Immunological Criteria for Differential Diagnosis of Hypertension in Pregnant Women

The aim of the investigation was to study expression characteristics of neutrophil and monocyte adhesion molecules (CD49b, CD11b, CD51 and CD99) in the venous blood of pregnant women with various hypertensive disorders and on the basis of these findings to find new criteria for differential diagnosis and to develop a diagnostic algorithm for the given pathology.

Materials and Methods. The study involved 205 women at 20–34 weeks' gestation: 62 women with preeclampsia (PE), 44 women with chronic arterial hypertension (CAH), 44 women with CAH and secondary PE, 55 women without hypertensive disorders. The concentration of CD11b⁺, CD49b⁺, CD51⁺ and CD99⁺ neutrophils and monocytes in venous blood was measured by means of multicolor flow cytofluometry.

Results. As compared to the control group the level of CD49b⁺ neutrophils was the highest in women with PE and CAH with secondary PE, the content of CD99⁺ neutrophils was higher in pregnant women with CAH and CAH with secondary PE, and the level of CD51⁺ neutrophils and CD11b⁺ monocytes appeared to be lower in pregnant women with CAH. In contrast to the group of women with CAH, in case of PE increase of CD49b⁺ and CD99⁺ neutrophils as well as CD11b⁺ monocytes was observed. Unlike pregnant women with CAH, women with CAH and secondary PE showed increase in CD49b⁺ neutrophils, CD11b⁺ monocytes and, unlike PE women, increase in CD99⁺ neutrophils. Using ROC-analysis of parameters under study we identified new immunological criteria for diagnosing various hypertensive disorders in pregnancy and developed a differential diagnostic algorithm of the given pathology.

Conclusion. Changes in concentration of CD11b⁺, CD49b⁺ and CD99⁺ neutrophils and monocytes in venous blood of pregnant women with hypertension may be regarded as additional differential diagnostic criteria for identifying its nosological form, which enables to determine patient managing tactics, as well as timely and differential approach to therapy.

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Panova I.A., Malyshkina A.I., Khlipunova D.A., Rokоtyanskаya E.A., Sytova L.A., Kudryashova A.V. Immunological Criteria for Differential Diagnosis of Hypertension in Pregnant Women. Sovremennye tehnologii v medicine 2015; 7(3): 103, https://doi.org/10.17691/stm2015.7.3.15