| Project/Area Number |
20791169
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Obstetrics and gynecology
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| Research Institution | Showa University |
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Principal Investigator |
SHIHO Yoshimura Showa University, 医学部, 普通研究生 (50384441)
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| Co-Investigator(Renkei-kenkyūsha) |
AKIHIKO Sekizawa 昭和大学, 医学部・産婦人科学教室, 准教授 (10245839)
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| Project Period (FY) |
2008 – 2009
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| Project Status |
Completed (Fiscal Year 2009)
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| Budget Amount *help |
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2009: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2008: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
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| Keywords | 癒着胎盤 / 母体血 / RNA / 妊娠高血圧症候群 / cell-free RNA / cellular RNA / 胎盤機能 / 血漿RNA / 大量出血 / 発症予知 |
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| Research Abstract |
To develop the strategy predicting the invasive placenta, we have been collecting over 660 blood samples. However, since nobody have complicated with invasive placenta in the cases, we could not assess the predictive markers for invasive placenta. Therefore, we employed to predict the preeclampsia. The objective of this study is to predict occurrence of preeclampsia in a series of patients at gestational week 15-20 using a panel of cell-free or cellular mRNA markers. Data from 62 preeclamptic patients asymptomatic at the time of blood testing and 310 controls were analyzed. Multivariable analysis was performed using discriminant analysis. In the analysis of cell-free RNA, univariable analysis identified vascular endothelial growth factor receptor 1 (FLT1) as the marker with the highest detection rate, and placenta-specific-1 with the lowest. Mean estimated score for preeclampsia was 9.4 for controls and 72.5 for subjects who developed preeclampsia. An ROC curve obtained using the estimated score for preeclampsia as test variable yielded a DR of 84% (95%CI 71.8-91.5) at a 5% false-positive rate with an area under the curve of 0.927 (p<0.001). Again, DR and score for each patient for classification as preeclamptic correlated with severity. Next, in the cellular RNA analysis, the univariate ROC analysis identified soluble Flt-1 and endoglin as the markers with the highest sensitivity. The best multivariable model was obtained by combining Flt-1, Endoglin, placenta growth factor (PlGF) and parity. The relative ROC curve yielded a sensitivity of 66% at a 10% 1-specificity rate with an area under the curve of 0.884 (p<0.001). In conclusion, a panel of cell-free or cellular mRNA is able to detect subjects who will develop preeclampsia.
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