Risk factors and possible predictors of PE based on proteomic (peptidomic) urine analysis

• Kamilla Т. Muminova
• Zulfiya S. Khodzhaeva
• Roman G. Shmakov
• Igor I. Baranov
• Alexey S. Kononikhin
• Natalia L. Starodubtseva
• Vladimir E. Frankevich
• Alexey M. Kholin

Abstract

Background. Due to high rate of maternal morbidity and mortality as well as long term outcomes for future health of mother and child search for preeclampsia (PE) major risk factors and its possible predictors is essential.

Aim of the study. Identification of major risk factors and possible predictors of PE based on proteomic (peptidomic) analysis of urine.

Materials and methods. Clinical, laboratory, instrumental, and special (peptidome analysis of urine, gene ontology analysis) tests. Combined I trimester screening comprised evaluation of maternal risk factors for PE, physical data, mean blood pressure (BP), ultrasound testing of the fetus, measurement of pulsatility index (PI) in uterine arteries, β-HCG, РАРР-А, PlGF. Diagnosis of mild and severe PE was based upon WHO criteria (2011) and recommendations of Ministry of Healthcare of Russia (2016). In women with high and low risk of PE urine was collected in dynamics: at 11-13, 16-18, 20-24, 30-34 weeks of pregnancy.

Results. 17 out of 22 women in study group had major risk factors for PE: history of PE, chronic arterial hypertension, hereditary thrombophilia of high risk. In study group peptides specific for PE were detected from 20^th week of gestation. 7 (35%) women of study group displayed peptides associated with PE at 30-34 weeks. PE peptide panel identified at 20-24 weeks was seen at 30-34 weeks as well.

Conclusion. To optimize results of I trimester screening one should: 1. Thoroughly assess maternal risk factors for PE. 2. When revealing major ones carry out combined screening at 11-13 weeks (including BP and PI in uterine arteries measurement). 3. Analyze urine peptidome in high risk women at 20 weeks.

Keywords:preeclampsia, hypertension in pregnancy, risk factors, biomarkers, mass spectrometry, peptidome, proteome, I trimester screening

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