Catestatin-A Potential New Therapeutic Target for Women with Preeclampsia? An Analysis of Maternal Serum Catestatin Levels in Preeclamptic Pregnancies

Evaluating maternal serum sortilin levels: a potential biomarker for predicting preeclampsia

OBJECTIVE

To determine the role of sortilin in the pathogenesis of preeclampsia by examining serum sortilin levels in maternal blood.

METHODS

This prospective case-control study was conducted from May to November 2023 at the Perinatology Clinic of Ankara Etlik City Hospital. The study cohort was divided into two groups: Group 1 consisted of 44 pregnant women diagnosed with preeclampsia, and Group 2 served as the control group, comprising 44 healthy pregnant women. The groups were matched individually, with controls selected based on similar maternal age and gestational age at the time of sample collection.

RESULTS

Maternal sortilin levels were significantly elevated in preeclampsia patients compared to controls. Using a cut-off value of > 3.57 ng/mL, sortilin levels could distinguish preeclampsia cases with a sensitivity of 90.9%, a specificity of 45.5%, and an area under the curve (AUC) of 0.679 (p = 0.002). At a cut-off of > 3.57 ng/mL, it was significantly associated with composite adverse neonatal outcomes, with a sensitivity of 89.6%, a specificity of 36.1%, and an AUC of 0.620 (p = 0.045). In addition, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and protein in 24-hour urine, which are important components in the diagnosis and severity of preeclampsia, were significantly correlated maternal blood sortilin levels.

CONCLUSION

Our findings indicate that maternal sortilin levels are elevated in patients with preeclampsia compared to those in a healthy pregnant control group. Furthermore, maternal sortilin levels may predict adverse neonatal outcomes. In addition, sortilin levels are correlated key clinical markers of preeclampsia severity.

Catestatin in Cardiovascular Diseases

Cardiovascular diseases are one of the leading causes of mortality and morbidity worldwide. The pathogenesis of this group of disorders is highly complex and involves interactions between various cell types and substances, among others, catestatin (CTS). In recent years, numerous researchers have expanded our knowledge about CTS's role in development and its potential for the treatment of a variety of diseases. In this review, the authors discuss CTS's importance in the pathogenesis of arterial hypertension, coronary artery disease, and heart failure. Moreover, we present CTS's influence on heart and vessel function.

Analysis of Circulating Catestatin in Early Pregnancy: A Preliminary Investigation

Background: During pregnancy, significant cardiovascular changes occur to accommodate fetal growth, and catestatin may play a role in these changes. Evidence suggests that catestatin, a pleiotropic sympathoinhibitory peptide, is involved in multiple cardiovascular pathologies, including hypertensive disorders. The objective of this study was to compare serum catestatin levels between first-trimester pregnant women and non-pregnant women, aiming to investigate catestatin's role in blood pressure regulation during early pregnancy. Methods: This cross-sectional study included 72 first-trimester pregnant women and 57 age-matched non-pregnant controls, all without known cardiovascular or metabolic disorders. Results: Serum catestatin concentrations were significantly higher in pregnant women compared to controls (12.4 (9.9-21.2) ng/mL vs. 7.1 (4.5-10.9) ng/mL, p < 0.001). However, there was no significant difference in serum catestatin levels between those with a normal and abnormal uterine artery pulsatility index (17.8 (8.3-22.3) ng/mL vs. 12.5 (9.9-22.4) ng/mL, p = 0.962). Similarly, catestatin concentrations did not significantly differ between primiparous and multiparous women (14.0 (11.5-22.4) ng/mL vs. 10.7 (8.8-19.0) ng/mL). A positive correlation was observed between systolic blood pressure and serum catestatin levels in the control group (r = 0.335, p = 0.011) but not in pregnant women. Conclusions: Research on catestatin in pregnancy is still in its early stages, necessitating further studies to fully elucidate its roles and potential therapeutic applications.

The Role of Catestatin in Preeclampsia

Preeclampsia (PE) is a unique pregnancy disorder affecting women across the world. It is characterized by the new onset of hypertension with coexisting end-organ damage. Although the disease has been known for centuries, its exact pathophysiology and, most importantly, its prevention remain elusive. The basis of its associated molecular changes has been attributed to the placenta and the hormones regulating its function. One such hormone is chromogranin A (CgA). In the placenta, CgA is cleaved to form a variety of biologically active peptides, including catestatin (CST), known inter alia for its vasodilatory effects. Recent studies indicate that the CST protein level is diminished both in patients with hypertension and those with PE. Therefore, the aim of the present paper is to review the most recent and most relevant in vitro, in vivo, and clinical studies to provide an overview of the proposed impact of CST on the molecular processes of PE and to consider the possibilities for future experiments in this area.