Maternal serum soluble Fas/Fas ligand level and expression of Fas/Fas ligand in placenta in preeclampsia.

Objective: The aims of this study were designed to determine that serum soluble Fas and Fas ligand levels are altered in women with preeclampsia and HELLP syndrome, and to assess the expression of placental Fas and Fas ligand in women with preeclampsia and HELLP syndrome. Methods: Blood samples were obtained from 31 women with normal pregnancy, 27 women with preeclampsia and five women with HELLP syndrome. Serum Fas/Fas ligand levels were measured by enzyme linked immunoassay. Immunohistochemical stain with polyclonal antibodies of Fas/Fas ligand were used to identify apoptosis. Mann-Whitney test, test, Pearson correlation coefficients and multiple regression test were used for statistical analysis. Results: Both soluble Fas ligand and Fas were detected in the sera of normal pregnancy, preeclampsia and HELLP syndrome. The mean serum level of soluble Fas was 5.830.37 U/mL in women with normal pregnancy, 10.840.93 U/mL in women with preeclampsia, and 10.790.69 U/mL in women with LELLP syndrome. The mean serum level of soluble Fas ligand was 0.590.03 U/mL in women with normal pregnancy, 0.510.21 U/mL in women with preeclampsia, and 0.600.01 U/mL in women with LELLP syndrome. The mean serum levels of soluble Fas were significantly higher in women with preeclampsia and HELLP syndrome than in women with normal pregnancy, but those of Fas ligand were no significant difference in each group. Apoptosis was conclusively demonstrated within placental tissue. The immunohistochemical analysis of Fas revealed diffuse immunoreactive stains were increased in women with preeclampsia than in women with normal pregnancy. But the immunohistochemical analysis of Fas ligand revealed diffuse immunoreactive stains were decreased in women with preeclampsia than in women with normal pregnancy. Conclusion: Placental apoptosis and altered expression of Fas and Fas ligand in trophoblast might influence the pathogenesis or pathophysiologic mechanism of preeclamsia. Elevated serum soluble Fas levels is associated with preeclampsia and HELLP syndrome. The source of elevated serum soluble Fas in preeclampsia and HELLP snydrome remains to be determined.