Amniotic fluid soluble human leukocyte antigen-G in term and preterm parturition, and intra-amniotic infection/inflammation.
Amniotic fluid soluble human leukocyte antigen-G in term and preterm parturition, and intra-amniotic infection/inflammation.
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DOI：
10.3109/14767050903019684
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发表时间：
2009-12
期刊：
影响因子：
--
通讯作者：
Hassan SS
中科院分区：
文献类型：
--
作者：
Kusanovic JP;Romero R;Jodicke C;Mazaki-Tovi S;Vaisbuch E;Erez O;Mittal P;Gotsch F;Chaiworapongsa T;Edwin SS;Pacora P;Hassan SS
循环中可溶性HLA-G（sHLA-G）与妊娠并发症有关，并且已报道在正常妊娠中测定羊水（AF）中的sHLA-G浓度。我们的目的是确定AF的sHLA-G浓度是否随着妊娠的进展、足月自然分娩、胎膜完整的自发性早产（PTL）患者以及存在或不存在羊膜内感染/炎症（IAI）的早产前胎膜破裂（PROM）患者而变化。该横断面研究包括以下组：1）中期妊娠（n=55）; 2）足月正常妊娠伴分娩（n=50）和不伴分娩（n=50）; 3）胎膜完整的自发性PTL，分为：a）足月分娩的PTL（n=153）; B）未伴IAI的早产PTL（n=108）;和c）伴IAI的PTL（n=84）;（4）早产胎膜早破伴IAI者46例，未伴IAI者44例。ELISA法测定血清sHLA-G浓度。非参数统计用于分析。1)在PTL患者中，IAI患者的中位AF sHLA-G浓度高于无IAI患者或足月分娩妇女（两组比较p<0.001）; 2）同样，早产胎膜早破和IAI患者的中位AF sHLA-G浓度高于无IAI患者（p=0.004）; 3）在PTL和分娩患者中，有组织学绒毛膜炎和/或脐带炎的患者比无组织学炎症的患者中位AF sHLA-G浓度更高（p<0.001）;和4）AF sHLA-G浓度中位数不随胎龄的增加而改变。AF sHLA-G浓度在与IAI相关的早产以及组织学绒毛膜炎中升高。我们认为sHLA-G可能参与调节宿主对羊膜内感染的免疫反应。
Circulating soluble HLA-G (sHLA-G) has been associated with pregnancy complications, and determination of sHLA-G concentrations in amniotic fluid (AF) has been reported in normal pregnancies. Our aim was to determine if the AF concentrations of sHLA-G change with advancing gestation, spontaneous labor at term, and in patients with spontaneous preterm labor (PTL) with intact membranes, as well as in those with preterm prelabor rupture of membranes (PROM), in the presence or absence of intraamniotic infection/inflammation (IAI). This cross-sectional study included the following groups: 1) midtrimester (n=55); 2) normal pregnancy at term with (n=50) and without (n=50) labor; 3) spontaneous PTL with intact membranes divided into: a) PTL who delivered at term (n=153); b) PTL who delivered preterm without IAI (n=108); and c) PTL with IAI (n=84); and 4) preterm PROM with (n=46) and without (n=44) IAI. sHLA-G concentrations were determined by ELISA. Non-parametric statistics were used for analysis. 1) Among patients with PTL, the median AF sHLA-G concentration was higher in patients with IAI than in those without IAI or women that delivered at term (p<0.001 for both comparisons); 2) Similarly, patients with preterm PROM and IAI had higher median AF sHLA-G concentrations than those without IAI (p=0.004); 3) Among patients with PTL and delivery, those with histologic chorioamnionitis and/or funisitis had a higher median AF sHLA-G concentration than those without histologic inflammation (p<0.001); and 4) The median AF sHLA-G concentration did not change with advancing gestational age. AF sHLA-G concentrations are elevated in preterm parturition associated to IAI as well as in histologic chorioamnionitis. We propose that sHLA-G may participate in the regulation of the host immune response against intra-amniotic infection.
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