels in women with early-onset and late-onset disease, and in women with preeclampsia with SGA babies would be beneficial.…”

Microbial invasion of the amniotic cavity in preeclampsia as assessed by cultivation and sequence-based methods

“…Preeclampsia has been associated with several mechanisms of disease including defective spiral artery remodeling [15, 39, 55], endothelial cell dysfunction [13, 23, 51, 58, 84, 90, 95, 98, 112, 125], an anti-angiogenic state [4, 17, 19–21, 26, 37, 38, 40, 47, 57, 59–61, 64–68, 70, 73, 75, 78, 91, 99, 105, 115, 121, 122, 127, 130–133, 135, 146], an exaggerated intravascular inflammatory response [7, 18, 22, 45, 48, 71, 72, 76, 77, 93, 94, 97, 109, 119, 120, 128, 129, 134, 142], oxidative stress [28, 52, 82, 83, 138] and a predominantly T helper (Th1)-biased immune response [6, 10, 25, 27, 35, 62, 79, 110, 123, 126, 137, 139]. …”

Microbial invasion of the amniotic cavity in pregnancies with small-for-gestational-age fetuses

“…Proposed mechanisms of disease of SGA include endothelial cell dysfunction,[5] an anti-angiogenic state,[9, 10, 18, 25, 62, 74] inadequate physiologic transformation of the spiral arteries[7, 22] and a maternal intravascular exaggerated inflammatory response. [29, 34, 46, 70, 72] Perinatal infections, mainly of viral or parasitic origin (i.e., cytomegalovirus, rubella, herpes, toxoplasmosis, etc)[26, 28, 33, 37, 48, 51, 52, 73], have also been implicated as a cause of SGA.…”