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Tiruneh SA, Vu TTT, Rolnik DL, Teede HJ, Enticott J. Machine Learning Algorithms Versus Classical Regression Models in Pre-Eclampsia Prediction: A Systematic Review. Curr Hypertens Rep 2024; 26:309-323. [PMID: 38806766 PMCID: PMC11199280 DOI: 10.1007/s11906-024-01297-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE OF REVIEW Machine learning (ML) approaches are an emerging alternative for healthcare risk prediction. We aimed to synthesise the literature on ML and classical regression studies exploring potential prognostic factors and to compare prediction performance for pre-eclampsia. RECENT FINDINGS From 9382 studies retrieved, 82 were included. Sixty-six publications exclusively reported eighty-four classical regression models to predict variable timing of onset of pre-eclampsia. Another six publications reported purely ML algorithms, whilst another 10 publications reported ML algorithms and classical regression models in the same sample with 8 of 10 findings that ML algorithms outperformed classical regression models. The most frequent prognostic factors were age, pre-pregnancy body mass index, chronic medical conditions, parity, prior history of pre-eclampsia, mean arterial pressure, uterine artery pulsatility index, placental growth factor, and pregnancy-associated plasma protein A. Top performing ML algorithms were random forest (area under the curve (AUC) = 0.94, 95% confidence interval (CI) 0.91-0.96) and extreme gradient boosting (AUC = 0.92, 95% CI 0.90-0.94). The competing risk model had similar performance (AUC = 0.92, 95% CI 0.91-0.92) compared with a neural network. Calibration performance was not reported in the majority of publications. ML algorithms had better performance compared to classical regression models in pre-eclampsia prediction. Random forest and boosting-type algorithms had the best prediction performance. Further research should focus on comparing ML algorithms to classical regression models using the same samples and evaluation metrics to gain insight into their performance. External validation of ML algorithms is warranted to gain insights into their generalisability.
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Affiliation(s)
- Sofonyas Abebaw Tiruneh
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Tra Thuan Thanh Vu
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Daniel Lorber Rolnik
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Joanne Enticott
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
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Tang H, Tian Y, Fang J, Yuan X, Yao M, Wang Y, Feng Y, Shu J, Ni Y, Yu Y, Wang Y, Liang P, Li X, Bai X. Detection of Urinary Misfolded Proteins for Imminent Prediction of Preeclampsia in Pregnant Women With Suspected Cases: Protocol for a Prospective Noninterventional Study. JMIR Res Protoc 2024; 13:e54026. [PMID: 38669061 PMCID: PMC11087858 DOI: 10.2196/54026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Preeclampsia (PE) is one of the most common hypertensive diseases, affecting 2%-8% of all pregnancies. The high maternal and fetal mortality rates of PE are due to a lack of early identification of affected pregnant women that would have led to closer monitoring and care. Recent data suggest that misfolded proteins might be a promising biomarker for PE prediction, which can be detected in urine samples of pregnant women according to their congophilia (aggregated) characteristic. OBJECTIVE The main purpose of this trial is to evaluate the value of the urine congophilia-based detection of misfolded proteins for the imminent prediction of PE in women presenting with suspected PE. The secondary objectives are to demonstrate that the presence of urine misfolded proteins correlates with PE-related maternal or neonatal adverse outcomes, and to establish an accurate PE prediction model by combining misfolded proteins with multiple indicators. METHODS At least 300 pregnant women with clinical suspicion of PE will be enrolled in this prospective cohort study. Participants should meet the following inclusion criteria in addition to a suspicion of PE: ≥18 years old, gestational week between 20+0 and 33+6, and single pregnancy. Consecutive urine samples will be collected, blinded, and tested for misfolded proteins and other PE-related biomarkers at enrollment and at 4 follow-up visits. Clinical assessments of PE status and related complications for all participants will be performed at regular intervals using strict diagnostic criteria. Investigators and participants will remain blinded to the results. Follow-up will be performed until 42 days postpartum. Data from medical records, including maternal and fetal outcomes, will be collected. The performance of urine misfolded proteins alone and combined with other biomarkers or clinical variables for the prediction of PE will be statistically analyzed. RESULTS Enrollment started in July 2023 and was still open upon manuscript submission. As of March 2024, a total of 251 eligible women have been enrolled in the study and enrollment is expected to continue until August 2024. Results analysis is scheduled to start after all participants reach the follow-up endpoint and complete clinical data are collected. CONCLUSIONS Upon completion of the study, we expect to derive an accurate PE prediction model, which will allow for proactive management of pregnant women with clinical suspicion of PE and possibly reduce the associated adverse pregnancy outcomes. The additional prognostic value of misfolded proteins is also expected to be confirmed. TRIAL REGISTRATION Chinese Clinical Trials Registry ChiCTR2300074878; https://www.chictr.org.cn/showproj.html?proj=202096. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54026.
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Affiliation(s)
- Haiyang Tang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yijia Tian
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jing Fang
- Department of Obstetrics, Lanxi People's Hospital, Jinhua, China
| | | | - Minli Yao
- Shuwen Biotech Co, Ltd, Hangzhou, China
| | - Yujia Wang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yan Feng
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jia Shu
- Department of Obstetrics, Ningbo Women and Children's Hospital, Ningbo, China
| | - Yan Ni
- Department of Obstetrics, Quzhou Maternity and Child Health Care Hospital, Quzhou, China
| | - Ying Yu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuanhe Wang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ping Liang
- Department of Obstetrics, Xinchang People's Hospital, Shaoxing, China
| | | | - Xiaoxia Bai
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Traditional Chinese Medicine for Reproductive Health Key Laboratory of Zhejiang Province, Hangzhou, China
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China
- Key Laboratory of Women's Reproductive Health, Hangzhou, China
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Peris M, Crompton K, Shepherd DA, Amor DJ. The association between human chorionic gonadotropin and adverse pregnancy outcomes: a systematic review and meta-analysis. Am J Obstet Gynecol 2024; 230:118-184. [PMID: 37572838 DOI: 10.1016/j.ajog.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVE This study aimed to evaluate the association between human chorionic gonadotropin and adverse pregnancy outcomes. DATA SOURCES Medline, Embase, PubMed, and Cochrane were searched in November 2021 using Medical Subject Headings (MeSH) and relevant key words. STUDY ELIGIBILITY CRITERIA This analysis included published full-text studies of pregnant women with serum human chorionic gonadotropin testing between 8 and 28 weeks of gestation, investigating fetal outcomes (fetal death in utero, small for gestational age, preterm birth) or maternal factors (hypertension in pregnancy: preeclampsia, pregnancy-induced hypertension, placental abruption, HELLP syndrome, gestational diabetes mellitus). METHODS Studies were extracted using REDCap software. The Newcastle-Ottawa scale was used to assess for risk of bias. Final meta-analyses underwent further quality assessment using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) method. RESULTS A total of 185 studies were included in the final review, including the outcomes of fetal death in utero (45), small for gestational age (79), preterm delivery (62), hypertension in pregnancy (107), gestational diabetes mellitus (29), placental abruption (17), and HELLP syndrome (2). Data were analyzed separately on the basis of categorical measurement of human chorionic gonadotropin and human chorionic gonadotropin measured on a continuous scale. Eligible studies underwent meta-analysis to generate a pooled odds ratio (categorical human chorionic gonadotropin level) or difference in medians (human chorionic gonadotropin continuous scale) between outcome groups. First-trimester low human chorionic gonadotropin levels were associated with preeclampsia and fetal death in utero, whereas high human chorionic gonadotropin levels were associated with preeclampsia. Second-trimester high human chorionic gonadotropin levels were associated with fetal death in utero and preeclampsia. CONCLUSION Human chorionic gonadotropin levels are associated with placenta-mediated adverse pregnancy outcomes. Both high and low human chorionic gonadotropin levels in the first trimester of pregnancy can be early warning signs of adverse outcomes. Further analysis of human chorionic gonadotropin subtypes and pregnancy outcomes is required to determine the diagnostic utility of these findings in reference to specific cutoff values.
