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. 2020 Apr 14;10:6398. doi: 10.1038/s41598-020-62193-7

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Decreased syncytin-1 EV signal in maternal circulation enables diagnosis of preeclampsia with high accuracy. (A) Syncytiotrophoblast EVs were quantified on the nanoparticle detector using anti-syncytin-1 antibody conjugated quantum dots. This demonstrated that preeclampsia subjects had lower levels of syncytin-1 expressing EVs compared to control subjects. NanoSight panels show syncytin-1 positive EV subpopulation (red) in relation to total plasma EV pool (blue). (B) Scatter plot analysis of STEV signal showed significantly decreased syncytin-1 signal in preeclampsia subjects (p = 2.82 × 10⁻¹¹). (C) Receiver operating characteristic curve (ROC) in a binary cohort of preeclampsia versus control subjects was constructed for syncytin-1 EV signal, total plasma EVs quantity, and mean plasma EV size. This demonstrated an area under the curve of 0.975 ± 0.020 for STEV quantitative profiling, and a syncytin-1 EV signal threshold level of <0.316 predicted preeclampsia in this cohort with 95.2% sensitivity and 95.6% specificity. Total plasma EV numbers and mean plasma EV size had low diagnostic accuracy compared to STEV signal quantitation.