BACKGROUND@#
Twin-to-twin transfusion syndrome (TTTS) is a serious complication of monochorionic
twin pregnancies. It results from disproportionate
blood supply to each
fetus caused by abnormal vascular anastomosis within the
placenta.
Amniotic fluid (AF) is an
indicator reflecting the various conditions of the
fetus, and an imbalance in AF volume is essential for the
antenatal diagnosis of TTTS by ultrasound. In this study, two different
mass spectrometry quantitative approaches were performed to identify differentially expressed
proteins (DEPs) within matched pairs of AF samples.@*
METHODS@#We characterized the AF
proteome in pooled AF samples collected from
donor and recipient
twin pairs (n = 5 each) with TTTS by a global
proteomics profiling approach and then preformed the
statistical analysis to determine the DEPs between the two groups. Next, we carried out a targeted proteomic approach (multiple reaction
monitoring) with DEPs to achieve high-confident TTTS-associated AF
proteins.@*RESULTS@#A total of 103 AF
proteins that were significantly altered in their abundances between
donor and recipient
fetuses. The majority of upregulated
proteins identified in the recipient
twins (including
carbonic anhydrase 1,
fibrinogen alpha chain,
aminopeptidase N,
alpha-fetoprotein,
fibrinogen gamma chain, and
basement membrane-specific
heparan sulfate proteoglycan core protein) have been associated with cardiac or dermatologic
disease, which is often seen in recipient
twins as a result of volume overload. In contrast,
proteins significantly upregulated in AF collected from
donor twins (including IgGFc-
binding protein,
apolipoprotein C-I,
complement C1q subcomponent subunit B,
apolipoprotein C-III,
apolipoprotein A-II,
decorin, alpha-2-macroglobulin,
apolipoprotein A-I, and
fibronectin) were those previously shown to be associated with
inflammation, ischemic cardiovascular
complications or renal
disease.@*CONCLUSION@#In this study, we identified proteomic
biomarkers in AF collected from
donor and recipient
twins in
pregnancies complicated by TTTS that appear to reflect underlying functional and pathophysiological challenges faced by each of the
fetuses.