Serum CASP3 levels and cleaved caspase-3 protein expression in adenovirus-associated spontaneous abortion: diagnostic and apoptotic implications.

Adenoviral infection has been implicated in spontaneous abortion, but the relationship between adenovirus-associated pregnancy loss and systemic apoptotic activation remains incompletely understood. This study investigated serum caspase-3 (CASP3) concentrations and cleaved caspase-3 protein expression in women with adenovirus-associated spontaneous abortion and evaluated the diagnostic performance of serum CASP3. A comparative cross-sectional study was conducted including 90 pregnant women: 46 with adenovirus-associated spontaneous abortion and 44 healthy pregnant controls. Serum CASP3 concentrations were quantified by ELISA, and cleaved caspase-3 expression was evaluated by Western blot in an exploratory sub-cohort. Pearson correlation, multivariable linear regression, and receiver operating characteristic (ROC) analyses were performed. Serum CASP3 was significantly elevated in the spontaneous abortion group relative to controls (5.60 ± 1.21 vs. 2.17 ± 0.49 ng/mL; p < 0.001). Western blot analysis revealed a 28.66 ± 4.80-fold upregulation of cleaved caspase-3 in the abortion cohort (relative expression: 4.30 ± 0.72 vs. 0.15 ± 0.01; p < 0.001). BMI was an independent positive predictor of serum CASP3, whereas hemoglobin demonstrated a significant inverse association. ROC analysis yielded an area under the curve of 0.844 (95% CI: 0.765-0.922), with an optimal diagnostic threshold of 3.45 ng/mL conferring 76.9% sensitivity and 88.6% specificity. Serum CASP3 concentrations and cleaved caspase-3 expression were significantly increased in women with adenovirus-associated spontaneous abortion, supporting an association with enhanced systemic apoptotic activity. Serum CASP3 demonstrated promising discriminatory performance within the study cohort; however, these findings require validation in larger prospective studies before clinical application.