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Affiliation(s)
- Monique Peris
- Neurodisability and Rehabilitation Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Neurodevelopment and Disability, Royal Children's Hospital, Melbourne, Australia
| | - Kylie Crompton
- Neurodisability and Rehabilitation Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Neurodevelopment and Disability, Royal Children's Hospital, Melbourne, Australia
| | - Daisy A Shepherd
- Neurodisability and Rehabilitation Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - David J Amor
- Neurodisability and Rehabilitation Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Neurodevelopment and Disability, Royal Children's Hospital, Melbourne, Australia.
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Singh Thakur A, Tayade S, Patel D, Gupta A, Batra N. Unraveling the Predictive Power: Placenta Growth Factor and Pregnancy-Associated Plasma Protein A in Pre-eclampsia. Cureus 2024; 16:e52752. [PMID: 38389635 PMCID: PMC10881904 DOI: 10.7759/cureus.52752] [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: 01/03/2024] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
This review provides a comprehensive exploration of the roles of placenta growth factor (PlGF) and pregnancy-associated plasma protein A (PAPP-A) in the context of pre-eclampsia, a pregnancy-related hypertensive disorder with significant implications for maternal and fetal health. The background elucidates the clinical significance of pre-eclampsia, highlighting its prevalence and impact. The review delves into the biological importance of PlGF and PAPP-A, emphasizing their critical roles in normal placental development and their dysregulation in pre-eclampsia. Notably, altered levels of these biomarkers emerge as potential diagnostic indicators, offering insights into the pathophysiology of the disorder. The exploration of pathophysiological mechanisms, including angiogenic imbalance and placental dysfunction, provides a nuanced understanding of pre-eclampsia's molecular landscape. The therapeutic implications of targeting PlGF and PAPP-A open avenues for future research, aiming at effective intervention strategies. The conclusion summarizes key findings, outlines implications for future research, and underscores the crucial role of PlGF and PAPP-A in understanding and managing pre-eclampsia, with the ultimate goal of improving outcomes for both mothers and infants.
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Affiliation(s)
- Aditi Singh Thakur
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Wardha, IND
| | - Surekha Tayade
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Wardha, IND
| | - Drashti Patel
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Wardha, IND
| | - Aishwarya Gupta
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Wardha, IND
| | - Nitish Batra
- Medicine, Jawaharlal Nehru Medical College, Wardha, IND
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Ji Q, Zhang S, Jiang W, Wang J, Luan Y, Xin Q. Serum protein profile analysis via label-free quantitation proteomics in patients with early-onset preeclampsia. J OBSTET GYNAECOL 2023; 43:2259982. [PMID: 37743728 DOI: 10.1080/01443615.2023.2259982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 08/27/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Preeclampsia (PE) is a serious pregnancy complication, resulting in potentially life-threatening conditions for both mother and foetus. It is worth noting that early-onset PE has become a great challenge for clinicians due to its complex manifestation, rapid progression and serious complications. This study aims to investigate differential serum proteome profiles in patients with early-onset PE. METHODS Each serum sample was separated using a nanoliter flow rate Easy-nLC chromatography system. Then the samples were analysed by mass spectrometry. Bioinformatics analyses were conducted to analyse the functional categories or signal transduction pathways for differentially abundant proteins. Key proteins identified by mass spectrometry were verified by ELISA. RESULTS We found 30 and 34 proteins were upregulated and downregulated in early-onset PE patients (n = 3) vs controls (n = 3), respectively. Functional enrichment analysis revealed differentially expressed proteins related to the immune response and regulation of peptidase activity. ELISA confirmed that there were lower CSH1 levels and higher LPA concentrations in the serum samples of early-onset PE patients (n = 22) than in healthy controls (n = 19) (p < 0.05 for CSH1 and p < 0.001 for LPA). CONCLUSIONS This study revealed the critical features of serum proteins in early-onset PE patients. LPA and CSH1 may serve as biomarkers for early-onset PE diagnosis and therapy.
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Affiliation(s)
- Qinghong Ji
- Department of Obstetrics, The Second Hospital of Shandong University, Jinan, Shandong, P.R. China
| | - Shulin Zhang
- Department of Digestive Disease, The Second Hospital of Shandong University, Jinan, Shandong, P.R. China
| | - Wen Jiang
- Central Laboratory, Institute of Medical Science, The Second Hospital of Shandong University, Jinan, Shandong, P.R. China
| | - Jue Wang
- Central Laboratory, Institute of Medical Science, The Second Hospital of Shandong University, Jinan, Shandong, P.R. China
| | - Yun Luan
- Central Laboratory, Institute of Medical Science, The Second Hospital of Shandong University, Jinan, Shandong, P.R. China
| | - Qian Xin
- Central Laboratory, Institute of Medical Science, The Second Hospital of Shandong University, Jinan, Shandong, P.R. China
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Piekarska K, Dratwa M, Radwan P, Radwan M, Bogunia-Kubik K, Nowak I. Pro- and anti-inflammatory cytokines and growth factors in patients undergoing in vitro fertilization procedure treated with prednisone. Front Immunol 2023; 14:1250488. [PMID: 37744353 PMCID: PMC10511889 DOI: 10.3389/fimmu.2023.1250488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Embryo implantation is a key moment in pregnancy. Abnormal production of pro- and anti-inflammatory cytokines, their receptors and other immune factors may result in embryo implantation failure and pregnancy loss. The aim of this study was to determine the profile of selected pro- and anti-inflammatory factors in the blood plasma of patients undergoing in vitro fertilization (IVF) and control women who achieved pregnancy after natural conception. The examined patients were administered steroid prednisone. We present results concern the plasma levels of IFN-ɣ, BDNF, LIF, VEGF-A, sTNFR1 and IL-10. We found that IVF patients receiving steroids differed significantly from patients who were not administered such treatment in terms of IFN-γ and IL-10 levels. Moreover, IVF patients differed in secretion of all tested factors with the fertile controls. Our results indicated that women who secrete at least 1409 pg/ml of sTNFR1 have a chance to become pregnant naturally and give birth to a child, while patients after IVF must achieve a concentration of 962.3 pg/ml sTNFR1 in blood plasma for successful pregnancy. In addition, IVF patients secreting VEGF-A above 43.28 pg/ml have a greater risk of miscarriage or a failed transfer in comparison to women secreting below this value. In conclusion, fertile women present a different profile of pro- and anti-inflammatory cytokines, and growth factors compared to patients with recurrent implantation failure (RIF).
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Affiliation(s)
- Karolina Piekarska
- Laboratory of Immunogenetics and Tissue Immunology, Department of Clinical Immunology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland
| | - Marta Dratwa
- Laboratory of Clinical Immunogenetics and Pharmacogenetics, Department of Clinical Immunology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland
| | - Paweł Radwan
- Department of Reproductive Medicine, Gameta Hospital, Rzgów, Poland
| | - Michał Radwan
- Department of Reproductive Medicine, Gameta Hospital, Rzgów, Poland
- Faculty of Health Sciences, The Mazovian Academy in Plock, Płock, Poland
| | - Katarzyna Bogunia-Kubik
- Laboratory of Clinical Immunogenetics and Pharmacogenetics, Department of Clinical Immunology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland
| | - Izabela Nowak
- Laboratory of Immunogenetics and Tissue Immunology, Department of Clinical Immunology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland
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Zhang W, Liang H. The role of serum markers PAPP-A β-hCG, AFP, and uE3 in predicting the risk of preeclampsia in early, middle, and late pregnancy. Technol Health Care 2022; 31:1027-1037. [PMID: 36442168 DOI: 10.3233/thc-220523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: Preeclampsia (PE) has adverse effects on pregnant women, fetuses, and newborns [1], and accounts for 3%–10% of pregnancy-related diseases globally. OBJECTIVE: This study aimed to screen a series of prenatal markers (pregnancy-associated plasma protein [PAPP-A], β-human chorionic gonadotropin [β-hCG], alpha fetoprotein [AFP], and estriol [uE3]) to establish a risk model and evaluate the diagnostic values of the markers for predicting PE. METHODS: Sixty-five pregnant women were enrolled in this study. They were divided into two groups containing healthy pregnant women (n= 51, the non-PE group) and pregnant women with PE (n= 14, the PE group). According to the stage of pregnancy, the pregnant women in each group were divided into early, middle, and late pregnancy groups for statistical analysis. The levels of PAPPA-A β-hCG, AFP, and uE3 were compared among these groups. Then, a risk model was established, and PE was diagnosed using receiver operating characteristic (ROC) curve results. RESULTS: In the early pregnancy group, the differences in the levels of PAPP-A, AFP, and uE3 between the PE and non-PE groups were statistically significant (P< 0.001, P= 0.029, and P= 0.033, respectively), while the difference in the single remaining marker was not statistically significant. A ROC curve analysis revealed that in early pregnancy, the sensitivity and specificity of PAPP-A were 76.5% and 71.4%, respectively, and the sensitivity and specificity of β-hCG were 82.4% and 57.1%, respectively. The sensitivity and specificity of the combination of the two markers for diagnosing PE were 86.3% and 57.1%, respectively. CONCLUSION: This study demonstrated that the combination of PAPP-A and β-hCG has diagnostic value for PE in pregnant women. Accordingly, we should formulate innovative PE screening strategies to target the prevention of PE and create important conditions for predictive and preventive personalized medical treatments.
