Dynamic Changes Of ITIH4 Protein In Serum Of Patients With Preeclampsia

Background and purpose:Preeclampsia（PE）is the important complications during pregnancy,is refers to the pregnant women in 20 weeks of gestation the phenomenon such as high blood pressure,proteinuria,edema,and affects the whole body important organ,it is the leading cause of maternal and neonatal illness and death reason of obstetrics,which can lead to premature delivery,fetal intrauterine retardation,maternal convulsions,important viscera injury,severe cases lead to maternal and fetal death,serious damage to the mother health^[1].Some scholars believe that the formation of PE is related to the complex changes in maternal biological regulation.Vidal et al.^[2]proposed that the complex interaction between two proteins（protein and nucleic acid）determines the biological regulation behavior.The early change of disease usually appears at the early stage of abnormal protein expression,which leads to the change of the whole protein expression spectrum in the disease state.Due to individual heterogeneity,multiple factors and multiple heredity of PE,the pathogenesis of PE is still being explored.For a long time,the etiology and pathogenesis of PE are the main aspects of obstetrical research and concern.In this experimental group,in the preliminary work,two-dimensional gel electrophoresis was used to compare the serum of patients with preeclampsia and normal pregnant women,and a total of 19 different proteins were obtained,among which 4 proteins were increased and 15 proteins were decreased.Image results were analyzed with Image Master 2D Platinum 5.0（GE）,specific protein markers were identified,differential proteins were identified with mal DI-TOF-MS,and NCBInr database was searched with Mascot.Among them,the protein with the biggest difference ratio,H4（ITIH4）,showed the most obvious decrease in expression.The results showed that ITIH4 protein content in serum of pregnant women with late preeclampsia significantly decreased.However,the dynamic changes of serum content in PE patients need to be further studied.To sum up,this experiment attempted to study the dynamic changes of ITIH4 in the serum of PE patients,To explore the relationship between itih4 and PE,and to support the prediction based on PE at the experimental level.Methods:（1）Selection criteria:From October 2018 to June the following year,regular prenatal examinations were performed on women who visited the obstetrics department of the Fourth Affiliated Hospital of Harbin Medical University.Pregnancy data were recorded at the first consultation,medical history was improved,informed consent was signed,and basic information and pregnancy-related information of the pregnant women were recorded.The subjects included in this study were:first delivery of single pregnancy（11-13 weeks of gestation+6）,pre-pregnancy BMI between18.5-24.9 Kg/m2,excluding the following conditions:A history of poor pregnancy and childbirth;Other pregnancy complications and internal and surgical complications;pregnant with smoking,alcohol and have drug history.（2）11-13+6 weeks in the early stages of pregnancy),medium（24 to 28 weeks）and late（after 34 weeks）respectively in the morning on an empty stomach take 4-5ml into object elbow venous blood（blood fasting before 8～10 hours）,immediately placed in a centrifuge,the implementation of 3 min centrifugal process（during the set speed of 3000 r/min）,pending centrifugal,partial shipments on qing dynasty into the EP tube（1.5 ml）,and then moved to-80℃refrigerator,storage.（3）The pregnancy outcomes of pregnant women were tracked and divided into groups according to the pregnancy outcomes:pregnant women with preeclampsia were divided into the experimental group（PE group）,and pregnant women without pregnancy complications were divided into the control group.30 women in each group were selected to be included in the group,with no restriction on delivery methods.Serum samples collected during pregnancy were collected to ensure complete serum samples in the first,second and third trimester of pregnancy.The level of ITIH4 in serum was determined by ELISA.The diagnostic criteria for PE and severity are consistent with those shown in the 9th edition of Obstetrics and Gynecology.Results:（1）In the first trimester,compared with the control group,the serum level of ITIH4 in PE patients decreased significantly,and P<0.05,I.e.differences show statistical value.（2）In the second trimester,compared with the control group,the serum levels of PE patients in ITIH4 were significantly reduced,while P<0.05,which showed a significant difference.（3）In the third trimester,compared with the control group,the serum level of ITIH4 in PE patients was greatly reduced,and P<0.05,that is,the difference showed statistical value.（4）In the PE group,the levels of ITIH4 protein in the serum showed a decreasing trend compared to the first trimester,the second trimester,and the third trimester,and the differences showed statistical value.（P<0.05）（5）In the normal pregnancy group,there was no significant change in serum ITIH4 protein content during the first,second and third trimesters,and P=0.501,which had no statistical value.Conclusions:（1）Compared with normal healthy pregnant women,the serum levels of itih4 in PE patients were significantly lower in early,middle and late pregnancy,middle and late pregnancy,and showed a dynamic change of decreasing trend throughout the onset period,so it was speculated that ITIH4 content was negatively correlated with the severity of PE;（2）Compared with normal healthy pregnant women,ITIH4 protein presented low expression in the serum of patients with preeclampsia in the first,second and third trimesters of pregnancy,and ITIH4 may be involved in the whole process of PE occurrence and development.The role of ITIH4 protein in the pathogenesis of preeclampsia needs to be further studied.