RESUMO
Cerebral complications in preeclampsia are leading causes of maternal mortality. Animal models suggest that an injured blood-brain barrier and neuroinflammation may be important but there is paucity of data from human studies. Therefore, we aimed to evaluate this in women with preeclampsia and eclampsia. We included women recruited to the South African Preeclampsia Obstetric Adverse Events (PROVE) biobank. Blood and cerebrospinal fluid (CSF) were collected around delivery. CSF was analyzed for neuroinflammatory markers interleukin 1ß, interleukin 6, interleukin-8 and tumor necrosis factor alpha (TNF-alpha). The CSF to plasma albumin ratio was measured to assess blood-brain barrier function. Women with eclampsia (n = 4) showed increased CSF concentrations of all pro-inflammatory cytokines and TNF-alpha compared to women with normotensive pregnancies (n = 7) and also for interleukin-6 and TNF-alpha compared to women with preeclampsia (n = 4). Women with preeclampsia also showed increases in pro-inflammatory cytokines IL-6 and IL-8 but not TNF-alpha in the CSF compared to women with normotensive pregnancies. In particular, women with eclampsia but also women with preeclampsia showed an increase in the CSF to plasma albumin ratio compared to normotensive women. In conclusion, women with preeclampsia and eclampsia show evidence of neuroinflammation and an injured blood-brain barrier. These findings are seen in particular among women with eclampsia.
Assuntos
Barreira Hematoencefálica/patologia , Eclampsia/sangue , Doenças Neuroinflamatórias/sangue , Doenças Neuroinflamatórias/complicações , Pré-Eclâmpsia/sangue , Adulto , Albuminas/metabolismo , Biomarcadores/líquido cefalorraquidiano , Eclampsia/líquido cefalorraquidiano , Feminino , Humanos , Doenças Neuroinflamatórias/líquido cefalorraquidiano , Pré-Eclâmpsia/líquido cefalorraquidiano , GravidezAssuntos
Eclampsia/líquido cefalorraquidiano , Imunoglobulinas/líquido cefalorraquidiano , Doenças do Recém-Nascido/líquido cefalorraquidiano , Adulto , Eclampsia/imunologia , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/imunologia , Deficiência Intelectual/líquido cefalorraquidiano , Deficiência Intelectual/imunologia , Masculino , Gravidez , Convulsões/líquido cefalorraquidiano , Convulsões/imunologia , SíndromeRESUMO
Continuous monitoring of the intraventricular CSF pressure was performed for 48 h in a woman of 23 years who had postpartum eclampsia with unconsciousness for 5 days and decerebrate spasms suggesting compression of the upper brainstem. The intraventricular pressure was normal with minor variations of 10--20 mm Hg.
