THE ROLE OF SUBCLINICAL INFECTION AND CYTOKINES IN PRETERM PARTURITION

该项目的目标是定义提升的角色 宫内感染在早产和分娩的病因中的作用 阐明早产信号的细胞和分子机制 在感染的背景下分娩，并将这一知识应用于 改进早产的诊断和治疗方法。 该实验室总结了以下研究： 1.患者微生物侵袭频度及临床意义 早产胎膜早破：38%的早产妇女 胎膜早破有微生物侵入羊膜 空洞。这些患者的入院分娩间隔较短， 早产率和围产儿发病率高于高危人群 无菌液体。 2.羊水微生物侵袭的快速诊断方法 空洞：羊水白细胞介素6的测定被发现是 最灵敏的检测微生物入侵的试验 羊膜腔。 3.对早产妇女的抗生素管理：科长 协助NICHD校外分会设计、执行和 迄今为止进行的最大规模随机临床试验的分析 确定抗生素对早产儿妇女的影响 劳力。抗生素不能改善围产儿结局。 4.巨噬细胞衍生细胞因子与感染性早产的研究 分娩：实验室确定：1)产妇死亡率大幅上升 血清和羊水中肿瘤坏死因子、白介素6和白介素1的浓度 IL-6和IL-1α在感染诱导早产前的浓度 动物的分娩和分娩和2)IL-1和肿瘤坏死因子直接影响 增加子宫肌层细胞和催产素引起的子宫收缩。

The objectives of this project are to define the role of ascending intrauterine infection in the etiology of preterm labor and delivery, to elucidate the cellular and molecular mechanisms signalling preterm parturition in the setting of infection and to apply this knowledge to improve the diagnostic and therapeutic approach to preterm labor. The laboratory concluded the following studies: 1. Frequency and clinical significance of microbial invasion in patients with preterm premature rupture of membranes: 38% of women with preterm premature rupture of membranes have microbial invasion of the amniotic cavity. These patients had a shorter admission to delivery interval, a higher rate of preterm delivery and perinatal morbidity than patients with sterile fluid. 2. Rapid methods for the diagnosis of microbial invasion of the amniotic cavity: Amniotic fluid interleukin-6 determination was found to be the most sensitive test for the detection of microbial invasion of the amniotic cavity. 3. Antibiotic administration to women in preterm labor: The Branch Chief assisted the Extramural Branch of NICHD in the design, conduction and analysis of the largest randomized clinical trial conducted to date to determine the effect of antibiotic administration to women with premature labor. Antibiotics did not improve perinatal outcome. 4. Studies of microphage-derived cytokines and infection-induced preterm labor: The laboratory determined that: 1) a dramatic increase in maternal serum concentrations of TNF, IL-6 and IL-1 and in amniotic fluid concentrations of IL-6 and IL-1 alpha precedes infection-induced preterm labor and delivery in animals and 2) IL-1 and TNF have direct effects on myometrial cells and increase oxytocin induced uterine contractility.