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Observational Study
. 2021 Jul 11;18(14):3206-3213.
doi: 10.7150/ijms.61014. eCollection 2021.

Maternal vascular endothelial growth factor receptor and interleukin levels in pregnant women with twin-twin transfusion syndrome

Nguyen Duy Anh  1 , Phan Huyen Thuong  1 , Nguyen Thi Sim  1 , Tran Thi Phuong Thao  2 , Luong Thi Lan Anh  3 , Than Thi Thu Canh  3 , Nguyen Van Dieu  2 , Nguyen Duy Bac  2 , Hoang Van Tong  2
Affiliations
Observational Study

Maternal vascular endothelial growth factor receptor and interleukin levels in pregnant women with twin-twin transfusion syndrome

Nguyen Duy Anh et al. Int J Med Sci. .

Abstract

Twin-twin transfusion syndrome (TTTS) is an unusual and serious condition that occurs in twin pregnancies when identical twins share a placenta but develop discordant amniotic fluid volumes. TTTS is associated with an increased risk of fetal death and birth defects if untreated. This study investigated the soluble levels of biomarkers including growth factors and interleukins in pregnant women with and without TTTS during pregnancy. We quantified plasma levels of VEGF-R1, VEGF-R2, IL-1β, IL-6 and IL-8 in twin pregnant women with (n=53) and without TTTS (n=72) and in women with single pregnancy (n=30) by ELISA and analyzed the association of maternal circulating biomarker levels with TTTS. Our results showed that maternal VEGF-R1 levels were significantly higher in twins compared to single pregnancy (P<0.05) and were decreased in the second trimester compared to the first trimester (P = 0.065, 0.019 and 0.072 for twins with and without TTTS and single pregnancy, respectively). VEGF-R2 levels had a trend to be lower in twins compared to single pregnancy. In addition, soluble VEGF-R1 and VEGF-R2 levels were significantly decreased while IL-6 levels were increased after surgical treatment with laser in twin pregnant women with TTTS (P = 0.016, 0.041 and 0.04, respectively). These results suggest that IL-6, VEGF-R1 and VEGF-R2 are involved in vascular regulation and stabilization in twin pregnancies and may contribute to the pathogenesis of TTTS and thus play a prognostic role in the surgical treatment of TTTS.

Keywords: IL-1β; IL-6; IL-8; Twin-twin transfusion syndrome; VEGF-R1 and VEGF-R2.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Strategy of investigation, sample sizes, and sampling timeline
Figure 2
Figure 2
Maternal soluble VEGF-R1 levels in pregnant women. Soluble VEGF-R1 levels were measured in different subgroups of pregnant women. TTTS: Twin-to-twin transfusion syndrome; P values were presented reflecting the comparison between groups. Two-sided Mann-Whitney U test or Wilcoxon signed-rank test was used to compare between groups.
Figure 3
Figure 3
Maternal soluble VEGF-R2 levels in pregnant women. Soluble VEGF-R2 levels were measured in different subgroups of pregnant women. TTTS: Twin-to-twin transfusion syndrome; P values were presented reflecting the comparison between groups. Two-sided Mann-Whitney U test or Wilcoxon signed-rank test was used to compare between groups.
Figure 4
Figure 4
Maternal soluble VEGF-R1 and VEGF-R2 levels in twin pregnant women with TTTS before and after surgical treatment. Soluble VEGF-R1 and VEGF-R2 levels were measured in twin pregnant women with TTTS who were treated with surgery and were compared between before and after surgical treatment. TTTS: Twin-to-twin transfusion syndrome; P values calculated by Wilcoxon signed-rank test were presented reflecting the comparison between groups.
Figure 5
Figure 5
Maternal Interleukin-6 levels in pregnant women. Interleukin-6 levels were measured in different subgroups of pregnant women. TTTS: Twin-to-twin transfusion syndrome; P values were presented reflecting the comparison between groups. Two-sided Mann-Whitney U test was used to compare between groups.
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