Abstract
Introduction: Tau, Neurofilament Light chain (NfL), S100B and Neuron Specific Enolase (NSE) are peripheral biomarkers of central nervous system injury. Women with preeclampsia suffer from an endothelial cell injury and might have an altered blood brain barrier which can be the underlying cause of eclampsia. Cognition and cortex volume are affected in women months to years after previous preeclampsia. No reliable predictors exist to predict eclampsia or longterm prognosis after preeclampsia.
Objectives: The primary aim of this study was to compare plasma levels of tau and NfL in healthy pregnant women and in women developing preeclampsia. The secondary aim was to investigate if plasma levels of tau, NfL, S100B and NSE could predict preeclampsia before onset of disease.
Methods: 469 healthy pregnant women were enrolled and plasma samples were collected at gestational weeks 10, 25, 28, 33 and 37. A nested case control study was performed where plasma concentrations of tau and NfL were analyzed in 16 women with preeclampsia and 36 randomly selected controls throughout pregnancy with single molecule array (Simoa) method. S100B and NSE have previously been analyzed in the same population. A predictive model with the four cerebral biomarkers for prediction of preeclampsia was constructed.
Results: Median time for diagnosis of preeclampsia was at 38 weeks of gestation. Plasma concentrations of NfL were significantly increased in women who developed preeclampsia in gestational week 33 and 37 (Fig. 1) and for tau in gestational week 37 (Fig. 2) in contrast to healthy controls. A predictive model for preeclampsia with tau, NfL, S100B and NSE in gestational 25 had an AUC of 0.77 (0.61–0.93), in week 28 AUC was 0.75 (0.56–0.95), in week 33 AUC was 0.89 (0.73–1.00) and in week 37 AUC was 0.83 (0.66–1.00).
Conclusions: Plasma concentrations of both tau and NfL are increased in the end of pregnancy in women developing preeclampsia in contrast to healthy pregnancies and cerebral biomarkers might predict preeclampsia 13 weeks before median time of diagnosis. Pathophysiological processes causing preeclampsia lead to endothelial injury and possibly blood brain barrier compromise alone or in combination with neuronal and glial damage very early in the course of disease.
Objectives: The primary aim of this study was to compare plasma levels of tau and NfL in healthy pregnant women and in women developing preeclampsia. The secondary aim was to investigate if plasma levels of tau, NfL, S100B and NSE could predict preeclampsia before onset of disease.
Methods: 469 healthy pregnant women were enrolled and plasma samples were collected at gestational weeks 10, 25, 28, 33 and 37. A nested case control study was performed where plasma concentrations of tau and NfL were analyzed in 16 women with preeclampsia and 36 randomly selected controls throughout pregnancy with single molecule array (Simoa) method. S100B and NSE have previously been analyzed in the same population. A predictive model with the four cerebral biomarkers for prediction of preeclampsia was constructed.
Results: Median time for diagnosis of preeclampsia was at 38 weeks of gestation. Plasma concentrations of NfL were significantly increased in women who developed preeclampsia in gestational week 33 and 37 (Fig. 1) and for tau in gestational week 37 (Fig. 2) in contrast to healthy controls. A predictive model for preeclampsia with tau, NfL, S100B and NSE in gestational 25 had an AUC of 0.77 (0.61–0.93), in week 28 AUC was 0.75 (0.56–0.95), in week 33 AUC was 0.89 (0.73–1.00) and in week 37 AUC was 0.83 (0.66–1.00).
Conclusions: Plasma concentrations of both tau and NfL are increased in the end of pregnancy in women developing preeclampsia in contrast to healthy pregnancies and cerebral biomarkers might predict preeclampsia 13 weeks before median time of diagnosis. Pathophysiological processes causing preeclampsia lead to endothelial injury and possibly blood brain barrier compromise alone or in combination with neuronal and glial damage very early in the course of disease.
| Original language | English |
|---|---|
| Pages (from-to) | 40-41 |
| Number of pages | 2 |
| Journal | Pregnancy Hypertension |
| Volume | 9 |
| DOIs | |
| Publication status | E-pub ahead of print - 12 Aug 2017 |