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To the Editor: Dr Gravett et al¹ studied 33 samples of human amniotic fluid in an attempt to relate biomarkers to intra-amniotic infection (IAI). Surface-enhanced laser desorption-ionization/time-of-flight (SELDI-TOF) mass spectrometry identified possible biomarker peaks in preterm intra-amniotic fluid in the 3- to 5-kDa and 11- to 12-kDa regions. The authors supported their conclusions using tryptic digests subject to liquid chromatography–tandem mass spectrometry analysis. They argued that calgranulin B and a fragment of insulinlike growth factor binding protein 1 (IGFBP-1) are biomarkers of IAI. Several aspects of this preliminary communication remain unclear.

First, no specific microbial or viral biomarkers were identified, only those of human neutrophil activation, a nonspecific response to inflammation. Several of the peaks in the 3- to 5-kDa cluster (Figure 1B) correspond to neutrophil defensins 1 to 3 as reported by Heine et al² in association with chorioamnionitis. The authors report that they matched the 10.8-kDa peak to . . . [Full Text of this Article]

Irina A. Buhimschi, MD
irina.buhimschi@yale.edu

Catalin S. Buhimschi, MD
Department of Obstetrics, Gynecology & Reproductive Sciences
Yale University
New Haven, Conn

Rob Christner, PhD
Ciphergen Biosystems
Fremont, Calif

Errol Norwitz, MD, PhD
Department of Obstetrics, Gynecology & Reproductive Sciences
Yale University
New Haven, Conn

Carl P. Weiner, MD, MBA
Department of Obstetrics, Gynecology & Reproductive Sciences
University of Maryland
Baltimore

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