We have read with great interest the published article by Akin et al. entitled with “Pentraxin 3 Concentrations of the Mothers with Preterm Premature Rupture of Membranes and Their Neonates, and Early Neonatal Outcome” [Citation1]. They have evaluated the association between the plasma pentraxin 3 (PTX3) concentrations of mothers with Preterm Premature Rupture of Membranes (PPROM) and of their neonates’ and early neonatal outcome, then they have concluded that maternal PTX3 concentrations were not an adequate marker in defining clinical or histological chorioamnionitis and early neonatal outcome. However, there are some points that need to be clarified.
PTX3 is an acute phase protein and produced in response to inflammatory conditions in vivo [Citation2]. Serum PTX3 levels could be affected by various conditions, which the authors had to define as exclusion criteria, such as several inflammatory or infectious diseases such as rheumatologic diseases, chronic kidney diseases, cardiovascular diseases, diabetes mellitus, immunological disorders, vasculitis, chronic obstructive pulmonary disease, asthma, pneumonia, and ulcerative colitis [Citation3]. But the authors defined exclusion criteria as just pregnancies without PPROM, older than 37 gestational weeks at birth and multiple pregnancies. In this regard, if simple laboratory tests such as C-reactive protein, erythrocyte sedimentation rate, complete blood count and routine biochemistry tests were performed in addition to PTX3; selection of participants for study could be more reliable.
Previous studies showed that statins and angiotensin converting enzyme inhibitors likely affect serum PTX3 levels [Citation4]. Besides, dietary supplements such as omega-3 fatty acid, vitamin D, vitamin A, and vitamin E could affect PTX3 levels [Citation5]. Although there is not enough study about Turkish population, Bailey et al. reported that supplement use was reported by 49% of the United States population [Citation6]. In this regard, the authors should state whether the participants use these kinds of dietary supplements or not.
In conclusion, we believe this study contributes valuable information to medical literature. If the authors set robust selection criteria and define possible variables for study group, relationship between PPROM and PTX3 levels could be shown. However the explanation of this concern will certainly provide the clearer information for the readers.
Declaration of interest
The authors report no conflicts of interest.
References
- Akin MA, Gunes T, Coban D, et al. Pentraxin 3 concentrations of the mothers with preterm premature rupture of membranes and their neonates, and early neonatal outcome. J Matern Fetal Neonatal Med 2014. doi: 10.3109/14767058.2014.947574
- Yaman H, Cakir E, Akgul EO, et al. Pentraxin 3 as a potential biomarker of acetaminophen-induced liver injury. Exp Toxicol Pathol 2013;65:147–51
- Bonacina F, Baragetti A, Catapano AL, Norata GD. Long pentraxin 3: experimental and clinical relevance in cardiovascular diseases. Mediators Inflamm 2013;2013: Article ID 725102
- Iwata A, Miura S, Tanaka T, et al. Plasma pentraxin-3 levels are associated with coronary plaque vulnerability and are decreased by statin. Coron Artery Dis 2012;23:315–21
- Rosjo E, Myhr KM, Loken-Amsrud KI, et al. Increasing serum levels of vitamin A, D and E are associated with alterations of different inflammation markers in patients with multiple sclerosis. J Neuroimmunol 2014;271:60–5
- Bailey RL, Gahche JJ, Lentino CV, et al. Dietary supplement use in the United States, 2003–2006. J Nutr 2011;141:261–6