Decreased endothelial progenitor cells (EPCs) and increased Natural Killer (NK) cells in peripheral blood as possible early markers of preeclampsia: a case-control analysis

PURPOSE: Endothelial Progenitor Cells (EPCs) and Natural Killer (NK) cells were recently advocates in the pathogenesis of preeclampsia (PE), since they can be mobilized into the bloodstream and may orchestrate vascular endothelium function. The aim of our study was to evaluate in early pregnancy circulating EPCs and NK cells in peripheral blood in women who later developed PE compared to uncomplicated pregnancies. METHODS: We prospectively enrolled pregnant women at 9+0-11+6 weeks of gestation at the time of first-trimester integrated screening for trisomy 21, who underwent peripheral venous blood (20 mL) sample. We included only women who later developed PE (cases) and women with uncomplicated pregnancy (controls), matched for maternal age, parity, and Body Mass Index. In these groups, we evaluated the levels of CD16+CD45+CD56+ NK cells and CD34+CD133+VEGF-R2+ EPCs in peripheral blood samples previously stored. RESULTS: EPCs were significantly lower (p < 0.001), whereas NK cells were significantly higher (p < 0.001) in PE group compared to uncomplicated pregnancies during the first trimester. CONCLUSION: The evaluation of EPCs and NK cells in peripheral blood during the first trimester may be considered an effective screening for the early identification of women at risk of developing PE.