title: Noninvasive diagnosis of intraamniotic infection: proteomic biomarkers in vaginal fluid.
abstract: OBJECTIVE
  We analyzed the vaginal fluid proteome to identify biomarkers of intraamniotic infection among women in preterm labor.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Vaginal fluid proteome analyses identified proteins capable of discriminating between patients with and without intraamniotic infection.
authors.affiliation: Department of Obstetrics/Gynecology, University of Washington, Seattle, WA, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Hitti
authors.forename: Jodi A
authors.initials: JA
authors.lastname: Lapidus
authors.forename: Xinfang
authors.initials: X
authors.lastname: Lu
authors.forename: Ashok P
authors.initials: AP
authors.lastname: Reddy
authors.forename: Thomas
authors.initials: T
authors.lastname: Jacob
authors.forename: Surendra
authors.initials: S
authors.lastname: Dasari
authors.forename: David A
authors.initials: DA
authors.lastname: Eschenbach
authors.forename: Michael G
authors.initials: MG
authors.lastname: Gravett
authors.forename: Srinivasa R
authors.initials: SR
authors.lastname: Nagalla
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000378:metabolism / Q000382:microbiology*; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D015331:Cohort Studies; D015180:Electrophoresis, Gel, Two-Dimensional; D005260:Female; D006801:Humans; D013058:Mass Spectrometry; D007752:Obstetric Labor, Premature / Q000378:metabolism / Q000382:microbiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000378:metabolism / Q000382:microbiology; D011446:Prospective Studies; D040901:Proteomics / Q000379:methods; D012372:ROC Curve; D014621:Vagina / Q000378:metabolism / Q000382:microbiology*; D055815:Young Adult
chemical_list: D015415:Biomarkers