Published Online
on January 3, 2005

A more recent version of this article appeared on February 1, 2005

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Submitted on August 26, 2004
Revised on September 18, 2004

In Preeclampsia, the Circulating Factors Capable of Altering In Vitro Endothelial Function Precede Clinical Disease

Jenny Myers^*; Gary Mires; Maureen Macleod; and Philip Baker

From the Maternal & Fetal Health Research Centre (J.M., P.B.), University of Manchester; Maternal and Child Health Sciences (G.M., M.M.), Ninewells Hospital and Medical School, Dundee, UK.

^* To whom correspondence should be addressed. E-mail: jenny.myers{at}manchester.ac.uk.

Abstract--The pathophysiology of preeclampsia involves the release of a circulating factor(s) from a hypoperfused placenta that activates the maternal endothelium. This study investigated the effect on in vitro endothelial function of plasma taken from women in whom preeclampsia subsequently developed. Women at increased risk for an adverse pregnancy outcome were identified using Doppler waveform analysis. Plasma samples (22 and 26 weeks) were incubated with myometrial vessels taken from women with uncomplicated pregnancies. Wire myography was used to study the effect of plasma on the endothelium-dependent vessel behavior. Incubation of vessels from normal pregnant women with plasma from women in whom preeclampsia subsequently developed (n=19) significantly reduced endothelium-dependent relaxation, compared with vessels incubated with plasma from normal pregnant women (n=48). This effect was demonstrable for plasma taken at 22 weeks (residual constriction 47.1±6.6% versus 32.0±4.4%, P=0.004 at 1-hour incubation; and 59.1±8.4% versus 42.3±5.9%, P=0.001 at 18-hour incubation) and 26 weeks (59.2±5.2% versus 29.1±5.6%, P<0.001 at 1 hour; and 63.3±7.6% versus 31.9 +/-7.2%, P<0.0001 at 18 hours). Endothelial-dependent relaxation was unaltered after incubation with plasma taken from women in whom normotensive intrauterine growth restriction subsequently developed (n=19). This study supports the hypothesis that plasma, from women in whom preeclampsia develops, collected weeks before diagnosis is capable of altering endothelial function.

Key words: pregnancy • preeclampsia • hypertension, pregnancy • endothelium • vasorelaxation

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