Affiliations: Department of Biochemistry, Genetic Engineering and
Biotechnology Research Division, National Research Center, Dokki, Giza,
Egypt | Department of Clinical pathology, Faculty of Medicine,
Ain Shams University, Cairo, Egypt | Department of Obstetrics and Gynecology, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
Note: [] Corresponding author: Associate Prof. Dr. Menha Swellam,
Biochemistry Department, Genetic Engineering and Biotechnology Research
Division, National Research Center, Tahrir Street, Dokki, Giza, 12311, Egypt.
Tel.: +20 23335451; Fax: +20 23370931; E-mail: menha_m_swellam@yahoo.com
Abstract: Objectives: Endothelial disturbance and excess inflammatory response
are pathogenic mechanisms in pre-eclampsia (PE). Authors determine the clinical
diagnostic role for thrombomodulin (TM), plasminogen activator inhibitor-1
(PAI-1) as endothelial markers and C-reactive protein (CRP), and interlukin-6
(IL-6) as inflammatory markers when tested independently or in combinations.
Materials and methods: We conducted a retrospective study in a
cohort of 185 women grouped as 80 women with PE, 55 normotensive pregnant and
50 healthy non-pregnant. Plasma levels of TM, PAI-1, CRP and IL-6 were examined
using enzyme linked immunosorbent assays. Results: Median levels and the positivity rates for the investigated
markers were higher in PE as compared to the other groups (P < 0.0001).
Using linear regression analysis, the investigated markers were significantly
correlated regarding healthy non-pregnant vs PE or normotensive pregnant vs PE.
The sensitivity of PAI-1 was the highest (98%) among the tested biomarkers.
Combination between the investigated markers revealed absolute sensitivity
(100%) and reliable specificity especially when PAI-1 was combined with CRP at
83% specificity. Conclusions: Investigated endothelial and inflammatory markers
revealed sensitive diagnostic test for PE. However, coupled combination between
PAI-1 with CRP showed superior both sensitivity and specificity which represent
a promising new approach for detection of PE.
