Amniotic fluid matrix metalloproteinase-8 indicates intra-amniotic infection

Angus, Stanley R.; Segel, Sally; Hsu, Chaur‐Dong; Locksmith, Gregory J.; Clark, Penny; Sammel, Mary D.; Macones, George A.; Strauss, Jerome F.; Parry, Samuel

doi:10.1067/mob.2001.118654

Cited by 66 publications

(37 citation statements)

References 15 publications

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“…A direct analysis of the AF is the most accurate way to detect IAI whether accompanied by infection or not (3,32). Clinically used tests for inflammation include WBC and neutrophil counts, while intra-amniotic infection is sought by glucose concentration, Gram staining, and microbial cultures.…”

Section: Discussionmentioning

confidence: 99%

“…The relevant protein peaks of the final proteomic descriptor were extracted using a logical stepwise algorithm, which we named massrestricted (MR) analysis. We found that four protein peaks (3,377,3,448,10,443,and 10,834 Da) were sufficient for the diagnosis of intra-amniotic inflammation (IAI; defined as an AF white blood cell [WBC] count of Ͼ100 cells/mm 3 ) with 100% sensitivity and specificity (8). These biomarkers were identified as two defensins, human neutrophil peptide 1 (HNP1) and HNP2, and S100 proteins calgranulin C (Cal-C; S100A12) and Cal-A (S100A8, MRP-8), respectively.…”

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confidence: 99%

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Proteomic but Not Enzyme-Linked Immunosorbent Assay Technology Detects Amniotic Fluid Monomeric Calgranulins from Their Complexed Calprotectin Form

Buhimschi

Weiner

et al. 2005

Clin Vaccine Immunol

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Four proteomic biomarkers (human neutrophil peptide 1 [HNP1], HNP2 [defensins], calgranulin C [Cal-C], and Cal-A) characterize the fingerprint of intra-amniotic inflammation (IAI). We compared proteomic technology using surfaced-enhanced laser desorption-ionization-time of flight (SELDI-TOF) mass spectrometry to enzyme-linked immunosorbent assay (ELISA) for detection of these biomarkers. Amniocentesis was performed on 48 women enrolled in two groups: those with intact membranes (n ‫؍‬ 27; gestational age [GA], 26.0 ؎ 0.8 weeks) and those with preterm premature rupture of the membranes (PPROM; n ‫؍‬ 21; GA, 28.4 ؎ 0.9 weeks). Paired abdominal amniotic fluids (aAFs)-vaginal AFs (vAFs) were analyzed in PPROM women. Quantitative aspects of HNP1-3, Cal-C, Cal-A, and calprotectin (a complex of Cal-A with Cal-B) were assessed by ELISA. SELDI-TOF mass spectrometry tracings from 16/48 (33.3%) aAFs and 13/17 (88.2%) vAFs were consistent with IAI (three or four biomarkers present). IAI (by SELDI-TOF mass spectrometry) was associated with increased HNP1-3 and Cal-C measured by ELISA. However, immunoassays detected Cal-A in only 4 of the AFs even though its specific SELDI-TOF mass spectrometry peak was identified in 19/48 AFs. Calprotectin immunoreactivity was decreased in AFs retrieved from women with IAI (P ‫؍‬ 0.01). In conclusion, IAI is associated with increased HNP1-3 levels. In the absence of isoform-specific ELISAs, mass spectrometry remains the only way to discriminate the HNP biomarker isoforms. Monomeric Cal-A is not reliably estimated by specific ELISA as it binds to Cal-B to form the calprotectin complex. Cal-C was reliably measured by SELDI-TOF mass spectrometry or specific ELISA.Premature delivery (PTD; birth before 37 weeks in humans) is a significant public health problem. While complicating 7 to 12% of deliveries, prematurity is associated with 75% of infant mortality and 50% of long-term neurological handicaps, including blindness, deafness, developmental delay, cerebral palsy, and chronic lung disease (4,10,18,22). The etiologies of most preterm births remain unknown (2, 5).Clinically, PTD presents as either preterm labor with intact membranes or with preterm premature rupture of the membranes (PPROM). Several distinct pathophysiological pathways are implicated as triggers for PTD (21): excessive myometrial stretching, decidual hemorrhage, maternal and fetal stress, and inflammation (9). Inflammation may be initiated along various pathways of which infection is but one. Microbial invasion of the amniotic cavity, as evidenced by a positive amniotic fluid (AF) culture, occurs in 10% of the patients with preterm labor and intact membranes and in 38% of the patients with PPROM (25). We previously demonstrated that it is not necessarily the intrauterine infection that causes poor outcomes but rather the resulting intrauterine inflammation which can damage the fetus long before triggering labor (7). Thus, specific and sensitive tests for intrauterine inflammation rather than for bacterial infection may be more ...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Proteomic but Not Enzyme-Linked Immunosorbent Assay Technology Detects Amniotic Fluid Monomeric Calgranulins from Their Complexed Calprotectin Form

