Cellular immune responses in amniotic fluid of women with preterm labor and intraâ amniotic infection or intraâ amniotic inflammation

ProblemPreterm birth is commonly preceded by preterm labor, a syndrome that is causally linked to both intraâ amniotic infection and intraâ amniotic inflammation. However, the stereotypical cellular immune responses in these two clinical conditions are poorly understood.Method of studyAmniotic fluid samples (n = 26) were collected from women diagnosed with preterm labor and intraâ amniotic infection (amniotic fluid ILâ 6 concentrations â ¥2.6 ng/mL and culturable microorganisms, n = 10) or intraâ amniotic inflammation (amniotic fluid ILâ 6 concentrations â ¥2.6 ng/mL without culturable microorganisms, n = 16). Flow cytometry was performed to evaluate the phenotype and number of amniotic fluid leukocytes. Amniotic fluid concentrations of classical proâ inflammatory cytokines, type 1 and type 2 cytokines, and Tâ cell chemokines were determined using immunoassays.ResultsWomen with spontaneous preterm labor and intraâ amniotic infection had (a) a greater number of total leukocytes, including neutrophils and monocytes/macrophages, in amniotic fluid; (b) a higher number of total T cells and CD4+ T cells, but not CD8+ T cells or B cells, in amniotic fluid; and (c) increased amniotic fluid concentrations of ILâ 6, ILâ 1β, and ILâ 10, compared to those with intraâ amniotic inflammation. However, no differences in amniotic fluid concentrations of Tâ cell cytokines and chemokines were observed between these two clinical conditions.ConclusionThe cellular immune responses observed in women with preterm labor and intraâ amniotic infection are more severe than in those with intraâ amniotic inflammation, and neutrophils, monocytes/macrophages, and CD4+ T cells are the main immune cells responding to microorganisms that invade the amniotic cavity. These findings provide insights into the intraâ amniotic immune mechanisms underlying the human syndrome of preterm labor.The relative distribution of innate and adaptive immune cell subsets in amniotic fluid of women with preterm labor and intraâ amniotic inflammation. Flow cytometry analysis is shown as a tâ SNE plot.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151891/1/aji13171_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151891/2/aji13171.pd

Ureaplasma-Urealyticum Chorioamnionitis

Controversy reigns over the role of Ureaplasma urealyticum in determining pregnancy outcome. U. urealyticum infection of the chorioamnion is strongly associated with chorioamnionitis (1-3), premature birth (2-4), and perinatal morbidity (4-6). We present 4 cases of U. urealyticum chorioamnionitis and associated morbidity and mortality