Circulating cell-derived microparticles in severe preeclampsia and in fetal growth restriction.

PROBLEM: The behavior of the circulating microparticles (cMP) in severe preeclampsia (PE) and fetal growth restriction (FGR) is disputed. METHOD OF STUDY Non-matched case-control study. Seventy cases of severe PE/HELLP/FGR were compared to 38 healthy pregnant women. Twenty healthy non-pregnant women acted as a control. cMP were analyzed using flow cytometry. Results are given as total (annexin-A5-ANXA5+), platelet (CD41+), leukocyte (CD45+), endothelial (CD144+CD31+//CD41-), and CD41-negative cMP/µL of plasma. Antiphospholipid antibodies (aPL) were analyzed through usual methods. RESULTS: Platelet and endothelial cMP increased in healthy pregnant women. PE whole group (PE±FGR) showed an increase in endothelial and CD41-negative, but not in platelet-derived, cMP. Comparing PE whole group versus healthy pregnant, we found cMP levels of endothelial and CD41- had increased. The cMP results obtained in PE group were similar to those of the PE whole group. Comparing PE group to isolated FGR, significant CD41-negative cMP increase was found in PE. According to its aPL positivity, a trend to decrease in leukocyte and endothelial-derived cMP was found in PE group. CONCLUSION: Normal pregnancy is accompanied by endothelial and platelet cell activation. Endothelial cell activation has been shown in PE but not in isolated FGR. In PE, aPL may contribute to endothelial and possibly to leukocyte cell activation.

Circulating cell-derived microparticles in women with pregnancy loss.

PROBLEM: To analyze cell-derived microparticles (cMP) in pregnancy loss (PL), both recurrent miscarriages (RM) and unexplained fetal loss (UFL). METHOD OF STUDY: Non-matched case-control study was performed at Vall d'Hebron Hospital. Cell-derived microparticles of 53 PL cases, 30 with RM, 16 with UFL, and 7 (RM + UFL), were compared to 38 healthy pregnant women. Twenty healthy non-pregnant women act as controls. Cell-derived microparticles were analyzed through flow cytometry. Results are given as total annexin (A5+), endothelial-(CD144+/CD31+ CD41-), platelet-(CD41+), leukocyte-(CD45+) and CD41- c-MP/µL of plasma. Antiphospholipid antibodies (aPLA) were analyzed according to established methods. RESULTS: Comparing PL versus healthy pregnant, we observed a significant endothelial cMP decrease in PL. When comparing RM subgroup with controls, we observed significant decreases in endothelial cMP. When comparing the PL positive for aPLA versus PL-aPLA-negative, no cMP numbering differences were seen. CONCLUSION: Pregnancy loss seems to be related to endothelial cell activation and/or consumption. A relationship between aPLA and cMP could not be demonstrated.

Anti-beta(2)-glycoprotein-I and anti-phosphatidylserine antibodies in women with spontaneous pregnancy loss.

OBJECTIVE: To evaluate the role of anti-beta(2)-glycoprotein-I (anti-beta(2)GPI-ab) and anti-phosphatidylserine (aPS-ab) antibodies as a risk factor in both recurrent miscarriage (RM) and unexplained fetal losses (UFL). DESIGN: Retrospective, cohort study. SETTING: Vall d'Hebron University Hospital, Barcelona, Spain. PATIENT(S): 122 pregnant women divided in two groups: study group of 54 women with RM and/or UFL and control group of 68 pregnant without RM history. INTERVENTION(S): Analysis of lupus anticoagulant, anticardiolipin antibodies, and anti-beta(2)GP1 and aPS antibodies. MAIN OUTCOME MEASURE(S): Comparison of aPL antibody between groups. RESULT(S): The prevalence of aPL positive results was 8 out of 54 (14.8%) in the study group and 3 out of 68 (4.41%) in the controls. In the RM subgroup, the prevalence was 3 out of 25 (12%) versus 3 out of 68 (4.4%), and 7 out of 34 (20.6%) versus 3 out of 68 (4.4%) in UFL subgroup. As a whole, the prevalence of anti-beta(2)GP1-ab in the RM/UFL group showed a difference compared with controls but not aPS-ab. In the RM women, anti-beta(2)GP1-ab was positive in 3 out of 25 (12%) versus 1 out of 68 (1.5%) in controls and in 4 out of 34 versus 0 out of 68 cases in women with UFL. In the RM subgroup, aPS-ab was positive in 1 out of 25 (4%) versus 2 out of 68 (2.9%) in control group and in 3 out of 34 versus 2 out of 68 cases in women with UFL. CONCLUSION(S): Our results suggest that anti-beta(2)GP1-ab but not aPS-ab is related to RM/UFL and should be considered as a pregnancy-loss risk factor.