EVIDENCE OF PARTICIPATION OF THE SOLUBLE TUMOR-NECROSIS-FACTOR RECEPTOR-I IN THE HOST RESPONSE TO INTRAUTERINE INFECTION IN PRETERM LABOR
EVIDENCE OF PARTICIPATION OF THE SOLUBLE TUMOR-NECROSIS-FACTOR RECEPTOR-I IN THE HOST RESPONSE TO INTRAUTERINE INFECTION IN PRETERM LABOR
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DOI：
10.1111/j.1600-0897.1993.tb00619.x
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发表时间：
1993-09-01
影响因子：
3.6
通讯作者：
FIDEL, P
中科院分区：
文献类型：
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作者：
BAUMANN, P;ROMERO, R;FIDEL, P
问题：本研究旨在确定：（1）可溶性肿瘤坏死因子受体I是否（2）羊水中sTNF-r I的浓度随胎龄的变化而变化;和（3）羊膜腔的微生物侵入（在足月分娩和早产）与羊水sTNF-r I浓度的变化有关。通过羊膜穿刺术从185名妇女中取出羊水，根据胎龄（中期妊娠、早产和足月）、有无分娩、自发性胎膜破裂和羊膜腔微生物侵入分为11组。sTNF-r I用敏感的酶联免疫吸附试验（ELISA）检测羊水。此外，sTNF-r I浓度测定胎儿血液中获得的脐带穿刺在早产（N = 24）或在分娩后自然分娩（N = 10）。结果：所有羊水、母血、胎儿血和新生儿尿中均检测到sTNF-r I的存在，且sTNF-r I在妊娠中期高于足月（平均值+/- SD：36.2 +/- 12.2 ng/ml对比平均值+/- SD：5.56 +/- 5.72 ng/ml [P < .05]）;早产和微生物侵入羊膜腔的患者（胎膜完整或破裂者）羊水中sTNF-r I浓度显著高于无微生物侵袭者;在没有微生物侵入的情况下，分娩（足月分娩和早产分娩）与羊水中sTNF-r I浓度的变化无关;新生儿尿液中sTNF-r I浓度在所有生物体液（包括母体和新生儿/胎儿血液和羊水）中最高。结论：得出结论，sTNF-r I是羊水的生理成分，以及胎儿和母体血浆;羊水sTNF-r I浓度作为孕龄的函数而降低，并且sTNF-r I浓度的增加是早产中对宫内感染的宿主反应的一部分。
PROBLEM: This study was conducted to determine whether: (1) the soluble tumor necrosis factor receptor I (sTNF-r I) is present in human amniotic fluid, neonatal urine, and the feto-maternal plasma; (2) there are changes in the concentration of the sTNF-r I in amniotic fluid with gestational age; and (3) microbial invasion of the amniotic cavity (in term and preterm parturition) is associated with changes in amniotic fluid sTNF-r I concentrations.METHOD: Amniotic fluid was retrieved by amniocentesis from 185 women classified into 11 groups according to gestational age (midtrimester, preterm gestation, and term), the presence or absence of labor, spontaneous rupture of membranes and microbial invasion of the amniotic cavity. sTNF-r I was assayed with a sensitive and enzyme-linked immunosorbent assay (ELISA) validated for amniotic fluid. In addition, sTNF-r I concentrations were determined in fetal blood obtained by cordocentesis in preterm gestations (N = 24) or at the time of delivery after spontaneous labor at term (N = 10). sTNF-r I concentrations were also measured in maternal venous and cord blood and neonatal urine (n = 13).RESULTS: sTNF-r I was found to be present in all amniotic fluid samples, maternal blood and fetal blood and neonatal urine samples; sTNF-r I concentrations were higher in the midtrimester than at term (mean +/- SD: 36.2 +/- 12.2 ng/ml versus mean +/- SD: 5.56 +/- 5.72 ng/ml [P < .05]); patients with preterm labor and microbial invasion of the amniotic cavity (with intact or with ruptured membranes) had significantly higher amniotic fluid concentrations of sTNF-r I than patients without microbial invasion; in the absence of microbial invasion, parturition (both term and preterm) was not associated with changes in amniotic fluid concentrations of sTNF-r I; neonatal urine contained the highest concentrations of sTNF-r I of all biological fluids assayed including maternal and neonatal/fetal blood and amniotic fluid.,CONCLUSIONS: It was concluded that sTNF-r I is a physiologic constitutent of amniotic fluid, as well as of the fetal and maternal plasma; that amniotic fluid sTNF-r I concentrations decrease as a function of gestional age and increases in the concentration of the sTNF-r I are part of the host response to intrauterine infection in preterm parturition.