Freis A, Schlegel J, Kuon R J, Doster A, Jauckus J, Strowitzki T, Germeyer A
Department of Gynecological Endocrinology and Fertility Disorders, University Hospital Heidelberg, INF 440, 69120, Heidelberg, Germany.
Reprod Biol Endocrinol. 2017 Nov 2;15(1):87. doi: 10.1186/s12958-017-0307-9.
Miscarriage is a common complication in pregnancy and there is still a lack of biomarkers usable in asymptomatic patients before the event occurs. Periostin (PER), whose levels rise particularly during injury or inflammation, has been shown to play an important local role in implantation and early embryonic development. As PER has been described as a biomarker in various medical conditions we intended to evaluate if changes in PER serum levels may help to identify women at risk for spontaneous abortion in the first trimester.
Women between 18 and 42 years without confounding comorbidities who conceived by IVF/ICSI and ovarian hyperstimulation were analysed in the study after informed consent. Maternal serum samples from 41 patients were assessed at the time of pregnancy testing (PT) and the following first ultrasound checkup (US). Patients were subsequently divided in two groups: (1) patients with subsequent miscarriage in the first trimester (n = 18) and (2) patients with ongoing pregnancy (n = 23), allowing for statistical analysis and investigating the change of PER levels per individual. PER levels were measured using enzyme-linked immunosorbent assay. Statistical analysis was performed using the Fisher exact and Student's t test. p ≤ 0.05 was considered to be significant.
There was no significant difference concerning possible confounders between the two groups. We did not find any significant difference in PER levels at the time point of PT or US. By investigating the interindividual changes of PER between the two time points however, we observed that patients with a following miscarriage showed increasing levels of PER at the time point of PT compared to US in contrast to patients with an ongoing pregnancy who demonstrated a decrease in PER levels. These alterations were significant in the absolute as well as in the relative comparison.
The relative expression of PER between PT and US is significantly altered in asymptomatic women with subsequent miscarriage compared to women with ongoing pregnancy. Therefore systemic PER levels might represent a potential promising biomarker for the assessment of pregnancy outcome.
Not applicable.
流产是孕期常见的并发症，在无症状患者流产事件发生前，仍缺乏可用的生物标志物。骨膜蛋白（PER）的水平尤其在损伤或炎症期间会升高，已被证明在着床和早期胚胎发育中发挥重要的局部作用。由于PER在各种医疗状况下都被描述为一种生物标志物，我们旨在评估血清PER水平的变化是否有助于识别孕早期有自然流产风险的女性。
本研究在获得知情同意后，对年龄在18至42岁之间、通过体外受精/卵胞浆内单精子注射及卵巢过度刺激受孕且无混杂合并症的女性进行分析。在妊娠试验（PT）时和随后的首次超声检查（US）时，对41例患者的母体血清样本进行评估。患者随后被分为两组：（1）孕早期发生流产的患者（n = 18）和（2）持续妊娠的患者（n = 23），以便进行统计分析并研究个体PER水平的变化。使用酶联免疫吸附测定法测量PER水平。采用Fisher精确检验和学生t检验进行统计分析。p≤0.05被认为具有统计学意义。
两组之间在可能的混杂因素方面无显著差异。我们在PT或US时间点未发现PER水平有任何显著差异。然而，通过研究两个时间点之间PER的个体间变化，我们观察到，与持续妊娠的患者PER水平下降相比，流产患者在PT时间点的PER水平相对于US时升高。这些变化在绝对和相对比较中均具有统计学意义。
与持续妊娠的女性相比，后续发生流产的无症状女性在PT和US之间PER的相对表达有显著改变。因此，全身PER水平可能是评估妊娠结局的一个有潜力的生物标志物。
不适用。
