Mechanism of increased maternal serum total activin a and inhibin a in preeclampsia.
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.
Silver
Helayne M
HM
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, and Department of Pathology, Brown University, Providence, Rhode Island 02905, USA. hsilver@whri.org
Lambert-Messerlian
Geralyn M
GM
Reis
Fernando M
FM
Diblasio
Anna Maria
AM
Petraglia
Felice
F
Canick
Jacob A
JA
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
D012333:RNA, Messenger; C422405:activin A; C422362:inhibin A; D028341:Activins; D007265:Inhibins; D028322:Inhibin-beta Subunits; D003404:Creatinine