D-chiro inositol phosphoglycan (IPG-P) as a potential urinary marker to predict preeclampsia

Preeclampsia is a pathological condition that can complicate human pregnancy with a frequency between 2 and 7% of healthy nulliparous women worldwide. Inositol phosphoglycans P type (IPG-P) are phospholipids that exert an insulin mimetic activity and increase during pregnancy in fetal and maternal compartments with a clear higher concentration in pregnancies complicated by preeclampsia. A comprehensive review of the literature was performed to identify the most relevant studies about this topic. Many authors in the last decades investigated IPG-P modifications in different compartments of preeclamptic pregnancies, finding an increased concentration of this phosphoglycans in villous stroma, cord blood, amniotic fluid and in maternal urines even weeks before the clinical onset of the disease. According to these findings, urinary IPG-P can be a reliable test to identify women at risk of preeclampsia weeks before the clinical presentation of the maternal syndrome. This test showed a good sensitivity and specificity and it is based on a low-cost and direct assay that makes this method of great interest especially in low-and middle-income countries. Further longitudinal studies in different ethnic groups are warranted to demonstrate a transverse efficacy of the test.