Serum Decorin and Biglycan as Potential Biomarkers to Predict PPROM in Early Gestation
Serum Decorin and Biglycan as Potential Biomarkers to Predict PPROM in Early Gestation
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DOI：
10.1177/1933719119831790
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发表时间：
2020-05-20
影响因子：
2.9
通讯作者：
Lechner, Beatrice
中科院分区：
文献类型：
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作者：
Underhill, Lori A.;Avalos, Nora;Lechner, Beatrice
早产是美国和全球新生儿死亡的主要原因，其中早产胎膜早破（PPROM）占早产的三分之一。目前没有预测性诊断可用于精确评估风险并可能降低PPROM的发病率。Bigycan和核心蛋白聚糖是存在于人类胎膜中的主要蛋白聚糖，它们参与胎膜的生理成熟以及早产的病理生理学。血清性激素结合球蛋白（SHBG）最近被确定为自发性早产的预测因子。我们推测血清核心蛋白聚糖和双糖链蛋白聚糖与SHBG之间的平衡可能有助于了解妊娠早期胎膜的状态，从而在出现症状前预测PPROM。使用病历审查，从2013-2016年确定了18例PPROM确诊病例。从冷冻库中取出这些病例的孕中期残留血清，沿着，每例病例有5个匹配的对照。首先分别分析生物标志物双糖链蛋白聚糖、核心蛋白聚糖和SHBG，然后组合分析以确定它们预测PPROM的能力。组合模型的预测评分显示AUC = 0.774。预测评分的ROC曲线的最佳阈值为0.238，敏感性和特异性分别为0.72和0.84。产前血清检测是一个有前途的血清筛查为基础的生化模型，预测PPROM的无症状妇女。
Preterm birth is a leading cause of neonatal mortality in the US and globally, with preterm premature rupture of fetal membranes (PPROM) accounting for one third of preterm births. Currently no predictive diagnostics are available to precisely assess risk and potentially reduce the incidence of PPROM. Bigycan and decorin, the main proteoglycans present in human fetal membranes, are involved in the physiological maturation of fetal membranes as well as in the pathophysiology of preterm birth. The serum protein sex hormone-binding globulin (SHBG) has recently been identified as a predictor of spontaneous preterm birth. We hypothesize that the balance between serum decorin and biglycan on one hand and SHBG on the other hand may provide insight into the status of the fetal membranes in early pregnancy, thereby predicting PPROM prior to symptoms. Using chart review, 18 patients with confirmed cases of PPROM were identified from 2013-2016. Second trimester residual serum was retreived from freezer storage for these cases along with 5 matched controls for each case. The biomarkers biglycan, decorin and SHBG were analyzed first separately, then in combination to determine their ability to predict PPROM. The predictive score for the combined model displays an AUC = 0.774. The ROC curve of the predicted score has an optimal threshold of 0.238 and a sensitivity and specificity of 0.72 and 0.84 respectively. This prenatal serum panel is a promising serum screening-based biochemical model to predict PPROM in asymptomatic women.