Role of tumor necrosis factor -α in the pathogenesis of pregnancy-induced hypertension

Objective To investigate the role of tumor necrosis factor α(TNFα) in the pathogenesis of pregnancy induced hypertension (PIH) by damaging endothelial cells. Methods 41 patients with PIH and 17 healthy pregnant women were studied. The concentration of TNFα in maternal plasma was measured by sensitive radioimmunoassay. The morphology of endothelial cells of placental blood vessels was observed. Endothelial cells were incubated in the presence of TNFα (400 U/ml) and sera (30% vol/vol) from PIH women and normal pregnant women to observe their growth and shape. Results Maternal plasma TNFα level in PIH was 2.29 μg/L±0.51 μg/L, higher than that in normal pregnancy (the latter was 1.73 μg/L±0.25 μg/L, t =5.60, P 0 01). The endothelial cells of placental blood vessels in PIH revealed morphologic damages. Both sera of PIH women and TNFα were cytotoxic to endothelial cells in culture, including inhibition of the proliferation and morphologic changes of the cells. Conclusion Damage of the endothelial cells of placental blood vessels is associated with the abnormal increase in the maternal blood TNFα. Sera of PIH women can damage the endothelial cells in culture and this effect is also associated with TNFα.