Exploring free pregnancy associated plasma protein a (fPAPP-A) as a biomarker in early pregnancy
Objectives: In combined first trimester screening for Down syndrome, Pregnancy-Associated Plasma Protein A (PAPP-A) is pivotal. PAPP-A tests evaluate total PAPP-A, consisting of the biologically active free PAPP-A (fPAPP-A) and PAPP-A complexed with eosinophil major basic protein's proform (pro...
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Elsevier
2024-11-01
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| Series: | Practical Laboratory Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S235255172400074X |
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| author | Jesper Friis Petersen Vilma Tiittanen Saara Wittfooth Ellen Løkkegaard Lennart Jan Friis-Hansen |
| author_facet | Jesper Friis Petersen Vilma Tiittanen Saara Wittfooth Ellen Løkkegaard Lennart Jan Friis-Hansen |
| author_sort | Jesper Friis Petersen |
| collection | DOAJ |
| description | Objectives: In combined first trimester screening for Down syndrome, Pregnancy-Associated Plasma Protein A (PAPP-A) is pivotal. PAPP-A tests evaluate total PAPP-A, consisting of the biologically active free PAPP-A (fPAPP-A) and PAPP-A complexed with eosinophil major basic protein's proform (proMBP). While PAPP-A is well-researched, limited understanding persists regarding fPAPP-A's first trimester concentrations and diagnostic utility. Design: and methods: PAPP-A and fPAPP-A levels were gauged in 602 serum samples at 2-week intervals (gestational weeks 4–14) from 159 women with delivery of a healthy neonate and 80 samples from 37 miscarriages. The final sample at the time of diagnosis from women who miscarried was included in analyses. Results: During the first trimester, PAPP-A and fPAPP-A levels displayed significant and strong correlation (r = 0.94), with median values doubling weekly. Free PAPP-A constituted only 3.0 % of PAPP-A over gestational weeks. Low fPAPP-A linked to miscarriage (p < 0.001), maternal weight (p < 0.001), and smoking (p = 0.02). For miscarriage prediction fPAPP-A was equal to PAPP-A (area under the receiver operating characteristics curve 0.79 vs. 0.81, p = 0.44). Conclusions: Investigating fPAPP-A presence and concentration directly in first trimester serum has not been done previously. This study report lower fPAPP-A values than anticipated from prior enzymatic studies of fPAPP-A. fPAPP-A was not superior to PAPP-A as a first trimester biomarker in this dataset. |
| format | Article |
| id | doaj-art-4e81ffccd80e4f7bb03218e3b734e4d9 |
| institution | OA Journals |
| issn | 2352-5517 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Practical Laboratory Medicine |
| spelling | doaj-art-4e81ffccd80e4f7bb03218e3b734e4d92025-08-20T02:37:02ZengElsevierPractical Laboratory Medicine2352-55172024-11-0142e0042810.1016/j.plabm.2024.e00428Exploring free pregnancy associated plasma protein a (fPAPP-A) as a biomarker in early pregnancyJesper Friis Petersen0Vilma Tiittanen1Saara Wittfooth2Ellen Løkkegaard3Lennart Jan Friis-Hansen4Department of Obstetrics and Gynecology, North Zealand Hospital, Dyrehavevej 29, 3400, Hillerød, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark; Corresponding author. Department of Obstetrics and Gynecology, North Zealand Hospital, Dyrehavevej 29, 3400, Hillerød, Denmark.Biotechnology Unit, Department of Life Technologies, 20014, University of Turku, FinlandBiotechnology Unit, Department of Life Technologies, 20014, University of Turku, FinlandDepartment of Obstetrics and Gynecology, North Zealand Hospital, Dyrehavevej 29, 3400, Hillerød, Denmark; Department of Clinical Medicine, University of Copenhagen, DenmarkDepartment of Clinical Biochemistry, Bispebjerg Hospital University Hospital, Nielsine Nielsens Vej 2, 2400, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, DenmarkObjectives: In combined first trimester screening for Down syndrome, Pregnancy-Associated Plasma Protein A (PAPP-A) is pivotal. PAPP-A tests evaluate total PAPP-A, consisting of the biologically active free PAPP-A (fPAPP-A) and PAPP-A complexed with eosinophil major basic protein's proform (proMBP). While PAPP-A is well-researched, limited understanding persists regarding fPAPP-A's first trimester concentrations and diagnostic utility. Design: and methods: PAPP-A and fPAPP-A levels were gauged in 602 serum samples at 2-week intervals (gestational weeks 4–14) from 159 women with delivery of a healthy neonate and 80 samples from 37 miscarriages. The final sample at the time of diagnosis from women who miscarried was included in analyses. Results: During the first trimester, PAPP-A and fPAPP-A levels displayed significant and strong correlation (r = 0.94), with median values doubling weekly. Free PAPP-A constituted only 3.0 % of PAPP-A over gestational weeks. Low fPAPP-A linked to miscarriage (p < 0.001), maternal weight (p < 0.001), and smoking (p = 0.02). For miscarriage prediction fPAPP-A was equal to PAPP-A (area under the receiver operating characteristics curve 0.79 vs. 0.81, p = 0.44). Conclusions: Investigating fPAPP-A presence and concentration directly in first trimester serum has not been done previously. This study report lower fPAPP-A values than anticipated from prior enzymatic studies of fPAPP-A. fPAPP-A was not superior to PAPP-A as a first trimester biomarker in this dataset.http://www.sciencedirect.com/science/article/pii/S235255172400074XPAPP-AFree PAPP-AFirst trimesterMiscarriageLive birthImmunoassay |
| spellingShingle | Jesper Friis Petersen Vilma Tiittanen Saara Wittfooth Ellen Løkkegaard Lennart Jan Friis-Hansen Exploring free pregnancy associated plasma protein a (fPAPP-A) as a biomarker in early pregnancy Practical Laboratory Medicine PAPP-A Free PAPP-A First trimester Miscarriage Live birth Immunoassay |
| title | Exploring free pregnancy associated plasma protein a (fPAPP-A) as a biomarker in early pregnancy |
| title_full | Exploring free pregnancy associated plasma protein a (fPAPP-A) as a biomarker in early pregnancy |
| title_fullStr | Exploring free pregnancy associated plasma protein a (fPAPP-A) as a biomarker in early pregnancy |
| title_full_unstemmed | Exploring free pregnancy associated plasma protein a (fPAPP-A) as a biomarker in early pregnancy |
| title_short | Exploring free pregnancy associated plasma protein a (fPAPP-A) as a biomarker in early pregnancy |
| title_sort | exploring free pregnancy associated plasma protein a fpapp a as a biomarker in early pregnancy |
| topic | PAPP-A Free PAPP-A First trimester Miscarriage Live birth Immunoassay |
| url | http://www.sciencedirect.com/science/article/pii/S235255172400074X |
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