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P66 The cytokine imbalance in women with early-onset preeclampsia
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Poster Presentations / Pregnancy Hypertension 1, Supplement 1 (2010) S43–S76
pressure of 12cms H2 O. Overnight half hourly blood pressure measurement was performed on both nights. Blood pressure results night four: mean systolic 141mmHg (maximum 160mmHg) and diastolic 87mmHg (maximum 97mmHg) and on night five: mean systolic 133mmHg (maximum 151mmHg) and diastolic 81mmHg (maximum 88mmHg). There were significant decreases in systolic and diastolic BP when CPAP was used compared to the night without positive pressure (p < 0.001 and p = 0.003) and when compared to Autoset (p = 0.03 and 0.002). Overnight blood pressure monitoring and sleep study revealed previously undiagnosed nocturnal hypertension and severe obstructive sleep apnea. CPAP therapy resulted in effective treatment for OSAHS and, together with antihypertensive medication, a significant reduction in sleeping blood pressure. Maternal and fetal outcomes were good and there was no progression to preeclampsia.
P66 The cytokine imbalance in women with early-onset preeclampsia Leandro De Oliveira 1 , Juliana Kuribayashi 2 , Nelson Sass 1 , Maria Peraçoli 3 , José Carlos Peraçoli 3 , Niels Olsen Camara 2 . 1 Federal University of São Paulo, São Paulo, Brazil; 2 São Paulo University, Brazil; 3 Botucatu Medical School UNESP, Brazil Background: An imbalance in Th1/Th2-type immunity contributes with the exaggerated inflammatory response that characterizes preeclampsia. Aims: To determine serum levels of anti-inflammatory and pro-inflammatory cytokines in women with early-onset preeclampsia. Methods: Serum was collected from women with early onset preeclampsia (hypertension and proteinuria before 34 weeks) and normal pregnant women (n= 18 in each group). The groups evaluated were matched for gestational age. IL-2, IL-4, IL-10, IL-6, TNF-α and INF-γ were measured by Cytometric Bead Array. Data were analyzed using a BD FACSCanto II (BD Biosciences, CA) equipped with the BD FACSDiva V6.1.1 operating software and FACAP Array software V1.0. The statistical analysis was performed using Prism software (version 4.02, GraphPad Software Inc., San Diego, CA). Differences between groups were evaluated using Mann-Whitney U test and were considered statistically significant at P<0.05. Results: The median serum concentration and range of each chemokine evaluated are shown in Table 1. Table 1. Serum levels (pg/mL) of different cytokines from normal pregnant and preeclamptic women Cytokine IL-2 IL-4 IL-10 IL-6 TNF-α INF-γ
Normal pregnant women
Preeclamptic women
P-values
2.05 (0.11–2.64) 2.03 (0.87–2.62) 4.98 (4.29–5.30) 2.79 (0.58–4.71) 0.73 (0.19–53.69) 0.90 (0.14–9.16)
0.54 (0.11–2.54) 1.63 (0.91–2.78) 4.54 (4.03–5.08) 3.41 (1.55–163.30) 3.30 (0.27–85.67) 0.74 (0.24–12.54)
0.043* 0.173 0.208 0.026* 0.254 0.531
Conclusion: Our results showed that IL-6 is one of the most important cytokines involved in the inflammatory response that characterizes early-onset preeclampsia.
