WILLMS TUMOUR-1, NEFRIN AND PODOCIN IN URINARY EXOSOMES OF PREGNANT WOMEN: EARLY MARKERS OF PRE-ECLAMPSIA
Pre-eclampsia. Urinary exonsomes.WT-1. Nephrin. Podocin.
Preeclampsia (PE) is a pregnancy-specific disease characterized by hypertension and proteinuria after 20 weeks of gestation. Complications of PE can directly affect the life of the mother and the fetus. Thus, the search for a reliable marker with predictive diagnostic power can lead to an early intervention, reducing the risk to maternal and fetal health. Since the association of podocytes (renal cells) with PE has been describe in the literature, it is important to evaluate the marker proteins of these cells in this group of patients. The development of a technique to concentrate exosomos eliminated in the urine has allowed to quantify small concentrations of cellular components carried in these microvesículas, among them proteins associated to podocytes, with tumor factor of Willms 1 (Wt-1), nefrina and podocina. In this way, proteins associated to podocytes (WT-1, nephrine and podocin) were investigated in urinary exosomes of pregnant women in search of potential predictive markers of preeclampsia using a non-invasively collected sample. In relation to metabolic control, an increase of glucose (p = 0.002), triglycerides (p = 0.012), urea (p = 0.022), creatinine (p = 0.004), phosphorus (p = 0.009),LDH (p = 0.001), AST (p = 0.042) and GGT (p = 0.04); and a decrease in albumin (p <0.001), protein (p = 0.001), and calcium (p = 0.001) in the group of patients with preeclampsia when compared to the control group. No alterations were observed between the studied groups in the values of total cholesterol (p = 0,486), uric acid (p = 0.209), alkaline phosphatase (p = 0.129) and ALT (p = 0.095). The increased urinary albumin / creatinine ratio, associated with changes in urea, albumin and total serum protein concentrations, suggests the development of an initial picture of renal impairment. There was a significant increase in WT-1, nephrin and podocin in the group of patients with pre-eclampsia when compared to the group of healthy pregnant women, suggesting that these proteins are potential predictive markers for the early diagnosis of preeclampsia.