Placental exosome in maternal circulation for the identification of Bart's hydrops fetalis

To determine whether: 1. placenta-derived exosome is elevated; and 2. exosome proteomics profile is differentially expressed in women with Bart's hydrops fetalis fetuses compared to controls. A prospective cohort multicentre study in pregnant women couple at risk for Hb Bart's hydrops fetalis at 11 weeks of gestation onwards was conducted. Participants were classified into 3 groups: 1. non-Bart's hydrops thalassemia conditions (n = 5); 2. Hb's Bart's hydrops fetalis (n = 5); and 3. pregnant women at risk of placental associated complications (control group) (n = 5). Gestational ages at blood sampling among the group were matched. Plasma exosomes were isolated by size exclusion chromatography and then collected exosome fractions. The exosomes were measured size and number of particles. Isolated exosomes and their plasma were measured PLAP level using Human Alkaline phosphatase (ELISA kit). Mass spectometry was used to determine placental exosome proteomics profile. Placental exosome levels and differentially expressed exosomal proteins were demonstrated in figure 1. This is the first study of placenta-derived exosome in women with Hb Bart's hydrops fetalis. Placental-derived exosome level is significantly higher in women with Hb Bart's hydrops fetalis fetuses. In addition, several exosomal proteins were differential expressed in women with Bart's hydropic fetuses and these proteins involve in immune response and vesicle mediated transport. The result of this study can be further used to determine whether placental exosome in maternal circulation can be used as a non-invasive prenatal test for the early identification of Bart's hydropic fetus. This will ultimately reduce the rate of unnecessary invasive prenatal diagnosis testing. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.