Buhimschi

Weiner

et al. 2005

Clin Vaccine Immunol

View full text Add to dashboard Cite

show abstract

“…Sampson et al [18] suggest that neutrophils in the amniotic fluid are of fetal origin, and the enzyme is secreted by activated neutrophils [18]. Increased amniotic fluid MMP-8 concentrations can identify patients at risk for intrauterine infection, impending preterm delivery, and adverse neonatal outcome [19,20].…”

Section: Discussionmentioning

confidence: 98%

Can levels of interleukins and matrix metalloproteinases in the amniotic fluid predict postnatal bowel function in fetuses with gastroschisis?

Fasching¹,

Haeusler²,

Mayr³

et al. 2005

Journal of Pediatric Surgery

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“…Intra- and inter-assay coefficients of variation were 3.1% and 9.5%, respectively. MMP-8 was used to assess the presence of intra-amniotic inflammation because previous studies indicated that it is a sensitive and specific index of inflammation [3, 23, 31]. Intra-amniotic inflammation was defined as an elevated AF MMP-8 concentration (>23 ng/mL), as previously reported [23, 31].…”

Section: Methodsmentioning

confidence: 99%

Amniotic fluid prostaglandin F2 increases even in sterile amniotic fluid and is an independent predictor of impending delivery in preterm premature rupture of membranes

Lee

Park

Romero

et al. 2009

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective To determine whether amniotic fluid concentration of prostaglandins (PGs) increases in patients with intra-amniotic inflammation and/or proven amniotic fluid infection in preterm PROM, and whether the amniotic fluid PG concentration can predict impending delivery. Methods Amniotic fluid PGF2a concentrations were determined by ELISA in 140 singleton pregnancies with preterm PROM (≤35 weeks). Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as genital mycoplasmas. Intra-amniotic inflammation was defined as an elevated amniotic fluid MMP-8 concentration (>23 ng/mL). Non-parametric tests and survival techniques were used for the statistics. Results 1) Patients with intra-amniotic inflammation and a negative amniotic fluid culture had a significantly higher median amniotic fluid PGF2a concentration than those without intra-amniotic inflammation and a negative amniotic fluid culture (median, 206 vs. 64 pg/mL; p<0.001); 2) however, there was no difference in the median amniotic fluid PGF2a concentration between patients with intra-amniotic inflammation with a negative culture and those with culture-proven amniotic fluid infection (median, 206 vs. 314 pg/mL, p=0.4); 3) amniotic fluid PGF2a ≥170 pg/mL had a sensitivity of 63% and a specificity of 89% in the identification of intra-amniotic inflammation and/or amniotic fluid infection; 4) patients with an elevated amniotic fluid PGF2a (≥170 pg/mL) had a significantly shorter interval-to-delivery than those with low amniotic fluid PGF2a (median, 72 vs. 155 hours; p<0.001); and 5) an elevated amniotic fluid PGF2a concentration was a significant predictor of the duration of pregnancy after adjusting for gestational age and amniotic fluid inflammation/infection (OR, 2.3; 95% CI, 1.4–4.0; p<0.005). Conclusions The amniotic fluid PGF2a concentration increased in patients with intra-amniotic inflammation regardless of amniotic fluid culture results. Moreover, an elevated AF PGF2a concentration was an independent predictor of impending delivery in preterm PROM.

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Amniotic fluid matrix metalloproteinase-8 indicates intra-amniotic infection

Cited by 66 publications

References 15 publications

Proteomic but Not Enzyme-Linked Immunosorbent Assay Technology Detects Amniotic Fluid Monomeric Calgranulins from Their Complexed Calprotectin Form

Proteomic but Not Enzyme-Linked Immunosorbent Assay Technology Detects Amniotic Fluid Monomeric Calgranulins from Their Complexed Calprotectin Form

Can levels of interleukins and matrix metalloproteinases in the amniotic fluid predict postnatal bowel function in fetuses with gastroschisis?

Amniotic fluid prostaglandin F2 increases even in sterile amniotic fluid and is an independent predictor of impending delivery in preterm premature rupture of membranes

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