Amniotic fluid proteomic signatures of cervical insufficiency and their association with length of latency

Govia, Rachelle; Birse, Kenzie; Sepehri, Shadi; Khafipour, Ehsan; Menticoglou, Savas; Burgener, Adam; Poliquin, Vanessa

doi:10.1111/aji.13030

Cited by 12 publications

(10 citation statements)

References 59 publications

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“…Similar to our results, Govia et al . analyzed proteomic profiling of AF using normal pregnancy (genetic amniocentesis) as a control group and found chemotaxis, homing of leukocytes, activation of cells, and inflammatory response as the top activated biological functions associated with CI [ 66 ]. Taken together, these IPA data suggest that inflammatory and immune responses that have occurred in the uterine cavity may play an important role in the process of premature cervical dilation.…”

Section: Discussionmentioning

confidence: 99%

Antibody microarray analysis of amniotic fluid proteomes in women with cervical insufficiency and short cervix, and their association with pregnancy latency length

et al. 2022

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Introduction This study aimed to investigate amniotic fluid (AF) proteins that were differentially expressed between patients with cervical insufficiency (CI) and asymptomatic short cervix (SCX, ≤ 25 mm), and whether these proteins could be predictive of spontaneous preterm birth (SPTB) in these patients. Method This was a retrospective cohort study of 129 singleton pregnant women with CI (n = 80) or SCX (n = 49) at 17 to 26 weeks who underwent amniocentesis. An antibody microarray was used to perform comparative proteomic profiling of AF from matched CI (n = 20) and SCX (n = 20) pregnancies. In the total cohort, an ELISA validation study was performed for 15 candidate proteins of interest. Subgroup analyses of patients with CI and SCX were conducted to evaluate the association between the 15 proteins and SPTB at < 32 weeks of gestation. Results Eighty-six proteins showed intergroup differences. ELISA validation confirmed significantly higher levels of AF EN-RAGE, IL-8, lipocalin-2, MMP-9, S100A8/A9, thrombospondin-2, and TNFR2 in patients with CI than in those with SCX. Multivariable analysis showed that increased AF levels of EN-RAGE, S100A8/A9, and uPA were independently associated with SPTB at < 32 weeks in patients with CI; whereas in patients with SCX, high AF levels of APRIL, EN-RAGE, LBP, and TNFR2 were independently associated with SPTB at < 32 weeks. Conclusions Multiple AF proteins show altered expression in patients with CI compared with SCX controls. Moreover, several novel mediators involved in inflammation were identified as potential biomarkers for predicting SPTB after the diagnosis of CI and SCX. These results provide new insights into target-specific molecules for targeted therapies to prevent SPTB in patients with CI/SCX.

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Section: Discussionmentioning

confidence: 99%

Antibody microarray analysis of amniotic fluid proteomes in women with cervical insufficiency and short cervix, and their association with pregnancy latency length

et al. 2022

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“…There is a solid body of evidence showing that the presence of intra-amniotic inflammation in pregnancies with cervical insufficiency with prolapsed fetal membranes is associated with a shorter interval between amniocentesis and delivery [4, 12, 13, 17, 37, 38], lower gestational age at sampling [4, 11, 13, 14, 17], and higher rates of preterm deliveries [4, 12, 13, 17, 37]. These findings were also confirmed by our study.…”

Section: Discussionmentioning

confidence: 99%

Intra-Amniotic Infection and Sterile Intra-Amniotic Inflammation in Cervical Insufficiency with Prolapsed Fetal Membranes: Clinical Implications

et al. 2020

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Introduction: The aim of this study was to identify the rates of 2 phenotypes of intra-amniotic inflammation: intra-amniotic infection (with microbial invasion of the amniotic cavity [MIAC]) and sterile intra-amniotic inflammation (without MIAC), and their outcomes, among women with cervical insufficiency with prolapsed fetal membranes. Methods of Study: This is a retrospective study of women admitted to the Department of Obstetrics and Gynecology, University Hospital Hradec Kralove between January 2014 and May 2020. Transabdominal amniocentesis to evaluate intra-amniotic inflammation (amniotic fluid interleukin-6) and MIAC (culturing and molecular biology methods) was performed as part of standard clinical management. Results: In total, 37 women with cervical insufficiency and prolapsed fetal membranes were included; 11% (4/37) and 43% (16/37) of them had intra-amniotic infection and sterile intra-amniotic inflammation, respectively. In women with intra-amniotic infection and sterile intra-amniotic inflammation, we noted shorter intervals between admission and delivery (both p < 0.0001), and lower gestational age at delivery (p < 0.0001 and p = 0.004) and percentiles of birth/abortion weight (p = 0.03 and p = 0.009, respectively) than in those without intra-amniotic inflammation. Conclusions: Both phenotypes of intra-amniotic inflammation, with sterile intra-amniotic inflammation being more frequent, are associated with worse outcomes in pregnancies with cervical insufficiency with prolapsed fetal membranes.

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“…The authors observed that peripheral CRP levels (≥4 mg/L) and WBC counts (≥10,000/mm 3 ) were associated with a significantly decreased likelihood of delivery at and after 28 weeks gestation [79]. Some authors expect that Gram's method and culture of amniotic fluid are imperfect techniques to detect infection in patients with cervical insufficiency that are qualified to emergency cerclage procedure [81]. Proteomic profiling of amniotic fluid could be better solution in that cases.…”

Section: Risk Factors Of the Emergency Suture Failurementioning

confidence: 99%

Emergency Cervical Cerclage

Wierzchowska-Opoka

Kimber-Trojnar

Leszczyńska‐Gorzelak

2021

JCM

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Despite the progress of medicine in the last decades, recurrent pregnancy loss, premature birth, and related complications are still a vast problem. The reasons for recurrent pregnancy loss and preterm delivery are diverse and multifactorial. One of the main reasons for these complications is cervical insufficiency, which means that the cervix is weak and unable to remain closed until the date of delivery. It manifests as painless softening and shortening of the cervix without contractions. The aim of the study was to review the available literature on rescue sutures, which are an emergency treatment in pregnancies with premature cervical dilatation and protrusion of the fetal membranes in the second trimester of pregnancy. This review confirms that emergency cerclage reduces the rate of preterm birth in patients with advanced cervical insufficiency. This procedure prolongs gestational age and improves the chances of survival of the newborn without increasing the risk of chorioamnionitis and preterm premature rupture of membranes.

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Amniotic fluid proteomic signatures of cervical insufficiency and their association with length of latency

Cited by 12 publications

References 59 publications

Antibody microarray analysis of amniotic fluid proteomes in women with cervical insufficiency and short cervix, and their association with pregnancy latency length

Antibody microarray analysis of amniotic fluid proteomes in women with cervical insufficiency and short cervix, and their association with pregnancy latency length

Intra-Amniotic Infection and Sterile Intra-Amniotic Inflammation in Cervical Insufficiency with Prolapsed Fetal Membranes: Clinical Implications

Emergency Cervical Cerclage

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