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Chiriac IE, Vilceanu N, Maghiar A, Andrei C, Hanganu B, Daina LG, Dunarintu S, Buhas LC. Maternal Serum Amyloid A as a Marker of Preterm Birth/PROM: A Systematic Review and Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1025. [PMID: 37374228 DOI: 10.3390/medicina59061025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/02/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: Preterm birth, one of the leading causes of neonatal mortality, occurs in between 5 and 18% of births. Premature birth can be induced by a variety of triggers, including infection or inflammation. Serum amyloid A, a family of apolipoproteins, increases significantly and rapidly at the onset of inflammation. This study aims to systematically review the results of studies in the literature that have examined the correlation between SAA and PTB/PROM. Materials and Methods: To examine the correlation between serum amyloid A levels in women who gave birth prematurely, a systematic analysis was performed according to PRISMA guidelines. Studies were retrieved by searching the electronic databases PubMed and Google Scholar. The primary outcome measure was the standardized mean difference in serum amyloid A level comparing the preterm birth or premature rupture of membranes groups and the term birth group. Results: Based on the inclusion criteria, a total of 5 manuscripts adequately addressed the desired outcome and were thus included in the analysis. All included studies showed a statistically significant difference in serum SAA levels between the preterm birth or preterm rupture of membranes groups and the term birth group. The pooled effect, according to the random effects model, is SMD = 2.70. However, the effect is not significant (p = 0.097). In addition, the analysis reveals an increased heterogeneity with an I2 = 96%. Further, the analysis of the influence on heterogeneity found a study that has a significant influence on heterogeneity. However, even after outline exclusion, heterogeneity remained high I2 = 90.7%. Conclusions: There is an association between increased levels of SAA and preterm birth/PROM, but studies have shown great heterogeneity.
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Affiliation(s)
- Ioana-Evelina Chiriac
- Doctoral School, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Narcis Vilceanu
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Adrian Maghiar
- Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Csep Andrei
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Bianca Hanganu
- Legal-Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania
| | - Lucia Georgeta Daina
- Department of Psycho-Neurosciences and Rehabilitation, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Simona Dunarintu
- Department of Radiology and Medical Imaging, Timisoara County Emergency Clinical Hospital, 300723 Timisoara, Romania
| | - Liana-Camelia Buhas
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
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Zuo L, Xu Y, Du S, Li X, Zhao T, Zhang Y, Liu Z, Li S. Diagnostic value of Serum Amyloid A, Interleukin-6 in gravidas with spontaneous preterm birth. Clin Chim Acta 2022; 534:77-80. [PMID: 35853546 DOI: 10.1016/j.cca.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/22/2022] [Accepted: 07/08/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Spontaneous preterm birth (SPB) can't be predicted accurately nowadays. We aim to investigate the value of serum amyloid A(SAA) and interleukin-6(IL-6) for forecasting the risk of SPB. METHODS A total of 302 pregnant women who completed delivery in our hospital from January 2019 to December 2021 were included. According to gestational days, they were divided into the case group (28-33+6 weeks, 41 cases; 34-36+6 weeks, 96 cases) and the control group (37-42 weeks, 165 cases). The general data of the two groups were analyzed and the values of SAA and IL-6 in speculating the risk of SPB were studied in this study. RESULTS The levels of SAA and IL-6 in the case group were higher than those in the control group(P < 0.05), and the most practical value of SAA and IL-6 access SPB risk were 17.35 mg/L, 112.41 pg/mL respectively. The area under the ROC curve of diagnosis to predict SPB were 0.8849, 0.8664. CONCLUSIONS The assessment of SPB risk by SAA and IL-6 bearscertain clinical value, which could assist clinicians in recognizing and evaluating the potential dangers of SPB.
