The effect of maternal asthma on serum PAPP-A levels and first trimester aneuploidy screening test running

Year 2024, Volume: 3 Issue: 2, 58 - 64, 28.06.2024

Bergen Laleli Koç , Gonca Türker Ergün , Özgür Kara , Atakan Tanaçan , Deniz Oluklu , Betül Akgün Aktaş , Ecem Kaya Dilek Sahin

Abstract

INTRODUCTION: PAPP-A (Pregnancy-associated plasma protein-A) is considered a pro-inflammatory marker and its serum levels are elevated in non-pregnant patients with asthma. In the current research, we aimed to investigate whether maternal serum PAPP-A levels, a biomarker for first-trimester aneuploidy screening, differ in pregnant women with asthma compared to healthy pregnant women.
METHODS: In the first step, maternal serum PAPP-A MoM values, used as the first-trimester fetal aneuploidy screening marker, were compared between pregnant women with asthma and a healthy pregnant group. In the second step, the groups compared whether PAPP-A and fβ-HCG ( free β human chorionic gonadotropin) levels were below or above the cut-off values for Trisomy 21 and compared them according to maternal age (<35; ≥35).
RESULTS: The median PAPP-A level was found to be 2.15 IU/L (0.41-9.91) in the asthma group and 2.54 IU/L (0.56-11.40) in the control group, and there was no difference between the groups (P=0.363). The median PAPP-A MoM value was 0.99 (0.15-3.28) in the asthma group and 1.07 (0.33-3.37) in the control group. This result did not show a statistically significant difference (P = 0.694). No statistically significant difference was shown between the groups below and above 35 age (P=0.456).
DISCUSSION AND CONCLUSION: Maternal serum PAPP-A levels in pregnant women with asthma do not vary compared to the healthy pregnant group without asthma. Based on the results of our study, the first-trimester fetal aneuploidy screening test is a reliable screening method for pregnant women with asthma.

