Institute of New Frontier Research Team, College of Medicine, Hallym University, Chuncheon, South Korea.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, South Korea.
Am J Reprod Immunol. 2022 Aug;88(2):e13577. doi: 10.1111/aji.13577. Epub 2022 May 23.
Cervical insufficiency (CI) is associated with intra-amniotic infection or inflammation. Antimicrobial peptides (AMPs) in amniotic fluid may protect the fetus against microbial invasion, giving their broad-spectrum microbiocidal properties. We evaluated changes in amniotic fluid AMP expression in women with CI and assessed whether these changes are related to their pregnancy outcomes.
We evaluated amniotic fluid human neutrophil peptide 3 (HNP-3), human β-defensin-2 (hBD-2), and LL-37 levels in 66 women with CI and 25 normal controls at 16-24 weeks of gestation. The CI group was divided into short cervix and cervical dilation groups, and the cervical dilation group was further divided into preterm and full-term delivery groups according to the pregnancy outcomes, and AMP expression was analyzed in each group.
HNP-3 and hBD-2 levels were higher in women with CI than in normal controls and in the cervical dilation as compared to the short cervix group. Among women with cervical dilation, 22 delivered at full-term, and 23 had spontaneous preterm births. The hBD-2 level in amniotic fluid mid-pregnancy was higher in the full-term delivery than in the preterm delivery groups. However, LL-37 levels in amniotic fluid were low in women with CI and normal controls.
Amniotic fluid HNP-3 and hBD-2 levels increased in women with CI compared with normal controls. Moreover, increased amniotic fluid hBD-2 levels mid-pregnancy were associated with favorable pregnancy outcomes in women with CI. AMPs in the amniotic fluid may participate in host defense against ascending infection in women with CI.
宫颈机能不全（CI）与羊膜内感染或炎症有关。羊水中的抗菌肽（AMPs）可能通过广谱杀菌特性保护胎儿免受微生物入侵。我们评估了 CI 孕妇羊水中 AMP 表达的变化，并评估这些变化是否与妊娠结局有关。
我们评估了 16-24 周 66 名 CI 孕妇和 25 名正常对照者的羊水中人中性粒细胞肽 3（HNP-3）、人β-防御素-2（hBD-2）和 LL-37 水平。CI 组分为短宫颈组和宫颈扩张组，宫颈扩张组根据妊娠结局进一步分为早产组和足月产组，分析每组 AMP 表达。
CI 孕妇的 HNP-3 和 hBD-2 水平高于正常对照组，宫颈扩张组高于短宫颈组。宫颈扩张的 22 例足月分娩，23 例自发性早产。足月产组妊娠中期羊水中 hBD-2 水平高于早产组。然而，CI 孕妇和正常对照组的羊水中 LL-37 水平较低。
与正常对照组相比，CI 孕妇羊水中 HNP-3 和 hBD-2 水平升高。此外，妊娠中期羊水中 hBD-2 水平升高与 CI 孕妇的良好妊娠结局相关。羊水中的 AMPs 可能参与 CI 孕妇上行感染的宿主防御。
