Abstract
Objective
HIV-associated preeclampsia reflects a combination of opposing influences on the immune
status. The adipocyte hormone leptin has been implicated in the pathophysiology of
preeclampsia and in enhancing immunity. This study is the first, to our knowledge,
to determine whether leptin levels in the placenta differ between HIV-associated normotensive
and preeclamptic pregnancies. The study also compares leptin levels between the exchange
and conducting areas of the placenta.
Study design
Pregnant women were recruited antenatally and grouped as follows: normotensive HIV
uninfected (n = 30), normotensive HIV infected (n = 60), preeclamptic HIV uninfected (n = 30) and preeclamptic HIV infected (n = 60). Anthropometric data were collected and placental leptin was analysed by immunohistochemistry
and ELISA.
Results
Leptin levels were similar in the central and peripheral regions of the placenta.
Leptin immunoreactivity was observed amongst the different trophoblast cell populations.
Both ELISA and immunohistochemistry of the placental exchange villi indicated that
leptin levels were higher in preeclampsia compared to normotensive pregnancies (p < 0.001). HIV status had no effect on leptin levels but levels were higher in participants
on highly active antiretroviral treatment (HAART) compared to those on prophylaxis
for prevention of mother to child transmission (PMTCT) with normotensive (p = 0.006) and preeclamptic (p = 0.002) pregnancies. The area of immunostaining was greater in the exchange compared
to the conducting villi in HIV infected and uninfected preeclampsia.
Conclusions
This novel study establishes an elevation of leptin in preeclamptic placentae, irrespective
of HIV status. Leptin elevation was not focal in that it occurred in both central
and peripheral regions of the preeclamptic placenta. This suggests a role of leptin
in the pathophysiology of preeclampsia.
Keywords
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Article info
Publication history
Published online: October 07, 2013
Accepted:
September 22,
2013
Received in revised form:
August 27,
2013
Received:
May 10,
2013
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
