Document Detail


Microbial invasion of the amniotic cavity in preeclampsia as assessed by cultivation and sequence-based methods.
MedLine Citation:
PMID:  20482470     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Infection has been implicated in the pathogenesis of preeclampsia, yet the association between microbial invasion of the amniotic cavity (MIAC) and preeclampsia has not been determined. The aim of this study was to determine the prevalence, and microbial diversity associated with MIAC, as well as the nature of the host response to MIAC in patients with preeclampsia.
METHOD OF STUDY: Amniotic fluid (AF) from 62 subjects with preeclampsia, not in labor, was analyzed with both cultivation and molecular methods. Broad-range and group-specific PCR assays targeting small subunit ribosomal DNA, or other gene sequences, from bacteria, fungi and archaea were used. Results were correlated with measurements of host inflammatory response, including AF white blood cell count and AF concentrations of glucose, interleukin-6 (IL-6) and MMP-8.
RESULTS: 1) The rate of MIAC in preeclampsia was 1.6% (1/62) based on cultivation techniques, 8% (5/62) based on PCR, and 9.6% (6/62) based on the combined results of both methods; 2) among the six patients diagnosed with MIAC, three had a positive PCR for Sneathia/Leptotrichia spp.; and 3) patients with MIAC were more likely to have evidence of an inflammatory response in the amniotic cavity than those without MIAC, as determined by a higher median AF IL-6 [1.65 ng/mL interquartile range (IQR): 0.35-4.62 vs. 0.22 ng/mL IQR: 0.12-0.51; P=0.002).
CONCLUSION: The prevalence of MIAC in preeclampsia is low, suggesting that intra-amniotic infection plays only a limited role in preeclampsia. However, the unexpectedly high number of positive AF specimens for Sneathia/Leptotrichia warrants further investigation.
Authors:
Daniel B DiGiulio; Mariateresa Gervasi; Roberto Romero; Shali Mazaki-Tovi; Edi Vaisbuch; Juan Pedro Kusanovic; Kimberley S Seok; Ricardo Gómez; Pooja Mittal; Francesca Gotsch; Tinnakorn Chaiworapongsa; Enrique Oyarzún; Chong Jai Kim; David A Relman
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of perinatal medicine     Volume:  38     ISSN:  1619-3997     ISO Abbreviation:  J Perinat Med     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-03     Completed Date:  2011-01-04     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0361031     Medline TA:  J Perinat Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  503-13     Citation Subset:  IM    
Affiliation:
Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amnion / microbiology*
Amniotic Fluid / immunology,  metabolism,  microbiology
Base Sequence
Chorioamnionitis / immunology,  metabolism,  microbiology
Cohort Studies
DNA Primers / genetics
DNA, Archaeal / genetics,  isolation & purification
DNA, Bacterial / genetics,  isolation & purification
DNA, Fungal / genetics,  isolation & purification
Female
Humans
Infant, Newborn
Inflammation Mediators / metabolism
Interleukin-6 / metabolism
Matrix Metalloproteinase 8 / metabolism
Microbiological Techniques
Polymerase Chain Reaction
Pre-Eclampsia / immunology,  microbiology*
Pregnancy
Pregnancy Complications, Infectious / immunology,  metabolism,  microbiology*
Pregnancy Outcome
Retrospective Studies
Young Adult
Grant Support
ID/Acronym/Agency:
DP1 OD000964-03/OD/NIH HHS; DP1 OD000964-04/OD/NIH HHS; DP1OD000964/OD/NIH HHS
Chemical
Reg. No./Substance:
0/DNA Primers; 0/DNA, Archaeal; 0/DNA, Bacterial; 0/DNA, Fungal; 0/IL6 protein, human; 0/Inflammation Mediators; 0/Interleukin-6; EC 3.4.24.-/MMP8 protein, human; EC 3.4.24.34/Matrix Metalloproteinase 8
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