Profiling of Clinical Parameters, Pre - natal Circulatory Stress Hormones, and Dendritic Cell Subsets in Pre - eclampsia Patients

Abstract

Background: Pre-eclampsia (PE) is a pro-inflammatory, hypertensive disease that occurs during pregnancy. For pharmacologic management, magnesium sulfate (MgSO4) and antihypertensive medications are administered in women with preeclampsia. This condition is treated by only delivery of the placenta and fetus. EOPE (early-onset pre-eclampsia) is a severe form of PE. There aren't any certain biomarkers available for the differential diagnosis of EOPE and LOPE. Clinical parameters such as hypertension, proteinuria, anemia, eclampsia, and family history contribute to the risk factors of PE. It has also been linked to HELLP syndrome and thrombocytopenia. Infant low birth weight and IUGR is also likely to be associated with PE. The profile of these clinical parameters in case of early-onset is still vague. Hence, profiling of these parameters may provide an approach for developing a differential diagnostic strategy. Cortisol and dehydroepiandrosterone-sulfate (DHEAS) are two hormones that are essential for a healthy pregnancy. The profile of these hormones may be valuable in the differential diagnosis of pre-eclampsia with early-onset. Human dendritic cell (DC) subtypes (CD1c+, CD141+ myeloid DCs, and plasmacytoid DCs) are implicated in the inflammatory process and are considerably changed in a number of proinflammatory illnesses. These modifications have implications for monitoring DC subsets’ profile and differential diagnosis of EOPE and LOPE. DC subsets are important in normal pregnancy because they facilitate trophoblast migration and invasion while also maintaining an anti-inflammatory immunotolerance milieu. The current state of DC subsets in the proinflammatory milieu of EOPE pregnancy, on the other hand, necessitates a detailed investigation. PE can be controlled by antihypertensive medicines and thus can have a significant impact on the functions of immune cells and their immune responses. DC subset imbalance has been shown to be initiating hypertension among CVD patients. Our study seeks to research the trend of DC subset imbalance in the early-onset of pre-eclampsia patients. Objective: To profile of clinical parameters, pre-natal circulatory stress hormones, and dendritic cell subsets in pre-eclampsia patients. Methods: The purpose of this study is to look at how clinical parameters, prenatal stress hormones, and DC subsets change in the blood of PE patients (n=49). For our study, blood samples were collected from Civil hospital, Gandhinagar. As controls, normal pregnant women (n=70) were used. Every pregnant woman generally test for the clinical parameters during pregnancy, in these lines profiling of clinical parameters was done. Cortisol and DHEA-S concentrations in human plasma were measured using an enzyme-linked immunosorbent assay (Competitive ELISA). Multiparametric flow cytometry technique was used in profiling of DC subsets. Results: clinical parameters, prenatal circulatory cortisol, and DHEA-S, dendritic cell subset were analysed in this study among late third-trimester normal and pre-eclampsia patients. The study has identified that platelets are significantly lower (p=0.026) in pre-eclampsia group of study participants. And within the pre-eclamptic group, the early onset of pre-eclampsia had significantly lower platelets count (p=0.016) compared to the normal pregnant women. While late onset of pre-eclampsia had no significant difference with that of normal pregnant womnen (p=0.16). The cortisol concentration was found to be significantly lower (p=0.025) in the pre-eclamptic group when compared to the normal study participants. Within the pre eclamptic group, the cortisol concentration was found to be significantly lower (p=0.039) in the early-onset group when comapared to the normal pregnant women. While there was no significant difference observed in the late-onset (p=0.086) when compared to the women with normal pregnancy. The dendritic cell subset profile in the pre-eclamptic group, which included both early-onset and late-onset study participants, was not significant and it resembled that of the normal study group. Conclusion: Platelets and cortisol stood out of all the parameters profiled during late-third trimester. Hence, they can be predictive for differential diagnosis of early and late-onset of pre-eclampsia. Although future studies are required to see if similar profiles are observed in the early two trimesters.