Biochemical Markers as Predictors for Preeclampsia
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads: Preeklampsija (PE) ir nozīmīga loma mātes un augļa saslimstībā un mirstībā visā pasaulē. Desmitiem gadu veiktie pētījumi centušies atrast bioķīmiskos marķierus un noskaidrot to potenciālu, lai ticami prognozētu PE attīstību. Līdz šim nav izdevies atrast vienu noteiktu efektīvu PE prognozēšanas marķieris, lai gan pēc iespējas agrīna PE atklāšana un taktika augļa un mātes veselībai ir ļoti nozīmīga.
Mērķi: Analizēt specifisko bioķīmisko marķieru efektivitāti PE prognozēšanā un identificēt bioķīmiskos marķierus, kam ir liels potenciāls PE prognozēšanā.
Materiāli un metodes: Šis pētnieciskais darbs ir literatūras apskats, kura pamatā, galvenokārt ir literatūras pirmavoti un nozīmīgi pētījumi, tostarp augstas kvalitātes zinātniskie raksti, klīnisko gadījumu apskati, kohortas pētījumi, sistemātiski apskati un meta analīzes. Pētījuma mērķis ir apskatīt, atlasīt un izanalizēt kvalitatīvus zinātniskos datus, identificējot un novērtējot specifisku bioķīmisko marķieru lietderību, tostarp bezšūnu augļa DNA (cffDNS), iekaisuma marķierus, lipīdu marķierus, šķīstošo fms-tipa tirozīna kināzi-1 (sFlt-1), placentas augšanas faktoru (PlGF), sFlt-1/PlGF attiecību, asinsvadu endotēlija augšanas faktoru (VEGF), šķīstošo endoglīnu (sEng) un ar grūtniecību saistīto plazmas proteīnu A (PAPP-A), agrīnā PE noteikšanā un identificēt, kuri marķieri varētu būt noderīgi praksē.
Secinājumi: Šī pētījuma galvenais secinājums ir, ka sFlt-1/PlGF attiecība ir daudzsološs rīks PE prognozēšanā, un gestācijas fāzei pielāgotās robežvērtības piedāvā potenciālu diagnostikas precizitāti. Atsevišķa PlGF testēšana ir parādījusi lielu PE prognozēšanas potenciālu, lai gan tā nav tik precīza kā sFlt-1/PlGF attiecības noteikšana. Citi daudzsološi marķieri ir sEng, kas parāda lielu potenciālu lietderību smagu PE pazīmju prognozēšanā, un PAPP-A, kas var sniegt potenciālu klīnisku nozīmi PE prognozēšanā, ja to kombinē kopā ar dzemdes artērijas PI.
Background: Preeclampsia (PE) plays an important role in maternal and foetal morbidity and mortality worldwide. Decades of research have studied biochemical markers and their potential to reliably predict PE development and to screen high-risk pregnancies. So far, no single effective predictive marker has been found. As PE can have detrimental immediate and long-term adverse outcomes on the mother and foetus, early detection and intervention are highly important. Objectives: To analyse the effectiveness of specific biochemical markers in the prediction of PE and to identify biochemical markers that serve great potential in PE prediction. Materials and methods: This research paper is a literature review, based on mainly primary literature sources and landmark studies, including high quality scientific articles, case-control studies, cohort studies, systematic reviews, and meta-analyses. The aim is to review, select and analyse quality scientific data by means of identifying and evaluating the usefulness of specific biochemical markers, including cell-free foetal DNA (cffDNA), inflammatory markers, lipid markers, soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), sFlt-1/PlGF ratio, vascular endothelial growth factor (VEGF), soluble endoglin (sEng) and pregnancy-associated plasma protein A (PAPP-A), in early detection of PE and to identify which markers could be useful in a practical setting. The main conclusion of this research paper is that the ratio of sFlt-1/PlGF shows to be a promising tool in the prediction of PE and gestational phase adapted cut-off values offer potential diagnostic accuracy. PlGF testing alone has also shown great potential in PE prediction, though not as accurate as determining the ratio to sFlt-1. Other promising markers are sEng, that shows great potential usefulness in the prediction of severe features of PE, and PAPP-A that has shown potential clinical importance in PE prediction when combined with uterine artery PI.
Background: Preeclampsia (PE) plays an important role in maternal and foetal morbidity and mortality worldwide. Decades of research have studied biochemical markers and their potential to reliably predict PE development and to screen high-risk pregnancies. So far, no single effective predictive marker has been found. As PE can have detrimental immediate and long-term adverse outcomes on the mother and foetus, early detection and intervention are highly important. Objectives: To analyse the effectiveness of specific biochemical markers in the prediction of PE and to identify biochemical markers that serve great potential in PE prediction. Materials and methods: This research paper is a literature review, based on mainly primary literature sources and landmark studies, including high quality scientific articles, case-control studies, cohort studies, systematic reviews, and meta-analyses. The aim is to review, select and analyse quality scientific data by means of identifying and evaluating the usefulness of specific biochemical markers, including cell-free foetal DNA (cffDNA), inflammatory markers, lipid markers, soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), sFlt-1/PlGF ratio, vascular endothelial growth factor (VEGF), soluble endoglin (sEng) and pregnancy-associated plasma protein A (PAPP-A), in early detection of PE and to identify which markers could be useful in a practical setting. The main conclusion of this research paper is that the ratio of sFlt-1/PlGF shows to be a promising tool in the prediction of PE and gestational phase adapted cut-off values offer potential diagnostic accuracy. PlGF testing alone has also shown great potential in PE prediction, though not as accurate as determining the ratio to sFlt-1. Other promising markers are sEng, that shows great potential usefulness in the prediction of severe features of PE, and PAPP-A that has shown potential clinical importance in PE prediction when combined with uterine artery PI.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Preeklampsija, Bioķīmiskais marķieris, sFlt-1, PlGF, sFlt-1 to PlGF attiecība, VEGF, sEng, PAPP-A, cffDNA, Iekaisuma marķieris, Lipīdu marķieris, Preeclampsia, Biochemical marker, sFlt-1, PlGF, sFlt-1 to PlGF ratio, VEGF, sEng, PAPP-A, cffDNA, Inflammatory marker, Lipid marker