Elevated tissue plasminogen activator as a potential marker of endothelial dysfunction in pre-eclampsia: correlation with proteinuria.
OBJECTIVE
To clarify the role played by endothelial cell production of fibrinolytic factors in normal pregnancy and pre-eclampsia.


METHODS
A longitudinal study performed during normal pregnancy and a cross sectional study performed in healthy and pre-eclamptic pregnant women in the third trimester of pregnancy.


METHODS
Department of Obstetrics and Gynaecology, University Hospital of S. João, Porto, Portugal.


METHODS
Fourteen normal pregnant women followed through the three trimesters of gestation. Two groups of women (normal, n = 56; pre-eclamptic, n = 37) evaluated at the third trimester of gestation.


METHODS
Measurement of platelet number, plasma levels of fibrinogen, tissue plasminogen activator (t-PA) antigen, plasminogen activator inhibitor-1 (PAI-1) activity, and fibrin fragment D-dimer.


METHODS
Pre-eclampsia, proteinuria.


RESULTS
All the substances, except platelet count, increased significantly throughout normal pregnancy. Comparison of the values in the third trimesters of normal and pre-eclamptic pregnancies showed similar values for the fibrinogen and platelet counts, and higher values of t-PA (almost twice normal median value; P < 0.0001), PAI-1 and D-dimer in the pre-eclamptic women. t-PA correlated positively and significantly with the degree of proteinuria in pre-eclamptic women (r = 0.575, P = 0.0002).


CONCLUSIONS
These findings suggest that elevated t-PA antigen may reflect endothelial disturbance in preeclampsia, and may be a potential biomarker of risk.
Belo
Luís
L
Department of Biochemistry, Faculty of Pharmacy, University of Porto, Portugal.
Santos-Silva
Alice
A
Rumley
Ann
A
Lowe
Gordon
G
Pereira-Leite
Luís
L
Quintanilha
Alexandre
A
Rebelo
Irene
I
D000328:Adult; D000941:Antigens / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000378:metabolism*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005342:Fibrinolysis / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D010976:Platelet Count; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000378:metabolism; D011263:Pregnancy Trimester, Third / Q000097:blood; D011507:Proteinuria / Q000097:blood*; D010959:Tissue Plasminogen Activator / Q000378:metabolism*; D014652:Vascular Diseases / Q000175:diagnosis*
D000941:Antigens; D015415:Biomarkers; D017395:Plasminogen Activator Inhibitor 1; D005340:Fibrinogen; D010959:Tissue Plasminogen Activator