Early Warning Test for Ectopic Pregnancy

Early Warning Test for Ectopic Pregnancy

What makes ectopic pregnancy the leading cause of death for pregnant women in their first trimester is the condition’s unpredictability. A growing embryo, lodged dangerously in the Fallopian tubes, occurs about once in 100 pregnancies, but most cases are not discovered until a patient seeks treatment in the emergency room. 

Now, however, Wistar researchers have discovered a set of protein biomarkers — blood-borne indicators of disease — that may provide doctors with the first blood test for ectopic pregnancy. 

David W. Speicher, Ph.D.

“The great power of biomarkers is to detect clinical disorders such as ectopic pregnancy or diseases, such as cancer, early when it is often easiest to treat the patient,” said David W. Speicher, Ph.D., who conducted the research with colleagues at Wistar and the University of Pennsylvania. “Here we can envision a useful blood test that could, as part of routine early prenatal care, save the lives of many women.”

According to Speicher, their work points to the power of proteomics — the study of the sum total of proteins that the body is making at a given time — in understanding the state of health or disease in people. Wistar has expertise in advanced proteomics, and Wistar researchers predict the discovery of new biomarkers that will expand the ability of doctors to detect and treat a variety of diseases. 

Proteomics provides researchers an “unbiased” approach to the discovery of biomarkers, proteins in this case, which could be used to signal the presence of a particular clinical disorder or disease.

“Most biomarkers being used clinically today were first discovered by focused studies of proteins known to be associated with a disease, such as the prostate-specific antigen (PSA) test for prostate cancer,” Speicher explained. “Proteomics is unbiased in the sense that we are not trying to confirm the presence of a known protein, we simply compare the entire protein profile of people in a particular clinical condition or disease state to the protein profile of people in a healthy state.”

“Instead of a single biomarker, we can define a panel of such markers, creating a test that weighs the relative importance of individual proteins,” Speicher said. “It makes for more sensitive, reliable tests.”

Recently, the Speicher laboratory compared the proteomic signature of blood samples taken from known cases of ectopic pregnancy with blood samples taken from women who experienced a normal pregnancy. They discovered about 70 candidate biomarkers that could signal ectopic pregnancy, which stringent statistical analysis whittled down to the 12 most promising biomarkers. While some of the proteins had previously known associations with ectopic pregnancies, the researchers found at least two, including ADAM12, which had never been previously associated with ectopic pregnancy.

The next step is to further confirm and validate the usefulness of their panel of biomarkers using additional patient samples in order to create a practical, reliable blood test for ectopic pregnancy, Speicher says.  

“This is also a proof-of-principle demonstration of a new method for the discovery of new blood-borne markers that may serve as diagnostic blood tests to detect or predict a variety of clinical conditions and diseases, from ectopic pregnancy to cancer,” Speicher said.

Speicher is professor and co-leader of Wistar’s Molecular and Cellular Oncogenesis Program, director of The Wistar Institute Center for Systems and Computational Biology, Caspar Wistar Professor in Systems and Computational Biology and scientific director of Wistar’s Proteomics Facility.