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Li A, Zhang L, Liu Q, Fang Z, Sun Y, Li S, Peng Y, Zhang M, Wang X. Proteomic analysis of amniotic fluid to identify potential targets predicting preterm delivery. BIOCHIMICA ET BIOPHYSICA ACTA. PROTEINS AND PROTEOMICS 2023; 1871:140879. [PMID: 36396099 DOI: 10.1016/j.bbapap.2022.140879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/04/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022]
Abstract
Preterm delivery is a common complication of pregnancy which leads to significant neonatal mortality and morbidity. Identifying predictive markers linked to spontaneous preterm delivery (SPTD) is important for effective treatment and prevention of PTD. To explore potential biomarkers related to SPTD, we performed proteomics analysis in amniotic fluid (AF). In total, we enrolled 30 pregnant women with singleton gestation who underwent clinically indicated amniocentesis at 15-24 weeks of gestation. LC-MS analysis was used to analyze the AF samples of 10 women with SPTD < 34 weeks after cervix cerclage (Preterm group), 10 women with term delivery (TD) ≥ 34 weeks after cervix cerclage (Term group), and 10 women who delivered at term (Normal group). ELISA validation was performed for candidate proteins in a second independent cohort. As a result, we identified 44 differentially expressed proteins (DEPs, P < 0.05) via proteomic analysis, and based on that, 9 primary pathways were also determined in SPTD. Results of the ELISA assay confirmed that the increased concentration of Serpin A1, decreased concentrations of Renin and IGFBP4 were significantly associated with SPTD at ≤34 weeks.
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Affiliation(s)
- Anna Li
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Maternal and child health care hospital of Shandong province, Jinan 250014, Shandong, China
| | - Lin Zhang
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Maternal and child health care hospital of Shandong province, Jinan 250014, Shandong, China
| | - Qunying Liu
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Maternal and child health care hospital of Shandong province, Jinan 250014, Shandong, China
| | - Zhenya Fang
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Maternal and child health care hospital of Shandong province, Jinan 250014, Shandong, China
| | - Yaqiong Sun
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Maternal and child health care hospital of Shandong province, Jinan 250014, Shandong, China
| | - Shuxian Li
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Maternal and child health care hospital of Shandong province, Jinan 250014, Shandong, China
| | - Yanjie Peng
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Maternal and child health care hospital of Shandong province, Jinan 250014, Shandong, China
| | - Meihua Zhang
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Maternal and child health care hospital of Shandong province, Jinan 250014, Shandong, China.
| | - Xietong Wang
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Maternal and child health care hospital of Shandong province, Jinan 250014, Shandong, China; Department of Obstetrics and Gynecology, Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China.
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Zhai YJ, Feng Y, Ma X, Ma F. Defensins: defenders of human reproductive health. Hum Reprod Update 2022; 29:126-154. [PMID: 36130055 PMCID: PMC9825273 DOI: 10.1093/humupd/dmac032] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/31/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Reproductive tract infection is an important factor leading to male and female infertility. Among female infertility factors, microbial and viral infections are the main factors affecting female reproductive health and causing tubal infertility, ectopic tubal pregnancy and premature delivery. Among male infertility factors, 13-15% of male infertility is related to infection. Defensins are cationic antibacterial and antiviral peptides, classified into α-defensins, β-defensins and θ-defensins. Humans only have α-defensins and β-defensins. Apart from their direct antimicrobial functions, defensins have an immunomodulatory function and are involved in many physiological processes. Studies have shown that defensins are widely distributed in the female reproductive tract (FRT) and male reproductive tract (MRT), playing a dual role of host defence and fertility protection. However, to our knowledge, the distribution, regulation and function of defensins in the reproductive tract and their relation to reproduction have not been reviewed. OBJECTIVE AND RATIONALE This review summarizes the expression, distribution and regulation of defensins in the reproductive tracts to reveal the updated research on the dual role of defensins in host defence and the protection of fertility. SEARCH METHODS A systematic search was conducted in PubMed using the related keywords through April 2022. Related data from original researches and reviews were integrated to comprehensively review the current findings and understanding of defensins in the human reproductive system. Meanwhile, female and male transcriptome data in the GEO database were screened to analyze defensins in the human reproductive tracts. OUTCOMES Two transcriptome databases from the GEO database (GSE7307 and GSE150852) combined with existing researches reveal the expression levels and role of the defensins in the reproductive tracts. In the FRT, a high expression level of α-defensin is found, and the expression levels of defensins in the vulva and vagina are higher