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Placenta Accreta has a Low Association with Hypertensive Disease During Pregnancy: A Systematic Review Incorporating a Network Meta-analysis. Reprod Sci 2022; 29:2119-2126. [PMID: 35471550 DOI: 10.1007/s43032-022-00938-7] [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: 08/17/2021] [Accepted: 04/02/2022] [Indexed: 10/18/2022]
Abstract
A meta-analysis was performed to evaluate the potential relationship between hypertensive disease during pregnancy and placenta accreta. A systematic literature search in OVID, Embase, Cochrane Library, PubMed, and Google scholar up to May 2021 was done, and 4 studies were found including 47,353 pregnant women at the start of the study; 4283 of them had hypertensive disease during pregnancy and 493 had placenta accreta. They were reporting relationships between hypertensive disease during pregnancy and placenta accreta. The odds ratio (OR) with 95% confidence intervals (CIs) was calculated to assess the potential relationship between hypertensive disease during pregnancy and placenta accreta using the dichotomous with a random or fixed-effect model. Hypertensive disease during pregnancy was significantly related to lower prevalence of placenta accreta (OR, 0.60; 95% CI, .38-.94, p = 0.03) compared with control (no hypertensive disease during pregnancy). When looking at the result comparing the prevalence of hypertensive disease during pregnancy in women with placenta accreta compared with control (no placenta accreta), we found that the placenta accreta was significantly related to lower prevalence of hypertensive disease during pregnancy (OR, 0.59; 95% CI, 0.38-0.94, p = 0.03) compared with control. Hypertensive disease during pregnancy may have a lower prevalence of placenta accreta. Further studies are required to validate these findings.
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A risk model that combines MAP, PlGF, and PAPP-A in the first trimester of pregnancy to predict hypertensive disorders of pregnancy. J Hum Hypertens 2022; 36:184-191. [PMID: 33594246 DOI: 10.1038/s41371-021-00488-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 01/03/2021] [Accepted: 01/18/2021] [Indexed: 02/06/2023]
Abstract
Whether the first trimester maternal mean arterial pressure (MAP), placental growth factor (PlGF), and pregnancy-associated plasma protein A (PAPP-A) can predict hypertensive disorders of pregnancy (HDP) is unclear. We conducted a retrospective case-control study with the total population of 539 gravidas, of these 447 had normal pregnancy, 27 had gestational hypertension (GH), 36 had preeclampsia (PE), and 29 had preeclampsia with severe features (SPE). Prediction for HDP was determined by the area under curve (AUC). Compared to the healthy group, the multiple of the median (MoM) for MAP was increased in the study groups, while PlGF and PAPP-A were decreased. When the cutoff values for MAP, PlGF, and PAPP-A were 1.069, 0.769, and 0.673 MoM, respectively, the sensitivities for predicting HDP were 0.517, 0.446, and 0.500 and the specificities were 0.744, 0.826, and 0.769, respectively. To predict GH, the highest AUC was 0.755 (95% CI: 0.655-0.856, p < 0.001) based on MAP, PlGF, and PAPP-A. The combined PlGF and PAPP-A had the highest AUC (0.683 [95% CI: 0.584-0.782, p < 0.001] and 0.755 [95% CI: 0.682-0.829, p < 0.001]) for prediction of PE and SPE. We found that MAP, serum levels of PlGF, and PAPP-A in the first trimester pregnancy are markers that predict HDP in the third trimester. The combination of markers is far superior to single markers alone. To improve the diagnostic value, specific cutoff values should be applied to GH, PE, SPE in each condition.
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Zhang J, Zhang Y, Li L, Nian Y, Chen Y, Shen R, Ma X. Pregnancy-associated plasma protein-A (PAPPA) promotes breast cancer progression. Bioengineered 2022; 13:291-307. [PMID: 34974815 PMCID: PMC8805841 DOI: 10.1080/21655979.2021.2000724] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Breast cancer is the most common malignancy in females and poses a significant health threat to women. Pregnancy-associated plasma protein-A (PAPPA) is highly expressed in pregnancy-associated breast cancer (PABC) tissues. In this study, we investigated the functional role of PAPPA in regulating the malignant phenotype of breast cancer. We first examined the expression level of PAPPA in PABC tissue and breast cancer cell lines using quantitative real-time polymerase-chain reaction (qRT-PCR) and western blot. Next, the functional role of PAPPA in breast cancer cells was validated by overexpression and knockdown experiments. Cell counting kit-8 (CCK-8) proliferation assay, 5-ethynyl-2'-deoxyuridine (EdU) incorporation assay, wound healing and transwell invasion assay were used to examine cell proliferation, migration, and invasion ability. We further identified the microRNA target regulating PAPPA and studied its functional role. Finally, we examined the impact of PAPPA on the tumorigenesis and metastasis of breast cancer in mice model. Our study revealed that PAPPA was upregulated in PABC tissues and breast cancer cells. Overexpression of PAPPA promoted cell proliferation, motility, invasion, and epithelial-mesenchymal transition (EMT). We further identified miR-497-5p as a negative regulator of PAPPA, which suppressed cell proliferation, migration, invasion, and EMT in breast cancer cells. We also validated the oncogenic role of PAPPA in the mouse xenograft model. Collectively, our study suggests that PAPPA is an oncogenic protein highly expressed in PABC tissues and promotes breast cancer progression, which could serve as a novel therapeutic target for breast cancer.
