Background: Pre-eclampsia is a significant cause of maternal and perinatal morbidity and mortality. The aetiology of preeclampsia remains elusive, but uric acid elevation often precedes hypertension and proteinuria (Powers et al., 2006). Uric acid has been used to predict poor outcomes in preeclampsia (Livingstone et al.,2014). Placental HPV infection has been demonstrated in pre-eclampsia (Slatter et al., in press). We asked whether uric acid levels correlated with the disease pattern of HPV infection in preeclampsia.
Objective: To investigate the relationship between HPV placental infection in preeclampsia and uric acid levels. To investigate the possibility of uric acid being a surrogate marker of placental inflammation and villitis.
Methods: Pre-eclampsia was defined using SOMANZ criteria and hyperuricaemia defined by gestational age reference range (Lind, et al., 1984). 12 women with preeclampsia were studied. Serum uric acids were collected prospectively. Histopathological examination was carried out blind to the serum levels. Immunohistochemistry for the HPV L1 antibody determined a positive HPV result in the placenta.
Results: Hyperuricemia was found in 75% cases. All cases were positive for HPV. In this small cohort high uric acid levels correlated with the presence of a chronic deciduitis. The uric acid levels did not correlate with HPV-associated villitis.
Conclusion: Extravillous trophoblastic HPV infection and a maternal lymphocytic response is associated with hyperuricaemia in pre-eclampsia. This may reflect poor placentation in PET and inflammatory activation. Further studies are progressing in a larger cohort.