Epigenetic Phenotype of Plasma Cell-Free DNA in the Prediction of Early-Onset Preeclampsia

BackgroundIn the current study, we sought to characterise the methylation haplotypes and nucleosome positioning patterns of placental DNA and plasma cell-free DNA of pregnant women with early-onset preeclampsia using whole genome bisulphite sequencing (WGBS) and methylation capture bisulphite sequencing (MCBS) and further develop and examine the diagnostic performance of a generalised linear model (GLM) by incorporating the epigenetic features for early-onset preeclampsia.MethodsThis case-control study recruited pregnant women aged at least 18 years who delivered their babies at our Hospital. In addition, non-pregnant women with no previous history of diseases were included. Placental samples of the villous parenchyma were taken at the time of delivery and venous blood was drawn from pregnant women during non-invasive prenatal testing at 12-15 weeks of pregnancy and nonpregnant women during the physical check-up. WGBS and MCBS were carried out of extracted genomic DNA. Then, we established the GLM by incorporating preeclampsia-specific methylation haplotypes and nucleosome positioning patterns and examined the diagnostic performance of the model by receiver operating characteristic (ROC) curve analysis.ResultsThe study included 135 pregnant women and 50 non-pregnant women. Our high-depth MCBS revealed notably different DNA methylation and nucleosome positioning patterns between women with and without preeclampsia. Preeclampsia-specific hypermethylated sites were found predominantly in the promoter regions and particularly enriched in CTCF on the X chromosome. Totally, 2379 preeclampsia-specific methylation haplotypes were found across the entire genome. ROC analysis showed that the area under the ROC curve (AUC) was 0.938 (95%CI 0.877, 1.000). At a GLM cut-off of 0.341, the AUC was the maximum, with a sensitivity of 95.6% and a specificity of 89.7%.ConclusionPregnant women with early-onset preeclampsia exhibit DNA methylation and nucleosome positioning patterns in placental and plasma DNA. Early-onset preeclampsia is a potentially dangerous condition that can have a profound impact on the health of both the expectant mother and her unborn child. This condition is particularly concerning because it's challenging to predict who may be affected using conventional methods such as monitoring blood pressure. In our research, we've developed an innovative, non-invasive approach to predict the onset of early preeclampsia. We do this by analysing the genetic material of the developing baby, which can be found in the mother's blood. Our method has shown remarkable accuracy in our testing populations, and its implications are substantial. By providing an early warning system, this breakthrough can benefit pregnant women immensely. It means that early-onset preeclampsia can be identified and addressed well before it becomes a serious health threat. This allows for timely medical interventions and treatments, significantly improving the well-being of both mothers and their precious little ones.