Serum Heat Shock Protein 70 Levels in Pre-Eclampsia and Adverse Pregnancy Outcomes,
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- Category: Vol. 77, September 2009
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Serum Heat Shock Protein 70 Levels in Pre-Eclampsia and Adverse Pregnancy Outcomes, MANAL H. EL-SAID, NAGWA A. MOHAMAD and SOLAF AHMAD
Abstract
Background: Heat shock protein 70 (Hsp 70), a marker of cellular stress, was suggested to be elevated in pregnancies complicated by pre-eclampsia. Adverse pregnancy outcomes (APOs) are a group of common obstetric diseases and many studies have been conducted in an effort to clarify their risk factors.
It is well known that these risk factors can induce the synthesis of a group of highly conserved proteins, called heat shock proteins (Hsps).
Objective: The aim of the study was to measure serum heat shock protein (Hsp)70 in mothers with pre-eclampsia and adverse pregnancy outcomes (APOs) and to evaluate whether it can be applied as a useful indicator for the devel-opment of these conditions.
Study Design: Eighty pregnant women were included in this study (20 pre-eclamptic women, 20 women with threatened preterm labor, 20 women with intrauterine growth restriction and 20 healthy women with non-complicated pregnancy).
After obtaining informed consent, serum samples were collected from all participants to measure Hsp70 levels.
The levels of Hsp 70 were measured using enzyme-linked immunosorbent assay.
Results: Measurement of serum Hsp 70 levels showed statistically higher values among pre-eclamptic patients compared to preterm, Intrauterine growth restriction (IUGR) and control groups (24.6±12.7ng/ml, 15.1±5.4ng/ml, 14.3± 6.1ng/ml, 11.7±4.9ng/ml respectively, p=<0.009). Sensitivity, specificity, positive and negative predictive values and overall accuracy were calculated for serum Hsp 70 in pre-eclamptic mothers and in patients with adverse pregnancy outcomes (Threatened preterm labor, IUGR groups) and our results demonstrated high sensitivity, specificity, positive and negative predictive values and overall accuracy for serum Hsp 70 levels in pre-eclamptic group only (80%, 65%, 69.57%, 76.47%, 72.5% respectively).
Univariate odds ratios (OR) and 95% CI for serum Hsp 70 levels above the optimum cut-off limit (18, 14, 14ng/ml respectively) were calculated between the studied pre-eclamptic, adverse pregnancy outcomes and control groups and demonstrated OR of 7.429, 1.256, 1.000, 95% CI = 1.778-
31.041, 0.334-4.733, 0.259-3.867 for the pre-eclamptic, preterm and IUGR groups respectively.
Also adjusted ORs and 95% CI for serum Hsp 70 above the optimum cut-off limit were calculated between the studied pre-eclamptic, adverse pregnancy outcomes and control groups and demonstrated OR of 5.444, 1.000, 1.333, 95% CI = 1.408- 21.055, 0.212-4.709, 0.300-5.926 respectively for the pre-eclamptic, preterm and IUGR groups.
Conclusion: Serum Hsp 70 levels are elevated in pre-eclamptic women and circulating Hsp 70 may be a useful indicator for the development of pre-eclampsia. However, further studies are needed to explore the underlying mecha-nisms for this elevation and its role in the pathogenesis of hypertensive disorders of pregnancy.