血浆急性期蛋白作为羊膜内炎症和感染的潜在预测因子。

IF 2.8 4区 医学 Q3 BIOCHEMISTRY & MOLECULAR BIOLOGY
Hee Young Cho, Kyo Hoon Park, Eunji Oh, Min Jung Lee, Bo Young Choi, Eun Mi Im
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引用次数: 0

摘要

背景:我们的目的是研究血浆中各种急性期蛋白(APPs)水平改变的潜力,无论是单独使用还是与超声、临床和常规血液检查联合使用,用于预测羊膜内炎症(IAI)、微生物侵入羊膜腔(MIAC)、组织学羊膜炎(HCA)和羊膜早破(PPROM)妇女羊膜早破(PPROM)的风险。方法:回顾性分析195例经羊膜穿刺术并获得羊膜穿刺术血浆样本的PPROM单胎孕妇(23 + 0 ~ 34 + 0周)。培养羊水(AF)评估MIAC,分析白细胞介素(IL)-6水平以确定IAI (AF IL-6水平≥2.6 ng/mL)。采用ELISA法检测血浆中hepcidin、甘露糖结合凝集素(MBL)、戊曲霉素-2、视黄醇结合蛋白4 (RBP4)、血清淀粉样蛋白A1 (SAA1)、丝氨酸蛋白A1的浓度。超声检查宫颈长度(CL)、中性粒细胞与淋巴细胞比值(NLR)和c反应蛋白水平。IAI/MIAC被定义为IAI、MIAC或两者兼而有之。结果:多因素logistic回归分析显示:(1)血浆hepcidin、SAA1水平升高,RBP4水平降低与IAI/MIAC独立相关;(2)血浆RBP4水平降低与膀胱炎独立相关;然而,(3)当调整基线协变量时,所调查的血浆APPs均与急性HCA无关。通过逐步回归分析,建立了包括血浆RBP4水平、CL、NLR和胎龄在内的无创预测模型,该模型对IAI/MIAC和膀胱炎有较好的预测效果(曲线下面积分别为0.80和0.72)。结论:Hepcidin、RBP4和SAA1被确定为PPROM患者IAI/MIAC或尿道炎的潜在血浆APP生物标志物。特别是,将这些APP生物标志物与超声、临床和常规血液标志物联合使用,可以显著支持IAI/MIAC和真菌炎的诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Plasma acute phase proteins as potential predictors of intra-amniotic inflammation and infection in preterm premature rupture of membranes.

Background: We aimed to investigate the potential of altered levels of various acute phase proteins (APPs) in the plasma, either used alone or in combination with ultrasound-, clinical-, and conventional blood-based tests, for predicting the risk of intra-amniotic inflammation (IAI), microbial invasion of the amniotic cavity (MIAC), histologic chorioamnionitis (HCA), and funisitis in women with preterm premature rupture of membranes (PPROM).

Methods: A total of 195 consecutive pregnancies involving singleton women with PPROM (at 23 + 0-34 + 0 weeks) who underwent amniocentesis and from whom plasma samples were obtained at amniocentesis were retrospectively included in this study. Amniotic fluid (AF) was cultured to assess the MIAC and analyzed for interleukin (IL)-6 levels to define IAI (AF IL-6 level of ≥2.6 ng/mL). The plasma concentrations of hepcidin, mannose-binding lectin (MBL), pentraxin-2, retinol-binding protein 4 (RBP4), serum amyloid A1 (SAA1), and serpin A1 were determined using ELISA. Ultrasonographic cervical length (CL), neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein levels were measured. IAI/MIAC was defined as IAI, MIAC, or both.

Results: Multivariate logistic regression analyses showed the following: (1) elevated plasma levels of hepcidin and SAA1 and decreased levels of RBP4 in the plasma were independently associated with IAI/MIAC and (2) decreased plasma RBP4 levels were independently associated with funisitis; however, (3) none of the plasma APPs investigated were associated with acute HCA when adjusted for baseline covariates. Using stepwise regression analysis, noninvasive prediction models comprising plasma RBP4 levels, CL, NLR, and gestational age at sampling were proposed, which provided a good prediction of IAI/MIAC and funisitis (area under the curve: 0.80 and 0.72, respectively).

Conclusions: Hepcidin, RBP4, and SAA1 were identified as potential APP biomarkers in the plasma predictive of IAI/MIAC or funisitis in patients with PPROM. In particular, combination of these APP biomarkers with ultrasound-, clinical-, and conventional blood-based markers can significantly support the diagnosis of IAI/MIAC and funisitis.

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来源期刊
Innate Immunity
Innate Immunity 生物-免疫学
CiteScore
7.20
自引率
0.00%
发文量
20
审稿时长
6-12 weeks
期刊介绍: Innate Immunity is a highly ranked, peer-reviewed scholarly journal and is the official journal of the International Endotoxin & Innate Immunity Society (IEIIS). The journal welcomes manuscripts from researchers actively working on all aspects of innate immunity including biologically active bacterial, viral, fungal, parasitic, and plant components, as well as relevant cells, their receptors, signaling pathways, and induced mediators. The aim of the Journal is to provide a single, interdisciplinary forum for the dissemination of new information on innate immunity in humans, animals, and plants to researchers. The Journal creates a vehicle for the publication of articles encompassing all areas of research, basic, applied, and clinical. The subject areas of interest include, but are not limited to, research in biochemistry, biophysics, cell biology, chemistry, clinical medicine, immunology, infectious disease, microbiology, molecular biology, and pharmacology.
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