The Evaluation of Intestinal Permeability in Preeclamptic Pregnancy

BACKGROUND: Zonulin is a physiological protein that regulates the tight connections and permeability of the intestine, serving as a biomarker for impaired intestinal permeability. OBJECTIVE: The aim of this study was to examine zonulin levels in preeclampsia, to investigate its associations with the cellular immune response marker soluble interleukin-2 receptor (sIL-2R) and exogenous antigen load marker lipopolysaccharide binding protein (LBP) and to evaluate the implications of these findings in the etiopathogenesis of preeclampsia. METHODS: We designed a cross-sectional case-control study and enrolled 22 pregnant women with preeclampsia and 22 healthy pregnant controls. Plasma zonulin levels were determined by ELISA. Serum sIL-2R and LBP levels were assessed by chemiluminescent immunometric methods. RESULTS: Women with preeclampsia had lower levels of plasma zonulin and serum LBP than normotensive healthy controls (p<0,05). The difference in serum sIL-2R levels was not significant (p: 0,751). There was a negative correlation between plasma zonulin and serum urea (r: -0.319, p: 0.035) and a positive correlation between serum sIL-2R and ALT (r: 0,335, p: 0,026) and AST (r: 0,319, p: 0,035) CONCLUSION: We found that zonulin and LBP, but not sIL-2R, levels were significantly lower in pregnant women with preeclampsia as compared with healthy pregnant controls. Reduced intestinal permeability in preeclampsia might be associated with impaired immune system functions or a lower fat mass and malnutrition. Further studies are needed to elucidate the exact pathogenetic role of intestinal permeability in preeclampsia.