Is cellular fibronectin a biological marker for pre-eclampsia?

Cellular fibronectin (cFn) appears to be an important factor in the regulation of cell-cell interactions. It is mostly synthesised by endothelial cells and its increased circulating values are thought to correspond to the endothelial damage. As pre-eclampsia is considered a pathology of endothelial cells, our study was intended to see if this circulating protein is increased during pre-eclampsia and to determine from which moment in pregnancy these changes occur. We studied cFn longitudinally in 198 consecutive pregnant patients, with or without pathologies associated to pregnancy. We measured the cFn concentrations by ELISA four times during pregnancy with the monoclonal antibody A 134. The values of cFn increased throughout the normal pregnancy, but a significant increase was observed only after the 36th week of pregnancy (P<0.0001). The values of doubling time of cFn gradually decreased, being inverse to cFn concentrations. The values of cFn were significantly higher (3.53 microg/ml; P=0.0009) in the third trimester in the group of women who developed pre-eclampsia, as compared to normals (2.23 microg/ml). cFn could not be used as a predictor of pre-eclampsia, because the clinical symptoms of this pathology were already present at the time of measurement. Our data represent the first longitudinal study showing the increase of cFn values throughout normal and pre-eclamptic pregnancies.