{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:26:30Z","timestamp":1772252790525,"version":"3.50.1"},"reference-count":26,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T00:00:00Z","timestamp":1689897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"General Secretariat for Research and Technology Management","award":["T2EDK-02288"],"award-info":[{"award-number":["T2EDK-02288"]}]},{"name":"General Secretariat for Research and Technology Management","award":["MDS-TARGET"],"award-info":[{"award-number":["MDS-TARGET"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome is a life-threatening complication of pregnancy, which is often secondary to preeclampsia. To date, there is no biomarker in clinical use for the early stratification of women with preeclampsia who are under increased risk of HELLP syndrome. Herein, we show that the levels of circulating developmental endothelial locus-1 (DEL-1), which is an extracellular immunomodulatory protein, are decreased in patients with HELLP syndrome compared to preeclampsia. DEL-1 levels are also negatively correlated with the circulating levels of kidney injury molecule-1 (KIM-1), which is a biomarker for disorders associated with kidney damage. Receiver-operating characteristic curve analysis for DEL-1 levels and the DEL-1 to KIM-1 ratio demonstrates that these values could be used as a potential biomarker that distinguishes patients with HELLP syndrome and preeclampsia. Finally, we show that placental endothelial cells are a source for DEL-1, and that the expression of this protein in placenta from patients with HELLP syndrome is minimal. Taken together, this study shows that DEL-1 is downregulated in HELLP syndrome both in the circulation and at the affected placental tissue, suggesting a potential role for this protein as a biomarker, which must be further evaluated.<\/jats:p>","DOI":"10.3390\/ijms241411762","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:47:03Z","timestamp":1690159623000},"page":"11762","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Decreased Levels of Soluble Developmental Endothelial Locus-1 Are Associated with Thrombotic Microangiopathy in Pregnancy"],"prefix":"10.3390","volume":"24","author":[{"given":"Gioulia","family":"Romanidou","sequence":"first","affiliation":[{"name":"Department of Nephrology, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana Campus, 68100 Alexandroupolis, Greece"},{"name":"General Hospital \u201cSismanoglio\u201d, Sismanoglou 45, 69133 Komotini, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4296-3414","authenticated-orcid":false,"given":"Theocharis G.","family":"Konstantinidis","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, School of Medicine, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasia-Maria","family":"Natsi","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantia","family":"Kantartzi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Panopoulou","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, School of Medicine, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanouil","family":"Kontomanolis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7869-6824","authenticated-orcid":false,"given":"Christina","family":"Tsigalou","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, School of Medicine, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8651-3680","authenticated-orcid":false,"given":"Maria","family":"Lambropoulou","sequence":"additional","affiliation":[{"name":"Laboratory of Histology-Embryology, School of Medicine, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8883-8208","authenticated-orcid":false,"given":"Eleni","family":"Gavriilaki","sequence":"additional","affiliation":[{"name":"Hematology Department-BMT Unit, General Hospital of Thessaloniki George Papanikolaou, 57010 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stylianos","family":"Panagoutsos","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ploumis","family":"Pasadakis","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9991-2362","authenticated-orcid":false,"given":"Ioannis","family":"Mitroulis","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Haram, K., Svendsen, E., and Abildgaard, U. 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