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Affiliation(s)
- Jun Zhang
- Department of Clinical Laboratory, The Fifth Hospital of Wuhan, Wuhan, China
| | - Yuan Zhang
- Department of Ultrasound Medicine, Yunnan Cancer Hospital, the Third Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lanjiang Li
- Department of Forensic Medicine, Kunming Medical University, Kunming, China
| | - Yinghua Nian
- Department of Ultrasound Medicine, Yunnan Cancer Hospital, the Third Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ying Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Kunming Medical University, Kunming, China
| | - Ruoxia Shen
- Department of Ultrasound Medicine, Yunnan Cancer Hospital, the Third Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiaoyan Ma
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
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Khanam Z, Mittal P, Suri J. Does the Addition of Serum PAPP-A and β-hCG Improve the Predictive Value of Uterine Artery Pulsatility Index for Preeclampsia at 11-14 Weeks of Gestation? A Prospective Observational Study. J Obstet Gynaecol India 2021; 71:226-234. [PMID: 34408341 DOI: 10.1007/s13224-020-01420-7] [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: 03/31/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022] Open
Abstract
Purpose of Study To study the role of uterine artery Doppler pulsatility index (UtA-PI), serum pregnancy-associated plasma protein-A (PAPP-A) and free beta human chorionic gonadotropin (fβ-hCG) levels, individually and in combination with each other, at 11-14 weeks of gestation for prediction of preeclampsia (PE). Methods In a prospective observational study, a total of 100 low-risk gravid females were recruited at 11-14-weeks of gestation. UtA-PI, PAPP-A and fβ-hCG levels were estimated. These women were followed up until delivery for the development of PE and gestational hypertension (GH). Results The best individual marker for screening PE and GH was UtA-PI with ROC AUC (± standard error) = 0.934 ± 0.028, p < 0.0001. UtA-PI at a cutoff value of ≥ 2.8 (95th percentile) had 77.8% sensitivity, 98.9% specificity, 97.8% NPV and 87.5% PPV in detecting PE. PAPP-A (MoM) at a cutoff value of ≤ 0.27 (5th percentile) demonstrated 44.4% sensitivity, 95.6% specificity, 94.5% NPV and 50% PPV. fβ-hCG (MoM) at a cutoff value of ≤ 0.5 (5th percentile) had a specificity of 94.5%. Among the combined markers, UtA-PI along with PAPP-A estimation served best with a sensitivity and specificity of 44% and 100%, respectively. Addition of fβ-hCG to either UtA-PI or PAPP-A levels was not found sensitive for detecting PE but yielded 100% specificity and 96% NPV. Conclusion UtA-PI as a stand-alone test was found most useful for the prediction of PE. Addition of either or both of PAPP-A and fβ-hCG to UtA-PI did not improve the sensitivity of combined test with only a slight improvement in specificity and NPV. Their routine addition to UtA-PI studies is not recommended for prediction of PE at 11-14 weeks of gestation in low- and lower-middle-income countries (LMIC).
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Affiliation(s)
- Zeba Khanam
- Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Pratima Mittal
- Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Jyotsna Suri
- Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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12
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Abbas RA, Ghulmiyyah L, Hobeika E, Usta IM, Mirza F, Nassar AH. Preeclampsia: A Review of Early Predictors. MATERNAL-FETAL MEDICINE 2021. [DOI: 10.1097/fm9.0000000000000088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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13
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Lentz EJM, Park AL, Langlois AWR, Huang T, Meschino WS, Ray JG. Risk of Severe Maternal Morbidity or Death in Relation to Prenatal Biochemical Screening: Population-Based Cohort Study. Am J Perinatol 2021; 38:44-59. [PMID: 31412403 DOI: 10.1055/s-0039-1694731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This study aimed to examine whether prenatal biochemical screening analytes are associated with an increased risk of severe maternal morbidity (SMM) or maternal mortality. STUDY DESIGN This population-based cohort study includes all women in Ontario, Canada, who underwent prenatal screening from 2001 to 2011. Increasing fifth percentiles of the multiple of the median (MoM) for alphafetoprotein (AFP), total human chorionic gonadotropin, unconjugated estriol (uE3), dimeric inhibin-A (DIA), and pregnancy-associated plasma protein A were evaluated. An abnormally high concentration (>95th percentile MoM) for each analyte, individually and combined, was also evaluated. The main outcome assessed was the adjusted relative risk (aRR) of SMM or maternal mortality from 20 weeks' gestation up to 26 weeks thereafter. RESULTS Among 748,972 pregnancies, 11,177 resulted in SMM or maternal mortality (1.5%). Except for uE3, the aRR of SMM or maternal mortality increased in association with increasing fifth percentiles of the MoM for all analytes. AFP (aRR: 2.10; 95% confidence interval [CI]: 1.97-2.25) and DIA (aRR: 2.33; 95% CI: 1.98-2.74) > 95th versus ≤ 5th percentile of the MoM were especially associated with SMM or death. CONCLUSION Women with abnormally high concentrations of certain prenatal biochemical analytes may be at a higher risk of SMM or death in pregnancy or postpartum.
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Affiliation(s)
- Eric J M Lentz
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Alison L Park
- Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Alec W R Langlois
- Faculty of Arts and Science, Queen's University, Kingston, Ontario, Canada
| | - Tianhua Huang
- Genetics Program, North York General Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Wendy S Meschino
- Genetics Program, North York General Hospital, Toronto, Ontario, Canada.,Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Joel G Ray
- Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, Health Policy Management and Evaluation, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.,Department of Obstetrics and Gynaecology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
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14
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Srinivasan S, Treacy R, Herrero T, Olsen R, Leonardo TR, Zhang X, DeHoff P, To C, Poling LG, Fernando A, Leon-Garcia S, Knepper K, Tran V, Meads M, Tasarz J, Vuppala A, Park S, Laurent CD, Bui T, Cheah PS, Tabitha Overcash R, Ramos GA, Roeder H, Ghiran I, Parast M, Breakefield XO, Lueth AJ, Rust SR, Dufford MT, Fox AC, Hickok DE, Burchard J, Boniface JJ, Laurent LC. Discovery and Verification of Extracellular miRNA Biomarkers for Non-invasive Prediction of Pre-eclampsia in Asymptomatic Women. Cell Rep Med 2020; 1:100013. [PMID: 32864636 PMCID: PMC7455024 DOI: 10.1016/j.xcrm.2020.100013] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 11/01/2019] [Accepted: 04/21/2020] [Indexed: 12/16/2022]
Abstract
Development of effective prevention and treatment strategies for pre-eclampsia is limited by the lack of accurate methods for identification of at-risk pregnancies. We performed small RNA sequencing (RNA-seq) of maternal serum extracellular RNAs (exRNAs) to discover and verify microRNAs (miRNAs) differentially expressed in patients who later developed pre-eclampsia. Sera collected from 73 pre-eclampsia cases and 139 controls between 17 and 28 weeks gestational age (GA), divided into separate discovery and verification cohorts, are analyzed by small RNA-seq. Discovery and verification of univariate and bivariate miRNA biomarkers reveal that bivariate biomarkers verify at a markedly higher rate than univariate biomarkers. The majority of verified biomarkers contain miR-155-5p, which has been reported to mediate the pre-eclampsia-associated repression of endothelial nitric oxide synthase (eNOS) by tumor necrosis factor alpha (TNF-α). Deconvolution analysis reveals that several verified miRNA biomarkers come from the placenta and are likely carried by placenta-specific extracellular vesicles.
