Maternal neutrophil apoptosis in normal pregnancy, preeclampsia, and normotensive intrauterine growth restriction.

Autor: von Dadelszen, P., Watson, R.W.G., Watson, R W, Noorwali, F, Marshall, J C, Parodo, J, Farine, D, Lye, S J, Ritchie, J W, Rotstein, O D
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Zdroj: American Journal of Obstetrics & Gynecology; Aug99, Vol. 181 Issue 2, p408-414, 7p, 2 Charts, 1 Graph
Abstrakt: Objective: In normal pregnancy there is both a neutrophilia and a mild neutrophil activation. In preeclampsia both direct and indirect evidence supports further marked neutrophil activation. In the pathogenesis of preeclampsia peripheral blood neutrophils may play a vital role in communicating between the preeclamptic placenta and the maternal vascular endothelium and contribute to the endothelial cell dysfunction that characterizes the maternal syndrome of preeclampsia. Preeclampsia shares many elements with the systemic inflammatory response syndrome. Neutrophils, key effectors of the systemic inflammatory response syndrome, are associated with hepatic necrosis and adult respiratory distress syndrome, both of which most commonly kill women with preeclampsia. We hypothesized that delayed neutrophil apoptosis could explain (1) the neutrophilia of normal pregnancy and (2) the differential maternal responses to the shared placental abnormality of preeclampsia and normotensive intrauterine growth restriction.Study Design: Neutrophils were isolated (dextran 500, Ficoll [Amersham Pharmacia Biotech AB, Uppsala, Sweden], and erythrocyte lysis) from (1) case patients with preeclampsia at Results: Compared with propidium iodide profile values in nonpregnant women (median, 25%; range, 14%-40%) neutrophil apoptosis was significantly delayed in normal pregnancy (median, 9.5%; range, 7.6%-15%) and normotensive pregnancy with intrauterine growth restriction (median, 11%; range. 9.3%-19%) and was further delayed in preeclampsia (median, 6.9%; range, 4.1%-8. 2%; P Conclusions: Impaired neutrophil apoptosis may explain the neutrophilia associated with normal pregnancy. In women with preeclampsia activated neutrophils remain in the circulation, perhaps contributing to the persistence of preeclampsia after delivery. Neutrophils appear to modulate the variation in maternal response between preeclampsia and normotensive intrauterine growth restriction. [ABSTRACT FROM AUTHOR]
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