Twin-twin transfusion syndrome (TTTS) is an unusual and serious condition that occurs in twin pregnancies when identical twins share a placenta but develop discordant amniotic fluid volumes. TTTS is associated with an increased risk of fetal death and birth defects if untreated. This study investigated the soluble levels of biomarkers including growth factors and interleukins in pregnant women with and without TTTS during pregnancy. We quantified plasma levels of VEGF-R1, VEGF-R2, IL-1β, IL-6 and IL-8 in twin pregnant women with (n=53) and without TTTS (n=72) and in women with single pregnancy (n=30) by ELISA and analyzed the association of maternal circulating biomarker levels with TTTS. Our results showed that maternal VEGF-R1 levels were significantly higher in twins compared to single pregnancy (P<0.05) and were decreased in the second trimester compared to the first trimester (P = 0.065, 0.019 and 0.072 for twins with and without TTTS and single pregnancy, respectively). VEGF-R2 levels had a trend to be lower in twins compared to single pregnancy. In addition, soluble VEGF-R1 and VEGF-R2 levels were significantly decreased while IL-6 levels were increased after surgical treatment with laser in twin pregnant women with TTTS (P = 0.016, 0.041 and 0.04, respectively). These results suggest that IL-6, VEGF-R1 and VEGF-R2 are involved in vascular regulation and stabilization in twin pregnancies and may contribute to the pathogenesis of TTTS and thus play a prognostic role in the surgical treatment of TTTS.

中文翻译：

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双胎输血综合征孕妇母体血管内皮生长因子受体及白细胞介素水平

双胞胎输血综合征 (TTTS) 是一种不寻常且严重的疾病，当同卵双胞胎共用一个胎盘但羊水量不一致时，会在双胎妊娠中发生这种情况。如果不治疗，TTTS 与胎儿死亡和出生缺陷的风险增加有关。本研究调查了妊娠期间患有和未患有 TTTS 的孕妇的可溶性生物标志物水平，包括生长因子和白细胞介素。我们量化了双胞胎孕妇（n=53）和没有 TTTS（n=72）和单胎妊娠（n = 30) 通过 ELISA 分析母体循环生物标志物水平与 TTTS 的关联。我们的研究结果表明，与单胎妊娠相比，双胞胎的母体 VEGF-R1 水平显着升高（P<0.05) 并且在孕中期与孕早期相比下降（P = 0.065, 0.019 和 0.072 对于有和没有 TTTS 的双胞胎和单胎妊娠，分别）。与单胎妊娠相比，双胞胎的 VEGF-R2 水平有降低的趋势。此外，TTTS双胞胎孕妇激光手术治疗后可溶性VEGF-R1和VEGF-R2水平显着降低，IL-6水平升高（P分别为0.016、0.041和0.04）。这些结果表明IL-6、VEGF-R1和VEGF-R2参与了双胎妊娠的血管调节和稳定，可能参与了TTTS的发病机制，从而在TTTS的手术治疗中发挥了预后作用。