Predicting pre-eclampsia

Published May 4 2016

Pre-eclampsia is a potentially dangerous complication in pregnancy characterized by high blood pressure. THE NATIONAL INSITUTES OF HEALTH

Pre-eclampsia affects roughly 3 percent of pregnant women in the U.S. and can lead to a host of complications that can include premature birth and even death for both mother and child. Unfortunately, there is no effective diagnostic test to predict the onset of the disease, which is characterized by high blood pressure that may not appear until the second half of pregnancy.

In a recent paper published in the Journal of Lipid Research, Steven Graves of Brigham Young University and colleagues described a set of biomarkers that could help in the early detection of pre-eclampsia.

Although proteins are considered a more conventional class of biomarker, Graves and his colleagues decided to look to lipids in the blood because they tend to be more forgiving subjects than their protein counterparts. According to Graves, lipids “are not particularly heat-sensitive compared to a protein or peptide, and they’re not degraded rapidly by proteolytic enzymes, which exist in the serum.”

Unlike invasive sampling procedures, which may be risky, serum samples containing the lipids can be collected in the clinic relatively easily with blood draws. The researchers used samples that had been collected for a trial studying the early in utero development of children with Down’s syndrome. From the available samples, they selected those taken between 12 and 14 weeks of gestation.

Using mass spectrometry data, the team compared the serum lipid profiles of women who went on to develop pre-eclampsia and those who did not. After an initial analysis and a second confirmatory run in another sample set, the team identified a set of 23 biomarkers in the form of mass spectral profiles that were able to predict those women who would go on to have a pre-eclamptic event.

Any biomarker on its own can’t provide sufficient predictive value, but combining the markers together into sets increased predictability. For their sample population, the investigators found that using six biomarkers helped with predicting pre-eclampsia; combining more than six markers failed to show an increase in predictive value. When the lipid test becomes publicly available, Graves advises using all 23 biomarkers together to account better for individual patient factors.

Though the lipid biomarkers are intriguing, Graves is careful to point out these biomarkers aren’t ready for the clinic just yet. A lipid-based test will be available only after further study and approval by the U.S. Food and Drug Administration. “What should happen now is one should establish a clear hypothesis that this set of markers would be useful and then carry out studies,” he says.

The research may not be of immediate clinical value, but knowledge of the biomarkers could help streamline the research process. Because the disease occurs infrequently, one of the biggest issues with prospective studies for pre-eclampisa is the sheer number of women that need to be enrolled in order to have adequate numbers of pre-eclamptic cases. However, if researchers first can narrow the population using a set of predictive biomarkers such as the one proposed in the paper, fewer women would need to be enrolled. According to Graves, this “could save time and allow for more things to be tested more efficiently.”

Bree Yanagisawa Bree Yanagisawa is a science writing intern at ASBMB Today and a Ph.D. candidate in pathobiology at Johns Hopkins School of Medicine.