| Objective: Hypertensive disorder complicating pregnancy ( HDCP ) is a specific disease during gestation period. Itsmorbility is 9.4% inland. HDCP is the major cause resulting in morbidity and mortality in pregnant women and neonates. But its etiology is not clear. In recent years, based on experimental and clinical researches , the theory may be the central part of the pathogenesis of HDCP, which is placental shallow bed and vascular endothelial damage. People have payed an abroad attention to cytokines and adhesion molecules in the pathogenes is on HDCP .NF-κB is a factor with transcripting and regulating a number of cytokines in the level of genes . it plays an import- ant role in the physiological and pathological processes of organism ,that including immune response, inflammation ,cell growth , apoptosis and so on. Research showed that NF-κB can be expressed in placental villus syncytiotrophoblast cells in pregnant women, and it can regulate the expression of adhesion molecule in vitro cell culture. it suggested that NF-κB activated might play an important role in the pathogenesis of HDCP. Cell adhesion molecule (CAM) is an family of factors with a variety of biological activity.It is important in a series of vascular endothelial inflammatory injury, or in the process of embryo formation and development . Placenta not only can express different types of CAM,but expressions of some CAM may change in trophoblast cells ,affecting the infiltration of trophobla -st cells and the development of placenta.As members of the villous adhesion molecule family ,the expressions of E-selection and VCAM-1 have be found in vascular endothelial cells and trophoblast cells, they have played an important role both in vascular endothelial inflammatory injury, and in the process of embryonic development. Otherwise, pathological damage and the abnormal expressions of adhesion molecules were found in partial placenta in preeclampsia.Thus, the two factors may be closely related to in the occurrence of HDCP. The aim of this investigation is to study the effect and inter-relation of NF-κB,E-selection and VCAM-1 in the pathogenesis of HDCP through expressions of NF-κB, E-selection and VCAM-1 in the placenta of preeclampsical patients and the normal placenta of pregnant women .Thus, further explosion is important for clinical treatment of HDCP.Method: Sixty four pregnant women were randomly divided into two groups:(1)control group(n=20,normal pregnant women), (2)preeclampsia group (n=42, twenty two with mild preeclamp sia and eighteen women with severe preeclampsia thereinto) They were diagnosed according to the criteria (Obstetrics and Gynecology, the Sixth Edition), without complications of internalmedicine and other complications of pregnancy. Each specimen (1cm×1cm×1cm) was collected fromcentral placenta after cesarean section and was washed with sodium chloride injection. Then they were fixed in 10% formalin and 24h later embedded in paraffin. Sections from each specimen were cut at 4μm.The expression of NF-κB,E-selection and VCAM-1 was determined by immunohistochemistry. All the data were processed by SPSS10.0 software. Spearman rank correlation were made for correlate analysis.Values were considered to be significant at P<0.05.Results: 1 There were no statistical differences between control and preeclampsia group on maternal age, the base blood pressure and gestational age (P>0.05).2 Activated NF-κB was predominantly located in the cytoplasm of placental villus syncytiotrophoblastic cells, capillary vascular endothelial cells and some decidual cells, occasionally in the nucleus. E-selection was mainly located in the membrane and cytoplasm of placental villus syncy- tiotrophoblast and capillary vascular endothelial cells ;VCAM-1 was mainly located in the membrane and cytoplasm of placental villus syncytiotrophoblast and capillary vascular endothelial cells.3 The expresstions of NF-κB,E-selection and VCAM-1 in placental villus capillary vascular endothelial cells of the control group and the pre-eclampsia group : positive expresstion rate of NF-κB in placenta were 40.9% , 58.3% and 83.3% in the normal, mild and severe preeclampsia group. Positive expresstion rate of E-selection in placenta were 45.45% , 62.5% and 83.3% in the normal, mild and severe pre-eclampsia group. Positive expresstion rate of VCAM-1 in placenta were 50.00%, 66.67% and 88.80% in the normal ,mild and severe preeclampsia group.The similar progressive trend was presented in three different groups on each fator. There was statistical significant difference between the normal and severe preeclampsia group (P<0.05), There were no statistical differences between the normal and the mild preeclampsia group, and the mild preeclampsia and severe preeclampsia group. (P>0.05)4 Spearman correlation analysis: In placental villus capillary vascular endothelial cells ,the expression of NF-κB was positive correlation with that of E-selection (r=0.652,P<0.05) and VCAM-1(r =0.481, P<0.05); There was positive correlation between the expression of E-selection and expression of VCAM-1 (r =0.583, P<0.05).5 The expresstions of NF-κB, E-selection and VCAM-1 in placent al villus syncytiotrophoblast cells of the control group and the preeclampsia group:Expresstion of NF-κB presented the progressive trend in placenta, the positive rate were 50.0% , 66.67% and 88.89% in the normal, mild and severe pre- eclampsia group. There was statistical significant difference between the normal and severe preeclampsia group, ( P<0.05 ) there was no statistical differences between the normal and the mild preeclampsia group, and the mild preeclampsia and severe preeclampsia group. (P>0.05) Expresstions of E-selection and VCAM-1 presented the the similar descended trend in placenta. There was no statistical differences between the normal and severe preeclampsia group (P<0.05) ,There was no statistical differences between the normal and the mild preeclampsia group, and the mild preeclampsia and severe preeclampsia group. (P>0.05)6 Spearman correlation analysis: In placental villus syncyt -iotrophoblast cells, the expression of NF-κB was negative correlation with that of E-selection (r=-0.441,P<0.05) and VCAM-1(r=-0.496,P<0.05); There was positive correlation between the expression of E-selection and expression of VCAM-1.(r =0.739, P<0.05)Conclusions:1 The expression of activated NF-κB in placenta of preeclampsia group was significantly higher than that of contral group , and that were positively correlated to the level of preeclampsia. That discovered NF-κB may break the balance of tissue immunity in pregnant women, participate in pathogenic process of pre-eclampsia, and expression of VCAM-1 and E-selection in placenta of preeclampsia group was significantly different from the contral group, which suggested that NF-κB, E-selection and VCAM-1 have been involved in the pathogenesis of preeclampsia.2 The expresstions of NF-κB,E-selection and VCAM-1 were significantly higher in placental villus capillary vascular endothelial cells of the preeclampsia group than that of the control group,and the differences were significant,which indicate that NF-κB may regulate expression of E-selection and VCAM-1 up, then promote the process of vascular endothelial cell injury in preeclampsia.3 According to the expression of NF-κB ,E-selection and VCAM-1in the placental villou syncytiotrophoblast cells in preeclampsia group and the result of correlation analysis between three factors , NF-κB activated may inhibit the expression of E-selection and VCAM-1 , there may be synergistic relation between E-selection and VCAM-1,then lead to trophoblastic limited invasion.4 The abnormal expressions of NF-κB, E-selection and VCAM-1 not only promote villous vascular endothelial damage of patients with preeclampsia, but also affect the placental implantation, resulting in the state of ischemia and hypoxia in placenta, causes a series of clinical symptoms of preeclampsia .
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