Galbiati Silvia, Gabellini Daniela, Ambrosi Alessandro, Soriani Nadia, Pasi Federica, Locatelli Massimo, Lucianò Roberta, Candiani Massimo, Valsecchi Luca, Zerbini Gianpaolo, Smid Maddalena
Complications of Diabetes Unit, Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.
Front Mol Biosci. 2023 Jan 19;10:1075604. doi: 10.3389/fmolb.2023.1075604. eCollection 2023.
Preeclampsia (PE) is a severe complication of pregnancy. The identification of a reliable predictive biomarker could help in setting up a specific preventive strategy. To this aim, we studied carbonic anhydrase IX (CAIX) as a marker of hypoxia (a pathway involved in PE pathogenesis) and compared the diagnostic accuracy of CAIX to that of the validated biomarker sFlt1/PlGF ratio. Fifteen women with overt PE and 38 women at a risk of developing PE, sampled at different time intervals during gestation (a total of 82 plasma samples collected), were enrolled and underwent the CAIX measurement. CAIX levels significantly increased ( < .001) before the onset of the disease in women (25% of the total number) who later on developed PE when compared to women who did not, starting from 28th gestational week. The best CAIX cut-off of 68.268 pg/mL yielded a sensitivity of 100%, a specificity of 81.82%, and an AUC value of .9221. In our pilot study, when compared to the sFlt1/PlGF ratio, CAIX performed better in predicting PE before the clinical onset. Furthermore when implemented as CAIX/PlGF ratio, showed up to be comparable in the identification of women with overt early PE. In conclusion, CAIX could represent an effective predictive biomarker of PE, and larger studies are mandatory to validate this finding.
子痫前期（PE）是一种严重的妊娠并发症。确定一种可靠的预测生物标志物有助于制定特定的预防策略。为此，我们研究了碳酸酐酶IX（CAIX）作为缺氧（PE发病机制中的一条途径）的标志物，并将CAIX的诊断准确性与已验证的生物标志物sFlt1/PlGF比值的诊断准确性进行了比较。招募了15例显性PE患者和38例有发生PE风险的女性，在妊娠期间的不同时间间隔进行采样（共采集82份血浆样本），并进行CAIX测量。与未发生PE的女性相比，后来发生PE的女性（占总数的25%）在疾病发作前，从妊娠第28周开始，CAIX水平显著升高（<0.001）。CAIX的最佳截断值为68.268 pg/mL，敏感性为100%，特异性为81.82%，AUC值为0.9221。在我们的初步研究中，与sFlt1/PlGF比值相比，CAIX在临床发作前预测PE方面表现更好。此外，当以CAIX/PlGF比值实施时，在识别显性早期PE女性方面表现相当。总之，CAIX可能是PE的一种有效预测生物标志物，需要更大规模的研究来验证这一发现。
