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(Hypertension. 2002;39:155.)
© 2002 American Heart Association, Inc.

Scientific Contributions

Activation of Leukocytes During the Uteroplacental Passage in Preeclampsia

Jan Roar Mellembakken; Pål Aukrust; Mette Kløvstad Olafsen; Thor Ueland; Kjetil Hestdal; Vibeke Videm

From the 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 (M.K.O.); the Section of Endocrinology and Research Institute of Internal Medicine (T.U.); and the Department of Pediatric Research (K.H.), The National Hospital, University of Oslo; and from 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

Endothelial dysfunction and inflammation appear to play a major role in the pathogenesis of preeclampsia. We hypothesize that a chronic inflammation in the decidua and placenta during preeclampsia may lead to a local leukocyte activation in this compartment. Venous blood was sampled simultaneously from antecubital and uterine veins during cesarean sections in 30 women with preeclampsia, 29 with uncomplicated pregnancies, and from 17 nonpregnant women. The expression of adhesion molecules and complement-related markers on neutrophils and monocytes was analyzed by flow cytometry. In patients with preeclampsia, neutrophil expression of the integrins CD11a, CD11b, and CD11c and of the complement related markers CD35 and CD59 was significantly higher in samples from uterine than from antecubital veins. No differences were found in nonpregnant women. On monocytes the expression of the Sialyl Lewis^x antigen, the integrins CD11a, CD11c, and CD49d, and the complement-related markers CD46 and CD59 was higher in samples from uterine than from antecubital veins during preeclampsia, but not in uncomplicated pregnancies, whereas in nonpregnant women CD31 was decreased. Our findings suggest activation of neutrophils and monocytes taking place during the uteroplacental passage in preeclamptic, but not in normal pregnancies. Such a local inflammatory response involving enhanced leukocyte/endothelial interaction may contribute to the pathogenesis of this disorder.

Key Words: preeclampsia • leukocytes • cell adhesion molecules • activation analysis

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