title: Urinary inositol phosphoglycan P-type as a marker for prediction of preeclampsia and novel implications for the pathophysiology of this disorder.
abstract: 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.
authors.affiliation: Department of Immunology and Molecular Pathology, Molecular Medicine Unit, Royal Free and University College London Medical School, London, United Kingdom.
authors.forename: Malcolm A
authors.initials: MA
authors.lastname: Paine
authors.forename: Marco
authors.initials: M
authors.lastname: Scioscia
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Williams
authors.forename: Khalid
authors.initials: K
authors.lastname: Gumaa
authors.forename: Charles H
authors.initials: CH
authors.lastname: Rodeck
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Rademacher
mesh_terms: 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
chemical_list: D015415:Biomarkers; D007295:Inositol Phosphates; D011134:Polysaccharides; C028039:inositol phosphate glycan