早期子痫前期的母体血液蛋白质组学研究

Q3 Medicine
M. G. Nikolaeva, V. Terekhina, A. Momot
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The ADAMTS-13/vWF ratio was evaluated separately.Results. For patients with recurrent еPE, a significant increase in ET-1 is characteristic at all stages of gestation: 0.92; 1.07 and 1.36 pmol/ml vs. 0.29; 0.33 and 0.29 pmol/ml in the control group (p < 0.0001 at all points). Regardless of pregnancy outcome, increasing gestational age was paralleled with elevating vWF level, however, upon еPE relapse, this parameter (Me = 343 IU) is significantly higher (p < 0.0001) than in control group (Me = 260 IU). In all groups, there was a significant decrease in ADAMTS-13 activity, whereas in main group ADAMTS-13 activity at first time point was minimal – 63.4 % (p = 0.0007 relative to control group). With regard to ADAMTS-13/vWF axis in relapsed еPE, significant differences were found compared with control group both at 11–13 weeks (0.32 versus 0.52; p < 0.0001) and at 27–28 weeks (0. 15 versus 0.22; p < 0.0001) pregnancy. The HC concentration declines with gestational age, but at first time point patients from main group had it (Me = 8.0 µmol/l) at significantly higher level than in control group (Me = 5.9 µmol/l; p < 0.00010).Conclusion. At gestational age of 11–13 weeks, all analyzed biomarkers contribute to developing еPE relapse accounting for an overall impact of 62.3 % of developing ePE risk. During pregnancy at 19–21 weeks, an imbalance in the ADAMTS-13/vWF along with elevated ET-1 levels determine the risk of disease relapse in 65.6 % of cases. 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引用次数: 0

摘要

目的:研究母体血液内皮细胞蛋白对早期子痫前期(ePE)复发的影响。对 137 名孕妇的外周血进行了蛋白质组学分析。临床上,在妊娠末期确定了三组:对照组(n = 40)--本次和上次妊娠过程顺利的患者;对比组(n = 59)--有子痫发作史但妊娠过程顺利的患者;主要组(n = 38)--子痫复发的患者。对证明内皮功能受损的生物活性物质进行了动态监测(11-13周、19-21周和27-28周):内皮素-1(ET-1)和金属蛋白酶ADAMTS-13的活性、von Willebrand因子(vWF)水平和同型半胱氨酸(HC)浓度。ADAMTS-13/vWF比值单独进行了评估。对于复发性еPE患者,ET-1在妊娠的各个阶段都会显著增加:对照组的 ET-1 分别为 0.92、1.07 和 1.36 pmol/ml,而对照组的 ET-1 分别为 0.29、0.33 和 0.29 pmol/ml(各点的 p 均小于 0.0001)。无论妊娠结果如何,孕龄的增加与 vWF 水平的升高是同步的,然而,еPE 复发时,该参数(Me = 343 IU)显著高于对照组(Me = 260 IU)(p < 0.0001)。在所有组别中,ADAMTS-13 活性都显著下降,而在主要组别中,ADAMTS-13 活性在第一个时间点的下降幅度最小 - 63.4 %(与对照组相比,p = 0.0007)。复发еPE的ADAMTS-13/vWF轴与对照组相比,在妊娠11-13周(0.32对0.52;p<0.0001)和27-28周(0.15对0.22;p<0.0001)时均有显著差异。HC 浓度随孕龄增长而下降,但在第一个时间点,主要组患者的 HC 浓度(Me = 8.0 µmol/l)明显高于对照组(Me = 5.9 µmol/l;p < 0.00010)。在妊娠 11-13 周时,所有分析的生物标志物都会导致 EPE 复发,占 EPE 复发风险的 62.3%。在妊娠 19-21 周时,ADAMTS-13/vWF 的失衡和 ET-1 水平的升高决定了 65.6% 的病例有复发的风险。研究发现,在妊娠 27-28 周时,ET-1、vWF 和 ADAMTS-13 的相关变化占疾病复发风险的 67.9%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Maternal blood proteomics during elapse of early preeclampsia
Aim: to study the contribution of maternal blood endothelial proteins to developing relapse of early preeclampsia (ePE).Materials and Methods. A proteomic analysis of the peripheral blood of 137 pregnant women was performed. Clinically, three groups were identified at the end of pregnancy: control (n = 40), patients with favorable course of the current and previous pregnancy; comparison group (n = 59) – patients with a history of еPE episode, but favorable course of ongoing pregnancy, and main group (n = 38) – patients with еPE relapse. Biologically active substances evidencing about impaired endothelial function were subject to dynamic monitoring (11–13, 19–21 and 27–28 weeks): activity of endothelin-1 (ET-1) and metalloproteinase ADAMTS-13, von Willebrand factor (vWF) level and homocysteine (HC)concentration. The ADAMTS-13/vWF ratio was evaluated separately.Results. For patients with recurrent еPE, a significant increase in ET-1 is characteristic at all stages of gestation: 0.92; 1.07 and 1.36 pmol/ml vs. 0.29; 0.33 and 0.29 pmol/ml in the control group (p < 0.0001 at all points). Regardless of pregnancy outcome, increasing gestational age was paralleled with elevating vWF level, however, upon еPE relapse, this parameter (Me = 343 IU) is significantly higher (p < 0.0001) than in control group (Me = 260 IU). In all groups, there was a significant decrease in ADAMTS-13 activity, whereas in main group ADAMTS-13 activity at first time point was minimal – 63.4 % (p = 0.0007 relative to control group). With regard to ADAMTS-13/vWF axis in relapsed еPE, significant differences were found compared with control group both at 11–13 weeks (0.32 versus 0.52; p < 0.0001) and at 27–28 weeks (0. 15 versus 0.22; p < 0.0001) pregnancy. The HC concentration declines with gestational age, but at first time point patients from main group had it (Me = 8.0 µmol/l) at significantly higher level than in control group (Me = 5.9 µmol/l; p < 0.00010).Conclusion. At gestational age of 11–13 weeks, all analyzed biomarkers contribute to developing еPE relapse accounting for an overall impact of 62.3 % of developing ePE risk. During pregnancy at 19–21 weeks, an imbalance in the ADAMTS-13/vWF along with elevated ET-1 levels determine the risk of disease relapse in 65.6 % of cases. It was found that at a gestational age of 27–28 weeks, the associated shift in ET-1, vWF and ADAMTS-13 magnitude accounts for 67.9 % of risk for disease relapse.
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CiteScore
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12 weeks
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