Term histologic chorioamnionitis: a heterogeneous condition

Conti, Nathalie; Torricelli, Michela; Voltolini, Chiara; Vannuccini, Silvia; Clifton, Vicki L.; Bloise, Enrrico; Petraglia, Felice

doi:10.1016/j.ejogrb.2015.02.034

Cited by 65 publications

(59 citation statements)

References 35 publications

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“…In the present study, there is likely considerable etiological heterogeneity given the multiple possible causes of the inflammatory process, i.e., the type of pathogen involved, if it is a monomicrobial or polymicrobial infection or indeed, non-infective (i.e. sterile chorioamnionitis) [24, 45-47]. Future studies should examine how different infective agents impact the expression of ABC transporters.…”

Section: Discussionmentioning

confidence: 99%

“…Placental samples were selected from pregnancies ending in PTD with histologic chorioamnionitis (PTDC; in total n=6) or PTD without histologic chorioamnionitis (PTD; in total n=6). Diagnosis of histologic chorioamnionitis (graded 0-3) was performed by Mount Sinai Hospital staff pathologists based on the presence of polymorphonuclear leukocyte infiltration within the chorionic plate and/or chorioamniotic membranes as previously described [23, 24]. …”

Section: Methodsmentioning

confidence: 99%

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Chorioamnionitis Induces a Specific Signature of Placental ABC Transporters Associated with an Increase of miR-331-5p in the Human Preterm Placenta

Império

Bloise

Javam³

et al. 2018

Cell Physiol Biochem

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Background/Aims: The ATP-binding cassette (ABC) transporters mediate drug biodisposition and immunological responses in the placental barrier. In vitro infective challenges alter expression of specific placental ABC transporters. We hypothesized that chorioamnionitis induces a distinct pattern of ABC transporter expression. Methods: Gene expression of 50 ABC transporters was assessed using TaqMan® Human ABC Transporter Array, in preterm human placentas without (PTD; n=6) or with histological chorioamnionitis (PTDC; n=6). Validation was performed using qPCR, immunohistochemistry and Western blot. MicroRNAs known to regulate P-glycoprotein (P-gp) were examined by qPCR. Results: Up-regulation of ABCB9, ABCC2 and ABCF2 mRNA was detected in chorioamnionitis (p<0.05), whereas placental ABCB1 (P-gp; p=0.051) and ABCG2 (breast cancer resistance protein-BCRP) mRNA levels (p=0.055) approached near significant up-regulation. In most cases, the magnitude of the effect significantly correlated to the severity of inflammation. Upon validation, increased placental ABCB1 and ABCG2 mRNA levels (p<0.05) were observed. At the level of immunohistochemistry, while BCRP was increased (p<0.05), P-gp staining intensity was significantly decreased (p<0.05) in PTDC. miR-331-5p, involved in P-gp suppression, was upregulated in PTDC (p<0.01) and correlated to the grade of chorioamnionitis (p<0.01). Conclusions: Alterations in the expression of ABC transporters will likely lead to modified transport of clinically relevant compounds at the inflamed placenta. A better understanding of the potential role of these transporters in the events surrounding PTD may also enable new strategies to be developed for prevention and treatment of PTD.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Chorioamnionitis Induces a Specific Signature of Placental ABC Transporters Associated with an Increase of miR-331-5p in the Human Preterm Placenta

Império

Bloise

Javam³

et al. 2018

Cell Physiol Biochem

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“…CHORIO is diagnosed with clinical or histological criteria (222,227,252,264). Maternal fever (temperature greater than 100.4°F), maternal tachycardia (>100 beats per minute), fetal tachycardia (>160 beats per minute), uterine fundal tenderness, and purulence or foul odor of amniotic fluid are all symptoms of clinical CHORIO (252, 264).…”

Section: Clinical Presentation Of Choriomentioning

confidence: 99%

“…Specifically, CHORIO affects 40-80% of very preterm deliveries, and 20-34% of deliveries at term (222,244,245). In term infants with HI encephalopathy, the presence of CHORIO predicts limited responsiveness to hypothermia treatment (244,246).…”

Section: Chorioamnionitismentioning

confidence: 99%

The Unifying Effects of Maternal-Placental-Fetal Axis Dysregulation on Neurodevelopment Following Infectious and Toxic In Utero Insults

Yellowhair¹,

Oppong²,

Maxwell³

et al. 2017

MRAJ

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Homeostasis during pregnancy and in the in utero environment is essential for prenatal development. Prenatal maturation is hallmarked by an orchestrated and rigorous developmental program characterized by critical cascades in multiple organ systems. During these critical periods of development, however, potential vulnerability to injury exists throughout pregnancy. Indeed, the developing central nervous system (CNS) is extremely vulnerable to environmental insults throughout the entirety of gestation. These insults can adversely affect the developing brain and spinal cord, and permanently alter the neurodevelopmental trajectory. Specifically, in utero insults and dysregulation of the maternal-placentalfetal axis can change molecular, cellular, structural, and functional development of the CNS, culminating in adverse outcomes and neurological disorders throughout postnatal life. In this review, we will discuss common infectious and toxin-induced in utero insults that have recently garnered attention, including Zika virus, prenatal opioid and alcohol exposure, and chorioamnionitis. The goals are to identify common pathophysiological mechanisms, to emphasize the urgent need for new diagnostic tools, and to promote a broader understanding of the diverse array of neurological outcomes presenting in these children throughout their lifespan. With an increasing number of infants exposed to in utero infections and toxins, and the expanding public health awareness of the consequences of Zika infection, the opioid crisis, alcohol consumption during pregnancy, and the frequency of preterm birth in the United States, familiarity with the underlying mechanisms of each of these insults is paramount to improve the diagnosis and treatment for this exceedingly vulnerable patient population.

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“…При этом если ранее основной фокус внимания исследователей и клиницистов был направлен на инфекционную патологию ниж-него отдела гениталий, то на современном этапе появляется все больше сообщений о хронической внутриматочной инфекции (ВМИ) и ее роли в осложненном течении беременности [25][26][27][28][29][30]32]. Реализация ВМИ у беременных женщин может быть следстви-ем восходящего инфицирования при наличии инфекции нижнего отдела репродуктивного тракта, а также персистенции микроорганиз-мов в эндометрии у женщин с хроническим эндометритом в анамнезе [1,9,11,22].…”

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