Thrombomodulin, plasminogen activator inhibitor type 1 (PAI-1) and fibronectin as biomarkers of endothelial damage in preeclampsia and eclampsia

Objective: Preeclampsia has been recently suggested to be an endothelial cell disorder. This study was initiated to determine the levels of various biomarkers of endothelial damage in preeclampsia and eclampsia. Methods: Blood samples were withdrawn from 70 pregnant women in their third trimester grouped as 25 mild preeclampsia, 15 severe preeclampsia, 10 eclampsia and 20 normotensive healthy women (controls) for the determination of thrombomodulin by ELISA, PAI-1 by urokinase method and fibronectin by radial immunodiffusion. Results were statistically analyzed by Student's t-test. Results: Circulation levels of PAI-1, thrombomodulin and fibronectin were increased with increasing severity of the disease. Thrombomodulin was the only parameter which did not change significantly in mild preeclampsia. The average percent increments in preeclampsia and eclampsia were 63%, 102% and 132%, respectively. Conclusions: These results demonstrate that fibronectin may be a more valuable biomarker than thrombomodulin and PAI-I for the assessment of endothelial damage in preeclampsia and eclampsia.