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Circulating concentrations of pro-inflammatory cytokines in preeclampsia with varying disease severity
Klara Palm1, Catherine Cluver2, Eduard Langenegger3
1Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Insights
Elevated levels of Interleukin-6 (IL-6) and Vascular Cell Adhesion Molecule-1 (VCAM-1) indicate preeclampsia with end-organ complications. C-Reactive Protein (CRP) did not show significant differences, suggesting IL-6 and VCAM-1 may identify severe preeclampsia risk.
Area of Science:
- Obstetrics and Gynecology
- Immunology
- Cardiovascular Research
Background:
- Preeclampsia is a serious pregnancy complication characterized by high blood pressure and potential organ damage.
- Circulating inflammatory proteins are implicated in preeclampsia pathogenesis, but their role in disease severity requires further elucidation.
Purpose of the Study:
- To investigate plasma levels of Interleukin-6 (IL-6), Vascular Cell Adhesion Molecule-1 (VCAM-1), and C-Reactive Protein (CRP) in women with preeclampsia.
- To compare these inflammatory markers between preeclampsia patients with and without end-organ complications.
Main Methods:
- Analysis of plasma samples from 183 women in Cape Town, South Africa, collected from biobanks and clinical trials.
- Quantification of IL-6, VCAM-1, and CRP concentrations in preeclampsia patients categorized by the presence and number of end-organ complications.
- Statistical analysis including covariate adjustment to compare marker levels across disease severity groups.
Main Results:
- Women with preeclampsia and two or more end-organ complications showed significantly higher plasma concentrations of IL-6 (4.9-fold increase) and VCAM-1 (1.7-fold increase) compared to those without complications.
- A 3.2-fold increase in IL-6 was observed in women with two or more complications versus those with one complication, but VCAM-1 did not differ significantly between these groups.
- Plasma concentrations of CRP did not significantly differ among the preeclampsia severity groups.
Conclusions:
- Elevated plasma IL-6 and VCAM-1 levels are associated with preeclampsia complicated by end-organ damage.
- These inflammatory markers, particularly IL-6 and VCAM-1, may serve as potential biomarkers for identifying women at high risk of severe preeclampsia.
- CRP is not a reliable indicator of end-organ complications in preeclampsia.
Objectives:
To assess whether plasma concentrations of the circulating inflammatory proteins Interleukin-6 (IL-6), Vascular Cell Adhesion Molecule-1 (VCAM-1) and C-Reactive Protein (CRP) are increased in women with preeclampsia with end-organ complications, compared with women with preeclampsia without end-organ complications.
Study Design:
We used samples from a large prospective biobank collection (Preeclampsia Obstetric Adverse Event biobank), and two large, randomized preeclampsia therapeutic treatment trials. All samples were collected in Cape Town, South Africa. The last plasma sample collected prior to birth was analyzed for IL-6, VCAM-1 and CRP concentrations. We categorized cases according to disease severity and compared circulating levels of these analytes. Covariate adjustment was performed.
Results:
183 women were included. Compared with women without end-organ complications (n = 119), those with preeclampsia with two or more end-organ complications (n = 15) had a 4.9-fold (95 % CI, 1.81-13.09, p = 0.001) increase in IL-6 and a 1.7-fold (95 % CI, 1.11-2.72, p = 0.012) increase in VCAM-1 plasma concentrations. Comparing women with two or more end-organ complications to those with one end-organ complication (n = 49), plasma concentrations of IL-6 were 3.2-fold (95 % CI, 1.18-8.39, p = 0.018) increased, while there was no statistically significant difference for VCAM-1 (1.2-fold higher, 95 % CI, 0.79-1.91, p = 0.50). Plasma concentrations of CRP did not differ between the groups.
Conclusions:
Plasma concentrations of IL-6 and VCAM-1, but not CRP, were increased among women with preeclampsia and end-organ complications, compared with women without end-organ complications. IL-6 and VCAM-1 could be drivers of disease in preeclampsia and potentially useful to identify women at high risk of severe disease.
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