A selective increase in plasma soluble vascular cell adhesion molecule-1 levels in preeclampsia

PROBLEM: The study was conducted to determine whether altered plasma levels of soluble intercellular adhesion molecule (ICAM)-1 and soluble vascular c ell adhesion molecule (VCAM)-1 are involved in the pathogenesis of preeclam psia. METHOD OF STUDY: Maternal plasma samples were collected from 20 patients wi th preeclampsia, 20 matched normotensive patients with uncomplicated pregna ncies, and ten healthy nonpregnant women. Samples were assayed for soluble VCAM-1 and soluble ICAM-1 by specific enzyme-linked immunosorbent assay. RESULTS: Both soluble VCAM-1 and soluble ICAM-1 were detectable in the plas ma of all preeclamptic, normotensive pregnant, and nonpregnant women. The m ean plasma lever of soluble VCAM-1 was significantly higher in preeclamptic women compared to normotensive pregnant women (1831 ng/mL +/- 534 ng/mL vs . 1254 ng/mL +/- 386 ng/mL, respectively; P < 0.05). However, the plasma le vel of soluble VCAM-1 was unchanged during the third-trimester of normal pr egnancy compared to nonpregnant women. The mean plasma level of soluble ICA M-1 in preeclamptic and normotensive pregnant women were increased when com pared to nonpregnant women. However, the mean plasma level of soluble ICAM- 1 was comparable in women with preeclampsia and normotensive pregnancy. CONCLUSIONS: The selective increased plasma levels of soluble VCAM-1 in pat ients with preeclampsia provide evidence for endothelial activation and sug gest distinct pathways for neutrophil and endothelial activation in preecla mpsia.