Lower maternal serum tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) levels in early preeclampsia. A retrospective study.

OBJECTIVE: To determine whether maternal serum concentrations of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), a cytokine with anti-inflammatory activity, also involved in cardiovascular morbidity, differ between women with early preeclampsia (<34 weeks) and those with uncomplicated pregnancies.

STUDY DESIGN: This nested case control study included 40 women carrying a single fetus with an uncomplicated pregnancy and 20 women with early preeclampsia (<34 weeks). Data were matched 1:2 for gestational age at the time of venipuncture (28-34 weeks of gestation), converted into multiples of the median and adjusted for maternal weight. The maternal serum TRAIL concentrations were determined using an enzyme immunoassay.

RESULTS: The TRAIL concentrations were lower in the patients with early preeclampsia when compared with those of the control group, being 29.64 ± 8.83 pg/dL and 43.8 ± 12.53 pg/dL (p-value < 0.001), respectively. The difference was also present after multiple of median conversion and maternal weight adjustment. The quoted multiple of median values were 1.00 ± 0.27 and 0.82 ± 0.23, respectively (p-value < 0.001).

CONCLUSIONS: Serum TRAIL concentrations are significantly reduced in patients with early preeclampsia. This result is in line with the presence of an intravascular inflammation typical of preeclampsia. The lower levels of TRAIL detected in preeclampsia should be useful for a more proper selection of women with long-term cardiovascular risk later in life.