Research
Basic science: Obstetrics
Endothelial microparticles and the antiangiogenic state in preeclampsia and the postpartum period

Presented at the 31st annual meeting of the Society for Maternal-Fetal Medicine, San Francisco, CA, Feb. 7-12, 2011.
https://doi.org/10.1016/j.ajog.2012.06.011Get rights and content

Objective

We sought to determine if endothelial microparticles (EMPs), markers of endothelial damage, are associated with soluble fms-like tyrosine kinase 1 (sFlt1), soluble endoglin, and placental growth factor (PlGF) in women with preeclampsia.

Study Design

A prospective cohort study was conducted on 20 preeclamptic women and 20 controls. EMPs by flow cytometry, sFlt1, soluble endoglin, and PlGF were measured at time of enrollment, 48-hours postpartum, and 1-week postpartum.

Results

Preeclamptic CD31+/42, CD62E+, and CD105+ EMP levels were significantly elevated in preeclamptics vs controls at time of enrollment. The sFlt1:PlGF ratio was correlated with CD31+/42 and CD105+ EMPs (r = 0.69 and r = 0.51, respectively) in preeclampsia. Levels of CD31+/42 EMPs remained elevated 1-week postpartum (P = .026).

Conclusion

EMPs are elevated in preeclampsia. The correlation of EMPs and the sFlt1:PlGF ratio suggests that antiangiogenesis is related to apoptosis of the endothelia. Endothelial damage persists 1 week after delivery.

Section snippets

Study subjects

A prospective, case-control study was conducted on 20 preeclamptic women and 20 healthy pregnant women recruited from Parkland Memorial Hospital, Dallas, TX, and its affiliated prenatal care clinics from February 2009 through June 2010. Eligibility for enrollment included women with singleton gestations ≥36 weeks. For study subjects, the diagnosis of preeclampsia was defined as blood pressure measurement ≥140/90 mm Hg on 2 occasions within 6 hours in a previously normotensive woman and ≥2+

Results

The demographic and clinical characteristics of the study subjects are presented in the Table. There were no significant differences in maternal age, race, parity, gestational age at enrollment, or smoking. Women with preeclampsia had a significantly higher prepregnancy body mass index than control subjects (P < .015). Women with preeclampsia had a higher mean arterial blood pressure than control subjects. The mode of delivery was similar between the 2 groups. The birthweight was significantly

Comment

The findings of this study support that the antiangiogenic environment of preeclampsia is related to the degree of endothelial damage occurring at the cellular level. Levine et al5, 6 has demonstrated an increase of the antiangiogenic proteins, sFlt1 and sEnd, in women destined to develop preeclampsia and hypothesized the interaction of these proteins with PlGF and VEGF leads to an antiangiogenic environment best reflected by the sFlt1:PlGF ratio. This ratio has been shown to correlate with the

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Cited by (0)

Supported by National Institutes of Health/National Center for Research Resources Grant 5 UL1 RR024982-03, Milton Packer, MD (principal investigator).

The authors report no conflict of interest.

Reprints not available from the authors.

Cite this article as: Petrozella L, Mahendroo M, Timmons B, et al. Endothelial microparticles and the antiangiogenic state in preeclampsia and the postpartum period. Am J Obstet Gynecol 2012;207:140.e20-6.

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