Alpha-hemoglobin-stabilizing protein (AHSP) in hemolysis,elevated liver enzyme,and low platelet (HELLP) syndrome,intrauterine growth restriction (IUGR) and fetal death

Objective Alpha hemoglobin-stabilizing protein (AHSP) inhibits the production of reactive oxygen species in various cells, including erythrocytes. Reduced AHSP can mean reduced protection from stressors. Our objective was to investigate whether AHSP is involved in the response to stress in pregnancy. Study design Placentas were collected from normal term pregnancies (n = 10) and pregnancies complicated by HELLP (n = 10), intrauterine growth restriction (IUGR; n = 10) or fetal death (IUFD; n = 6). AHSP messenger RNA (mRNA) and protein were determined using real time quantitative polymerase chain reaction (PCR) and Western blot, respectively. All statistical analyses were performed by using the GraphPad Prism Software. Differences were considered significant at p < 0.05. Results Placental AHSP mRNA level in HELLP (4.16E10⁻⁴ ± 1.77) and IUFD (4.19E10⁻⁴ ± 3.37) were significantly decreased compared with controls (28.47E10⁻⁴ ± 14.86; p < 0.01), whereas levels in the IUGR group (7.55E10⁻⁴ ± 6.4) showed a trend toward being lower but the difference did not reach statistical significance. Western blot analysis results indicate a no significant increase of ASHP protein in the HELLP syndrome group and a significant decrease in the IUFD group compared with controls. There was no significant difference between the IUGR and control groups. Conclusion ASHP mRNA expression in the placenta is decreased in complicated pregnancies, and it may be involved in the pathogenic mechanisms leading to the adverse pregnancy outcome. This paper was presented as a poster at the 27th Annual Meeting of the Society for Maternal Fetal Medicine; San Francisco, CA, USA, February 5–10, 2007. Monica Emanuelli and Davide Sartini contributed equally to this paper.