title: Soluble Tumor Necrosis Factor-α Receptor 2 in Urine Is a Potential Biomarker for Noninvasive Diagnosis of Malaria During Pregnancy.
abstract: Background.  During pregnancy, the placenta is inaccessible for diagnosis of placental malaria (PM), but soluble tumor necrosis factor-α receptors (sTNFR) are elevated in the plasma of women with PM. Methods.  In this study, sTNFR-1 and sTNFR-2 were quantified in urine of pregnant and nonpregnant Cameroonian women who were positive or negative for malaria by blood-smear microscopy. Results.  We found that levels of both sTNFR in urine were higher in pregnant compared with nonpregnant women, but malaria-positive pregnant women excreted substantially more sTNFR-1 (P = .005) and sTNFR-2 (P < .001) than malaria-negative pregnant women. The amount of sTNFR-1(rs = 0.784, P < .001) and sTNFR-2 (rs = 0.816, P < .001) in urine correlated with parasitemia, even in afebrile pregnant women. Urine sTNFR-2 predicted maternal malaria with an area under curve of 0.892 (95% confidence interval, .787-.898). At cutoff concentrations of 9.8 ng and 13.6 ng of sTNFR-2 per mL urine, the sensitivity/specificity were 82.6%/87.0% and 78.3%/95.7%, respectively. Conclusions.  The sTNFR-2 in noninvasive urine samples may be useful for diagnosis of malaria during pregnancy.
authors.affiliation: Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu; The Biotechnology Center, University of Yaoundé 1, Cameroon.
authors.forename: Samuel
authors.initials: S
authors.lastname: Tassi Yunga
authors.affiliation: Department of Tropical Medicine, Medical Microbiology and Pharmacology , John A. Burns School of Medicine, University of Hawaii at Manoa , Honolulu.
authors.forename: Audrey Davidson
authors.initials: AD
authors.lastname: Thévenon
authors.affiliation: The Biotechnology Center, University of Yaoundé 1 , Cameroon.
authors.forename: Rose Gana Fomban
authors.initials: RG
authors.lastname: Leke
authors.affiliation: Department of Tropical Medicine, Medical Microbiology and Pharmacology , John A. Burns School of Medicine, University of Hawaii at Manoa , Honolulu.
authors.forename: Diane Wallace
authors.initials: DW
authors.lastname: Taylor
keywords: TNF-α receptors; biomarker; malaria; pregnancy; urine