Changes in lymphocyte subsets during pregnancy and post-partum in cases of beginning eclampsia.
OBJECTIVE
The goal of the present retrospective study was to examine the peripheral blood lymphocytes for expression of phenotypic and activation markers concerning the development of hypertension in pregnancy.


METHODS
16 women (aged 25-43 years; mean 35.1) developing hypertension in the third trimester (week 25-34) have had blood samples taken in the first (< 14 weeks), the second (week 14-23), the third trimester (week 24-35), in late pregnancy (week 36-termination of pregnancy) and within 1 week post-partum, The control group consisted of 16 age-matched pregnant healthy women, who underwent the same regime. All blood samples were taken in the morning, stored at room temperature and stained within 6 hours and measured within 24 hours. Kruskal-Wallis analysis of variance between both groups was done with multiple comparison according to Dunn.


RESULTS
Comparing both groups, the total white cell count was significantly increased in all pregnancies and post-partum. In case of hypertension in pregnancy the cell numbers of suppressor/cytotoxic (CD 8+) and CD 56(+)-activated T cells showed a significant increase in the first trimester (< 14 weeks) [p < 0.05] and decreased thereafter to normal values. In the second trimester (week 14-23) helper/inducer lymphocytes and CD 56+/CD 3+ lymphocytes decreased in case of pre-ecclampsia and cytotoxic lymphocytes elevated [p < 0.05]. In the third trimester (week 24-35) there was no difference in both study groups and in late pregnancy (week 36-termination) there were only small differences without statistical significance. Within 1 week postnatal the value of Il-2 receptor T lymphocytes decreased in the group of pre-eclampsia in comparison to normal pregnancies [p < 0.05].


CONCLUSIONS
Regarding the major changes in activated T cells in both study groups no specific pattern of lymphocyte subsets in case of pre-eclampsia could be found in comparison to healthy pregnant women. Further investigations should focus on functional activation and/or suppression of the cellular immune system. Perhaps this could lead to a screening test for pre-eclampsia in future, which is non-invasive for the patient and economic for our social community because it might reduce medical costs.
Kühnert
M
M
Department of Obstetrics and Perinatology, University Hospital Marburg, Marburg, Germany.
Schmidt
S
S
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D017252:CD3 Complex / Q000032:analysis; D019002:CD56 Antigen / Q000032:analysis; D004078:Dihydralazine / Q000627:therapeutic use; D004461:Eclampsia / Q000178:diet therapy / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D005865:Gestational Age; D006684:HLA-DR Antigens / Q000276:immunology; D006760:Hospitalization; D006801:Humans; D007694:Killer Cells, Natural; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets; D008750:Methyldopa / Q000627:therapeutic use; D049590:Postpartum Period / Q000276:immunology*; D011247:Pregnancy; D011507:Proteinuria; D013601:T-Lymphocytes / Q000276:immunology; D013602:T-Lymphocytes, Cytotoxic; D006377:T-Lymphocytes, Helper-Inducer
D000959:Antihypertensive Agents; D017252:CD3 Complex; D019002:CD56 Antigen; D006684:HLA-DR Antigens; D008750:Methyldopa; D004078:Dihydralazine