Longitudinal Profiling of Maternal-Fetal Microbiome and Immunological Biomarkers in Pre-Eclampsia: Implications for Early Diagnosis and Precision Interventions.

Abstract

Pre-eclampsia is a multi-organ dysfunction syndrome of pregnancy leading to significant maternal and fetus morbidity and mortality. There is emerging evidence that changes in the maternal-fetal microbiome and immune dysregulation play a part in the pathogenesis of pre-eclampsia which suggests there is a need for search of new predictive biomarkers. To investigate the role longitudinal profiling of maternal-fetal microbiome and immunological biomarkers in early diagnosis of pre-eclampsia and their implications for precision based interventions and management. Longitudinal cohort studies have been performed where women at different gestational stages of the pregnancy are recruited. Serial biological samples transporting maternal blood, placental tissue and microbiome samples have been collected and analysed. Microbiome sequencing and immunoassays have been performed to evaluate the dynamic changes in inflammatory markers and microbial composition. Association between two sets of biomarkers with the development of pre-eclampsia has been studied 1184 numbers of participants in total were included in analyses. Longitudinal profiling revealed specific disturbances in maternal and placental microbiome and elevated a pro inflammatory cytokines in patients who later developed pre-eclampsia. Specific microbiome signatures and immune biomarkers show strong predictive value for early disease. Integrative analysis has enabled improved risk stratification and identification of high-risk pregnancies in advance of clinical presentation.