than those in other organs. The expression of defensins in the endometrium varies with menstrual cycle stages and with microbial invasion. Defensins also participate in the local immune response to regulate the risk of spontaneous preterm birth. In the MRT, a high expression level of β-defensins is also found. It is mainly highly expressed in the epididymal caput and corpus, indicating that defensins play an important role in sperm maturation. The expression of defensins in the MRT varies with androgen levels, age and the status of microbial invasion. They protect the male reproductive system from bacterial infections by neutralizing lipopolysaccharide and downregulating pro-inflammatory cytokines. In addition, animal and clinical studies have shown that defensins play an important role in sperm maturation, motility and fertilization. WIDER IMPLICATIONS As a broad-spectrum antimicrobial peptide without drug resistance, defensin has great potential for developing new natural antimicrobial treatments for reproductive tract infections. However, increasing evidence has shown that defensins can not only inhibit microbial invasion but can also promote the invasion and adhesion of some microorganisms in certain biological environments, such as human immunodeficiency virus. Therefore, the safety of defensins as reproductive tract anti-infective drugs needs more in-depth research. In addition, the modulatory role of defensins in fertility requires more in-depth research since the current conclusions are based on small-size samples. At present, scientists have made many attempts at the clinical transformation of defensins. However, defensins have problems such as poor stability, low bioavailability and difficulties in their synthesis. Therefore, the production of safe, effective and low-cost drugs remains a challenge.
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Affiliation(s)
| | | | - Xue Ma
- Correspondence address. Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China. E-mail: https://orcid.org/0000-0002-7781-821X (F.M.); Department of Pediatric Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. E-mail: https://orcid.org/0000-0002-7650-6214 (X.M.)
| | - Fang Ma
- Correspondence address. Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China. E-mail: https://orcid.org/0000-0002-7781-821X (F.M.); Department of Pediatric Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. E-mail: https://orcid.org/0000-0002-7650-6214 (X.M.)
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Maternal immunity and pregnancy outcome: focus on preconception and autophagy. Genes Immun 2015; 17:1-7. [PMID: 26656449 DOI: 10.1038/gene.2015.57] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 11/06/2015] [Indexed: 12/25/2022]
Abstract
Modulation of the maternal immune system before conception has a major role in determining subsequent pregnancy outcome. However, this has been a neglected area of investigation. There is a correlation between the length of time a woman is exposed to semen from her male partner and the development of regulatory T cells that limit a maternal antifetal immune response. Similarly, the composition of the vaginal microbiota influences the capacity of microorganisms to bypass the cervical barrier and colonize the uterus before pregnancy. The extent that this preconception colonization influences pre- and post-implantation gestational events depends on the types of microbes present, the genetic make-up of the mother and environmental influences on the magnitude and direction of her immune responses. Prepregnancy uterine and placental colonization with commensal bacteria may be beneficial to the fetus and newborn by generating tolerance to organisms that enhance postnatal well-being. Efforts to prevent or stop the progression of premature myometrial contractions have been limited because of an incomplete understanding of the mechanism(s) that trigger this occurrence. Based on recent studies of autophagy during gestation and parturition, inhibition of autophagy in myometrial cells may be the critical factor leading to a sequence of events culminating in induction of myometrial contractions either prematurely or at term.
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Laudanski P, Raba G, Kuc P, Lemancewicz A, Kisielewski R, Laudanski T. Assessment of the selected biochemical markers in predicting preterm labour. J Matern Fetal Neonatal Med 2013; 25:2696-9. [PMID: 22646705 DOI: 10.3109/14767058.2012.699116] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The differential diagnosis between preterm and false labour remains one of the most challenging issues in perinatal medicine. AIM To assess the prognostic importance of the selected biochemical markers in predicting preterm labour. MATERIAL AND METHODS 74 patients hospitalized due to threatening preterm labour. 51 women gave birth prematurely; the remaining 23 were diagnosed with false labour. We used ELISA arrays to study 13 proteins: IGFBP-1, IGFBP-2, BDNF, L-Selectin, E-Selectin, ICAM-1, PECAM, VCAM-1, MIP-1 delta (MIP-1d) MIP-3β (MIP-3b), Eotaxin-1, Eotaxin-2, BLC. RESULTS An increased risk of preterm labour should be expected when the serum concentration for: IGFBP-1 > 158.83 pg/ml (sens. 0.608, sp. 0.609, p < 0.0001); MIP-1d < 27.66 pg/ml (sens. 0.627, sp. 0.627, p = 0.021); BDNF >36.54 pg/ml (sens. 0.630, sp. 0.647, p = 0.002); BLC >25.46 pg/ml (sens. 0.588, sp. 0.609, p < 0.001); Eotaxin-1 >1.16 pg/ml (sens. 0.633, sp. 0.652). CONCLUSION There have been reported statistically significant differences in serum concentrations of selected proteins in women with preterm labour and false labour.
