趋化因子配体1（CCL20）：该趋化因子参与足月自然分娩、早产及宫内感染的证据
Exodus-1 (CCL20): evidence for the participation of this chemokine in spontaneous labor at term, preterm labor, and intrauterine infection.
作者信息
Hamill Neil, Romero Roberto, Gotsch Francesca, Kusanovic Juan Pedro, Edwin Sam, Erez Offer, Than Nandor Gabor, Mittal Pooja, Espinoza Jimmy, Friel Lara A, Vaisbuch Edi, Mazaki-Tovi Shali, Hassan Sonia S
机构信息
Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, USA.
出版信息
J Perinat Med. 2008;36(3):217-27. doi: 10.1515/JPM.2008.034.
AIM
CCL20, also known as MIP-3 alpha, is a chemokine that participates in chemotaxis of immature dendritic cells, effector/memory T-cells, and B-lymphocytes. The objectives of this study were to determine whether CCL20 can be detected in amniotic fluid (AF) and if AF concentration of this chemokine changes with advancing gestational age, parturition (term and preterm), and intra-amniotic infection/inflammation (IAI).
METHODS
A cross-sectional study was conducted including the following groups: (1) mid-trimester of pregnancy (n=65); (2) term not in labor (TNL; n=22); (3) term in labor (TIL; n=47); (4) spontaneous preterm labor (PTL) who delivered at term (n=57); (5) spontaneous PTL without IAI who delivered preterm (n=71); and (6) spontaneous PTL with IAI (n=38). AF CCL20 concentrations were determined using ELISA.
RESULTS
(1) The median AF CCL20 concentration in TNL was higher than that of mid-trimester patients; (2) Women in spontaneous labor at term had a higher median AF concentration of CCL20 than patients at term not in labor; (3) Patients with spontaneous PTL and IAI had a significantly higher median AF concentration of CCL20 than those without IAI who delivered preterm and those who delivered at term. Moreover, women with spontaneous PTL without IAI who delivered preterm had a significantly higher median AF concentration than those with PTL who subsequently delivered at term.
CONCLUSIONS
(1) CCL20 is a physiologic constituent of AF and its concentration increases as term approaches; (2) spontaneous labor (term and preterm) in the absence of IAI is associated with increased bioavailability of AF CCL20 suggesting that an increase in CCL20 is part of the common pathway of human parturition; (3) patients with IAI had dramatic elevations in the AF CCL20 concentrations suggesting that this chemokine participates in the host response to infection or other stimuli associated with intra-amniotic infection.
目的
CCL20，也被称为巨噬细胞炎症蛋白-3α，是一种趋化因子，参与未成熟树突状细胞、效应/记忆T细胞和B淋巴细胞的趋化作用。本研究的目的是确定羊水（AF）中是否能检测到CCL20，以及该趋化因子的羊水浓度是否会随着孕周增加、分娩（足月和早产）以及羊膜腔内感染/炎症（IAI）而发生变化。
方法
进行了一项横断面研究，包括以下几组：（1）妊娠中期（n = 65）；（2）足月未临产（TNL；n = 22）；（3）足月临产（TIL；n = 47）；（4）足月分娩的自发性早产（PTL）（n = 57）；（5）未发生IAI的自发性PTL且早产的患者（n = 71）；以及（6）发生IAI的自发性PTL患者（n = 38）。采用酶联免疫吸附测定法（ELISA）测定羊水CCL20浓度。
结果
（1）TNL组羊水CCL20浓度中位数高于妊娠中期患者；（2）足月自然临产妇女羊水CCL20浓度中位数高于足月未临产患者；（3）发生自发性PTL且伴有IAI的患者羊水CCL20浓度中位数显著高于未发生IAI的早产患者和足月分娩患者。此外，未发生IAI的自发性PTL且早产的妇女羊水CCL20浓度中位数显著高于随后足月分娩的PTL患者。
结论
（1）CCL20是羊水的一种生理成分，其浓度随着足月临近而增加；（2）在未发生IAI的情况下，自然分娩（足月和早产）与羊水CCL20生物利用度增加有关，这表明CCL20增加是人类分娩共同途径的一部分；（3）发生IAI的患者羊水CCL20浓度显著升高，这表明该趋化因子参与宿主对感染或与羊膜腔内感染相关的其他刺激的反应。
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