Increased plasma von Willebrand factor antigen levels but normal von Willebrand factor cleaving protease (ADAMTS13) activity in preeclampsia

Attila Molvarec; János Rigó Jr; Tamás Bõze; Zoltán Derzsy; László Cervenak; Veronika Makó; Tímea Gombos; Miklós László Udvardy; Jolán Hársfalvi; Zoltán Prohászka

doi:10.1160/TH08-05-0330

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2009; 101(02): 305-311
DOI: 10.1160/TH08-05-0330

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Increased plasma von Willebrand factor antigen levels but normal von Willebrand factor cleaving protease (ADAMTS13) activity in preeclampsia

Attila Molvarec

¹Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary

,

János Rigó Jr

¹Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary

,

Tamás Bõze

¹Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary

,

Zoltán Derzsy

¹Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary

,

László Cervenak

²Research Group of Inflammation Biology and Immunogenomics, Hungarian Academy of Sciences, Budapest, Hungary

,

Veronika Makó

³Department of Internal Medicine and Szentágothai Knowledge Center, Semmelweis University, Budapest, Hungary

,

Tímea Gombos

³Department of Internal Medicine and Szentágothai Knowledge Center, Semmelweis University, Budapest, Hungary

,

Miklós László Udvardy

⁴Clinical Research Center, University of Debrecen, Debrecen, Hungary

,

Jolán Hársfalvi

⁴Clinical Research Center, University of Debrecen, Debrecen, Hungary

,

Zoltán Prohászka

²Research Group of Inflammation Biology and Immunogenomics, Hungarian Academy of Sciences, Budapest, Hungary

³Department of Internal Medicine and Szentágothai Knowledge Center, Semmelweis University, Budapest, Hungary

› Author Affiliations

Abstract

Summary

The activity of ADAMTS13, the von Willebrand factor (VWF) cleaving protease is low in several conditions, including HELLP (haemolysis, elevated liver enzymes, and low platelet count) syndrome. As HELLP syndrome develops in most cases on the basis of preeclampsia, our aim was to determine whether plasma ADAMTS13 activity is decreased in preeclampsia. Sixty-seven preeclamptic patients, 70 healthy pregnant women and 59 healthy non-pregnant women were involved in this case-control study. Plasma ADAMTS13 activity was determined with the FRETS-VWF73 assay, while VWF antigen (VWF:Ag) levels with an enzyme-linked immunosorbent assay. The multimeric pattern of VWF was analyzed by SDS-agarose gel electrophoresis. There was no significant difference in plasma ADAMTS13 activity between the preeclamptic and the healthy pregnant and non-pregnant groups (median [25–75 percentile]: 98.8 [76.5–112.8] %, 96.3 [85.6–116.2] % and 91.6 [78.5–104.4] %, respectively; p>0.05). However, plasma VWF:Ag levels were significantly higher in preeclamptic patients than in healthy pregnant and non-pregnant women (187.1 [145.6–243.1] % versus 129.3 [105.1–182.8] % and 70.0 [60.2–87.3] %, respectively; p<0.001). The multimeric pattern of VWF was normal in each group. Primiparas had lower plasma ADAMTS13 activity than multi-paras (92.6 [75.8–110.6] % versus 104.2 [92.1–120.8] %; p=0.011). No other relationship was found between clinical characteristics, laboratory parameters and plasma ADAMTS13 activity in either study group. In conclusion, plasma ADAMTS13 activity is normal in preeclampsia despite the increased VWF:Ag levels. However, further studies are needed to determine whether a decrease in plasma ADAMTS13 activity could predis-pose preeclamptic patients to develop HELLP syndrome.

Keywords

ADAMTS13 - HELLP syndrome - preeclampsia - pregnancy - von Willebrand factor

Full Text

References

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