INVESTIGATION OF THE RELATIONSHIP BETWEEN PLASMA APELIN LEVEL AND PRE-ECLAMPSIA CASES

Abstract

Objective Pre-eclampsia, a multi-systemic disease that develops during pregnancy, is a pathology that causes at least 42.000 maternal deaths per year. Theories regarding the pathophysiology of pre-eclampsia are mainly based on maternal-fetal (paternal) immune malperfusion, which is thought to be associated with superficial placentation, and the cause of preeclampsia has not yet been fully elucidated. Apelin is a peptide that affects blood pressure regulation and vascular functions, and also has various physiological functions. In this study, plasma apelin-13 levels were studied in normal and development of early-onset pre-eclampsia pregnant women to evaluate whether apelin-13 has a role in the development of early-onset pre-eclampsia. Material and Method In this case-control prospective study, a total of 60 pregnant women who applied to the Obstetrics and Gynecology Service were included in the study. The groups in the project were designed as healthy pregnant control (n: 30) and the development of early-onset pre-eclampsia pregnant (n: 30). The development of early-onset pre-eclampsia group consisted of the development of early-onset preeclampsia pregnant women diagnosed with preeclampsia at the 30th week. Platelet, serum albumin, ALT, AST, urea, creatinine and plasma apelin-13 values were measured from the blood samples taken from the participants at the 30th week. Results Compared to healthy pregnant controls, the decreases in platelet and serum albumin levels, and the increases in ALT, AST, urea, and creatinine parameters in the development of early-onset pre-eclampsia pregnant women were statistically significant (p=0,011; p=0,001; p=0,006; p=0,05; p=0,001; p=0,003; respectively). When the plasma apelin-13 value was compared between healthy and the development of early-onset pre-eclampsia pregnant women, no significant difference was found. Conclusion Apelin-13 has no diagnostic value in the diagnosis of development of early-onset pre-eclampsia developing after the 30th week.

Keywords

• Apelin
• Apelin 13
• Hypertension
• Preeclampsia
• Pregnancy

PLAZMA APELİN DÜZEYİ VE PRE-EKLAMPSİ VAKALARI ARASINDAKİ BAĞLANTININ ARAŞTIRILMASI

Abstract

Amaç Gebelikte gelişen ve multi-sistemik bir hastalık olan pre-eklampsi, yılda en az 42.000 anne ölümüne sebep olan bir patolojidir. Pre-eklampsi patofizyolojisine ilişkin teoriler, temel olarak yüzeysel plasentasyon ile ilişkili olduğu düşünülen maternal-fetal immün malperfüzyona dayanmakta ve pre-eklampsinin nedeni ise henüz tam olarak aydınlatılamamıştır. Apelin, kan basıncı regülasyonu ve vasküler fonksiyonları etkileyen, ayrıca çeşitli fizyolojik görevleri olan bir peptittir. Bu çalışmada, pre-eklampsi gelişiminde apelin-13’ün rolünün olup olmadığını değerlendirmek amacıyla normal ve erken başlangıçlı pre-eklampsili gebelerde, plazma apelin-13 seviyeleri çalışıldı. Gereç ve Yöntem Bu vaka kontrol prospektif çalışma, Kadın Hastalıkları ve Doğum Servisine başvuran gebelerin içerisinde toplam 60 gebe çalışmaya dahil edildi. Projedeki gruplar sağlıklı gebe kontrol (n:30) ve erken başlangıçlı pre-eklampsi gebe (n:30) olarak dizayn edildi. Erken başlangıçlı pre-eklampsi grubu 30. haftada pre-eklampsi tanısı konan erken başlangıçlı pre-eklampsi gebelerden oluşmakta idi. Katılımcılardan 30. hafta alınan kan örneklerinden trombosit, serum albümin, ALT, AST, üre, kreatinin ve plazma apelin-13 değerleri ölçüldü. Bulgular Sağlıklı gebe kontrollere göre, erken başlangıçlı pre-eklampsi gebelerdeki trombosit, serum albümin, seviyelerindeki azalma ve ALT, AST, üre ve kreatinin parametrelerindeki artma, istatiksel değerlendirme açısından anlamlı bulundu (p=0,011; p=0,001; p=0,006; p=0,05; p=0,001; p=0,003; sırasıyla). Plazma apelin-13 değeri sağlıklı ve erken başlangıçlı pre-eklampsi gebeler arasında karşılaştırıldığında anlamlı bir fark bulunmadı. Sonuç 30. haftadan sonra gelişen erken başlangıçlı pre-eklampsinin teşhisinde Apelin-13’ün tanısal değeri bulunmamaktadır.

Keywords

• Apelin
• Apelin 13
• Gebelik
• Hipertansiyon
• Pre-eklampsi.

