Evaluating Serum Amyloid A as a Biomarker in Preeclampsia

Montadhar K. Sultan, Moaed E. Al-Gazally, Bushra J. Al-Rubayae

 
For citation: Sultan MK, Al-Gazally ME, Al-Rubayae BJ. Evaluating Serum Amyloid A as a Biomarker in Preeclampsia. International Journal of Biomedicine. 2025;15(1):108-111. doi:10.21103/Article15(1)_OA9
 
Originally published March 5, 2025

Abstract: 

Background: Preeclampsia (PE) is the major cause of perinatal morbidity and mortality.  The causes of the condition can be ascribed to excessive maternal systemic inflammatory response to pregnancy. Emerging evidence indicates that serum amyloid A (SAA), the acute phase response protein, may be a damage-associated molecular pattern molecule in pregnancy. This study aimed to evaluate serum amyloid A as a biomarker in preeclampsia.
Methods and Results: This case-control study was conducted at Babylon Teaching Hospital for Maternity and Children from January 23, 2024, to June 13, 2024. The study involved 65 patients diagnosed with PE during their third trimester and 65 healthy expectant mothers. Preeclampsia was diagnosed according to the criteria of the American College of Obstetricians and Gynecologists (ACOG, 2020). Patients provided midstream urine samples for protein level estimation using dipstick tests. After a rest, blood pressure was measured three times, and the final recorded reading was the average of the two lowest readings from those three measurements. The sandwich-ELISA method was used to estimate Human SAA levels. The median SAP in the PE group was 38.48 μg/mL versus 30.74 μg/mL in the control group (P<0.001). We found significantly higher SAA levels in PE patients with stage 2 hypertension than in PE patients with elevated blood pressure or stage 1 hypertension (P=0.036).
Conclusion: SAA is a promising biomarker for predicting the progression of preeclampsia. Further study of SAA during pregnancy may explain how inflammation is initiated in gestational tissues in normal and abnormal pregnancies.

Keywords: 
serum amyloid A • preeclampsia • hypertension
References: 
  1. Ngene NC, Moodley J. Preventing maternal morbidity and mortality from preeclampsia and eclampsia particularly in low- and middle-income countries. Best Pract Res Clin Obstet Gynaecol. 2024 Jun;94:102473. doi: 10.1016/j.bpobgyn.2024.102473. Epub 2024 Feb 15. PMID: 38513504.
  2. Chang KJ, Seow KM, Chen KH. Preeclampsia: Recent Advances in Predicting, Preventing, and Managing the Maternal and Fetal Life-Threatening Condition. Int J Environ Res Public Health. 2023 Feb 8;20(4):2994. doi: 10.3390/ijerph20042994. PMID: 36833689; PMCID: PMC9962022.
  3. Erez O, Othman M, Rabinovich A, Leron E, Gotsch F, Thachil J. DIC in Pregnancy - Pathophysiology, Clinical Characteristics, Diagnostic Scores, and Treatments. J Blood Med. 2022 Jan 6;13:21-44. doi: 10.2147/JBM.S273047. PMID: 35023983; PMCID: PMC8747805.
  4. Degryse M, Vanacker E. The association between anatomopathological abnormalities of the placenta and pre-eclampsia. Ghent University, Belgium; 2023.
  5. Stevens DU, de Nobrega Teixeira JA, Spaanderman MEA, Bulten J, van Vugt JMG, Al-Nasiry S. Understanding decidual vasculopathy and the link to preeclampsia: A review. Placenta. 2020 Aug;97:95-100. doi: 10.1016/j.placenta.2020.06.020. Epub 2020 Jun 27. PMID: 32792071.
  6. Torres-Torres J, Espino-Y-Sosa S, Martinez-Portilla R, Borboa-Olivares H, Estrada-Gutierrez G, Acevedo-Gallegos S, Ruiz-Ramirez E, Velasco-Espin M, Cerda-Flores P, Ramirez-Gonzalez A, Rojas-Zepeda L. A Narrative Review on the Pathophysiology of Preeclampsia. Int J Mol Sci. 2024 Jul 10;25(14):7569. doi: 10.3390/ijms25147569. PMID: 39062815; PMCID: PMC11277207.
  7. Malle E, De Beer FC. Human serum amyloid A (SAA) protein: a prominent acute-phase reactant for clinical practice. Eur J Clin Invest. 1996 Jun;26(6):427-35. doi: 10.1046/j.1365-2362.1996.159291.x. PMID: 8817153.
  8. Zhang Y, Zhang J, Sheng H, Li H, Wang R. Acute phase reactant serum amyloid A in inflammation and other diseases. Adv Clin Chem. 2019;90:25-80. doi: 10.1016/bs.acc.2019.01.002. Epub 2019 Mar 5. PMID: 31122611.
  9. Lin L, Huai J, Li B, Zhu Y, Juan J, Zhang M, Cui S, Zhao X, Ma Y, Zhao Y, Mi Y, Ding H, Chen D, Zhang W, Qi H, Li X, Li G, Chen J, Zhang H, Yu M, Sun X, Yang H. A randomized controlled trial of low-dose aspirin for the prevention of preeclampsia in women at high risk in China. Am J Obstet Gynecol. 2022 Feb;226(2):251.e1-251.e12. doi: 10.1016/j.ajog.2021.08.004. Epub 2021 Aug 10. PMID: 34389292.
  10. Michalczyk M, Celewicz A, Celewicz M, Woźniakowska-Gondek P, Rzepka R. The Role of Inflammation in the Pathogenesis of Preeclampsia. Mediators Inflamm. 2020 Oct 5;2020:3864941. doi: 10.1155/2020/3864941. PMID: 33082708; PMCID: PMC7556088.
  11. Kristensen K, Wide-Swensson D, Lindstrom V, Schmidt C, Grubb A, Strevens H. Serum amyloid a protein and C-reactive protein in normal pregnancy and preeclampsia. Gynecol Obstet Invest. 2009;67(4):275-80. doi: 10.1159/000214081. Epub 2009 Apr 24. PMID: 19390201.
  12. El-Kady MA, Ali DY, Boshnak NH, AHMED S. Amyloid A as a biomarker for preeclampsia. Evid Based Women’s Heal J. 2020;10(1):27–30.
  13. Patrick DM, Van Beusecum JP, Kirabo A. The role of inflammation in hypertension: novel concepts. Curr Opin Physiol. 2021 Feb;19:92-98. doi: 10.1016/j.cophys.2020.09.016. Epub 2020 Oct 13. PMID: 33073072; PMCID: PMC7552986.
  14. Zhang Z, Zhao L, Zhou X, Meng X, Zhou X. Role of inflammation, immunity, and oxidative stress in hypertension: New insights and potential therapeutic targets. Front Immunol. 2023 Jan 10;13:1098725. doi: 10.3389/fimmu.2022.1098725. PMID: 36703963; PMCID: PMC9871625.
  15. Al-Gazally ME, Al-Awad AS, Kzar HH. Evaluating the superoxide dismutase-1 status in wild type and mutant at codons 12 and 13 of KRAS gene spectrum for the patients with sporadic colorectal cancer International Journal of PharmTech Research. 2016;9(3):272-279.
  16. Al-Gazally ME, Al-Awad AS, Kzar HH. Assessment of antioxidant status in different genotypes/phenotypes at codon 72 of TP53 gene for patients with sporadic colorectal cancer in Babylon province. International Journal of PharmTech Research. 2016;9(3):280-286.

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Received December 11, 2024.
Accepted February 26, 2025.
©2025 International Medical Research and Development Corporation.