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Increased Plasma Adenosine Concentrations and the Severity of Preeclampsia

From the Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan; and the Center for Perinatal Biology, Loma Linda University, Loma Linda, California.

Address reprint requests to: Yoshio Yoneyama, MD, Nippon Medical School, Department of Obstetrics and Gynecology, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan; E-mail: yoshi-1{at}nms.ac.jp.

OBJECTIVE: To investigate the relationship between changes in plasma adenosine and the severity of preeclampsia, and norepinephrine and tumor necrosis factor– concentrations.

METHODS: Plasma concentrations of adenosine, norepinephrine, and tumor necrosis factor– relating to the pathogenesis of preeclampsia were measured in women with mild (n = 21) and severe (n = 21) preeclampsia and normal pregnancies (n = 21), matched for age, gestational age, and parity, in the third trimester of pregnancy. We then evaluated the relationships among plasma adenosine, norepinephrine, tumor necrosis factor– concentrations, and the severity of preeclampsia.

RESULTS: Mean plasma adenosine, norepinephrine, and tumor necrosis factor– concentrations were significantly higher in women with mild and severe preeclampsia than in normal control subjects (P < .05). In women with preeclampsia, plasma adenosine concentrations increased according to the severity of preeclampsia (0.60 ± 0.03 µmol/L and 0.72 ± 0.03 µmol/L, respectively, versus 0.41 ± 0.03 µmol/L for normal subjects), which correlated with increases of norepinephrine and tumor necrosis factor– concentrations (r = .58, P < .05; r = .49, P < .05, respectively). In preeclampsia, norepinephrine concentration also correlated with maternal blood pressure (r = .50, P < .05).

CONCLUSION: Adenosine is an established suppressor of the effects of norepinephrine and tumor necrosis factor– The increased plasma concentrations of adenosine in preeclampsia might serve to counteract further progression of the complication.

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