References

1. 1. Mol BWJ, Roberts CT, Thangaratinam S, Magee LA, De Groot CJM, Hofmeyr GJ. Pre-eclampsia. Lancet. 2016;387(10022):999–1011.
2. 2. Chappell LC, Cluver CA, Kingdom J, Tong S. Pre-eclampsia. Lancet. 2021;398(10297):341–54.
3. 3. Abraham C, Kusheleva N. Management of preeclampsia and eclampsia. Oxymag. 2019;23(15):10832.
4. 4. Burton GJ, Redman CW, Roberts JM, Moffett A. Pre-eclampsia: pathophysiology and clinical implications. BMJ. 2019;366:1–15.
5. 5. Kleinz MJ, Davenport AP. Emerging roles of apelin in biology and medicine. Pharmacol Ther. 2005;107(2):198–211.
6. 6. Cheng J, Luo X, Huang Z, Chen L. Apelin/APJ system: A potential therapeutic target for endothelial dysfunction-related diseases. J Cell Physiol. 2019;234(8):12149–60.
7. 7. Castan-Laurell I, Masri B, Valet P. The apelin/APJ system as a therapeutic target in metabolic diseases. Expert Opin Ther Targets. 2019;23(3):215–25.
8. 8. Hamza RZ, Diab AAA, Zahra MH, Asalah AK, Moursi SMM, Al-Baqami NM, et al. Correlation between Apelin and Some Angiogenic Factors in the Pathogenesis of Preeclampsia: Apelin- 13 as Novel Drug for Treating Preeclampsia and Its Physiological Effects on Placenta. Int J Endocrinol. 2021;2021.

9. 9. Wang C, Liu X, Kong D, Qin X, Li Y, Teng X, et al. Apelin as a novel drug for treating preeclampsia. Exp Ther Med. 2017;14(6):5917–23.
10. 10. Hamza RZ, Diab AAA, Zahra MH, Asalah AK, Attia MS, Moursi SMM. Ameliorative effect of apelin-13 against renal complications in L-NAME-induced preeclampsia in rats. PeerJ. 2021;9:1–17.
11. 11. Gürlek B, Yılmaz A, Durakoğlugil ME, Karakaş S, Kazaz İM, Önal Ö, et al. Evaluation of serum apelin-13 and apelin-36 concentrations in preeclamptic pregnancies. J Obstet Gynaecol Res. 2020;46(1):58–65.
12. 12. Bortoff KD, Qiu C, Runyon S, Williams MA, Maitra R. Decreased maternal plasma apelin concentrations in preeclampsia. Hypertens Pregnancy. 2012;31(4):398–404.
13. 13. Deniz R, Baykus Y, Ustebay S, Ugur K, Yavuzkir Ş, Aydin S. Evaluation of elabela, apelin and nitric oxide findings in maternal blood of normal pregnant women, pregnant women with pre-eclampsia, severe pre-eclampsia and umbilical arteries and venules of newborns. J Obstet Gynaecol (Lahore). 2019;39(7):907–12.
14. 14. Inuzuka H, Nishizawa H, Inagaki A, Suzuki M, Ota S, Miyamura H, et al. Decreased expression of apelin in placentas from severe pre-eclampsia patients. Hypertens Pregnancy. 2013;32(4):410–21.
15. 15. Simsek Y, Celik O, Yilmaz E, Karaer A, Dogan C, Aydin S, et al. Serum levels of apelin, salusin-alpha and salusin-beta in normal pregnancy and preeclampsia. J Matern Neonatal Med. 2012;25(9):1705–8.
16. 16. Lee DL, Cheng R, Nguyen T, Fan T, Kariyawasam AP, Liu Y, et al. Characterization of apelin, the ligand for the APJ receptor. J Neurochem. 2000;74(1):34–41.
17. 17. Colcimen N, Bulut G, Erkec ÖE, Ragbetli MÇ. Investigation of role of vascular endothelial growth factor, Annexin A5 and Apelin by immunohistochemistry nıethod in placenta of preeclampsia patients. Cell Mol Biol. 2017;63(11):42–5.
18. 18. Yamaleyeva LM, Chappell MC, Bridget Brosnihan K, Anton L, Caudell DL, Shi S, et al. Downregulation of apelin in the human placental chorionic villi from preeclamptic pregnancies. Am J Physiol - Endocrinol Metab. 2015;309(10):852–60.
19. 19. Liao Y-M, Qiao F-Y. Expression of Apelin in placentas of patients with hypertensive disorders complicating pregnancy. Zhonghua Fu Chan Ke Za Zhi. 2007;42(6):382–5.
20. 20. Hypertension in Pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obs Gynecol. 2013;122(5):1122–31.
21. 21. Kocabas R, Akoz M. The effects of vitamin D supplementation on healthy and hypercholesterolemic rabbits on levels of OSI and paraoxonase. Turk J Biochem. 2018;43(5):549–56.
22. 22. Temur M, Yilmaz Ö, Taşgöz FN, Kume T. The evaluation of serum apelin levels in patients complicated with preeclampsia. J Matern Neonatal Med. 2022;35(10):1848-1852.
23. 23. Kucur M, Tuten A, Oncul M, Acikgoz AS, Yuksel MA, Imamoglu M, et al. Maternal serum apelin and YKL-40 levels in early and late-onset pre-eclampsia. Hypertens Pregnancy. 2014;33(4):467–75.
24. 24. Cobellis L, De Falco M, Mastrogiacomo A, Giraldi D, Dattilo D, Scaffa C, et al. Modulation of apelin and APJ receptor in normal and preeclampsia-complicated placentas. Histol Histopathol. 2007;22(1–3):1–8.