title: Mechanism of increased maternal serum total activin a and inhibin a in preeclampsia.
abstract: OBJECTIVE
  To determine whether increased levels of maternal serum total activin A and inhibin A in preeclampsia are related to total blood volume, urinary clearance, or placental production.
  
  
  METHODS
  Activin A and inhibin A levels were measured in preeclamptic subjects and matched normotensive gravidas. In a subset of preeclamptic subjects (n = 21) and controls (n = 30), we performed blood volume studies. In an overlapping subset of preeclamptic subjects (n = 56), creatinine clearance results were available. Placental tissue was obtained from six preeclamptics and matched normotensive gravida for analysis of activin A and inhibin A mRNA expression.
  
  
  RESULTS
  Maternal serum levels of inhibin A but not activin A were significantly negatively correlated with blood volume in preeclampsia (r(2) =.26, P =.017, and r(2) =.02, P =.44, respectively). Levels of both proteins were negatively correlated to creatinine clearance (r(2) =.29, P <.0001, and r(2) =.15, P =.003, respectively). Placental mRNA expression for both the alpha and betaA subunits was increased in preeclampsia (P =.038 and.049, respectively).
  
  
  CONCLUSIONS
  Although placental mRNA expression of the subunits for both analytes is increased in preeclampsia, the increased levels of activin A appear to be more specifically a reflection of increased placental production than do the increased levels of inhibin A.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, and Department of Pathology, Brown University, Providence, Rhode Island 02905, USA. hsilver@whri.org
authors.forename: Helayne M
authors.initials: HM
authors.lastname: Silver
authors.forename: Geralyn M
authors.initials: GM
authors.lastname: Lambert-Messerlian
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Reis
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Diblasio
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
authors.forename: Jacob A
authors.initials: JA
authors.lastname: Canick
mesh_terms: D028341:Activins / Q000097:blood* / Q000235:genetics; D001810:Blood Volume; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D028322:Inhibin-beta Subunits / Q000097:blood* / Q000235:genetics; D007265:Inhibins / Q000097:blood* / Q000235:genetics; D016014:Linear Models; D010920:Placenta / Q000737:chemistry; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D012333:RNA, Messenger / Q000032:analysis
chemical_list: D012333:RNA, Messenger; C422405:activin A; C422362:inhibin A; D028341:Activins; D007265:Inhibins; D028322:Inhibin-beta Subunits; D003404:Creatinine