Keywords

Aneuploidy screening, Asthma, PAPP-A, Pregnancy

References

• 1. Schatz M, Dombrowski MP, Wise R, et al.: Asthma morbidity during pregnancy can be predicted by severity classification. J Allergy Clin Immunol. 2003, 112:283-288. 10.1067/mai.2003.1516
• 2. NAEPP expert panel report. Managing asthma during pregnancy: recommendations for pharmacologic treatment-2004 update. J Allergy Clin Immunol. 2005, 115:34-46. 10.1016/j.jaci.2004.10.023
• 3. Canick JA, Lambert-Messerlian GM, Palomaki GE, et al.: Comparison of serum markers in first-trimester down syndrome screening. Obstet Gynecol. 2006, 108:1192-1199. 10.1097/01.AOG.0000241095.19638.f2
• 4. Wapner R, Thom E, Simpson JL, et al.: First-trimester screening for trisomies 21 and 18. N Engl J Med. 2003, 349:1405-1413. 10.1056/NEJMoa025273
• 5. Kirkegaard I, Uldbjerg N, Oxvig C: Biology of pregnancy-associated plasma protein-A in relation to prenatal diagnostics: an overview. Acta Obstet Gynecol Scand. 2010, 89:1118-1125. 10.3109/00016349.2010.505639
• 6. Coskun A, Balbay O, Duran S, et al.: Pregnancy-associated plasma protein-A and asthma. Adv Ther. 2007, 24:362-367. 10.1007/bf02849905
• 7. Lin TM, Galbert SP, Kiefer D, Spellacy WN, Gall S: Characterization of four human pregnancy-associated plasma proteins. Am J Obstet Gynecol. 1974, 118:223-236. 10.1016/0002-9378(74)90553-5
• 8. Krantz DA, Larsen JW, Buchanan PD, Macri JN: First-trimester Down syndrome screening: free beta-human chorionic gonadotropin and pregnancy-associated plasma protein A. Am J Obstet Gynecol. 1996, 174:612-616. 10.1016/s0002-9378(96)70436-2
• 9. Spencer K, Ong C, Skentou H, Liao AW, K HN: Screening for trisomy 13 by fetal nuchal translucency and maternal serum free beta-hCG and PAPP-A at 10-14 weeks of gestation. Prenat Diagn. 2000, 20:411-416.
• 10. Tul N, Spencer K, Noble P, Chan C, Nicolaides K: Screening for trisomy 18 by fetal nuchal translucency and maternal serum free beta-hCG and PAPP-A at 10-14 weeks of gestation. Prenat Diagn. 1999, 19:1035-1042. 10.1002/(sici)1097-0223(199911)19:11<1035::aid-pd694>3.0.co;2-2
• 11. Dugoff L, Hobbins JC, Malone FD, et al.: First-trimester maternal serum PAPP-A and free-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: a population-based screening study (the FASTER Trial). Am J Obstet Gynecol. 2004, 191:1446-1451. 10.1016/j.ajog.2004.06.052
• 12. ATAMAN YILDIRIM Z, TUĞRUL ERSAK D, TİMUR B, KAHYAOĞLU S: The Predictive Value of First and Second Trimester Screening Test Biomarkers in Preeclampsia. Forbes Journal of Medicine. 2022, 3.
• 13. D'Antonio F, Rijo C, Thilaganathan B, et al.: Association between first-trimester maternal serum pregnancy-associated plasma protein-A and obstetric complications. Prenat Diagn. 2013, 33:839-847. 10.1002/pd.4141
• 14. Overgaard MT, Boldt HB, Laursen LS, Sottrup-Jensen L, Conover CA, Oxvig C: Pregnancy-associated plasma protein-A2 (PAPP-A2), a novel insulin-like growth factor-binding protein-5 proteinase. J Biol Chem. 2001, 276:21849-21853. 10.1074/jbc.M102191200
• 15. Hjortebjerg R: IGFBP-4 and PAPP-A in normal physiology and disease. Growth Horm IGF Res. 2018, 41:7-22. 10.1016/j.ghir.2018.05.002
• 16. Bischof P, DuBerg S, Herrmann W, Sizonenko PC: Pregnancy-associated plasma protein-A (PAPP-A) and hCG in early pregnancy. Br J Obstet Gynaecol. 1981, 88:973-975. 10.1111/j.1471-0528.1981.tb01683.x
• 17. Overgaard MT, Oxvig C, Christiansen M, et al.: Messenger ribonucleic acid levels of pregnancy-associated plasma protein-A and the proform of eosinophil major basic protein: expression in human reproductive and nonreproductive tissues. Biol Reprod. 1999, 61:1083-1089. 10.1095/biolreprod61.4.1083
• 18. Conover CA, Harrington SC, Bale LK: Differential regulation of pregnancy associated plasma protein-A in human coronary artery endothelial cells and smooth muscle cells. Growth Horm IGF Res. 2008, 18:213-220. 10.1016/j.ghir.2007.09.001
• 19. Talay F, Tosun M, Yaşar ZA, et al.: Evaluation of Pregnancy-Associated Plasma Protein-A Levels in Patients with Chronic Obstructive Pulmonary Disease and Associations with Disease Severity. Inflammation. 2016, 39:1130-1133. 10.1007/s10753-016-0345-z
• 20. Bulut I, Ozseker ZF, Coskun A, Serteser M, Unsal I: Pregnancy-associated plasma protein-A (PAPP-A) levels in patients with severe allergic asthma are reduced by omalizumab. J Asthma. 2018, 55:1116-1121. 10.1080/02770903.2017.1396471
• 21. Li Y, Zhou C, Zhou X, Song L, Hui R: PAPP-A in cardiac and non-cardiac conditions. Clin Chim Acta. 2013, 417:67-72. 10.1016/j.cca.2012.12.006
• 22. Gutiérrez-Leonard H, Martínez-Lara E, Fierro-Macías AE, et al.: Pregnancy-associated plasma protein-A (PAPP-A) as a possible biomarker in patients with coronary artery disease. Ir J Med Sci. 2017, 186:597-605. 10.1007/s11845-016-1515-6
• 23. Hjortebjerg R, Rasmussen LM, Gude MF, et al.: Local IGF Bioactivity Associates with High PAPP-A Activity in the Pericardial Cavity of Cardiovascular Disease Patients. J Clin Endocrinol Metab. 2020, 105. 10.1210/clinem/dgaa617