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Affiliation(s)
- Luguang Zuo
- Department of Laboratory Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei, China.
| | - Yuhuan Xu
- Department of Laboratory Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei, China
| | - Shuai Du
- Department of Gastroenterology, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei, China
| | - Xiaoying Li
- Department of Laboratory Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei, China
| | - Tong Zhao
- Department of Ultrasound, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei, China
| | - Yuhong Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei, China
| | - Zhenkui Liu
- Department of Pediatrics, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei, China
| | - Shutie Li
- Department of Geriatrics, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei, China
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Lee JE, Dan K, Kim HJ, Kim YM, Park KH. Plasma proteomic analysis to identify potential biomarkers of histologic chorioamnionitis in women with preterm premature rupture of membranes. PLoS One 2022; 17:e0270884. [PMID: 35797368 PMCID: PMC9262229 DOI: 10.1371/journal.pone.0270884] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 06/18/2022] [Indexed: 01/08/2023] Open
Abstract
Introduction
To identify potential biomarkers in the plasma that could predict histologic chorioamnionitis (HCA) in women with preterm premature rupture of membranes (PPROM), using shotgun and targeted proteomic analyses.
Methods
This retrospective cohort study included 78 singleton pregnant women with PPROM (24–34 gestational weeks) who delivered within 96 h of blood sampling. Maternal plasma samples were analyzed by label-free liquid chromatography-tandem mass spectrometry for proteome profiling in a nested case-control study design (HCA cases vs. non-HCA controls [n = 9 each]). Differential expression of 12 candidate proteins was assessed by multiple reaction monitoring-mass spectrometry (MRM-MS) analysis in individual plasma samples from cases and controls matched by gestational age at sampling (n = 40, cohort 1). A validation study was further performed in an independent study group (n = 38, cohort 2) using ELISA and turbidimetric immunoassay for three differentially expressed proteins.
Results
Shotgun proteomics analyses yielded 18 proteins that were differentially expressed (P < 0.05) between HCA cases and non-HCA controls. MRM-MS analysis of 12 differentially expressed proteins further revealed that the CRP, C4A, and SAA4 levels were significantly increased in women with HCA. A multi-marker panel comprising plasma SAA4 and C4A showed enhanced potential for differentiating HCA from non-HCA women (area under the curve = 0.899). Additional validation of these findings by ELISA assays revealed that the CRP levels were significantly higher in women with HCA than in those without HCA, whereas the plasma levels of C4A and SAA4 did not significantly differ between the two groups.
Conclusions
Plasma C4A, SAA4, and CRP were identified as potential biomarkers for detecting HCA in women with PPROM, based on targeted and shotgun proteomic analyses, showing good accuracy when used as a combined dual-biomarker panel (C4A and SAA4). Nevertheless, ELISA validation of these proteins, except for CRP, may not yield clinically useful markers for predicting HCA.
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Affiliation(s)
- Ji Eun Lee
- Center for Theragnosis, Biomedical Research Division, Korea Institute of Science and Technology, Seoul, Korea
| | - Kisoon Dan
- Proteomics Core Facility, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Hyeon Ji Kim
- Departments of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yu Mi Kim
- Departments of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyo Hoon Park
- Departments of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- * E-mail:
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Cho I, Lee KN, Joo E, Kim YM, Kim TE, Park KH. Plasma E-selectin and kallistatin as predictive markers of histologic chorioamnionitis in women with preterm premature rupture of membranes. Am J Reprod Immunol 2022; 88:e13584. [PMID: 35772987 DOI: 10.1111/aji.13584] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/23/2022] [Accepted: 06/13/2022] [Indexed: 12/01/2022] Open
Abstract
PROBLEM We aimed to assess the predictive potential of 12 plasma biomarkers to predict acute histologic chorioamnionitis (HCA) in women with preterm premature rupture of membranes (PPROM) and to develop multi-biomarker panels based on these biomarkers in combination with widely used conventional laboratory markers. METHOD OF STUDY This was a retrospective cohort study involving 81 singleton pregnant women (24-34 weeks of gestation) who delivered within 96 h of blood sampling. White blood cell (WBC) count, differential counts, and C-reactive protein (CRP) levels were measured at admission. The levels of DKK-3, Fas, haptoglobin, IGFBP-2, kallistatin, MIP-1α, MMP-2, MMP-8, pentraxin 3, progranulin, E-selectin, and P-selectin were evaluated by ELISA using stored plasma samples. The primary outcome measure was acute HCA. RESULTS Multivariate analyses showed that low plasma E-selectin and kallistatin levels were independently associated with HCA occurrence after adjusting for gestational age. Using a stepwise regression analysis, a multi-biomarker panel comprising plasma E-selectin, serum CRP, and WBC was developed, which provided a good prediction of acute HCA in women with PPROM (area under the curve [AUC], 0.899), with a significantly higher AUC than that of any single variable included in the panel (P<0.05). The plasma levels of DKK-3, Fas, haptoglobin, IGFBP-2, MIP-1α, MMP-2, MMP-8, pentraxin 3, and P-selectin were not significantly associated with HCA occurrence. CONCLUSIONS This study identified E-selectin and kallistatin as potential plasma biomarkers associated with acute HCA in women with PPROM. Their combined analysis with serum CRP and WBC counts significantly improved acute HCA diagnosis. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Iseop Cho
