Prediction of Preeclampsia with Novel Biomarkers at Second Trimester of Pregnancy

Ahmed Abdel Samie Omran, Ashraf Mohammed Mohammed Osman
2016 Journal of Clinical & Cellular Immunology  
Objective: To evaluate the ability of the soluble vascular endothelial growth factor receptor (sFlt-1), neutrophilflt-1, monocyte-flt-1, pentraxin 3 (PTX3), nitric oxide (NO) and alpha fetoprotein (AFP) measurements at gestational weeks 14-18 to predict preeclampsia (PE). Subjects & Methods: Fifty pregnant females at second trimester of pregnancy divided into 25 normotensive pregnant females who remained normotensive till delivery (group I) and 25 high risk pregnant females who subsequently
more » ... ho subsequently developed PE (group II). Twenty five healthy non-pregnant females served as control (group III). Maternal blood samples were collected at 14-18 gestational weeks. EDTA samples were investigated for both neutrophil-and monocyte-flt-1 by flow cytometer. Plasma samples were used to estimate PTX3, along with stored serum samples which were analyzed for sFlt-1, NO and AFP all by ELISA. Results: Alpha fetoprotein, sFlt-1 and pentraxin 3 were found to be statistically significantly increased in group II when compared with group I (P-value=0.024, <0.001 and 0.006) and group III (P-value ≤ 0.001). However, there was statistically significant decrease in neutrophil-flt-1 and nitric oxide in group II when compared with group I (P-value ≤ 0.001 and 0.016). Group II had significant negative correlation between soluble flt-1 and both neutrophil-and monocyte-flt-1 (P-value ≤ 0.001 and 0.009) and between neutrophil-flt-1 and PTX3 (P-value=0.007). Soluble flt-1 was found to have the highest predictive value for predicting preeclampsia (AUC=0.941 and P-value ≤ 0.001) Conclusion: soluble Flt-1 was found to be the best single biomarker in predicting preeclampsia at first half of the second trimester with the best diagnostic sensitivity and specificity. Soluble flt-1 was significantly negatively correlated with neutrophil-flt-1 and monocyte-flt-1. So, the predictive utility of sFlt-1 could be strengthened when combined with both neutrophil-and monocyte-flt-1. This may be an approach to develop a novel predictive model for preeclampsia combining the three biomarkers with better sensitivity and specificity.
doi:10.4172/2155-9899.1000435 fatcat:tftzbr6ku5hofjxmo3nsni2hbi