Relationship between antenatal inflammation and antenatal infection identified by detection of microbial genes by polymerase chain reaction
Relationship between antenatal inflammation and antenatal infection identified by detection of microbial genes by polymerase chain reaction
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DOI：
10.1203/01.pdr.0000155944.48195.97
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发表时间：
2005-04-01
影响因子：
3.6
通讯作者：
Kotecha, S
中科院分区：
文献类型：
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作者：
Miralles, R;Hodge, R;Kotecha, S
尽管产前感染被认为在早产和新生儿疾病的发病机制中发挥着重要作用，但其确切机制尚不清楚。我们试图阐明产前感染与宫内和新生儿炎症之间的关系。从 36 名母亲分娩的 41 名妊娠 < 33 周的早产儿中获取样本，并使用 PCR 分析 16s 核糖体 RNA (16s rRNA) 基因的存在以及促炎细胞因子 IL-6 和 IL-8。在 16 例 (44%) 母婴配对中，至少有一份样本被发现 16s rRNA 基因呈阳性。除一份阳性样本外，所有阳性样本均来自患有早产前胎膜破裂 (pPROM) 或自发性特发性早产的母亲。研究发现 16s rRNA 基因的存在与绒毛膜羊膜炎和绳索炎之间存在密切关联。在 16s rRNA 基因阳性的所有组织中，包括胎盘、胎膜、脐带血，以及支气管肺泡灌洗液 (BAL) 和羊水中（如果有样本），IL-6 和 IL-8 显着增加。有趣的是，如果任何其他宫内或 BAL 样本呈阳性，胃液中 16s IRNA 基因总是呈阳性，这表明该样本可以提供羊水的替代品来识别产前感染。总之，我们发现微生物基因在早产儿和自发性早产群体中特别普遍，并且它们的存在与明显的宫内炎症反应密切相关。
Although antenatal infection is thought to play an important role in the pathogenesis of preterm labor and neonatal diseases, the exact mechanisms are largely unknown. We sought to clarify the relationship between antenatal infection and intrauterine and neonatal inflammation. Samples were obtained from 41 preterm infants of < 33 wk gestation delivered to 36 mothers and analyzed for the presence of 16s ribosomal RNA (16s rRNA) genes using PCR and for the proinflammatory cytokines IL-6 and IL-8. In 16 (44%) mother-baby pairings, at least one sample was found to be positive for the presence of 16s rRNA genes. All but one of the positive samples were from mothers presenting with preterm prelabor rupture of membranes (pPROM) or in spontaneous idiopathic preterm labor. A strong association was found between the presence of 16s rRNA genes and chorioamnionitis and with funisitis. A marked increase in IL-6 and IL-8 was noted in all tissues positive for 16s rRNA genes, including placenta, fetal membranes, cord blood serum, and, where samples were available, in bronchoalveolar lavage fluid (BAL) and in amniotic fluid. Interestingly, gastric fluid was always positive for 16s IRNA genes if any other intrauterine or BAL sample was positive, suggesting that this sample may provide an alternative to amniotic fluid to identify antenatal infection. In conclusion, we have found that microbial genes are particularly prevalent in pPROM and spontaneous preterm labor groups and that their presence is strongly associated with a marked intrauterine inflammatory response.