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Affiliation(s)
- Srimeenakshi Srinivasan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Ryan Treacy
- Sera Prognostics, 2749 East Parleys Way, Salt Lake City, UT 84109, USA
| | - Tiffany Herrero
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
- Department of Obstetrics and Gynecology, Stanford University, Palo Alto, CA 94305, USA
| | - Richelle Olsen
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
- Franciscan Maternal-Fetal Medicine Associates at St. Joseph, Tacoma, WA 98405, USA
| | - Trevor R. Leonardo
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
- Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Xuan Zhang
- Neurology and Radiology Services and Program in Neuroscience, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02115, USA
| | - Peter DeHoff
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Cuong To
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Lara G. Poling
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Aileen Fernando
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Sandra Leon-Garcia
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Katharine Knepper
- Department of Pathology, University of California, San Diego, La Jolla, CA 92037, USA
| | - Vy Tran
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Morgan Meads
- Department of Pathology, University of California, San Diego, La Jolla, CA 92037, USA
| | - Jennifer Tasarz
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Aishwarya Vuppala
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Soojin Park
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Clara D. Laurent
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Tony Bui
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Pike See Cheah
- Neurology and Radiology Services and Program in Neuroscience, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02115, USA
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor Darul Ehsan, Malaysia
| | - Rachael Tabitha Overcash
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Gladys A. Ramos
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Hilary Roeder
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
- Kaiser Permanente San Diego, San Diego, CA 92120, USA
| | - Ionita Ghiran
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Mana Parast
- Department of Pathology, University of California, San Diego, La Jolla, CA 92037, USA
| | - Xandra O. Breakefield
- Neurology and Radiology Services and Program in Neuroscience, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02115, USA
| | - Amir J. Lueth
- Sera Prognostics, 2749 East Parleys Way, Salt Lake City, UT 84109, USA
| | - Sharon R. Rust
- Sera Prognostics, 2749 East Parleys Way, Salt Lake City, UT 84109, USA
| | - Max T. Dufford
- Sera Prognostics, 2749 East Parleys Way, Salt Lake City, UT 84109, USA
| | - Angela C. Fox
- Sera Prognostics, 2749 East Parleys Way, Salt Lake City, UT 84109, USA
| | - Durlin E. Hickok
- Sera Prognostics, 2749 East Parleys Way, Salt Lake City, UT 84109, USA
| | - Julja Burchard
- Sera Prognostics, 2749 East Parleys Way, Salt Lake City, UT 84109, USA
| | - J. Jay Boniface
- Sera Prognostics, 2749 East Parleys Way, Salt Lake City, UT 84109, USA
| | - Louise C. Laurent
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92037, USA
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15
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Autonomous lab-on-a-chip generic architecture for disposables with integrated actuation. Sci Rep 2019; 9:20320. [PMID: 31889049 PMCID: PMC6937297 DOI: 10.1038/s41598-019-55111-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/22/2019] [Indexed: 11/09/2022] Open
Abstract
The integration of actuators within disposable lab-on-a-chip devices is a demanding goal that requires reliable mechanisms, systematic fabrication procedures and marginal costs compatible with single-use devices. In this work an affordable 3D printed prototype that offers a compact and modular configuration to integrate actuation in autonomous lab-on-a-chip devices is demonstrated. The proposed concept can handle multiple step preparation protocols, such as the enzyme-linked immunosorbent assay (ELISA) configuration, by integrating reagents, volume metering capabilities with performance comparable to pipettes (e.g. 2.68% error for 5 μL volume), arbitrary dilution ratio support, effective mixing and active control of the sample injection. The chosen architecture is a manifold served by multiple injectors ending in unidirectional valves, which exchange a null dead volume when idle, thus isolating reagents until they are used. Functionalization is modularly provided by a plug-in element, which together with the selection of reagents can easily repurpose the platform to diverse targets, and this work demonstrates the systematic fabrication of 6 injectors/device at a development cost of USD$ 0.55/device. The concept was tested with a commercial ELISA kit for tumor necrosis factor (TNF), a marker for infectious, inflammatory and autoimmune disorders, and its performance satisfactorily compared with the classical microplate implementation.
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16
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Tarca AL, Romero R, Benshalom-Tirosh N, Than NG, Gudicha DW, Done B, Pacora P, Chaiworapongsa T, Panaitescu B, Tirosh D, Gomez-Lopez N, Draghici S, Hassan SS, Erez O. The prediction of early preeclampsia: Results from a longitudinal proteomics study. PLoS One 2019; 14:e0217273. [PMID: 31163045 PMCID: PMC6548389 DOI: 10.1371/journal.pone.0217273] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/08/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To identify maternal plasma protein markers for early preeclampsia (delivery <34 weeks of gestation) and to determine whether the prediction performance is affected by disease severity and presence of placental lesions consistent with maternal vascular malperfusion (MVM) among cases. STUDY DESIGN This longitudinal case-control study included 90 patients with a normal pregnancy and 33 patients with early preeclampsia. Two to six maternal plasma samples were collected throughout gestation from each woman. The abundance of 1,125 proteins was measured using high-affinity aptamer-based proteomic assays, and data were modeled using linear mixed-effects models. After data transformation into multiples of the mean values for gestational age, parsimonious linear discriminant analysis risk models were fit for each gestational-age interval (8-16, 16.1-22, 22.1-28, 28.1-32 weeks). Proteomic profiles of early preeclampsia cases were also compared to those of a combined set of controls and late preeclampsia cases (n = 76) reported previously. Prediction performance was estimated via bootstrap. RESULTS We found that 1) multi-protein models at 16.1-22 weeks of gestation predicted early preeclampsia with a sensitivity of 71% at a false-positive rate (FPR) of 10%. High abundance of matrix metalloproteinase-7 and glycoprotein IIbIIIa complex were the most reliable predictors at this gestational age; 2) at 22.1-28 weeks of gestation, lower abundance of placental growth factor (PlGF) and vascular endothelial growth factor A, isoform 121 (VEGF-121), as well as elevated sialic acid binding immunoglobulin-like lectin 6 (siglec-6) and activin-A, were the best predictors of the subsequent development of early preeclampsia (81% sensitivity, FPR = 10%); 3) at 28.1-32 weeks of gestation, the sensitivity of multi-protein models was 85% (FPR = 10%) with the best predictors being activated leukocyte cell adhesion molecule, siglec-6, and VEGF-121; 4) the increase in siglec-6, activin-A, and VEGF-121 at 22.1-28 weeks of gestation differentiated women who subsequently developed early preeclampsia from those who had a normal pregnancy or developed late preeclampsia (sensitivity 77%, FPR = 10%); 5) the sensitivity of risk models was higher for early preeclampsia with placental MVM lesions than for the entire early preeclampsia group (90% versus 71% at 16.1-22 weeks; 87% versus 81% at 22.1-28 weeks; and 90% versus 85% at 28.1-32 weeks, all FPR = 10%); and 6) the sensitivity of prediction models was higher for severe early preeclampsia than for the entire early preeclampsia group (84% versus 71% at 16.1-22 weeks). CONCLUSION We have presented herein a catalogue of proteome changes in maternal plasma proteome that precede the diagnosis of preeclampsia and can distinguish among early and late phenotypes. The sensitivity of maternal plasma protein models for early preeclampsia is higher in women with underlying vascular placental disease and in those with a severe phenotype.
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Affiliation(s)
- Adi L. Tarca
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- Department of Computer Science, Wayne State University College of Engineering, Detroit, Michigan, United States of America
| | - Roberto Romero
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, United States of America
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, Michigan, United States of America
| | - Neta Benshalom-Tirosh
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Nandor Gabor Than
- Systems Biology of Reproduction Research Group, Institute of Enzymology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
- First Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
- Maternity Clinic, Kutvolgyi Clinical Block, Semmelweis University, Budapest, Hungary
| | - Dereje W. Gudicha
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Bogdan Done
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
| | - Percy Pacora
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Tinnakorn Chaiworapongsa
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Bogdan Panaitescu
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Dan Tirosh
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Nardhy Gomez-Lopez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- C.S. Mott Center for Human Growth and Development, Wayne State University, Detroit, Michigan, United States of America
- Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Sorin Draghici
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- Department of Computer Science, Wayne State University College of Engineering, Detroit, Michigan, United States of America
| | - Sonia S. Hassan
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Offer Erez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- Maternity Department "D," Division of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
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The Relationship of Pregnancy-Associated Plasma Protein A and Human Chorionic Gonadotropin with Adverse Pregnancy Outcomes: A Prospective Study. J Obstet Gynaecol India 2019; 69:412-419. [PMID: 31598043 DOI: 10.1007/s13224-019-01217-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 03/04/2019] [Indexed: 01/13/2023] Open
Abstract
Purpose This prospective study investigated the relationship between pregnancy-associated plasma protein A (PAPP-A) and human chorionic gonadotropin (hCG) and adverse pregnancy outcomes in the Iranian population. Materials Overall, 994 singleton pregnant mothers of 18-35-year old were referred for first-trimester screening tests, including PAPP-A and β-hCG, at the age of 6 days and 11-13 weeks, and were followed until the end of their pregnancy. The adverse pregnancy outcomes, PAPP-A, and β-hCG serum levels were recorded and analyzed. The sensitivity and specificity of the test were measured by calculating the area under the curve of receiver operating characteristic curve (ROC). Results The mean serum level of PAPP-A and β-hCG was 1.10 ± 0.69 and 1.09 ± 0.8 MoM, respectively. Pregnancy-associated plasma protein A, regardless of its percentile, showed a significant relationship with the incidence of preeclampsia, preterm birth, and fetal low birth weight (p < 0.001 for each). However, the relationship between PAPP-A and abortion was not significant (p > 0.05). According to ROC, the results indicated that PAPP-A had a significant relationship with the incidence of preeclampsia, preterm birth, and fetal low birth weight (p < 0.001). However, β-hCG levels showed no significant relationship with adverse pregnancy outcomes. Conclusions The result of this study revealed that lower level of PAPP-A and β-hCG could be a predictive factor in preterm labor. Also, this study indicated that PAPP-A measurements could be a screening test for adverse pregnancy outcomes, such as preeclampsia, low birth weight and preterm labor.