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyong-No Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eunwook Joo
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yu Mi Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Eun Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyo Hoon Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Gan XW, Wang WS, Lu JW, Ling LJ, Zhou Q, Zhang HJ, Ying H, Sun K. De novo Synthesis of SAA1 in the Placenta Participates in Parturition. Front Immunol 2020; 11:1038. [PMID: 32582166 PMCID: PMC7297131 DOI: 10.3389/fimmu.2020.01038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/29/2020] [Indexed: 12/23/2022] Open
Abstract
Serum amyloid A1 (SAA1) is an acute phase protein produced mainly by the liver to participate in immunomodulation in both sterile and non-sterile inflammation. However, non-hepatic tissues can also synthesize SAA1. It remains to be determined whether SAA1 synthesized locally in the placenta participates in parturition via eliciting inflammatory reactions. In this study, we investigated this issue by using human placenta and a mouse model. We found that SAA1 mRNA and protein were present in human placental villous trophoblasts, which was increased upon syncytialization as well as treatments with lipopolysaccharides (LPS), tumor necrosis factor-α (TNF-α), and cortisol. Moreover, significant increases in SAA1 abundance were observed in the placental tissue or in the maternal blood in spontaneous deliveries without infection at term and in preterm birth with histological chorioamnionitis. Serum amyloid A1 treatment significantly increased parturition-pertinent inflammatory gene expression including interleukin-1β (IL-1β), IL-8, TNF-α, and cyclooxygenase-2 (COX-2), along with increased PGF2α production in syncytiotrophoblasts. Mouse study showed that SAA1 was present in the placental junctional zone and yolk sac membrane, which was increased following intraperitoneal administration of LPS. Intraperitoneal injection of SAA1 not only induced preterm birth but also increased the abundance of IL-1β, TNF-α, and COX-2 in the mouse placenta. Conclusively, SAA1 can be synthesized in the human placenta, which is increased upon trophoblast syncytialization. Parturition is accompanied with increased SAA1 abundance in the placenta. Serum amyloid A1 may participate in parturition in the presence and absence of infection by inducing the expression of inflammatory genes in the placenta.
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Affiliation(s)
- Xiao-Wen Gan
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Wang-Sheng Wang
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Jiang-Wen Lu
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Li-Jun Ling
- Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qiong Zhou
- Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hui-Juan Zhang
- Shanghai International Maternal and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hao Ying
- Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Kang Sun
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
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Ibrahim MI, Ellaithy MI, Hussein AM, Nematallah MM, Allam HA, Abdelhamid AS, Harara RM, Riad AA, Rafaat TA. Measurement of maternal serum amyloid A as a novel marker of preterm birth. J Matern Fetal Neonatal Med 2019; 34:2467-2472. [PMID: 31522581 DOI: 10.1080/14767058.2019.1668370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To study the association between maternal serum amyloid A (mSAA) levels and preterm birth (PTB). METHODS This prospective observational nested case control study was conducted at Ain Shams University Maternity Hospital, Cairo, Egypt, between May 2017 and December 2017. The study recruited pregnant women at 26-34 weeks presented with threatened preterm labor (PTL). Women with PTB were included in cases group while control group included women who continued pregnancy and delivered at term. Serum samples were collected to measure mSAA levels. The main outcome of the study was the association between mSAA levels and PTB. Secondary outcomes included neonatal intensive care unit admissions and neonatal mortality. RESULTS Fifty-eight women were included in the final analysis (29 in each group). Women with PTB had a statistically significant higher mSAA levels [5.1 (4.5-7.7) vs. 1.2 (0.0-2.5) mg/l, for cases and controls respectively, p < .001]. Higher mSAA levels were also observed among women whose babies were admitted to NICU, but there was no significant relation between mSAA level and neonatal death. A statistically significant negative correlation was found between mSAA and gestational age at delivery and neonatal birth weight. mSAA had an excellent value to predict PTB (AUC = 0.972 [95% CI, 0.891-0.998], p < .0001), fair value to predict admission to NICU and a poor value to predict neonatal death. CONCLUSIONS mSAA level was found to be elevated among women with threatened PTL who end with PTB; mSAA is a potentially useful predictive marker of PTB that warrant further study. CLINICALTRIALS.GOV: NCT01639027.
