Analysis of the cAMP-PCT-CGRP axis in normal and pathological pregnancy

The pro-hormone Procalcitonin (PCT) is one of the best diagnostic and prognostic markers in clinical practice, which exerts an immunomodulatory role during inflammation. We previously showed that PCT has turned out to be a powerful tool to study the ability of pregnant serum to regulate mononuclear phagocytes function. The modulation of PCT may help us to understand the mechanisms responsible for the imbalance in the immune-endocrine crosstalk in pregnancy and encourage further research to identify effective therapeutic strategies in pre-eclampsia (PE). Our recent findings show that PCT levels are higher in PE sera compared to those of healthy pregnant women. We demonstrated the local synthesis of PCT in normal and PE placenta due to macrophages and trophoblast cells. PE sera have the ability to upregulate the PCT production in trophoblasts cells and MΦ. TNFα, IL-1β and IL-6 are more concentrated in PE serum, their expression is upregulated in M1 MΦ, and seem to drive together the regulation of the synthesis of PCT and CGRP. We show that TNFα alone is not able to increase the PCT expression in human MΦ. A mAb to TNFα completely abrogated the ability of PE sera to upregulate PCT production in these cells. These data emphasize that additional factors in the gravid serum play a role in the PCT synthesis, indicating that its regulation might have an impact on the use of this laboratory marker for the analysis of the inflammatory status in healthy and pathological pregnancy.