Distinct inflammatory profile in preeclampsia and postpartum preeclampsia reveal unique mechanisms

Preeclampsia (PE) is a poorly understood pregnancy complication. It has been suggested that changes in the maternal immune system may contribute to PE, but evidence of this remains scarce. Whilst PE is commonly experienced prepartum, it can also occur in the postpartum period (postpartum PE-PPPE), a...

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Bibliographic Details
Published in:Biology of reproduction 2019-01, Vol.100 (1), p.187-194
Main Authors: Brien, Marie-Eve, Boufaied, Ines, Soglio, Dorothée Dal, Rey, Evelyne, Leduc, Line, Girard, Sylvie
Format: Article
Language:English
Subjects:
Adult
Angiotensin Amide - blood
Angiotensin Amide - immunology
Case-Control Studies
Female
Humans
Immune system
Immune System - physiology
immunology
Inflammation Mediators - blood
Inflammation Mediators - metabolism
macrophage
placenta
Placenta - metabolism
Placenta - pathology
Postpartum Period - blood
Postpartum Period - immunology
Pre-Eclampsia - blood
Pre-Eclampsia - immunology
Pre-Eclampsia - metabolism
Pre-Eclampsia - pathology
Preeclampsia
Pregnancy
Puerperal Disorders - blood
Puerperal Disorders - immunology
Quebec
Reproductive health
Retrospective Studies
Signal Transduction - immunology
syncytiotrophoblast
Womens health
Young Adult
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Summary:Preeclampsia (PE) is a poorly understood pregnancy complication. It has been suggested that changes in the maternal immune system may contribute to PE, but evidence of this remains scarce. Whilst PE is commonly experienced prepartum, it can also occur in the postpartum period (postpartum PE-PPPE), and the mechanisms involved are unknown. Our goal was to determine whether changes occur in the maternal immune system and placenta in pregnancies complicated with PE and PPPE, compared to normal term pregnancies. We prospectively recruited women and collected blood samples to determine the circulating immune profile, by flow cytometry, and assess the circulating levels of inflammatory mediators and angiogenic factors. Placentas were collected for histological analysis. Levels of alarmins in the maternal circulation showed increased uric acid in PE and elevated high-mobility group box 1 in PPPE. Analysis of maternal immune cells revealed distinct profiles in PE vs PPPE. PE had increased percentage of lymphocytes and monocytes whilst PPPE had elevated NK and NK-T cells as well. Elevated numbers of immune cells (CD45+) were detected in placentas from women that developed PPPE, and those were macrophages (CD163+). This work reveals changes within the maternal immune system in both PE and PPPE, and indicate a striking contrast in how this occurs. Importantly, elevated immune cells in the placenta of women with PPPE strongly suggest a prenatal initiation of the pathology. A better understanding of these changes will be beneficial to identify women at high risk of PPPE and to develop novel therapeutic targets. Summary Sentence Antepartum and postpartum preeclampsia have distinct immune profiles, and analysis of the placenta suggests a prenatal initiation of the postpartum pathology.
ISSN:0006-3363
1529-7268
DOI:10.1093/biolre/ioy164