Clinical chorioamnionitis at term II: The intra-amniotic inflammatory response

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dc.catalogadoraba
dc.contributor.authorRomero, Roberto
dc.contributor.authorChaemsaithong, Piya
dc.contributor.authorKorzeniewski, Steven J.
dc.contributor.authorTarca, Adi L.
dc.contributor.authorBhatti, Gaurav
dc.contributor.authorXu, Zhonghui
dc.contributor.authorKusanovic, Juan Pedro
dc.contributor.authorDong, Zhong
dc.contributor.authorDocheva, Nikolina
dc.contributor.authorMartínez Varea, Alicia
dc.contributor.authorYoon, Bo Hyun
dc.contributor.authorHassan, Sonia S.
dc.contributor.authorChaiworapongsa, Tinnakorn
dc.contributor.authorYeo, Lami
dc.date.accessioned2023-08-11T22:05:38Z
dc.date.available2023-08-11T22:05:38Z
dc.date.issued2016
dc.description.abstractObjective: Recent studies indicate that clinical chorioamnionitis is a heterogeneous condition and only approximately one-half of the patients have bacteria in the amniotic cavity, which is often associated with intra-amniotic inflammation. The objective of this study is to characterize the nature of the inflammatory response within the amniotic cavity in patients with clinical chorioamnionitis at term according to the presence or absence of 1) bacteria in the amniotic cavity and 2) intra-amniotic inflammation. Materials and methods: A retrospective cross-sectional case-control study was conducted to examine cytokine and chemokine concentrations in the amniotic fluid (AF). Cases consisted of women with clinical chorioamnionitis at term (n=45). Controls were women with uncomplicated pregnancies at term who did not have intra-amniotic inflammation and were in labor (n=24). Women with clinical chorioamnionitis were classified according to the results of AF cultures, broad-range polymerase chain reaction coupled with electrospray ionization mass spectrometry, and AF concentration of interleukin-6 (IL-6) into those: 1) without intra-amniotic inflammation, 2) with microbial-associated intra-amniotic inflammation, and 3) with intra-amniotic inflammation without detectable bacteria. The AF concentrations of 29 cytokines/chemokines were determined using sensitive and specific V-PLEX immunoassays. Results: 1) The AF concentrations of pro- and anti-inflammatory cytokines/chemokines such as interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin-4 (IL-4), macrophage inflammatory protein-1 beta (MIP-1β), and interleukin-8 (IL-8) (except Eotaxin-3) were significantly higher in women with clinical chorioamnionitis at term than in controls (term labor without intra-amniotic inflammation); 2) patients with microbial-associated intra-amniotic inflammation, and those with intra-amniotic inflammation without detectable bacteria, had a dramatic differential expression of cytokines and chemokines in AF compared to patients with spontaneous labor without intra-amniotic inflammation. However, no difference could be detected in the pattern of the intra-amniotic inflammatory response between patients with intra-amniotic inflammation with and without detectable bacteria; and 3) in patients with clinical chorioamnionitis at term but without intra-amniotic inflammation, the behavior of cytokines and chemokines in the AF was similar to those in spontaneous labor at term. Conclusions: Patients with clinical chorioamnionitis who had microbial-associated intra-amniotic inflammation or intra-amniotic inflammation without detectable bacteria had a dramatic upregulation of the intra-amniotic inflammatory response assessed by amniotic fluid concentrations of cytokines. A subset of patients with term clinical chorioamnionitis does not have intra-amniotic infection/inflammation, as demonstrated by elevated AF concentrations of inflammation-related proteins, when compared to women in term labor with uncomplicated pregnancies, suggesting over-diagnosis. These observations constitute the first characterization of the cytokine/chemokine network in the amniotic cavity of patients with clinical chorioamnionitis at term.
dc.fechaingreso.objetodigital2023-07-06
dc.format.extent18 páginas
dc.fuente.origenORCID
dc.identifier.doi10.1515/jpm-2015-0045
dc.identifier.issn1619-3997
dc.identifier.urihttps://doi.org/10.1515/jpm-2015-0045
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/74387
dc.identifier.wosidWOS:000368146600002
dc.information.autorucEscuela de Medicina; Kusanovic, Juan Pedro; 0000-0003-0640-2070; 1008900
dc.issue.numero1
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final22
dc.pagina.inicio5
dc.revistaJournal of Perinatal Medicine
dc.rightsacceso abierto
dc.subjectAmniocentesises_ES
dc.subjectChemokineses_ES
dc.subjectCytokineses_ES
dc.subjectFunisitises_ES
dc.subjectHistologic chorioamnionitises_ES
dc.subjectInterleukin-6 (IL-6)es_ES
dc.subjectIntra-amniotic infection/inflammationes_ES
dc.subjectMicrobial invasion of the amniotic cavity (MIAC)es_ES
dc.subjectPolymerase chain reaction coupled with electrospray ionization mass spectrometry (PCR/ESI-MS)es_ES
dc.subjectSterile inflammationes_ES
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.ods05 Gender equality
dc.subject.odspa03 Salud y bienestar
dc.subject.odspa05 Igualdad de género
dc.titleClinical chorioamnionitis at term II: The intra-amniotic inflammatory responsees_ES
dc.typeartículo
dc.volumen44
sipa.codpersvinculados1008900
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