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Affiliation(s)
- Moustafa I Ibrahim
- Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed I Ellaithy
- Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed M Hussein
- Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mona M Nematallah
- Obstetrics and Gynecology Department, Kafr Eldawar Hospital, Elbeheira, Egypt
| | - Heba A Allam
- Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed S Abdelhamid
- Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rany M Harara
- Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Amr A Riad
- Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Tarek A Rafaat
- Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Çakar E, Çakar ŞE, Taşan HA, Karçaaltıncaba D, Şentürk MB, Koç N, Uluhan R. Diagnostic and Prognostic Value of Presepsin for Subclinical Chorioamnionitis in Pregnancies between 23-28 Week with Preterm Premature Rupture of the Membranes. Balkan Med J 2016; 33:668-674. [PMID: 27994922 DOI: 10.5152/balkanmedj.2016.160293] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 04/25/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Presepsin is an inflammatory marker released from monocytes and macrophages as an acute reaction to microbial infection. We hypothesized that it may be useful in pregnancies with preterm premature rupture of the membranes (PPROM) for early diagnosis of subclinical chorioamnionitis. AIMS To determine whether the plasma presepsin level has any diagnostic or prognostic value for subclinical chorioamnionitis in pregnancies complicated with PPROM. STUDY DESIGN Prospective cohort study. METHODS Fifty-three singleton pregnancies between 23 and 28 weeks of gestation diagnosed with PPROM were prospectively included in the study. Venous blood samples were collected at admission, at the 48th hour of admission, and at the time of delivery to determine presepsin and C-reactive Protein (CRP) levels and white blood cell (WBC) counts. Chorioamnionitis was diagnosed by microscopic examination of the placenta and cords. RESULTS Of the 53 PPROM cases included in the study, 41 (77.4%) had histologically confirmed chorioamnionitis. Neonatal sepsis developed in 24 (45.3%) of the newborns. The median presepsin level at admission was 135.0 pg/mL for pregnancies with subclinical chorioamnionitis and 113.5pg/mL for pregnancies without chorioamnionitis (p=0.573). There was also no significant difference between subclinical chorioamnionitis (+) and (-) cases in terms presepsin levels at the 48th hour and at delivery. However, chorioamnionitis (+) cases showed a significant decrease in both presepsin level and WBC count at the 48th hour after the administration of antibiotics, which increased significantly at delivery (p<0.001 and p=0.011, respectively). CONCLUSION The striking fluctuations in presepsin level after the diagnosis of PPROM can be used to predict subclinical chorioamnionitis and determine the optimal timing of delivery before the clinical signs of chorioamnionitis are established. However, presepsin level itself was neither diagnostic nor prognostic for neonatal sepsis.