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Biochemical Markers for Prediction of Hypertensive Disorders of Pregnancy. J Med Biochem 2019; 38:71-82. [PMID: 30820186 PMCID: PMC6298456 DOI: 10.2478/jomb-2018-0001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 01/27/2018] [Indexed: 12/01/2022] Open
Abstract
Background Gestational hypertension (GH) and pre eclampsia (PE) are the most common gestational complications. Several placental biochemical markers are used to predict GH/PE, but with conflicting results. Methods The study aim was to estimate the biochemical markers’ ability to predict hypertensive disorders in pregnancy. On the first ultrasonographic examination, 104 healthy pregnant women were recruited. At the regular pregnancy check-ups, BMI, blood pressure, occurrence of gestational hypertension (early or late onset), preeclampsia, eclampsia and other complications were recorded. Serum concentrations (in multiples of median – MoM) of human chorionic gonadotropin (HCG) and pregnancyassociated plasma protein A (PAPPA) were measured from the 11th to 14th gestational week, while HCG, alpha feto protein (AFP), estriol and inhibin were determined between the 16th and 19th gestational week. Results Hypertensive disorders throughout pregnancy were diagnosed in 20.2% women. Early-onset GH was registered in 7 and PE in 6 patients, while 14 had late-onset GH and 10 additional women PE. There were no significant differences (p≥0.05) in biochemical markers concentrations between women with and without GH/PE. PAPPA levels in the first and HCG in the second trimester correlated with early and late GH/PE. Moreover, higher AFP concentrations were registered in women with preeclampsia signs/symptoms. According to ROC analysis, AFP>1.05 MoM properly identified 80% of GH/PE cases. Obtained models imply that HCG, PAPPA and AFP should be used for GH/PE prediction. Conclusions Biochemical markers HCG, PAPPA and AFP could be useful in predicting gestational hypertension and preeclampsia. However, different markers should be used for early and late onset GH/PE.
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19
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Wang W, Fan D, Wang J, Wu S, Lu Y, He Y, Liu Z. Association between hypertensive disorders complicating pregnancy and risk of placenta accreta: a meta-analysis and systematic review. Hypertens Pregnancy 2018; 37:168-174. [PMID: 30040502 DOI: 10.1080/10641955.2018.1498880] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 07/05/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Previous studies have reported a positive association between hypertensive disorders complicating pregnancy and placenta accreta. However, whether hypertensive disorders complicating pregnancy associated with placenta accreta is still not clear. The objective was to systematically review the literature to determine a possible association between hypertensive disorders complicating pregnancy and placenta accreta. METHODS A systematic search of PubMed database, the Cochrane Library, Willy Online Library, and ScienceDirect database through 1st December 2015, was conducted. Two authors independently assessed data extraction and quality of the studies using the Newcastle-Ottawa Scale. Assessment of heterogeneity and analysis of data were operated by Review Manager 5.3.0. RESULTS Three studies involving 4174 patients who developed hypertensive disorders complicating pregnancy of a total of 38,004 pregnant women were selected. The result of our meta-analysis revealed that pregnancy induced hypertension was significantly associated with a reduction of placenta accreta (OR = 0.50, 95% CI: 0.30-0.82; heterogeneity: I2 = 13%, p = 0.32). CONCLUSIONS Our meta-analysis demonstrated that the risk of placenta accreta is reduced in women with hypertensive disorders complicating pregnancy. Further well-designed studies are warranted to testify the result and explored any potential mechanism association between hypertensive disorders complicating pregnancy and placenta accreta.
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Affiliation(s)
- Wen Wang
- a Department of Obstetrics , Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan , Foshan , Guangdong , China
- b Foshan Institute of Fetal Medicine , Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan , Foshan , Guangdong , China
| | - Dazhi Fan
- a Department of Obstetrics , Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan , Foshan , Guangdong , China
- b Foshan Institute of Fetal Medicine , Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan , Foshan , Guangdong , China
- c Department of Epidemiology and Biostatistics , School of Public Health, Anhui Medical University , Hefei , Anhui , China
| | - Jun Wang
- d Department of Obstetrics , Anhui Medical University Affiliated the Second Provincial Hospital , Hefei , Anhui , China
| | - Shuzhen Wu
- a Department of Obstetrics , Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan , Foshan , Guangdong , China
- b Foshan Institute of Fetal Medicine , Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan , Foshan , Guangdong , China
| | - Ying Lu
- e Department of Communicable Disease Control and Prevention , Guangzhou centre for disease control and prevention , Guangzhou , Guangdong , China
- f Department of Epidemiology and Biostatistics , School of Public Health, Sun yat-sen University , Guangzhou , Guangdong , China
| | - Yunying He
- a Department of Obstetrics , Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan , Foshan , Guangdong , China
| | - Zhengping Liu
- a Department of Obstetrics , Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan , Foshan , Guangdong , China
- b Foshan Institute of Fetal Medicine , Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan , Foshan , Guangdong , China
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Eastabrook G, Aksoy T, Bedell S, Penava D, de Vrijer B. Preeclampsia biomarkers: An assessment of maternal cardiometabolic health. Pregnancy Hypertens 2018; 13:204-213. [PMID: 30177053 DOI: 10.1016/j.preghy.2018.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 05/09/2018] [Accepted: 06/09/2018] [Indexed: 12/15/2022]
Abstract
Preeclampsia is a serious pregnancy condition defined as new-onset hypertension and proteinuria, commonly characterized as either early, 'placental', or late onset, 'maternal', using a cut-off of 34 weeks gestation. However, it may be more useful to differentiate between the vascular remodelling and placental invasion vs. inflammation and metabolic pathophysiology that underlie these forms of preeclampsia. Due to rising rates of obesity, the late-onset, maternal form is increasingly occurring earlier in pregnancy. Predictive tests for preeclampsia typically include biophysical markers such as maternal body mass index and mean arterial pressure, indicating the importance of cardiovascular and metabolic health in its pathophysiology. In contrast, the placental, inflammatory, endothelial and/or metabolic biomarkers used in these tests are generally thought to indicate an abnormal response to placentation and predict the disease. However, many of these non-placental biomarkers are known to predict impaired metabolic health in non-pregnant subjects with obesity (metabolically unhealthy obesity) and coronary artery disease or stroke in people at risk for cardiovascular events. Similarities between the performance of these markers in the prediction of cardiovascular and metabolic health outside of pregnancy suggests that they may be more indicative of maternal health than predictive for preeclampsia. This paper reviews the biophysical and biochemical markers in preeclampsia prediction and compares their performance to tests assessing metabolic health and risk of cardiovascular disease, particularly in the obese population.
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Affiliation(s)
- Genevieve Eastabrook
- Department of Obstetrics and Gynaecology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute and Lawson Health Research Institute, London, Ontario, Canada.
| | - Tuba Aksoy
- Department of Obstetrics and Gynecology, Mackenzie Richmond Hill Hospital, Richmond Hill, Ontario, Canada.
| | - Samantha Bedell
- Department of Obstetrics and Gynaecology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada.
| | - Debbie Penava
- Department of Obstetrics and Gynaecology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute and Lawson Health Research Institute, London, Ontario, Canada.
| | - Barbra de Vrijer
- Department of Obstetrics and Gynaecology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute and Lawson Health Research Institute, London, Ontario, Canada.
