Comprehensive proteomic investigation of infectious and inflammatory changes in late preterm prelabour rupture of membranes

Marie Vajrychová,Petra Zedníková,Bo Jacobsson,Malin Barman,Lenka Plíšková,Ctirad Andrýs,Radka Bolehovská,Marian Kacerovský,Jaroslav Stráník,Juraj Lenčo,Rudolf Kukla,Vojtěch Tambor,Helena Hornychová,Kristýna Pimková

doi:10.1038/s41598-020-74756-9

Abstract

Preterm prelabour rupture of membranes beyond the 34th week of gestation (late PPROM) is frequently associated with the risk of the microbial invasion of the amniotic fluid (MIAC) and histological chorioamnionitis (HCA). Hence, we employed a Tandem Mass Tag-based approach to uncover amniotic fluid proteome response to the presence of MIAC and HCA in late PPROM. Protein dysregulation was associated with only five cases in the group of 15 women with confirmed MIAC and HCA. Altogether, 138 amniotic fluid proteins were changed in these five cases exclusively. These proteins were particularly associated with excessive neutrophil responses to infection, such as neutrophil degranulation and extracellular trap formation. We believe that the quantification of these proteins in amniotic fluid may assist in revealing women with the highest risk of excessive inflammatory response in late PPROM.

Highlights

Preterm prelabour rupture of membranes beyond the 34th week of gestation is frequently associated with the risk of the microbial invasion of the amniotic fluid (MIAC) and histological chorioamnionitis (HCA)
Our group has previously shown that the presence of both MIAC and HCA in women with late prelabour rupture of membranes (PPROM) was associated with an increase of amniotic fluid interleukin-6 (IL-6) in comparison with women with either HCA alone, MIAC alone or with absence of both c onditions[13]
A late PPROM cohort of 60 amniotic fluid samples with the presence or absence of MIAC and/or HCA was designed (Fig. 1A) and important clinical characteristics were compared among the subgroups (Table 1)

Summary

Introduction

Preterm prelabour rupture of membranes beyond the 34th week of gestation (late PPROM) is frequently associated with the risk of the microbial invasion of the amniotic fluid (MIAC) and histological chorioamnionitis (HCA). The main rationale for the guidelines is the possible presence of subclinical complications such as microbial invasion of the amniotic cavity (MIAC) and intra-amniotic inflammation such as acute histological chorioamnionitis (HCA). These complications are related to the highest incidence of fetal inflammatory response syndrome and short-term neonatal m orbidity[10,11,12]. The heterogeneity of individual cases may hamper proper assessment of how severe the intra-amniotic inflammation is

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