Placental expression and serum concentrations of cytokeratin 19 in preeclampsia.

Abstract

To evaluate cytokeratin 19 as a serum marker of preeclampsia. Serum cytokeratin 19 levels were measured in 46 women with preeclampsia and 46 controls matched for gestational age and parity, using an immunoradiometric assay. Cytokeratin 19 was evaluated immunohistochemically in placental specimens from 28 healthy pregnant women and 24 women with preeclampsia. Cytokeratin 19 was identified in the syncytiotrophoblast in 13 (46. 4%) of 28 and 23 (95.8%) of 24 placental specimens from controls and women with preeclampsia, respectively (P =.03). Median serum levels of cytokeratin 19 in controls and women with preeclampsia were 1.7 (range 0.3-4.7) microg/mL and 2.7 (range 0.8-8.2) microg/mL, respectively (P <.001). Cytokeratin 19 significantly influenced the odds of presenting with preeclampsia (P <.001) and the odds of developing severe disease (P <.001). Serum cytokeratin 19 correlated inversely with fetal birth weight (Kendall tau-b correlation coefficient = -0.2, P =.007). Compared with healthy pregnant women, women with severe preeclampsia had significantly higher and more rapidly increasing cytokeratin 19 serum levels throughout the third trimester (P <.001). Placental stimulation of cytokeratin 19, and release of it into maternal circulation, seem to be a feature of preeclampsia. Correlations with clinical characteristics suggest that cytokeratin 19 is a marker of disease severity.