Amer Ali E, Nori W, Salman AF, Al-Rawi TSS, Hameed BH, Al-Ani RM. Elabela is a reliable biomarker for predicting early onset preeclampsia: A comparative study. World J Clin Cases 2023; 11(17): 3993-4002 [PMID: 37388778 DOI: 10.12998/wjcc.v11.i17.3993]
Corresponding Author of This Article
Raid M Al-Ani, MBChB, N/A, Academic Editor, Consultant Physician-Scientist, Full Professor, Researcher, Science Editor, Department of Surgery/Otolaryngology, University of Anbar College of Medicine, University of Anbar College of Medicine, Al-Andalus, No. 41 Street, Ramadi City 31001, Anbar, Iraq. med.raed.alani2003@uoanbar.edu.iq
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 16, 2023; 11(17): 3993-4002 Published online Jun 16, 2023. doi: 10.12998/wjcc.v11.i17.3993
Elabela is a reliable biomarker for predicting early onset preeclampsia: A comparative study
Eham Amer Ali, Wassan Nori, Alea Farhan Salman, Taghreed S Saeed Al-Rawi, Ban H Hameed, Raid M Al-Ani
Eham Amer Ali, Department of Chemistry and Biochemistry, Mustansiriyah University, Baghdad 10052, Iraq
Wassan Nori, Ban H Hameed, Department of Obstetrics and Gynecology, Mustansiriyah University, Baghdad 10052, Iraq
Alea Farhan Salman, National Central of Hematology, Mustansiriyah University, Baghdad 10052, Iraq
Taghreed S Saeed Al-Rawi, Department of Biochemistry, University of Anbar College of Medicine, Ramadi City 31001, Anbar, Iraq
Raid M Al-Ani, Department of Surgery/Otolaryngology, University of Anbar College of Medicine, University of Anbar College of Medicine, Ramadi City 31001, Anbar, Iraq
Author contributions: Ali EA and Nori W designed research and reviewed data, wrote and revised the manuscript; Salman AF and Hameed BH collected and analyzed the data; Al-Rawi TSS and Al-Ani RM did the literature review; Al-Ani RM was responsible for the final revision and drafting of the manuscript; and all the authors have read and agreed on the final version of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Scientific-Ethical Committee of the Mustansiriyah University (Approval No. IRB126).
Informed consent statement: All pregnant gave written consent prior to enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets analyzed during the current study are available in the hospital’s “sheet patient records” and from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raid M Al-Ani, MBChB, N/A, Academic Editor, Consultant Physician-Scientist, Full Professor, Researcher, Science Editor, Department of Surgery/Otolaryngology, University of Anbar College of Medicine, University of Anbar College of Medicine, Al-Andalus, No. 41 Street, Ramadi City 31001, Anbar, Iraq. med.raed.alani2003@uoanbar.edu.iq
Received: March 18, 2023 Peer-review started: March 18, 2023 First decision: May 9, 2023 Revised: May 9, 2023 Accepted: May 15, 2023 Article in press: May 15, 2023 Published online: June 16, 2023 Processing time: 85 Days and 14.8 Hours
Abstract
BACKGROUND
Preeclampsia (PE) is a multisystemic metabolic disease with an undetermined etiology. PE is a worldwide cause of maternal and perinatal morbidity, subdivided into early (EoPE) and late-onset (LoPE) according to 34 wk of gestation as a divider. Many researchers investigated biomarkers for predicting PE to halt its consequences on the feto-maternal outcome. Elabela (Ela) is a newly discovered peptide hormone that was implicated in PE pathogenesis. Earlier rodent studies discussed Ela’s role in controlling blood pressure. Moreover, Ela deficiency was associated with PE development.
AIM
To test whether plasma Ela could serve as a reliable marker for predicting PE based on the time of onset (EoPE vs LoPE) compared to age and body mass matched healthy controls since no definitive treatment exists for PE but to terminate a pregnancy.
METHODS
This case-control study recruited (n = 90) pregnant who fulfilled inclusion criteria; they were allocated into three groups: EoPE (30/90) (< 34 wk of gestation); LoPE (30/90) (≥ 34 wk of gestation); and healthy pregnant (30/90). Demographic criteria; biochemical, hematological, and maternal plasma Ela levels were recorded for comparison.
RESULTS
Serum Ela was significantly reduced in EoPE compared to LoPE and healthy controls (P = 0.0023). The correlation confirmed a strong inverse relationship with mean atrial blood pressure (r = -0.7, P < 0.001), while gestational age and platelets count showed a moderate correlation with (r = 0.4 with P < 0.0001). No correlation was confirmed between the body mass index (BMI) and urine albumin. The predictive ability of 25 centile serum Ela had an Odds ratio of 5.21, 95% confidence interval (1.28, 21.24), P = 0.02 for predicting EoPE. The receiver operator characteristic curve defined the Ela cutoff value at > 9.156 with 96.7% and 93.3% sensitivity and specificity, P < 0.0001 in predicting EoPE.
CONCLUSION
A strong correlation of serum Ela with PE parameters with excellent sensitivity and specificity in distinguishing EoPE independent of the BMI, age, and blood pressure which makes Ela a recommendable marker in screening. Further research is warranted to explore prognostic and therapeutic applications for Ela in PE.
Core Tip: Preeclampsia (PE) is a worldwide cause of increased maternal and perinatal morbidity; PE is divided into early-onset and late-onset subtypes. The precise pathophysiology of PE is obscured, and currently no treatment exists but to terminate pregnancy. Several researches seek a reliable biomarker to anticipate PE to mitigate its negative effects. Elabela (Ela), a recently discovered peptide hormone secreted by the fetus and human placenta; animal studies confirmed Ela’s critical role in maintaining blood pressure; its deficiency was linked to elevated blood pressure. The purpose of this study was to evaluate the accuracy of Ela in predicting PE based on the time of occurrence.
