Receptores de citocinas proinflamatórias na pré-eclâmpsia

Preeclampsia is a disease specific of human pregnancy that affects 3-8% of pregnant women, and it is one of the three leading causes of maternal mortality and morbidity. The disease is characterized by hypertension and proteinuria after the 20th week of gestation. The risk factors for this disease are not completely understood but appear to include dysregulation of the immune response arising from defects in placentation, environmental and genetic factors. This study aimed to determine whether the variation in the amount of proinflammatory cytokine receptors IL-1R2, IL-6R and TNF-αR1 would be involved in preeclampsia. They were recruited women with preeclampsia (n=24) and women who evolved during pregnancy without changes in blood pressure (n=12) were recruited. Clinical and laboratory data were collected. The cytokine receptors (IL-1R2, TNF-αR1 and IL-6R) were assessed in mononuclear cells isolated from peripheral blood using flow cytometry (Control = 8; PE = 24). C-reactive protein (CRP) was determined by CRP ultrasensitive method (Control = 7; PE = 18) was performed using sera pregnant women. Women with preeclampsia had higher weight at the beginning of the pregnancy (p=0.0171) and lower gestational age at delivery (0.0008). Classical monocytes were decreased in preeclampsia but not intermediate or non-classical monocytes. The frequency of IL-1R2 pro inflammatory cytokine receptors is decreased in women with PE only in the subpopulation of non-classical monocytes (p = 0.0011). TNF-αR1 receptor and IL-6R, had a decreased frequency in the three subpopulations of monocyte (classic, intermediate and non-classical) when compared to women with normal pregnancy. An increase in IL-1R2 receptor in TCD4+ lymphocytes, but a decrease in TNF-receptor and IL-6R in women with preeclampsia were found. No differences in the frequency of those receptors in CD3+/CD8+ in preeclampsia. There was no difference in C-reactive protein in preeclampsia. The reduction in the amount of IL-1R2, TNF- αR1 and IL-6R monocytes and lymphocytes can be involved in the regulation of inflammation observed in preeclampsia, contributing to disease.

A pré-eclâmpsia é uma doença que afeta 3-8% das mulheres grávidas. Os fatores de risco para essa doença não são completamente compreendidos, mas incluem desregulação da resposta imune oriundos de defeitos na placentação, fatores ambientais e genéticos. O presente estudo teve como objetivo investigar associação variação na quantidade de receptores de citocinas pró-inflamatórias (IL-1R, IL-6R e TNF-αR) estariam envolvidos com a pré-eclâmpsia. Receptores de citocinas (IL-1R2, TNF-αR1 e IL-6R) foram avaliados em células mononucleares das grávidas normotensas (controle n=11) e grávidas com pré-eclâmpsia (PE, n=24). Mulheres com pré-eclampsia tinham peso mais elevado no início da gravidez (p=0.0171). Foi observado uma diminuição de monócitos clássicos, mas não de monócitos intermediários e não-clássicos na pré-eclâmpsia. A frequência dos receptores de citocinas proinflamatórias IL-1R2, TNF-αR IL-6R aderidos a membrana das subpopulações de monócitos (clássicos, intermediários e não clássicos) e linfócitos (CD3+CD4+ e CD3+CD8+) estavam diminuídas em pacientes com pré-eclâmpsia, quando comparados com grávidas normais. A redução na quantidade de receptores de citocinas IL-1R2, TNF-αR1 e IL-6R em monóciots e linfócitos pode ser um fator mantenedor do estado inflamatório na pré-eclampsia.