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Affiliation(s)
- Piotr Laudanski
- Department of Perinatology, Medical University of Białystok, Poland
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Kamath-Rayne BD, Smith HC, Muglia LJ, Morrow AL. Amniotic fluid: the use of high-dimensional biology to understand fetal well-being. Reprod Sci 2013; 21:6-19. [PMID: 23599373 DOI: 10.1177/1933719113485292] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Our aim was to review the use of high-dimensional biology techniques, specifically transcriptomics, proteomics, and metabolomics, in amniotic fluid to elucidate the mechanisms behind preterm birth or assessment of fetal development. We performed a comprehensive MEDLINE literature search on the use of transcriptomic, proteomic, and metabolomic technologies for amniotic fluid analysis. All abstracts were reviewed for pertinence to preterm birth or fetal maturation in human subjects. Nineteen articles qualified for inclusion. Most articles described the discovery of biomarker candidates, but few larger, multicenter replication or validation studies have been done. We conclude that the use of high-dimensional systems biology techniques to analyze amniotic fluid has significant potential to elucidate the mechanisms of preterm birth and fetal maturation. However, further multicenter collaborative efforts are needed to replicate and validate candidate biomarkers before they can become useful tools for clinical practice. Ideally, amniotic fluid biomarkers should be translated to a noninvasive test performed in maternal serum or urine.
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Affiliation(s)
- Beena D Kamath-Rayne
- 1Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Proteomics advancements in fetomaternal medicine. Clin Biochem 2013; 46:487-96. [DOI: 10.1016/j.clinbiochem.2012.10.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 10/05/2012] [Accepted: 10/11/2012] [Indexed: 12/11/2022]
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Fotopoulou C, Kyeyamwa S, Linder M, Thieme D, Hartenstein S, Klein O, Dudenhausen JW, Henrich W, Kalache KD, Bamberg C. Proteomic analysis of midtrimester amniotic fluid to identify novel biomarkers for preterm delivery. J Matern Fetal Neonatal Med 2012; 25:2488-93. [PMID: 22827563 DOI: 10.3109/14767058.2012.712565] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to identify possible biomarkers for preterm delivery by analyzing midtrimester amniotic fluid. METHODS Thirty-two amniotic fluid samples were studied; 16 patients had a spontaneous preterm delivery and 16 patients delivered at term. The proteomic technique consisted of surface-enhanced laser desorption ionization time-of-flight (SELDI-TOF) using different types of solid chromatographic chips (Q10, CM10 and IMAC30). RESULTS Mass spectrometry tracings were obtained from the amniotic fluids of both patients who delivered preterm and patients who delivered at term. Seven potential markers were identified to be differentially expressed in patients who delivered preterm. CONCLUSIONS Proteomic analysis of amniotic fluid obtained in the midtrimester reveals the presence of a set of proteins in patients at risk for preterm delivery.
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Affiliation(s)
- Christina Fotopoulou
- Department of Gynecology, Berlin Centrum for Regenerative Therapies, Charité-University Hospital, Berlin, Germany
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Ma Z, Liu C, Deng B, Dong S, Tao G, Zhan X, Wang C, Liu S, Qu X. Different protein profile in amniotic fluid with nervous system malformations by surface-enhanced laser desorption-ionization/time-of-flight mass spectrometry (SELDI-TOF-MS) technology. J Obstet Gynaecol Res 2011; 36:1195-203. [PMID: 21114572 DOI: 10.1111/j.1447-0756.2010.01390.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM To detect the distinct proteins in amniotic fluid (AF) between nervous system malformations fetuses and normal fetuses. MATERIAL AND METHODS Surface-enhanced laser desorption-ionization/time-of-flight mass spectrometry was used to characterize AF peptides in AF between nervous system malformations fetuses and normal fetuses. WCX2 protein chips were used to characterize AF peptides in AF. Protein chips were examined in a PBSIIC protein reader, the protein profiling was collected by ProteinChip software version 3.1 (Ciphergen Biosystems, Fremont, CA, USA) and analyzed by Biomarker Wizard software (Ciphergen Biosystems). Nine distinct proteins were identified in AF between nervous system malformations fetuses and normal fetuses. RESULTS Compared with the control group, three proteins with m/z 4967.5 Da, 5258.0 Da, and 11,717.0 Da were down-regulated, and six proteins with m/z 2540.4 Da, 3107.1 Da, 3396.8 Da, 4590.965 Da, 5589.2 Da and 6429.4 Da up-regulated in nervous system malformations fetuses. CONCLUSION The results suggest that there are distinct proteins in protein profiling of AF between nervous system malformations fetuses and normal fetuses.