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Affiliation(s)
- Erbil Çakar
- Department of Obstetrics and Gynecology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, İstanbul, Turkey
| | - Şule Eren Çakar
- Deparment of Infectious Diseases, Ümraniye Training and Research Hospital, İstanbul, Turkey
| | - Habibe Ayvacı Taşan
- Department of Obstetrics and Gynecology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, İstanbul, Turkey
| | - Deniz Karçaaltıncaba
- Department of Obstetrics and Gynecology, Gazi University School of Medicine, Ankara, Turkey
| | - Mehmet Baki Şentürk
- Department of Obstetrics and Gynecology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, İstanbul, Turkey
| | - Nermin Koç
- Department of Pathology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, İstanbul, Turkey
| | - Ramazan Uluhan
- Department of Clinical Microbiology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, İstanbul, Turkey
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Wang F, Wang Y, Wang R, Qiu H, Chen L. Predictive value of maternal serum NF-κB p65 and sTREM-1 for subclinical chorioamnionitis in premature rupture of membranes. Am J Reprod Immunol 2016; 76:217-23. [PMID: 27521929 DOI: 10.1111/aji.12543] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 07/05/2016] [Indexed: 11/30/2022] Open
Abstract
PROBLEM The aim of this study was to investigate the levels of nuclear factor kappa B-p65 (NF-κB p65) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in maternal blood with premature rupture of membranes (PROM) and to assess their values for prediction of subclinical chorioamnionitis. METHOD NF-κB p65 and sTREM-1 levels were measured in maternal blood and cord blood by fluorescence quantitative RT-PCR assay. According to the placental membranes pathological examination, pregnant women with PROM were divided into chorioamnionitis group (n=28) and non-chorioamnionitis group (n=22). RESULTS In the PROM group,the NF-κB p65 and sTREM-1 levels in maternal blood were significantly higher in women with chorioamnionitis than women without chorioamnionitis (P<.05). The cutoff value of maternal NF-κB p65, sTREM-1, C-reactive protein (CRP), and WBC level were 6.73, 2.93, 6.75 mg/L, and 10.8×10(9) /L, respectively, through analysis of the area under the ROC curve (AUC). The optimal combination test was detection of maternal blood NF-κB p65 and CRP levels, which resulted in a sensitivity of 89.3% and a specificity of 72.7% for the prediction of subclinical chorioamnionitis. CONCLUSION Combined measurements of maternal NF-κB p65 and CRP levels may be used as early biological indicators that predict subclinical chorioamnionitis in premature rupture of membranes.
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Affiliation(s)
- Fan Wang
- Department of Obstetrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yuhuan Wang
- Department of Obstetrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Rongyue Wang
- Department of Obstetrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Haifan Qiu
- Department of Obstetrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lulu Chen
- Department of Obstetrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Liu Y, Liu Y, Du C, Zhang R, Feng Z, Zhang J. Diagnostic value of amniotic fluid inflammatory biomarkers for subclinical chorioamnionitis. Int J Gynaecol Obstet 2016; 134:160-4. [PMID: 27177518 DOI: 10.1016/j.ijgo.2016.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 12/23/2015] [Accepted: 04/05/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the value of measuring amniotic fluid inflammatory biomarkers for diagnosis of subclinical chorioamnionitis. METHODS A prospective study was conducted among pregnant women with cervical dilation, preterm premature rupture of membranes, threatened late abortion, or threatened premature labor who attended a tertiary care hospital in Guangzhou, China, between June 1, 2012, and January 31, 2014. Participants were divided into two groups according to the presence or absence of subclinical chorioamnionitis. Surface-enhanced laser desorption/ionization time-of-flight mass spectroscopy (SELDI-TOF-MS) was used to detect human neutrophil defensins (HNP-1 and HNP-2), calgranulins A (S100A8), and calgranulins C (S100A12) in amniocentesis samples. RESULTS Overall, 22 patients had subclinical chorioamnionitis and 17 patients did not. Positive test results for HNP-2 were noted for more patients with subclinical chorioamnionitis than for those without for HNP-2 (19 [86%] vs 2 [12%]; P<0.001), HNP-1 (19 [86%] vs 5 [29%]; P=0.001), S100A12 (20 [91%] vs 9 [53%]; P=0.011), and S100A8 (12 [55%] vs 0; P<0.001). When three or four of these biomarkers were present, the accuracy for a diagnosis of subclinical chorioamnionitis was 89.7%. The sensitivity, specificity, positive predictive value, and negative predictive value were 81.8%, 100.0%, 100.0%, and 81.0%, respectively. CONCLUSION Detection of inflammatory biomarkers in the amniotic fluid by SELDI-TOF-MS exhibited high diagnostic accuracy for subclinical chorioamnionitis.
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Affiliation(s)
- Yinglin Liu
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
| | - Yukun Liu
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chuying Du
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Rui Zhang
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ziya Feng
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jianping Zhang
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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