Postpartum Circulating Markers of Inflammation and the Systemic Acute-Phase Response After Early-Onset Preeclampsia

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2016-02, Vol.67 (2), p.404-414
• Main Authors: van Rijn, Bas B, Bruinse, Hein W, Veerbeek, Jan H, Post Uiterweer, Emiel D, Koenen, Steven V, van der Bom, Johanna G, Rijkers, Ger T, Roest, Mark, Franx, Arie
• Format: Article
• Language: English
• Subjects: Acute-Phase Reaction - blood; Acute-Phase Reaction - immunology; Adult; Biomarkers - blood; C-Reactive Protein - metabolism; Cytokines - blood; Female; Follow-Up Studies; Humans; Immunity, Innate; Inflammation - blood; Inflammation - immunology; Postpartum Period - blood; Pre-Eclampsia - blood; Pre-Eclampsia - immunology; Pre-Eclampsia - physiopathology; Pregnancy; Risk Factors
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/HYPERTENSIONAHA.115.06455

Preeclampsia is an inflammatory-mediated hypertensive disorder of pregnancy and seems to be an early indicator of increased cardiovascular risk, but mechanisms underlying this association are unclear. In this study, we identified levels of circulating inflammatory markers and dynamic changes in the systemic acute-phase response in 44 women with a history of severe early-onset preeclampsia, compared with 29 controls with only uneventful pregnancies at 1.5 to 3.5 years postpartum. Models used were in vivo seasonal influenza vaccination and in vitro whole-blood culture with T-cell stimulants and the toll-like receptor-4 ligand lipopolysaccharide. Outcome measures were C-reactive protein, interleukin-6 (IL-6), IL-18, fibrinogen, myeloperoxidase, and a panel of 13 cytokines representative of the innate and adaptive inflammatory response, in addition to established cardiovascular markers. The in vivo acute-phase response was higher for women with previous preeclampsia than that for controls without such a history, although only significant for C-reactive protein (P=0.04). Preeclampsia was associated with higher IL-1β (P