Increased sTREM-1 in pregnant women with premature rupture of membranes and subclinical chorioamnionitis

Abstract

Abstract. Premature rupture of membranes (PROM) is a common obstetric complication frequently occurring with concomitant chorioamnionitis. The present study aimed to evaluate levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in serum and amniotic fluid in pregnant women with PROM and to compare sTREM-1 with the commonly used laboratory indicators, serum C-reactive protein (CRP) and white blood cell (WBC) count. A total of 55 pregnant women with PROM were enrolled. Their venous blood and amniotic fluid were collected at delivery. sTREM-1 concentrations in the serum and amniotic fluid were determined by enzyme-linked immunosorbent assay. The measured data were compared with the pathological results of the placenta and fetal membrane. Meanwhile, sTREM-1 was compared with the laboratory indicators, serum CRP and WBC count. Serum and amniotic fluid sTREM-1 levels were significantly higher in pregnant women with subclinical chorioamnionitis compared to pregnant women without chorioamnionitis. Serum concentration of sTREM-1 yielded a sensitivity of 81.8% and a specificity of 77.3% for the prediction of subclinical chorioamnionitis. The amniotic fluid concentration of sTREM-1 resulted in a sensitivity of 81.8% and a specificity of 86.4% for the prediction of subclinical chorioamnionitis. In conclusion, serum and amniotic fluid sTREM-1 levels may emerge as early biological indicators for predicting PROM complicated with subclinical chorioamnionitis. sTREM-1 levels are superior to WBC count in predicting subclinical chorioamnionitis. IntroductionPremature rupture of membranes (PROM) refers to the rupture of membranes occurring prior to the onset of labor. As a common obstetric complication, it occurs in 2.7-17% of total deliveries and its incidence continues to rise (1). The mechanisms of PROM are not fully clear, and major causes responsible for PROM include infection, structural abnormalities of the fetal membrane, amniotic villus degeneration and micronutrient deficiencies. Although the etiology of PROM is multifactorial, epidemiological, clinical and molecular biology data have confirmed that ascending infection-caused genital tract inflammation plays a major role in the occurrence of PROM (2). Approximately 60% of PROM cases have concomitant chorioamnio nitis, and infection is proportionately more common when fewer gestational weeks have elapsed at the time of PROM occurrence (3). Prolonged duration of PROM boosts the risk of infection (4,5). Romero et al reported that the positive rate of bacterial culture using samples from transabdominal amniocentesis of PROM patients was 38% (6). It is now widely accepted that PROM and premature labor are a group of clinical syndromes closely associated with infection of the amniotic cavity.PROM complicated with chorioamnionitis is a common cause of perinatal infant mortality. It may lead to intrauterine infection, preterm labor of fetuses and low survival rate. In addition, it may result in maternal puerperal infection and even sepsis. It is difficult ...

Mechanisms Involved in the Association between Periodontitis and Complications in Pregnancy

“…Interestingly, the expression of TLR4 in placenta is higher in women with premature delivery and chorioamnionitis than in controls ( 101 ). LPS induces the production of pro-inflammatory mediators such as prostaglandins, which are modulators of uterine contractions.…”

TREM-1; Is It a Pivotal Target for Cardiovascular Diseases?

“…Indeed, TREM-1 knockout mice have shown reduced inflammatory reactions when they were exposed to LPS or other inflammatory agents such PG, in acute as well in chronic disease settings. Trem-1 −/− mice were found to be resistant to severe forms of pneumonia, peritonitis, or septic shock [ 19 , 72 , 85 ]. The resistance that they developed is associated with the down-regulation of pro-inflammatory cytokines and chemokines, and in some cases, with an increased expression of anti-inflammatory proteins.…”

TREM-1; is It a Pivotal Target for Cardiovascular Diseases?

“…Indeed TREM-1 knockout mice have shown reduced inflammatory reaction when they were exposed to LPS or other inflammatory agent such PG, in acute as well in chronic diseases settings. Trem-1 -/-mice were found to be resistant to severe form pneumonia, peritonitis, or septic shock 19,88,89 . The resistance that they developed is associated with down regulation of pro inflammatory cytokines and chemokines and in some cases with an increased expression of anti-inflammatory proteins.…”