Emerging role of endothelial and inflammatory markers in preeclampsia.
OBJECTIVE
Endothelial disturbance and excess inflammatory response are pathogenic mechanisms in pre-eclampsia (PE). Authors determine the clinical diagnostic role for thrombomodulin (TM), plasminogen activator inhibitor-1 (PAI-1) as endothelial markers and C-reactive protein (CRP), and interlukin-6 (IL-6) as inflammatory markers when tested independently or in combinations.


METHODS
We conducted a retrospective study in a cohort of 185 women grouped as 80 women with PE, 55 normotensive pregnant and 50 healthy non-pregnant. Plasma levels of TM, PAI-1, CRP and IL-6 were examined using enzyme linked immunosorbent assays.


RESULTS
Median levels and the positivity rates for the investigated markers were higher in PE as compared to the other groups (P < 0.0001). Using linear regression analysis, the investigated markers were significantly correlated regarding healthy non-pregnant vs PE or normotensive pregnant vs PE. The sensitivity of PAI-1 was the highest (98%) among the tested biomarkers. Combination between the investigated markers revealed absolute sensitivity (100%) and reliable specificity especially when PAI-1 was combined with CRP at 83% specificity.


CONCLUSIONS
Investigated endothelial and inflammatory markers revealed sensitive diagnostic test for PE. However, coupled combination between PAI-1 with CRP showed superior both sensitivity and specificity which represent a promising new approach for detection of PE.
Swellam
Menha
M
Department of Biochemistry, Genetic Engineering and Biotechnology Research Division, National Research Center, Dokki, Giza, Egypt. menha_m_swellam@yahoo.com
Samy
Nervana
N
Wahab
Susan Abdl
SA
Ibrahim
Mohamed Saeed
MS
D000328:Adult; D015415:Biomarkers / Q000032:analysis*; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011247:Pregnancy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D015415:Biomarkers