Maternal Serum Activin A, Inhibin A and Follistatin-Related Proteins across Preeclampsia: Insights into Their Role in Pathogenesis and Prediction
, , , und | 19. Aug. 2023
Article Category: Review
Online veröffentlicht: 19. Aug. 2023
Seitenbereich: 119 - 133
Eingereicht: 10. Dez. 2022
Akzeptiert: 11. Juni 2023
DOI: https://doi.org/10.34763/jmotherandchild.20232701.d-23-00002
Schlüsselwörter
© 2023 Jorge A. Barrero et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Background
Within the endocrine-paracrine signalling network at the maternal-foetal interface, the activin-inhibin-follistatin system modulates extravillous trophoblast invasion, suggesting a potential role in preeclampsia pathogenesis. This study aimed to compile the evidence published in the last decade regarding the variation in maternal serum activins, inhibin- and follistatin-related proteins in preeclamptic pregnancies compared to healthy pregnancies, and to discuss their role in predicting and understanding the pathophysiology of preeclampsia.
Material and methods
A scoping review was conducted in MEDLINE, EMBASE and LILACS databases to identify studies published within the last ten years (2012–2022).
Results
Thirty studies were included. None of the studies addressed maternal serum changes of isoforms different from activin A, inhibin A, follistatin, and follistatin-like 3. Sixteen studies evaluated the potential of these isoforms in predicting preeclampsia through the area under the curve from a receiver operating characteristic curve.
Conclusions
In preeclampsia, inhibin A is upregulated in all trimesters, whereas activin A increases exclusively in the late second and third trimesters. Serum follistatin levels are reduced in women with preeclampsia during the late second and third trimesters. However, changes in follistatin-like 3 remain inconclusive. Inhibin A and activin A can potentially serve as biomarkers of early-onset preeclampsia based on the outcomes of the receiver operating characteristic curve analysis. Further investigations are encouraged to explore the feasibility of quantifying maternal serum levels of activin A and inhibin A as a clinical tool in early preeclampsia prediction.