Clinical and experimental evidence indicate that infection in pregnancy is associated with fetal brain damage. However, the inflammatory processes that compromise the fetal brain are not fully understood. In this study, we used a single, low dose of lipopolysaccharide (LPS, 0.1 g/kg i.v.) to provoke an acutephase response in unanesthetized fetal sheep in utero. COX-2 mRNA was increased in the cortex and cerebellum at 24 and 48 h after LPS, and immunoreactive COX-2 protein was increased in perivascular cells throughout gray and white matter at 24 h after LPS administration. Plasma albumin was observed in the parenchyma of the brain in cortex, thalamus, hypothalamus, corpus callosum, fornix, hippocampus, midbrain, subcallosal bundle, and cerebellar Purkinje cells. Large, rounded, lectin-positive cells with the appearance of macrophages were observed around blood vessels in subventricular white matter. These results indicate that blood-brain barrier permeability is increased in the fetal brain after exposure to endotoxin and suggests that cytotoxic and pro-inflammatory substances could pass from the circulation into the brain after peripheral inflammatory stimulation. There is a strong association between perinatal brain damage and intrauterine infection in human pregnancy (1). Infection is associated with histologic evidence of vascular inflammation of the umbilical cord (2), raised cytokine levels in amniotic fluid (3, 4), and increased incidence of white matter damage in the brain of the neonate (5). Nonetheless, the inflammatory responses provoked by infection in the fetus, and the events that lead to compromise of the fetal and neonatal brain, are poorly understood.Stimulation of the immune system by the bacterial endotoxin LPS leads to a series of host responses known as the acutephase reaction. The acute-phase reaction is mediated in large part by inflammatory cytokines (6). Cytokines in the circulation cross the BBB slowly and in amounts too small to stimulate inflammatory responses in the brain itself (7). However, cytokine receptors present on the luminal surface of the endothelial cells of cerebral blood vessels (8) may lead to stimulation of PG production on the basal side of the endothelial cell (9). This suggests that endothelial-derived PG could act on signal transduction pathways within the CNS, leading to the febrile response (10), changes of the sleep-wake cycle, and activation of the autonomic nervous system and hypothalamopituitary-adrenal axis (11).COX-1 and COX-2 are the rate-limiting enzymes for PG production from arachidonic acid. COX-1 is constitutively expressed in many cell types and is relatively unaffected by immune stimulation (12). In the adult brain, the constitutive synthesis of PG may be important for maintaining neuronal metabolism and synaptic function. COX-1 is localized to specific regions in fetal sheep brain, including some regions of cortex, hypothalamus, hippocampus, midbrain, pons, and medulla (13). In contrast to the COX-1 isoform, COX-2 expression is usually minimal unde...