# Combination of Markers, Including hsCRP, TGFβ 1, IL-6, and T-regs, and their Predictive Value as Early Warning Signs for Preeclampsia: Insights from a Tertiary Care Medical Centre in Eastern India

## TL;DR

This study identifies specific immune markers that can predict preeclampsia early, helping distinguish high-risk pregnancies.

## Contribution

The study establishes threshold values for T-regs, TGFβ1, IL-6, and hsCRP as predictive markers for preeclampsia.

## Key findings

- Threshold values for T-regs and cytokines were determined to differentiate preeclamptic from normal pregnancies.
- TGFβ1, IL-6, and hsCRP showed significant differences between preeclamptic and non-preeclamptic groups.
- Reference intervals were established using CLSI guidelines and ROC curve analysis.

## Abstract

Regulatory T cells (T-regs), a subset of CD4+ T-lymphocytes play a crucial role in the maintenance of immunological tolerance and immune homeostasis. The study has been done to evaluate the threshold values and reference intervals of Regulatory T cells, TGF-β1, IL-6, and hsCRP as a comprehensive panel for preeclampsia.

In this cross-sectional study the T-regulatory cells (CD4, CD25, FOXP3) were assessed using a flow-cytometer, and TGF-β1, and IL-6 were analysed by sandwich ELISA method and hsCRP analysed by Beckman Coulter autoanalyser.

The reference range for the parameters in the studied groups was estimated based on CLSI C28-A3 guidelines. The lower and upper limits were estimated by a non-parametric method with 90% CI. Threshold values were estimated from the ROC curve based on optimal sensitivity and specificity measured by the Youden Index.

The study established a threshold value level for CD3+CD4+T-cells, CD4+CD25+T-regs, and CD4+FOXP3+ T-regs to separate individuals with preeclampsia from those without the condition. The threshold values for TGF-β1, IL-6, and hsCRP were chosen as they demonstrated significant differences between the two groups, indicating an association with the presence of preeclampsia.

The statistical analysis of the study population aimed to establish a clear difference between the two groups, thereby providing a dependable foundation to differentiate impending preeclampsia from a normal pregnancy in order to assist in theranostics.