TY - JOUR
T1 - Twin-twin transfusion syndrome is associated with alterations in the metabolic profile of maternal plasma in early gestation
T2 - a pilot study
AU - Yang, Yang
AU - Wen, Li
AU - Han, Ting-Li
AU - Zhang, Lan
AU - Fu, Huijia
AU - Gan, Jie
AU - Saffery, Richard
AU - Tong, Chao
AU - Li, Junnan
AU - Qi, Hongbo
AU - Baker, Philip
AU - Kilby, Mark
PY - 2021/3/15
Y1 - 2021/3/15
N2 - Objective: Twin-twin transfusion syndrome (TTTS) causes perinatal mortality and morbidity in monochorionic (MC) twins. Early recognition and interventional therapy for TTTS is associated with a more favorable overall prognosis. However, the prediction by ultrasound in the first trimester has relatively poor sensitivity and specificity. This study aims to profile maternal metabolic changes before the clinical onset of TTTS and identify potential metabolic biomarkers to aid ultrasound screening.
Method: Maternal plasma was prospectively collected between 11-15 weeks of gestation in apparently uncomplicated MCDA pregnancies. This cohort was divided into: i) patients subsequently diagnosed using ultrasound with TTTS and ii) uncomplicated matched controls. Gas chromatography-mass spectrometry was used for metabolomic profiling.
Results: The levels of fatty acids, organic acids, oxaloacetic acid, and beta-alanine were significantly lower in the maternal plasma of TTTS at 11-15 weeks of gestation, while methionine and glycine were higher (p<0.05, FDR<0.12). Generally, in TTTS pregnancies, metabolism of amino acid, carbohydrate, cofactors, vitamins, and purine were ‘down-regulated’; whilst bile secretion and pyrimidine metabolism were ‘upregulated’.
Conclusions: Metabolomics scanning of early gestation maternal plasma may identify those pregnancies that subsequently develop TTTS, especially,
downregulated fatty acid level may be biologically plausible to be implicated in the pathogenesis of TTTS.
Keywords: Twin-twin transfusion syndrome, GC-MS, metabolite, biomarker
Acknowledgments
We thank team members for their support and contribution to this study. Especially, thanks for all participants who volunteered to provide blood samples.
AB - Objective: Twin-twin transfusion syndrome (TTTS) causes perinatal mortality and morbidity in monochorionic (MC) twins. Early recognition and interventional therapy for TTTS is associated with a more favorable overall prognosis. However, the prediction by ultrasound in the first trimester has relatively poor sensitivity and specificity. This study aims to profile maternal metabolic changes before the clinical onset of TTTS and identify potential metabolic biomarkers to aid ultrasound screening.
Method: Maternal plasma was prospectively collected between 11-15 weeks of gestation in apparently uncomplicated MCDA pregnancies. This cohort was divided into: i) patients subsequently diagnosed using ultrasound with TTTS and ii) uncomplicated matched controls. Gas chromatography-mass spectrometry was used for metabolomic profiling.
Results: The levels of fatty acids, organic acids, oxaloacetic acid, and beta-alanine were significantly lower in the maternal plasma of TTTS at 11-15 weeks of gestation, while methionine and glycine were higher (p<0.05, FDR<0.12). Generally, in TTTS pregnancies, metabolism of amino acid, carbohydrate, cofactors, vitamins, and purine were ‘down-regulated’; whilst bile secretion and pyrimidine metabolism were ‘upregulated’.
Conclusions: Metabolomics scanning of early gestation maternal plasma may identify those pregnancies that subsequently develop TTTS, especially,
downregulated fatty acid level may be biologically plausible to be implicated in the pathogenesis of TTTS.
Keywords: Twin-twin transfusion syndrome, GC-MS, metabolite, biomarker
Acknowledgments
We thank team members for their support and contribution to this study. Especially, thanks for all participants who volunteered to provide blood samples.
UR - http://www.scopus.com/inward/record.url?scp=85102851502&partnerID=8YFLogxK
U2 - 10.1002/pd.5933
DO - 10.1002/pd.5933
M3 - Article
SN - 0197-3851
VL - 41
SP - 1080
EP - 1088
JO - Prenatal Diagnosis
JF - Prenatal Diagnosis
IS - 9
ER -