SERUM INTERLEUKIN‑35, PENTRAXIN‑3, GALECTIN‑3 AND HMGB1 IN BRUCELLA‑ASSOCIATED RECURRENT PREGNANCY LOSS: A HOSPITAL‑BASED CASE–CONTROL STUDY FROM MAYSAN, SOUTHERN IRAQ
DOI:
https://doi.org/10.61841/4zg7cc46Keywords:
Brucellosis, Recurrent pregnancy loss, Interleukin‑35, Pentraxin‑3, Galectin‑3, HMGB1, IraqAbstract
Background. Brucellosis is endemic in Iraq and has been associated with adverse pregnancy outcomes, yet the serum immunological profile of Brucella‑associated recurrent pregnancy loss (RPL) remains poorly characterised. We evaluated four candidate biomarkers — interleukin‑35 (IL‑35), pentraxin‑3 (PTX3), galectin‑3 and high‑mobility group box 1 (HMGB1) — together with a panel of inflammatory mediators in women with and without Brucella infection.
Methods. In this hospital‑based case–control study, 210 women aged 20–40 years were enrolled into three groups of 70: healthy fertile controls (G1), Brucella‑negative RPL (G2) and Brucella‑positive RPL (G3). Serum biomarkers were measured by enzyme‑linked immunosorbent assay (ELISA). Brucella infection was confirmed by the Rose Bengal test and IgG/IgM ELISA. Groups were compared by one‑way ANOVA or Kruskal–Wallis tests with post‑hoc correction; diagnostic performance was assessed by receiver operating characteristic (ROC) analysis.
Results. From G1 to G3, IL‑35 decreased progressively (217.3 → 150.2 → 109.0 pg/mL), whereas PTX3 (2.6 → 8.4 → 14.2 ng/mL), galectin‑3 (10.3 → 14.8 → 19.4 ng/mL) and HMGB1 (87.4 → 140.7 → 209.4 ng/mL) increased (all P < 0.001). IL‑10 and VEGF declined, while TNF‑α, IL‑6, TGF‑β1, MMP‑9, CRP and ESR rose. HMGB1 and PTX3 separated Brucella‑positive RPL from controls with the highest accuracy.
Conclusions. Brucella‑positive RPL was characterised by a distinct serum signature combining suppressed immunoregulatory cytokines with heightened innate‑immune and alarmin activity. These biomarkers merit prospective validation as candidate indicators of infection‑associated pregnancy loss in endemic settings.
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