ABSTRACT

Aim of the study: To establish endothelial activation markers which could uncover endothelial damage during physiological pregnancy. Type of study: Prospective study. Method:We examined 403 pregnant women with a physiological pregnancy. Venous blood samples were collected from the women at the beginning of the pregnancy, a second sample was collected in the interval 24-28 weeks gestation. Parameters were examined using methods: t-PA – ELISA, PAI-1 – ELISA, vWF Ag – EIA ePCR – ELISA, MMP-2,9 – ELISA with fluorogenic detection, TIMP-2 – ELISA, endothelial microparticles - flow cytometry. Results: The level of vWF antigen increased during the entire course of pregnancy (in the I. trimester the average level was 152,32%, in the II. and III. trimester 173.34% and 216.20% respectively). At the same time, vWf activity also increased (I. trimester average level 130.20%, II. and III. trimester 150.09% and 181.91% respectively). The level of thrombomodulin significantly increased during pregnancy (I. trimester average level 19,05 ng/ml, II. and III. trimester 28,47 ng/ml and 39,86 ng/ml respectively). The level of soluble form of EPCR increased during pregnancy (I. trimester average level 201.76 ng/ml, II. and III. trimester 274.68 ng/ml and 324.07 ng/ml respectively). The level of PAI–1 increased during the entire course of pregnancy (I. trimester average level 36.14 ng/ml, II. and III. trimester 50.07 ng/ml and 60.12 ng/ml respectively). The level of t- PA did not change significantly during the course of pregnancy (I. trimester average level 2.48 ng/ml, II. and III. trimester 2.97 and 3,34 ng/ml respectively). The levels of MMP-2 (I. trimester average level 9043,76 RFU, II. and III. trimester 9315.38 and 8800.27 RFU respectively), MMP-9 (I. trimester average level 8371.90, II. and III. trimester 8290.81 and 7470.50 respectively), TIMP-2 (I. trimester average level 92.5 ng/ml, II. and III. trimester 98.5 and 96.5 ng/ml respectively) or endothelial microparticles (I. trimester average level 3838.38 particles/μl, II. and III. trimester 3836.59 and 3650.59 particles/μl respectively) did not change significantly throughout the individual trimesters. Conclusion: We confirmed the hypothesis regarding the significant influence pregnancy has on changes in levels of these markers. Key words: endothelium, pregnancy, activation, preeclampsia.