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Exp Clin Endocrinol Diabetes 2019; 127(09): 585-589
DOI: 10.1055/a-0777-2090
Article
© Georg Thieme Verlag KG Stuttgart · New York

Biomarkers in Non-Complicated Pregnancy: Insights About Serum Myeloperoxidase and Ultrasensitive C-Reactive Protein

Danielle C. Kalva-Borato
1   Department of Clinical and Toxicological Analysis, State University of Ponta Grossa – UEPG, Uvaranas Campus, Ponta Grossa – PR, Brazil
,
Josilaine Tonin Ribas
1   Department of Clinical and Toxicological Analysis, State University of Ponta Grossa – UEPG, Uvaranas Campus, Ponta Grossa – PR, Brazil
,
Gisele Chibinski Parabocz
1   Department of Clinical and Toxicological Analysis, State University of Ponta Grossa – UEPG, Uvaranas Campus, Ponta Grossa – PR, Brazil
,
Luciana Maria Borba
1   Department of Clinical and Toxicological Analysis, State University of Ponta Grossa – UEPG, Uvaranas Campus, Ponta Grossa – PR, Brazil
,
Margarete Aparecida Salina Maciel
1   Department of Clinical and Toxicological Analysis, State University of Ponta Grossa – UEPG, Uvaranas Campus, Ponta Grossa – PR, Brazil
,
Fabio André dos Santos
2   Department of Dentistry, State University of Ponta Grossa – UEPG, Uvaranas Campus, Ponta Grossa – PR, Brazil
,
José Carlos Rebuglio Vellosa
1   Department of Clinical and Toxicological Analysis, State University of Ponta Grossa – UEPG, Uvaranas Campus, Ponta Grossa – PR, Brazil
› Author Affiliations
Further Information

Publication History

received 04 August 2018
revised 11 October 2018

accepted 26 October 2018

Publication Date:
23 November 2018 (online)

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Abstract

Introduction Pregnancy is characterized by increased innate immune response, with low-grade systemic inflammation. The specific role of MPO during normal pregnancy remains not well understood. Therefore, the aim of this study was to evaluate plasma levels of MPO, hs-CRP, total leukocyte, absolute neutrophil and monocyte counts, in all trimesters of normal human pregnancy compared with non-pregnant controls. In addition, possible fluctuations of MPO according to different inflammatory conditions in the normal gestation were studied.

Materials and methods Case-control study (n=84) developed with 63 normal pregnant women and 21 healthy non-pregnant women. Total leukocyte, absolute neutrophils and absolute monocytes count, hs-CRP and MPO were measured in non-pregnant women and normal human pregnancy. They were evaluated according to the 3 trimesters of pregnancy and systemic low grade inflammatory status, which was identified through increased hs-CRP levels.

Results MPO levels in the normal pregnant women were not elevated in every 3 trimesters of pregnancy (P=0.456) or in systemic inflammation (P=0.446). The hs-CRP levels, total leukocyte, absolute neutrophil and monocyte counts are present in higher concentrations in normal pregnant women in relation to non-pregnant women.

Conclusions The MPO did not show fluctuations in plasma levels during the 3 trimesters of gestation or in relation to different inflammation conditions. Considering MPO and hs-CRP levels are changed in high cardiovascular risk conditions and MPO levels (unlike hs-CRP) didn’t increase during non complicated pregnancy, MPO could be a better biomarker than hs-CRP to monitor these patients.

