Siljee Jacqueline E, Wortelboer Esther J, Koster Maria P H, Imholz Sandra, Rodenburg Wendy, Visser Gerard H A, de Vries Annemieke, Schielen Peter C J I, Pennings Jeroen L A
Centre for Infectious Disease Research, Diagnostics and Screening (IDS), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Prenat Diagn. 2013 Dec;33(12):1183-8. doi: 10.1002/pd.4219. Epub 2013 Aug 31.
This study aimed to determine the predictive value of growth factors, cardiovascular, and immunological markers for first trimester identification of early onset pre-eclampsia (PE).
In a retrospective case-control study, maternal serum samples of 35 early onset PE cases and 35 controls were analysed by multiplexed immunoassays, to determine serum concentrations of 41 proteins whose functionality can be associated with PE pathogenesis. All levels were converted into multiples of the gestation-specific normal median. For prediction modelling, proteins that were found to be significant were combined with previously obtained values of three established PE markers, that is, placental growth factor, placental protein 13, and pregnancy-associated plasma protein A. Prediction modelling was used to determine predicted detection rates for 5% and 10% false-positive rates.
Three of the proteins examined in this study, interleukin-1 beta (IL-1β), fibrinogen, and carcinoembryonic antigen, showed significantly different serum levels at p < 0.05. In prediction modelling, only IL-1β added predictive value to the three previously established biomarkers, by increasing detection from 38.2% to 44.1% at a 5% false-positive rate.
This study indicates that IL-1β has potential to improve first trimester prediction of pre-eclampsia. Studies on larger cohorts will be needed to validate these findings.
本研究旨在确定生长因子、心血管和免疫标志物在孕早期识别早发型子痫前期（PE）中的预测价值。
在一项回顾性病例对照研究中，通过多重免疫测定分析了35例早发型PE病例和35例对照的孕妇血清样本，以确定41种功能可能与PE发病机制相关的蛋白质的血清浓度。所有水平均转换为孕周特异性正常中位数的倍数。对于预测模型，将发现有显著意义的蛋白质与先前获得的三种已确立的PE标志物，即胎盘生长因子、胎盘蛋白13和妊娠相关血浆蛋白A的值相结合。使用预测模型确定5%和10%假阳性率时的预测检出率。
本研究中检测的三种蛋白质，即白细胞介素-1β（IL-1β）、纤维蛋白原和癌胚抗原血清水平差异显著（p<0.05）。在预测模型中，只有IL-1β为三种先前确立的生物标志物增加了预测价值，在5%假阳性率时将检出率从38.2%提高到44.1%。
本研究表明IL-1β有改善子痫前期孕早期预测的潜力。需要对更大队列进行研究以验证这些发现。
