Anti-vascular endothelial cell antibodies in severe preeclampsia

There is mounting evidence to suggest that vascular endothelial cell injury plays an important role in the pathogenesis of preeclampsia. In this study an enzyme-linked immunoassay was used to demonstrate increased binding of immunoglobulins G and M to human umbilical vein endothelial cells by sera from women with severe preeclampsia as compared with normal pregnant control women. Fifty percent of women with preeclampsia versus 15.4% of control women had either immunoglobulin G or immunoglobulin M binding. In addition, immunofluorescent staining of normal renal cortical tissue with preeclamptic sera showed increased binding of immunoglobulin G to arterioles in patients with anti-vascular endothelial cell antibodies. These antibodies were not directed at HLA antigens and did not cross react with platelets. Interferon-gamma stimulation did not increase immunoglobulin binding. Antibodies to antigens expressed on vascular endothelial cells may be important in mediating the endothelial damage seen in preeclampsia.