The relationship between plasma and placental tissue factor, and tissue factor pathway inhibitors in severe pre-eclampsia patients

Objective: To investigate the mechanism underlying the hypercoagulable state in severe pre-eclampsia. Methods: Plasma tissue factor (TF) and tissue factor pathway inhibitor (TFPI) expression from pre-eclampsia patients and healthy pregnant controls were determined by ELISA. Placental TF and TFPI gene and protein expression were detected by quantitative RT-PCR, immunohistochemistry, and Western analysis. Results: The plasma TF level in the pre-eclampsia group was significantly higher than the control group (p<0.01), and surprisingly, the plasma TFPI-1 and TFPI-2 in the pre-eclampsia group were significantly lower (p<0.01). Placental TF gene and protein expression levels in the pre-eclampsia group was significantly higher than the control group, while TFPI-1 and TFPI-2 levels were significantly lower (p<0.05). Lastly, a significant correlation was found between plasma and placental TF protein levels in the pre-eclampsia group (p<0.01). Conclusion: Higher expression and/or release of TF from the placenta may contribute towards a pathological hypercoagulable state in pre-eclampsia patients. (C) 2010 Elsevier Ltd. All rights reserved.