Department of Anesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
PLoS One. 2021 Feb 8;16(2):e0246786. doi: 10.1371/journal.pone.0246786. eCollection 2021.
Cerebral injury is a common cause of maternal mortality due to preeclampsia and is challenging to predict and diagnose. In addition, there are associations between previous preeclampsia and stroke, dementia and epilepsy later in life. The cerebral biomarkers S100B, neuron specific enolase, (NSE), tau protein and neurofilament light chain (NfL) have proven useful as predictors and diagnostic tools in other neurological disorders. This case-control study sought to determine whether cerebral biomarkers were increased in cerebrospinal fluid (CSF) as a marker of cerebral origin and potential cerebral injury in preeclampsia and if concentrations in CSF correlated to concentrations in plasma.
CSF and blood at delivery from 15 women with preeclampsia and 15 women with normal pregnancies were analysed for the cerebral biomarkers S100B, NSE, tau protein and NfL by Simoa and ELISA based methods. MRI brain was performed after delivery and for women with preeclampsia also at six months postpartum.
Women with preeclampsia demonstrated increased CSF- and plasma concentrations of NfL and these concentrations correlated to each other. CSF concentrations of NSE and tau were decreased in preeclampsia and there were no differences in plasma concentrations of NSE and tau between groups. For S100B, serum concentrations in preeclampsia were increased but there was no difference in CSF concentrations of S100B between women with preeclampsia and normal pregnancy.
NfL emerges as a promising circulating cerebral biomarker in preeclampsia and increased CSF concentrations point to a neuroaxonal injury in preeclampsia, even in the absence of clinically evident neurological complications.
子痫前期导致的脑损伤是产妇死亡的常见原因，且难以预测和诊断。此外，子痫前期与日后发生的中风、痴呆和癫痫之间存在关联。S100B、神经元特异性烯醇化酶（NSE）、tau 蛋白和神经丝轻链（NfL）等脑生物标志物已被证明可作为其他神经疾病的预测和诊断工具。本病例对照研究旨在确定脑生物标志物是否会在脑脊液（CSF）中增加，以作为子痫前期中脑源性和潜在脑损伤的标志物，以及 CSF 中的浓度是否与血浆中的浓度相关。
对 15 例子痫前期和 15 例正常妊娠妇女分娩时的 CSF 和血液进行 Simoa 和 ELISA 检测，分析 S100B、NSE、tau 蛋白和 NfL 等脑生物标志物。分娩后对所有妇女进行脑部 MRI 检查，对子痫前期妇女还在产后 6 个月进行检查。
子痫前期妇女的 CSF 和血浆 NfL 浓度均升高，且两者之间呈正相关。NSE 和 tau 蛋白的 CSF 浓度在子痫前期中降低，而两组间血浆 NSE 和 tau 浓度无差异。S100B 的血清浓度在子痫前期中升高，但 CSF 浓度在子痫前期和正常妊娠妇女之间无差异。
NfL 是子痫前期中一种有前途的循环脑生物标志物，CSF 浓度升高提示子痫前期存在神经轴突损伤，即使没有明显的临床神经并发症。
