Novel Biomarkers of Preeclampsia, Aquaporin, Fatty Acid, and S110B

Study Overview
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Brief Summary
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This is a research study designed to help identify preeclampsia in pregnant women earlier, and possibly lead to better treatment for women preeclampsia.

Detailed Description
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There is a paucity of biomarkers to predict preeclampsia and for predicting the severity of preeclampsia. This study was designed to identify novel biomarkers for both the prediction of preeclampsia in previously normal pregnancies and for the prediction of the severity of preeclampsia in preeclamptic women. The investigators plan to perform targeted testing for markers that the investigators predict based on their findings or based on available published evidence and the investigators also plan testing for novel markers using various approaches such as proteomics, lipidomics and genomics. The targeted markers will include Aquaporin 4 (AQP4), soluble aquaporin fragments, chemokines, and halogenated fatty acids in the plasma and/or spinal fluid. Aquaporin fragments and AQP4 have been hypothesized to correlate with severe headaches which are complications of severe preeclampsia. The investigators found in their murine studies that there is a correlation between the presence of halogenated fatty acids in the plasma and elevated blood pressure in a murine model of preeclampsia. The approaches will complement the targeted analyses to identify novel markers that have not been predicted yet.

Official Title
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Novel Biomarkers of Preeclampsia: Aquaporin, Fatty Acid, and S100B

Conditions
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Preeclampsia

Intervention / Treatment
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* Other: Women w/ Preeclampsia w/o Visual Disturbances or Headache
* Other: Women w/ Preeclampsia w/ Visual Disturbances or Headaches
* Other: Women w/o Preeclampsia


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Greater than or equal to 20 years of age Greater than 24 weeks of gestation Obstetrics/Anesthesia Team had decided that Combined Spinal/Epidural (CSE) or Spinal Anesthesia will be performed Exclusion Criteria: Pre-pregnancy comorbidities: hypertension, diabetes, or pulmonary hypertension use of steroids, beta blockers, Ca channel antagonist, anticoagulants cardiac or vascular conditions severe headaches or visual disturbances Inability to receive CSE or Spinal Anesthesia Chorioamnionitis, fever, bronchitis, pneumonia

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Women w/ Preeclampsia w/o Visual Disturbances or Headache<br>Preeclampsia Without either Visual Disturbances or Headaches Blood Pressure: >Systolic 160 or Diastolic 110 | Other: Women w/ Preeclampsia w/o Visual Disturbances or Headache<br>* Up to three maternal blood samples collected from each participant, cerebrospinal fluid collected from each participant during spinal or combined spinal/epidural anesthesia, one umbilical cord blood sample obtained from each participant, four placenta samples obtained from each placenta from each participant<br>|
| Women w/ Preeclampsia w/ Visual Disturbances or Headaches<br>Preeclampsia With either Visual Disturbances or Headaches Blood Pressure: >Systolic 160 or Diastolic 110 | Other: Women w/ Preeclampsia w/ Visual Disturbances or Headaches<br>* Up to three maternal blood samples collected from each participant, cerebrospinal fluid collected from each participant during spinal or combined spinal/epidural anesthesia, one umbilical cord blood sample obtained from each participant, four placenta samples obtained from each placenta from each participant<br>|
| Women w/o Preeclampsia<br>Normal Pregnancy Blood Pressure: <140/90 | Other: Women w/o Preeclampsia<br>* Up to three maternal blood samples collected from each participant, cerebrospinal fluid collected from each participant during spinal or combined spinal/epidural anesthesia, one umbilical cord blood sample obtained from each participant, four placenta samples obtained from each placenta from each participant<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Aquaporin 4 protein fragments in maternal blood plasma | The investigators plan to perform targeted testing for markers that the investigators predict based on their findings or based on available published evidence | Between hospital admission and prior to epidural or combined spinal/epidural anesthesia | 
| S100B protein fragments in maternal blood plasma | The investigators plan to perform targeted testing for markers that The investigators predict based on their findings or based on available published evidence | Between hospital admission and prior to epidural or combined spinal/epidural anesthesia | 
| Aquaporin 4 protein fragments in cerebrospinal fluid | The investigators plan to perform targeted testing for markers that the investigators predict based on their findings or based on available published evidence | At the time of spinal or combined spinal/epidural anesthesia | 
| S100B protein fragments in cerebrospinal fluid | The investigators plan to perform targeted testing for markers that the investigators predict based on their findings or based on available published evidence | At the time of spinal or combined spinal/epidural anesthesia | 
| Aquaporin 4 protein fragments in cord blood and placental samples | The investigators plan to perform targeted testing for markers that the investigators predict based on their findings or based on available published evidence | Between delivery and 2 hours after delivery | 
| S100B protein fragments in cord blood and placental samples | The investigators plan to perform targeted testing for markers that the investigators predict based on their findings or based on available published evidence | Between delivery and 2 hours after delivery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fatty acids in maternal blood | The investigators plan to perform targeted testing for markers that the investigators predict based on their findings or based on available published evidence | Between hospital admission and prior to epidural or combined spinal/epidural anesthesia | 
| Fatty acids in cord blood and placental samples | The investigators plan to perform targeted testing for markers that The investigators predict based on their findings or based on available published evidence | Between immediately post-delivery and 2 hours after delivery | 
| Fatty Acids in cerebrospinal fluid | The investigators plan to perform targeted testing for markers that The investigators predict based on their findings or based on available published evidence | during epidural or combined spinal/epidural anesthesia | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Preeclampsia, Pregnancy, Complications, Eclampsia, Aquaporin, Aquaporin 4