Circulating concentrations of glycocalyx degradation products in preeclampsia

Niclas Carlberg; Catherine Cluver; Camilla Hesse; Sven-Egron Thörn; Robin Gandley; Tor Damén; Lina Bergman

doi:10.3389/fphys.2022.1022770

Circulating concentrations of glycocalyx degradation products in preeclampsia

Front Physiol. 2022 Oct 13:13:1022770. doi: 10.3389/fphys.2022.1022770. eCollection 2022.

Authors

Niclas Carlberg^{1

2}, Catherine Cluver^{3

4

5}, Camilla Hesse⁶, Sven-Egron Thörn^{1

7}, Robin Gandley⁸, Tor Damén^{7

9}, Lina Bergman^{3

10

2}

Affiliations

¹ Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital Östra, Gothenburg, Sweden.
² Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
³ Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa.
⁴ Translational Obstetrics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VI, Australia.
⁵ Mercy Perinatal, Mercy Hospital for Women, Heidelberg, VI, Australia.
⁶ Department of Laboratory Medicine, Institute of Biomedicine, Gothenburg University, Gothenburg, Sweden.
⁷ Department of Anesthesiology and Intensive Care Medicine, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁸ Department of Obstetrics, Gynecology and Reproductive Sciences and Magee Womens Research Institute, University of Pittsburgh, Pittsburgh, PA, United States.
⁹ Section of Cardiothoracic Anesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
¹⁰ Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Abstract

Background and Objectives: Preeclampsia is a multisystem disorder that affects maternal endothelium. The glycocalyx lines and protects the endothelial surface. In severe systemic diseases, like sepsis, it is shed and glycocalyx degradation products can be detected in increased concentrations in plasma. The aim of this study was to compare circulating concentrations of glycocalyx degradation products in degrees of preeclampsia severity. Study design: In this observational study, we included women from the South African PROVE biobank. Women were divided into normotensive controls, women with preeclampsia without end-organ complications, women with a single end-organ complication and women with multiple end-organ complications. Plasma samples taken at inclusion after diagnosis (preeclampsia cases) or at admission for delivery (normotensive controls) were analyzed with ELISA for syndecan-1, hyaluronic acid and thrombomodulin and compared between groups. Results: Women with preeclampsia (n = 47) had increased plasma concentrations of hyaluronic acid (100.3 ng/ml IQR 54.2-204 vs. 27.0 ng/ml IQR (13.5-66.6), p < 0,001) and thrombomodulin (4.22 ng/ml IQR 3.55-5.17 vs. 3.49 ng/ml IQR 3.01-3.68, p = 0.007) but not syndecan-1 compared with normotensive women (n = 10). There were no differences in plasma concentration in any of these biomarkers in women with preeclampsia with no end-organ complications (n = 10) compared with women with preeclampsia and one end-organ complication (n = 24). Women with preeclampsia with two or more end-organ complications (n = 13) had increased plasma concentrations of thrombomodulin (5.46 ng/ml, IQR 4.85-7.83 vs. 4.66 ng/ml, IQR 3.45-4.88, p = 0.042) compared with women with preeclampsia and no end-organ complications. Conclusion: Thrombomodulin was associated with disease severity and may be valuable for risk-stratifying women with preeclampsia.

Keywords: endothelial dysfuction; glycocalyx; hyaluronic acid; hypertension in pregnancy; preeclampsia; syndecan 1; thrombomodulin.