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Affiliation(s)
- Zhe Ma
- Department of Ultrasound Basic Medicine, Qilu Hospital, Shandong University, Shandong Province, China
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Noguchi T, Sado T, Naruse K, Shigetomi H, Onogi A, Haruta S, Kawaguchi R, Nagai A, Tanase Y, Yoshida S, Kitanaka T, Oi H, Kobayashi H. Evidence for activation of Toll-like receptor and receptor for advanced glycation end products in preterm birth. Mediators Inflamm 2010; 2010:490406. [PMID: 21127710 PMCID: PMC2993025 DOI: 10.1155/2010/490406] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 10/11/2010] [Accepted: 10/26/2010] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Individuals with inflammation have a myriad of pregnancy aberrations including increasing their preterm birth risk. Toll-like receptors (TLRs) and receptor for advanced glycation end products (RAGE) and their ligands were all found to play a key role in inflammation. In the present study, we reviewed TLR and RAGE expression, their ligands, and signaling in preterm birth. RESEARCH DESIGN AND METHODS A systematic search was performed in the electronic databases PubMed and ScienceDirect up to July 2010, combining the keywords "preterm birth," "TLR", "RAGE", "danger signal", "alarmin", "genomewide," "microarray," and "proteomics" with specific expression profiles of genes and proteins. RESULTS This paper provides data on TLR and RAGE levels and critical downstream signaling events including NF-kappaB-dependent proinflammatory cytokine expression in preterm birth. About half of the genes and proteins specifically present in preterm birth have the properties of endogenous ligands "alarmin" for receptor activation. The interactions between the TLR-mediated acute inflammation and RAGE-mediated chronic inflammation have clear implications for preterm birth via the TLR and RAGE system, which may be acting collectively. CONCLUSIONS TLR and RAGE expression and their ligands, signaling, and functional activation are increased in preterm birth and may contribute to the proinflammatory state.
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Affiliation(s)
- Taketoshi Noguchi
- Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Toshiyuki Sado
- Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Katsuhiko Naruse
- Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Hiroshi Shigetomi
- Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Akira Onogi
- Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Shoji Haruta
- Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Ryuji Kawaguchi
- Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Akira Nagai
- Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Yasuhito Tanase
- Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Shozo Yoshida
- Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Takashi Kitanaka
- Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Hidekazu Oi
- Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Hiroshi Kobayashi
- Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
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Randis TM. Progress toward improved understanding of infection-related preterm birth. Clin Perinatol 2010; 37:677-88. [PMID: 20813278 DOI: 10.1016/j.clp.2010.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Current strategies to prevent infection-related preterm birth and its associated neonatal morbidities have had limited success. Improved understanding of the pathogen-host interactions underlying altered colonization of the lower genital tract is necessary before significant progress can be made. The application of novel diagnostic techniques such as broad range PCR and proteomic analysis contribute to our knowledge of the diversity and abundance of microbial species invading the amniotic cavity as well as the resultant inflammatory response. Preterm infants delivered following intrauterine infection may respond differently to subsequent infectious challenges in the neonatal intensive care unit.
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Affiliation(s)
- Tara M Randis
- Division of Neonatology, Columbia University Medical Center, 3959 Broadway, CHN 1201, New York, NY 10032, USA.
