PLASMA TYPE-II PHOSPHOLIPASE A(2) LEVELS ARE ELEVATED IN SEVERE PREECLAMPSIA

OBJECTIVE: Our purpose was to compare plasma concentrations of type II phospholipase A(2) in normal and preeclamptic pregnancies and to determine whether plasma from preeclamptic patients increases ;endothelial cell secretion of type II phospholipase A(2). STUDY DESIGN: We compared the plasma levels of type II phospholipase A(2) in 23 patients with normal pregnancies and 25 pat!eis with strictly defined preeclampsia. Plasma samples were collected throughout pregnancy and stored at - 80 degrees C. Patients with preeclampsia were matched as closely as possible with controls formaternal age, race, gestational age at blood sampling, and parity. Plasma levels of type II phospholipase A(2) were measured by enzyme immunoassay. To investigate endothelial cell type II phospholipase A(2) production, we measured levels of prostacyclin and type II phospholipase A(2) in conditioned media from cultured human umbilical vein endothelial cells exposed to plasma from pieeclamptic and normal pregnant patients. RESULTS: The mean plasma type II phospholipase A(2) level in the mild preeclampsia group (6.1 +/- 3.0 ng/ml, n = 6) was not different from that in control patients (6.0 +/- 3.2 ng/ml, n = 23). However, the mean type II phospholipase A(2) level in patients with severe preeclampsia (19.9 +/- 12.3 ng/ml, n = 19) was Significantly higher when compared with the other two groups (p < 0.001). Prostacyclin concentrations in conditioned media of endothelial cells exposed to plasma from patients with preeclampsia were elevated compared with cells incubated with control plasma (8.6 +/- 1.7 vs 4.0 +/- 5.0 ng/ml, p < 0.05). However, the Concentratjonof type II phospholipase A(2) in conditioned medium was not significantly different (1.6 +/- 0.3 vs. 1.8 +/- 1.0 ng/ml, p = 0.40). CONCLUSIONS: Plasma concentrations of type II phospholipase A(2) are elevated in preeclampsia and correlate well with the severity of disease. Plasma from preeclamptic women increased secretion of prostacyclin, but not type II phospholipase A(2) by endothelial cells in culture.