///2017 Abstract Details
2017 Abstract Details2019-08-02T15:54:53-05:00

The protein content of cerebrospinal fluid is altered in preeclampsia

Abstract Number: GM-02
Abstract Type: Original Research

Erin J Ciampa MD, PhD1 ; Towia Libermann PhD2; Laura Sorabella MD3; Yunping Li MD4; S. Ananth Karumanchi MD5; Philip Hess MD6

Introduction: Some of the clinical manifestations of preeclampsia (hypertension, proteinuria, fetal growth restriction) can now be explained with specific molecular pathways that implicate endothelial dysfunction as a central pathogenic process [1, 2]. No such molecular-level understanding exists for its central nervous system manifestations, which include headache, hyperexcitability, visual disturbances, and seizures. We hypothesized that the protein content of the cerebrospinal fluid (CSF) may reflect metabolic disturbances, inflammatory states, or other pathologic factors encountered by the brain in preeclampsia that may contribute to its neurologic manifestations.

Methods: We enrolled 14 patients with preeclampsia and 14 control patients, each presenting in spontaneous labor or for induction of labor or Cesarean section for any indication. CSF was collected at the time of administration of spinal anesthesia. Samples were applied to a SOMAscan assay, a proteomics platform that uses single-stranded DNA aptamer technology to capture > 1,300 proteins for quantitiative analysis at a wide range of concentrations (SOMALogic Inc, Boulder, CO). Mean protein concentrations and SEM were calculated for preeclamptic and control groups; unpaired student t-test was applied to determine the statistical significance of the difference among groups for each protein.

Results: SOMAscan analysis revealed more than 50 proteins whose expression levels were significantly different (p < 0.05) in CSF from preeclamptic patients versus controls (Figure 1A). Principal component analysis reveals that separation of the preeclamptic group from the control group can be achieved in three dimensions (Figure 1B), with the first principal component accounting for 31% of the variance.

Conclusions: CSF protein content is altered in preeclampsia. Physiologic functions represented among the proteins up- or down-regulated include: neuronal growth, signaling, and electrophysiology, metabolism, inflammation, coagulation, and vasoactive factors. Several of the hits are well represented in prior studies of preeclampsia, including: INHBA, INHBB, FLRG, sRAGE, and IGFBP1, though the functional significance of these proteins in preeclampsia is unknown.

1. Nat Med, 2006. 12(6): p. 642-9.

2. J Clin Invest, 2016. 126(7): p. 2561-74.

SOAP 2017