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Published on: October 23, 2011
Noninvasive diagnosis of intraamniotic infection: proteomic biomarkers in vaginal fluid
Jane Hitti1, Jodi A Lapidus, Xinfang Lu
1Department of Obstetrics/Gynecology, University of Washington, Seattle, WA, USA.
Objective:
We analyzed the vaginal fluid proteome to identify biomarkers of intraamniotic infection among women in preterm labor.
Study Design:
Proteome analysis was performed on vaginal fluid specimens from women with preterm labor, using multidimensional liquid chromatography, tandem mass spectrometry, and label-free quantification. Enzyme immunoassays were used to quantify candidate proteins. Classification accuracy for intraamniotic infection (positive amniotic fluid bacterial culture and/or interleukin-6 >2 ng/mL) was evaluated using receiver-operator characteristic curves obtained by logistic regression.
Results:
Of 170 subjects, 30 (18%) had intraamniotic infection. Vaginal fluid proteome analysis revealed 338 unique proteins. Label-free quantification identified 15 proteins differentially expressed in intraamniotic infection, including acute-phase reactants, immune modulators, high-abundance amniotic fluid proteins and extracellular matrix-signaling factors; these findings were confirmed by enzyme immunoassay. A multi-analyte algorithm showed accurate classification of intraamniotic infection.
Conclusion:
Vaginal fluid proteome analyses identified proteins capable of discriminating between patients with and without intraamniotic infection.
