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- Title
Decreased Expression of Placental Proteins in Recurrent Pregnancy Loss: Functional Relevance and Diagnostic Value.
- Authors
Tóth, Eszter; Györffy, Dániel; Posta, Máté; Hupuczi, Petronella; Balogh, Andrea; Szalai, Gábor; Orosz, Gergő; Orosz, László; Szilágyi, András; Oravecz, Orsolya; Veress, Lajos; Nagy, Sándor; Török, Olga; Murthi, Padma; Erez, Offer; Papp, Zoltán; Ács, Nándor; Than, Nándor Gábor
- Abstract
Miscarriages affect 50–70% of all conceptions and 15–20% of clinically recognized pregnancies. Recurrent pregnancy loss (RPL, ≥2 miscarriages) affects 1–5% of recognized pregnancies. Nevertheless, our knowledge about the etiologies and pathophysiology of RPL is incomplete, and thus, reliable diagnostic/preventive tools are not yet available. Here, we aimed to define the diagnostic value of three placental proteins for RPL: human chorionic gonadotropin free beta-subunit (free-β-hCG), pregnancy-associated plasma protein-A (PAPP-A), and placental growth factor (PlGF). Blood samples were collected from women with RPL (n = 14) and controls undergoing elective termination of pregnancy (n = 30) at the time of surgery. Maternal serum protein concentrations were measured by BRAHMS KRYPTOR Analyzer. Daily multiple of median (dMoM) values were calculated for gestational age-specific normalization. To obtain classifiers, logistic regression analysis was performed, and ROC curves were calculated. There were differences in changes of maternal serum protein concentrations with advancing healthy gestation. Between 6 and 13 weeks, women with RPL had lower concentrations and dMoMs of free β-hCG, PAPP-A, and PlGF than controls. PAPP-A dMoM had the best discriminative properties (AUC = 0.880). Between 9 and 13 weeks, discriminative properties of all protein dMoMs were excellent (free β-hCG: AUC = 0.975; PAPP-A: AUC = 0.998; PlGF: AUC = 0.924). In conclusion, free-β-hCG and PAPP-A are valuable biomarkers for RPL, especially between 9 and 13 weeks. Their decreased concentrations indicate the deterioration of placental functions, while lower PlGF levels indicate problems with placental angiogenesis after 9 weeks.
- Subjects
PREGNANCY proteins; PLACENTAL growth factor; BLOOD proteins; RECURRENT miscarriage; PROTEIN expression; CHORIONIC gonadotropins; ABORTION
- Publication
International Journal of Molecular Sciences, 2024, Vol 25, Issue 3, p1865
- ISSN
1661-6596
- Publication type
Article
- DOI
10.3390/ijms25031865