Results year 1
Does the outcome of the blood test to be established in Surabaya when applied in early pregnancy noninvasively and pre-symptomatically predict the development of pregnancy complications in late pregnancy resulting in improved care?
The modifications to our blood test as successfully established and implemented in Surabaya thanks to the AFAS Foundation donation in year 1 appears to have four consequences compared to the original Amsterdam test:
1. The test also appears to recognize pre-eclampsia syndromes other than the severe but less common early form with growth retardation to which the original RNA blood test was limited. This would mean an increase in the number of affected pregnancies that could be predicted with the modified test (increase diagnostic potency).
2. This broader applicability probably lies not in the fact that we added an additional marker (circNRIP1), but by including in the analysis of plasma the platelets present there as an additional source of biological information (augmentation clinical information).
3. Third, the use of low-dose aspirin prevents 50, 25 and 0%, respectively, of early, preterm and term forms of pre-eclampsia. In other words, in 50, 75 and 100% of cases, aspirin has no therapeutic effect. Given the effect of aspirin on platelets and the importance of platelets in the development of pre-eclampsia, it may be that our test will distinguish between those pregnant women who do or do not respond to aspirin. This will provide an as yet missing diagnostic and therapeutic tool for identifying these non-aspirin responding pregnant women followed by preventive measures other than aspirin.
4. Finally, the addition of the additional and new circNRIP1 marker had no effect on the primary readout value (increase ratio) but did affect the variability of the test: the test became more reliable (lower dispersion). Modification of the test using two complementary markers of one gene (NRIP1) may mean that the final test becomes cheaper while maintaining specificity and reproducibility.
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Based on these results, the AFAS Foundation granted a donation of 59K Euros for further development of these results in year 2.