Plasminogen activator inhibitors (PAI-1 and PAI-2) in normal pregnancies, pre-eclampsia and hydatidiform mole.
OBJECTIVE
To examine the behaviour of the major inhibitors of fibrinolysis (PAI-1 and PAI-2) in normal pregnancy and pregnancy complicated by either pre-eclampsia or hydatidiform mole.


METHODS
Prospective study.


METHODS
Antenatal Clinic and Maternity Hospital.


METHODS
Eleven women with established pre-eclampsia and eleven women, matched by age, parity, and duration of pregnancy who were undergoing uncomplicated pregnancy. Two women having surgery for hydatidiform mole.


METHODS
Plasma levels of PAI-1 and PAI-2 antigens determined by sensitive specific ELISA. Functional identification of PAI-2 by nondenaturing gel electrophoresis with overlay zymography.


RESULTS
In pre-eclampsia PAI-2 antigen was significantly lower than in normal pregnancy (105.3 +/- 34.9 versus 187.1 +/- 67.9 ng/ml; P < 0.001). In contrast PAI-1 antigen was significantly higher in pre-eclampsia than in normal pregnancy (170.7 +/- 71.2 versus 113.8 +/- 35.6 ng/ml; P < 0.05). In consequence the ratio of PAI-1/PAI-2 increased markedly in pre-eclampsia (2.5 versus 0.6). No PAI-2 was detected in plasma of women with hydatidiform moles.


CONCLUSIONS
PAI-2 levels fell significantly in pre-eclampsia probably as a result of decreased placental mass or function. The raised PAI-1 level in pre-eclampsia may reflect a response to hypertension or renal damage that is not specific to pregnancy or may reflect altered placental function. The use of the ratio of PAI-1/PAI-2 assists in separating normal from abnormal pregnancies.
Department of Medicine and Therapeutics, Foresterhill, Aberdeen, UK.
A
A
Reith
N A
NA
Booth
N R
NR
Moore
D J
DJ
Cruickshank
B
B
Bennett
D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000097:blood*; D008423:Maternal Age; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D017396:Plasminogen Activator Inhibitor 2 / Q000097:blood*; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies; D014594:Uterine Neoplasms / Q000097:blood*
D017395:Plasminogen Activator Inhibitor 1; D017396:Plasminogen Activator Inhibitor 2