title: Adhesion molecules changes at 20 gestation weeks in pregnancies complicated by preeclampsia.
abstract: OBJECTIVE
  To examine soluble E-selectin, L-selectin, P-selectin, ICAM-1, and VCAM-1 levels in normotensive and preeclamptic pregnancies. To determine cut-offs useful for preeclampsia early detection.
  
  
  METHODS
  A cohort of nulliparous women was recruited at family medicine clinics in Mexico City. Preeclampsia developed in 75 patients; 125 normotensive controls were matched. Adhesion molecules were assessed in serum obtained at 20 gestation weeks and in third trimester pregnancies. Predictive values and odds ratios for preeclampsia development were calculated with the 20 gestation week results. Threshold values were selected based on ROC curves values.
  
  
  RESULTS
  In women with subsequent preeclampsia, sL-selectin and sVCAM-1 concentrations were significantly lower, whereas sE-selectin, sP-selectin and sICAM-1 levels were significantly higher, compared with controls at mid-pregnancy (p<0.05). The odds ratio for low sL-selectin was 25.6 (95% CI, 8.9-73.5; cut-off, 1414 ng/ml). The sensitivity, specificity, and positive and negative predictive values of low sL-selectin for preeclampsia development were 84, 90, 39, and 98%, respectively, whereas its sensitivity, specificity, and positive and negative predictive values for severe preeclampsia development (cut-off, 1210 ng/ml) were 100, 98, 60, and 100%, respectively.
  
  
  CONCLUSIONS
  Early enhanced activation of endothelial cells, platelets and leukocytes seem to be present in preeclamptic patients, especially in those that develop severe preeclampsia. Low sL-selectin levels at 20 gestation weeks may be an indicator of preeclampsia development.
authors: Medical Research Unit in Reproductive Medicine, Luis Castelazo-Ayala Gynecology and Obstetrics Hospital, Mexican Institute of Social Security, Mexico City, Mexico. maria.chavarriao@imss.gob.mx <maria.chavarriao@imss.gob.mx>
authors: María E
authors: ME
authors: Chavarría
authors: Lina
authors: L
authors: Lara-González
authors: Yolanda
authors: Y
authors: García-Paleta
authors: Víctor S
authors: VS
authors: Vital-Reyes
authors: Alejandro
authors: A
authors: Reyes
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000097:blood*; D015331:Cohort Studies; D019040:E-Selectin / Q000097:blood; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D019041:L-Selectin / Q000097:blood; D019007:P-Selectin / Q000097:blood; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000097:blood*; D012680:Sensitivity and Specificity; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
chemical_list: D015415:Biomarkers; D015815:Cell Adhesion Molecules; D019040:E-Selectin; D019007:P-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D019041:L-Selectin