HELLP syndrome is associated with an increased inflammatory response, which may be inhibited by administration of prednisolone. Hypertension in pregnancy : official journal of the International Society for the Study of Hypertension in Pregnancy [Hypertens Pregnancy] Journal article | | Title | HELLP syndrome is associated with an increased inflammatory response, which may be inhibited by administration of prednisolone. | | Author(s) | van Runnard Heimel PJ, Kavelaars A, Heijnen CJ, Peters WH, Huisjes AJ, Franx A, Bruinse HW | | Institution | Department of Perinatology and Gynaecology, University Medical Centre Utrecht, Utrecht, The Netherlands. heimel@hotmail.com | | Source | Hypertens Pregnancy 2008; 27(3):253-65. | | Abstract | OBJECTIVE: To investigate the effect of prednisolone on HELLP syndrome by assessing several markers of the inflammatory response and hepatic damage associated with HELLP syndrome.
DESIGN: Prospective study.
SETTING: Single-center, tertiary obstetric care facility at the University Medical Centre Utrecht, The Netherlands.
POPULATION: Study subjects included normal controls, patients with non-HELLP preeclampsia, and patients with preeclampsia and HELLP syndrome.
METHODS: HELLP syndrome was defined by hemolysis (serum lactate dehydrogenase [LDH] >600 IU/L and/or haptoglobin <or=0.3 g/L), elevated liver enzymes (serum aspartate aminotransferase [AST] >70 U/L and/or serum alanine aminotransferase [ALT] >70 U/L), and a low platelet count (<100 x 10(9)/L). Blood samples from patients with HELLP syndrome who were receiving either prednisolone or placebo were obtained before, during, and after a HELLP exacerbation in the antepartum period. Plasma levels of CRP, IL-1RA, IL-6, sIL-6R, IL-8, IL-10, TNF-alpha, and GSTA1-1 were determined. Samples from women with preeclampsia but without HELLP syndrome and from healthy pregnant women were included as controls.
MAIN OUTCOME MEASURES: Plasma levels of CRP, IL-1RA, IL-6, sIL-6R, IL-8, IL-10, TNF-alpha, and GSTA1-1.
RESULTS: During a HELLP exacerbation CRP, IL-6, IL-1Ra, and GSTA1-1 levels are significantly increased (p < 0.01). In the group of patients treated with prednisolone, significantly lower IL-6 levels were observed during a HELLP exacerbation, compared with patients who did not receive prednisolone (p < 0.01).
CONCLUSION: HELLP syndrome is associated with an increased inflammatory response. Circulating IL-6 levels in HELLP syndrome are reduced during prednisolone administration, suggesting a stabilizing effect on the inflammatory endothelial process. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 18696354 |
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