Immunocytochemical localization of neutrophil elastase in term placenta decidua and myometrium in pregnancy-induced hypertension

Article Abstract:

Neutrophils are a type of white blood cell that may be involved in blood vessel disorders. The neutrophils contain granules that are released when this blood cell is activated. Neutrophil granules contain an enzyme called elastase, which destroys the endothelial cells lining the inside of blood vessels. In addition, elastase is released with free radicals and leukotrienes that can also damage and impair the function of blood vessels. Pregnancy-induced hypertension (PIH) is a complication of pregnancy characterized by damage to blood vessels in the placenta, the tissue that provides nutrients to the fetus during pregnancy. One study showed that blood levels of neutrophil elastase were increased in women with PIH, suggesting that neutrophils may be activated in PIH. The activation of neutrophils may contribute to the damage of placental blood vessels in pregnancies affected hypertension. The presence of elastase-containing neutrophils at the maternal-fetal interface was assessed in 51 pregnant women, including 23 with normal pregnancies and 28 with PIH. The maternal-fetal interface consists of the placenta, the decidua (lining of the uterus during pregnancy), and myometrium (muscle layer of the uterus). In all patients, elastase-containing neutrophils were not detected in the myometrium, but were present in the placenta, specifically in areas of fibrin, a whitish, filament-like protein. Greater numbers of elastase containing neutrophils were detected in the fibrin of the decidua in patients with PIH than in normal pregnancies. These findings are consistent with the possibility that neutrophil elastase in the decidua could contribute to the blood vessel damage associated with PIH. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Development and progression, Elastases

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Neutrophil activation is confined to the maternal circulation in pregnancy-induced hypertension

Article Abstract:

High blood pressure is frequently found in women after they become pregnant and is thus termed pregnancy-induced hypertension. This condition can cause damage to the blood vessels. Activated neutrophils, a type of white blood cell released by the bone marrow, is thought to play a role in the vascular damage that results from hypertension. Neutrophil activation is seen in both nonpregnant women with hypertension and those with pregnancy-induced hypertension. Fetal circulation is altered in women with pregnancy-induced hypertension. This study examined whether fetal neutrophils are activated by this condition, increasing the risk for vascular damage in the fetus. Maternal and fetal blood was obtained from 21 healthy pregnant women and 23 women with pregnancy-induced hypertension. Results showed that birth weights were significantly lower for the infants born to the women with hypertension than for those born to the healthy women. Neutrophil elastase, an indicator of neutrophil activation, was significantly higher in the maternal blood of hypertensive women than in the normal women. There was no difference in the concentration of neutrophil elastase between the two fetal groups, as measured in blood specimens obtained through the umbilical vein. There was a significant difference in fetal blood concentration of neutrophil elastase between infants delivered vaginally and those delivered by cesarean section, with a greater concentration in those who were delivered vaginally. These results indicate that neutrophil activation associated with pregnancy-induced hypertension is limited to the maternal circulation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Pregnancy, Complications of, Pregnancy complications

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Neutrophil activation in small for gestational age pregnancies

Article Abstract:

Neutrophils are a type of white blood cell that, when activated, release factors that can damage blood vessels. These factors can act upon the cells that line the vessels or upon other layers, changing blood vessel permeability, constriction and reactivity. As a result of neutrophil activation, blood levels of human neutrophil elastase (hNE, a substance released from the granules within neutrophils) increase. One disorder in which this occurs is pregnancy-induced hypertension (high blood pressure). Since some histopathologic abnormalities in uteroplacental tissue (where the uterus and placenta are joined) in cases of intrauterine growth retardation (IUGR, in which the fetus does not grow normally) resemble those in pregnancy-induced hypertension, it is possible that hNE release also occurs in IUGR. To evaluate this, hNE was measured in the blood of 14 women whose fetuses were ''small for gestational age'' (SGA), meaning that the value of the fetal abdominal circumference was below the 10th percentile. A comparison group of 20 women had healthy term pregnancies. Mothers of SGA babies were evaluated at an average gestational age of 40 weeks. Blood concentrations of hNE were higher in the SGA group than the comparison group. This implies that neutrophil activation and degranulation (breaking of the storage granules inside neutrophils) occur in SGA infants, perhaps contributing to the vascular damage that has been observed in the uteroplacental bed. Further research concerning neutrophil activation in pregnancies with complications could reveal much about the causes of tissue damage. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Birth weight, Low, Low birth weight, Pregnancy

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