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21
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Nevalainen J, Korpimaki T, Kouru H, Sairanen M, Ryynanen M. Performance of first trimester biochemical markers and mean arterial pressure in prediction of early-onset pre-eclampsia. Metabolism 2017; 75:6-15. [PMID: 28964327 DOI: 10.1016/j.metabol.2017.07.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 05/23/2017] [Accepted: 07/12/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To develop a predictive risk model for early-onset pre-eclampsia (EO-PE) using maternal characteristics, combined screening markers, previously reported biomarkers for PE and mean arterial pressure (MAP). METHODS This retrospective study was conducted at Oulu University hospital between 2006 and 2010. Maternal serum from first trimester combined screening was further analyzed for alpha fetoprotein (AFP), placental growth factor (PlGF), soluble tumor necrosis factor receptor-1 (sTNFR1), retinol binding protein-4 (RBP4), a disintegrin and metalloprotease-12 (ADAM12), soluble P-selectin (sP-selectin), follistatin like-3 (FSTL3), adiponectin, angiopoietin-2 (Ang-2) and sex hormone binding globulin (SHBG). First, the training sample set with 29 cases of EO-PE and 652 controls was developed to study whether these biomarkers separately or in combination with prior risk (maternal characteristics, first trimester pregnancy associated plasma protein-A (PAPP-A) and free beta human chorionic gonadotrophin (fβ-hCG)) could be used to predict the development of EO-PE. Second, the developed risk models were validated with a test sample set of 42 EO-PE and 141 control subjects. For the test set MAP data was also available. RESULTS Single marker statistically significant (ANOVA p<0.05) changes between control and EO-PE pregnancies were observed with AFP, RBP4 and sTNFR1 with both training and test sample sets. Based on the test sample set performances, the best detection rate, 47% for a 10% false positive rate, was achieved with PlGF and sTNFR1 added with prior risk and MAP. CONCLUSION Based on our results, the best first trimester biomarkers to predict the subsequent EO-PE were AFP, PlGF, RBP4 and sTNFR1. The risk models that performed best for the prediction of EO-PE included prior risk, MAP, sTNFR1 and AFP or PlGF or RBP4.
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Affiliation(s)
- Jaana Nevalainen
- Department of Obstetrics and Gynecology, Oulu University Hospital, Finland.
| | | | - Heikki Kouru
- PerkinElmer, Mustionkatu 6, 20750 Turku, Finland.
| | | | - Markku Ryynanen
- Department of Obstetrics and Gynecology, Oulu University Hospital, Finland.
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22
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Yu M, Wang J, Liu S, Wang X, Yan Q. Novel function of pregnancy-associated plasma protein A: promotes endometrium receptivity by up-regulating N-fucosylation. Sci Rep 2017; 7:5315. [PMID: 28706275 PMCID: PMC5509645 DOI: 10.1038/s41598-017-04735-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 05/19/2017] [Indexed: 12/27/2022] Open
Abstract
Glycosylation of uterine endometrial cells plays important roles to determine their receptive function to blastocysts. Trophoblast-derived pregnancy-associated plasma protein A (PAPPA) is specifically elevated in pregnant women serum, and is known to promote trophoblast cell proliferation and adhesion. However, the relationship between PAPPA and endometrium receptivity, as well as the regulation of N-fucosylation remains unclear. We found that rhPAPPA and PAPPA in the serum samples from pregnant women or conditioned medium of trophoblast cells promoted endometrium receptivity in vitro. Moreover, rhPAPPA increased α1,2-, α1,3- and α1,6-fucosylation levels by up-regulating N-fucosyltransferases FUT1, FUT4 and FUT8 expression, respectively, through IGF-1R/PI3K/Akt signaling pathway in human endometrial cells. Additionally, α1,2-, α1,3- and α1,6-fucosylation of integrin αVβ3, a critical endometrium receptivity biomarker, was up-regulated by PAPPA, thereby enhanced its adhesive functions. Furthermore, PAPPA blockage with antibody inhibited embryo implantation in vivo, mouse embryo adhesion and spreading in vitro, as well as N-fucosylation level of the endometrium in pregnant mice. In summary, this study suggests that PAPPA is essential to maintain a receptive endometrium by up-regulating N-fucosylation, which is a potential useful biomarker to evaluate the receptive functions of the endometrium.
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Affiliation(s)
- Ming Yu
- Department of Biochemistry and Molecular Biology, Dalian Medical University, Liaoning Provincial Core Lab of Glycobiology and Glycoengineering, Dalian, 116044, China
| | - Jiao Wang
- Departmentof Hematology, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116023, China
| | - Shuai Liu
- Department of Biochemistry and Molecular Biology, Dalian Medical University, Liaoning Provincial Core Lab of Glycobiology and Glycoengineering, Dalian, 116044, China
| | - Xiaoqi Wang
- Departmentof Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Qiu Yan
- Department of Biochemistry and Molecular Biology, Dalian Medical University, Liaoning Provincial Core Lab of Glycobiology and Glycoengineering, Dalian, 116044, China.
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23
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First trimester screening of circulating C19MC microRNAs and the evaluation of their potential to predict the onset of preeclampsia and IUGR. PLoS One 2017; 12:e0171756. [PMID: 28182660 PMCID: PMC5300267 DOI: 10.1371/journal.pone.0171756] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 01/25/2017] [Indexed: 12/17/2022] Open
Abstract
Objectives A nested case control study of a longitudinal cohort comparing pregnant women enrolled at 10 to 13 gestational weeks was carried out to evaluate risk assessment for preeclampsia and IUGR based on circulating placental specific C19MC microRNAs in early pregnancy. Methods The expression of placental specific C19MC microRNAs (miR-516b-5p, miR-517-5p, miR-518b, miR-520a-5p, miR-520h, and miR-525-5p) was determined in plasma samples from pregnancies that subsequently developed preeclampsia (n = 21), IUGR (n = 18), and 58 normal pregnancies using real-time PCR and comparative Ct method relative to synthetic Caenorhabditis elegans microRNA (cel-miR-39). Results Circulating C19MC microRNAs were up-regulated (miR-517-5p, p = 0.005; miR-518b, p = 0.013; miR-520h, p = 0.021) or showed a trend toward up-regulation in patients destined to develop preeclampsia (miR-520a-5p, p = 0.067; miR-525-5p, p = 0.073). MiR-517-5p had the best predictive performance for preeclampsia with a sensitivity of 42.9%, a specificity of 86.2%, a PPV of 52.9% and a NPV of 80.6%. The combination of all examined circulating C19MC microRNAs had no advantage over using only the miR-517-5p biomarker to predict the occurrence of preeclampsia (a sensitivity of 20.6%, a specificity of 90.8%, a PPV of 44.8%, and a NPV of 76.0%). Conclusions Up-regulation of miR-517-5p, miR-518b and miR-520h was associated with a risk of later development of preeclampsia. First trimester screening of extracellular miR-517-5p identified a proportion of women with subsequent preeclampsia. No circulating C19MC microRNA biomarkers were identified that could predict later occurrence of IUGR.
