Levels of Co-inhibitory Receptors TIM- 3, LAG-3 and TIGIT in Preeclampsia Patients

Background: Preeclampsia (PE) is a hypertensive disorder that affects 2-15% of pregnancies and is linked to immune system overactivation. Co-inhibitory receptors play a key role in regulating the immune system during pregnancy. Objective: This study aimed to compare expression levels of co-inhibitory receptors LAG-3, TIM-3 and TIGIT in blood and decidual tissue, as well as the serum IL10 levels between preeclampsia patients and those with normal pregnancy and to assess their diagnostic potential in predicting preeclampsia including those with severe features. Methodology: Blood and decidual tissue samples were collected from 24 patients with PE and 24 healthy pregnant controls. Expression of TIM-3, TIGIT and LAG-3 genes was determined by RT-qPCR. Serum IL-10 levels were measured by ELISA in both groups. Results: our results showed significantly reduced expression in blood TIM-3, LAG-3 and TIGIT as well as decidual LAG-3 and TIGIT among PE patients compared to controls. The decrease in expression levels was significantly pronounced in the blood than in the decidua of PE patients. Serum levels of regulatory cytokine IL10 were also significantly lower in PE cases compared to controls, with a significant positive correlation with tissue TIM-3. Additionally, TIGIT expression was significantly lower in PE patients with severe features compared to those without. Conclusions: The expression levels of immune checkpoints (TIM-3, LAG-3, and TIGIT) and IL-10 in the blood and decidua of patients with preeclampsia (PE) differ from those in healthy pregnancies, indicating their potential role in the pathogenesis and prediction of PE and its complications.