将游离妊娠相关血浆蛋白 a（fPAPP-A）作为孕早期生物标志物的探索

IF 1.7 Q3 MEDICAL LABORATORY TECHNOLOGY

Practical Laboratory Medicine Pub Date : 2024-09-16 DOI:10.1016/j.plabm.2024.e00428

Jesper Friis Petersen , Vilma Tiittanen , Saara Wittfooth , Ellen Løkkegaard , Lennart Jan Friis-Hansen

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引用次数: 0

摘要

目标在唐氏综合征的首胎联合筛查中，妊娠相关血浆蛋白 A (PAPP-A) 至关重要。PAPP-A 检测可评估总 PAPP-A，包括具有生物活性的游离 PAPP-A（fPAPP-A）和与嗜酸性粒细胞主要碱性蛋白原形（proMBP）复合物的 PAPP-A。虽然对 PAPP-A 的研究较多，但对 fPAPP-A 在妊娠头三个月的浓度和诊断作用的了解仍然有限：设计与方法：对 159 名分娩健康新生儿的妇女和 37 名流产妇女的 80 份血清样本中的 602 份血清样本进行了 PAPP-A 和 fPAPP-A 水平测定，每隔 2 周（孕周 4-14）测定一次。结果在妊娠头三个月，PAPP-A 和 fPAPP-A 水平显示出显著的强相关性（r = 0.94），中位值每周翻一番。游离 PAPP-A 仅占孕周 PAPP-A 的 3.0%。低 fPAPP-A 与流产（p < 0.001）、产妇体重（p < 0.001）和吸烟（p = 0.02）有关。在预测流产方面，fPAPP-A 与 PAPP-A（接收者操作特征曲线下面积 0.79 vs. 0.81，p = 0.44）相当。本研究报告的 fPAPP-A 值低于之前对 fPAPP-A 进行酶学研究的预期值。

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Exploring free pregnancy associated plasma protein a (fPAPP-A) as a biomarker in early pregnancy

Objectives

In combined first trimester screening for Down syndrome, Pregnancy-Associated Plasma Protein A (PAPP-A) is pivotal. PAPP-A tests evaluate total PAPP-A, consisting of the biologically active free PAPP-A (fPAPP-A) and PAPP-A complexed with eosinophil major basic protein's proform (proMBP). While PAPP-A is well-researched, limited understanding persists regarding fPAPP-A's first trimester concentrations and diagnostic utility.

Design

and methods: PAPP-A and fPAPP-A levels were gauged in 602 serum samples at 2-week intervals (gestational weeks 4–14) from 159 women with delivery of a healthy neonate and 80 samples from 37 miscarriages. The final sample at the time of diagnosis from women who miscarried was included in analyses.

Results

During the first trimester, PAPP-A and fPAPP-A levels displayed significant and strong correlation (r = 0.94), with median values doubling weekly. Free PAPP-A constituted only 3.0 % of PAPP-A over gestational weeks. Low fPAPP-A linked to miscarriage (p < 0.001), maternal weight (p < 0.001), and smoking (p = 0.02). For miscarriage prediction fPAPP-A was equal to PAPP-A (area under the receiver operating characteristics curve 0.79 vs. 0.81, p = 0.44).

Conclusions

Investigating fPAPP-A presence and concentration directly in first trimester serum has not been done previously. This study report lower fPAPP-A values than anticipated from prior enzymatic studies of fPAPP-A. fPAPP-A was not superior to PAPP-A as a first trimester biomarker in this dataset.

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来源期刊

Practical Laboratory Medicine Health Professions-Radiological and Ultrasound Technology

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

7 weeks

期刊介绍： Practical Laboratory Medicine is a high-quality, peer-reviewed, international open-access journal publishing original research, new methods and critical evaluations, case reports and short papers in the fields of clinical chemistry and laboratory medicine. The objective of the journal is to provide practical information of immediate relevance to workers in clinical laboratories. The primary scope of the journal covers clinical chemistry, hematology, molecular biology and genetics relevant to laboratory medicine, microbiology, immunology, therapeutic drug monitoring and toxicology, laboratory management and informatics. We welcome papers which describe critical evaluations of biomarkers and their role in the diagnosis and treatment of clinically significant disease, validation of commercial and in-house IVD methods, method comparisons, interference reports, the development of new reagents and reference materials, reference range studies and regulatory compliance reports. Manuscripts describing the development of new methods applicable to laboratory medicine (including point-of-care testing) are particularly encouraged, even if preliminary or small scale.