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Cobo T, Palacio M, Navarro-Sastre A, Ribes A, Bosch J, Filella X, Gratacós E. Predictive value of combined amniotic fluid proteomic biomarkers and interleukin-6 in preterm labor with intact membranes. Am J Obstet Gynecol 2009; 200:499.e1-6. [PMID: 19375569 DOI: 10.1016/j.ajog.2008.12.036] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Revised: 09/22/2008] [Accepted: 12/22/2008] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To assess proteomic biomarkers and interleukin-6 alone or in combination to predict intraamniotic infection, preterm birth, and neonatal morbidity in preterm labor with intact membranes. STUDY DESIGN Amniotic fluid interleukin-6 and selected proteomic biomarkers were assayed from 86 patients with preterm labor and intact membranes (22-36 weeks). The predictive value of each marker alone or in combination was evaluated for intraamniotic infection, preterm birth, and neonatal composite morbidity. RESULTS Both interleukin-6 (odds ratio, 19.5; P = .012) and proteomic biomarkers (odds ratio, 25.2; P = .001) were statistically independent predictors of intraamniotic infection with sensitivity, positive predictive value, and false-positive rates of 25%, 17.6%, and 20% when 1 marker was present and of 75%, 75%, and 4.3% when both were detected. Their combination did not improve prediction of preterm birth or neonatal morbidity. CONCLUSION The combined use of proteomic biomarkers and interleukin-6 to predict intraamniotic infection shows better accuracy than when used alone.
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Application of proteomics for diagnosis of fetal aneuploidies and pregnancy complications. J Proteomics 2009; 72:731-9. [PMID: 19332162 DOI: 10.1016/j.jprot.2009.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 03/11/2009] [Accepted: 03/16/2009] [Indexed: 11/22/2022]
Abstract
Proteomic technologies represent new strategies towards high-throughput, simultaneous analysis of thousands of biological molecules leading to the discovery of biomarkers for early diagnosis, prognosis and prediction of pregnancy outcome. Proteomics have additional relevance in understanding pathophysiology and the development of molecularly targeted therapeutics. Comparison of normal human amniotic fluid proteome with that coming from pregnancies carrying fetuses with chromosomal abnormalities facilitated the detection of panels of potential biomarkers for prenatal detection of fetal aneuploidies. Candidate biomarkers for the early prediction of preeclampsis are also available, while four biomarkers (defensins-2 and -1, calgranulin-C, and calgranulin-A), which were called the "MR score", can quickly and accurately detect potentially dangerous infections and predict premature birth. Researchers remain hopeful that proteomic studies will allow for the identification of either one protein marker or of a panel of markers for prenatal detection of fetal aneuploidies and pregnancy complications that could be usefully employed for diagnostic purposes or improvement of the current screening methods. For maximum predictive power however, biomarkers should be selected for further comparative analysis of expression and structural modifications in large numbers of samples from chromosomally normal and abnormal pregnancies obtained from different populations.
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Kolialexi A, Mavrou A, Spyrou G, Tsangaris GT. Mass spectrometry-based proteomics in reproductive medicine. MASS SPECTROMETRY REVIEWS 2008; 27:624-634. [PMID: 18618655 DOI: 10.1002/mas.20181] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The emergence of powerful mass spectrometry-based proteomic techniques has added a new dimension to the field of biomedical research. Application of these high throughput methodologies in pregnancy-related pathology has contributed to the comprehension of the underlying pathophysiologies and the successful identification of relevant protein biomarkers that can potentially change early diagnosis and treatment of several medical conditions related to human pregnancy. Most of the existing research on human reproduction and gestation has focused on follicular fluid, cervical/vaginal fluid, and amniotic fluid. Although proteome technologies in reproductive medicine research are not as yet widely applied, characterization of the proteome of reproductive fluids can be expected to significantly improve maternal healthcare. This article aims to summarize the applications of mass spectrometry based technology on the most important and specific biological fluids related to reproduction and gestation.
