PURPOSE: Early diagnosis of prelabor rupture of membranes (PROM) is essential to protect mother and fetus from intra-uterus infection and preterm birth. A simple and rapid bedside test would help clinicians confirm the diagnosis for early treatment. EXPERIMENTAL DESIGN: A protein array was used to screen cervical-vaginal fluid (CVF) and amniotic fluid (AF) samples collected from normal and PROM pregnant women. Enzyme-linked immunosorbent assay was used to quantify two novel and potentially useful analytes, soluble intercellular adhesion molecule-1 (sICAM-1) and Axl receptor tyrosine kinase (Axl). RESULTS: The mean concentration of sICAM-1 and Axl was 85 and 482 times higher separately in 30 healthy AF samples than in 110 CVF samples of normal pregnancies. Comparing 110 CVF samples of PROM/Preterm PROM with 110 CVF samples of normal pregnancies, the diagnostic value for PROM was demonstrated by their high sensitivity and specificity (96.4 and 92.7%, respectively, for sICAM-1, and 92.4 and 90.4%, respectively, for Axl). CONCLUSIONS AND CLINICAL RELEVANCE: The results indicate that sICAM-1 and Axl in AF leaked to vagina are sensitive and specific biomarkers for the diagnosis of PROM. Furthermore, sICAM-1 or Axl can be developed into a rapid strip test for bedside use.
PURPOSE: Early diagnosis of prelabor rupture of membranes (PROM) is essential to protect mother and fetus from intra-uterus infection and preterm birth. A simple and rapid bedside test would help clinicians confirm the diagnosis for early treatment. EXPERIMENTAL DESIGN: A protein array was used to screen cervical-vaginal fluid (CVF) and amniotic fluid (AF) samples collected from normal and PROM pregnant women. Enzyme-linked immunosorbent assay was used to quantify two novel and potentially useful analytes, soluble intercellular adhesion molecule-1 (sICAM-1) and Axlreceptor tyrosine kinase (Axl). RESULTS: The mean concentration of sICAM-1 and Axl was 85 and 482 times higher separately in 30 healthy AF samples than in 110 CVF samples of normal pregnancies. Comparing 110 CVF samples of PROM/Preterm PROM with 110 CVF samples of normal pregnancies, the diagnostic value for PROM was demonstrated by their high sensitivity and specificity (96.4 and 92.7%, respectively, for sICAM-1, and 92.4 and 90.4%, respectively, for Axl). CONCLUSIONS AND CLINICAL RELEVANCE: The results indicate that sICAM-1 and Axl in AF leaked to vagina are sensitive and specific biomarkers for the diagnosis of PROM. Furthermore, sICAM-1 or Axl can be developed into a rapid strip test for bedside use.
Authors: Yujing J Heng; Stella Liong; Michael Permezel; Gregory E Rice; Megan K W Di Quinzio; Harry M Georgiou Journal: Front Physiol Date: 2015-05-13 Impact factor: 4.566