Fran Balamuth1, Zhe Zhang, Eric Rappaport, Katie Hayes, Cynthia Mollen, Kathleen E Sullivan. 1. From the *Division of Emergency Medicine, The Children's Hospital of Philadelphia; †Perelman School of Medicine, University of Pennsylvania; ‡Bioinformatics Core Facility, §Microarray Core Facility, The Children's Hospital of Philadelphia; ∥Division of Emergency Medicine, Children's National Medical Center; and ¶Division of Allergy and Immunology, The Children's Hospital of Philadelphia, Philadelphia, PA.
Abstract
BACKGROUND: Adolescents are at high risk for pelvic inflammatory disease (PID). Because accurate diagnosis of PID is difficult, and complications of untreated PID are significant, novel methods to improve diagnosis are essential. OBJECTIVES: To determine if patients with PID have unique RNA expression patterns compared to controls. METHODS: Peripheral blood was collected from adolescent females with PID in the emergency department, and from control patients in the operating room. RNA was isolated, and microarray analysis was performed. Initial analysis involved a training set of 18 patients (9 PID patients with either Neisseria gonorrhoeae or Chlamydia trachomatis infection and 9 control patients). Supervised and unsupervised cluster analyses were performed, followed by network analysis. The training set was used to classify a set of 15 additional PID patients and 2 controls. RESULTS: Supervised cluster analysis of the training set revealed 170 genes which were differentially expressed in PID patients versus controls. Network analysis indicated that several differentially expressed genes are involved in immune activation. Analysis of additional PID patients based on the training set findings revealed that patients with positive testing for Trichomonas vaginalis partitioned with the PID group, whereas patients with no organism identified partitioned with both groups. CONCLUSIONS: RNA sample collection from adolescents in the emergency department is feasible. Genes were identified which were differentially expressed in PID patients versus controls, many of which are involved in inflammation. Future studies should confirm the training set findings on a larger sample and may lead to improved accuracy of PID diagnosis.
BACKGROUND: Adolescents are at high risk for pelvic inflammatory disease (PID). Because accurate diagnosis of PID is difficult, and complications of untreated PID are significant, novel methods to improve diagnosis are essential. OBJECTIVES: To determine if patients with PID have unique RNA expression patterns compared to controls. METHODS: Peripheral blood was collected from adolescent females with PID in the emergency department, and from control patients in the operating room. RNA was isolated, and microarray analysis was performed. Initial analysis involved a training set of 18 patients (9 PID patients with either Neisseria gonorrhoeae or Chlamydia trachomatis infection and 9 control patients). Supervised and unsupervised cluster analyses were performed, followed by network analysis. The training set was used to classify a set of 15 additional PID patients and 2 controls. RESULTS: Supervised cluster analysis of the training set revealed 170 genes which were differentially expressed in PID patients versus controls. Network analysis indicated that several differentially expressed genes are involved in immune activation. Analysis of additional PID patients based on the training set findings revealed that patients with positive testing for Trichomonas vaginalis partitioned with the PID group, whereas patients with no organism identified partitioned with both groups. CONCLUSIONS: RNA sample collection from adolescents in the emergency department is feasible. Genes were identified which were differentially expressed in PID patients versus controls, many of which are involved in inflammation. Future studies should confirm the training set findings on a larger sample and may lead to improved accuracy of PID diagnosis.
Authors: Jennifer L Reed; Rick T Strait; Andrea M Kachelmeyer; Terri L Byczkowski; Mona L Ho; Jill S Huppert Journal: Acad Emerg Med Date: 2011-07 Impact factor: 3.451
Authors: Brandie D Taylor; Toni Darville; Robert E Ferrell; Candace M Kammerer; Roberta B Ness; Catherine L Haggerty Journal: J Infect Dis Date: 2012-01-11 Impact factor: 5.226
Authors: Matthew P R Berry; Christine M Graham; Finlay W McNab; Zhaohui Xu; Susannah A A Bloch; Tolu Oni; Katalin A Wilkinson; Romain Banchereau; Jason Skinner; Robert J Wilkinson; Charles Quinn; Derek Blankenship; Ranju Dhawan; John J Cush; Asuncion Mejias; Octavio Ramilo; Onn M Kon; Virginia Pascual; Jacques Banchereau; Damien Chaussabel; Anne O'Garra Journal: Nature Date: 2010-08-19 Impact factor: 49.962
Authors: Xiaojing Zheng; Catherine M O'Connell; Wujuan Zhong; Uma M Nagarajan; Manoj Tripathy; De'Ashia Lee; Ali N Russell; Harold Wiesenfeld; Sharon Hillier; Toni Darville Journal: J Immunol Date: 2018-03-12 Impact factor: 5.422