THE CELL-ADHESION MOLECULE, VCAM-1, IS SELECTIVELY ELEVATED IN SERUM IN PREECLAMPSIA - DOES THIS INDICATE THE MECHANISM OF LEUKOCYTE ACTIVATION

Objective To determine whether circulating levels of cell adhesion mol ecules, markers of endothelial damage and leucocyte activation, were i ncreased in pre-eclampsia. Design Serum was prepared from peripheral v enous blood and stored at -70 degrees C. The cell adhesion molecules, VCAM-1, E-Selectin and ICAM-1, were measured by ELISA. Setting Departm ent of Obstetrics and Gynaecology, Royal Infirmary, Glasgow. Subjects Sixteen primigravid women with pre-eclampsia were recruited for the st udy. The pre-eclampsia group were compared with 18 healthy primigravid women with uncomplicated pregnancies. Results The pre-eclamptic group had significantly higher serum levels of the cell adhesion molecule V CAM-1 (t = 3.673; P < 0.001). There were no significant differences in the adhesion molecules ICAM-1 or E-Selectin. Conclusions Endothelial damage and dysfunction are common to all the pathological features of pre-eclampsia. This study shows that concentrations of cell adhesion m olecules, which indicate leucocyte-endothelial attachment: and activat ion, are elevated in the serum of patients with pre-eclampsia. Such in creases in soluble circulating cell adhesion molecules may reflect inc reased expression of these molecules on the endothelium and thereby ex plain the mechanism for leucocyte activation in pre-eclampsia.