Neutrophil extracellular traps in acute chorioamnionitis: A mechanism of host defense

Gomez‐Lopez, Nardhy; Romero, Roberto; Leng, Yaozhu; Garcia‐Flores, Valeria; Xu, Yi; Miller, Derek; Hassan, Sonia S.

doi:10.1111/aji.12617

Cited by 43 publications

(34 citation statements)

References 103 publications

(167 reference statements)

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“…99,129 This suggests that, besides the chorioamniotic membranes, maternal and fetal leukocytes are a source of extracellular ASC in the amniotic cavity. Further research is needed to investigate whether the different microorganisms invading the amniotic cavity can differentially activate the inflammasome in the chorioamniotic membranes and amniotic fluid immune cells.…”

Section: Discussionmentioning

confidence: 99%

“…Women with IAI have numerous amniotic fluid immune cells, 96,[125][126][127][128] which could be of fetal and/or maternal origin, 92 and commonly present severe acute inflammatory lesions in the placenta. 99,129 This suggests that, besides the chorioamniotic membranes, maternal and fetal leukocytes are a source of extracellular ASC in the amniotic cavity. Further research is needed to investigate whether the different microorganisms invading the amniotic cavity can differentially activate the inflammasome in the chorioamniotic membranes and amniotic fluid immune cells.…”

Section: Inflammasome Activation In Spontaneous Preterm Labor With mentioning

confidence: 99%

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Inflammasome activation during spontaneous preterm labor with intra‐amniotic infection or sterile intra‐amniotic inflammation

Gomez‐Lopez

Romero

Panaitescu

et al. 2018

American J Rep Immunol

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Section: Discussionmentioning

confidence: 99%

Section: Inflammasome Activation In Spontaneous Preterm Labor With mentioning

confidence: 99%

Inflammasome activation during spontaneous preterm labor with intra‐amniotic infection or sterile intra‐amniotic inflammation

Gomez‐Lopez

Romero

Panaitescu

et al. 2018

American J Rep Immunol

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“…Previous studies indicated that infiltrating neutrophils in the chorioamniotic membranes of women with acute histologic chorioamnionitis, a manifestation of intra-amniotic infection/inflammation 36, 87, 121-124 , are of maternal origin, observed while using fluorescent in situ hybridization 52, 125 . Such infiltrating maternal neutrophils can participate in the mechanisms of host defense against intra-amniotic infection by forming neutrophil extracellular traps 126 . Taken together, these findings suggest that neutrophils migrate from the maternal vasculature into the amniotic fluid of women with intra-amniotic infection/inflammation to participate in the host defense mechanisms against pathogens invading the amniotic cavity.…”

Section: Discussionmentioning

confidence: 99%

Are amniotic fluid neutrophils in women with intraamniotic infection and/or inflammation of fetal or maternal origin?