P67 Serum levels of chemokines in women with early-onset preeclampsia Leandro De Oliveira 1 , Juliana Kuribayashi 2 , Nelson Sass 1 , Maria Peraçoli 3 , José Carlos Peraçoli 3 , Niels Olsen Câmara 2 . 1 Federal University of São Paulo, São Paulo, Brazil; 2 São Paulo University, Brazil; 3 Botucatu Medical School UNESP, Brazil Background: Preeclampsia is characterized by intense inflammatory response and anti-angiogenic state. A shift towards Th-1 type immunity is involved in this process. Aims: To determine serum levels of pro-inflammatory chemokines in women with early-onset preeclampsia. Methods: Serum was collected from women with early onset preeclampsia (hypertension and proteinuria before 34 weeks) and normal pregnant women (n= 10 in each group). The groups evaluated were matched for gestational age. CCL2/MCP-1, CXCL10/IP-10, CCL5/RANTES, CXCL9/MIG and CXCL8/IL-8 were measured by Cytometric Bead Array. Data were analyzed using a BD FACSCanto II (BD Biosciences, CA) equipped with the BD FACSDiva V6.1.1 operating software and FACAP Array software V1.0. The statistical analysis was performed using Prism software (version 4.02,
GraphPad Software Inc., San Diego, CA). Differences between groups were evaluated using Mann-Whitney U test and were considered statistically significant at P<0.05. Results: The median serum concentration and range of each chemokine evaluated are shown in Table 1. Table 1. Serum levels (pg/mL) of different chemokines from normal pregnant and preeclamptic women Chemokine CCL2/MCP-1 CXCL10/IP-10 CCL5/RANTES CXCL9/MIG CXCL8/IL-8
Normal pregnant women
Preeclamptic women
P-values
103.5 (62–149.5) 52.28 (12.58–104.8) 2078.0 (1017.0–3338.0) 7.66 (1.86–13.37) 5.14 (3.88–5.45)
138.40 (101.8–296.7) 109.5 (42.21–216.2) 2376.0 (1667.0–3116.0) 13.67 (5.27–47.45) 147.0 (15.64–838.3)
0.0112* 0.0028* 0.289 0.023* 0.0079*
Conclusion: Preeclamptic women have significantly higher serum concentrations of CCL2/MCP-1, CXCL10/IP-10, CXCL9/MIG and CXCL8/IL-8. These chemokines are known to have important roles either on the establishment or maintenance of inflammatory and anti-antiangiogenic processess. Therefore, these chemokines can be implicated in the pathogenesis of preeclampsia.
P68 Proportion of iNKT cells in pregnant women with preeclampsia: an evaluation in peripheral blood, placenta and umbilical cord blood Leandro De Oliveira 1 , Marcos Cenedeze 1 , Rafael Larocca 2, Nelson Sass 1 , Niels Olsen Câmara 2 . 1 Federal University of São Paulo, Brazil; 2 São Paulo University, Brazil Background: Invariant Natural Killer T (iNKT) cells have strong capacity to secrete cytokines. Therefore, these cells are supposed to be involved in the pathogenesis of preeclampsia. Aims: To evaluate the proportion of iNKT cells in maternal peripheral blood, umbilical cord blood and infiltrating the placental tissues of preeclamptic women. Methods: The following groups were evaluated: healthy non-pregnant women, normal pregnant women and preeclamptic patients (n= 10 in each group). Umbilical cord blood and placental samples were also collected from 6 normal pregnant women and 6 preeclamptic patients undergoing elective cesarean section. Lymphocytes were purified by density gradient centrifugation. Placental tissues (4g) were minced and treated with 0.1% collagenase and 0.05% DNase I to release infiltrating lymphocytes. After purification and digestion, 1×106 of the total cells in suspension were used for flow cytometric analysis. The following anti-human antibodies were used: anti-invariant NKT (clone 6B11; BD Pharmigen PE labeled); antiCD4; anti-CD8; anti-CD161. Data were analyzed using a BD FACSCanto II (BD Biosciences, CA) equipped with the BD FACSDiva V6.1.1 operating software. Results: The mean percentage of iNKT cells in peripheral blood from non-pregnant women (0.33%) was significantly higher than normal pregnant women (0.13%) and preeclamptic patients (0.15%); (p=0.0015 and p<0.0001, respectively). No difference was found between normal pregnant and preeclamptic women. The percentage of iNKT cells released from preeclamptic placentas (0.11%) was significantly higher than normal placentas (0.20%); (p=0.041). There was no difference in terms of umbilical cord blood. Conclusion: Either normal pregnant or preeclamptic women have reduction in the percentage of iNKT cells in peripheral blood when compared to non-pregnant women. Although we found higher proportion of iNKT cells infiltrating preeclamptic placentas, these results should be interpreted with caution as these placentas cannot be matched for gestational age for ethical reasons.
