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Proteomic Profiling in Patients With Peripartum Cardiomyopathy
Quick Takes
- Serum proteome profiling in patients with peripartum cardiomyopathy (PPCM) identified multiple novel biomarkers that could be useful for diagnostic testing.
- The differential expression of several proteins in patients with PPCM highlights the complex nature of this disease process (immune response, inflammation, fibrosis, angiogenesis, apoptosis, and coagulation).
Study Questions:
Can the serum proteome profile of patients with newly diagnosed peripartum cardiomyopathy (PPCM) identify novel protein biomarkers?
Methods:
Untargeted serum proteome profiling was performed on 84 patients with PPCM and 29 postpartum healthy controls. Differences in protein intensities were analyzed and classified using the Boruta algorithm.
Results:
Mean ejection fraction among patients with PPCM was 33.5% ± 9.3%. Compared to healthy controls, patients with PPCM had 15 differentially up-regulated and 14 down-regulated proteins; of these, the Boruta algorithm identified seven of these as significant. The best diagnostic precision was a combination of adiponectin (ADIPOQ), quiescin sulfhydryl oxidase 1 (QSOX1), inter-α-trypsin inhibitor heavy chain (ITIH3), and N-terminal pro–B-type natriuretic peptide (NT-proBNP) (area under the curve = 0.90; 95% confidence interval, 0.84-0.96).
Conclusions:
These identified proteins can be further explored as diagnostic markers and for their role in the pathogenesis of PPCM, including mechanisms of immune response, inflammation, fibrosis, angiogenesis, apoptosis, and coagulation.
Perspective:
Despite progress in understanding the pathophysiology of PPCM, significant gaps remain. This study used serum proteome profiling to identify multiple proteins modified in PPCM. The cohort was an ethnically diverse group of PPCM patients from multiple centers. Two important takeaway points are: 1) multiple proteins and pathways are involved in the pathogenesis of PPCM, and 2) multiple biomarkers should be used to improve diagnostic accuracy. Further studies that validate the combination of NT-proBNP, QSOX1, ADIPOQ, and ITIH3 in larger cohorts would be useful. Additional study of the mechanistic pathways in which these markers are involved in the pathogenesis of PPCM are needed.
Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure, Heart Failure and Cardiac Biomarkers
Keywords: Biomarkers, Cardiomyopathies, Heart Failure, Peripartum Period, Proteome
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