Correlated plasma elastase and sera cytotoxicity in eclampsia - A possible role of endothelin-1 induced neutrophil activation in preeclampsia eclampsia

The activation of neutrophils was studied in preeclampsia (n = 10) and eclampsia (n = 20) compared to normotensive controls (n = 10) and nonpregnant essential hypertensives (n = 10). Plasma elastase levels were raised in preeclampsia (0.53 +/- 0.32 mu g/mL, P <.002) and eclampsia (1.26 +/- 0.8 mu g/mL, P <.001) respectively compared to normal pregnancies (0.032 +/- 0.009 mu g/mL). The plasma elastases were more elevated in eclamptic cases compared to essential hypertensive (0.53 +/- 0.27 mu g/mL; P = .01) patients. We analyzed the correlation among elastase values, systolic (SBP), mean blood pressures (MBP), endothelin-l (ET-1) levels and sera cytotoxicity (as measured by fura-2 release from human umbilical venous endothelial cell culture) in eclamptic cases. SEP and MBP were significantly correlated with plasma elastase levels in preeclampsia (r = 0.67, 0.63, respectively; P <.03) and eclampsia (r = 0.49, 0.49, respectively; P <.02). ET-1 levels were correlated with SEP (P = .003) and MBP (P = .001) and corresponding elastase levels (r = 0.606, P <.003) in eclamptic patients. Doses of 10, 25, and 50 pmol/mL of ET-1 increased elastase release in human neutrophil cultures dose and time dependently. Cytotoxicity of eclamptic sera correlated (P <.001) to the corresponding plasma elastase values, Therefore, this study suggests that neutrophil activation and ET-1 induced neutrophil activation occurs in this disease.