P69 The effect of pregnancy-associated hormones on trophoblast function Jessie Chen, May Wong, Shaun Brennecke, Rosemary Keogh. University of Melbourne, Department of Obstetrics and Gynaecology and Department of Perinatal Medicine Pregnancy Research Centre, Royal Women’s Hospital, Parkville, Victoria, Australia Background: Remodelling of the uterine vasculature during the first trimester of pregnancy requires invasion of trophoblast from the placenta into maternal decidual spiral arterioles. The commencement of vascular remodelling coincides with the highest concentrations of chorionic go-
Poster Presentations / Pregnancy Hypertension 1, Supplement 1 (2010) S43–S76
pressure of 12cms H2 O. Overnight half hourly blood pressure measurement was performed on both nights. Blood pressure results night four: mean systolic 141mmHg (maximum 160mmHg) and diastolic 87mmHg (maximum 97mmHg) and on night five: mean systolic 133mmHg (maximum 151mmHg) and diastolic 81mmHg (maximum 88mmHg). There were significant decreases in systolic and diastolic BP when CPAP was used compared to the night without positive pressure (p < 0.001 and p = 0.003) and when compared to Autoset (p = 0.03 and 0.002). Overnight blood pressure monitoring and sleep study revealed previously undiagnosed nocturnal hypertension and severe obstructive sleep apnea. CPAP therapy resulted in effective treatment for OSAHS and, together with antihypertensive medication, a significant reduction in sleeping blood pressure. Maternal and fetal outcomes were good and there was no progression to preeclampsia.
P66 The cytokine imbalance in women with early-onset preeclampsia Leandro De Oliveira 1 , Juliana Kuribayashi 2 , Nelson Sass 1 , Maria Peraçoli 3 , José Carlos Peraçoli 3 , Niels Olsen Camara 2 . 1 Federal University of São Paulo, São Paulo, Brazil; 2 São Paulo University, Brazil; 3 Botucatu Medical School UNESP, Brazil Background: An imbalance in Th1/Th2-type immunity contributes with the exaggerated inflammatory response that characterizes preeclampsia. Aims: To determine serum levels of anti-inflammatory and pro-inflammatory cytokines in women with early-onset preeclampsia. Methods: Serum was collected from women with early onset preeclampsia (hypertension and proteinuria before 34 weeks) and normal pregnant women (n= 18 in each group). The groups evaluated were matched for gestational age. IL-2, IL-4, IL-10, IL-6, TNF-α and INF-γ were measured by Cytometric Bead Array. Data were analyzed using a BD FACSCanto II (BD Biosciences, CA) equipped with the BD FACSDiva V6.1.1 operating software and FACAP Array software V1.0. The statistical analysis was performed using Prism software (version 4.02, GraphPad Software Inc., San Diego, CA). Differences between groups were evaluated using Mann-Whitney U test and were considered statistically significant at P<0.05. Results: The median serum concentration and range of each chemokine evaluated are shown in Table 1. Table 1. Serum levels (pg/mL) of different cytokines from normal pregnant and preeclamptic women Cytokine IL-2 IL-4 IL-10 IL-6 TNF-α INF-γ
Normal pregnant women
Preeclamptic women
P-values
2.05 (0.11–2.64) 2.03 (0.87–2.62) 4.98 (4.29–5.30) 2.79 (0.58–4.71) 0.73 (0.19–53.69) 0.90 (0.14–9.16)
0.54 (0.11–2.54) 1.63 (0.91–2.78) 4.54 (4.03–5.08) 3.41 (1.55–163.30) 3.30 (0.27–85.67) 0.74 (0.24–12.54)
0.043* 0.173 0.208 0.026* 0.254 0.531
Conclusion: Our results showed that IL-6 is one of the most important cytokines involved in the inflammatory response that characterizes early-onset preeclampsia.
