QUANTITIVE MICRBIOLOGIC MODEL FOR PRETERM DELIVERY

早产的定量微生物模型

• 批准号: 6343206
• 负责人: ANDREW B. ONDERDONK
• 金额: $ 28.1万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-01-01 至 2001-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6343206
• 关键词: Candida albicans; bacterial disease; cervical /vaginal smear; clinical research; disease /disorder proneness /risk; female; human morbidity; human mortality; human pregnant subject; human subject; infant mortality; lipase; mathematical model; microorganism population study; model design /development; nucleic acid quantitation /detection; pregnancy infection; premature infant human; women's health

Preterm delivery (PTD) is the leading cause of infant morbidity and mortality in the United States, and prevention of PTD is a primary goal in perinatal health care. Recent data indicates a strong association a strong association between maternal genital tract infection, including bacterial vaginosis, and PTD, with compelling evidence that micro- organisms are a cause of PTD. However, the relationship between concentrations of vaginal microorganisms and PTD, the identification of key microbial populations that are significant risk factors for PTD, and the pathophysiologic mechanisms by which bacteria contribute to PTD remain to be determined. In addition, the interactions between microbial populations of significance to PTD are unknown. Preterm labor may be initiated by bacterial phospholipases A2 and which release arachidonic acid-the primary substance for prostaglandins which are considered fundamental to the initiation of labor. It has been hypothesized that the combined activities of lipase and phospholipases also account for a variety of effects associated with membrane damage. However, the relationship between these combined enzyme activities in the vagina and pregnancy outcome has not been determined. The objective of the proposed project is to prospectively collect quantitative data on microbiologic populations and enzyme activities and to receptor the presence or absence of bacterial vaginosis in two cohorts at high risk for PTD and one to record the presence or absence of bacterial vaginosis in two cohorts at high risk for PTD and one cohort at low risk. Generalized estimating equation regression will be used to analyze repeat measurement data and to formulate quantitative models to predict PTD. The following Specific Aims will be addressed: (1) quantitatively identify key microbial population as risk factors for PTD, (2) identify interactions between microbial populations that contribute to PTD, (3) determine whether there is an association between vaginal enzyme (lipase, phospholipase) activities and PTD, and (4) document any relationship between the presence or absence of bacterial vaginosis and PTD, and (4) document any relationship between the presence of absence of bacterial vaginosis and PTD. Recognition of predictive pathway(s) for PTD may permit the identification of individuals at risk for PTD may permit the identification of individuals at risk for PTD and, ultimately, the implementation of noel strategies for its prevention.

早产 (PTD) 是美国婴儿发病和死亡的主要原因，预防 PTD 是围产期保健的首要目标。最近的数据表明，包括细菌性阴道病在内的孕产妇生殖道感染与 PTD 之间存在很强的相关性，并且有令人信服的证据表明微生物是 PTD 的一个原因。然而，阴道微生物浓度与PTD之间的关系、作为PTD重要危险因素的关键微生物种群的鉴定以及细菌导致PTD的病理生理机制仍有待确定。此外，对 PTD 具有重要意义的微生物种群之间的相互作用尚不清楚。早产可能是由细菌磷脂酶 A2 引发的，它会释放花生四烯酸——前列腺素的主要物质，前列腺素被认为是引发分娩的基础。据推测，脂肪酶和磷脂酶的联合活性也解释了与膜损伤相关的多种效应。然而，阴道中这些组合酶活性与妊娠结局之间的关系尚未确定。拟议项目的目的是前瞻性地收集微生物种群和酶活性的定量数据，并接收两组 PTD 高风险人群中是否存在细菌性阴道病，并记录两组 PTD 高风险人群和一组低风险人群中是否存在细菌性阴道病。广义估计方程回归将用于分析重复测量数据并制定定量模型来预测PTD。将解决以下具体目标：(1) 定量确定作为 PTD 危险因素的关键微生物种群，(2) 确定导致 PTD 的微生物种群之间的相互作用，(3) 确定阴道酶（脂肪酶、磷脂酶）活性与 PTD 之间是否存在关联，以及 (4) 记录细菌性阴道病是否存在与 PTD 之间的任何关系，以及 (4) 记录存在之间的任何关系 不存在细菌性阴道病和PTD。对 PTD 预测途径的识别可能允许识别有 PTD 风险的个体，并最终实施诺埃尔策略来预防 PTD。