Plasma gelsolin as a potential biomarker for intrauterine inflammation in pregnant women with preterm premature rupture of membranes: A pilot study

BACKGROUND: Gelsolin is an actin-binding protein, the blood levels of which decrease in response to inflammation and tissue injury. However, the dynamics of gelsolin during pregnancy and its relationship with intrauterine inflammation remain unclear. In cases of preterm premature rupture of membranes, conventional indicators such as white blood cell (WBC) count and C-reactive protein (CRP) have known limitations, and reliable biomarkers for predicting intrauterine inflammation are limited. In this study, we investigated changes in plasma gelsolin concentrations during pregnancy and evaluated their association with intrauterine inflammation in patients with preterm premature rupture of membranes. METHODS: In this pilot study, plasma gelsolin concentrations were measured by enzyme-linked immunosorbent assay in healthy pregnant women and in patients with preterm premature rupture of membranes. In healthy pregnancies, samples from the first, second, and third trimesters were analyzed. In cases with preterm premature rupture of membranes, serial measurements were performed from the time of membrane rupture to delivery. Correlation analyses with inflammatory markers (C-reactive protein and white blood cell) were conducted. Additionally, immunohistochemical staining for gelsolin was performed on placental tissues from chorioamnionitis cases and controls to compare expression levels and distribution patterns. RESULTS: In healthy pregnant women, plasma gelsolin levels significantly decreased as pregnancy progressed. In cases with preterm premature rupture of membranes, plasma gelsolin levels showed a significant negative correlation with C-reactive protein and tended to decrease over time following membrane rupture. Immunohistochemical staining revealed a trend toward an increased number of gelsolin-positive cells in the chorionic membrane of chorioamnionitis cases. CONCLUSION: Plasma gelsolin decreases with the progression of pregnancy and intrauterine inflammation and may particularly reflect the progression of intrauterine inflammation in cases of preterm premature rupture of membrane. Gelsolin has the potential to serve as a novel biomarker for detecting inflammatory conditions that are not readily identified by conventional markers.