Department of Obstetrics and Gynecology, Faculty of Medicine in Hradec Kralove, Charles University, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
Department of Clinical Immunology and Allergy, Faculty of Medicine in Hradec Kralove, Charles University, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
J Matern Fetal Neonatal Med. 2021 Mar;34(5):736-746. doi: 10.1080/14767058.2019.1615049. Epub 2019 May 15.
The amniotic fluid nicotinamide phosphoribosyltransferase (NAMPT) levels have not been compared among women with preterm prelabor rupture of membranes (PPROM) comorbid with intra-amniotic infection, sterile intra-amniotic inflammation (IAI), colonization, or without IAI and microbial invasion of the amniotic cavity (MIAC). Therefore, the main aim was to quantify the amniotic fluid NAMPT in women with PPROM complicated by intra-amniotic infection, sterile IAI, or colonization. The second aim was to characterize the diagnostic indices of NAMPT to reveal IAI. The third aim was to determine whether the cervical fluid and maternal serum NAMPT quantitation might be of value in the identification of intra-amniotic inflammatory complications in PPROM. NAMPT levels in amniotic fluid, cervical fluid, and maternal serum were assessed in three independent cohorts of women with singleton pregnancies complicated by PPROM between 24 and 36 weeks of gestation consisting of 88, 121, and 88 women, respectively. Amniotic fluid samples were obtained by transabdominal amniocentesis, cervical fluid samples were obtained using a Dacron polyester swab and maternal blood was obtained by venipuncture of the cubital vein. The NAMPT levels were measured by an enzyme-linked immunosorbent assay. Testing for MIAC and IAI was performed on all women, who were then categorized into four subgroups: intra-amniotic infection (MIAC and IAI), sterile IAI (IAI alone), colonization (MIAC alone), and without MIAC and IAI. Women with intra-amniotic infection and women with sterile IAI had higher NAMPT levels than did women with colonization and women without MIAC and IAI (intra-amniotic infection: median 73.6 ng/mL, sterile IAI: median 55.5 ng/mL, colonization: median 12.1 ng/mL, without MIAC and IAI: 10.6 ng/mL; < .0001). An amniotic fluid NAMPT level of 37 ng/mL was the best value for the detection of intra-amniotic infection in women with PPROM. Cervical fluid ( = .51) and maternal serum ( = .50) NAMPT levels did not reflect intra-amniotic inflammatory complications in women with PPROM. Intra-amniotic infection and sterile IAI are associated with higher NAMPT levels in amniotic fluid but not in cervical fluid or maternal serum in women with PPROM. Amniotic fluid NAMPT might be a marker for invasive identification of IAI in PPROM.
尚未比较过并发羊膜腔内感染、无菌性羊膜腔炎症（IAI）、定植或无 IAI 和微生物羊膜腔侵袭（MIAC）的早产胎膜早破（PPROM）孕妇的羊水烟酰胺磷酸核糖基转移酶（NAMPT）水平。因此，主要目的是定量测定并发羊膜腔内感染、无菌性 IAI 或定植的 PPROM 孕妇的羊水 NAMPT。第二个目的是描述 NAMPT 的诊断指标以揭示 IAI。第三个目的是确定宫颈液和母血清 NAMPT 定量分析是否有助于识别 PPROM 中的羊膜腔内炎症性并发症。分别对 88、121 和 88 名妊娠 24-36 周并发 PPROM 的单胎妊娠妇女的三个独立队列进行羊水、宫颈液和母血清 NAMPT 水平评估。通过经腹羊膜穿刺术获取羊水样本，使用 Dacron 聚酯拭子获取宫颈液样本，并通过肘静脉穿刺获取母血。通过酶联免疫吸附试验测量 NAMPT 水平。对所有女性进行 MIAC 和 IAI 检测，然后将其分为四个亚组：羊膜腔内感染（MIAC 和 IAI）、无菌性 IAI（仅 IAI）、定植（仅 MIAC）和无 MIAC 和 IAI。与定植和无 MIAC 和 IAI 的女性相比，羊膜腔内感染和无菌性 IAI 的女性的 NAMPT 水平更高（羊膜腔内感染：中位数 73.6ng/mL，无菌性 IAI：中位数 55.5ng/mL，定植：中位数 12.1ng/mL，无 MIAC 和 IAI：10.6ng/mL；<.0001）。PPROM 女性中，羊水 NAMPT 水平为 37ng/mL 时，检测羊膜腔内感染的最佳值。宫颈液（ = .51）和母血清（ = .50）NAMPT 水平不能反映 PPROM 女性的羊膜腔内炎症性并发症。PPROM 女性中，羊膜腔内感染和无菌性 IAI 与羊水 NAMPT 水平升高相关，但与宫颈液或母血清 NAMPT 水平升高无关。羊水 NAMPT 可能是 PPROM 中侵袭性 IAI 鉴定的标志物。
