Studies On The Activation Of NF-kB In Placenta,the Maternal Blood Level Of TNF-α,ET-1 And The Umbilical Blood Level Of TNF-α In Patients With Pregnancy Induced Hypertension

Pregnancy-Induced-Hypertension (PIH) is a principle cause to fetal and maternal morality. The incidency rate of it is 9.4%. Its etiology and pathogenesis are undefined now, which hold up the improvement of the diagonosis therapy and prevention of PIH.Nuclear factor-kappaB(NF-kB) protein is a family of transcription factors which distributes and works very widely. It plays important role in the physiologicaK pathologic process of organism's immunoresponsivness immune response and cell growth and development apoptosis and so on. Activated by many stimulations such as oxidation-stress bacterium lipopolysaccharide cellular molecule and so on, NF-kB can bind specificly to kB site which is at many genes'promoter region and promote transcriptonal expression. It can regulate the production of pro-inflammatory cytokine cellular surface receptor transcription factor adhension molecule, and further cause organism microcirculatory obstruction and vessel endotheliocyte damage. Many scholars believe that maternal-fetal immunoimbalance is a vital link of the cause of pregnancy induced hypertension. The aim of this study is to elucidate the role of NF-kB in pathophysiological changes of PIH and provide new theoreticalfoundation for the prevention and treatment of PIH. Some targets were examined in this experiment. They were NF-kB activity in placenta, maternal blood level of tumor necrosis factor- α (TNF- α ) endothelin-l(ET-l) and umbilical blood level of TNF- α in normal late pregnant women and patients with PIH.Material and Method: 1.A11 the subjects were divided into two groups: (1)the normal late pregnant group (20), women with normal late pregnancy; (2)the PIH group (n=60), according to the diagnostic standard (OBSTESTRICS AND GENECOLOGY, the Fifth Edit), it is further subdivided into mild (n=18), moderate (n=21) and severe (n=21) groups. None of the patients had no other complications of pregnancy and primary hypertension and other visceral disorders. There were no significant difference between PIH group and the normal late pregnant group in maternal age and gestatoinal age (p>0.05). The mean systolic and diastolic blood pressure of three groups of PIH were significantly higher than the normal late pregnant group (p<0.001). 2.NF-RB activity in placenta was determined by immunohistochemistry, blood levels of TNF- α ET were measured by radioimmunoassay.Result: 1.Activated NF-kB was present predominantly in syncytiotrophoblastic cells, some stem villous endothelium and decidual cells. The intensity of NF-kB immunostaining was significantly increased in PIH group compared with the normal late pregnant group, especially in moderate and severe PIH group (p<0.001). There was positive correlation between the intensity of NF-kB immunostaining and the state of PIH (p<0.001). 2.Compared with normal term pregnant women, maternal blood and umbilical blood level of TNF- α in PIH group increased with seriousness of PIH, especially in moderate and severe PIH groups (p<0.05). 3.The maternal blood ET-1 level was higher in three groups of PIH than that of normal term pregnant women (p<0.05). 4.Of four groups, there was a significant positive correlation between the level of maternal blood TNF- α and activation of placenta NF-kB. Normal late pregnant group (rs=0.64, p<0.01 ), mild PIH group (rs=0.62, p<0.01), moderate PIH group(rs=0.77, p<0.001), severe PIH group (rs=0.73, p<0.001). 5.Positive correlationwas observed between maternal blood TNF- a and ET-1 in all groups. Normal late pregnant group (r=0.55, p<0.001), mild PIH group (r=0.65, p<0.001) , moderate PIH group (r=0.61, p<0.0001), severe PIH group (r=0.72, p<0.0001).Conclusion: l.Activated NF-kB protein was present predominantly in cytoplasm, occasionaly in nucleus. It could be determined in syncytiotrophoblastic cells, some stem villous endothelium and decidual cells. 2.The intensity of NF-kB immunostaining was significantly increased in PIH group compared with the normal late pregnant group. There was positive correlation between the...