title: Elevated soluble endothelial cell protein C receptor (sEPCR) levels in women with preeclampsia: a marker of endothelial activation/damage?
abstract: The endothelial protein C receptor (EPCR) plays a crucial role in the anticoagulant and anti-inflammatory effects of the protein C pathway, whereas its soluble form (sEPCR) exhibits opposite properties. High plasma levels of sEPCR have been observed in subjects carrying the A3 haplotype of PROCR, the EPCR gene. Elevated plasma levels of sEPCR were also recently reported in women with preeclampsia (PE), a multisystemic syndrome involving inflammation, endothelial dysfunction and thrombosis. To determine whether this increase is genetically mediated or acquired, we analyzed sEPCR levels and the A3 haplotype distribution in 145 preeclamptic women and 145 age- and term-matched women with normal pregnancies enrolled in a case-control study. Plasma sEPCR levels were higher in the women with PE than in the controls, and this difference was not due to A3 haplotype over-representation. We observed a positive correlation between sEPCR levels and two markers of endothelium activation/damage (von Willebrand factor and soluble thrombomodulin), and a trend towards a third (sVCAM1). We also found an association between sEPCR levels in the highest quartile and the PE risk. The modest increase of sEPCR levels, together with the correlation with other endothelium activation/damage markers, suggest that it is more an innocent bystander of the endothelium activation/damage than an actor in PE.
authors.affiliation: AP-HP, Hôpital Robert Debré Service d'Hématologie Biologique, Paris, France; INSERM, Unité de Recherche 765, Paris, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Saposnik
authors.forename: Edith
authors.initials: E
authors.lastname: Peynaud-Debayle
authors.forename: Alain
authors.initials: A
authors.lastname: Stepanian
authors.forename: Gabriel
authors.initials: G
authors.lastname: Baron
authors.forename: Maud
authors.initials: M
authors.lastname: Simansour
authors.forename: Laurent
authors.initials: L
authors.lastname: Mandelbrot
authors.forename: Dominique
authors.initials: D
authors.lastname: de Prost
authors.forename: Sophie
authors.initials: S
authors.lastname: Gandrille
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D000074283:Endothelial Protein C Receptor; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D011247:Pregnancy; D015995:Prevalence; D011956:Receptors, Cell Surface / Q000097:blood*; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; D000074283:Endothelial Protein C Receptor; C478370:PROCR protein, human; D011956:Receptors, Cell Surface