Fetal Medicine Centre, Birmingham Women's Foundation Trust, Edgbaston, Birmingham, UK.
Acta Obstet Gynecol Scand. 2012 Oct;91(10):1206-11. doi: 10.1111/j.1600-0412.2012.01507.x. Epub 2012 Aug 21.
To investigate the effects of chorionicity and severe twin to twin transfusion (TTTS) on maternal circulating cell-free messenger RNA (cf-mRNA).
Prospective cohort study.
A UK tertiary referral Fetal Medicine Center.
All monochorionic (MC) twins complicated by severe TTTS (n= 23) and a cohort of uncomplicated dichorionic (DC) (n= 10) and MC (n= 7) pregnancies, between October 2006 and December 2007.
Maternal cf-mRNA encoding glyceraldehyde 3-phosphate dehydrogenase (GAPDH), vascular endothelial growth factor receptor 1(VEGFR-1(Flt-1)), vascular endothelial growth factor A (VEGF-A), Endoglin, placental growth factor (PlGF), tyrosine kinase with immunoglobulin-like and EGF-like domains 1 (Tie-1), angiopoietin 1 (Ang-1) and angiopoietin 2 (Ang-2) were measured by a quantitative two-step real-time PCR assay after extraction from maternal plasma.
The amounts of cf-mRNA detectable are reported for uncomplicated DC, MC and TTTS pregnancies, respectively: GAPDH - 80, 100 and 96%; VEGFR-1 - 10, 0 and 26%; VEGF-A- 80, 71 and 96%; Endoglin-70, 71 and 91%; PlGF-70, 57, 26%; Tie-1 0, 43, 0%; Ang-1 71, 50 and 60% and Ang-2 83, 50 and 89%. There was a significant difference in VEGF-A (medians DC -337.3, MC - 390.8, TTTS - 618.6 copies/mL plasma p= 0.024), Endoglin (medians DC-14.49, MC-1171, TTTS - 2896 copies/mL plasma p= 0.027) and Ang-2 (medians DC-13.66, MC-8.49, TTTS 44.80 copies/mL plasma p= 0.007).
Maternal cf-mRNA could be reliably detected for GAPDH, PlGF, VEGF-A, Endoglin, Ang-1 and Ang-2 in twin pregnancies and a significant difference was demonstrated in VEGF-A, Endoglin and Ang-2 between uncomplicated twins and MC twin pregnancies complicated by TTTS. If such alterations in maternal cf-mRNA precede the onset of clinically apparent disease, this may be used as an adjuvant blood test to complement ultrasound screening.
研究绒毛膜性和严重双胎输血综合征（TTTS）对母体循环游离信使 RNA（cf-mRNA）的影响。
前瞻性队列研究。
英国一家三级转诊胎儿医学中心。
所有复杂性单绒毛膜（MC）双胎妊娠伴严重 TTTS（n=23）以及一组单纯性双绒毛膜（DC）（n=10）和 MC（n=7）妊娠，于 2006 年 10 月至 2007 年 12 月期间纳入研究。
采用两步实时定量 PCR 法从母体血浆中提取甘油醛 3-磷酸脱氢酶（GAPDH）、血管内皮生长因子受体 1（VEGFR-1（Flt-1））、血管内皮生长因子 A（VEGF-A）、内皮糖蛋白（Endoglin）、胎盘生长因子（PlGF）、含免疫球蛋白样和表皮生长因子样结构域的酪氨酸激酶 1（Tie-1）、血管生成素 1（Ang-1）和血管生成素 2（Ang-2）的 cf-mRNA。
未合并 DC、MC 和 TTTS 妊娠时，cf-mRNA 的检测量分别为：GAPDH-80、100 和 96%；VEGFR-1-10、0 和 26%；VEGF-A-80、71 和 96%；Endoglin-70、71 和 91%；PlGF-70、57 和 26%；Tie-1-0、43 和 0%；Ang-1-71、50 和 60%和 Ang-2-83、50 和 89%。VEGF-A（中位数 DC-337.3、MC-390.8、TTTS-618.6 拷贝/mL 血浆，p=0.024）、Endoglin（中位数 DC-14.49、MC-1171、TTTS-2896 拷贝/mL 血浆，p=0.027）和 Ang-2（中位数 DC-13.66、MC-8.49、TTTS-44.80 拷贝/mL 血浆，p=0.007）在 MC 双胎妊娠伴 TTTS 与未合并 TTTS 的 DC 和 MC 双胎妊娠之间存在显著差异。
GAPDH、PlGF、VEGF-A、Endoglin、Ang-1 和 Ang-2 可在双胎妊娠中可靠地检测到母体 cf-mRNA，并且在未合并 TTTS 的 MC 双胎妊娠与 TTTS 合并的 MC 双胎妊娠之间，VEGF-A、Endoglin 和 Ang-2 存在显著差异。如果母体 cf-mRNA 的这种改变先于临床明显疾病的发生，那么它可能作为辅助血液检查，以补充超声筛查。
