Panaitescu Bogdan, Romero Roberto, Gomez-Lopez Nardhy, Pacora Percy, Erez Offer, Vadillo-Ortega Felipe, Yeo Lami, Hassan Sonia S, Hsu Chaur-Dong
Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI, USA.
Department of Obstetrics & Gynecology, Wayne State University School of Medicine, Detroit, MI, USA.
J Matern Fetal Neonatal Med. 2020 Jan;33(1):5-15. doi: 10.1080/14767058.2018.1484089. Epub 2018 Jul 22.
ELABELA is a newly discovered peptide hormone that appears to be implicated in the mechanisms leading to preeclampsia, independently of angiogenic factors. The aim of the current study was to investigate whether women with early- or late-onset preeclampsia have altered ELABELA plasma concentrations compared to gestational-age-matched normal pregnant women. This retrospective cross-sectional study focused on the maternal plasma samples collected from 232 women with a singleton pregnancy who were allocated into the following groups: (1) early-onset preeclampsia (<34 weeks of gestation, = 56); (2) late-onset preeclampsia (≥34 weeks of gestation, = 57); and (3) gestational-age-matched controls with a normal pregnancy [(<34 weeks of gestation, = 59); (≥34 weeks of gestation, = 60)]. ELABELA plasma concentrations were determined using a validated enzyme immunoassay. (1) ELABELA plasma concentrations are higher in patients with late-onset preeclampsia compared with those from gestational-age-matched controls with a normal pregnancy [median: 7.99 ng/mL (IQR, 5.3-13.95 ng/mL) versus median: 4.17 ng/mL (IQR, 3-11.19 ng/mL), =.001]; (2) ELABELA plasma concentrations in patients with early-onset preeclampsia do not differ from those of normal pregnant women [median: 6.09 ng/mL (IQR, 2.8-10.66 ng/mL) versus median: 4.02 ng/mL (IQR, 3.26-7.49), = .32]; and (3) ELABELA plasma concentrations are higher in patients with late-onset preeclampsia compared to those with early-onset preeclampsia [median: 7.99 ng/mL (IQR, 5.3-13.95 ng/mL) versus median: 6.09 ng/mL (IQR, 2.8-10.66 ng/mL), = .01]. ELABELA plasma concentrations are higher in patients with late-onset preeclampsia than in those with a normal pregnancy. However, women with early-onset preeclampsia have similar ELABELA plasma concentrations to those with a normal pregnancy. These findings provide insight into the ELABELA axis during the human syndrome of preeclampsia. In addition, these data support the concept that different pathophysiologic mechanisms are implicated in early- and late-onset preeclampsia.
ELABELA是一种新发现的肽类激素,似乎与子痫前期的发病机制有关,且独立于血管生成因子。本研究的目的是调查早发型或晚发型子痫前期女性与孕周匹配的正常孕妇相比,其血浆中ELABELA浓度是否发生改变。这项回顾性横断面研究聚焦于从232名单胎妊娠女性中采集的母体血浆样本,这些女性被分为以下几组:(1)早发型子痫前期(妊娠<34周,n = 56);(2)晚发型子痫前期(妊娠≥34周,n = 57);以及(3)孕周匹配的正常妊娠对照组[(妊娠<34周,n = 59);(妊娠≥34周,n = 60)]。使用经过验证的酶免疫测定法测定ELABELA血浆浓度。(1)与孕周匹配的正常妊娠对照组相比,晚发型子痫前期患者的ELABELA血浆浓度更高[中位数:7.99 ng/mL(四分位间距,5.3 - 13.95 ng/mL) vs 中位数:4.17 ng/mL(四分位间距,3 - 11.19 ng/mL),P = 0.001];(2)早发型子痫前期患者的ELABELA血浆浓度与正常孕妇的无差异[中位数:6.09 ng/mL(四分位间距,2.8 - 10.66 ng/mL) vs 中位数:4.02 ng/mL(四分位间距,3.26 - 7.49),P = 0.32];并且(3)与早发型子痫前期患者相比,晚发型子痫前期患者的ELABELA血浆浓度更高[中位数:7.99 ng/mL(四分位间距,5.3 - 13.95 ng/mL) vs 中位数:6.09 ng/mL(四分位间距,2.8 - 10.66 ng/mL),P = 0.01]。晚发型子痫前期患者的ELABELA血浆浓度高于正常妊娠患者。然而,早发型子痫前期女性的ELABELA血浆浓度与正常妊娠女性相似。这些发现为子痫前期人类综合征期间的ELABELA轴提供了见解。此外,这些数据支持早发型和晚发型子痫前期涉及不同病理生理机制的概念。