Human β-defensin-3 participates in intra-amniotic host defense in women with labor at term, spontaneous preterm labor and intact membranes, and preterm prelabor rupture of membranes

被引：31

作者：

Para, Robert ^{[1
,2
,3
]}

Romero, Roberto ^{[1
,2
,4
,5
,6
]}

Miller, Derek ^{[1
,2
,3
]}

Panaitescu, Bogdan ^{[1
,2
,3
]}

Varrey, Aneesha ^{[1
,2
,3
]}

Chaiworapongsa, Tinnakorn ^{[1
,2
,3
]}

Hassan, Sonia S. ^{[1
,2
,3
,7
]}

Hsu, Chaur-Dong ^{[3
,7
]}

Gomez-Lopez, Nardhy ^{[1
,2
,3
,8
]}

机构：

[1] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Perinatol Res Branch, Div Obstet & Maternal Fetal Med, Div Intramural Res,NIH,US Dept HHS, Bethesda, MD USA

[2] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Perinatol Res Branch, Div Obstet & Maternal Fetal Med, Div Intramural Res,NIH,US Dept HHS, Detroit, MI USA

[3] Wayne State Univ, Sch Med, Dept Obstet & Gynecol, Detroit, MI 48201 USA

[4] Univ Michigan, Dept Obstet & Gynaecol, Ann Arbor, MI 48109 USA

[5] Michigan State Univ, Dept Epidemiol & Biostat, E Lansing, MI 48824 USA

[6] Wayne State Univ, Ctr Mol Med & Genet, Detroit, MI USA

[7] Wayne State Univ, Sch Med, Dept Physiol, Detroit, MI 48201 USA

[8] Wayne State Univ, Sch Med, Dept Immunol Microbiol & Biochem, Detroit, MI USA

来源：

JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE | 2020年 / 33卷 / 24期

基金：

美国国家卫生研究院;

关键词：

Amniotic fluid; antimicrobial peptide; chorioamnionitis; funisitis; infection; intra-amniotic inflammation; microbial invasion of the amniotic cavity; neutrophils; parturition; sterile inflammation; HUMAN BETA-DEFENSINS; FLUID NITRIC-OXIDE; AMNIOTIC-FLUID; FETAL MEMBRANES; MICROBIAL INVASION; HISTOLOGIC CHORIOAMNIONITIS; ANTIMICROBIAL PEPTIDES; CLINICAL-SIGNIFICANCE; PREMATURE RUPTURE; HUMAN PARTURITION;

D O I：

10.1080/14767058.2019.1597047

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Objective: Human beta-defensin-3 (HBD-3) has a broad spectrum of antimicrobial activity, and activity and, therefore, plays a central role in host defense mechanisms against infection. Herein, we determined whether HBD-3 was a physiological constituent of amniotic fluid during midtrimester and at term and whether the concentration of this defensin was increased in amniotic fluid of women with spontaneous preterm labor and intact membranes and those with preterm prelabor rupture of membranes (pPROM) with intra-amniotic inflammation or intra-amniotic infection. Methods: Amniotic fluid was collected from 219 women in the following groups: (1) midtrimester who delivered at term (n = 35); (2) with or without spontaneous labor at term (n = 50); (3) spontaneous preterm labor with intact membranes who delivered at term (n = 29); (4) spontaneous preterm labor with intact membranes who delivered preterm with or without intra-amniotic inflammation or intra-amniotic infection (n = 69); and (5) pPROM with or without intra-amniotic infection (n = 36). Amniotic fluid HBD-3 concentrations were determined using a sensitive and specific ELISA kit. Results: (1) HBD-3 is a physiological constituent of amniotic fluid; (2) the amniotic fluid concentration of HBD-3 did not change with gestational age (midtrimester versus term not in labor); (3) amniotic fluid concentrations of HBD-3 were higher in women with spontaneous labor at term than in those without labor; (4) in the absence of intra-amniotic inflammation, amniotic fluid concentrations of HBD-3 were similar between women with spontaneous preterm labor who delivered preterm and those who delivered at term; (5) among patients with spontaneous preterm labor who delivered preterm, amniotic fluid concentrations of HBD-3 were greater in women with intra-amniotic infection than in those without this clinical condition; (6) among patients with spontaneous preterm labor, amniotic fluid concentrations of HBD-3 were higher in women with intra-amniotic inflammation or intra-amniotic infection who delivered preterm than in those without these clinical conditions who delivered at term; and (7) women with pPROM and intra-amniotic infection had higher median amniotic fluid concentrations of HBD-3 than those without this clinical condition. Conclusion: Human beta-defensin-3 is a physiological constituent of amniotic fluid and increases during the process of labor at term. Amniotic fluid concentrations of HBD-3 were increased in women with spontaneous preterm labor with intact membranes or pPROM with intra-amniotic inflammation or intra-amniotic infection, indicating that this defensin participates in the host defense mechanisms in the amniotic cavity against microorganisms or danger signals. These findings provide insight into the soluble host defense mechanisms against intra-amniotic inflammation and intra-amniotic infection.

引用

页码：4117 / 4132

页数：16

共 202 条

[41] Inhibition of the NLRP3 inflammasome can prevent sterile intra-amniotic inflammation, preterm labor/birth, and adverse neonatal outcomes [J].