Erythrocyte microvesicles and cell-free nucleic acids as biomarkers of severe preeclampsia in the third trimester: A comparative study
Makulbek Z.B. Akylbaeva A.A. Mugazov M.M. Omertayeva D.E. Uvasheva A.D.
1 July 2025Kaz Med Print LLP
Reproductive Medicine (Central Asia)
2025#2025Issue 2144 - 152 pp.
Relevance: Severe preeclampsia (SPE) is a life-threatening pregnancy complication characterized by hypertension, proteinuria, and systemic endothelial dysfunction. It affects up to 2% of pregnancies and is associated with significant maternal and perinatal morbidity. Erythrocyte microvesicles (EMVs) and cell-free nucleic acids (cfNAs) in erythrocytes and plasma may reflect pathogenic processes such as oxidative stress and apoptosis, but their role as biomarkers of SPE remains underexplored. The study aimed to determine the diagnostic and prognostic value of erythrocyte microvesicles and extracellular nucleic acids (DNA, RNA, acid-soluble fraction) for severe preeclampsia by analyzing differences in their concentrations in erythrocytes and plasma between pregnant women with this disorder and healthy pregnant women in the third trimester. Materials and Methods: This cross-sectional comparative study included 32 women with severe preeclampsia (SPE group) and 25 healthy pregnant women (control group) at 27–40 weeks of gestation. Venous blood samples were collected once using EDTA anticoagulant. EMV concentrations were measured by flow cytometry (CD235a marker), and cfNA levels were quantified using fluorescence spectroscopy. Statistical analysis involved t-tests, Mann-Whitney U-tests, and Pearson correlation analysis ( p<0.05). Results: The content of erythrocyte microvesicles in pregnant women with severe preeclampsia (88.9 ± 34.6 units/mL) was significantly higher than in healthy pregnant women (16.6 ± 8.2 units/mL, p <0.001). Levels of extracellular nucleic acids (erythrocyte DNA and RNA, plasma DNA and RNA, erythrocyte cfRNA) also differed: correlations were identified between EMVs and erythrocyte DNA (r=0.65, p <0.01), EMVs and systolic blood pressure (r=0.58, p <0.05), and erythrocyte DNA and proteinuria (r=0.49, p <0.05). Conclusion: The increased content of erythrocyte microvesicles and extracellular nucleic acids in pregnant women with severe preeclampsia indicates their role in pathogenesis and their potential as non-invasive biomarkers. The combined use of these markers may improve the diagnosis and monitoring of severe preeclampsia.
biomarkers , cell-free nucleic acids , erythrocyte microvesicles , severe preeclampsia
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Department of Obstetrics, Gynecology and Perinatology, Karaganda Medical University, Karaganda, Kazakhstan
Department of Emergency Medicine, Anesthesiology, and Intensive Care, Karaganda Medical University, Karaganda, Kazakhstan
Department of Obstetrics
Department of Emergency Medicine
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