Elevated Serum level of soluble Programmed Death-1 and C-Reactive Protein as biomarkers of Immune Dysregulation in Preeclampsia: Implications for Early Detection

Abstract

Background Preeclampsia is a serious pregnancy related hypertensive condition with potentially life-threatening complications for the mother and fetus. its immunopathogenesis involves complex immune responses characterized by systemic inflammation and immune dysregulation. Soluble Programmed Death-1 (sPD-1) is an immune checkpoint has been implicated in immune exhaustion, and C-reactive protein (CRP) is an inflammatory marker associated with adverse pregnancy outcomes. Monitoring the levels of serum sPD-1 and CRP in preeclamptic pregnancies may be used as biomarkers for disease severity, immune dysregulation, and early detection of preeclampsia. Objective This study aimed to determine the levels of sPD-1 and CRP in preeclamptic patients, explore their association with proteinuria, and determine their potential as diagnostic markers for preeclampsia and disease severity. Methods A cross-sectional study was conducted at the University of Gondar specialized hospital. 79 pregnant women were included; of these, 39 had preeclampsia and 40 were age matched normotensive controls. Levels of CRP and sPD-1 were measured using enzyme-linked immuno sorbent assay (ELISA)and Quick read go CRP analyzer, and proteinuria was categorized using urine dipstick tests into three levels (+ 1, + 2, +3). Statistical analysis was performed to examine the median difference in sPD-1 and CRP level between preeclamptic women and normotensive controls, as well as across different proteinuria levels of preeclamptic women Results Preeclamptic women have higher median sPD-1 (5616 pg/L, IQR: 4592–7422 vs 4347 pg/L, IQR: 3885–4939) and CRP levels (4.5 mg/L, IQR: 3.8–5.3) than normotensive controls (4347 pg/L, IQR: 3885–4939 and 2.6 mg/L, IQR: 2.2–3.0 respectively). But there was no significant difference in sPD-1 and CRP levels across different categories of proteinuria levels in preeclamptic women. Conclusion In conclusion, Preeclamptic women have higher median sPD-1 and CRP levels than normotensive control, indicating a potential link between these biomarkers and the pathology of preeclampsia. However, sPD-1 and CRP levels does not differ across different proteinuria categories in preeclamptic women.