Distinct inflammatory profile in preeclampsia and postpartum preeclampsia reveal unique mechanisms†
- 13 July 2018
- journal article
- research article
- Published by Oxford University Press (OUP) in Biology of Reproduction
- Vol. 100 (1), 187-194
- https://doi.org/10.1093/biolre/ioy164
Abstract
Preeclampsia (PE) is a poorly understood pregnancy complication. It has been suggested that changes in the maternal immune system may contribute to PE, but evidence of this remains scarce. Whilst PE is commonly experienced pre-partum, it can also occur in the postpartum period (postpartum PE-PPPE), and the mechanisms involved are unknown. Our goal was to determine whether changes occur in the maternal immune system and placenta in pregnancies complicated with PE and PPPE, compared to normal term pregnancies. We prospectively recruited women and collected blood samples to determine the circulating immune profile, by flow cytometry, and assess the circulating levels of inflammatory mediators and angiogenic factors. Placentas were collected for histological analysis. Levels of alarmins in the maternal circulation showed increased uric acid in PE and elevated high-mobility group box 1 (HMGB1) in PPPE. Analysis of maternal immune cells revealed distinct profiles in PE vs PPPE. PE had increased percentage of lymphocytes and monocytes whilst PPPE had elevated NK and NK-T cells as well. Elevated numbers of immune cells (CD45 + ) were detected in placentas from women that developed PPPE, and those were macrophages (CD163 + ). This works reveal changes within the maternal immune system in both PE and PPPE, and indicates a striking contrast in how this occurs. Importantly, elevated immune cells in the placenta of women with PPPE strongly suggest a prenatal initiation of the pathology. A better understanding of these changes will be beneficial to identify women at high risk of PPPE and to develop novel therapeutic targets.Keywords
Funding Information
- Ste-Justine Hospital Foundation
- Réseau Québécois en Reproduction
- Fonds de Recherche Québec Santé
- Preeclampsia Foundation of Canada
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