Urinary congophilia in preeclampsia: Experience from a rural tertiary-care hospital in India

Nagarajappa, Chandrakala; Rangappa, Sheela Shikaripur; Suryanarayana, Ravishankar; Balakrishna, Sharath

doi:10.1016/j.preghy.2018.05.006

Cited by 22 publications

(23 citation statements)

References 24 publications

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“…Based on the above premises, we found that quantification of urine congophilia carries diagnostic and prognostic potential for PE [13]. Other groups validated the clinical usefulness of assessing congophilia in pregnant women for PE diagnosis using our research laboratory protocol on nitrocellulose [14], [15], [16].…”

Section: Introductionmentioning

confidence: 53%

“…Several groups have validated, in cohorts different than ours, that women with PE have elevated urine congophilia [14], [15], [16]. Importantly, all of these studies employed our previously published nitrocellulose laboratory protocol [13].…”

Section: Discussionmentioning

confidence: 91%

“…Importantly, all of these studies employed our previously published nitrocellulose laboratory protocol [13]. Most recently, Nagarajappa et al concluded that urinary congophilia can be used to identify PE women from normotensive pregnant women [15]. Their study replicated our protocol in a laboratory hospital in rural India and showed that urinary congophilia was not affected by clinical variables such as GA of onset, severity, superimposition by eclampsia, fetal growth restriction or stillbirth.…”

Section: Discussionmentioning

confidence: 93%

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Congo Red Dot Paper Test for Antenatal Triage and Rapid Identification of Preeclampsia

et al. 2019

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Background Proteins in the urine of women with preeclampsia (PE) bind Congo Red dye (urine congophilia). We sought to determine the diagnostic performance of a paper-based point-of-care test detecting urine congophilia for rapid triage and diagnosis of PE. Methods Prospective cohort study conducted in 346 consecutive pregnant women evaluated for PE in the Labour and Delivery triage unit at our institution. The Congo Red Dot (CRD) Paper Test (index test) was performed on fresh urine samples. The CRD Paper Test results were compared to an expert adjudicated diagnosis in each case. The accuracy of the CRD Paper Test was also compared to urine and serum analytes (placental growth factor and soluble fms-like tyrosine kinase-1) previously proposed as diagnostic aids for PE. Findings During the first triage visit, 32% (112/346) of women received a clinical diagnosis of PE. Yet, 63% (217/346) were admitted for in-patient diagnostic work-up or delivery. The CRD Paper Test was positive in 25% (86/346) of the cases. Adjudication confirmed PE in 28% (96/346) of all cases. The CRD Paper Test outperformed measured serum and urine markers (80·2% sensitivity, 89·2% specificity, 92·1% negative predictive value, 86·7% accuracy). The pre-test, positive and negative post-test probabilities were 27·7%, 74·0%, and 8·0%, respectively. Of women who were discharged undelivered, 38% (133/346) had at least one additional triage visit and the interval between the last negative and first positive CRD Paper Test was 12 (interquartile range, [5–34]) days. Interpretation The CRD Paper Test is a simple, non-invasive, “sample-in/answer-out” point-of-care clinical tool for rapid identification of PE. Funding Saving Lives at Birth Program and NICHD.

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Section: Introductionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 93%

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Congo Red Dot Paper Test for Antenatal Triage and Rapid Identification of Preeclampsia

et al. 2019

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“…Initially, proteomic analysis suggested that preeclampsia is associated with misfolded proteins which are aggregated in the placenta [5]. This was then confirmed by four studies which demonstrated that in late pregnancy maternal urine samples taken at the time of preeclampsia diagnosis there was considerably more congophilia than in unaffected pregnancies [6][7][8][9].…”

Section: Introductionmentioning

confidence: 94%

Late pregnancy screening for preeclampsia with a urinary point-of-care test for misfolded proteins

Li¹,

Liu

Xu³

et al. 2020

PLoS ONE

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The aim was to describe and assess a new late pregnancy point-of-care urinary preeclampsia screening test. Urine samples were collected from a consecutive series of 1,532 pregnant women hospitalized at 20-41 weeks gestation in a Chinese single obstetric unit. A simple disposable Congo red based device was newly developed and employed to prospectively test misfolded proteins in pregnant women's urine. A total of 140 preeclampsia cases were clinically diagnosed, 101 severe and 87 pre-term. Detection and false positive rates were similar in the training and validation subsets with combined 74% and 3.0%. The detection rate was 83% in severe, 86% in pre-term, 49% and 50% in mild and term cases (P<0.0001) respectively. In conclusion, a simple point-of-care urinary test for misfolded proteins can be used to screen for preeclampsia in late pregnancy with very high screening performance. To the best of our knowledge, this is the first study to screen for preeclampsia using Congo red based device in Chinese pregnant population.

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“…This multisystem pathology is often associated with proteinuria and other signs of multiple organ dysfunction. 2–6 Early recognition and timely delivery may prevent bad outcomes; however, the reliable early diagnostic tests still need to be developed.…”

Section: Introductionmentioning

confidence: 99%

The high-resolution mass spectrometry study of the protein composition of amyloid-like urine aggregates associated with preeclampsia

Sergeeva

Zakharova

Бугрова

et al. 2019

Eur J Mass Spectrom (Chichester)

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The study of protein misfolding and post-translational processing abnormalities is a promising diagnostic approach for socially significant pathologies associated with the accumulation of abnormal forms of proteins. Recently, it was shown that amyloid-like aggregates can be observed in the urine of pregnant women with preeclampsia, which is the most severe hypertensive complication that can lead to fateful outcomes. The protein composition of urine aggregates may clarify the molecular mechanisms underlying the pathology and has not yet been studied in detail. Using a proteomic approach based on high-resolution mass spectrometry, we studied the protein composition of amyloid-like structures that aggregate in the presence of Congo red azo-dye in the urine of pregnant women with preeclampsia. Fragments of β-sheets of α-1-antitrypsin, complement 3, haptoglobin, ceruloplasmin, and trypstatin were identified as most likely targets for Congo red binding.

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Urinary congophilia in preeclampsia: Experience from a rural tertiary-care hospital in India

Cited by 22 publications

References 24 publications

Congo Red Dot Paper Test for Antenatal Triage and Rapid Identification of Preeclampsia

Congo Red Dot Paper Test for Antenatal Triage and Rapid Identification of Preeclampsia

Late pregnancy screening for preeclampsia with a urinary point-of-care test for misfolded proteins

The high-resolution mass spectrometry study of the protein composition of amyloid-like urine aggregates associated with preeclampsia

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