Role and Expression of Annexin IV (ANXA4) and Matrix-remodeling Associated 5 protein (MXRA5) in connective tissue remodeling of placenta in preeclampsia.

Abstract

Abstract Objective: To evaluate the expression of Annexin IV (ANXA4), Matrix-remodelling associated 5 (MXRA5), and Tissue inhibitor metalloproteinase 2 (TIMP2) level in connective tissue remodelling of placenta in women with preeclampsia.Methods: Forty-eight pregnant women complicated by preeclampsia, their age range from 20 to 40 years, in addition to 48 age and sex matched normotensive pregnant women served as control group were enrolled in the study. The placental samples in this study were obtained by cesarean section, frozen immediately in liquid nitrogen, and stored at − 80°C till time of assay for subsequent RNA and protein biochemical measurements.Results: There was statistically significant decrease in mean ANXA4 among cases compared to controls. Additionally, there was statistically significant decrease in mean MXRA5 among cases compared to controls (p < 0.001 for both). There was statistically significant decrease in mean MXRA5 among patients with severe PE compared to mild PE (p < 0.001). A statistically significant moderate positive correlation between ANXA4 and MXRA5 (r = 0.571, p < 0.001) in total sample, and the degree of correlation increased to 0.732 among cases when stratified the groups to cases and controls. There was a statistically significant lower mean difference of pAKT-ELIZA among PE patients (0.29 ± 0.04) compared to controls (0.56 ± 0.14, p < 0.001).Conclusions: In pre-eclampsia patients, there was a statistically significant positive correlation between the pAKT protein level and ANXA4 and MXRA5 compared to controls. Reduced MXRA5 expression is a more sensitive biomarker for predicting the severity of PE compared to ANXA4.