Document Detail

Maternal cell-free messenger RNA in twin pregnancies: the effects of chorionicity and severe twin to twin transfusion syndrome (TTTS).
MedLine Citation:
PMID:  22862673     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the effects of chorionicity and severe twin to twin transfusion (TTTS) on maternal circulating cell-free messenger RNA (cf-mRNA).
DESIGN: Prospective cohort study.
SETTING: A UK tertiary referral Fetal Medicine Center.
POPULATION: All monochorionic (MC) twins complicated by severe TTTS (n= 23) and a cohort of uncomplicated dichorionic (DC) (n= 10) and MC (n= 7) pregnancies, between October 2006 and December 2007.
METHODS: Maternal cf-mRNA encoding glyceraldehyde 3-phosphate dehydrogenase (GAPDH), vascular endothelial growth factor receptor 1(VEGFR-1(Flt-1)), vascular endothelial growth factor A (VEGF-A), Endoglin, placental growth factor (PlGF), tyrosine kinase with immunoglobulin-like and EGF-like domains 1 (Tie-1), angiopoietin 1 (Ang-1) and angiopoietin 2 (Ang-2) were measured by a quantitative two-step real-time PCR assay after extraction from maternal plasma.
RESULTS: The amounts of cf-mRNA detectable are reported for uncomplicated DC, MC and TTTS pregnancies, respectively: GAPDH - 80, 100 and 96%; VEGFR-1 - 10, 0 and 26%; VEGF-A- 80, 71 and 96%; Endoglin-70, 71 and 91%; PlGF-70, 57, 26%; Tie-1 0, 43, 0%; Ang-1 71, 50 and 60% and Ang-2 83, 50 and 89%. There was a significant difference in VEGF-A (medians DC -337.3, MC - 390.8, TTTS - 618.6 copies/mL plasma p= 0.024), Endoglin (medians DC-14.49, MC-1171, TTTS - 2896 copies/mL plasma p= 0.027) and Ang-2 (medians DC-13.66, MC-8.49, TTTS 44.80 copies/mL plasma p= 0.007).
CONCLUSION: Maternal cf-mRNA could be reliably detected for GAPDH, PlGF, VEGF-A, Endoglin, Ang-1 and Ang-2 in twin pregnancies and a significant difference was demonstrated in VEGF-A, Endoglin and Ang-2 between uncomplicated twins and MC twin pregnancies complicated by TTTS. If such alterations in maternal cf-mRNA precede the onset of clinically apparent disease, this may be used as an adjuvant blood test to complement ultrasound screening.
Caroline E Fox; Akihiko Sekizawa; Samantha J Pretlove; Ben C Chan; Takashi Okai; Mark D Kilby
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-08-21
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  91     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-18     Completed Date:  2012-11-19     Revised Date:  2013-02-15    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  1206-11     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Fetal Medicine Centre, Birmingham Women's Foundation Trust, Edgbaston, Birmingham, UK.
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MeSH Terms
Angiopoietin-2 / blood
Antigens, CD / blood
Biological Markers / blood
Case-Control Studies
Cell-Free System*
Cohort Studies
Fetofetal Transfusion / blood*,  diagnosis,  genetics
Infant, Newborn
Prospective Studies
RNA, Messenger / blood*
Real-Time Polymerase Chain Reaction
Receptors, Cell Surface / blood
Severity of Illness Index
Twins, Monozygotic
Vascular Endothelial Growth Factor A / blood
Reg. No./Substance:
0/Angiopoietin-2; 0/Antigens, CD; 0/Biological Markers; 0/ENG protein, human; 0/RNA, Messenger; 0/Receptors, Cell Surface; 0/VEGFA protein, human; 0/Vascular Endothelial Growth Factor A

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