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Cell-derived microparticles and vascular pregnancy complications: a systematic and comprehensive review
Jaume Alijotas-Reig1, Carles Palacio-Garcia, Elisa Llurba
1Aging and Systemic Autoimmune Disease Unit, Department of Internal Medicine I, Vall d'Hebron University Hospital, Barcelona, Spain. 16297jar@comb.es
Objective:
To assess current studies on the relationship between cell-derived microparticles (cMP) and recurrent miscarriages (RM) and pre-eclampsia (PE), and review the relationships between cMP and inflammatory and clot pathways, antiphospholipid antibodies (aPL), cytokines, and pregnancy complications.
Design:
Systematic and comprehensive review of the literature from January 2000 to January 2012.
Setting:
Vall d'Hebron University Hospital.
Patient(S):
Women with recurrent miscarriages or PE, healthy nonpregnant women, and healthy pregnant women.
Intervention(S):
None.
Main Outcome Measure(S):
Comparison of cMP numbers and types among groups.
Result(S):
Platelet and endothelial cMP are increased in women with normal pregnancies compared with nonpregnant healthy women. Only five case-control studies regarding cMP and RM and 16 on cMP and PE were found to match our objective. Three of five articles referring to RM showed differences in cMP numbering, and 13 of 16 on cMP and PE showed differences in some type of cMP compared with controls.
Conclusion(S):
Cell-derived microparticles were raised in normal pregnancy. Recurrent miscarriage seems to be related to endothelial and platelet cell activation and/or consumption. An increase in almost all cMP types was observed in PE. A relationship between cMP and endothelial activation and proinflammatory status seems to exist.
Insights
Cell-derived microparticles (cMP) increase during normal pregnancy. Elevated cMP levels are linked to recurrent miscarriage, potentially due to endothelial and platelet activation, and are significantly increased in pre-eclampsia.
Area of Science:
- Reproductive immunology
- Maternal-fetal medicine
- Vascular biology
Background:
- Cell-derived microparticles (cMP) are small vesicles released from cell membranes.
- Their role in pregnancy complications like recurrent miscarriage (RM) and pre-eclampsia (PE) requires further investigation.
- cMP are associated with inflammatory and coagulation pathways.
Purpose of the Study:
- To systematically review current literature on cell-derived microparticles (cMP) in relation to recurrent miscarriage (RM) and pre-eclampsia (PE).
- To explore the associations between cMP and inflammatory markers, antiphospholipid antibodies, cytokines, and pregnancy outcomes.
Main Methods:
- A systematic and comprehensive literature review was conducted.
- Studies published between January 2000 and January 2012 were included.
- Data from women with RM or PE, and healthy pregnant and nonpregnant women were compared.
Main Results:
- Platelet and endothelial cMP are elevated in normal pregnancy compared to nonpregnant controls.
- Limited studies exist for cMP in RM (5) and PE (16).
- Significant differences in cMP numbers or types were observed in women with RM and PE compared to controls.
Conclusions:
- Cell-derived microparticles are generally increased in pregnancy.
- Recurrent miscarriage may involve endothelial and platelet cell activation or consumption.
- Pre-eclampsia is associated with a broad increase in various cMP types, suggesting a link to endothelial activation and inflammation.