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Affiliation(s)
- Aggeliki Kolialexi
- Department of Medical Genetics, Athens University School of Medicine, Athens, Greece
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Buhimschi IA, Zhao G, Funai EF, Harris N, Sasson IE, Bernstein IM, Saade GR, Buhimschi CS. Proteomic profiling of urine identifies specific fragments of SERPINA1 and albumin as biomarkers of preeclampsia. Am J Obstet Gynecol 2008; 199:551.e1-16. [PMID: 18984079 DOI: 10.1016/j.ajog.2008.07.006] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2007] [Revised: 04/12/2008] [Accepted: 07/03/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The cause of preeclampsia remains unknown and the diagnosis can be uncertain. We used proteomic-based analysis of urine to improve disease classification and extend the pathophysiologic understanding of preeclampsia. STUDY DESIGN Urine samples from 284 women were analyzed by surface-enhanced laser desorption/ionization. In the exploratory phase, 59 samples were used to extract the proteomic fingerprint characteristic of severe preeclampsia requiring mandated delivery and to develop a diagnostic algorithm. In the challenge phase, we sought to prospectively validate the algorithm in 225 women screened for a variety of high- and low-risk conditions, including preeclampsia. Of these, 19 women were followed longitudinally throughout pregnancy. The presence of biomarkers was interpreted relative to clinical classification, need for delivery, and other urine laboratory measures (ratios of protein to creatinine and soluble fms-like tyrosine kinase-1 to placental growth factor). In the translational phase, biomarker identification by tandem mass spectrometry and validation experiments in urine, serum, and placenta were used to identify, quantify, and localize the biomarkers or related proteins. RESULTS We report that women with preeclampsia appear to present a unique urine proteomic fingerprint that predicts preeclampsia in need of mandated delivery with highest accuracy. This characteristic proteomic profile also has the ability to distinguish preeclampsia from other hypertensive or proteinuric disorders in pregnancy. Pregnant women followed longitudinally who developed preeclampsia displayed abnormal urinary profiles more than 10 weeks before clinical manifestation. Tandem mass spectrometry and de novo sequencing identified the biomarkers as nonrandom cleavage products of SERPINA1 and albumin. Of these, the 21 amino acid C-terminus fragment of SERPINA1 was highly associated with severe forms of preeclampsia requiring early delivery. In preeclampsia, increased and aberrant SERPINA1 immunoreactivity was found in urine, serum, and placenta, in which it localized predominantly to placental villi and placental vascular spaces adherent to the endothelium. In addition, significant perivascular deposits of misfolded SERPINA1 aggregates were exclusively identified in preeclamptic placentae. CONCLUSION Proteomics-based characterization of urine in preeclampsia identified a proteomic fingerprint composed of SERPINA1 and albumin fragments, which can accurately diagnose preeclampsia and shows promise to discriminate it from other hypertensive proteinuric diseases. These findings provide insight into a novel pathophysiological mechanism of preeclampsia related to SERPINA1 misfolding, which may offer new therapeutic opportunities in the future.
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Abstract
The complex nature of amniotic fluid reflects contributions from many fetal systems, many functional roles, and multiple interactions with fetal maturation, obstetric, and maternal factors. Simple ultrasound measurement, probably done best with the maximum vertical pocket method, has a clinical role in fetal surveillance, substantiated by extensive level II and some level I evidence. Interventions (amnioinfusion for oligohydramnios, amnioreduction for polyhydramnios) have not been studied effectively in controlled fashion, with the exception of intrapartum applications, where effective reduction of cesarean delivery for fetal distress and perinatal impacts of meconium aspiration may follow amnioinfusion. A wealth of research opportunities exists into regulation of amniotic fluid constituents and their relation to preterm delivery.
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Affiliation(s)
- Christopher R Harman
- Division of Maternal and Fetal Medicine, School of Medicine, University of Maryland Baltimore, Baltimore, MD 21201, USA.
