Elevated soluble adhesion molecules in women with pre-eclampsiadd - Do cytokines like tumour necrosis factor-alpha and interleukin-1 beta cause endothelial activation?

Objective: The purpose of the present study was to evaluate the clinical si gnificance of tumour necrosis factor-alpha. (TNF-alpha) and interleukin-1 b eta (IL-1 beta) for endothelial cell activation in pre-eclampsia. Therefore , we determined and compared the correlations between these cytokines and c irculating adhesion molecules in the sera of pre-eclamptic pregnant women, normotensive pregnant women and nonpregnant women. Methods: The soluble adh esion molecules VCAM-1, ICAM-1, E-selectin, and P-selectin were determined in the serum of 38 pre-eclamptic pregnant women and 40 normotensive pregnan t and nonpregnant controls using ELISA-techniques. We correlated these seru m concentrations with the serum levels of TNF-alpha and IL-1 beta, respecti vely, also determined by ELISA. Results: Elevated serum levels of VCAM-1 an d E-selectin could be detected in pre-eclamptic patients, with and without HELLP-syndrome. In contrast, no increased serum concentration of ICAM-1, P- selectin, TNF-alpha and IL-1 beta were found in these patients. While signi ficant correlation between VCAM-1 and E-selectin could be determined (r=0.6 04; p<0.001) no unambiguous correlations, however, were found between TNF-a lpha or between IL-1 beta and the examined adhesion molecules or the select ins. Conclusions: In contrast to in vitro investigations on cultured umbili cal vein endothelium, our experimental results indicate that the cytokines TNF-alpha and IL-1 beta can not explain endothelial cell activation, and th at their measurement in serum is not useful for the detection of pre-eclamp sia. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.