Platelet and neutrophil activation

There is evidence of increased platelet and neutrophil activation in pre-eclampsia. Plasma concentrations of neutrophil elastase (a specific marker for activation in vivo) are elevated, and correlate with those of von Willebrand factor, a marker of endothelial damage. Neutrophil elastase can cause endothelial dysfunction and promote further neutrophil activation and adherence. The mechanism underlying neutrophil activation is unknown. Plasma cytokine levels are increased in pre-eclampsia, and cytokines (particularly tumor necrosis factor-a and some interleukins) are known to trigger both endothelial cell and neutrophil activation. They may also mediate the increase in vascular cell adhesion molecule expression (VCAM-1) seen in pre-eclampsia. Increased platelet activation and adhesiveness may explain some features of the coagulopathy seen in pre-eclampsia.

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