Proteases and their inhibitors are indicative in gestational disease.
OBJECTIVE
To assess whether various proteolytic factors which are involved in trophoblast invasion show different concentrations in plasma and placenta of patients with HELLP syndrome, pre-/eclampsia and highly pathological Doppler flow measurements but without additional complications (hpD).


METHODS
Case control and observational study; 18 women with HELLP syndrome, 21 with pre-/eclampsia, 13 with hpD, as well as healthy pregnant women (matched pairs); statistical analysis: sign test and Wilcoxon test.


RESULTS
Urokinase-type plasminogen activator (uPA), uPA receptor, tissue-type plasminogen activator (tPA), plasminogen activator inhibitor 1 (PAI-1), matrix metalloproteinases MMP-8, MMP-9 and tissue inhibitor of metalloproteinases TIMP-1 were measured by ELISA. PAI-1 plasma levels are significantly elevated in all three groups studied. In HELLP syndrome, tPA and TIMP-1 are also elevated, and in patients with hpD, MMP-8 is increased, whereas MMP-9, and TIMP-1 are lower. In placenta extract, only pre-/eclampsia shows reduced MMP-9 concentrations.


CONCLUSIONS
The increased frequency of small-for-gestational-age infants observed in all three study groups is an expression of impaired placental implantation and remodelling processes. These disturbances manifest themselves in the form of changes in some of the factors in plasma and placenta extract that are involved in these processes.
Kolben
M
M
Department of Obstetrics and Gynecology, Technical University of Munich, Klinikum rechts der Isar, Germany.
Lopens
A
A
Bläser
J
J
Ulm
K
K
Schmitt
M
M
Schneider
K T
KT
Tschesche
H
H
D000328:Adult; D016022:Case-Control Studies; D017364:Collagenases / Q000097:blood / Q000378:metabolism; D010450:Endopeptidases / Q000097:blood* / Q000378:metabolism; D005260:Female; D006023:Glycoproteins / Q000097:blood; D017359:HELLP Syndrome / Q000201:enzymology*; D006801:Humans; D020784:Matrix Metalloproteinase 8; D020780:Matrix Metalloproteinase 9; D008666:Metalloendopeptidases / Q000097:blood; D010920:Placenta / Q000201:enzymology; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011225:Pre-Eclampsia / Q000201:enzymology*; D011247:Pregnancy; D019714:Tissue Inhibitor of Metalloproteinases; D010959:Tissue Plasminogen Activator / Q000097:blood / Q000378:metabolism; D014568:Urokinase-Type Plasminogen Activator / Q000097:blood / Q000378:metabolism
D006023:Glycoproteins; D017395:Plasminogen Activator Inhibitor 1; D019714:Tissue Inhibitor of Metalloproteinases; D010450:Endopeptidases; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator; D017364:Collagenases; D008666:Metalloendopeptidases; D020784:Matrix Metalloproteinase 8; D020780:Matrix Metalloproteinase 9