Abnormal levels of serum N-terminal propeptide of collagen type IV (PIVNP) in women one year after preeclampsia

Abstract

Proteins of the extracellular matrix (ECM) play an important role in normal pregnancy and preeclampsia (PE). Type IV collagen (COL4) is a major ECM structural element, uniquely presented in basement membranes. The N-terminal propeptide of collagen type IV (PIVNP) is a marker of COL4 synthesis. In the present study, we determined serum PIVNP levels in women one year after PE and tested whether PIVNP is related to hypertension development after preeclamptic pregnancy. The current research examined 32 women one year after PE (mean age 25.3±6.3 years) and a control group of 20 women one year after normal pregnancy (mean age 25.6±5.6 years). The enzyme-linked immunosorbent assay (ELISA) was used to determine concentrations of PIVNP. We found that at 1 year after delivery, 38.46% of women who suffered PE had developed arterial hypertension (AH), and 5.77% had developed diabetes mellitus. Women who had normal pregnancies developed neither AH nor diabetes mellitus 1 year after delivery. The distribution of women who had developed AH after preeclamptic pregnancy was as follows: Grade I AH-7; Grade II AH-4; and Grade III AH- 2. Serum PIVNP levels in women one year after PE were statistically significantly lower than in women one year after normal pregnancy: 0.26 (0.1÷0.65) vs. 0.45 ng/ml (0.3÷0.6) (KW= 5.342; p=0.02). PIVNP showed a correlation with creatinine (r= -0.26; p=0.05). Hypertensive women one year after PE showed the lowest levels of serum PIVNP.Our data showed decreased levels of PIVNP in the sera of women one year after PE. This finding demonstrated altered COL4 turnover after preeclamptic pregnancy. The diminished COL4 synthesis might play an important role in persistent vascular wall injury and dysfunction postpartum. We suggest that PIVNP might be involved in the pathogenic mechanisms determining the development of hypertension postpartum.

Keywords

• N-terminal propeptide of collagen type IV
• extracellular matrix
• collagen IV turnover
• history of preeclampsia
• arterial hypertension

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