role of Thrombomodulin, IL-12, transforming growth factor-beta2 in early onset preeclamsia: a potential biomarker for disease severity

Early onset Preeclampsia is a pregnancy specific heterogeneous syndrome with genetic predisposition ranging from hypertension, proteinuria and edema to severe preeclampsia with complications. A defective implantation and placentation, circulating factors including proinflammatory molecules, cytokines and adhesion molecules have been implicated in the pathogenesis of preeclampsia. Was to assess the clinical value of assaying maternal serum concentration of thrombomodulin [TM] interleukin-12 [IL-12] and transforming growth factor beta-2 [TGF-beta 2], in normotensive, mild and severe preeclamptic pregnant women, and to evaluate the correlation between these factors and the blood pressure, uric acid and creatinine. The second objective was to look for differences between mild and severe early onset preeclampsia, compared with a healthy pregnant and non pregnant cross sectional investigated groups. Serum TM, IL-12 and TGF-beta 2 were measured using enzyme linked immunoassay [ELISA] and enzyme immunoassay respectively in 45 women with preeclampsia divided into 24 mild and 21 severe preeclamptic patients and compared with 21 pregnant normotensive and 20 non pregnant controls. Serum uric acid and creatinine were measured as well. Severe preeclamptic women had significantly increased levels of TM [p<0.01], IL-12 [p<0.01] and TGF-beta 2 p<0.01] compared with women with normal pregnancy and non pregnant women. Serum creatinine and uric acid co1Icentrations were significantly higher in severe preeclamptic patients [1.35 +/- 0.17mg/dL, 7.43 +/- 0.74mg/dL, respectively, mean +/- SD] and did not change significantly in mild preeclamptic women compared with those of healthy normotensive pregnant women. Significant positive correlations existed between serum TGF-beta 2 concentrations and mean arterial blood pressure, TM. serum creatinine and uric acid concentrations in severe pre peclamptic patients. Conclusion: Increase concentration of thrombomodulin, II-12 and TGF-beta 2, in severe preeclamptic patient might explain the shallow placentation, endothelial cell dysfunction and renal involvement described in severe preeclampsia. Measurement of maternal plasma of TM, IL-l2, TGF-beta 2 levels in preeclampsia can be useful biomarker for the assessment of the severity of the disease

Congenital cytomegalovirus infection among preterm and full-term newborn infants in a neonatal intensive care unit

Cytomegalovirus [CMV] is the most common cause of congenital infections in human. The aim of the present study was to determine the prevalence and the clinical manifestations of congenital CMV infection among preterm and full-term newborn infants under intensive care and to correlate this infection with some features linked to the infants and their mothers. Serum samples were taken from 90 newborn infants [including 47 preterm and 43 full-term infants] and from their mothers, and were subjected to testing for IgM antibodies to CMV [CMV-IgM] by ELISA test. Sera from the mothers were also tested for IgG antibodies to CMV [CMV-IgG] by ELISA test. In addition, urine samples were taken from the newborns and were investigated for the presence of CMV DNA by nested polymerase chain reaction. It was found that 16 of the 90 newborns [17.8%] had congenital CMV infection, [all of them were positive for both CMV-IgM in serum and CMV DNA in urine] including 11[12.2%] preterm and 5[5.6%] full-term infants, with a significantly higher prevalence of infection among preterm infants [P<0.05]. On comparing between preterm and full-term newborn infants with congenital CMV infection, no significant difference in sex was found between both groups of infants [P> 0.05], but the gestational age and the birth weight were significantly higher in infected full-term infants [P< 0.05], while the presence of symptomatic CMV infection at birth was significantly more frequent in infected preterm infants [P< 0.05]. This symptomatic infection was found in 7 of the 16[43.8%] congenitally infected infants, including 6[37.5%] preterm infants and 1[6.3%] full-term infant. The main clinical manifestations of this symptomatic infection were low birth weight, jaundice, hepatosplenomegaly, anaemia, thrombocytopenia, purpura and microcephaly. Furthermore, on comparing between newborn infants with and without congenital CMV infection for features related to the newborns and their mothers, no significant difference was found between these two groups of infants concerning sex, gestational age, birth weight, maternal age or parity [P> 0.05], but maternal CMV-IgG seropositivity was significantly more frequent among infected newborns' mothers [P< 0.01], while maternal prenatal care reception was significantly more frequent among non infected newborn's mothers [P<0.01]. Screening newborns under intensive care for congenital CMV infection is recommended to allow for early treatment of symptomatic cases and follow-up of asymptomatic ones, giving the chance for better prognosis for these infected infants. Adequate prenatal care is also recommended to decrease the risk of transmission of CMV infection from infected pregnant mothers to their fetuses and to reduce infants' perinatal mortality from this infection