lactoferrin and Pre-Eclampsia

Preeclamptic pregnancies seem to be associated with a higher extent of inflammation compared with normal ones. We intended to test this proposal and also to clarify the contribution of some variables in such inflammatory process. We measured total and differential leukocyte count, serum C-reactive protein (CRP), and plasma levels of lactoferrin, elastase, and granulocyte-macrophage colony-stimulating factor (GM-CSF). Uric acid was also evaluated and used as an indicator of the severity of the disease. A cross-sectional study was performed by evaluating healthy and preeclamptic women in the third trimester of gestation (n = 67 and n = 51, respectively) and 24 to 48 h postpartum (n = 32 and n = 26, respectively). When comparing the third trimester of normal and preeclamptic pregnancies, we found significantly higher levels of uric acid, CRP, and elastase, and a significantly higher elastase to neutrophil ratio in the pathologic group. However, for CRP, statistical significance was lost after adjustment for maternal weight. No significant differences were found in total leukocyte count, plasma levels of GM-CSF, and lactoferrin between groups. In preeclampsia, a significant positive correlation was found between elastase and lactoferrin and these neutrophil activation products correlated positively with uric acid level. Considering the analysis of all variables in the postpartum period, only CRP and uric acid levels were significantly elevated in the pathologic group. However, CRP differences obtained in the puerperium seem to be influenced by the increased number of dystocic deliveries in the preeclamptic group. In conclusion, our data suggest that inflammation is further pronounced in preeclampsia and that the extent of neutrophil activation correlates with the severity of this syndrome.

Topics: Adult; Biomarkers; C-Reactive Protein; Case-Control Studies; Cohort Studies; Female; Granulocyte-Macrophage Colony-Stimulating Factor; Humans; Inflammation Mediators; Lactoferrin; Multivariate Analysis; Neutrophil Activation; Pancreatic Elastase; Pre-Eclampsia; Pregnancy; Pregnancy Trimester, Third; Probability; Prognosis; Reference Values; Risk Factors; Sensitivity and Specificity; Severity of Illness Index; Statistics, Nonparametric; Uric Acid

To investigate whether neutrophils and systemic complement are activated in pregnancies complicated by preeclampsia more than in normal pregnancies.. We measured native complement components and activation products in plasma by enzyme immunoassays in 19 women with uncomplicated pregnancies, 15 with preeclampsia before cesarean deliveries, and 16 nonpregnant women. Neutrophil activation was measured by specific enzyme immunoassays for myeloperoxidase and lactoferrin.. Myeloperoxidase was significantly higher in women with preeclampsia (197 microg/L, 95% confidence interval [CI] 94, 646) than in women with uncomplicated pregnancies (124 microg/L, 95% CI 70, 289; P =.009), whereas lactoferrin did not differ between groups. C4 was decreased in preeclamptic women (0.16 g/L, 95% CI 0.07, 0.48) compared with women with uncomplicated pregnancies (0.21, 95% CI 0.10, 0.30, P <.001). There were no differences for the other native complement components. There was a significant decrease in C1rs-C1 inhibitor, 13 AU/mL (95% CI 9, 34) versus 19 (95% CI 13, 38) (P < or =.001) in normal pregnant women compared with nonpregnant women. There also was an increase in C3, C4, C9 (data not shown), C4bp, 132% (95% CI 94%, 161%) versus 91% (95% CI 57%, 128%); C3bc (7.4 AU/mL, 95% CI 4.2, 10.7) versus 4.8 AU/mL (95% CI 3.2, 7.3) and C4bc (8.6 AU/mL, 95% CI 5.7, 14.0) versus 3.5 AU/mL (95% CI 2.2, 6.7) in normal pregnant women compared with nonpregnant women (P < or =.001).. Neutrophil activation in preeclampsia was shown by systemic increases in myeloperoxidase. Except for a decrease in C4, systemic complement activation could not be detected in preeclampsia.

Topics: Adult; Case-Control Studies; Complement Activation; Complement System Proteins; Female; Humans; Immunoenzyme Techniques; Lactoferrin; Neutrophils; Peroxidase; Pre-Eclampsia; Pregnancy

To determine if human defensins and lactoferrin, both markers of neutrophil activation, are elevated in preeclamptic plasma.. Blood samples were obtained from 18 preeclamptic and 29 normal pregnant women in the third trimester. Demographic and clinical data were obtained from the medical record. No patient had evidence of labor and/or infection when blood was drawn. Preeclamptic patients were defined by elevated blood pressure, 140/90 mm Hg, proteinuria of > 300 mg in a 24-hour collection and hyperuricemia. Human defensins and lactoferrin were measured by enzyme immunoassay of plasma samples diluted 1:100 and 1:10, respectively. Standard curve values ranged from 0.25 to 16 ng/mL. Data for human defensins and lactoferrin are presented as median values +/-SE. Statistical analysis included Student's t test for comparison of clinical data, Mann-Whitney U test for comparison of absolute values between groups and Fisher's exact test, when appropriate.. There was no difference in age or estimated gestational age between the two groups. There were more nulliparous patients in the preeclamptic group. Human defensin levels were significantly elevated (P = .005) in plasma of preeclamptic patients (25.1 ng/mL +/- 16.2) as compared to normal controls (9.0 ng/mL +/- 8.9). Nine of 18 (50%) preeclamptic patients and 2 of 29 (7%) normal controls had defensin levels above the low point on the standard curve (P = .001). There was no difference in lactoferrin levels between the two groups.. Our results suggest that preeclampsia is associated with neutrophil activation. The biologic effect of elevated human defensins in preeclamptic plasma remains to be determined.

Topics: Adult; Blood Proteins; Defensins; Female; Humans; Lactoferrin; Neutrophil Activation; Pre-Eclampsia; Pregnancy; Reference Values

To test lactoferrin as a blood discriminator of neutrophil activation between normal and preeclamptic pregnancy.. Comparative study between normal (n = 40) and preeclamptic women receiving treatment (n = 42) in the third trimester of pregnancy and in the post partum period (30 women with normal pregnancy and 22 with preeclampsia).. Blood, serum or plasma measurements of neutrophils, lactoferrin, vitamin C, vitamin E, lipid peroxidation products, elastase, C-reactive protein (CRP), gamma-glutamyltranspeptidase (gamma GT), haptoglobin, osmotic fragility, urea, creatinine, uric acid, transaminases (ASAT, ALAT), lactic dehydrogenase (LDH), platelets, red and white blood cells.. In preeclamptic women the ratios of lactoferrin per neutrophil or per erythrocyte are higher before delivery than in normal women but decrease after delivery. Delivery induces a greater inflammatory response in normal pregnancy as detected by blood concentrations of inflammatory markers and hepatic and renal parameters.. Whereas in normal pregnant women neutrophil activation increases with delivery, in preeclamptic women the opposite occurs.

Topics: Adult; Biomarkers; C-Reactive Protein; Female; gamma-Glutamyltransferase; Humans; Kidney; Lactoferrin; Leukocyte Elastase; Lipid Peroxidation; Liver; Lymphocyte Activation; Neutrophils; Pancreatic Elastase; Pre-Eclampsia; Pregnancy