Comparison of maternal serum total activin A and inhibin A in normal, preeclamptic, and nonproteinuric gestationally hypertensive pregnancies

Silver, Helayne M.; Lambert-Messerlian, Geralyn; Star, Jami; Hogan, Joseph W.; Canick, Jacob A.

doi:10.1016/s0002-9378(99)70606-x

Cited by 89 publications

(44 citation statements)

References 11 publications

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“…Several recent studies have shown that maternal serum activin A levels are significantly elevated in women with established preeclampsia (Muttukrishna et al 1997, 2000a, Silver et al 1999. It is also accepted that the placenta is the major source of circulating activin in normal pregnancy (Wallace & Healy 1996).…”

Section: Discussionmentioning

confidence: 99%

Activin A and activin receptors in gestational tissue from preeclamptic pregnancies

Manuelpillai

Schneider-Kolsky

Dole

et al. 2001

Journal of Endocrinology

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Maternal serum activin A levels are elevated in women with preeclampsia. To explore whether this could be due, at least in part, to increased production by the gestational tissues, we have measured activin A in the serum of women with (n=23) or without preeclampsia (n=62) at 29-40 weeks of gestation and in placenta and fetal membranes from preterm preeclamptic (PT-PE, n=8), term preeclamptic (T-PE, n=10) and healthy term controls (T-C, n=10). We have also explored if there are associated changes in activin receptor Alk2, ActRII and ActRIIB in these tissues. The relative amounts of receptor proteins were measured by densitometry on Western blots and receptors and activin A subunit localised by immunohistochemistry in PT-PE, T-PE and T-C gestational tissues (n=8-10/group).Maternal serum activin A levels were significantly elevated in women with preeclampsia (multiples of the normal median (MoM)=3·5, P<0·0001, Mann-Whitney U test) compared with healthy women (median MoM=1·0). Compared with control tissues, the activin A content was significantly higher in preeclamptic placentae (P=0·001 and P=0·0005 for PT-PE and T-PE respectively, Mann-Whitney U test), but significantly lower in the amnion (P=0·005 and P=0·014 for PT-PE and T-PE respectively) and choriodecidua (P=0·009 for T-PE). The maternal serum activin A level in women with preeclampsia was significantly correlated with elevated placental production (P=0·01, Pearson's correlation). Receptor Alk2 protein levels were significantly elevated in T-PE placentae (P=0·0006, Mann-Whitney U test), ActRIIB levels were significantly lower in PT-PE placentae (P=0·01) and ActRII levels were significantly lower in PT-PE choriodecidua (P=0·0002) compared with controls. There were no apparent differences in the distribution of the A subunit and receptors Alk2, ActRII and ActRIIB between control and preeclamptic tissues.These findings suggest that elevated levels of activin A in the maternal circulation in association with preeclampsia are due, at least in part, to increased placental production, and that the regulation of activin synthesis in placenta and fetal membranes is differentially regulated. Further, the differences in activin receptor protein levels between preeclamptic and control placenta and choriodecidua suggest that activin A-induced regulation may be altered in preeclampsia.

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Section: Discussionmentioning

confidence: 99%

Activin A and activin receptors in gestational tissue from preeclamptic pregnancies

Manuelpillai

Schneider-Kolsky

Dole

et al. 2001

Journal of Endocrinology

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“…Inhibin A participates in the regulation of cell growth and differentiation in the placenta, and levels of maternal serum alpha-fetoprotein (MSAFP), maternal serum human chorionic gonadotrophin (hCG), and low uE 3 are associated with placental permeability and placentation. Despite many studies on the relationships between serum markers and preeclampsia, these markers have not achieved sufficient predictive value to be used alone for the screening of preeclampsia [7,8] .…”

Section: Introductionmentioning

confidence: 99%

Early Detection of Preeclampsia Using Inhibin A and Other Second-Trimester Serum Markers

Ree¹,

Hahn²,

Chang³

et al. 2011

Fetal Diagn Ther

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Objective: The purpose of this study was to determine whether second-trimester maternal serum markers including inhibin A are useful for the detection of preeclampsia. Methods: Between January 2005 and March 2009, we analyzed the data of 4,764 subjects who underwent second-trimester multiple-marker screening for Down syndrome. Serum samples were assayed at 15+0 to 20+6 weeks for maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotrophin (hCG), unconjugated estriol (uE₃) and inhibin A. We reviewed all medical records retrospectively, and assessed the relationships of several markers with preeclampsia using logistic regression analysis. Results: The study sample included 41 patients who developed preeclampsia and a control group consisting of the other 4,723 healthy subjects treated between January 2005 and March 2009. There were no significant differences in gestational ages at blood sampling, maternal weights, gravidity and parity between the two groups. However, the mean ages, Apgar scores, gestational age at delivery and neonatal weights were significantly different between the study group and the control group. The levels of markers in the study group were significantly increased compared to the control group, 1.76 ± 2.68 for inhibin A, 1.18 ± 0.69 for MSAFP, and 1.62 ± 1.18 for hCG, but uE₃ did not differ significantly between the two groups. The AUC of inhibin A was 0.715, but the AUC of a three-marker combination model (0.800) was even better. A mid-trimester inhibin A concentration of 1.5 MoM or greater had a sensitivity of 60% and a false-positive rate of 16% for the prediction of preeclampsia. Inhibin A was the best predictor of preeclampsia. Three other markers were reliable predictive markers of preeclampsia. Conclusions: Inhibin A and other second-trimester serum markers may be useful for early detection of preeclampsia. Inhibin A was in fact the most important predictable marker among the markers we surveyed. The results of this study support those of previous studies, and provide quantified data elucidating the occurrence of preeclampsia.

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“…(Muttukrishna et al, 1997a;Silver et al, 1999) Extreme inhibin levels (137.51 MoM) were reported in one patient having HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome complicated with triploidy (Craig et al, 2000) The present patient did not have pre-eclampsia or HELLP syndrome. Patients with granulosa cell tumor also have dramatically elevated serum inhibin A levels (Burger et al, 1996;Petraglia et al, 1998;Robertson et al, 1999).…”

Section: Discussionmentioning

confidence: 53%

High maternal serum inhibin A levels following the loss of one fetus in a twin pregnancy

et al. 2000

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Comparison of maternal serum total activin A and inhibin A in normal, preeclamptic, and nonproteinuric gestationally hypertensive pregnancies

Cited by 89 publications

References 11 publications

Activin A and activin receptors in gestational tissue from preeclamptic pregnancies

Activin A and activin receptors in gestational tissue from preeclamptic pregnancies

Early Detection of Preeclampsia Using Inhibin A and Other Second-Trimester Serum Markers

High maternal serum inhibin A levels following the loss of one fetus in a twin pregnancy

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