Precision Biomarkers of pre-eclampsia

先兆子痫是一种妊娠期高血压疾病，每年夺去数千名母亲和婴儿的生命。它是全世界产妇和胎儿发病和死亡的主要原因。先兆子痫没有治愈方法，但从最早的妊娠期开始就保持严格的血压控制，同时经常进行医学检查以确定疾病的进展，可以及时分娩，以获得母亲和婴儿的最佳结果。此外，最近发现的阿司匹林治疗前16周，以防止疾病的发展清楚地表明，需要进行尖锐试验，以预测哪些患者最有可能在怀孕期间发展先兆子痫。目前寻求识别未来先兆子痫风险患者的方法是基于母体风险因素。人们对检测母体循环中的预测性生物标志物越来越感兴趣，所述生物标志物从受先兆子痫影响的器官（胎盘或母体内皮）释放为“痛苦信号”。最近的NICE指南鼓励使用可溶性Flt 1（sFlt 1）和胎盘生长因子（PlGF）在有症状的孕妇的调查。NHS临床实验室服务最近采用了这些指南，提供了从妊娠中获得有价值的回顾性真实的血清样本的途径，这些样本具有明确的结局。该项目将提供探索其他有前途的生物标志物的附加值的机会，并使学生能够发展从实验室方法到生物标志物性能和回归建模开发的翻译生物标志物研究的广泛技能。该项目还将侧重于研究了解这些生物标志物可能有助于疾病发病机制的机制-这是更好地了解潜在病理生理学的关键;这一部分将提供发展胎盘生物学和疾病分子基础的尖端技能的机会。

Preeclampsia is a hypertensive disorder of pregnancy which claims the lives of thousands of mothers and babies every year. It is the major cause of both maternal and fetal morbidity and mortality worldwide. There is no cure for preeclampsia but maintaining tight blood pressure control from the earliest possible gestation, alongside frequent medical reviews to identify progression of the disease, allows timely delivery to obtain the best outcome for both mum and baby. Further, the recently discovered benefits of aspirin therapy before 16 weeks to prevent the development of the disease clearly demonstrates the need for acurate test to predict which patients are most likely to develop preeclampsia in their pregnancy. The current means sought to identify patients at risk of future preeclampsia is based on maternal risk factors. there is growing interest in detecting predictive biomarkers in the maternal circulation that are released as 'distress signals' from organs affected by pre-eclampsia: the placenta or the maternal endothelium. Recent NICE guidelines encourage the use of soluble Flt1 (sFlt1) and placental growth factor (PlGF) in the investigation of symptomatic pregnant women. Recent adoption by NHS clinical laboratory services of these guidlines, offers access to valuable retrospective real world serum samples from pregnancies with clearly defined outcomes. This project will offer the opportunity to explore added value of additional promising biomarkers and enable the student to develop a wide range of skills in translational biomarker research from laboratory methods to biomarker performance and development of regression modelling. The project will also focus on investigations toward understanding the mechanisms by which such biomarkers may contribute to disease pathogenesis - which is key in allowing better understanding of the underlying pathophysiology; this part will offer the opportunity to develop cutting edge skills in placental biology and molecular basis of disease.