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Mavrou A, Anagnostopoulos AK, Kolialexi A, Vougas K, Papantoniou N, Antsaklis A, Fountoulakis M, Tsangaris GT. Proteomic Analysis of Amniotic Fluid in Pregnancies with Turner Syndrome Fetuses. J Proteome Res 2008; 7:1862-6. [DOI: 10.1021/pr700588u] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Ariadni Mavrou
- Medical Genetics, Athens University School of Medicine, Athens, Greece, Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation, Academy of Athens, Athens, Greece, and 1st Department of Obstetrics & Gynaecology, Athens University School of Medicine, Athens, Greece
| | - Athanasios K. Anagnostopoulos
- Medical Genetics, Athens University School of Medicine, Athens, Greece, Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation, Academy of Athens, Athens, Greece, and 1st Department of Obstetrics & Gynaecology, Athens University School of Medicine, Athens, Greece
| | - Aggeliki Kolialexi
- Medical Genetics, Athens University School of Medicine, Athens, Greece, Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation, Academy of Athens, Athens, Greece, and 1st Department of Obstetrics & Gynaecology, Athens University School of Medicine, Athens, Greece
| | - Konstantinos Vougas
- Medical Genetics, Athens University School of Medicine, Athens, Greece, Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation, Academy of Athens, Athens, Greece, and 1st Department of Obstetrics & Gynaecology, Athens University School of Medicine, Athens, Greece
| | - Nikos Papantoniou
- Medical Genetics, Athens University School of Medicine, Athens, Greece, Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation, Academy of Athens, Athens, Greece, and 1st Department of Obstetrics & Gynaecology, Athens University School of Medicine, Athens, Greece
| | - Aris Antsaklis
- Medical Genetics, Athens University School of Medicine, Athens, Greece, Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation, Academy of Athens, Athens, Greece, and 1st Department of Obstetrics & Gynaecology, Athens University School of Medicine, Athens, Greece
| | - Michael Fountoulakis
- Medical Genetics, Athens University School of Medicine, Athens, Greece, Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation, Academy of Athens, Athens, Greece, and 1st Department of Obstetrics & Gynaecology, Athens University School of Medicine, Athens, Greece
| | - George Th. Tsangaris
- Medical Genetics, Athens University School of Medicine, Athens, Greece, Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation, Academy of Athens, Athens, Greece, and 1st Department of Obstetrics & Gynaecology, Athens University School of Medicine, Athens, Greece
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18
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Buhimschi IA, Buhimschi CS. Proteomics of the amniotic fluid in assessment of the placenta. Relevance for preterm birth. Placenta 2008; 29 Suppl A:S95-101. [PMID: 18191197 DOI: 10.1016/j.placenta.2007.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Revised: 11/30/2007] [Accepted: 12/03/2007] [Indexed: 11/18/2022]
Abstract
Proteomics is the study of expressed proteins and has emerged as a complement to genomic research. The major advantage of proteomics over DNA-RNA based technologies is that it more closely relates to phenotypes and not the source code. Proteomics thus holds the promise of providing a direct insight into the true mechanisms of human diseases. Historically, examination of the placenta has been the first modality to subclassify pathogenetic entities responsible for preterm birth. Because placenta is a key pathophysiological participant in several major obstetrical syndromes (preterm birth, pre-eclampsia, intrauterine growth restriction) identification of relevant biomarkers of placental function can profoundly impact on the prediction of fetal outcome and treatment efficacy. Since proteomics is a young science and studies that associate proteomic patterns with long-term outcome require follow-up of children up to school age, using placental pathological footprints of cellular injury as intermediate outcomes can be useful in the interim. Furthermore, knowledge on the identity of the dysregulated proteins may provide the needed breakthrough insight into novel pathophysiological pathways and unravel possible targets for therapeutical intervention that could not have been envisioned through hypothesis-driven approaches.
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Affiliation(s)
- I A Buhimschi
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, LLCI 804, New Haven, CT 06520, USA.
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19
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Kolialexi A, Mavrou A, Tsangaris GT. Proteomic analysis of human reproductive fluids. Proteomics Clin Appl 2007; 1:853-60. [DOI: 10.1002/prca.200700040] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2007] [Indexed: 11/06/2022]
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20
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McManemy J, Cooke E, Amon E, Leet T. Recurrence risk for preterm delivery. Am J Obstet Gynecol 2007; 196:576.e1-6; discussion 576.e6-7. [PMID: 17547902 DOI: 10.1016/j.ajog.2007.01.039] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2006] [Revised: 01/05/2007] [Accepted: 01/28/2007] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To estimate recurrence risk of preterm delivery in third births. STUDY DESIGN We conducted a population-based cohort study of Missouri mothers who delivered 3 consecutive singleton live births during 1989-1997. The recurrence risk was computed for 4 cohorts based on prior preterm delivery status and adjusted using Mantel-Haenszel stratified analysis. RESULTS The study population included 19,025 third births. The recurrence risk ranged from 42% (for women with 2 prior preterm deliveries), through 21% (term/preterm) and 13% (preterm/term), to 5% (term/term). The recurrence risk was highest (57%) for women with 2 prior very preterm deliveries (21-31 weeks) and lowest (33%) for those with 2 prior moderate preterm deliveries (32-36 weeks). The recurrence risk was less pronounced for women with 1 prior very or moderate preterm delivery. CONCLUSION These data show a strong association between prior preterm delivery and recurrence risk, which is affected by the frequency, order, and severity of prior preterm births.
