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PDGF-BB as a potential biomarker for early diagnosis of postpartum hemorrhage
Karthikeyan Thirugnanam1, Brock E Polnaszek2, Kevin Eng3
1Division of Neonatology, Department of Pediatrics, Developmental Vascular Biology Program, Medical College of Wisconsin, Children's Research Institute (CRI), Milwaukee, WI, United States.
Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality, highlighting the need for effective methods to detect early identification and intervention. Previous data demonstrates that endothelial cilia, a microtubule-based organelle is responsible for vascular stability. Thus, we rationalized that proteins inside endothelial cilia may be candidates for conditions affected by dysregulated flow and barrier formation. Protein expression of four ciliary-associated candidates, including Platelet-Derived Growth Factor-BB (PDGF-BB), were quantified using Western blot and enzyme-linked immunosorbent assay (ELISA). Baseline characteristics were compared across groups, and logistic regression and receiver operating characteristic (ROC) analyses were performed to evaluate the association between PDGF-BB levels and PPH risk. Baseline characteristics were comparable across groups, except for maternal race and pre-pregnancy body mass index. Among the proteins evaluated, PDGF-BB demonstrated consistent differential expression across both analytical platforms. Higher PDGF-BB levels were independently associated with a lower risk of PPH in both unadjusted and adjusted models (adjusted OR 0.62, 95% CI 0.44-0.88; p = 0.0068). ROC analysis identified a PDGF-BB threshold of 11.5 pg/mL, yielding high discriminatory performance for PPH. These findings may suggest that low levels of PDGF-BB may be associated with risk of PPH, providing a potential early biomarker for this condition to inform management. Further prospective studies are needed to confirm the temporal relationship, causal pathway, and diagnostic utility of PDGF-BB for risk of PPH.
Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality, highlighting the need for effective methods to detect early identification and intervention. Previous data demonstrates that endothelial cilia, a microtubule-based organelle is responsible for vascular stability. Thus, we rationalized that proteins inside endothelial cilia may be candidates for conditions affected by dysregulated flow and barrier formation. Protein expression of four ciliary-associated candidates, including Platelet-Derived Growth Factor-BB (PDGF-BB), were quantified using Western blot and enzyme-linked immunosorbent assay (ELISA). Baseline characteristics were compared across groups, and logistic regression and receiver operating characteristic (ROC) analyses were performed to evaluate the association between PDGF-BB levels and PPH risk. Baseline characteristics were comparable across groups, except for maternal race and pre-pregnancy body mass index. Among the proteins evaluated, PDGF-BB demonstrated consistent differential expression across both analytical platforms. Higher PDGF-BB levels were independently associated with a lower risk of PPH in both unadjusted and adjusted models (adjusted OR 0.62, 95% CI 0.44-0.88; p = 0.0068). ROC analysis identified a PDGF-BB threshold of 11.5 pg/mL, yielding high discriminatory performance for PPH. These findings may suggest that low levels of PDGF-BB may be associated with risk of PPH, providing a potential early biomarker for this condition to inform management. Further prospective studies are needed to confirm the temporal relationship, causal pathway, and diagnostic utility of PDGF-BB for risk of PPH.