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Yang J, Pearl M, DeLorenze GN, Romero R, Dong Z, Jelliffe-Pawlowski L, Currier R, Flessel M, Kharrazi M. Racial-ethnic differences in midtrimester maternal serum levels of angiogenic and antiangiogenic factors. Am J Obstet Gynecol 2016; 215:359.e1-9. [PMID: 27073062 DOI: 10.1016/j.ajog.2016.04.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 03/23/2016] [Accepted: 04/04/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Little is known about racial-ethnic differences in the distribution of maternal serum levels of angiogenic and antiangiogenic factors and their associations with early-onset preeclampsia. OBJECTIVE We sought to investigate the distribution of midtrimester maternal serum levels of placental growth factor, soluble endoglin, and soluble vascular endothelial growth factor receptor 1 and their associations with early-onset preeclampsia in whites, Hispanics, and blacks. STUDY DESIGN A population-based nested case-control design was used to identify cases and controls of white, Hispanic, and black origin from a 2000 through 2007 live-birth cohort in 5 southern California counties. Cases included 197 women (90 whites, 67 Hispanics, and 40 blacks) with early-onset preeclampsia defined as hypertension and proteinuria with onset <32 weeks according to hospital records. Controls included a random sample of 2363 women without early-onset preeclampsia. Maternal serum specimens collected at 15-20 weeks' gestation as part of routine prenatal screening were tested for placental growth factor, soluble endoglin, and soluble vascular endothelial growth factor receptor 1. Serum levels of the 3 factors were log-normally distributed. Adjusted natural logarithmic means were compared between cases and controls and between racial-ethnic groups. Odds ratios and 95% confidence intervals derived from logistic regression models were calculated to measure the magnitude of the associations. RESULTS Cases showed lower adjusted logarithmic means of placental growth factor but higher adjusted logarithmic means of soluble endoglin than controls across all 3 groups (P < .05). Cases also had higher adjusted means of soluble vascular endothelial growth factor receptor 1 than controls in whites (7.75 vs 7.52 log pg/mL, P < .05) and Hispanics (7.73 vs 7.40 log pg/mL, P < .05) but not in blacks (7.85 vs 7.69 log pg/mL, P = .47). Blacks were found to have higher levels of placental growth factor in both cases and controls when compared to whites and Hispanics (adjusted means: 4.69 and 5.20 log pg/mL in blacks, 4.08 and 4.78 log pg/mL in whites, and 3.89 and 4.70 log pg/mL in Hispanics, respectively, P < .05). Hispanic cases had the highest adjusted mean of soluble endoglin compared to white and black cases (9.24, 9.05, and 8.93 log pg/mL, respectively, P < .05). The weakest association of early-onset preeclampsia with placental growth factor and soluble endoglin was observed in blacks. The adjusted odds ratio per log pg/mL increase of the 2 analytes were 0.219 (95% confidence interval, 0.124-0.385) and 5.02 (95% confidence interval, 2.56-9.86) in blacks in comparison to 0.048 (95% confidence interval, 0.026-0.088) and 36.87 (95% confidence interval, 17.00-79.96) in whites (P < .05) and 0.028 (95% confidence interval, 0.013-0.060) and 86.68 (95% confidence interval, 31.46-238.81) in Hispanics (P < .05), respectively. As for soluble vascular endothelial growth factor receptor 1, the association was not significantly different among the racial-ethnic groups. CONCLUSION Racial-ethnic differences were observed in the distribution of midtrimester maternal levels of placental growth factor and soluble endoglin and in the associations with early-onset preeclampsia. These differences should be considered in future studies to improve etiologic and prognostic understanding of early-onset preeclampsia.
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Affiliation(s)
- Juan Yang
- Genetic Disease Screening Program, California Department of Public Health, Richmond, CA.
| | | | - Gerald N DeLorenze
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Roberto Romero
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI
| | - Zhong Dong
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Detroit, MI
| | - Laura Jelliffe-Pawlowski
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Robert Currier
- Genetic Disease Screening Program, California Department of Public Health, Richmond, CA
| | - Monica Flessel
- Genetic Disease Screening Program, California Department of Public Health, Richmond, CA
| | - Martin Kharrazi
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA
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25
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Lopez-Hernandez Y, Saldivar-Nava JA, Garza-Veloz I, Delgado-Enciso I, Martinez-de-Villarreal LE, Yahuaca-Mendoza P, Rodriguez-Sanchez IP, Lopez-Gilibets L, Galvan-Tejada JI, Galvan-Tejada CE, Celaya-Padilla JM, Martinez-Fierro ML. Nested case-control study reveals increased levels of urinary proteins from human kidney toxicity panels in women predicted to develop preeclampsia. Int Urol Nephrol 2016; 48:2051-2059. [PMID: 27571961 DOI: 10.1007/s11255-016-1397-6] [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: 04/26/2016] [Accepted: 08/11/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this study was to evaluate the usefulness of urine concentrations of 12 proteins as a risk parameter for developing preeclampsia (PE). METHODS A nested case-control study was designed to determine protein concentrations in urine from women predicted to develop PE (WPD-PE) and normotensive pregnancies (controls). Protein profiles were determined at 12, 16 and 20 gestational weeks (GW) using the Bio-Plex Pro human kidney toxicity Panel 1 and Panel 2 (Bio-Rad). Receiver operating characteristic (ROC) curve analyses were performed. Correlations between proteins and clinical parameters at the time of PE diagnosis were also assessed. RESULTS Significant differences were observed in urine cystatin C (Cys C) levels at 16 and 20 GW and clusterin at 20 GW between WPD-PE and controls (P < 0.05). ROC analysis revealed that Cys C at 16 GW had the highest area under the ROC curve (0.758). At 16 GW, patients with urine Cys C levels above 73.7 ng/mL had eightfold increased odds for developing PE (odds ratio 7.92; 95 % CI 1.3-47.5; P = 0.027). A positive correlation was found between urinary Cys C (at 16 and 20 GW) and leukocyte counts, total proteins, aspartate aminotransferase, alanine aminotransferase, bilirubin and lactate dehydrogenase at the time of PE diagnosis (P value < 0.05). CONCLUSIONS Urinary Cys C and clusterin showed predictive value for PE development in our cohort. Further studies are needed to validate their use as predictive biomarkers for PE and/or their participation in PE pathogenesis.
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Affiliation(s)
- Yamile Lopez-Hernandez
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Carretera Zacatecas-Guadalajara Km 6 Ejido la Escondida, Zacatecas, CP 98160, Mexico.,Catedras Program, Consejo Nacional de Ciencia y Tecnología (CONACYT), Ciudad de Mexico, Mexico
| | - Jorge Alejandro Saldivar-Nava
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Carretera Zacatecas-Guadalajara Km 6 Ejido la Escondida, Zacatecas, CP 98160, Mexico
| | - Idalia Garza-Veloz
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Carretera Zacatecas-Guadalajara Km 6 Ejido la Escondida, Zacatecas, CP 98160, Mexico.,Bioengineering Laboratory, Centro de Investigacion e Innovacion Tecnologica Industrial, Unidad Academica de Ingenieria Electrica, Universidad Autonoma de Zacatecas, Zacatecas, Mexico.,Grupo de Investigacion Regional Emergente (GIRE), Zacatecas, Mexico
| | - Ivan Delgado-Enciso
- Facultad de Medicina, Universidad Autonoma de Colima, Colima, Mexico.,Servicios de Salud del Estado de Colima, Instituto Estatal de Cancerologia, Colima, Mexico
| | | | - Patricia Yahuaca-Mendoza
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Carretera Zacatecas-Guadalajara Km 6 Ejido la Escondida, Zacatecas, CP 98160, Mexico
| | - Iram Pablo Rodriguez-Sanchez
- Departamento de Genetica, Facultad de Medicina, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Laura Lopez-Gilibets
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Carretera Zacatecas-Guadalajara Km 6 Ejido la Escondida, Zacatecas, CP 98160, Mexico
| | - Jorge Issac Galvan-Tejada
- Bioengineering Laboratory, Centro de Investigacion e Innovacion Tecnologica Industrial, Unidad Academica de Ingenieria Electrica, Universidad Autonoma de Zacatecas, Zacatecas, Mexico.,Grupo de Investigacion Regional Emergente (GIRE), Zacatecas, Mexico
| | - Carlos Eric Galvan-Tejada
- Bioengineering Laboratory, Centro de Investigacion e Innovacion Tecnologica Industrial, Unidad Academica de Ingenieria Electrica, Universidad Autonoma de Zacatecas, Zacatecas, Mexico.,Grupo de Investigacion Regional Emergente (GIRE), Zacatecas, Mexico
| | - Jose Maria Celaya-Padilla
- Bioengineering Laboratory, Centro de Investigacion e Innovacion Tecnologica Industrial, Unidad Academica de Ingenieria Electrica, Universidad Autonoma de Zacatecas, Zacatecas, Mexico.,Grupo de Investigacion Regional Emergente (GIRE), Zacatecas, Mexico
| | - Margarita L Martinez-Fierro
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y Ciencias de la Salud, Universidad Autonoma de Zacatecas, Carretera Zacatecas-Guadalajara Km 6 Ejido la Escondida, Zacatecas, CP 98160, Mexico. .,Bioengineering Laboratory, Centro de Investigacion e Innovacion Tecnologica Industrial, Unidad Academica de Ingenieria Electrica, Universidad Autonoma de Zacatecas, Zacatecas, Mexico. .,Grupo de Investigacion Regional Emergente (GIRE), Zacatecas, Mexico.
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