The Alabama Preterm Birth study: polymorphonuclear and mononuclear cell placental infiltrations, other markers of inflammation, and outcomes in 23- to 32-week preterm newborn infants

Andrews, William; Goldenberg, Robert L.; Faye-Petersen, Ona; Cliver, Suzanne P.; Goepfert, Alice R.; Hauth, John C.

doi:10.1016/j.ajog.2006.06.083

Cited by 228 publications

(181 citation statements)

References 17 publications

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“…Although infection in amniotic fluid is common, systemic sepsis soon after birth is detected in only 2% of these preterm infants (2). However, ϳ50% of infants exposed to chorioamnionitis have a systemic inflammatory response, referred to as fetal inflammatory response syndrome (FIRS) 3 (3)(4)(5). Unlike the cytokine storm associated with the adult systemic inflammatory response, FIRS is often a more subtle inflammatory response (4,6).…”

Section: Pulmonary and Systemic Endotoxin Tolerance In Pretermmentioning

confidence: 99%

Pulmonary and Systemic Endotoxin Tolerance in Preterm Fetal Sheep Exposed to Chorioamnionitis

Kallapur

Jobe

Ball

et al. 2007

The Journal of Immunology

110

139

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In a model of human chorioamnionitis, fetal sheep exposed to a single injection, but not repeated injections, of intra-amniotic endotoxin develop lung injury responses. We hypothesized that repeated exposure to intra-amniotic endotoxin induces endotoxin tolerance. Fetal sheep were given intra-amniotic injections of saline (control) or Escherichia coli LPS O55:B5 (10 mg) either 2 days (2-day group, single exposure), 7 days (7-day group, single exposure), or 2 plus 7 days (2- and 7-day repeat exposure) before preterm delivery at 124 days gestation (term = 150 days). Endotoxin responses were assessed in vivo in the lung and liver, and in vitro in monocytes from the blood and the lung. Compared with the single 2-day LPS exposure group, the (2 plus 7 days) repeat LPS-exposed lambs had: 1) decreased lung neutrophil and monocyte inducible NO synthase (NOSII) expression, and 2) decreased lung cytokine and liver serum amyloid A3 mRNA expression. In the lung, serum amyloid A3 mRNA expression decreased in the airway epithelial cells but not in the lung inflammatory cells. Unlike the single 7-day LPS exposure group, peripheral blood and lung monocytes from the repeat-LPS group did not increase IL-6 secretion or hydrogen peroxide production in response to in vitro LPS. Compared with controls, TLR4 expression did not change but IL-1R-associated kinase M expression increased in the monocytes from repeat LPS-exposed lambs. These results are consistent with the novel finding of endotoxin tolerance in preterm fetal lungs exposed to intra-amniotic LPS. The findings have implications for preterm infants exposed to chorioamnionitis for both responses to lung injury and postnatal nosocomial infections.

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Section: Pulmonary and Systemic Endotoxin Tolerance In Pretermmentioning

confidence: 99%

Pulmonary and Systemic Endotoxin Tolerance in Preterm Fetal Sheep Exposed to Chorioamnionitis

Kallapur

Jobe

Ball

et al. 2007

The Journal of Immunology

110

139

View full text Add to dashboard Cite

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“…18 Chorioamnionitis was not associated with the development of BPD in large cohort studies in Australia and the United States. 14,15,19 Several practices in perinatal medicine have changed over the past decade. The ventilation style now favors continuous positive airway pressure (CPAP), which is a less invasive way to support ventilation.…”

Section: Antenatal Inflammationmentioning

confidence: 99%

Antenatal inflammation and lung injury: prenatal origin of neonatal disease

Kramer¹

2008

J Perinatol

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“…8,59,[91][92][93] The association seems to be augmented by additional prolonged presence of PPROM. 91 These observations are not surprising given the alleged infectious etiology of chorioamnionitis.…”

Section: Sepsismentioning

confidence: 99%

“…However, the Alabama Preterm Birth study further differentiated between the effects of histological chorioamnionitis (as reducing the risk of RDS) and the presence of ureaplasma/mycoplasma-positive cord blood cultures (as having no effect on RDS). 59 Given the complexity of clinical exposures in duration and bacterial agents, animal models are useful to study how fetal exposure to inflammation affects the fetal lung. Bry et al 60 discovered that the intra-amniotic injection of IL-1 improved lung pressure-volume curves and induced mRNA for the surfactant proteins in rabbit fetuses.…”

Section: Lungsmentioning

confidence: 99%

Chorioamnionitis: a multiorgan disease of the fetus?

et al. 2010

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The bacterial infection of chorion and amnion is a common finding in premature delivery and is referred to as chorioamnionitis. As the mother rarely shows symptoms of a systemic inflammation, the course of chorioamnionitis is frequently asymptomatic and chronic. In contrast, the fetal inflammatory response syndrome represents a separate phenomenon, including umbilical inflammation and increased serum levels of proinflammatory cytokines in the fetus. Ascending maternal infections frequently lead to systemic fetal inflammatory reaction. Clinical studies have shown that antenatal exposure to inflammation puts the extremely immature neonates at a high risk for worsening pulmonary, neurological and other organ development. Interestingly, the presence of chorioamnionitis is associated with a lower rate of neonatal mortality in extremely immature newborns. In the following review, the pathogeneses of inflammation-associated perinatal morbidity are outlined. The concept of fetal multiorganic disease during intrauterine infection is introduced and discussed.

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The Alabama Preterm Birth study: polymorphonuclear and mononuclear cell placental infiltrations, other markers of inflammation, and outcomes in 23- to 32-week preterm newborn infants

Cited by 228 publications

References 17 publications

Pulmonary and Systemic Endotoxin Tolerance in Preterm Fetal Sheep Exposed to Chorioamnionitis

Pulmonary and Systemic Endotoxin Tolerance in Preterm Fetal Sheep Exposed to Chorioamnionitis

Antenatal inflammation and lung injury: prenatal origin of neonatal disease

Chorioamnionitis: a multiorgan disease of the fetus?

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