Intrauterine inflammation, infection, or both (Triple I): A new concept for chorioamnionitis

Peng, Chun-Chih; Chang, Jui‐Hsing; Lin, Hsiao-Chuan; Cheng, Po‐Jen; Su, Bai-Horng

doi:10.1016/j.pedneo.2017.09.001

Cited by 109 publications

(97 citation statements)

References 53 publications

(43 reference statements)

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“…Due to complications, over one million premature newborns will die shortly after birth (3,4). Chorioamnionitis, defined as inflammatory cell infiltration of fetal membranes, is frequently associated with preterm birth and typically occurs due to an ascending bacterial infection (5-7) that can be acute or chronic (8). Intrauterine exposure of preterm infants to chorioamnionitis is associated with an increased risk of adverse neonatal outcomes (9, 10), including necrotizing enterocolitis (NEC) (9, 11, 12).…”

Section: Introductionmentioning

confidence: 99%

Chronic Intra-Uterine Ureaplasma parvum Infection Induces Injury of the Enteric Nervous System in Ovine Fetuses

et al. 2020

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Background: Chorioamnionitis, inflammation of the fetal membranes during pregnancy, is often caused by intra-amniotic (IA) infection with single or multiple microbes. Chorioamnionitis can be either acute or chronic and is associated with adverse postnatal outcomes of the intestine, including necrotizing enterocolitis (NEC). Neonates with NEC have structural and functional damage to the intestinal mucosa and the enteric nervous system (ENS), with loss of enteric neurons and glial cells. Yet, the impact of acute, chronic, or repetitive antenatal inflammatory stimuli on the development of the intestinal mucosa and ENS has not been studied. The aim of this study was therefore to investigate the effect of acute, chronic, and repetitive microbial exposure on the intestinal mucosa, submucosa and ENS in premature lambs. Materials and Methods: A sheep model of pregnancy was used in which the ileal mucosa, submucosa, and ENS were assessed following IA exposure to lipopolysaccharide (LPS) for 2 or 7 days (acute), Ureaplasma parvum (UP) for 42 days (chronic), or repetitive microbial exposure (42 days UP with 2 or 7 days LPS). Results: IA LPS exposure for 7 days or IA UP exposure for 42 days caused intestinal injury and inflammation in the mucosal and submucosal layers of the gut. Repetitive microbial exposure did not further aggravate injury of the terminal ileum. Chronic IA UP exposure caused significant structural ENS alterations characterized by loss of PGP9.5 Heymans et al. Chorioamnionitis Induces ENS Alterations and S100β immunoreactivity, whereas these changes were not found after re-exposure of chronic UP-exposed fetuses to LPS for 2 or 7 days. Conclusion: The in utero loss of PGP9.5 and S100β immunoreactivity following chronic UP exposure corresponds with intestinal changes in neonates with NEC and may therefore form a novel mechanistic explanation for the association of chorioamnionitis and NEC.

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Section: Introductionmentioning

confidence: 99%

Chronic Intra-Uterine Ureaplasma parvum Infection Induces Injury of the Enteric Nervous System in Ovine Fetuses

et al. 2020

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“…Recently described as "intrauterine inflammation or infection or both (Triple I)," chorioamnionitis is a common cause of preterm birth and adverse neonatal and perinatal outcomes in humans (37,38). In humans, Ureaplasma is commonly isolated bacteria from amniotic fluid in the setting of preterm birth with or without clinical chorioamnionitis (39)(40)(41), yet a significant percentage of cases with intraamniotic detection of Ureaplasma show no histological inflammation (42).…”

Section: Discussionmentioning

confidence: 99%

Fetal and amniotic fluid iron homeostasis in healthy and complicated murine, macaque, and human pregnancy

Fisher¹,

Sangkhae²,

Presicce³

et al. 2020

JCI Insight

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“…Adverse outcomes associated with pregnancy and the early postpartum period in mothers and neonates have previously been diagnosed and treated based on traditional microbiological culture. However, there exists a vast body of literature highlighting failure of such techniques to identify specific aetiological agents, or for treatment to result in resolution of the condition or to prevent adverse outcomes . This suggests that the presence of the microorganisms alone is not causative, rather interactions between the host, the microbe, microbial components, and the environment represent a complex interplay with multiple potential outcomes.…”

Section: Methodological Considerations In the Reproductive Tract Micrmentioning

confidence: 99%

Re‐assessing microbiomes in the low‐biomass reproductive niche

Turner

Nitert

et al. 2019

BJOG

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The female reproductive tract represents a continuum between the vagina and the upper genital tract. New evidence from cultivation‐independent studies suggests that the female upper genital tract is not sterile; however, the significance of this for reproductive health and disease remains to be elucidated fully. Further, diagnosis and treatment of infectious reproductive tract pathologies using cultivation‐independent technologies represents a largely unchartered area of modern medical science. The challenge now is to design well‐controlled experiments to account for the ease of contamination known to confound molecular‐based studies of low‐biomass niches, including the uterus and placenta. This will support robust assessment of the potential function of microorganisms, microbial metabolites, and cell‐free bacterial DNA on reproductive function in health and disease. Tweetable abstract Molecular microbial studies of low‐biomass niches require stringent experimental controls to reveal causal relations in reproductive health and disease.

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Intrauterine inflammation, infection, or both (Triple I): A new concept for chorioamnionitis

Cited by 109 publications

References 53 publications

Chronic Intra-Uterine Ureaplasma parvum Infection Induces Injury of the Enteric Nervous System in Ovine Fetuses

Chronic Intra-Uterine Ureaplasma parvum Infection Induces Injury of the Enteric Nervous System in Ovine Fetuses

Fetal and amniotic fluid iron homeostasis in healthy and complicated murine, macaque, and human pregnancy

Re‐assessing microbiomes in the low‐biomass reproductive niche

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