Evaluating <i>SEPHS2</i> expression and glutathione peroxidase as biomarkers in recurrent pregnancy loss: a new insight

BACKGROUND: Selenophosphate synthetase 2 (SEPHS2) activates selenophosphate, a donor for selenocysteine required for glutathione peroxidase (GPX) production. GPX protects placental tissue. Dysregulation of SEPHS2 and reduced GPX activity may contribute to oxidative stress-mediated placental dysfunction in recurrent pregnancy loss (RPL). AIM: To evaluate SEPHS2 gene expression and plasma GPX levels as prognostic biomarkers in women with idiopathic RPL and their association with oxidative imbalance. METHODS: A total of 100 women with idiopathic RPL and 100 healthy women without history of RPL were included. SEPHS2 gene expression was quantified using quantitative reverse transcription polymerase chain reaction (qRT-PCR), and plasma GPX levels were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS: SEPHS2 expression was significantly elevated in the RPL group compared with controls (mean fold change: 14 ± 11.4 vs. 5 ± 8), while plasma GPx levels were markedly reduced in women with RPL (5.57 ± 0.40 vs. 9.53 ± 3.28; P < 0.001, 95% CI: 3.32-4.62). These findings indicate an association between increased SEPHS2 expression, reduced antioxidant activity, and recurrent pregnancy loss. CONCLUSION: Elevated SEPHS2 expression suggests disrupted selenoprotein-mediated antioxidant defense in RPL. SEPHS2 and GPX may serve as prognostic biomarkers.