Plasma SerpinA5 in conjunction with uterine artery pulsatility index and clinical risk factor for the early prediction of preeclampsia.

Yonggang Zhang,Limin Zhao,Yipeng Zhang,Junzhu Shi,Hongling Yang,Maurizio Mandalà

doi:10.1371/journal.pone.0258541

Abstract

This study aimed to combine plasma protein SerpinA5 with uterine artery doppler ultrasound and clinical risk factor during the first trimester for prediction of preeclampsia. This study was a nested cohort study and was divided into the screening set and developing set. The plasma was collected during the first trimester (11+0-13+6 weeks), at the same time, UtA-PI was detected and recorded with four-dimensional color Doppler ultrasound. These pregnancies were followed up until after delivery. The plasma proteins were examined using ultra-performance liquid chromatography-mass spectrometry (UPLC-MS) and enzyme linked immunosorbent assay (ELISA). Placental samples preserved after delivery were analysed by immunohistochemistry. Clinical risk factors were obtained from medical records or antenatal questionnaires. Upregulation or downregulation of SerpinA5 expression in TEV-1 cells was performed to investigate the role of SerpinA5 in trophoblasts invasion. We demonstrated that SerpinA5 levels were greater not only in preeclampsia placental tissue but also in plasma (both p<0.05), and we found that SerpinA5 may interfere with trophoblastic cell invasion by inhibiting MSP. SerpinA5 may be a potential predictor of preeclampsia. What is more, the sensitivity and specificity of predictive power were strengthened when plasma SerpinA5 was combined with UtA-PI and pre-pregnancy BMI & family history of PE for prediction of preeclampsia. These findings showed that placenta-derived plasma SerpinA5 may be a novel biomarker for preeclampsia, which together with uterine artery Doppler ultrasound and clinical risk factor can more effectively predict preeclampsia.

Highlights

Preeclampsia (PE) is a common and important obstetric disease
We demonstrated that SerpinA5 levels were greater in preeclampsia placental tissue and in plasma, and we found that SerpinA5 may interfere with trophoblastic cell invasion by inhibiting macrophage stimulating protein (MSP)
These findings showed that placenta-derived plasma SerpinA5 may be a novel biomarker for preeclampsia, which together with uterine artery Doppler ultrasound and clinical risk factor can more effectively predict preeclampsia

Summary

Introduction

Preeclampsia (PE) is a common and important obstetric disease. PE occurs in 5–7% of all pregnancies and is a leading cause of maternal mortality. It is reported that apparently 16% of maternal deaths in developed countries are associated with PE and up to 25% in developing countries [1]. Compared to the healthy population, PE patients and their infants are likely to have a four-fold higher risk of elevated blood pressure and diabetes within 10–20 years [2]. Screening for PE before the onset is important for identifying at-risk patients who might benefit from close follow-up and potential treatment to prevent adverse pregnancy outcomes [3, 4]. Given that multi faceted joint forecasting may play a role in the management of preeclampsia [2, 5], the union of placental-derived plasma protein, color Doppler ultrasound examination and epidemiological investigation may be a research strategy for preeclampsia

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