title: RNA Biosignatures in Adolescent Patients in a Pediatric Emergency Department With Pelvic Inflammatory Disease.
abstract: BACKGROUND
  Adolescents are at high risk for pelvic inflammatory disease (PID). Because accurate diagnosis of PID is difficult, and complications of untreated PID are significant, novel methods to improve diagnosis are essential.
  
  
  OBJECTIVE
  To determine if patients with PID have unique RNA expression patterns compared to controls.
  
  
  METHODS
  Peripheral blood was collected from adolescent females with PID in the emergency department, and from control patients in the operating room. RNA was isolated, and microarray analysis was performed. Initial analysis involved a training set of 18 patients (9 PID patients with either Neisseria gonorrhoeae or Chlamydia trachomatis infection and 9 control patients). Supervised and unsupervised cluster analyses were performed, followed by network analysis. The training set was used to classify a set of 15 additional PID patients and 2 controls.
  
  
  RESULTS
  Supervised cluster analysis of the training set revealed 170 genes which were differentially expressed in PID patients versus controls. Network analysis indicated that several differentially expressed genes are involved in immune activation. Analysis of additional PID patients based on the training set findings revealed that patients with positive testing for Trichomonas vaginalis partitioned with the PID group, whereas patients with no organism identified partitioned with both groups.
  
  
  CONCLUSIONS
  RNA sample collection from adolescents in the emergency department is feasible. Genes were identified which were differentially expressed in PID patients versus controls, many of which are involved in inflammation. Future studies should confirm the training set findings on a larger sample and may lead to improved accuracy of PID diagnosis.
authors.affiliation: From the *Division of Emergency Medicine, The Children's Hospital of Philadelphia; †Perelman School of Medicine, University of Pennsylvania; ‡Bioinformatics Core Facility, §Microarray Core Facility, The Children's Hospital of Philadelphia; ∥Division of Emergency Medicine, Children's National Medical Center; and ¶Division of Allergy and Immunology, The Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Fran
authors.initials: F
authors.lastname: Balamuth
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zhang
authors.forename: Eric
authors.initials: E
authors.lastname: Rappaport
authors.forename: Katie
authors.initials: K
authors.lastname: Hayes
authors.forename: Cynthia
authors.initials: C
authors.lastname: Mollen
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Sullivan
mesh_terms: D000293:Adolescent; D002648:Child; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D015870:Gene Expression; D005819:Genetic Markers / Q000235:genetics*; D006776:Hospitals, Pediatric; D006801:Humans; D046228:Microarray Analysis / Q000379:methods*; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D000292:Pelvic Inflammatory Disease / Q000235:genetics* / Q000382:microbiology; D012313:RNA / Q000235:genetics*; D012749:Sexually Transmitted Diseases / Q000235:genetics* / Q000382:microbiology; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D005819:Genetic Markers; D012313:RNA