Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Cytokine. 2023 Sep;169:156308. doi: 10.1016/j.cyto.2023.156308. Epub 2023 Aug 1.
We investigated the association between altered levels of inflammatory proteins in the cervicovaginal fluid (CVF) and acute histologic chorioamnionitis (HCA) and funisitis in women with preterm labor (PTL).
In this study, a total of 134 consecutive singleton pregnant women with PTL (at 23+0-34+0 weeks) who delivered preterm (at < 37 weeks) and from whom CVF samples were collected at admission were retrospectively enrolled. The CVF levels of haptoglobin, interleukin-6/8, kallistatin, lipocalin-2, matrix metalloproteinase (MMP)-8, resistin, S100 calcium-binding protein A8, and serpin A1 were determined using enzyme-linked immunosorbent assay. The placentas were histologically analyzed after delivery.
Multiple logistic regression analyses showed significant associations between elevated CVF interleukin-8 and resistin levels and acute HCA after adjusting for baseline covariates (e.g., gestational age at sampling). CVF haptoglobin, interleukin-6/8, kallistatin, MMP-8, and resistin levels were significantly higher in women with funisitis than in those without, whereas the baseline covariates were similar between the two groups (P > 0.1). The area under the receiver operating characteristic curves of the aforementioned biomarkers ranged from 0.61 to 0.77 regarding each outcome. Notably, HCA risk significantly increased with increasing CVF levels of interleukin-8 and resistin (P for trend < 0.05).
Haptoglobin, interleukin-6/8, kallistatin, MMP-8, and resistin were identified as potential inflammatory CVF biomarkers predictive of acute HCA and funisitis in women with PTL. Moreover, the risk severity of acute HCA may be associated with the degree of the inflammatory response in the CVF (particularly based on interleukin-8 levels).
我们研究了宫颈阴道液（CVF）中炎症蛋白水平改变与早产孕妇（PTL）急性组织学绒毛膜羊膜炎（HCA）和脐带炎的关系。
本研究回顾性纳入了 134 例连续的 PTL 单胎孕妇（23+0-34+0 周），这些孕妇在早产（<37 周）时入院并采集了 CVF 样本。采用酶联免疫吸附试验检测 haptoglobin、白细胞介素-6/8、kallistatin、lipocalin-2、基质金属蛋白酶（MMP）-8、抵抗素、S100 钙结合蛋白 A8 和丝氨酸蛋白酶抑制剂 A1 的 CVF 水平。分娩后对胎盘进行组织学分析。
多因素逻辑回归分析显示，在校正基线协变量（如采样时的孕周）后，CVF 白细胞介素-8 和抵抗素水平升高与急性 HCA 显著相关。与无脐带炎的孕妇相比，患有脐带炎的孕妇 CVF haptoglobin、白细胞介素-6/8、kallistatin、MMP-8 和抵抗素水平显著升高，而两组的基线协变量相似（P>0.1）。上述生物标志物对每种结局的受试者工作特征曲线下面积范围为 0.61-0.77。值得注意的是，随着 CVF 白细胞介素-8 和抵抗素水平的升高，HCA 风险显著增加（趋势 P 值<0.05）。
haptoglobin、白细胞介素-6/8、kallistatin、MMP-8 和抵抗素被确定为预测 PTL 孕妇急性 HCA 和脐带炎的潜在 CVF 炎症生物标志物。此外，急性 HCA 的严重程度可能与 CVF 中的炎症反应程度（特别是基于白细胞介素-8 水平）相关。
