| Background and objective:Preeclampsia, a pregnancy-specific condition, is characterized by hypertension and proteinuria after20weeks of gestation and remains one of the major causes of maternal deaths. In addition, preeclampsia may have an impact on women’s health beyond their pregnancies, and has been associated with increased risks for future hypertension and cardiovascular disease.To investigate the course and pathogenesis of preeclampsia is great significance. In the past years, the study about them reported that major of the preeclampsia could be attribute to placental ischemia and hupoxia and the damage or dysfunction of vascual endothelial. Maternal-fetal immune imbalance lends to the placenta shallow implantation and the placental ischemia hupoxia, the increasing of cytokines and tissue factor in maternal circulation results to a wide range of inflammatory reaction which leads to widespread maternal endothelial dysfunction.Autoantibodies to the angiotensin II type I receptor (AT1-AA) as a autoimmune antibody, have a great relation to placental ischemia and hupoxia. Endothelin1(ET1) produced and released by the endothelial cells, as one class of endogenous peptide shrink blood vessels, relates to maternal endothelial dysfunction and hypertension closely. AT1-AA and ET1both have the function of elevating blood pressure, and they have relate withe each other tightly. Agonistic autoantibodies to the angiotensin Ⅱ type Ⅰ receptor (AT1-AA) might mediate a hypertensive response through dysregulation of the endothelin-1system. Hypertension induced by AT1-AA was attenuated by the AT1receptor and/or endothelin-1type A receptor antagonists.Here, by using enzyme-linked immunosorbent assay (ELISA) and reverse transcription-polymerase chain reaction (RT-PCR), the expression and relationship of AT1-AA and ET1in maternal peripheral blood, umbilical cord blood and placenta in preeclampsia was determined, at the same time, the correcion of the levels of AT1-AA and S/D value of umbilical artery, and the weight of the birth and the placental were analysed. In addition the correction and mechanism of preeclampisa with AT1-AA and ET1were investigated too.Methods:Ninety pregnant women who delivered from June2011to December2011in the First Affiliated Hospital of Zhengzhou University were chosen as the study objects. They were classified into mild preeclampsia group(n=30), severe preeclampsia group(n=30) and normal group(control group, n=30). The age, gravidity and body mass index (BMI) in every group have negative difference.The levels of AT1-AA and ET1in maternal peripheral blood and umbilical cord blood were detected by enzyme-linked immuno sorbent assay (ELISA). In addition, the mRNA expression levels of AT1-AA and ET1in placenta tissues were determined by reverse transcription-polymerase chain reaction(RT-PCR). Moreover, the correlation clinical indexes were detected and analyzed.Results:1.The levels of AT1-AA and ET1in maternal peripheral blood of preeclampsia [mild group(113.519±19.384) ng/L,(31.341±8.718) ng/L; severe group (145.084±15.247) ng/L,(38.053±9.547) ng/L] were both significantly higher than that of control group [(58.758±5.068) ng/L,(16.932±3.472) ng/L].In addition, compared with mind group, the levels of AT1-AA and ET1in severe group were significantly higher(P<0.05).2. The levels of AT1-AA and ET1in umbilical cord blood of preeclampsia [mild group(104.590±13.957) ng/L,(34.812±6.056) ng/L; severe group(117.924±14.374) ng/L,(39.856±4.715) ng/L] were significantly higher than that of control group [(60.800±12.203) pg/mL,(24.211±4.614) ng/L].In addition, compared with mind group, the levels of AT1-AA and ET1in severe group were significantly higher (P<0.05).3. The mRNA expression levels of AT1-AA and ET1in placenta tissues of mind group(0.313±0.039,0.296±0.028)and severe group(0.568±0.052,0.577±0.046) were significantly higher than that in control group(0.198±0.017,0.137±0.012), and the levels in severe group were significantly higher than that in mild group(P<0.05).4. There was an evident positive correlation between AT1-AA and ET1levels of preeclampsia women’s peripheral blood, umbilical cord blood and placenta(P<0.5).5. The level of AT1-AA in umbilical cord blood of preeclampsia pregnant women was positively correlated with S/D value of umbilical artery(P<0.5), and negatively correlated with the weight of the birth and the placental(P<0.5).Conclusions:1. There may have great correlation between the levels of AT1-AA and ET1in preeclampsia, AT1-AA may lead the occur of preeclampsia by increasing the ET1secretion.2. AT1-AA may come through the placental barrier, role in fetal circulation and make the supplication of oxygen to placenta and the blood to umbilical artery insufficient, leading to fetal growth restriction. |
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