Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Am J Reprod Immunol. 2022 Sep;88(3):e13584. doi: 10.1111/aji.13584. Epub 2022 Jul 10.
We aimed to assess the predictive potential of 12 plasma biomarkers to predict acute histologic chorioamnionitis (HCA) in women with preterm premature rupture of membranes (PPROM) and to develop multi-biomarker panels based on these biomarkers in combination with widely used conventional laboratory markers.
This was a retrospective cohort study involving 81 singleton pregnant women (24-34 weeks of gestation) who delivered within 96 h of blood sampling. White blood cell (WBC) count, differential counts, and C-reactive protein (CRP) levels were measured at admission. The levels of DKK-3, Fas, haptoglobin, IGFBP-2, kallistatin, MIP-1α, MMP-2, MMP-8, pentraxin 3, progranulin, E-selectin, and P-selectin were evaluated by ELISA using stored plasma samples. The primary outcome measure was acute HCA.
Multivariate analyses showed that low plasma E-selectin and kallistatin levels were independently associated with HCA occurrence after adjusting for gestational age. Using a stepwise regression analysis, a multi-biomarker panel comprising plasma E-selectin, serum CRP, and WBC was developed, which provided a good prediction of acute HCA in women with PPROM (area under the curve [AUC], 0.899), with a significantly higher AUC than that of any single variable included in the panel (P < 0.05). The plasma levels of DKK-3, Fas, haptoglobin, IGFBP-2, MIP-1α, MMP-2, MMP-8, pentraxin 3, and P-selectin were not significantly associated with HCA occurrence.
This study identified E-selectin and kallistatin as potential plasma biomarkers associated with acute HCA in women with PPROM. Their combined analysis with serum CRP and WBC counts significantly improved acute HCA diagnosis.
我们旨在评估 12 种血浆生物标志物预测未足月胎膜早破（PPROM）孕妇发生急性组织学绒毛膜羊膜炎（HCA）的潜力，并基于这些生物标志物结合广泛使用的常规实验室标志物开发多生物标志物组合。
这是一项回顾性队列研究，涉及 81 名单胎孕妇（妊娠 24-34 周），在采血后 96 小时内分娩。入院时测定白细胞（WBC）计数、分类计数和 C 反应蛋白（CRP）水平。采用 ELISA 法检测储存血浆样本中的 DKK-3、Fas、触珠蛋白、IGFBP-2、卡利斯塔丁、MIP-1α、MMP-2、MMP-8、五聚素 3、颗粒蛋白前体、E-选择素和 P-选择素水平。主要结局指标为急性 HCA。
多变量分析显示，在校正胎龄后，低血浆 E-选择素和卡利斯塔丁水平与 HCA 的发生独立相关。采用逐步回归分析，建立了一个包含血浆 E-选择素、血清 CRP 和 WBC 的多生物标志物组合，该组合能很好地预测 PPROM 孕妇的急性 HCA（曲线下面积 [AUC]，0.899），其 AUC 明显高于组合中任何单个变量（P < 0.05）。血浆 DKK-3、Fas、触珠蛋白、IGFBP-2、MIP-1α、MMP-2、MMP-8、五聚素 3 和 P-选择素水平与 HCA 的发生无显著相关性。
本研究发现 E-选择素和卡利斯塔丁是与 PPROM 孕妇急性 HCA 相关的潜在血浆生物标志物。它们与血清 CRP 和 WBC 计数的联合分析显著提高了急性 HCA 的诊断。
