The agonistic autoantibodies to the angiotensin II type 1 receptor in pregnancies complicated by hypertensive disorders
Agata Szpera-Gozdziewicz (PL), Tomasz Gozdziewicz (PL), Przemyslaw Wirstlein (PL), Ewa Wender-Ozegowska (PL), Grzegorz Breborowicz (PL)
[Szpera-Gozdziewicz] Poznan University of Medical Sciences, [Gozdziewicz] Poznan University of Medical Sciences, [Wirstlein] Poznan University of Medical Sciences, [Wender-Ozegowska] Poznan University of Medical Sciences, [Breborowicz] Poznan University of Medical Sciences
Context: Hypertensive disorders complicate about 6 to 8 percent of all pregnancies and are responsible for many cases of iatrogenic preterm deliveries and are associated with both neonatal and maternal mortality and morbidity. The etiology and pathogenesis of pre-eclampsia and other types of hypertension in pregnancy, despite many theories, are not yet fully understood, but are assumed to be both complex and multifactorial. Objective: Previous investigations demonstrated the relationship between the levels of the agonistic autoantibodies to the angiotensin II type 1 receptor (AT1-AA) and pre-eclampsia. The purpose of our study was to determine the role of agonistic autoantibodies to the angiotensin II type I receptor in the pathophysiology of hypertensive disorders in pregnancy. Methods: The enzyme-linked immunosorbent assay kits were used to for the evaluation of the presence of autoantibodies in patient’s venous blood. Patients: Sixty three pregnant women were enrolled in our study. We then created 3 study groups—pregnant women with chronic hypertension [n=13], those with gestational hypertension [n=17], and those with pre-eclampsia [n=16]—as well as a control group consisting of 17 healthy normotensive pregnant women. Interventions: none. Main Outcome Measures: The titers of autoantibodies as measured from venous blood obtained in the third trimester of pregnant women from study and control groups. Results: We found statistically higher AT1-AA titers in the group of gestational hypertension and pre-eclampsia compared to healthy normotensive pregnant women [median 9,6 vs 7,8, p=0,01 and 10,9 vs 7,8, p=0,02 respectively]. After adjusting by BMI significant differences remain only in the pre-eclamsia group. Conclusions: Autoantibodies against AT1-AA may play role in the pathogenesis of pre-eclampsia.