Biomarkers of Coagulation, Inflammation, and Angiogenesis are Independently Associated with Preeclampsia

Authors

  • Roland Boij,

    Corresponding author
    1. Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
    • Department of Obstetrics and Gynecology, County Hospital Ryhov, Jönköping, Sweden
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  • Judit Svensson,

    1. Unit for Autoimmunity and Immune Regulation, Division of Clinical Immunology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
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  • Kristina Nilsson-Ekdahl,

    1. Division of Clinical Immunology, Rudbeck Laboratory C5, Uppsala University, Uppsala, Sweden
    2. School of Natural Sciences, Linneaus University, Kalmar, Sweden
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  • Kerstin Sandholm,

    1. School of Natural Sciences, Linneaus University, Kalmar, Sweden
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  • Tomas L. Lindahl,

    1. Division of Clinical Chemistry, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
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  • Elzbieta Palonek,

    1. Karolinska University Hospital, Huddinge, Sweden
    2. Department of Clinical Pharmacology, Doping Control Laboratory, Stockholm, Sweden
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  • Mats Garle,

    1. Karolinska University Hospital, Huddinge, Sweden
    2. Department of Clinical Pharmacology, Doping Control Laboratory, Stockholm, Sweden
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  • Göran Berg,

    1. Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
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  • Jan Ernerudh,

    1. Unit for Autoimmunity and Immune Regulation, Division of Clinical Immunology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
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  • Maria Jenmalm,

    1. Unit for Autoimmunity and Immune Regulation, Division of Clinical Immunology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
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  • Leif Matthiesen

    1. Faculty of Health Sciences of Linköping University, Linköping, Sweden
    2. Department of Obstetrics and Gynecology, Helsingborg Hospital, Helsingborg, Sweden
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Correspondence

Roland Boij, Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, SE-581 85 Linköping, Sweden. E-mails: roland.boij@lj.se; boijro@gmail.com

Abstract

Problem

Although preeclampsia has been associated with inflammation, coagulation, and angiogenesis, their correlation and relative contribution are unknown.

Method of Study

About 114 women with preeclampsia, 31 with early onset (EOP) and 83 with late onset preeclampsia (LOP), and 100 normal pregnant controls were included. A broad panel of 32 biomarkers reflecting coagulation, inflammation, and angiogenesis was analyzed.

Results

Preeclampsia was associated with decreased antithrombin, IL-4 and placental growth factor levels and with increased C3a, pentraxin-3, and sFlt-1 levels, with more marked differences in the EOP group. The Th1-associated chemokines CXCL10 and CXCL11 were significantly higher in the preeclampsia and EOP group than in controls, respectively. No correlations between the biomarkers were found in preeclampsia. Multivariate logistic regression tests confirmed the results.

Conclusions

Cytokines, chemokines and complement activation seem to be part of a Th1-like inflammatory reaction in preeclampsia, most pronounced in EOP, where chemokines may be more useful than cytokines as biomarkers. Biomarkers were not correlated suggesting partly independent or in time separated mechanisms.

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