title: Complexes of activated protein C with alpha 1-antitrypsin in normal pregnancy and in severe preeclampsia.
abstract: Protein C is a vitamin K-dependent regulator of blood coagulation. Activated protein C is regulated in plasma in large part by two inhibitors, protein C inhibitor and alpha 1-antitrypsin. Complexes of activated protein C with both inhibitors in plasma samples from subjects with normal or pathologic pregnancy were measured. In normal pregnancy we observed a progressive and significant increase in activated protein C/alpha 1-antitrypsin complex levels, from 9 +/- 3 ng/ml in the first trimester to 16 +/- 3 ng/ml in the third trimester, as well as an increase in alpha 1-antitrypsin plasma levels. In severe preeclampsia, but not in chronic hypertension with superimposed severe preeclampsia, there was a greater increase in activated protein C/alpha 1-antitrypsin levels (25 +/- 10 ng/ml) (p less than 0.001) and a decrease in protein C and protein C inhibitor levels as compared with normal pregnant women at similar gestational ages. These data show an increase in the activation of the protein C pathway in both normal and pathologic pregnancy and provide evidence for an enhancement of thrombin generation in severe preeclampsia compared with chronic hypertension with superimposed severe preeclampsia.
authors.affiliation: Research Center Hospital La Fe, Valencia, Spain.
authors.forename: F
authors.initials: F
authors.lastname: España
authors.forename: J
authors.initials: J
authors.lastname: Gilabert
authors.forename: J
authors.initials: J
authors.lastname: Aznar
authors.forename: A
authors.initials: A
authors.lastname: Estellés
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: J H
authors.initials: JH
authors.lastname: Griffin
mesh_terms: D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000032:analysis; D000704:Analysis of Variance; D001219:Aspartate Aminotransferases / Q000032:analysis; D001798:Blood Proteins / Q000032:analysis; D003404:Creatinine / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000378:metabolism; D007770:L-Lactate Dehydrogenase / Q000032:analysis; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000378:metabolism*; D011247:Pregnancy / Q000378:metabolism*; D011249:Pregnancy Complications, Cardiovascular; D011486:Protein C / Q000378:metabolism*; D018046:Protein C Inhibitor; D015842:Serine Proteinase Inhibitors / Q000032:analysis; D000515:alpha 1-Antitrypsin / Q000378:metabolism*
chemical_list: D001798:Blood Proteins; D011486:Protein C; D018046:Protein C Inhibitor; D015842:Serine Proteinase Inhibitors; D000515:alpha 1-Antitrypsin; D003404:Creatinine; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase