Microbial invasion and histological chorioamnionitis upregulate neutrophil-gelatinase associated lipocalin in preterm prelabor rupture of membranes
Language English Country Great Britain, England Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
- Keywords
- Amniotic fluid, histological chorioamnionitis, microbial invasion of the amniotic cavity, neutrophil-gelatinase associated lipocalin, preterm prelabor rupture of membranes,
- MeSH
- Biomarkers metabolism MeSH
- Chorioamnionitis metabolism microbiology MeSH
- Adult MeSH
- Cohort Studies MeSH
- Humans MeSH
- Lipocalin-2 MeSH
- Lipocalins metabolism MeSH
- Young Adult MeSH
- Amniotic Fluid metabolism microbiology MeSH
- Fetal Membranes, Premature Rupture metabolism microbiology MeSH
- Acute-Phase Proteins metabolism MeSH
- Proto-Oncogene Proteins metabolism MeSH
- Pregnancy MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Biomarkers MeSH
- LCN2 protein, human MeSH Browser
- Lipocalin-2 MeSH
- Lipocalins MeSH
- Acute-Phase Proteins MeSH
- Proto-Oncogene Proteins MeSH
Our recent exploratory proteomic study suggested increased levels of neutrophil-gelatinase associated lipocalin (P80188, NGAL_HUMAN) due to microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA) in women with preterm prelabor rupture of the membranes. In this study, we verified the proteomics findings by assessing the amniotic fluid NGAL by ELISA in the original exploratory cohort. The NGAL level was significantly higher in women positive for both MIAC and HCA compared to women with both conditions ruled out (median 75.1 ng/ml versus 27.9 ng/ml; p < 0.0001). For independent validation and to assess NGALs potential to stratify women positive for both MIAC and HCA from women in whom at least one of these conditions was absent, we subsequently designed a retrospective replication cohort. Significantly higher NGAL levels were found in women positive for both MIAC and HCA (median 65.9 ng/ml versus 34.2 ng/ml; p = 0.0061). Significantly higher levels of NGAL were confirmed only in strata below 32 weeks of gestation. Based on the observed likelihood ratio, the best predictive cutoff level (47.1 ng/ml) was evaluated in both cohorts. Data from the verification cohort implied that NGAL is a valuable clinical marker for revealing MIAC leading to HCA; however, this potential was not replicated in the replication cohort.
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