Steroid profiling in preeclamptic women: evidence for aromatase deficiency.
OBJECTIVE
Experimental data have revealed the critical role played by 2-methoxy-estradiol, a metabolite of 17β-estradiol, in the pathophysiology of preeclampsia. We used gas chromatography/mass spectrometry to measure a whole panel of hormonal steroids in the plasma from women during the third trimester of their pregnancy.


METHODS
The population study consists of 24 pregnant patients with different outcomes: normal, or complicated by isolated preeclampsia or by severe preeclampsia with Hemolysis Enzyme Liver Low Platelets (HELLP) syndrome.


RESULTS
17β-estradiol was reduced by 50% in isolated preeclampsia, and by 70% in severe preeclampsia with HELLP syndrome (normal: 8.54 ± 0.9 ng/mL; isolated preeclampsia: 4.65 ± 1.0 ng/mL; severe preeclampsia with HELLP syndrome: 2.64 ± 0.4 ng/mL), as is estrone. Downstream, 2-methoxy-estradiol was decreased only in severe preeclampsia with HELLP syndrome. The concentrations of estrone and 17β-estradiol precursors were comparable between groups, suggesting that placental aromatase is deficient in preeclampsia.


CONCLUSIONS
The gradual decrease of estrogen levels with increasing severity of preeclampsia suggests an impairment of placental steroidogenesis.
Hertig
Alexandre
A
APHP, Urgences Néphrologiques et Transplantation Rénale and INSERM U702, Hôpital Tenon, Paris, France.
Liere
Philippe
P
Chabbert-Buffet
Nathalie
N
Fort
Julie
J
Pianos
Antoine
A
Eychenne
Bernard
B
Cambourg
Annie
A
Schumacher
Michael
M
Berkane
Nadia
N
Lefevre
Guillaume
G
Uzan
Serge
S
Rondeau
Eric
E
Rozenberg
Patrick
P
Rafestin-Oblin
Marie-Edith
ME
D000328:Adult; D000704:Analysis of Variance; D001141:Aromatase / Q000097:blood* / Q000172:deficiency; D004958:Estradiol / Q000097:blood*; D004970:Estrone / Q000097:blood; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D017359:HELLP Syndrome / Q000097:blood*; D006801:Humans; D010865:Pilot Projects; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third / Q000097:blood*
D004970:Estrone; D004958:Estradiol; D001141:Aromatase