PLASMA TYPE-II PHOSPHOLIPASE A(2) LEVELS ARE ELEVATED IN SEVERE PREECLAMPSIA

OBJECTIVE: Our purpose was to compare plasma concentrations of type II phospholipase A(2) in normal and preeclamptic pregnancies and to dete rmine whether plasma from preeclamptic patients increases ;endothelial cell secretion of type II phospholipase A(2). STUDY DESIGN: We compar ed the plasma levels of type II phospholipase A(2) in 23 patients with normal pregnancies and 25 pat!eis with strictly defined preeclampsia. Plasma samples were collected throughout pregnancy and stored at - 80 degrees C. Patients with preeclampsia were matched as closely as poss ible with controls formaternal age, race, gestational age at blood sam pling, and parity. Plasma levels of type II phospholipase A(2) were me asured by enzyme immunoassay. To investigate endothelial cell type II phospholipase A(2) production, we measured levels of prostacyclin and type II phospholipase A(2) in conditioned media from cultured human um bilical vein endothelial cells exposed to plasma from pieeclamptic and normal pregnant patients. RESULTS: The mean plasma type II phospholip ase A(2) level in the mild preeclampsia group (6.1 +/- 3.0 ng/ml, n = 6) was not different from that in control patients (6.0 +/- 3.2 ng/ml, n = 23). However, the mean type II phospholipase A(2) level in patien ts with severe preeclampsia (19.9 +/- 12.3 ng/ml, n = 19) was Signific antly higher when compared with the other two groups (p < 0.001). Pros tacyclin concentrations in conditioned media of endothelial cells expo sed to plasma from patients with preeclampsia were elevated compared w ith cells incubated with control plasma (8.6 +/- 1.7 vs 4.0 +/- 5.0 ng /ml, p < 0.05). However, the Concentratjonof type II phospholipase A(2 ) in conditioned medium was not significantly different (1.6 +/- 0.3 v s. 1.8 +/- 1.0 ng/ml, p = 0.40). CONCLUSIONS: Plasma concentrations of type II phospholipase A(2) are elevated in preeclampsia and correlate well with the severity of disease. Plasma from preeclamptic women inc reased secretion of prostacyclin, but not type II phospholipase A(2) b y endothelial cells in culture.