Aim: Pre-eclampsia (PE) is a disorder of pregnancy associated with maternal and fetal mortality and morbidity. The aim of the present study was to use proteomics to identify biomarkers of, and elucidate the pathogenesis of, PE. Methods: Serum samples were analyzed using peptide ligand library beads (PLLB) on liquid chromatographymass spectrometry/mass spectrometry. Retinol-binding protein 4 (RBP4) was used as the target protein for further validation on enzyme-linked immunosorbent assay, immunohistochemistry and real-time polymerase chain reaction. Transwell invasion assay was used to evaluate whether RBP4 affects the invasive ability of trophoblast tumor cells. Results: Twenty upregulated and 17 downregulated proteins were differentially expressed between severe PE patients and healthy pregnant women. Those proteins were further classified according to molecular function and biological process according to the gene ontology terms. RBP4 concentration was significantly lower in women with severe PE than in those with healthy pregnancy. Conclusions: RBP4 is able to function as biomarker to distinguish severe PE from normal pregnancy. More importantly, these results may shed light on the role of RPB4 in the pathogenesis in PE. Further studies are required to validate these results, and determine the precise role of RBP4 in the pathogenesis of PE.

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