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Pregnancy Complications in Lupus: Can Blood Transcriptomics Predict?

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Pregnancy Complications in Lupus: Can Blood Transcriptomics Predict?

What mechanisms make pregnancies for women with systemic lupus erythematosus different than pregnancies in healthy women?

Researchers from the Baylor Research Institute find that the neutrophil signature is a potential early biomarker of preeclampsia in women with systemic lupus erythematosus.

The research, led by Seunghee Hong of Baylor, was presented on Nov. 13 at the American College of Rheumatology annual meeting held in Washington, D.C.

The autoimmune disease systemic lupus erythematosus usually affects women in child-bearing years, and those pregnancies have higher rates of adverse outcomes than pregnancies in healthy women. For this study, the authors characterized the blood transcriptome to better understand the molecular mechanisms in pregnant women with systemic lupus erythematosus.

For the study, researchers characterized the blood transcriptome through microarray, of 135 pregnant women (43 healthy and 92 systemic lupus erythematosus) and 54 non-pregnant women (34 healthy controls and 20 systemic lupus erythematosus) from the PROMISSE Study. They drew blood four times during the pregnancy time period, and once in the postpartum period. They classified poor pregnancy outcomes as preeclampsia, and other complications like preterm delivery, growth restriction and fetal/neonatal death. Pregnant systemic lupus erythematosus study subjects included 24 preeclampsia cases, 22 other complications and 46 with no complications.

Researchers identified 9,687 transcripts expressed in healthy pregnant women, like neutrophil upregulation, myeloid inflammation and erythropoiesis signatures. They also found downregulation of immune pathways linked to lupus pathogenesis, like IFN and plasma cells. Then they compared the signatures in women with systemic lupus erythematosus/non-complicated pregnancies to those from healthy, non-pregnant women. They found that the women with systemic lupus erythematosus/non-complicated pregnancies had the same dynamic features as women with healthy pregnancies.

They found a lower plasma cell signature in women with systemic lupus erythematosus non-complicated pregnancies compared to systemic lupus erythematosus non-pregnant women and healthy non-pregnant women. Also, the IFN signature was patent through pregnancy compared to the healthy non-pregnant control subjects. Systemic lupus erythematosus groups with pregnancy complications did not downregulate plasma cell signatures and IFN signatures to the same levels as their systemic lupus erythematosus counterparts who had no pregnancy complications. Systemic lupus erythematosus patients with preeclampsia showed early upregulation of neutrophil signatures, with early preeclampsia biomarkers being AZU1, CTSG and ELANE.

Researchers concluded that the neutrophil signature is a potential early biomarker of preeclampsia.


Seunghee Hong. "Longitudinal Blood Transcriptomics Uncovers Immune Networks Associated with Complications in Lupus Pregnancy," Abstract number 914. 12:15 p.m., Nov. 13, 2016. ACR/ARHP 2016 Annual Meeting.

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