Plasma SST2 And Angiogenesis/Anti-angiogenesis Exploratory Factors In The Application Of Preeclampsia

[Background]Preeclampsia is associated with pregnancy can cause multiple system lesions of clinical disease. Worldwide incidence of 2% to 5%, is a maternal and perinatal morbidity and mortality one of the important reasons.In recent years, the incidence of preeclampsia has significantly increased over the past ten years, this may inducing factors of incidence of a disease has increased with are closely related, such as maternal age 35 years of age, or at the beginning of the prenatal BMI,35 kg/m2 or chronic high blood pressure, diabetes, etc.^Preeclampsia pathogenesis is not very clear, because the disease often quickly ease or after the placenta can self-healing, some scholars called it a "placenta disease".Recently, some scholars have put forward hypothesis, due to changes in immune response during pregnancy can cause abnormal placenta and extensive vascular endothelial damage.On the other hand, the vascular endothelial injury and can cause a variety of cytokines and growth factors of exponential growth, and the clinical manifestations of preeclampsia main.In recent years, has been studied using angiogenesis factor (such as VEGF, PLGF and TGF-B) and anti-angiogenesis factors (such as sFlt-1 and sEng) prediction and diagnosis of preeclampsia, but not all of the patients with preeclampsia can be determined by these markers, so you need to continue to seek additional biomarkers.Soluble ST2 form (sST2), can be combined with interleukin (IL)-33 proteins, thereby promoting Thl immune response, has been reported in preeclampsia matrix is higher in plasma.This article is mainly about the sST2 and angiogenesis/anti-angiogenesis factor correlation studies in preeclampsia.[Objective](1) plasma sST2 differences in normal pregnancy group and experimental group(2) plasma sST2 and sEng, sFlt-1, PLGF in preeclampsia(3) plasma, sEng, sST2 and sFlt-1 PLGF correlation analysis in preeclampsia.[Method]According to the diagnostic criteria for 51 patients with preeclampsia preeclampsia, and select the healthy pregnant women without pregnancy complications and complications 34 cases as control group.Collection of preeclampsia and normal pregnancy group elbow venous blood 4 ml, then 3000 RPM centrifugal 10 minutes, drain upper plasma inserted in EP, sealed to -80℃ refrigerator save, using enzyme-linked immunosorbent assay (ELISA) method to detect preeclampsia and normal pregnancy group pregnant women blood sST2, sEng, sFlt-1 and the concentration of PLGF.Use Microsoft office Excel 2003 establishing database of all the research object, using SPSS 19.0 statistical analysis, the various indicators compared between any two groups of pregnant women using t test, correlation between any two variables inspection using Pearson correlation analysis, with p< 0.05 for the difference was statistically significant.[Result]1.SST2 concentration in plasma:1. Subjects sST2 in preeclampsia patients plasma concentration is higher than normal pregnancy women (78.21+/-0.56 ng/mL and 28.27+/-1.020 ng/mL, p< 0.0001), and patients with severe preeclampsia sST2 concentration in plasma is significantly higher than mild preeclampsia (91.82+/-0.67 ng/mL and 53.39+/-1.23 ng/mL, p< 0.01), late onset severe preeclampsia is higher than early hairstyle severe preeclampsia (93.7450.43+/-1.32/mL, p< 0.01).2. The plasma concentrations of sEng:participants sEng in preeclampsia patients plasma concentration is higher than normal pregnancy women (4.95+/-1.21 ng/mL and 2.16+/-0.52 ng/mL, p< 0.0001), and severe preeclampsia patients plasma concentrations of sEng is significantly higher than mild preeclampsia (+/-1.23 ng/mL and 5.19 (3.89+/-0.62 ng/mL, p< 0.01), early hairstyle severe preeclampsia is higher than late onset severe preeclampsia (5.87+/-1.02 ng/mL and 4.54+/-0.42 ng/mL, p < 0.01), the difference had statistical significance.3. The subjects sFlt-1 in plasma concentration:preeclampsia group sFlt-1 in plasma concentration higher than in normal pregnancy group (354.12+/-182.38 pg/mL and 82.42+/-36.57 pg/mL, p< 0.0001), and severe preeclampsia patients sFlt-1 in plasma concentration is significantly higher than mild preeclampsia (396.32+/-165.30 pg/mL and 264.32+/-152.45) pg/mL, p< 0.01), early hairstyle severe preeclampsia is higher than late onset severe preeclampsia (421.75+/-230.47/mL and 230.47+/-98.48 pg/mL, p< 0.01), the difference was statistically significant,4. Participants PLGF concentration in plasma:normal pregnancy PLGF in plasma concentration higher than that of preeclampsia group (332.16+/-108.86 pg/mL and 189.72+/-62.31 pg/mL, p< 0.0001), patients with severe preeclampsia PLGF in plasma concentration is significantly higher than mild preeclampsia (average 207.82+/-91.32 pg/mL and 207.82+/-48.37) pg/mL, p< 0.01), early hairstyle severe preeclampsia is higher than late onset severe preeclampsia (162.21+/-82.12 pg/mL and 82.12+/-62.14 pg/mL, p< 0.01), the difference was statistically significant.5. A single specific biomarkers sFlt-173%, sensitivity 92%, AUC 0.914;SEng specificity 82%, sensitivity 96%, AUC 0.945, and the composite factor sEng/PLGF specificity 92%, sensitivity 95%, AUC 0.962;SFlt-1* sEng/PLGF specificity 91%, sensitivity 93%, AUC 0.967.6.SST2 in group PE patients plasma and sFlt-1, sEng has significant positive correlation (r=0.67,0.73, p< 0.01), sST2 and PLGF were significantly negative correlation (r=0.61, p< 0.01).[Conclusion](1) Patients with preeclampsia sST2 concentration can be detected in blood circulation, the rise of preeclampsia patients is higher than normal pregnant women, pregnancy and severe preeclampsia is higher than mild preeclampsia;At 34 weeks’gestation> diagnostic value is greater than the pregnancy< 34 weeks.SST2 concentration increases in plasma for preeclampsia prediction has important clinical significance.(2) Angiogenesis/anti-angiogenesis factors can early to predict preeclampsia, but its 34 weeks after diagnosis of preeclampsia is lower than the sST2 performance.A single biomarkers has important clinical significance to predict preeclampsia, combined use of angiogenesis//PLGF anti-angiogenesis factors such as sFlt-1,1* sEng sEng/PLGF and sFlt-/PLGF ratio can improve the prediction accuracy of preeclampsia.(3)The sST2 in preeclampsia patients plasma and sFlt-1, sEng was significantly positively related, sST2 and PLGF has significant negative correlation.