P67 Serum levels of chemokines in women with early-onset preeclampsia Leandro De Oliveira 1 , Juliana Kuribayashi 2 , Nelson Sass 1 , Maria Peraçoli 3 , José Carlos Peraçoli 3 , Niels Olsen Câmara 2 . 1 Federal University of São Paulo, São Paulo, Brazil; 2 São Paulo University, Brazil; 3 Botucatu Medical School UNESP, Brazil Background: Preeclampsia is characterized by intense inflammatory response and anti-angiogenic state. A shift towards Th-1 type immunity is involved in this process. Aims: To determine serum levels of pro-inflammatory chemokines in women with early-onset preeclampsia. Methods: Serum was collected from women with early onset preeclampsia (hypertension and proteinuria before 34 weeks) and normal pregnant women (n= 10 in each group). The groups evaluated were matched for gestational age. CCL2/MCP-1, CXCL10/IP-10, CCL5/RANTES, CXCL9/MIG and CXCL8/IL-8 were measured by Cytometric Bead Array. Data were analyzed using a BD FACSCanto II (BD Biosciences, CA) equipped with the BD FACSDiva V6.1.1 operating software and FACAP Array software V1.0. The statistical analysis was performed using Prism software (version 4.02,
GraphPad Software Inc., San Diego, CA). Differences between groups were evaluated using Mann-Whitney U test and were considered statistically significant at P<0.05. Results: The median serum concentration and range of each chemokine evaluated are shown in Table 1. Table 1. Serum levels (pg/mL) of different chemokines from normal pregnant and preeclamptic women Chemokine CCL2/MCP-1 CXCL10/IP-10 CCL5/RANTES CXCL9/MIG CXCL8/IL-8
Normal pregnant women
Preeclamptic women
P-values
103.5 (62–149.5) 52.28 (12.58–104.8) 2078.0 (1017.0–3338.0) 7.66 (1.86–13.37) 5.14 (3.88–5.45)
138.40 (101.8–296.7) 109.5 (42.21–216.2) 2376.0 (1667.0–3116.0) 13.67 (5.27–47.45) 147.0 (15.64–838.3)
0.0112* 0.0028* 0.289 0.023* 0.0079*
Conclusion: Preeclamptic women have significantly higher serum concentrations of CCL2/MCP-1, CXCL10/IP-10, CXCL9/MIG and CXCL8/IL-8. These chemokines are known to have important roles either on the establishment or maintenance of inflammatory and anti-antiangiogenic processess. Therefore, these chemokines can be implicated in the pathogenesis of preeclampsia.
P68 Proportion of iNKT cells in pregnant women with preeclampsia: an evaluation in peripheral blood, placenta and umbilical cord blood Leandro De Oliveira 1 , Marcos Cenedeze 1 , Rafael Larocca 2, Nelson Sass 1 , Niels Olsen Câmara 2 . 1 Federal University of São Paulo, Brazil; 2 São Paulo University, Brazil Background: Invariant Natural Killer T (iNKT) cells have strong capacity to secrete cytokines. Therefore, these cells are supposed to be involved in the pathogenesis of preeclampsia. Aims: To evaluate the proportion of iNKT cells in maternal peripheral blood, umbilical cord blood and infiltrating the placental tissues of preeclamptic women. Methods: The following groups were evaluated: healthy non-pregnant women, normal pregnant women and preeclamptic patients (n= 10 in each group). Umbilical cord blood and placental samples were also collected from 6 normal pregnant women and 6 preeclamptic patients undergoing elective cesarean section. Lymphocytes were purified by density gradient centrifugation. Placental tissues (4g) were minced and treated with 0.1% collagenase and 0.05% DNase I to release infiltrating lymphocytes. After purification and digestion, 1×106 of the total cells in suspension were used for flow cytometric analysis. The following anti-human antibodies were used: anti-invariant NKT (clone 6B11; BD Pharmigen PE labeled); antiCD4; anti-CD8; anti-CD161. Data were analyzed using a BD FACSCanto II (BD Biosciences, CA) equipped with the BD FACSDiva V6.1.1 operating software. Results: The mean percentage of iNKT cells in peripheral blood from non-pregnant women (0.33%) was significantly higher than normal pregnant women (0.13%) and preeclamptic patients (0.15%); (p=0.0015 and p<0.0001, respectively). No difference was found between normal pregnant and preeclamptic women. The percentage of iNKT cells released from preeclamptic placentas (0.11%) was significantly higher than normal placentas (0.20%); (p=0.041). There was no difference in terms of umbilical cord blood. Conclusion: Either normal pregnant or preeclamptic women have reduction in the percentage of iNKT cells in peripheral blood when compared to non-pregnant women. Although we found higher proportion of iNKT cells infiltrating preeclamptic placentas, these results should be interpreted with caution as these placentas cannot be matched for gestational age for ethical reasons.
P69 The effect of pregnancy-associated hormones on trophoblast function Jessie Chen, May Wong, Shaun Brennecke, Rosemary Keogh. University of Melbourne, Department of Obstetrics and Gynaecology and Department of Perinatal Medicine Pregnancy Research Centre, Royal Women’s Hospital, Parkville, Victoria, Australia Background: Remodelling of the uterine vasculature during the first trimester of pregnancy requires invasion of trophoblast from the placenta into maternal decidual spiral arterioles. The commencement of vascular remodelling coincides with the highest concentrations of chorionic go-