The cell adhesion molecule, VCAM‐1, is selectively elevated in serum in pre‐eclampsia: does this indicate the mechanism of leucocyte activation?

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Abstract
Objective To determine whether circulating levels of cell adhesion molecules, markers of endothelial damage and leucocyte activation, were increased in pre-eclampsia. Design Serum was prepared from peripheral venous blood and stored at –70°C. The cell adhesion molecules, VCAM-1, E-Selectin and ICAM-1, were measured by ELISA. Setting Department of Obstetrics and Gynaecology, Royal Infirmary, Glasgow. Subjects Sixteen primigravid women with pre-eclampsia were recruited for the study. The pre-eclampsia group were compared with 18 healthy primigravid women with uncomplicated pregnancies. Results The pre-eclamptic group had significantly higher serum levels of the cell adhesion molecule VCAM-1 (t= 3.673; P < 0.001). There were no significant differences in the adhesion molecules ICAM-1 or E-Selectin. Conclusions Endothelial damage and dysfunction are common to all the pathological features of pre-eclampsia. This study shows that concentrations of cell adhesion molecules, which indicate leucocyte-endothelial attachment and activation, are elevated in the serum of patients with pre-eclampsia. Such increases in soluble circulating cell adhesion molecules may reflect increased expression of these molecules on the endothelium and thereby explain the mechanism for leucocyte activation in pre-eclampsia.