title: Circulating endothelial cell number and markers of endothelial dysfunction in previously preeclamptic women.
abstract: OBJECTIVE
  Patients with preeclampsia (PE) have endothelial dysfunction and an increased future risk of cardiovascular (CV) mortality. The number of circulating endothelial cells (CECs) is markedly increased in conditions associated with a high degree of endothelial cell activation/injury including PE. We hypothesized that the number of CECs continues to be increased in women with a history of PE, reflecting ongoing endothelial cell activation/injury.
  
  
  METHODS
  CECs, flow-mediated vasodilation, levels of adhesion molecules and soluble vascular endothelial growth factor receptor-1 (sVEGFR1), and urine albumin/creatinine ratio were determined in 21 healthy women with ongoing normal pregnancy, 24 healthy currently nonpregnant women with a history of normal pregnancy, a total of 17 women with currently active mild (n = 11) or severe (n = 6) PE without hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome, and 16 currently nonpregnant women with a history of mild (n = 10) or severe (n = 6) PE.
  
  
  RESULTS
  Blood samples from women with active preeclampsia had higher CECs (9.9 ± 7.9 cells/mL) than healthy pregnant women (3.0 ± 4.1 cells/mL; P < .001), healthy nonpregnant women with a history of normal pregnancy (3.4 ± 4.0 cells/mL; P < .001), or women with a history of preeclampsia (2.4 ± 2.0 cells/mL; P < .001). The number of CECs were similar between women with a history of preeclampsia and healthy nonpregnant women with a history of normal pregnancy. Patients with active preeclampsia had significantly higher soluble vascular cell adhesion molecule-1, soluble E-selectin, sVEGFR1, and urinary albumin/creatinine ratio than healthy pregnant women. However, soluble vascular cell adhesion molecule-1, soluble E-selectin, urinary albumin/creatinine ratio were similar in women with a history of preeclampsia and healthy nonpregnant women with a history of normal pregnancy. However, women with a history of preeclampsia had higher sVEGFR1 levels than women with a history of normal pregnancy (P < .05).
  
  
  CONCLUSIONS
  Markers of endothelial activation, dysfunction, and damage were increased in patients with PE. After the delivery, this activation status is similar to the age-matched nonpregnant women with a history of normal pregnancy. However, sVEGFR-1 levels remain higher in women with a history of preeclampsia compared with women without a history of preeclampsia.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Zeyneb Baspehlivan
authors.initials: ZB
authors.lastname: Tuzcu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Asicioglu
authors.affiliation: Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Sunbul
authors.affiliation: Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Beste
authors.initials: B
authors.lastname: Ozben
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Hakki
authors.initials: H
authors.lastname: Arikan
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey. Electronic address: drmkoc@yahoo.com.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Koc
mesh_terms: D000328:Adult; D000419:Albuminuria; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D003404:Creatinine / Q000652:urine; D019040:E-Selectin / Q000097:blood*; D042783:Endothelial Cells / Q000166:cytology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D011225:Pre-Eclampsia / Q000378:metabolism* / Q000503:physiopathology; D011247:Pregnancy; D012720:Severity of Illness Index; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*; D014664:Vasodilation; D055815:Young Adult
chemical_list: D019040:E-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein; D003404:Creatinine; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1
keywords: circulating endothelial cells; endothelial dysfunction; preeclampsia; pregnancy; vascular endothelial growth factor receptor-1