Placental expression and serum levels of cytokeratin-18 are increased in women with preeclampsia

OBJECTIVE: To evaluate placental expression and serum cytokeratin-18 in wom en with preeclampsia. METHODS: Serum cytokeratin-18 was evaluated in 44 women with preeclampsia a nd 44 healthy pregnant women using an immunoradiometric assay. Placental ex pression of cytokeratin-18 was investigated in specimens from 23 women with preeclampsia and 20 healthy pregnant women by immunohistochemistry. RESULTS: Median serum cytokeratin-18 in women with preeclampsia and healthy pregnant women was 106.7 and 76.0 U/L, respectively (P = .02). Among women with preeclampsia, serum cytokeratin-18 was significantly associated with severity of disease (P = .001) and showed a sensitivity (standard error) an d specificity (standard error) of 85% (7%) and 65% (12%), respectively. In placental specimens, the cytoplasm of the synctiotrophoplast stained positi ve for cytokeratin-18 with strong and widespread staining in 83% and 45% of placental specimens of women with preeclampsia and healthy pregnant women, respectively (P = .01). CONCLUSION: Elevated serum cytokeratin-18 values are associated with diseas e severity in women with preeclampsia. Our data provide additional evidence that the placenta might be the source of the elevated serum cytokeratin-18 values in women with preeclampsia. Copyright (C) 2001 by the Society for G ynecologic Investigation.