Linking Glomerular Endothelial Dysfunction with Urinary KIM-1, sFlt-1, Serum IL-10, and Regulatory T Cells in Preeclampsia.

Background: Preeclampsia (PE) usually presents after 20 weeks of pregnancy with high blood pressure and protein levels in the urine. An imbalance between the body's proinflammatory and anti-inflammatory responses has been suggested to be a key issue in the pathophysiology of the disease. Some important factors, such as soluble fms like tyrosine kinase -1 (sFlt-1), T regulatory cells (Tregs), and Interleukin-10 (IL-10) molecules are thought to be involved as mediators in a systematic response affecting the blood vessel lining. Proteinuria is an essential feature of preeclampsia suggesting the involvement of the kidneys in the disease. Objective: Our study aimed to explore how Tregs, IL-10 and sFlt-1 correlate with Kidney Injury Molecule-1(KIM-1) protein levels in urine to better understand preeclampsia-induced renal endothelial dysfunction in better way. Methodology: 36 normal pregnant women and 29 women with preeclampsia were enrolled in this cross-sectional study. Tregs, IL-10, sFlt-1 and KIM-1 levels were analysed and correlated between both the groups. Results: Our findings revealed that the levels of CD4+FOXP3+ Treg cells and serum IL-10 were much higher and the levels of serum sFlt-1 and urinary KIM-1 were lower in normal pregnant women than in those with preeclampsia. ROC curve showed that serum sFlt-1 was a strong marker for diagnosing preeclampsia with a sensitivity of 93% and specificity of 92%, followed by urinary KIM-1 with a sensitivity of 76% and specificity of 58%, implying at ongoing kidney injury in preeclampsia. Conclusion: Our study elucidates preeclampsia and supports better biomarker use and treatments, aiming to improve health outcomes for mothers and babies.