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(Hypertension. 2001;38:394.)
© 2001 American Heart Association, Inc.

Scientific Contributions

Chemokines and Leukocyte Activation in the Fetal Circulation During Preeclampsia

Jan Roar Mellembakken; Pål Aukrust; Kjetil Hestdal; Thor Ueland; Thomas Åbyholm; Vibeke Videm

Departments of Pediatric Research and Obstetrics and Gynecology (J.R.M.), the Section of Clinical Immunology and Infectious Diseases and Research Institute of Internal Medicine (Medical Department) (P.A.), the Department of Pediatric Research (K.H.), the Section of Endocrinology and Research Institute of Internal Medicine (T.U.), and the Department of Obstetrics and Gynecology (T.Å.), The National Hospital, University of Oslo, Oslo, Norway; and the Department of Immunology and Transfusion Medicine, Institute of Laboratory Medicine, Norwegian University of Science and Technology (V.V.), Trondheim, Norway.

Correspondence to Jan Mellembakken, MD, Department of Obstetrics and Gynecology, The National Hospital, 0027 Oslo, Norway. E-mail jan.mellembakken{at}rikshospitalet.no

Abstract—— Preeclampsia is a potentially life-threatening disease for both mother and fetus. Endothelial dysfunction is pivotal in the pathogenesis of this disorder, possibly reflecting a state of persistent inflammation. In the present study, we examined whether signs of inflammation with production of chemokines and leukocyte activation were present in the fetal circulation during preeclampsia. Venous cord blood was sampled during cesarean sections from 36 neonates born after uncomplicated pregnancies and from 35 born after severe preeclamptic pregnancies with premature newborns. The expression of adhesion molecules on neutrophils and monocytes was analyzed by flow cytometry, and plasma levels of chemokines and soluble adhesion molecules were analyzed by enzyme immunoassay. Newborns of preeclamptic mothers had increased expression of CD15s (P=0.003), CD49d/CD29 (P=0.01/0.005), and CD31 (P=0.007) on neutrophils and CD15s (P<0.001), CD11c (P=0.009), and CD54 (P=0.001) on monocytes. This activation of neutrophils and monocytes was accompanied by raised plasma levels of the CXC chemokines interleukin-8 (P=0.007) and growth-related oncogene- (P=0.01) and decreased plasma levels of soluble E-selectin (P=0.001) and L-selectin (P=0.002). Although raised levels of adhesion molecules on leukocytes or decreased levels of soluble adhesion molecules in plasma were not related to prematurity or the degree of preeclampsia, raised interleukin-8 levels were found only in neonates of preeclamptic mothers with the highest blood pressures. Our findings suggest the activation of neutrophils and monocytes in the fetus during preeclampsia involving enhanced chemokine activation, possibly contributing to the fetal morbidity of this disorder.

Key Words: preeclampsia • circulation • leukocytes • peptides

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