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(Hypertension. 1997;29:291.)
© 1997 American Heart Association, Inc.

Arthur C. Corcoran Memorial Lecture

Endothelial Adhesion Molecules and Leukocyte Integrins in Preeclamptic Patients

Hermann Haller; Eva-Maria Ziegler; Volker Homuth; Marek Drab; Jens Eichhorn; Zsuzsanna Nagy; Andreas Busjahn; Klaus Vetter; Friedrich C. Luft

From the Franz Volhard Clinic and the Max-Delbrück Center for Molecular Medicine, Virchow Klinikum, Humboldt University of Berlin; and the Department of Obstetrics, Neukölln Hospital (K.V.), Berlin, Germany.

Correspondence to Hermann Haller, MD, Franz Volhard Klinik, Wiltberg Strasse 50, 13122 Berlin, Germany. E-mail haller{at}mdc-berlin.de

Endothelial cell activation is important in the pathogenesis of preeclampsia; however, the nature of the activation is unknown. We investigated 22 patients with preeclampsia, 29 normotensive pregnancies, and 18 nonpregnant women to test the hypothesis that serum from preeclamptic patients induces expression of intercellular adhesion molecule-1 (ICAM-1) and vascular adhesion molecule-1 (VCAM-1) and stimulates intracellular free calcium concentrations [Ca²⁺]_i in cultured endothelial cells. We then asked whether the corresponding integrin adhesive counter receptors lymphocyte function-associated antigen-1 (CD11a/CD18), macrophage-1 antigen (CD11b/CD18), p150,95 (CD11c/CD18), and very late activation antigen-4 (CD49/CD29) are increased in patients with preeclampsia. In the pregnant women, the measurements were conducted both before and after delivery. Integrin expression was measured by fluorescent antibody cell sorting analysis using monoclonal antibodies. ICAM-1 and VCAM-1 were analyzed on endothelial cells by enzyme-linked immunosorbent assay. [Ca²⁺]_i was measured with fura 2. Serum from preeclamptic patients increased endothelial cell ICAM-1 expression but not VCAM-1 expression. Preeclamptic patients' serum also increased [Ca²⁺]_i in endothelial cells compared with serum from normal nonpregnant or normal pregnant women. Endothelial cell [Ca²⁺]_i concentrations were correlated with the ICAM-1 expression in preeclamptic patients (r=.80, P<.001) before but not after delivery. Expression of the integrin counter receptors on leukocytes was similarly increased in preeclampsia and normal pregnancy compared with the nonpregnant state. The expression decreased significantly after delivery in both groups. Our results demonstrate that serum from preeclamptic women induces increased ICAM-1 surface expression on endothelial cells, while the expression of the integrin counterreceptors was not different. The effect on endothelial cells may be related to an increase in [Ca²⁺]_i. The effect on cultured endothelial cells and the rapid decrease after delivery suggests the presence of a circulating serum factor which increases endothelial cell [Ca²⁺]_i and enhances adhesion molecule expression.

Key Words: preeclampsia • adhesion molecules • VCAM • ICAM • endothelial cells • integrins • leukocytes

Abbreviations: ICAM-1 = intercellular adhesion molecule-1 • LFA-1 = lymphocyte function-associated antigen-1 • MAC-1 = macrophage-1 antigen • PE = phycoerythrin • VCAM-1 = vascular adhesion molecule-1 • VLA-4 = very late activation antigen-4

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