RNA Biosignatures in Adolescent Patients in a Pediatric Emergency Department With Pelvic Inflammatory Disease.

TitleRNA Biosignatures in Adolescent Patients in a Pediatric Emergency Department With Pelvic Inflammatory Disease.
Publication TypeJournal Article
Year of Publication2015
AuthorsBalamuth F, Zhang Z, Rappaport E, Hayes K, Mollen C, Sullivan KE
JournalPediatr Emerg Care
Volume31
Issue7
Pagination465-72
Date Published07/2015
ISSN1535-1815
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.

DOI10.1097/PEC.0000000000000483
Alternate JournalPediatr Emerg Care
PubMed ID26125533
PubMed Central IDPMC4495580
Grant ListK12 HL109009 / HL / NHLBI NIH HHS / United States
K12-HL109009 / HL / NHLBI NIH HHS / United States
UL1TR000003 / TR / NCATS NIH HHS / United States