EXPERIMENTAL MODEL FOR CHORIODECIDUAL INFECTION & PRETERM LABOR IN MACAQUES

宫内感染是早产的重要原因。我们 先前已经证明实验性羊膜内感染 在恒河猴中导致羊水(AF)的顺序增加 细胞因子(肿瘤坏死因子和白介素1b)和前列腺素(PGE2和PGF2a)， 其次是早产和分娩。然而，它的作用是 早产中的绒毛蜕膜感染尚不清楚。刻画 绒毛膜蜕膜后事件的病理生理序列 感染，我们使用了慢性仪器猕猴和 通过以下方式确定绒毛蜕膜感染的计时妊娠 接种低接种量(&lt；102CFU；n=2)、中等接种量 接种组(103-104 CFU；n=4)或高接种量(&gt；105 CFU；n=3) B链球菌(GBS)进入绒毛蜕膜间隙。 接种后，2个低接种组均未发生分娩，2个低接种组 中等接种量4只，高接种量2只。在4个国家中 感染引产的动物，子宫增加 收缩在接种后21小时(14-30小时)出现。 子宫收缩能力的增加先于羊膜腔内 GBS在4只动物中有3只平均12小时(6-24小时)入侵 小时)。房颤前炎症细胞因子与前列腺素水平 在这5只动物中，没有超过接种前的水平 接种该疫苗并未导致分娩。相比之下，重要的是 在4例患者中观察到房颤细胞因子和前列腺素的增加 在GBS羊膜内入侵之后，但不是在之前，分娩的动物 房颤中位数浓度(pg/ml)事件肿瘤坏死因子IL-1b 前列腺素E_2-前列腺素F_(2a)预接种50&20 430 86开始分娩900 110 5 550 316 交付1,320 844 15,754 1,474这些结果表明 绒毛膜蜕膜接种可上升至羊膜腔， 在确定羊膜内感染后，早产 随之而来。相反，绒毛膜蜕膜接种没有并发 羊膜内感染不会导致早产。

Intrauterine infection is an important cause of preterm birth. We have previously demonstrated that experimental intraamniotic infection in rhesus monkeys leads to sequential increases in amniotic fluid (AF) cytokines (TNF and IL-1b) and prostaglandins (PGE2 and PGF2a), followed by preterm labor and delivery. However, the role of choriodecidual infection in preterm labor is unclear. To characterize the pathophysiologic sequence of events following choriodecidual infection, we utilized chronically instrumented rhesus monkeys with timed gestations in which choriodecidual infection was established by inoculation of either a low inoculum (<102 cfu; n=2), moderate inoculum (103-104 cfu; n=4), or high inoculum (>105 cfu; n=3) of Group B streptococcus (GBS) bacteria into the choriodecidual space. Following inoculation, labor occurred in none of 2 low inoculum, 2 of 4 moderate inoculum, and in 2 of 3 high inoculum animals. In the 4 animals with infection-induced labor, increases in uterine contractility occurred 21 hours (14-30 hrs) after inoculation. Increases in uterine contractility were preceded by intraamniotic invasion by the GBS in 3 of 4 animals by an average of 12 hours (6-24 hrs). AF proinflammatory cytokine and prostaglandin concentrations did not rise above pre-inoculation levels among those 5 animals in which inoculation did not result in labor. In contrast, significant increases in AF cytokines and prostaglandins were observed in the 4 laboring animals after, but not before, intraamniotic invasion of GBS Median AF Concentrations (pg/ml) Event TNF IL-1b PGE2 PGF2a Pre-inoculation 50 <20 430 86 Onset Labor 900 110 5,550 316 Delivery 1,320 844 15,754 1,474 These results demonstrate that choriodecidual inoculation may ascend to the amniotic cavity and that following the establishment of intraamniotic infection, preterm labor ensues. In contrast, choriodecidual inoculation without concurrent intraamniotic infection did not lead to preterm labor.