Visfatin/Pre-B cell colony-enhancing factor in amniotic fluid in normal pregnancy, spontaneous labor at term, preterm labor and prelabor rupture of membranes: an association with subclinical intrauterine infection in preterm parturition

Abstract

Objective: Visfatin, a novel adipokine originally discovered as a pre-B-cell colony enhancing factor, is expressed by amniotic epithelium, cytotrophoblast, and decidua and is over-expressed when fetal membranes are exposed to mechanical stress and/or pro-inflammatory stimuli. Visfatin expression by fetal membranes is dramatically up-regulated after normal spontaneous labor. The aims of this study were to determine if visfatin is detectable in amniotic fluid (AF) and whether its concentration changes with gestational age, spontaneous labor, preterm prelabor rupture of membranes (preterm PROM) and in the presence of microbial invasion of the amniotic cavity (MIAC). Methods: In this cross-sectional study, visfatin concentration in AF was determined in patients in the following groups: 1) mid-trimester (ns75); 2) term not in labor (ns27); 3) term in spontaneous labor (ns51); 4) patients with preterm labor with intact membranes (PTL) without MIAC who delivered at term (ns35); 5) patients with PTL without MIAC who delivered preterm (ns52); 6) patients with PTL with MIAC (ns25); 7) women with preterm PROM without MIAC (ns26); and 8) women with preterm PROM with MIAC (ns26). Non-parametric statistics were used for analysis. Results: 1) The median AF concentration of visfatin was significantly higher in patients at term than in midtrimester; 2) Among women with PTL who delivered preterm, the median visfatin concentration was significantly higher in patients with MIAC than those without MIAC; 3) Similarly, patients with PTL and MIAC had a higher median AF visfatin concentration than those with PTL who delivered at term; 4) Among women with preterm PROM, the median AF visfatin concentration was significantly higher in patients with MIAC than those without MIAC. Conclusions: 1) Visfatin is a physiologic constituent of AF; 2) The concentration of AF visfatin increases with advancing gestational age; 3) AF visfatin concentration is elevated in patients with MIAC, regardless of the membrane status, suggesting that visfatin participates in the host response against infection.Keywords: Microbial invasion of the amniotic cavity (MIAC); pre-B cell colony-enhancing factor (PBEF); preterm labor; preterm prelabor rupture of membranes (preterm PROM); visfatin.

Choriodecidual leukocytes display a unique gene expression signature in spontaneous labor at term

“…The fact that choriodecidual leukocytes express transcripts implicated in the humoral immune response pathway is in line with previous reports indicating that visfatin, a pre-B-cell colony enhancing factor, is expressed in the decidua [75] and amniotic fluid [76] during the physiologic and infection-related pathologic processes of labor. Together, these data suggest that the humoral immune response pathway is implicated in the mechanisms of labor amplification and the host defense response against intra-amniotic infection.…”

227: Evidence for differential regulation of the adipokine visfatin in the maternal and fetal compartments in normal spontaneous labor at term

“…In addition, gestational diabetes mellitus [5,11,37,42,66], preeclampsia [4,17,24,107], large-for-gestational-age neonate [66], fetal growth restriction [16,47] and preterm labor [53] were linked to changes in circulating maternal visfatin concentrations when compared to normal pregnant women. Consistent with these findings, patients with intraamniotic infection/inflammation have a higher amniotic fluid concentration of visfatin than those without intra-amniotic infection/inflammation [63].…”

“…Concentrations of visfatin in maternal and fetal plasma were determined using specific and sensitive enzyme immunoassays (Phoenix Pharmaceuticals, Inc. Belmont, CA, USA). An initial assay validation was performed in our laboratory prior to the conduction of this study and the detailed description of the assay has been previously published [53,63,65,66]. The calculated inter-and intra-assay coefficients of variation for visfatin C-terminal immunoassays in our laboratory were 5.3% and 2.4%, respectively.…”

Suppression of leukocyte infiltration and cartilage degradation by selective inhibition of pre-B cell colony-enhancing factor/visfatin/nicotinamide phosphoribosyltransferase: Apo866-mediated therapy in human fibroblasts and murine collagen-induced arthrit

“…PBEF is detectable in serum and synovial fluid (1,6), and the levels of PBEF have been found to be increased in patients with rheumatoid arthritis, in whom it is clinically correlated with the Disease Activity Score in 28 joints and elevated C-reactive protein level (1,2,6). Other groups have detected PBEF in a variety of bodily fluids (35,(38)(39)(40)(41), and the levels appear to be correlated with inflammation (35,39,40). This suggests that infiltrating leukocytes and/or stromal cells at sites of inflammation actively secrete PBEF.…”