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Total and fetal circulating cell-free DNA, angiogenic, and antiangiogenic factors in preeclampsia and HELLP syndrome

dc.contributor.authorMuñoz-Hernández R.
dc.contributor.authorMedrano-Campillo P.
dc.contributor.authorMiranda M.L.
dc.contributor.authorMacher H.C.
dc.contributor.authorPraena-Fernández J.M.
dc.contributor.authorVallejo-Vaz A.J.
dc.contributor.authorDominguez-Simeon M.J.
dc.contributor.authorMoreno-Luna R.
dc.contributor.authorStiefel P.
dc.date.accessioned2020-09-02T22:24:12Z
dc.date.available2020-09-02T22:24:12Z
dc.date.issued2017
dc.identifier10.1093/ajh/hpx024
dc.identifier.citation30, 7, 673-682
dc.identifier.issn08957061
dc.identifier.urihttps://hdl.handle.net/20.500.12728/5535
dc.descriptionBACKGROUND Preeclampsia (PE) is a hypertensive disorder of pregnancy characterized by hypertension and proteinuria. The HELLP syndrome is the most severe form of PE. The aim of the present study was to determine different potential biomarkers that may help us perform an early diagnosis of the disease, assess on the severity of the disease, and/or predict maternal or fetal adverse outcomes. METHODS We measured serum levels of total and fetal circulating cell-free DNA (cfDNA), soluble endoglin, soluble form of vascular endothelial growth factor receptor, and placental growth factor in a healthy control group of pregnant women (n = 26), patients with mild (n = 37) and severe PE (n = 25), and patients with HELLP syndrome (n = 16). RESULTS We observed a gradual and strong relationship between all the biomarkers mentioned and the range of severity of PE, with the highest levels in patients with HELLP syndrome. Nevertheless, only the values of total cfDNA were able to significantly differentiate severe PE and HELLP syndrome (20 957 ± 2 784 vs. 43 184 ± 8 647 GE/ml, P = 0.01). Receiver operating characteristic (ROC) curves were constructed (i) for the healthy group with respect to the groups with PE and (ii) for patients with PE with respect to the group with HELLP syndrome; sensitivity and specificity values at different cutoff levels were calculated in each case. The maximum ROC area under the curve value for PE and HELLP syndrome (with respect to controls) was 0.91 (P < 0.001). CONCLUSIONS The measured biomarkers of cell damage, angiogenesis, and antiangiogenesis may reflect the severity of PE, with higher levels in patients who develop HELLP syndrome. In addition, these biomarkers may also help predict adverse fetal and maternal outcomes. © American Journal of Hypertension, Ltd 2017.
dc.language.isoen
dc.publisherOxford University Press
dc.subjectangiogenic factors
dc.subjectantiangiogenic factors
dc.subjectblood pressure
dc.subjectcell-free DNA
dc.subjectHELLP syndrome
dc.subjecthypertension
dc.subjecthypertension in pregnancy
dc.subjectmaternal-fetal adverse outcomes
dc.subjectpreeclampsia.
dc.subjectangiogenic factor
dc.subjectaspartate aminotransferase
dc.subjectbiological marker
dc.subjectDNA
dc.subjectendoglin
dc.subjectfetal circulating cell free DNA
dc.subjectlactate dehydrogenase
dc.subjectplacental growth factor
dc.subjectunclassified drug
dc.subjectvasculotropin receptor
dc.subjectvasculotropin receptor 1
dc.subjectangiogenic protein
dc.subjectcell free nucleic acid
dc.subjectendoglin
dc.subjectENG protein, human
dc.subjectFLT1 protein, human
dc.subjectPGF protein, human
dc.subjectplacental growth factor
dc.subjectvasculotropin receptor 1
dc.subjectadult
dc.subjectadverse outcome
dc.subjectangiogenesis
dc.subjectArticle
dc.subjectaspartate aminotransferase blood level
dc.subjectblood pressure measurement
dc.subjectblood sampling
dc.subjectcomparative study
dc.subjectcontrolled study
dc.subjectdiastolic blood pressure
dc.subjectdisease severity
dc.subjectearly diagnosis
dc.subjectfemale
dc.subjectfetus circulation
dc.subjectfetus death
dc.subjectfetus outcome
dc.subjectgestational age
dc.subjectHELLP syndrome
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmaternal serum
dc.subjectnewborn
dc.subjectprediction
dc.subjectpreeclampsia
dc.subjectpregnant woman
dc.subjectpriority journal
dc.subjectprotein urine level
dc.subjectreceiver operating characteristic
dc.subjectreference value
dc.subjectsensitivity and specificity
dc.subjectsystolic blood pressure
dc.subjectarea under the curve
dc.subjectblood
dc.subjectcase control study
dc.subjectdifferential diagnosis
dc.subjectgenetics
dc.subjectHELLP syndrome
dc.subjectpredictive value
dc.subjectpreeclampsia
dc.subjectpregnancy
dc.subjectseverity of illness index
dc.subjectthird trimester pregnancy
dc.subjectupregulation
dc.subjectAdult
dc.subjectAngiogenic Proteins
dc.subjectArea Under Curve
dc.subjectCase-Control Studies
dc.subjectCell-Free Nucleic Acids
dc.subjectDiagnosis, Differential
dc.subjectEndoglin
dc.subjectFemale
dc.subjectHELLP Syndrome
dc.subjectHumans
dc.subjectPlacenta Growth Factor
dc.subjectPre-Eclampsia
dc.subjectPredictive Value of Tests
dc.subjectPregnancy
dc.subjectPregnancy Trimester, Third
dc.subjectROC Curve
dc.subjectSeverity of Illness Index
dc.subjectUp-Regulation
dc.subjectVascular Endothelial Growth Factor Receptor-1
dc.titleTotal and fetal circulating cell-free DNA, angiogenic, and antiangiogenic factors in preeclampsia and HELLP syndrome
dc.typeArticle


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