Taguchi Ayumi, Yamashita Aki, Kawana Kei, Nagamatsu Takeshi, Furuya Hitomi, Inoue Eri, Osuga Yutaka, Fujii Tomoyuki
1 Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
These authors contributed equally to this work.
Reprod Sci. 2017 Jan;24(1):7-18. doi: 10.1177/1933719115618282. Epub 2016 Sep 27.
Preterm birth is one of the most common obstetrical complications, with an incidence of about 5% to 18% of all pregnancies worldwide. Acute chorioamniotic infection is likely antecedent to preterm birth through the local production of inflammatory mediators, followed by uterine contraction and cervical ripening. Microbial chorioamnionitis and local inflammation synergistically form a vicious circle toward preterm birth. Principal therapeutic interventions focus on anti-infection and anti-inflammation strategies to block this vicious circle. Anti-inflammatory therapeutics include agents that directly inhibit inflammatory cytokine production/reaction and that resolve supraphysiological inflammation toward a normal condition. In particular, naturally produced compounds, including polyphenols, omega-3 polyunsaturated fatty acid metabolites, and statins, are attractive agents in terms of safety for pregnant women and their infants. This review summarizes the mechanisms of perinatal inflammation induced by acute chorioamnionitis and therapeutic resolution of inflammation of the uterus to avoid the harmful exposure of preterm infants to inflammation in utero.
早产是最常见的产科并发症之一，在全球所有妊娠中发生率约为5%至18%。急性绒毛膜羊膜炎可能通过局部产生炎症介质先于早产发生，随后导致子宫收缩和宫颈成熟。微生物性绒毛膜羊膜炎和局部炎症协同作用，形成导致早产的恶性循环。主要的治疗干预措施集中在抗感染和抗炎策略上，以阻断这一恶性循环。抗炎治疗药物包括直接抑制炎症细胞因子产生/反应以及使超生理炎症恢复到正常状态的药物。特别是天然产生的化合物，包括多酚、ω-3多不饱和脂肪酸代谢产物和他汀类药物，就对孕妇及其婴儿的安全性而言是有吸引力的药物。本综述总结了急性绒毛膜羊膜炎引起的围产期炎症的机制以及子宫炎症的治疗消退，以避免早产婴儿在子宫内受到炎症的有害影响。