Key words

MPO - hs-CRP - biomarkers - human gestation - case-control study
 

  • References

  • 1 Adar T, Grisaru-Granovsky S, Ben Ya’acov A. et al. Pregnancy and the Immune System: General overview and the gastroenterological perspective. Dig Dis Sci 2015; 60: 2581-2589
    CrossrefPubMedGoogle Scholar
  • 2 Challis JR, Lockwood CJ, Myatt L. et al. Inflammation and pregnancy. In: Reproductive Sciences. 2009; 206-215
    PubMedGoogle Scholar
  • 3 Ernst GDS, De Jonge LL, Hofman A. et al. C-reactive protein levels in early pregnancy, fetal growth patterns, and the risk for neonatal complications: The generation R study. Am J Obstet Gynecol 2011; 205: 132.e1-12
    CrossrefPubMedGoogle Scholar
  • 4 Luppi P, Haluszczak C, Betters D. et al. Monocytes are progressively activated in the circulation of pregnant women. J Leukoc Biol 2002; 72: 874-884
    PubMedGoogle Scholar
  • 5 Belo L, Santos-Silva A, Rocha S. et al. Fluctuations in C-reactive protein concentration and neutrophil activation during normal human pregnancy. Eur J Obstet Gynecol Reprod Biol 2005; 123: 46-51
    CrossrefPubMedGoogle Scholar
  • 6 Tjoa ML, Van Vugt JMG, Go ATJJ. et al. Elevated C-reactive protein levels during first trimester of pregnancy are indicative of preeclampsia and intrauterine growth restriction. J Reprod Immunol 2003; 59: 29-37
    CrossrefPubMedGoogle Scholar
  • 7 Rebelo I, Carvalho-Guerra F, Pereira-Leite L. et al. Lactoferrin as a sensitive blood marker of neutrophil activation in normal pregnancies. Eur J Obstet Gynecol 1995; 62: 189-194
    CrossrefPubMedGoogle Scholar
  • 8 Nicholls SJ, Hazen SL. Myeloperoxidase, modified lipoproteins, and atherogenesis. J Lipid Res 2009; 50: S346-S351
    CrossrefPubMedGoogle Scholar
  • 9 Hung TH, Chen SF, Lo LM. et al. Myeloperoxidase in the plasma and placenta of normal pregnant women and women with pregnancies complicated by preeclampsia and intrauterine growth restriction. Placenta 2012; 33: 294-303
    CrossrefPubMedGoogle Scholar
  • 10 Teran E, Escudero C, Moya W. et al. Elevated C-reactive protein and pro-inflammatory cytokines in Andean women with pre-eclampsia. Int J Gynecol Obstet 2001; 75: 243-249
    CrossrefPubMedGoogle Scholar
  • 11 Cohen Y, Ascher-Landsberg J, Cohen A. et al. The role of C-reactive protein measurement as a diagnostic aid in early pregnancy. Eur J Obstet Gynecol Reprod Biol 2014; 176: 64-67
    CrossrefPubMedGoogle Scholar
  • 12 Hwang HS, Kwon JY, Kim MA. et al. Maternal serum highly sensitive C-reactive protein in normal pregnancy and pre-eclampsia. Int J Gynecol Obstet 2007; 98: 105-109
    CrossrefPubMedGoogle Scholar
  • 13 Kashanian M, Aghbali F, Mahali N. Evaluation of the diagnostic value of the first-trimester maternal serum high-sensitivity C-reactive protein level for prediction of pre-eclampsia. J Obstet Gynaecol Res 2013; 39: 1549-1554
    CrossrefPubMedGoogle Scholar
  • 14 Haedersdal S, Salvig JD, Aabye M. et al. Inflammatory markers in the second trimester prior to clinical onset of preeclampsia, intrauterine growth restriction, and spontaneous preterm birth. Inflammation 2013; 36: 907-913
    CrossrefPubMedGoogle Scholar
  • 15 Ertas IE, Kahyaoglu S, Yilmaz B. et al. Association of maternal serum high sensitive C-reactive protein level with body mass index and severity of pre-eclampsia at third trimester. J Obstet Gynaecol Res 2010; 36: 970-977
    CrossrefPubMedGoogle Scholar
  • 16 Deveci K, Sogut E, Evliyaoglu O. et al. Pregnancy-associated plasma protein-A and C-reactive protein levels in pre-eclamptic and normotensive pregnant women at third trimester. J Obstet Gynaecol Res 2009; 35: 94-98
    CrossrefPubMedGoogle Scholar
  • 17 Belo L, Santos-Silva A, Caslake M. et al. Neutrophil activation and c-reactive protein concentration in preeclampsia. Hypertens Pregnancy 2003; 22: 129-141
    CrossrefPubMedGoogle Scholar
  • 18 Üstün Y, Engin-Üstün Y, Kamaci M. Association of fibrinogen and C-reactive protein with severity of preeclampsia. Eur J Obstet Gynecol Reprod Biol 2005; 121: 154-158
    CrossrefPubMedGoogle Scholar
  • 19 Malek A, Bersinger NA, Di Santo S. et al. C-reactive protein production in term human placental tissue. Placenta 2006; 27: 619-625
    CrossrefPubMedGoogle Scholar
  • 20 Lurie S, Rahamim E, Piper I. et al. Total and differential leukocyte counts percentiles in normal pregnancy. Eur J Obstet Gynecol Reprod Biol 2008; 136: 16-19
    CrossrefPubMedGoogle Scholar
  • 21 von Dadelszen P, Watson RW, Noorwali F. et al. Maternal neutrophil apoptosis in normal pregnancy, preeclampsia, and normotensive intrauterine growth restriction. Am J Obstet Gynecol 1999; 181: 408-414
    CrossrefPubMedGoogle Scholar
  • 22 Crocker IP, Wellings RP, Fletcher J. et al. Neutrophil function in women with pre-eclampsia. Br J Obstet Gynaecol 1999; 106: 822-828
    CrossrefPubMedGoogle Scholar
  • 23 Gandley RE, Rohland J, Zhou Y. et al. Increased myeloperoxidase in the placenta and circulation of women with preeclampsia. Hypertension 2008; 52: 387-393
    CrossrefPubMedGoogle Scholar
  • 24 Kindzelskii AL, Clark AJ, Espinoza J. et al. Myeloperoxidase accumulates at the neutrophil surface and enhances cell metabolism and oxidant release during pregnancy. Eur J Immunol 2006; 36: 1619-1628
    CrossrefPubMedGoogle Scholar
  • 25 Shukla J, Walsh SW. Neutrophil release of myeloperoxidase in systemic vasculature of obese women may put them at risk for preeclampsia. Reprod Sci 2015; 22: 300-307
    CrossrefPubMedGoogle Scholar
  • 26 Matos A, Pereira da Silva A, Clara Bicho M. et al. In Women with previous pregnancy hypertension, levels of cardiovascular risk biomarkers may be modulated by haptoglobin polymorphism. Obstet Gynecol Int 2014; 2014: 1-10
    PubMedGoogle Scholar
  • 27 Rocha-Penha L, Caldeira-Dias M, Tanus-Santos JE. et al. Myeloperoxidase in hypertensive disorders of pregnancy and its relation with nitric oxidenovelty and significance. Hypertension 2017; 69: 1173-1180
    CrossrefPubMedGoogle Scholar