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      Integrative single-cell and cell-free plasma RNA transcriptomics elucidates placental cellular dynamics

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          Significance

          The human placenta is a dynamic and cellular heterogeneous organ, which is critical in fetomaternal homeostasis and the development of preeclampsia. Previous work has shown that placenta-derived cell-free RNA increases during pregnancy. We applied large-scale microfluidic single-cell transcriptomic technology to comprehensively characterize cellular heterogeneity of the human placentas and identified multiple placental cell-type–specific gene signatures. Analysis of the cellular signature expression in maternal plasma enabled noninvasive delineation of the cellular dynamics of the placenta during pregnancy and the elucidation of extravillous trophoblastic dysfunction in early preeclampsia.

          Abstract

          The human placenta is a dynamic and heterogeneous organ critical in the establishment of the fetomaternal interface and the maintenance of gestational well-being. It is also the major source of cell-free fetal nucleic acids in the maternal circulation. Placental dysfunction contributes to significant complications, such as preeclampsia, a potentially lethal hypertensive disorder during pregnancy. Previous studies have identified significant changes in the expression profiles of preeclamptic placentas using whole-tissue analysis. Moreover, studies have shown increased levels of targeted RNA transcripts, overall and placental contributions in maternal cell-free nucleic acids during pregnancy progression and gestational complications, but it remains infeasible to noninvasively delineate placental cellular dynamics and dysfunction at the cellular level using maternal cell-free nucleic acid analysis. In this study, we addressed this issue by first dissecting the cellular heterogeneity of the human placenta and defined individual cell-type–specific gene signatures by analyzing more than 24,000 nonmarker selected cells from full-term and early preeclamptic placentas using large-scale microfluidic single-cell transcriptomic technology. Our dataset identified diverse cellular subtypes in the human placenta and enabled reconstruction of the trophoblast differentiation trajectory. Through integrative analysis with maternal plasma cell-free RNA, we resolved the longitudinal cellular dynamics of hematopoietic and placental cells in pregnancy progression. Furthermore, we were able to noninvasively uncover the cellular dysfunction of extravillous trophoblasts in early preeclamptic placentas. Our work showed the potential of integrating transcriptomic information derived from single cells into the interpretation of cell-free plasma RNA, enabling the noninvasive elucidation of cellular dynamics in complex pathological conditions.

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          Most cited references40

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          Accounting for technical noise in single-cell RNA-seq experiments.

          Single-cell RNA-seq can yield valuable insights about the variability within a population of seemingly homogeneous cells. We developed a quantitative statistical method to distinguish true biological variability from the high levels of technical noise in single-cell experiments. Our approach quantifies the statistical significance of observed cell-to-cell variability in expression strength on a gene-by-gene basis. We validate our approach using two independent data sets from Arabidopsis thaliana and Mus musculus.
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            Seq-Well: A Portable, Low-Cost Platform for High-Throughput Single-Cell RNA-Seq of Low-Input Samples

            Single-cell RNA-Seq can precisely resolve cellular states but application to sparse samples is challenging. Here, we present Seq-Well, a portable, low-cost platform for massively-parallel single-cell RNA-Seq. Barcoded mRNA capture beads and single cells are sealed in an array of subnanoliter wells using a semi-permeable membrane, enabling efficient cell lysis and transcript capture. We characterize Seq-Well using species-mixing experiments and PBMCs, and profile thousands of primary human macrophages exposed to tuberculosis.
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              Pre-eclampsia part 1: current understanding of its pathophysiology.

              Pre-eclampsia is characterized by new-onset hypertension and proteinuria at ≥20 weeks of gestation. In the absence of proteinuria, hypertension together with evidence of systemic disease (such as thrombocytopenia or elevated levels of liver transaminases) is required for diagnosis. This multisystemic disorder targets several organs, including the kidneys, liver and brain, and is a leading cause of maternal and perinatal morbidity and mortality. Glomeruloendotheliosis is considered to be a characteristic lesion of pre-eclampsia, but can also occur in healthy pregnant women. The placenta has an essential role in development of this disorder. Pathogenetic mechanisms implicated in pre-eclampsia include defective deep placentation, oxidative and endoplasmic reticulum stress, autoantibodies to type-1 angiotensin II receptor, platelet and thrombin activation, intravascular inflammation, endothelial dysfunction and the presence of an antiangiogenic state, among which an imbalance of angiogenesis has emerged as one of the most important factors. However, this imbalance is not specific to pre-eclampsia, as it also occurs in intrauterine growth restriction, fetal death, spontaneous preterm labour and maternal floor infarction (massive perivillous fibrin deposition). The severity and timing of the angiogenic imbalance, together with maternal susceptibility, might determine the clinical presentation of pre-eclampsia. This Review discusses the diagnosis, classification, clinical manifestations and putative pathogenetic mechanisms of pre-eclampsia.
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                Author and article information

                Journal
                Proc Natl Acad Sci U S A
                Proc. Natl. Acad. Sci. U.S.A
                pnas
                pnas
                PNAS
                Proceedings of the National Academy of Sciences of the United States of America
                National Academy of Sciences
                0027-8424
                1091-6490
                12 September 2017
                22 August 2017
                22 August 2017
                : 114
                : 37
                : E7786-E7795
                Affiliations
                [1] aLi Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong , Shatin, New Territories, Hong Kong SAR, China;
                [2] bDepartment of Chemical Pathology, The Chinese University of Hong Kong , Shatin, New Territories, Hong Kong SAR, China;
                [3] cDepartment of Obstetrics and Gynaecology, The Chinese University of Hong Kong , Shatin, New Territories, Hong Kong SAR, China;
                [4] dDepartment of Anatomical and Cellular Pathology, The Chinese University of Hong Kong , Shatin, New Territories, Hong Kong SAR, China
                Author notes
                2To whom correspondence may be addressed. Email: jchtsang@ 123456cuhk.edu.hk or loym@ 123456cuhk.edu.hk .

                Contributed by Yuk Ming Dennis Lo, July 27, 2017 (sent for review June 19, 2017; reviewed by Roberto Romero and Joe Leigh Simpson)

                Author contributions: J.C.H.T. and Y.M.D.L. designed research; J.C.H.T., J.S.L.V., L.J., L.C.Y.P., and Y.K.Y.C. performed research; K.O.L., Y.-B.N., K.F.T., R.W.K.C., and Y.M.D.L. contributed new reagents/analytic tools; J.C.H.T., J.S.L.V., L.J., P.J., R.W.K.C., and Y.M.D.L. analyzed data; L.C.Y.P. and Y.K.Y.C. recruited patients; and J.C.H.T., J.S.L.V., L.J., and Y.M.D.L. wrote the paper.

                Reviewers: R.R., US Department of Health and Human Services; and J.L.S., Research and Global Programs at the March of Dimes.

                1J.C.H.T., J.S.L.V., and L.J. contributed equally to this work.

                Article
                PMC5604038 PMC5604038 5604038 201710470
                10.1073/pnas.1710470114
                5604038
                28830992
                4378ff0a-638c-47c4-ab3c-b8aa272a78dd

                Freely available online through the PNAS open access option.

                History
                Page count
                Pages: 10
                Funding
                Funded by: Research Grants Council, University Grants Committee (RGC, UGC) 501100002920
                Award ID: T12-403/15-N
                Funded by: Chinese University of Hong Kong (CUHK) 501100004853
                Award ID: FIA2016/B/01
                Categories
                PNAS Plus
                Biological Sciences
                Medical Sciences
                PNAS Plus

                single-cell transcriptomics,cell-free RNA,noninvasive prenatal testing,placenta,preeclampsia

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