To evaluate the role of matrix-remodeling associated 5 (MXRA5), and tissue inhibitor metalloproteinase 2 (TIMP2) levels in predicting the severity of preeclampsia. Forty-eight pregnant women complicated by preeclampsia, whose ages ranged from 20 to 40 years, in addition to 48 age- and sex-matched normotensive pregnant women, served as the control group included in the study. The placental samples in this study were obtained via cesarean section, frozen immediately in liquid nitrogen, and stored at − 80 °C until the time of assay for subsequent RNA and protein biochemical measurements. There was a statistically significant decrease in the mean MXRA5 level among cases compared with controls (p <0.001 for both). However, there was no statistically significant difference in the mean TIMP2 level between the cases and controls. There was a statistically significant lower mean difference in pAKT-ELIZA among PE patients (0.29±0.04) than among controls (0.56±0.14, p<0.001), with a positive correlation between pAKT and MXRA5. MXRA5 performed high accuracy (sensitivity: 96.7%, specificity: 94.4%) in excluding cases and controls with PE. Furthermore, MXRA5 exhibited greater sensitivity in distinguishing between severe and mild cases (95.5%, sensitivity 96.7%, specificity), whereas the role of TIMP2 was insignificant.
In conclusion: in pre-eclampsia patients, reduced MXRA5 expression is a highly sensitive biomarker for detecting and predicting the severity of PE.