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Kahouadji S, Giguère Y, Lambert S, Forest JC, Bernard N, Blanchon L, Marceau G, Durif J, Pereira B, Gallot D, Sapin V, Bouvier D. CX3CL1/Fractalkine as a biomarker for early pregnancy prediction of preterm premature rupture of membranes. Clin Chem Lab Med 2024; 62:1101-1108. [PMID: 38278625 PMCID: PMC11056942 DOI: 10.1515/cclm-2023-1202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/13/2024] [Indexed: 01/28/2024]
Abstract
OBJECTIVES The objective of our study was to evaluate serum CX3CL1/Fractalkine, a monocyte/macrophage chemoattractant expressed in cytotrophoblasts and decidual cells, as a predictive biomarker for the occurrence of preterm premature rupture of membranes (PPROM). METHODS A case-control study of 438 pregnancies including 82 PPROM cases and 64 preterm labor with intact membranes cases with blood samples collected at first trimester, second trimester and delivery was conducted. The predictive ability of CX3CL1 and maternal risk factors for the occurrence of PPROM was assessed by receiver operating characteristic curve analysis. A second, independent cohort was prospectively constituted to confirm the case-control study results. RESULTS First trimester CX3CL1 was significantly increased in PPROM cases when compared to matched controls. Multivariate regression analysis highlighted a significant difference for CX3CL1 measured during the first trimester (p<0.001). Alone, CX3CL1 predicts PPROM with a 90 % sensitivity and a specificity around 40 %. The area under the receiver operating characteristic curve for PPROM prediction were 0.64 (95% confidence interval: 0.57-0.71) for first trimester CX3CL1, and 0.61 (95% confidence interval: 0.54-0.68) for maternal risk factors (body mass index<18.5 kg/m2, nulliparity, tobacco use and the absence of high school diploma). The combination of CX3CL1 and maternal risk factors significantly improved the area under the curve: 0.72 (95% confidence interval: 0.66-0.79) (p<0.001). The results were confirmed on a second independent cohort. CONCLUSIONS CX3CL1 is a promising blood biomarker in the early (first trimester) prediction of PPROM.
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Affiliation(s)
- Samy Kahouadji
- Biochemistry and Molecular Genetic Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Faculty of Medicine, CNRS 6293, INSERM 1103, GReD, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Yves Giguère
- Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Québec City, Canada
- Faculty of Medicine, Department of Molecular Biology, Medical Biochemistry and Pathology, Université Laval, Québec City, Canada
| | - Salomé Lambert
- Faculty of Medicine, CNRS 6293, INSERM 1103, GReD, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jean-Claude Forest
- Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Québec City, Canada
- Faculty of Medicine, Department of Molecular Biology, Medical Biochemistry and Pathology, Université Laval, Québec City, Canada
| | - Nathalie Bernard
- Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Québec City, Canada
| | - Loïc Blanchon
- Faculty of Medicine, CNRS 6293, INSERM 1103, GReD, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Geoffroy Marceau
- Biochemistry and Molecular Genetic Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Faculty of Medicine, CNRS 6293, INSERM 1103, GReD, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Julie Durif
- Biochemistry and Molecular Genetic Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit (DRCI), CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Denis Gallot
- Faculty of Medicine, CNRS 6293, INSERM 1103, GReD, Université Clermont Auvergne, Clermont-Ferrand, France
- Department of Obstetrics and Gynecology, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Vincent Sapin
- Biochemistry and Molecular Genetic Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Faculty of Medicine, CNRS 6293, INSERM 1103, GReD, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Damien Bouvier
- Biochemistry and Molecular Genetic Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Faculty of Medicine, CNRS 6293, INSERM 1103, GReD, Université Clermont Auvergne, Clermont-Ferrand, France
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