ACTIVIN-A AND INHIBIN-A AS POSSIBLE ENDOCRINE MARKERS FOR PREECLAMPSIA

Background Inhibin A and activin A are produced by the placenta during human pregnancy. This study aimed to measure circulating concentratio ns of inhibin A, pro alpha C-containing inhibins, and activin A in the serum of women with pre-eclampsia and of healthy matched control preg nant women, and to establish the molecular-weight forms of circulating inhibin A and activin A in pre-eclampsia. Methods In a retrospective cross-sectional study, blood samples were taken from 20 women in hospi tal with established pre-eclampsia, and from 20 control pregnant women attending antenatal clinics, who were matched for duration of gestati on (preeclampsia mean 29.15 [SD 3.75] weeks; controls 29.30 [3.93] wee ks), parity, and maternal age. Serum samples were analysed for inhibin A, inhibin B, pro alpha C, and activin A. Pooled samples of control ( n=3) and pre-eclampsia serum (n=3) subsequently underwent fast protein liquid chromatographic analysis to assess the molecular-weight forms of inhibin A and activin A. Results are expressed as mean and SD for a ll variables measured. Findings Serum concentrations of inhibin A, act ivin A, and pro alpha C were significantly higher in pre-eclampsia tha n in control normal pregnancy (inhibin A 3.05 [1.8] vs 0.36 [0.14] ng/ mL, p<0.001; activin A 38.08 [25.88] vs 3.95 [2.32] ng/mL, p<0.001; pr o alpha C-containing inhibins 2.2 [0.81] vs 0.71 [0.33] ng/mL, p<0.001 ). Inhibin B concentrations in maternal serum were not increased. Mole cular-weight forms of inhibin A (32 kDa) and activin A (>100 kDa) were similar in pre-eclampsia and normal pregnancy. The mean concentration s of hCG were 59.05 [43.98] and 16.3 [8.72] ng/mL, respectively. Inter pretation Higher maternal serum concentrations of inhibin A, pro alpha C, and total activin A in preeclampsia than in control pregnancies co uld be helpful in the diagnosis of preeclampsia. These changes are int erpreted as further evidence for trophoblast dysfunction in pre-eclamp sia.