Gomez‐Lopez

Romero

et al. 2017

American Journal of Obstetrics and Gynecology

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101

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Background Neutrophils are the most abundant white blood cells found in the amniotic cavity of women with intra-amniotic infection and/or inflammation. The current belief is that these neutrophils are of fetal origin. However, abundant neutrophils have been found in the amniotic fluid of women with a severe acute maternal inflammatory response but without a fetal inflammatory response in the placenta, suggesting that these innate immune cells can also be of maternal origin or a mixture of both fetal and maternal neutrophils. Objectives To investigate the origin of amniotic fluid neutrophils from women with intra-amniotic infection and/or inflammation, and to correlate these findings with acute histologic maternal and fetal inflammatory responses in the placenta. Study Design Amniotic fluid was collected from 15 women with suspected intra-amniotic infection and/or inflammation (positive microbiological cultures and/or interleukin (IL)-6 concentrations≥2.6 ng/mL). Amniotic fluid neutrophils were purified by fluorescence-activated cell sorting, DNA was extracted, and DNA fingerprinting was performed. DNA fingerprinting was also performed in the umbilical cord and maternal blood DNA. Fluorescence in situ hybridization (FISH) was assayed in women with male neonates. Blinded placental histopathological evaluations were conducted. Results 1) DNA fingerprinting revealed that 43% (6/14) of the women who underwent a single amniocentesis had mostly fetal neutrophils in the amniotic fluid; 2) DNA fingerprinting showed that 36% (5/14) of the women who underwent a single amniocentesis had predominantly maternal neutrophils in the amniotic fluid; 3) DNA fingerprinting indicated that 21% (3/14) of the women who underwent a single amniocentesis had an evident mixture of fetal and maternal neutrophils in the amniotic fluid; 4) DNA fingerprinting revealed that a woman who underwent two amniocenteses (patient #15) had fetal neutrophils first, and as infection progressed, abundant maternal neutrophils invaded the amniotic cavity ; 5) FISH confirmed DNA fingerprinting results by showing that both fetal and maternal neutrophils are present in the amniotic fluid; 6) Most of the women who had predominantly amniotic fluid neutrophils of fetal origin at the time of collection delivered extremely preterm neonates [71% (5/7)]; 7) All of the women who had predominantly amniotic fluid neutrophils of maternal origin at the time of collection delivered term or late preterm neonates [100% (6/6)]; 8) Two of the women who had an evident mixture of fetal and maternal neutrophils in the amniotic fluid at the time of collection delivered extremely preterm neonates [67% (2/3)], and the third woman delivered a term neonate [33% (1/3)]; and 9) Most of the women included in this study presented acute maternal and fetal inflammatory responses in the placenta [87 % (13/15)]. Conclusion Amniotic fluid neutrophils can be either predominantly of fetal or maternal origin, or a mixture of both fetal and maternal origin, in women with intra-amniotic inf...

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“…Although blood neutrophils have a short life-span, neutrophils in the decidua have greatly increased survival, mediated in part by up-regulating anti-apoptotic mediators including Bcl-2 family members (e.g., Bcl2A1, called Bfl-1 in humans) (84,152). Neutrophils can amplify the inflammatory response and neutralize microorganisms by releasing neutrophil extracellular traps (NETs), producing antimicrobial enzymes such as defensins, neutrophil elastase, and myeloperoxidase (MPO), and releasing reactive oxygen species (ROS) (153)(154)(155). Neutrophilderived pro-inflammatory mediators can trigger preterm labor and matrix metalloproteinases (MMPs) can weaken the collagen scaffolding, resulting in preterm rupture of membranes (156)(157)(158).…”

Section: Neutrophilsmentioning

confidence: 99%

Immunobiology of Acute Chorioamnionitis

2020

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Acute chorioamnionitis is characterized by neutrophilic infiltration and inflammation at the maternal fetal interface. It is a relatively common complication of pregnancy and can have devastating consequences including preterm labor, maternal infections, fetal infection/inflammation, fetal lung, brain, and gastrointestinal tract injury. In this review, we will discuss current understanding of the pathogenesis, immunobiology, and mechanisms of this condition. Most commonly, acute chorioamnionitis is a result of ascending infection with relatively low-virulence organisms such as the Ureaplasma species. Furthermore, recent vaginal microbiome studies suggest that there is a link between vaginal dysbiosis, vaginal inflammation, and ascending infection. Although less common, microorganisms invading the maternal-fetal interface via hematogenous route (e.g., Zika virus, Cytomegalovirus, and Listeria) can cause placental villitis and severe fetal inflammation and injury. We will provide an overview of the knowledge gleaned from different animal models of acute chorioamnionitis and the role of different immune cells in different maternal-fetal compartments. Lastly, we will discuss how infectious agents can break the maternal tolerance of fetal allograft during pregnancy and highlight the novel future therapeutic approaches.

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Neutrophil extracellular traps in acute chorioamnionitis: A mechanism of host defense

Cited by 43 publications

References 103 publications

Inflammasome activation during spontaneous preterm labor with intra‐amniotic infection or sterile intra‐amniotic inflammation

Inflammasome activation during spontaneous preterm labor with intra‐amniotic infection or sterile intra‐amniotic inflammation

Are amniotic fluid neutrophils in women with intraamniotic infection and/or inflammation of fetal or maternal origin?

Immunobiology of Acute Chorioamnionitis

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