Fetal macrophages assist in the repair of ruptured amnion through the induction of epithelial-mesenchymal transition

Kawamura, Yosuke; Mogami, Haruta; Yasuda, Eriko; Takakura, Masahito; Matsuzaka, Yu; Ueda, Yusuke; Inohaya, Asako; Kawasaki, K.; Chigusa, Yoshitsugu; Mandai, Masaki; Kondoh, Eiji

doi:10.1126/scisignal.abi5453

Cited by 4 publications

(1 citation statement)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…sPPROM has very limited options for therapeutic influence and is often associated with therapeutic nihilism in the literature. That fact results from the limited, clinically insignificant tendency of the FM to spontaneous healing and the relative absence of therapeutic agents intensifying the activity referred to, which ultimately does not allow the causal treatment of the diagnosis [ 26 , 27 ]. Due to the unfavourable prognostic profile of pregnancy, certain patients opt for artificial interruption, which is deemed an acceptable therapeutic alternative in context-sensitive relationships.…”

Section: Reviewmentioning

confidence: 99%

Anti-infectious and anti-inflammatory effect of amniopatch in the treatment of spontaneous previable rupture of membranes

Alföldi,

Ferianec

2024

Arch Gynecol Obstet

View full text Add to dashboard Cite

Spontaneous previable rupture of membranes complicates approximately 0.4–0.7% of pregnancies and is associated with severe maternal and neonatal morbidity and mortality. Intra-amniotic inflammation is present in up to 94.4% of cases, most often caused by a bacterial infection. In comparison, the effectiveness of antibiotic therapy in its eradication reaches less than 17%. Inflammatory activity in the amniotic cavity disrupts the physiological development of the fetus with an increase in maternal, fetal, and neonatal inflammatory morbidity through the development of fetal inflammatory response syndrome, maternal chorioamnionitis, and neonatal sepsis. Amniopatch is an invasive therapeutic technique based on intra-amniotic administration of maternal hemoderivates in the form of thromboconcentrate and plasma cryoprecipitate to provide the temporary closure of the fetal membranes defect and secondary restitution of normohydramnios with correction of pressure–volume ratios. The supposed basis of this physical–mechanical action is the aggregation of coagulant components of amniopatch in the area of the defect with the formation of a valve cap. The background for the formulation of the hypothesis on the potential anti-infectious and anti-inflammatory action of non-coagulant components of amniopatch involved: i) clinical–academic and publishing outputs of the authors based on their many years’ experience with amniopatch application in the treatment of spontaneous previable rupture of membranes (2008–2019), ii) the documented absence of clinically manifested chorioamnionitis in patients treated this way with a simultaneously reduced incidence of neonatal respiratory distress syndrome compared to expectant management (tocolysis, corticotherapy, antibiotic therapy). The non-coagulant components of plasma cryoprecipitate include mainly naturally occurring isohemagglutinins, albumin, and soluble plasma fibrinogen. Although these components of the amniopatch have not been attributed a significant therapeutic role, the authors assume that due to their opsonizing and aggregative properties, they can significantly participate in optimizing the intrauterine environment through the reduction in bacterial and cytokine charge in the amniotic fluid. The authors think these facts constitute a vital stimulus to future research–academic activity and, at the same time, an idea for reconsidering the therapeutic role of amniopatch as a tool for improving perinatal results of spontaneous previable ruptures of membranes.

show abstract

Section: Reviewmentioning

confidence: 99%