Early prediction of preeclampsia in pregnancy with cell-free RNA.
Mira N MoufarrejSevahn K VorperianRonald J WongAna A CamposCecele C QuaintanceRene V SitMichelle TanAngela M DetweilerHoney MekonenNorma F NeffCourtney Baruch-GravettJames A LitchMaurice L DruzinVirginia D WinnGary M ShawDavid K StevensonStephen R QuakePublished in: Nature (2022)
Liquid biopsies that measure circulating cell-free RNA (cfRNA) offer an opportunity to study the development of pregnancy-related complications in a non-invasive manner and to bridge gaps in clinical care 1-4 . Here we used 404 blood samples from 199 pregnant mothers to identify and validate cfRNA transcriptomic changes that are associated with preeclampsia, a multi-organ syndrome that is the second largest cause of maternal death globally 5 . We find that changes in cfRNA gene expression between normotensive and preeclamptic mothers are marked and stable early in gestation, well before the onset of symptoms. These changes are enriched for genes specific to neuromuscular, endothelial and immune cell types and tissues that reflect key aspects of preeclampsia physiology 6-9 , suggest new hypotheses for disease progression and correlate with maternal organ health. This enabled the identification and independent validation of a panel of 18 genes that when measured between 5 and 16 weeks of gestation can form the basis of a liquid biopsy test that would identify mothers at risk of preeclampsia long before clinical symptoms manifest themselves. Tests based on these observations could help predict and manage who is at risk for preeclampsia-an important objective for obstetric care 10,11 .
Keyphrases
- pregnancy outcomes
- cell free
- pregnant women
- early onset
- gene expression
- healthcare
- palliative care
- gestational age
- bioinformatics analysis
- public health
- circulating tumor
- genome wide
- preterm infants
- dna methylation
- quality improvement
- birth weight
- ionic liquid
- ultrasound guided
- risk factors
- endothelial cells
- mental health
- case report
- weight loss
- depressive symptoms
- risk assessment
- health information