Penka Lukas, Kagan Karl-Oliver, Hamprecht Klaus
Institute for Medical Virology and Epidemiology of Viral Diseases, University Hospital of Tuebingen, Elfriede-Aulhorn-Straße 6, 72076 Tuebingen, Germany.
Department of Obstetrics and Gynaecology, University Hospital of Tuebingen, Calwerstrasse 7, 72076 Tuebingen, Germany.
J Clin Med. 2020 Apr 26;9(5):1258. doi: 10.3390/jcm9051258.
Antenatal Cytomegalovirus infection (CMV) can be associated with severe fetal symptoms and newborn outcome. The current prenatal diagnosis is based on amniocentesis (AC). No reliable biomarker for fetal infection is available.
We measured Placenta-derived growth factor (PlGF), and soluble fms-like tyrosine kinase 1 (sFlt1), concentrations in maternal serum and amniotic fluid (AF) in context of maternal CMV primary infection. Blood sampling was carried out at the time of AC for detection of fetal CMV infection. The study cohort was divided into four subcohorts according to the presence or absence of fetal infection and preemptive hyperimmunoglobulin (HIG) treatment during the time interval between diagnosis of the CMV primary infection and AC.
The study cohort involved 114 pregnancies. In the non-transmitting subcohorts (NT) with and without prior HIG treatment, the median sFlt1 concentrations were 1.5 ng/mL (NT, HIG+) and 1.4 ng/mL (NT, HIG-), respectively. In the two transmitting groups (T) the concentrations were 1.3 ng/mL (T, HIG+) and 2.3 ng/mL (T, HIG-), respectively (NT, HIG- vs. T, HIG-, < 0.001). The corresponding PlGF levels and the sFlt1/PlGF ratios showed no significant differences between the cohorts. The empirical cut-off values <1504 pg/mL sFlt1 and <307 pg/mL PlGF, were associated with the exclusion of CMV transmission ( < 0.001).
sFlt1 concentration in the maternal blood could be a predictive biomarker for maternofetal CMV transmission.
产前巨细胞病毒（CMV）感染可能与严重的胎儿症状及新生儿结局相关。目前的产前诊断基于羊膜腔穿刺术（AC）。尚无用于胎儿感染的可靠生物标志物。
在孕妇原发性CMV感染的情况下，我们检测了母血清和羊水（AF）中胎盘衍生生长因子（PlGF）和可溶性fms样酪氨酸激酶1（sFlt1）的浓度。在进行羊膜腔穿刺术时采集血样以检测胎儿CMV感染。根据在CMV原发性感染诊断至羊膜腔穿刺术期间胎儿感染及预防性高免疫球蛋白（HIG）治疗的有无，将研究队列分为四个亚组。
研究队列包括114例妊娠。在接受和未接受过HIG治疗的非传播亚组（NT）中，sFlt1浓度中位数分别为1.5 ng/mL（NT，HIG+）和1.4 ng/mL（NT，HIG-）。在两个传播组（T）中，浓度分别为1.3 ng/mL（T，HIG+）和2.3 ng/mL（T，HIG-）（NT，HIG-与T，HIG-相比，<0.001）。各队列之间相应的PlGF水平和sFlt1/PlGF比值无显著差异。sFlt1<1504 pg/mL和PlGF<307 pg/mL的经验性临界值与排除CMV传播相关（<0.001）。
母血中sFlt1浓度可能是母婴CMV传播的预测生物标志物。
