Portal de Periódicos da CAPES

Artigo Acesso aberto Produção Nacional Revisado por pares

BIBTEX RIS

455: Inflammatory response to polymicrobial infection in human fetal membranes

2013; Elsevier BV; Volume: 210; Issue: 1 Linguagem: Inglês

10.1016/j.ajog.2013.10.488

1097-6868

Nathalia Noda Nicolau, Jossimara Polettini, Marcia Silva, Tariq A. Syed, Talar Kechichian, Morgan R. Peltier, George R. Saade, Ramkumar Menon,

Reproductive System and Pregnancy

Prevalence of genital mycoplasmas, Mycoplasma hominis (MH) and Ureaplasma urealyticum (UU), and vaginal pathogen, Gardnerella vaginalis (GV), in the amniotic cavity have been associated with spontaneous preterm birth (PTB). The inflammatory response, mechanistic inducer of labor, to a single microbial infection is well studied, but the pattern in polymicrobial infections is unclear. Objective of the study was to investigate dose dependent changes in inflammatory signature to polymicrobial exposure including MH, UU and GV in human fetal membrane. Fetal membranes from normal term Cesareans (n=8), not in labor, were maintained in an organ explant system and stimulated with individual or multiple combinations of heat inactivated MH, UU and GV at the concentration of 106 colony-forming units (CFU)/mL. We also stimulated membranes with genital mycoplasmas at 103 CFU/mL with GV at 106 CFU/mL and genital mycoplasmas at 106 CFU/mL with GV at 103 CFU/mL. Cytokines (IL-1β, IL-10, IL-13, GM-CSF, TNF-α) and their soluble receptors (sIL-1RI, sIL-1RII, sTNFRI and sTNFRII) were measured in culture media using Multiplex assay. 1) Individual stimulation by UU significantly increased IL-13 concentration, GV increased IL-10, TNF-α, GM-CSF while MH had no effect; 2) Combination of genital mycoplasmas (UU+MH) did not elicit any inflammatory response; 3) UU+MH+GV increased IL-1β, IL-10, IL-13, TNF-α, GM-CSF; 4) GV at 106 CFU/mL and mycoplasmas at 103 CFU/mL increased IL-1β, IL-10, TNF-α, GM-CSF and sTNFRII (Table 1). This is the first in vitro study to document effect of polymicrobial infections on fetal membrane inflammatory response. We conclude that GV induce inflammation and presence of mycoplasma enhances the GV effect. Moreover, mycoplasmas either alone or in combination do not elicit a pro-inflammatory response, but, their responses regulate inflammation by creating a healthy probiotic environment.