Normal pregnancy and preeclampsia both produce inflammatory changes in peripheral blood leukocytes akin to those of sepsis☆,☆☆,★,★★
Section snippets
Material and methods
Peripheral venous blood sampled by use of a syringe was immediately added to anticoagulant, either 10 μg/mL leupeptin, a protease inhibitor (Sigma, Poole, United Kingdom) for surface antigen analysis, or 10 IU/mL preservative-free heparin (Sigma) for measurement of intracellular reactive oxygen species. The anticoagulated blood was processed and analyzed within 45 minutes of venipuncture.
Whole blood was analyzed flow cytometrically with use of the fluorescent nuclear vital dye LDS-751
Results
Granulocytes and monocytes from normal pregnant women, women with preeclampsia, and patients with sepsis all showed significantly higher surface expression of CD11b and CD64 compared with the normal nonpregnant control women. Surface expression of l-selectin on granulocytes was significantly reduced in samples from preeclamptic women and cases with sepsis but not normal pregnant women. Normal pregnancy was characterized by significantly higher expression of CD14 on both monocytes and
Comment
The isolation of leukocytes from whole blood may cause activation and artifactual differences not present in vivo.9 Hence we used whole blood flow cytometry, which produces less in vitro activation than does conventional density gradient centrifugation or red blood cell lysis.10 The fluorescent vital nucleic acid dye LDS-751 allowed nucleated leukocytes to be differentiated from nonnucleated erythrocytes.7 Because the cells were unfixed, intracellular reactive oxygen species, which are a
Acknowledgements
We thank Staff Midwife Davina Buckley and Dr Mark Juniper for help in recruiting normal pregnant women and septic patients, respectively.
References (25)
- et al.
The pathologic anatomy of eclampsia, bilateral renal cortical necrosis, pituitary necrosis, and other acute fatal complications of pregnancy, and its possible relationship to the generalized Shwartzman phenomenon
Am J Obstet Gynecol
(1953) - et al.
A simple flow cytometric procedure for the determination of surface antigens on unfixed leucocytes in whole blood
J Immunol Methods
(1993) - et al.
Effects of cell purification methods on CD11b and L-selectin expression as well as the adherence and activation of leucocytes
J Immunol Methods
(1995) - et al.
Increased oxidative metabolism in PMA-activated lymphocytes: a flow cytometric study
Int J Immunopharmacol
(1992) - et al.
Neutrophils express the high affinity receptor for IgG (Fc gamma RI, CD64) after in vivo application of recombinant human granulocyte colony-stimulating factor
Blood
(1991) - et al.
Altered leukocyte immunophenotypes in septic shock: studies of HLA-DR, CD11b, CD14, and IL-2R expression
Chest
(1993) - et al.
Influence of surgical stress on monocytes and complications of infection in patients with esophageal cancer—monocyte HLA-DR antigen expression and respiratory burst capacity
J Surg Res
(1995) - et al.
Transcription factors as targets for oxidative signalling during lymphocyte activation
Biochim Biophys Acta
(1995) - et al.
Oxidative stress as a mediator of apoptosis
Immunol Today
(1994) - et al.
Bidirectional cytokine interactions in the maternal-fetal relationship: is successful pregnancy a Th2 phenomenon?
Immunol Today
(1993)
Some immunological and endocrinological problems raised by the evolution of viviparity in vertebrates
Symp Soc Exp Biol
Essential immunology
Cited by (715)
The role of neutrophils and neutrophil extracellular traps (NETs) in stages, outcomes and pregnancy complications
2024, Journal of Reproductive ImmunologyPreeclampsia epidemiology(ies) and pathophysiology(ies)
2024, Best Practice and Research: Clinical Obstetrics and GynaecologyGrowth restriction in preeclampsia: lessons from animal models
2023, Current Opinion in PhysiologyPreeclampsia at term: evidence of disease heterogeneity based on the profile of circulating cytokines and angiogenic factors
2023, American Journal of Obstetrics and Gynecology
- ☆
From the Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital.
- ☆☆
Supported by Action Research and Oxford Regional Health Authority (G.P.S.) and the Soros Foundation (K.S.).
- ★
Reprint requests: Gavin P. Sacks, MD, Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford, United Kingdom OX3 9DU.
- ★★
0002-9378/98 $5.00 + 0 6/1/88526