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Sphingosine-1-Phosphate, a Marker of Endothelial Injury and Disease Severity in Preeclampsia

Edvinsson, Camilla LU ; Piani, Federica LU ; Matthes, Frank LU orcid ; Vanherle, Lotte LU ; Erlandsson, Lena LU ; Meissner, Anja LU orcid and Hansson, Stefan R. LU orcid (2025) In Hypertension 82(5). p.914-925
Abstract

BACKGROUND: Preeclampsia is a hypertensive pregnancy disorder marked by endothelial damage. Healthy endothelium is covered by a protective glycocalyx layer, which, when degraded, releases detectable products into the blood. Sphingosine-1phosphate (S1P) is a cardiovascular biomarker involved in glycocalyx preservation, linked to placentation and preeclampsia development. The study aimed to test the hypothesis that plasma S1P is altered alongside glycocalyx degradation products in severe preeclampsia compared with controls. METHODS: We included 121 females: 41 with severe preeclampsia requiring treatment in the intensive care unit, 40 with preeclampsia but no need of intensive care unit treatment, and 40 with normotensive pregnancies.... (More)

BACKGROUND: Preeclampsia is a hypertensive pregnancy disorder marked by endothelial damage. Healthy endothelium is covered by a protective glycocalyx layer, which, when degraded, releases detectable products into the blood. Sphingosine-1phosphate (S1P) is a cardiovascular biomarker involved in glycocalyx preservation, linked to placentation and preeclampsia development. The study aimed to test the hypothesis that plasma S1P is altered alongside glycocalyx degradation products in severe preeclampsia compared with controls. METHODS: We included 121 females: 41 with severe preeclampsia requiring treatment in the intensive care unit, 40 with preeclampsia but no need of intensive care unit treatment, and 40 with normotensive pregnancies. Plasma levels of S1P and glycocalyx degradation products—hyaluronic acid, SDC-1 (syndecan-1), and HSPG2 (heparan sulfate proteoglycan-2)—were analyzed from blood samples taken within 27 hours postpartum. RESULTS: Postpartum plasma S1P was significantly lower in the intensive care unit cohort compared with both preeclampsia controls and normotensive controls (P<0.001). Hyaluronic acid and SDC-1 levels were elevated in the intensive care unit group versus normotensive controls (P=0.009 and P=0.023), while HSPG2 was lower (P<0.001). Plasma S1P correlated with hyaluronic acid and blood pressure. CONCLUSION: Intensive care patients with severe preeclampsia have lower plasma S1P levels and higher concentrations of glycocalyx degradation products, indicating more pronounced endothelial damage. These findings suggest that S1P is associated with preeclampsia severity and may serve as a biomarker to assess vascular damage in this patient population. Further studies are needed to explore the potential role of S1P in long-term cardiovascular risk assessment for patients with preeclampsia.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
biomarkers, blood pressure, endothelium, preeclampsia, severity, sphingosine-1-phosphate
in
Hypertension
volume
82
issue
5
pages
12 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:39840434
  • scopus:85217143382
ISSN
0194-911X
DOI
10.1161/HYPERTENSIONAHA.124.24118
language
English
LU publication?
yes
id
b857289b-426f-4afa-9f4c-12b68721c757
date added to LUP
2025-05-28 09:13:14
date last changed
2025-07-09 21:09:38
@article{b857289b-426f-4afa-9f4c-12b68721c757,
  abstract     = {{<p>BACKGROUND: Preeclampsia is a hypertensive pregnancy disorder marked by endothelial damage. Healthy endothelium is covered by a protective glycocalyx layer, which, when degraded, releases detectable products into the blood. Sphingosine-1phosphate (S1P) is a cardiovascular biomarker involved in glycocalyx preservation, linked to placentation and preeclampsia development. The study aimed to test the hypothesis that plasma S1P is altered alongside glycocalyx degradation products in severe preeclampsia compared with controls. METHODS: We included 121 females: 41 with severe preeclampsia requiring treatment in the intensive care unit, 40 with preeclampsia but no need of intensive care unit treatment, and 40 with normotensive pregnancies. Plasma levels of S1P and glycocalyx degradation products—hyaluronic acid, SDC-1 (syndecan-1), and HSPG2 (heparan sulfate proteoglycan-2)—were analyzed from blood samples taken within 27 hours postpartum. RESULTS: Postpartum plasma S1P was significantly lower in the intensive care unit cohort compared with both preeclampsia controls and normotensive controls (P&lt;0.001). Hyaluronic acid and SDC-1 levels were elevated in the intensive care unit group versus normotensive controls (P=0.009 and P=0.023), while HSPG2 was lower (P&lt;0.001). Plasma S1P correlated with hyaluronic acid and blood pressure. CONCLUSION: Intensive care patients with severe preeclampsia have lower plasma S1P levels and higher concentrations of glycocalyx degradation products, indicating more pronounced endothelial damage. These findings suggest that S1P is associated with preeclampsia severity and may serve as a biomarker to assess vascular damage in this patient population. Further studies are needed to explore the potential role of S1P in long-term cardiovascular risk assessment for patients with preeclampsia.</p>}},
  author       = {{Edvinsson, Camilla and Piani, Federica and Matthes, Frank and Vanherle, Lotte and Erlandsson, Lena and Meissner, Anja and Hansson, Stefan R.}},
  issn         = {{0194-911X}},
  keywords     = {{biomarkers; blood pressure; endothelium; preeclampsia; severity; sphingosine-1-phosphate}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{914--925}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Hypertension}},
  title        = {{Sphingosine-1-Phosphate, a Marker of Endothelial Injury and Disease Severity in Preeclampsia}},
  url          = {{http://dx.doi.org/10.1161/HYPERTENSIONAHA.124.24118}},
  doi          = {{10.1161/HYPERTENSIONAHA.124.24118}},
  volume       = {{82}},
  year         = {{2025}},
}