Characterization of five marker levels of the hemostatic system and endothelial status in normotensive pregnancy and pre-eclampsia.
OBJECTIVE
Pre-eclampsia is associated with changes in the hemostatic system and endothelial status. Urinary 11-dehydrothromboxane B2/creatinine (11-DTXB2/Cr) is a marker for platelet activation and vascular constriction, thrombin-antithrombin complex (TAT) for thrombin formation, serum thrombomodulin (TM) for endothelial damage, and beta-thromboglobulin (beta-TG) and platelet factor 4 (PF-4) for platelet activation and releasing reaction. The present study attempted to evaluate these five markers in normotensive pregnancy and pre-eclampsia.


METHODS
These five markers were simultaneously measured in urine and blood samples from 25 women who were not pregnant (group 1, controls), 31 women with normotensive pregnancy (group 2, second controls), 22 women with mild pre-eclampsia (group 3), and 21 women with severe pre-eclampsia (group 4). The average gestational age was 36 wk.


RESULTS
The 11-DTXB2/Cr, TAT, and beta-TG levels were significantly higher (P < 0.01) in groups 2, 3, and 4 than in group 1. The TM and beta-TG levels were significantly higher (P < 0.05) in group 3 than in group 2. The TM, beta-TG, and PF-4 levels were increased significantly (P < 0.05-0.01) in group 4 compared to those in groups 1, 2, and 3.


CONCLUSIONS
Platelet aggregation, vascular constriction, and thrombin formation (detected by 11-DTXB2/Cr and TAT) may be markedly enhanced even in group 2, but further enhancement may be relatively slight in groups 3 and 4. In contrast, endothelial damage (determined by TM) and platelet release of PF-4 may not increase significantly in group 2, but they may increase in group 4. Platelet-release of beta-TG may be enhanced in groups 2, 3, and 4. Endothelial damage and platelet-releasing reaction (detected by PF-4 and beta-TG) may be significantly more enhanced in group 4 than in group 3.
Hayashi
Masatoshi
M
Department of Obstetrics and Gynecology, Koshigaya Hospital, Dokkyo University School of Medicine, Koshigaya-shi, Saitama, Japan. mhayashi@lilac.plala.or.jp
Inoue
Teruo
T
Hoshimoto
Kazunori
K
Negishi
Hideaki
H
Ohkura
Takeyoshi
T
Inaba
Noriyuki
N
D000328:Adult; D000990:Antithrombin III / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001794:Blood Pressure; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000378:metabolism; D005260:Female; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D010447:Peptide Hydrolases / Q000097:blood / Q000652:urine; D010976:Platelet Count; D010978:Platelet Factor 4 / Q000032:analysis / Q000652:urine; D011225:Pre-Eclampsia / Q000097:blood* / Q000503:physiopathology / Q000652:urine; D011247:Pregnancy; D018180:Thrombomodulin / Q000032:analysis / Q000097:blood; D013929:Thromboxane B2 / Q000031:analogs & derivatives* / Q000097:blood / Q000652:urine; D001620:beta-Thromboglobulin / Q000032:analysis / Q000652:urine
D015415:Biomarkers; D018180:Thrombomodulin; C046193:antithrombin III-protease complex; D001620:beta-Thromboglobulin; D010978:Platelet Factor 4; D013929:Thromboxane B2; C049235:11-dehydro-thromboxane B2; D000990:Antithrombin III; D010447:Peptide Hydrolases