PROFILE OF ADAMTS13 ACTIVITY AND ANTIGEN CONCENTRATION IN PREECLAMPTIC AND ECLAMPTIC PREGNANT WOMEN OF DOUALA, CAMEROON

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Background: Von Willebrand factor (vWF) is a glycoprotein described as a biological "glue" in primary hemostasis, while ADAMTS13 is the metalloprotease responsible for its cleavage into smaller multimers, considered potential markers in preeclamptic states despite their controversial roles in the disease's pathophysiology. This study aimed to evaluate variations in ADAMTS13 concentration and activity among preeclamptic/eclamptic pregnant women in Douala, Cameroon.Materials and Methods: A case–control study was conducted from January to June 2017 in four hospitals in Douala. Pregnant women without apparent pathology (controls) and preeclamptic/eclamptic women (cases) were enrolled. Participants completed a questionnaire and provided blood samples collected in dry and EDTA tubes. Aliquoted sera stored at –25°C were analyzed using Technozym ADAMTS13 Antigen and Technozym ADAMTS13 Activity ELISA kits at the serology laboratory of Douala General Hospital. Statistical analyses were performed with SPSS version 20.Results: A total of 159 women were enrolled, including 71 cases and 88 controls. A statistically significant difference (p = 0.05) in ADAMTS13 activity was observed between preeclamptic and eclamptic patients; however, given the borderline p-value, this finding should be interpreted with caution. Mean ADAMTS13 antigen was significantly higher (p < 0.002) in controls (87.06 ± 42.60 IU/mL) compared with preeclamptics (62.46 ± 26.94 IU/mL). Mean ADAMTS13 activity (110.36 ± 27 IU/mL) was significantly reduced (p < 0.0001) in preeclamptics (68.04 ± 31.62 IU/mL). Thrombocytopenia and leukocytosis were significantly associated (p < 0.0001) with decreased ADAMTS13 activity, whereas antigen levels remained stable.Conclusion: This study demonstrates that ADAMTS13 activity progressively decreases from normal pregnancy to preeclampsia and further to eclampsia. The mechanism underlying the progressive decrease in ADAMTS13 activity warrants further investigation, including assessment of potential inhibitors.