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Affiliation(s)
- Julie McManemy
- Department of Pediatrics, Division of Emergency Medicine, Washington University School of Medicine, St Louis, MO, USA
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21
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Laudanski P, Pierzynski P, Laudanski T. Reductionist and system approaches to study the role of infection in preterm labor and delivery. BMC Pregnancy Childbirth 2007; 7 Suppl 1:S9. [PMID: 17570169 PMCID: PMC1892066 DOI: 10.1186/1471-2393-7-s1-s9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
A substantial number of patients with preterm labor and delivery do not show clinical signs of infection, however, it is the subclinical form which is the main causative factor and often results in premature delivery. The hitherto commonly applied methods of inflammation detection are based either on potentially hazardous amniocentesis or still insufficient inflammation-related protein measurement in the serum or other biological fluids. The advent of new "omics" technologies has led to a paradigm-shift in experimental approach which tends to primarily generate rather than form hypotheses. This has resulted in a surge of wealth of data composed of sets of individual or clusters of new genes and proteins that can be of potential importance as new markers of inflammation leading to preterm labor. It is hoped that as a result of those new methodologies the overall perception of medical research and practice would gradually change from reductionist to systems approach. Despite several successes of reductionism in the diagnosis and treatment of preterm labor it seems that system-based methodology would contribute to a more favorable personalized rather than one-for-all patient assistance. In this review we present the current knowledge on this new attractive field of medical studies with emphasis on early detection of infection related with preterm labor.
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Affiliation(s)
- Piotr Laudanski
- Department of Pathophysiology of Pregnancy, ul. Marii Sklodowskiej-Curie 24a 15-243 Bialystok, Medical University of Bialystok, Poland
| | - Piotr Pierzynski
- Department of Pathophysiology of Pregnancy, ul. Marii Sklodowskiej-Curie 24a 15-243 Bialystok, Medical University of Bialystok, Poland
| | - Tadeusz Laudanski
- Department of Pathophysiology of Pregnancy, ul. Marii Sklodowskiej-Curie 24a 15-243 Bialystok, Medical University of Bialystok, Poland
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22
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Pettker CM, Buhimschi IA, Magloire LK, Sfakianaki AK, Hamar BD, Buhimschi CS. Value of placental microbial evaluation in diagnosing intra-amniotic infection. Obstet Gynecol 2007; 109:739-49. [PMID: 17329528 DOI: 10.1097/01.aog.0000255663.47512.23] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the ability of microbiologic and pathologic examination of the placenta to accurately diagnose intraamniotic infection and inflammation. METHODS One hundred eighty-three women with a clinically indicated amniocentesis were enrolled prospectively. We applied our analysis to 56 women with evidence of preterm labor or preterm premature rupture of membranes who delivered within 48 hours of amniotic fluid testing results. Twenty-three patients, assessed for fetal lung maturity in the third trimester, served as controls. Amniotic fluid was cultured for aerobic, anaerobic, Ureaplasma, and Mycoplasma species. We used mass spectrometry to assess the degree of intraamniotic inflammation (Mass Restricted scoring). After delivery, microbiologic and histologic studies of the placenta were performed. These results were interpreted in comparison with the direct microbiologic and inflammatory analysis of the amniotic fluid. A sample size of 45 patients was required to show a test accuracy of 80% or more. RESULTS Ninety-two percent of women with positive amniotic fluid cultures tested with at least one positive placenta culture. Eighty percent of women who had negative amniotic fluid cultures also tested with a positive placenta culture. The accuracy of placental cultures in predicting amniotic fluid infection varied from 44% to 57%. Placental pathology showed an accuracy of only 58% in diagnosing intraamniotic inflammation. CONCLUSION Placental microbiologic and histologic studies poorly reflect the infectious and inflammatory status of the amniotic fluid. Results of such studies should be interpreted with caution in the management and future counseling of women with preterm labor or preterm premature rupture of membranes. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Christian M Pettker
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
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Abstract
Preterm birth remains the leading cause of neonatal morbidity and mortality and is likely the result of interactions between specific genes and the maternal or fetal environment. The strong familial clustering of disease with documented increased risks in patients with a personal or family history of preterm birth and the racial disparities in the incidence of preterm birth support a genetic component of this condition. New technologies such as microarray, single nucleotide polymorphism analysis, and proteomics will lead to the eventual identification and characterization of the genetic etiology of preterm birth.
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Affiliation(s)
- Michael Sean Esplin
- The University of Utah Health Sciences Center, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Salt Lake City, Utah, USA.
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