Neuroserpin's Dual Role: A Potential Biomarker and Protector in Preeclampsia, finds study

Recent study evaluated maternal serum neuroserpin concentrations in pregnancies affected by preeclampsia and their relationship with disease severity, considering neuroserpin's roles in anti-inflammation and neuroprotection. This prospective case-control investigation was conducted from September 2024 to January 2025 at a tertiary referral hospital in Ankara, Türkiye, with a total of 88 participants: 44 diagnosed with preeclampsia and 44 healthy gestational-age-matched controls. ### Methodology Participants comprised pregnant women aged 21 to 45 with singleton pregnancies, diagnosed with preeclampsia based on the American College of Obstetricians and Gynecologists (ACOG) criteria. Exclusion criteria included multiple gestations, existing maternal comorbidities, substance abuse, prior corticosteroid treatment, and fetal anomalies. Serum samples (≥ 3 mL) were collected post-fasting and preserved at -80 °C until analysis. Neuroserpin levels were quantified using a Human NSP ELISA Kit via the sandwich ELISA method, with statistical significance evaluated through various tests (e.g., Student's t-test, Mann-Whitney U test) and assessed using receiver operating characteristic (ROC) curve analysis for diagnostic efficacy. ### Key Results

The results demonstrated significantly reduced serum neuroserpin levels in women with preeclampsia compared to the control group (p = 0.018). Furthermore, women with severe preeclampsia (Preeclampsia-SF) exhibited even lower neuroserpin levels, indicating a potential link between neuroserpin reduction and disease severity. Notably, these variations in neuroserpin levels occurred independently of maternal demographic factors, such as age and BMI, enhancing its potential as a biomarker for preeclampsia identification.

Diagnostic Analysis

ROC analysis established that a neuroserpin level threshold of ≤ 22.95 ng/mL could identify preeclampsia with a sensitivity of 86.4% and specificity of 43.2%. For severe cases, a threshold of ≤ 14.7 ng/mL produced a sensitivity of 50.0% and a specificity of 96.7%. These outcomes indicate that neuroserpin could function as a valuable diagnostic instrument for evaluating both the presence and severity of preeclampsia.

Neuroserpin Properties -

Neuroserpin, a serine protease inhibitor secreted mainly by neurons and monocytes, possesses known anti-inflammatory properties that could alleviate the endothelial and inflammatory dysfunctions associated with preeclampsia. Under normal physiological conditions, it is thought to mitigate extracellular damage, particularly in ischemic situations, which may be vital for preserving vascular integrity during pregnancy. These findings suggest that decreased neuroserpin levels in preeclamptic pregnancies may exacerbate unregulated vascular inflammation, thereby worsening endothelial dysfunction.

Study Limitations

Limitations of this study include its relatively small sample size and its focus on a single center, which may limit the generalizability of the findings. Additionally, the cross-sectional design does not permit longitudinal tracking of neuroserpin levels throughout pregnancy or during postpartum recovery. ### Conclusion

Implications

In conclusion, lower maternal serum neuroserpin levels are significantly linked to both the presence and severity of preeclampsia, indicating its potential as a biomarker for assessing disease burden and inflammatory activity. Future multi-center, longitudinal studies could further confirm these results and investigate the clinical implications of neuroserpin in predicting and managing preeclampsia.

The key points from the research paper are: 1. Maternal serum neuroserpin levels were significantly lower in women diagnosed with preeclampsia compared to healthy pregnant controls. Moreover, neuroserpin levels were further decreased in those with severe preeclampsia, suggesting a potential role of neuroserpin not only in the presence but also in the progression of the disease. 2. The observed suppression of neuroserpin in preeclamptic pregnancies may reflect impaired physiological upregulation in response to inflammatory vascular stress. In healthy pregnancies, neuroserpin expression may serve as a compensatory mechanism to maintain endothelial integrity, and its reduction in preeclampsia could facilitate unchecked vascular inflammation and endothelial dysfunction. 3. Receiver operating characteristic (ROC) curve analysis showed that a serum neuroserpin cutoff value of ≤ 22.95 ng/mL had a sensitivity of 86.4% and a specificity of 43.2% for identifying preeclampsia, while a cutoff of ≤ 14.7 ng/mL had a sensitivity of 50.0% and a specificity of 96.7% for identifying severe preeclampsia. These findings suggest that neuroserpin may serve as a candidate biomarker reflecting disease burden and inflammatory activity in preeclampsia.

Reference –

Belgin Savran Ucok et al. (2025). Investigation Of Serum Neuroserpin Levels In Pregnant Women Diagnosed With Pre-Eclampsia: A Prospective Case-Control Study. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07673-2.