title: Predominantly placenta-expressed mRNAs in maternal plasma as predictive markers for twin-twin transfusion syndrome.
abstract: OBJECTIVE
  This study aimed to identify a set of predominantly placental (PP) mRNAs, which are associated with later-developing twin-to-twin transfusion syndrome (TTTS).
  
  
  METHODS
  First, out of 50 PP mRNAs we previously reported, we select target mRNAs that are ordinarily detectable in maternal plasma. Plasma concentrations of these PP mRNAs were measured in monochorionic diamniotic twin (MCDA-T) pregnancies complicated by TTTS later (n = 11) and in uncomplicated MCDA-T pregnancies (n = 17). Finally, the diagnostic values of the PP mRNAs in plasma were evaluated.
  
  
  RESULTS
  From 50 PP mRNAs, nine [human placental lactogen (hPL); pregnancy-specific glycoproteins 2 (PSG2); human pregnancy-specific glycoproteins 3 (PSG3); syncytin; syncytin 2; retinoic acid-induced 14; A disintegrin and metalloproteinase domain-containing protein 12 (ADAM12); chorionic glycoprotein hormones, alpha polypeptide; and chorionic glycoprotein hormones, and beta polypeptide] were selected as target mRNAs. Changes in six PP mRNAs [increased hPL, PSG2, and PSG3 and decreased syncytin, syncytin2, and ADAM12] in maternal plasma were detected in MCDA-T pregnant women who subsequently developed TTTS. Finally, mRNA signatures gave elevated AUCs (hPL/PSG2: 0.8717; hPL/PSG3: 0.8449; hPL/ADAM12: 0.8396) compared with single hPL mRNA.
  
  
  CONCLUSIONS
  Quantitative aberration of plural cell-free PP mRNAs in maternal plasma precedes the appearance of clinically apparent TTTS. This suggests that pathophysiological changes in the placenta are associated with morbid conditions of TTTS.
authors.affiliation: Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Miura
authors.forename: Ai
authors.initials: A
authors.lastname: Higashijima
authors.forename: Shoko
authors.initials: S
authors.lastname: Miura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mishima
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamasaki
authors.forename: Shuhei
authors.initials: S
authors.lastname: Abe
authors.forename: Yuri
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Masanori
authors.initials: M
authors.lastname: Kaneuchi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshida
authors.forename: Akira
authors.initials: A
authors.lastname: Kinoshita
authors.forename: Koh-Ichiro
authors.initials: K
authors.lastname: Yoshiura
authors.forename: Hideaki
authors.initials: H
authors.lastname: Masuzaki
mesh_terms: D051722:ADAM Proteins / Q000235:genetics; D000072199:ADAM12 Protein; D000328:Adult; D019540:Area Under Curve; D005260:Female; D005330:Fetofetal Transfusion / Q000097:blood / Q000175:diagnosis / Q000235:genetics*; D020869:Gene Expression Profiling; D015686:Gene Products, env / Q000235:genetics; D006801:Humans; D008565:Membrane Proteins / Q000235:genetics; D010455:Peptides / Q000235:genetics; D010920:Placenta / Q000378:metabolism*; D010928:Placental Lactogen / Q000235:genetics; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000235:genetics; D059285:Pregnancy, Twin; D012333:RNA, Messenger / Q000097:blood / Q000235:genetics*; D014430:Twins, Monozygotic; D055815:Young Adult
chemical_list: C518353:ERVFRD-1 protein, human; D015686:Gene Products, env; D008565:Membrane Proteins; D010455:Peptides; D011257:Pregnancy Proteins; D012333:RNA, Messenger; C405335:syncytin; D010928:Placental Lactogen; D051722:ADAM Proteins; D000072199:ADAM12 Protein; C000606480:ADAM12 protein, human