Supervisors info:
Αναπληρωτής Καθηγητής Ρίζος Δημήτριος (επιβλέπων), Αναπληρωτής Καθηγητής Μαστοράκος Γεώργιος, Επίκουρος Καθηγητής Πανουλής Κωνσταντίνος
Summary:
Aim of the study: Preeclampsia is a systematic disease of pregnancy
characterized by hypertension and proteinouria developing after 20th week of
pregnancy. Several new studies have shown that the concentration levels of
circulating NGAL are seriously altered in preeclamptic pregnancies and their
measurement in maternal serum may be useful in screening and/or diagnosis of
patients at high risk of developing preeclampsia. The purpose of our study was
to explore the role of NGAL and its complex with MMP-9 in the prevention, early
diagnosis of the syndrome and its evaluation as a specific diagnostic marker to
determine the maternal health and the neonatal outcome.
Patients and Methods: In 52 pregnant women [32 normal, 10 pregnancies that
developed preeclampsia and 10 with SGA (small for gestational age) infants] we
determined the concentrations of NGAL and MMP-9/NGAL complex in serum samples
drawn in the first (11+1 to 13+6 weeks), second ( 20+1 to 24+0 weeks) and third
(28+1 – 34+0 weeks) trimester of pregnancy. Concentrations of NGAL and
MMP-9/NGAL complex were determined with commercially available kits: Human
Lipocalin-2/NGAL Quantikine ELISA Kit and Human MMP-9/NGAL Complex Quantikine
ELISA Kit, R&D SYSTEMS.
Results: Mean concentrations of NGAL in normal pregnancies were: 18,93 ±16,8;
29,86±20,1; 55,63±37,7 ng/mL in the three trimesters respectively. NGAL
concentrations in pregnancies that developed preeclampsia were significantly
different from normal in the 1st and 2nd trimester but not in the 3rd,
(35,31±18,3/p=0,005; 51,80±28,2/ρ=0,014; 90,57±60,4 ng/mL/p=0,184) in the three
trimesters respectively. On the contrary, women with SGA infants had no
significantly different NGAL concentrations in each trimester compared to
normals or pre-eclamptic pregnancies (25,54±26,9; 1st trim; 34,82±31,0; 2nd
trim; 43,30±33,4; 3rd trim). MMP-9/NGAL concentrations in pregnancies that
developed preeclampsia didn’t differ significantly among the three groups of
pregnancies in any trimester. There was no correlation between NGAL in normal
pregnancies and the birth weight of the newborn.
Conclusion: According to our findings concentration of NGAL in normal
pregnancies was significantly different among the three trimesters increasing
as the pregnancy develops. In pregnancies that developed preeclampsia,
statistically significant difference in NGAL concentration was found between
1st and 3rd trimesters. The most important finding of our study is the fact
that NGAL levels in pregnancies with pre-eclampsia were significantly different
than those in normal pregnancies in the 1st and 2nd but not in the 3rd
trimester (P=0,005 for 1st trim; P=0,014 for 2nd trim; P=0,184 for 3rd trim).
Finally MMP-9/NGAL concentrations in pregnancies that developed preeclampsia
didn’t differ significantly from concentrations in normal or pregnancies with
SGA infants in any trimester.
Keywords:
Preeclampsia, Pregnancy, Lipocalin-2 (NGAL), Matrix Metalloproteinase 9 (MMP-9), SGA
