Browsing by Author "Gudicha, Dereje W."

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    The vaginal immunoproteome for the prediction of spontaneous preterm birth: A retrospective longitudinal study
    (2024) Shaffer, Zachary; Romero, Roberto; Tarca, Adi L.; Galaz, Jose; Arenas-Hernandez, Marcia; Gudicha, Dereje W.; Chaiworapongsa, Tinnakorn; Jung, Eunjung; Suksai, Manaphat; Theis, Kevin R.; Gomez-Lopez, Nardhy; Simon, Carlos
    Background: Preterm birth is the leading cause of neonatal morbidity and mortality worldwide. Most cases of preterm birth occur spontaneously and result from preterm labor with intact (spontaneous preterm labor [sPTL]) or ruptured (preterm prelabor rupture of membranes [PPROM]) membranes. The prediction of spontaneous preterm birth (sPTB) remains underpowered due to its syndromic nature and the dearth of independent analyses of the vaginal host immune response. Thus, we conducted the largest longitudinal investigation targeting vaginal immune mediators, referred to herein as the immunoproteome, in a population at high risk for sPTB. Methods: Vaginal swabs were collected across gestation from pregnant women who ultimately underwent term birth, sPTL, or PPROM. Cytokines, chemokines, growth factors, and antimicrobial peptides in the samples were quantified via specific and sensitive immunoassays. Predictive models were constructed from immune mediator concentrations. Results: Throughout uncomplicated gestation, the vaginal immunoproteome harbors a cytokine network with a homeostatic profile. Yet, the vaginal immunoproteome is skewed toward a pro-inflammatory state in pregnant women who ultimately experience sPTL and PPROM. Such an inflammatory profile includes increased monocyte chemoattractants, cytokines indicative of macrophage and T-cell activation, and reduced antimicrobial proteins/peptides. The vaginal immunoproteome has improved predictive value over maternal characteristics alone for identifying women at risk for early (<34 weeks) sPTB. Conclusions: The vaginal immunoproteome undergoes homeostatic changes throughout gestation and deviations from this shift are associated with sPTB. Furthermore, the vaginal immunoproteome can be leveraged as a potential biomarker for early sPTB, a subset of sPTB associated with extremely adverse neonatal outcomes.
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    Toward a new taxonomy of obstetrical disease: improved performance of maternal blood biomarkers for the great obstetrical syndromes when classified according to placental pathology
    (2022) Romero, Roberto; Jung, Eunjung; Chaiworapongsa, Tinnakorn; Erez, Offer; Gudicha, Dereje W.; Kim, Yeon Mee; Kim, Jung-Sun; Kim, Bomi; Kusanovic, Juan Pedro; Gotsch, Francesca; Taran, Andreea B.; Yoon, Bo Hyun; Hassan, Sonia S.; Hsu, Chaur-Dong; Chaemsaithong, Piya; Gomez-Lopez, Nardhy; Yeo, Lami; Kim, Chong Jai; Tarca, Adi L.
    BACKGROUND: The major challenge for obstetrics is the prediction and prevention of the great obstetrical syndromes. We propose that defining obstetrical diseases by the combination of clinical presentation and disease mechanisms as inferred by placental pathology will aid in the discovery of biomarkers and add specificity to those already known.