Plasma type II phospholipase A2 levels are elevated in severe preeclampsia,

OBJECTIVE: Our purpose was to compare plasma concentrations of type II phospholipase A2 in normal and preeclamptic pregnancies and to determine whether plasma from preeclamptic patients increases endothelial cell secretion of type II phospholipase A2. STUDY DESIGN: We compared the plasma levels of type II phospholipase A2 in 23 patients with normal pregnancies and 25 patients with strictly defined preeclampsia. Plasma samples were collected throughout pregnancy and stored at −80° C. Patients with preeclampsia wre matched as closely as possible with controls for maternal age, race, gestational age at blood sampling, and partly. Plasma levels of type II phospholipase A2 were measured by enzyme immunoassay. To investigate endothelial cell type II phospholipse A2 production, we measured levels of prostacyclin and type II phospholipase A2 in conditioned media from cultured human umbilical vein endothelial cells exposed to plasma from preeclamptic and normal pregnant patients. RESULTS: The mean plasma type II phospholipase A2 level in the mild preeclampsia group (6.1 ± 3.0 ng/ml, n = 6) was ot different from that in control patients (6.0 ± 3.2 ng/ml, n = 23). However, the mean type II phospholipase A2levelin patients with severe preeclampsia (19.9 ± 12.3 ng/ml, n = 19) was significantly higher when compared with the other two groups (p< 0.001). Prostacyclin concentrations in conditioned media of endothelial cells exposed to plasma from patients with preeclampsia were elevated compared with cells incubated with control plasma (8.6 ± 1.7 vs 4.0 ± 5.0 ng/ml, p< 0.05). However, the concentration of type II phospholipase A2 in conditioned medium was not significantly different (1.6 ± 0.3 vs, 1.8 ± 1.0 ng/ml, p = 0.40). CONCLUSIONS: Plasma concentrations of type II phospholipase A2 are elevated in preeclampsia and correlate well with the severity of disease. Plasma from preeclamptic women increased secretion of prostacyclin, but not type II phospholipase A2 by endothelial cells in culture.