Disturbance of gut microbiota aggravates the inflammatory response and damages the vascular endothelial function in patients with preeclampsia.

OBJECTIVE: To investigate the influence of intestinal flora imbalance on inflammatory factors in the serum and vascular endothelial functionality in individuals with preeclampsia (PE). METHODS: From January 2022 to December 2023, a total of 58 individuals with PE (PE group) and 60 healthy controls (CON group) were included in this study; they were matched for age and pre-pregnancy Body Mass Index (BMI). A comparison was made between the two groups in terms of the general data and the number of unique intestinal flora. Additionally, clinical blood measures, serum inflammatory factors, and vascular endothelial function were also assessed and compared between the groups. RESULTS: Age, gestational age, and pre-pregnancy BMI were similar between the PE and control group. However, diastolic and systolic blood pressure were significantly higher in the PE group. The abundance of Lactobacillus, Bifidobacterium, Enterobacter, and Enterococcus. Interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) were considerably higher in the PE group compared to the CON group, but Interleukin-4 (IL-4) was noticeably lower, and the amount of White blood cells (WBC), neutrophil count (N) and lymphocyte count (L) in the PE group were significantly higher than those in the CON group. In the PE group, serum vascular endothelin (ET) and soluble endoglin (sEng) were higher than in the CON group, vascular endothelial growth factor (VEGF) and nitric oxide (NO) levels were considerably lower than in the CON group, and the levels of TC, TG, LDL-C and HDL-C were significantly higher in the PE group than in the CON group. The presence of Lactobacillus and Bifidobacterium was inversely associated with levels of TNF-α, IL-6, Interleukin-10 (IL-10), ET, and sEng, and positively associated with levels of IL-4, VEGF, and NO. Nevertheless, there was a positive correlation between the abundance of Enterobacterium and Enterococcus with the levels of TNF-α, IL-6, IL-10, ET, and sEng. Conversely, there was a negative correlation between the abundance of Enterobacterium and Enterococcus and the levels of IL-4, VEGF, and NO. CONCLUSION: Patients with PE exhibited dysbiosis of intestinal flora, characterized by altered gut microbiota diversity, increased serum pro-inflammatory factors, and impaired vascular endothelial function.