Urinary inositol phosphoglycan P-type as a marker for prediction of preeclampsia and novel implications for the pathophysiology of this disorder.
OBJECTIVE
Hypertensive disorders represent the most common complications of human pregnancy with substantial impact on fetal and maternal outcomes. Inositol phosphoglycan P-type has recently been identified as a novel marker of preeclampsia, the most severe form of hypertension during pregnancy, with a significant increase in urinary excretion preceding the clinical diagnosis.


METHODS
A prospective, longitudinal study was carried out to assess the potential of urinary levels of inositol phosphoglycan P-type as a screening test for preeclampsia. A specific ELISA-based test was used to assess urinary levels of P-IPG.


RESULTS
Nine patients out of 93 women recruited (496 urinary samples were collected) went on to develop preeclampsia in a cohort of women with high-risk pregnancies. A cut-off value of urinary inositol phosphoglycan P-type was identified by ROC analysis providing a sensitivity and specificity for the current protocol of 88.9% and 62.7%, respectively. Twenty-three women with healthy pregnancies had sporadic episodes of increased excretion of inositol phosphoglycan P-type during pregnancy that consistently resolved back to normal baseline without development of preeclampsia. There was no correlation of urine levels of inositol phosphoglycan P-type and urine protein and patients with gestational hypertension had normal levels of urine inositol phosphoglycan P-type.


CONCLUSIONS
These findings suggest that, given the rapid raise of P-IPG before the onset of the disease, multiple assessments may help at identifying women at risk of developing preeclampsia.
Paine
Malcolm A
MA
Department of Immunology and Molecular Pathology, Molecular Medicine Unit, Royal Free and University College London Medical School, London, United Kingdom.
Scioscia
Marco
M
Williams
Philip J
PJ
Gumaa
Khalid
K
Rodeck
Charles H
CH
Rademacher
Thomas W
TW
D000704:Analysis of Variance; D015415:Biomarkers / Q000652:urine; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007295:Inositol Phosphates / Q000652:urine*; D011134:Polysaccharides / Q000652:urine*; D011225:Pre-Eclampsia / Q000652:urine*; D011237:Predictive Value of Tests; D011247:Pregnancy; D018566:Pregnancy, High-Risk / Q000652:urine*; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity
D015415:Biomarkers; D007295:Inositol Phosphates; D011134:Polysaccharides; C028039:inositol phosphate glycan