SERPINA1 Peptides in Urine as A Potential Marker of Preeclampsia Severity

Preeclampsia (PE) is a multisystem disorder associated with pregnancy and its frequency varies from 5 to 20 percent of pregnancies. Although a number of preeclampsia studies have been carried out, there is no consensus about disease etiology and pathogenesis so far. Peptides of 1-antitrypsin) in urine remain one of the most promising peptide markers of PE. In this study the diagnostic potential of urinary α1-antitrypsin peptides in PE was evaluated. The urinary peptidome composition of 79 pregnant women with preeclampsia (PE), chronic arterial hypertension (CAH), and a control group was investigated. Mann-Whitney U-test ( < 0.05) revealed seven PE specific peptides demonstrating 52% sensitivity and 100% specificity. in urine has been associated with the most severe forms of preeclampsia ( = 0.014), in terms of systolic hypertension ( = 0.01) and proteinuria ( = 0.006). According to Spearman correlation analysis, the normalized intensity of urinary peptides has a similar diagnostic pattern with known diagnostic PE markers, such as sFLT/PLGF. peptides were not urinary excreted in superimposed PE (PE with CAH), which is a milder form of PE. An increase in expression of in the structural elements of the placenta during preeclampsia reflects a protective mechanism against hypoxia. Increased synthesis of in the trophoblast leads to protein accumulation in fibrinoid deposits. It may block syncytial knots and placenta villi, decreasing trophoblast invasion. Excretion of PE specific peptides is associated with syncytiotrophoblast membrane destruction degradation and increased staining. It confirms that the placenta could be the origin of peptides in urine. Significant correlation ( < 0.05) of expression in syncytiotrophoblast membrane and cytoplasm with the main clinical parameters of severe PE proves the role of in PE pathogenesis. Estimation of peptides in urine can be used as a diagnostic test of the severity of the condition to determine further treatment, particularly the need for urgent surgical delivery.