Endothelial Extracellular Vesicles as Biomarkers of Endothelial Activation in Pregnant Women With Hypertensive Disorders of Pregnancy (HYPER-endoEV-p)

July 22, 2026 updated by: Ines Drenjancevic, Josip Juraj Strossmayer University of Osijek

Endothelial Extracellular Vesicles as Biomarkers of Blood Pressure-Induced Endothelial Activation in Pregnant Women With Hypertensive Disorders of Pregnancy

Hypertensive disorders of pregnancy are associated with endothelial dysfunction and increased maternal and fetal morbidity. Endothelial extracellular vesicles (EEVs) have emerged as promising biomarkers of endothelial activation; however, their relationship with blood pressure and endothelial function during pregnancy remains incompletely understood. This observational case-control study aims to compare circulating EEV concentrations between normotensive pregnant women and pregnant women with hypertensive disorders of pregnancy. The study will also investigate the associations between EEV levels, blood pressure, microvascular endothelial function assessed by laser Doppler flowmetry, and circulating biomarkers of endothelial activation. The findings may improve understanding of endothelial injury during pregnancy and support the development of non-invasive biomarkers for early detection and monitoring of hypertensive disorders of pregnancy.

Study Overview

Status

Recruiting

Conditions

Study Type

Observational

Enrollment (Estimated)

80

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Croatia
      • Osijek, Croatia
        • Recruiting
        • Faculty of Medicine Osijek
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population will include pregnant women aged 18 years and older recruited from the outpatient clinics of the Department of Obstetrics and Gynecology, University Hospital Centre Osijek, Croatia. Participants will comprise normotensive pregnant women and women with newly diagnosed hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia, diagnosed according to current international clinical guidelines.

Description

Inclusion Criteria:

  • Pregnant women aged ≥18 years.
  • Singleton pregnancy.
  • Ability to provide written informed consent.
  • Normotensive pregnancy or diagnosis of gestational hypertension or preeclampsia according to current clinical guidelines.
  • Ability to comply with study procedures.

Exclusion Criteria:

  • Chronic hypertension diagnosed before pregnancy.
  • Multiple pregnancy.
  • Pre-existing diabetes mellitus.
  • Chronic kidney disease.
  • Autoimmune disease.
  • Known cardiovascular disease.
  • Active infection or inflammatory disease.
  • Malignancy.
  • Inability or unwillingness to provide informed consent.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Normotensive Pregnancy
Pregnant women with normal blood pressure and uncomplicated singleton pregnancy.
Hypertensive Disorders of Pregnancy
Pregnant women diagnosed with hypertensive disorders of pregnancy, including gestational hypertension or preeclampsia, according to current clinical guidelines.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Plasma endothelial extracellular vesicle concentration
Time Frame: Baseline
Concentration of circulating endothelial extracellular vesicles quantified by flow cytometry following size-exclusion chromatography isolation.
Baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Post-occlusive reactive hyperemia (PORH)
Time Frame: Baseline
Microvascular endothelium-dependent vasodilation assessed by laser Doppler flowmetry following 1-minute arterial occlusion.
Baseline
Acetylcholine-induced vasodilation (AChID)
Time Frame: Baseline
Endothelium-dependent microvascular vasodilation assessed by acetylcholine iontophoresis and laser Doppler flowmetry.
Baseline
Sodium nitroprusside-induced vasodilation (SNPID)
Time Frame: Baseline
Endothelium-independent microvascular vasodilation assessed by sodium nitroprusside iontophoresis and laser Doppler flowmetry.
Baseline
VCAM-1 concentration
Time Frame: Baseline
Plasma vascular cell adhesion molecule-1 (VCAM-1) concentration measured as a marker of endothelial activation.
Baseline
ICAM-1 concentration
Time Frame: Baseline
Plasma intercellular adhesion molecule-1 (ICAM-1) concentration measured as a marker of endothelial activation.
Baseline
Endocan concentration
Time Frame: Baseline
Plasma endocan concentration measured as a marker of endothelial dysfunction.
Baseline
von Willebrand factor (vWF)
Time Frame: Baseline
Plasma von Willebrand factor concentration measured as a marker of endothelial injury.
Baseline
Matrix metalloproteinase-9 (MMP-9)
Time Frame: Baseline
Plasma MMP-9 concentration measured as a marker of vascular remodeling and endothelial dysfunction.
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Josip Juraj Strossmayer University of Osijek

Collaborators

Osijek University Hospital

Investigators

  • Study Chair: Ana Stupin, MD, PhD, Faculty of Medicine Osijek, Josip Juraj Strossmayer of Osijek

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 1, 2026

Primary Completion (Estimated)

April 30, 2029

Study Completion (Estimated)

September 30, 2029

Study Registration Dates

First Submitted

July 22, 2026

First Submitted That Met QC Criteria

July 22, 2026

First Posted (Actual)

July 27, 2026

Study Record Updates

Last Update Posted (Actual)

July 27, 2026

Last Update Submitted That Met QC Criteria

July 22, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • HYPER-endoEV-pregnancy

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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